ADVERTISING AND TOBACCO USE

Tobacco companies spend more than $5 billion annually to advertise and promote cigarettes and other tobacco products. Tobacco companies claim that the purpose and desired effect of marketing are merely to provide information and to influence brand selection among current smokers, although only about 10 percent of smokers switch brands in any one year. Since more than one million adult smokers stop smoking every year and almost half a million other adult smokers die from smoking-related diseases, the tobacco companies must recruit an average of 3,300 new young smokers every day to replace those who die or otherwise stop smoking. Tobacco companies contend that smoking is an "adult habit" and that adult smokers "choose" to smoke. However, many medical researchers assert that cigarette smoking is primarily a childhood addiction or disease and that most of the adults who smoke started as children and could not quit.

Unlike the pharmaceutical companies, which are tightly regulated as to their advertising and promotion, the tobacco industry has had few regulations. The basic restrictions have been that companies cannot use paid advertising on television or radio, they cannot claim what they cannot prove (e.g., that low-tar cigarettes are less hazardous to health), and they must include one of four warnings on cigarette packages and ads. The fact that warning labels are printed on a pack of cigarettes has been successfully used by the tobacco companies as a defense against tobacco victims' lawsuits.

The whole picture changed when Florida, Minnesota, Mississippi, and Texas were able to reach an agreement in 1997 and early 1998 with the major tobacco companies and won compensation for the effects of smoking on their health-care expenses. Minnesota was able to obtain copies of long-secret memos, reports, letters, and other documents that were made public as part of the $6.6 billion settlement reached in their lawsuit against cigarette makers.

On November 23, 1998, the major tobacco companies entered into an agreement with the other forty-six states. This agreement, which is known as the Master Settlement Agreement (MSA), settled litigation brought by the states and other entities that were seeking the reimbursement of expenditures related to smoking and health. Under this agreement, the states and tobacco companies jointly agreed to concrete provisions to reduce youth smoking, new public health initiatives, and important new rules for governing a tobacco company's way of doing business.

The cigarette companies agreed to pay $368.5 billion over 25 years. Of this, $246 billion goes to the states, and they have started to receive payments under this agreement. The state of Florida receives $450 million each year under this agreement, Iowa $54.9 million, and the other states differing amounts. Iowa, Kansas, and Washington have agreed to set aside this money entirely for health care. Iowa has passed a law that their money shall go to three areas: access to health care, public health and smoking prevention, and substance-abuse treatment and prevention. In other states, this new-found money has created hot political battles over how much of their tobacco settlement to spend on tobacco prevention programs.

A two-year education effort and ad campaign has lowered the number of teen smokers in Florida. The campaign reduced middle-school smoking by more than half and lowered smoking among high-school students by 24 percent. This multimillion-dollar campaign was financed by Florida's $11.3 billion tobacco settlement, of which Florida has already received $2 billion.

The MSA has changed the way cigarette companies can market, advertise, and promote their cigarettes. The agreement specifically includes the following:

• No participating manufacturer may take any action, directly or indirectly, to target youth in the advertising, promotion, or marketing of tobacco products. It also prohibits any action the primary purpose of which is to initiate, maintain, or increase the incidence of youth smoking.
• Effective April 23, 1999, billboards, stadium signs, and transit signs advertising tobacco are banned. However, this does not apply to retail establishments selling tobacco. They may have signs up to 14 square feet inside or outside their stores.
• Effective May 22, 1999, the use of cartoon characters in advertising, promoting, packaging, or labeling of tobacco products is banned. (This applies only to "exaggerated depictions, or depictions of entities with superhuman powers". It does not cover the standard camel logo or simple drawings of a camel. It does not prohibit the continued use of the Marlboro man or other human characters.)
• Beginning July 1, 1999 participating manufacturers and others licensed by them may no longer market, distribute, offer or sell, or license any apparel or merchandise bearing a tobacco brand name.
• Free product sampling is banned anywhere, except for a facility or enclosed space where an operator may ensure that no minors are present.
• Manufacturers may not sell or distribute cigarette packs containing less than twenty cigarettes until the year 2001.
• There shall be no payment for the use of tobacco products in movies, TV programs, live performances, videos, or video games. (Does not apply to media viewed in an adult-only facility or to media not intended for distribution to or display to the public.)
• There shall be no licensing of third parties to use or advertise any brand name in a way that would constitute a violation of the MSA if done by the participants.
• No nonbranded item may be given in exchange for the purchase of tobacco products or redemption of coupons or proof of purchase without proof of age.
• No use of a tobacco brand name as part of the name of a stadium shall be allowed.
• Tobacco sponsorships are limited to one per year, after a three-year grace period (from November 1998). Such brand-name sponsorship may not include concerts, events in which any paid participant or contestants are youth, or any athletic event between opposing teams in any football, basketball, baseball, soccer, or hockey league.

