Tobacco display advertising in retail stores appears to be associated with teens experimenting with cigarette smoking, while promotional giveaways and price breaks may be associated with the transition to regular smoking among youth, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine.


Research has found that beginning to smoke at a young age is associated with eventually smoking more cigarettes per day and a higher risk of long-term consequences, according to background information in the article. Certain types of cigarette marketing that may appeal to young people, including advertisements that use cartoon characters, were banned as part of the 1998 Master Settlement Agreement with tobacco companies. Evidence suggests the tobacco industry may be turning to retail stores for marketing efforts. "In fact, in 2003, the tobacco industry spent $14.2 billion on retail advertising and price and other promotions, which accounts for 94 percent of all its 2003 advertising and promotional spending," the authors note.

Sandy J. Slater, Ph.D., of the Institute for Health Research and Policy, University of Illinois at Chicago, and colleagues analyzed surveys of 26,301 eighth-, 10th- and 12th-grade students collected from February 1999 to June 2003. Based on their responses, students were divided into levels of smoking uptake, which range from puffers (who have smoked once or twice) to current established smokers (who either smoked regularly at the time of the survey or smoked regularly in the past and at least occasionally during the past 30 days).

The students came from 966 communities, where the researchers then gathered cigarette marketing data, visiting up to 30 retail locations to evaluate the types and frequency of tobacco advertisements, the availability of promotions (such as coupons and gifts with purchase) and also the price of a pack of cigarettes.

Overall, 53.7 of the students had never smoked, 20.7 percent were puffers and 11.5 percent were current established smokers. "Higher levels of advertising, lower cigarette prices and greater availability of cigarette promotions were associated with smoking uptake," the authors write. "Advertising increased the likelihood of youth initiating smoking, price increased the likelihood of smoking at most levels of uptake and availability of promotions increased the likelihood that youth will move from experimentation to regular smoking."

Based on the estimates in their study, the authors predict that if stores had no advertising, there would be a relative decline of about 11 percent in puffers, whereas eliminating promotions would result in a relative decline of about 13 percent in current established smokers. "Overall, our results provide evidence that restricting point-of-sale advertising will discourage youth from trying smoking, and policies that increase cigarette prices and/or restrict price-based promotions will have a long-term positive impact by preventing youth from moving farther along the smoking uptake continuum toward regular smoking," they conclude.
(Arch Pediatr Adolesc Med. 2007;161:440-445. Available to the media pre-embargo at

Editor's Note: This study was supported by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention. The Monitoring the Future Survey is supported by the National Institute on Drug Abuse. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


"On closer scrutiny, the evidence that this new study provides about the impact of retail point-of-sale marketing techniques on youth smoking uptake is informative and insightful for understanding the environmental factors that promote tobacco use," writes Dale Kunkel, Ph.D., University of Arizona, Tucson, in an accompanying editorial. "These data provide clear lessons for how best to proceed with policies that would most effectively reduce smoking."

"If the policy goal of tobacco marketing restrictions is to focus the government’s efforts on advertising practices that increase youth smoking uptake, which over time translates into increased morbidity, then the study by Slater et. al. clearly demonstrates that it is time for some new regulations to be adopted," Dr. Kunkel writes.

"While advertisers have First Amendment rights, those privileges are always subject to restriction in the face of evidence that demonstrates a ‘compelling governmental interest’," he concludes. "Helping to protect young people from becoming addicted to tobacco clearly meets that standard."
(Arch Pediatr Adolesc Med. 2007;161:515-516)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

Topics #cigarette #marketing #pediatrics #smoking #teen #tobacco