Tobacco Industry Marketing at Point of Purchase After the 1998 MSA Billboard Advertising Ban

Tobacco advertising is a public health issue if these activities increase smoking. Although public health advocates assert that tobacco advertising does increase smoking, there is significant empirical literature that finds little or no effect of tobacco advertising. In this paper, these prior studies are examined more closely with several important insights emerging from this analysis. This paper also provides new empirical evidence on the effect of tobacco advertising in 22 Organization for Economic Cooperation and Development (OECD) countries. The primary conclusion of this research is that a comprehensive set of tobacco advertising bans can reduce tobacco consumption and that a limited set of advertising bans will have little or no effect.

Whether tobacco advertising and promotion increases the likelihood that youths will begin smoking has important public policy implications. To evaluate the association between receptivity to tobacco advertising and promotional activities and progress in the smoking uptake process, defined sequentially as never smokers who would not consider experimenting with smoking, never smokers who would consider experimenting, experimenters (smoked at least once but fewer than 100 cigarettes), or established smokers (smoked at least 100 cigarettes). Prospective cohort study with a 3-year follow-up through November 1996. A total of 1752 adolescent never smokers who were not susceptible to smoking when first interviewed in 1993 in a population-based random-digit dial telephone survey in California were reinterviewed in 1996. Becoming susceptible to smoking or experimenting by 1996. More than half the sample (n=979) named a favorite cigarette advertisement in 1993 and Joe Camel advertisements were the most popular. Less than 5% (n=92) at baseline possessed a promotional item but a further 10%(n=172) were willing to use an item. While having a favorite advertisement in 1993 predicted which adolescents would progress by 1996 (odds ratio [OR] = 1.82; 95% confidence interval [CI], 1.04-3.20), possession or willingness to use a promotional item was even more strongly associated with future progression (OR=2.89; 95% CI, 1.47-5.68). From these data, we estimate that 34% of all experimentation in California between 1993 and 1996 can be attributed to tobacco promotional activities. Nationally, this would be over 700000 adolescents each year. These findings provide the first longitudinal evidence to our knowledge that tobacco promotional activities are causally related to the onset of smoking.

This prospective study examined the effect of tobacco marketing on progression to established smoking. Massachusetts adolescents (n = 529) who at baseline had smoked no more than 1 cigarette were reinterviewed by telephone in 1997. Analyses examined the effect of receptivity to tobacco marketing at baseline on progression to established smoking, controlling for significant covariates. Adolescents who, at baseline, owned a tobacco promotional item and named a brand whose advertisements attracted their attention were more than twice as likely to become established smokers (odds ratio = 2.70) than adolescents who did neither. Participation in tobacco marketing often precedes, and is likely to facilitate, progression to established smoking. Hence, restrictions on tobacco marketing and promotion could reduce addiction to tobacco.