The previous voluntary cigarette advertising and promotion code rules are also still in effect:

• Cigarette smoking is an adult custom. Children should not smoke. Laws prohibiting the sale of cigarettes to minors should be strictly enforced. The cigarette manufacturers advertise and promote their products only to adults smokers. They support the enactment and enforcement of state laws prohibiting the sale of cigarettes to persons under 18 years of age.

Advertising.

1. Cigarette advertising shall not appear in publications directed primarily to those under 21 years of age, including school, college, or university media (such as athletic, theatrical, or other programs). Comic books or comic supplements are included.
2. No one depicted in cigarette advertising shall be or appear to be under 25 years of age.
3. Cigarette advertising shall not suggest that smoking is essential to social prominence, distinction, success, or sexual attraction, nor shall it picture a person smoking in an exaggerated manner.
4. Cigarette advertising may picture attractive, healthy-looking persons provided there is no suggestion that their attractiveness and good health are due to cigarette smoking.
5. Cigarette advertising shall not depict as a smoker anyone who is or has been well known as an athlete, nor shall it show any smoker participating in, or obviously just having participated in, a physical activity requiring stamina or athletic conditioning beyond that of normal recreation.
6. No sports or celebrity testimonials shall be used or those of others who would have special appeal to persons under 21 years of age.

All the agreed-on advertising and promotional restrictions spelled out in the MSA should be very helpful in curbing underage smoking, but the tobacco companies have always found ways to bypass the bans and advertise in other venues. Billboard advertising is now banned but tobacco companies have increased their level of advertising in magazines, many of which are read by teenagers. Seventy-three percent of teens (aged 12 to 17) reported seeing tobacco advertising in the previous 2 weeks, compared to only 33 percent of adults surveyed. Since billboards were banned, 61 percent of teens who recalled tobacco advertising saw it in magazines, compared to 50 percent the year before.

A survey also revealed that 77 percent of teens say it is easy for people under the age of 18 to buy cigarettes and other tobacco products. Many displays of cigarettes in convenience stores are at waist level, making them plainly available to children. The campaign to restrict access by youths under the age of 18 to cigarettes has not been too successful.

A California suit against R.J. Reynolds Tobacco, filed on May 11, 2000, charges that the company has violated the legal settlement with state governments by improperly distributing large quantities of free cigarettes by mail. This case marks the first time an attorney general has taken a cigarette company to court to enforce the terms of the MSA. Reynolds said it was part of a program of "consumer testing" and was therefore allowable under the agreement. The attorney general alleges Reynolds mailed the free cigarettes "under the guise of consumer testing or evaluation in order to market and advertise its products." According to the suit, Reynolds sent more than 900,000 multipack cigarette mailings to more than 115,000 California residents during 1999, some receiving as many as ten packs at a time.

In his memoirs, former Surgeon General C. Everett Koop said this about the tobacco industry, "After studying in depth the health hazards of smoking, I was dumbfounded—and furious. How could the tobacco industry trivialize extraordinarily important public-health information: the connection between smoking and heart disease, lung and other cancers, and a dozen or more debilitating and expensive diseases? The answer was—it just did. The tobacco industry is accountable to no one."

UNDERSTANDING THE SMOKING HABIT

Almost all smokers started before the age of 21—most before the age of 18—many before the age of 14. Young people who learn to inhale cigarette smoke and experience the mood-altering effects from the inhaled nicotine quickly become dependent on cigarettes to help them cope with the complexities of everyday life. Having developed a nicotine dependence, they find they must continue smoking to avoid the downside of nicotine withdrawal. The earlier they start to smoke, the more dependent they seem to become—and the sooner they start to experience smoking-related health problems. Six years of research at the National Center on Addiction and Substance Abuse at Columbia University reveals that a child who reaches age 21 without smoking, using illegal drugs, or abusing alcohol is virtually certain never to do so.

A survey conducted by the U.S. Department of Health and Human Services among high school students who smoked half a pack of cigarettes a day found that 53 percent had tried to quit but could not. When asked whether they would be smoking 5 years later, only 5 percent said they would be—but 8 years later, 75 percent were still smoking.

PURPOSE OF CIGARETTE ADVERTISING

The tobacco companies are very adept at using advertising and different kinds of promotional programs to help them accomplish several major objectives:

1. To reassure current smokers. To offset the effect of thousands of studies showing the adverse health effects of smoking and of the requested warning labels on cigarette packages, the tobacco industry has continued to claim that no one has yet "proven" that smoking "causes" health problems—that these are just "statistical associations." But, recently in Florida, a six-person jury decided, on April 7, 2000, that tobacco companies' cigarettes were a deadly, addictive, and defective product and caused cancer for three smokers who sued the industry in a class-action lawsuit. The companies must pay $12.7 million to the plaintiffs. The jury has yet to decide the punitive damages, which could be massive. The state of Florida, in order to protect its tobacco payments in the future, passed a law capping the amount of bond the companies would have to post in order to appeal such punitive damages at $100 million or 10 percent of the company's net worth, whichever is less.
2. To associate smoking with pleasurable activities. In their ads, tobacco companies show healthy young people enjoying parties, dancing, attending sporting events, having a picnic at the beach, sailing, and so on. The implication is that if you smoke, you too will experience the kind of good times enjoyed by the smokers in the ads.
3. To associate smoking with other risk-taking activities. Since as indicated by the warning labels on every package of cigarettes, smoking involves risk to one's health, the tobacco companies attempt to counter this by showing in their ads such risk-taking activities as ballooning, mountain climbing, sky diving, and motorcycle riding. This is the industry's not so subtle way of saying: Go ahead and take a risk by smoking. You are capable of deciding the level of risk you want to assume. The tobacco companies are betting on the fact that most young people consider themselves to be immortal and do not believe any of smoking's bad effects will ever happen to them.
4. To associate cigarette smoking with becoming an adult. Realizing that teenagers desire to be considered adults, to be free to make their own decisions, and to be free from restrictions on what they can and cannot do, the tobacco companies go to great lengths to stress that smoking is an "adult habit"—that only adults have the right to choose whether or not to smoke. Since teenagers are in a hurry to grow up and be free, the simple act of smoking cigarettes can become their way of showing to the world that they are indeed adults.
5. To associate cigarette smoking with attractiveness to the opposite sex. Many ads for cigarettes imply that if you smoke, you will also be attractive to members of the opposite sex. In fact, surveys of young people and adults show that most people prefer to date nonsmokers.
6. To associate smoking with women's liberation. "You've come a long way baby" was the theme of the early ads for Virginia Slims cigarettes. What these ads did not say is that women who smoke like men will die like men who smoke. The slogan "Torches of Freedom" coupled with an image of women smoking cigarettes while marching down Fifth Avenue in the Easter Parade was a cigarette company's public relations ploy years ago to influence women to start smoking. In the 1990s, lung cancer became the number one cancer found in women, exceeding the incidence of breast cancer.
7. To show that smoking is an integral part of our society. The sheer number of cigarette ads—those on billboards, on articles of clothing, on signs at sporting events—leave the impression that smoking is socially accepted by the majority of people. This image is supported by movies that include scenes of cigarette smoking. Many events sponsored by tobacco companies include the name of a major brand of cigarettes or smokeless tobacco, such as the Kool Jazz Festival, the Benson & Hedges Blues Festival, the Magna Custom Auto Show, the Winston Cup (stock car racing), the Marlboro Cup (soccer), the Marlboro Stakes (horse racing), and the Virginia Slims Tennis Tournament, just to name a few. Although tobacco advertising is legally prohibited on television, the ban has been ignored by the strategic placement of tobacco-product ads in baseball and football stadiums, basketball arenas, and hockey rinks, around auto racetracks, and at tractor pulls and other sporting events.
8. To discourage articles in magazines about the health risks of smoking. So important to magazines are the ads they carry for cigarettes, beer, food, and other products, which are marketed by the major cigarette companies or their parent companies, that many publishers are very reluctant to antagonize cigarette producers by running articles on the health risks of smoking. This is especially true with women's magazines.
9. To gain legitimacy. Tobacco companies seek public acceptance and recognition by supporting worthwhile groups and programs. Many groups receive significant amounts of funding from the tobacco companies to support their programs. One especially large grant, from RJR Nabisco, was a contribution of $30 million for "innovative education programs" to schools across the country. In 1989, Philip Morris made arrangements to sponsor the Philip Morris Bill of Rights Exhibit, which toured the United States in celebration of the 200th anniversary of the Bill of Rights. In this way, Philip Morris tried to associate its company—including its tobacco subsidiary—with the Bill of Rights, and to reap positive press coverage as the exhibit went on display in each city.

HISTORY OF TOBACCO ADVERTISING AND PROMOTION

Tobacco companies' advertising, before restrictions were implemented, was focused on television, radio, newspapers, and magazines. The advertising was represented by ads such as "I'd walk a mile for a camel" or the "Call for Phillip Morris" or "More doctors smoke Camels" or "Not a cough in a carload." This evolved into the "Joe Camel" ads, the "Kool Penguin" ads, and the "Newport Menthol" cigarette ads.

Tobacco advertising and promotional expenses have steadily increased. In 1997, the tobacco companies spent $5.66 billion to promote their products, up from $5.11 billion in 1996. The largest category of spending was for promotional allowances to wholesalers and retailers, $2.4 billion, more than double their spending in 1990. Next were expenditures for retail value added. At $970 million, this category includes non-cigarette items given away with cigarettes. Coupons and multiple pack offers were an additional $552 million, followed by specialty item distribution, $512 million; point of sale advertising, $305 million; outdoor advertising, $295 million; magazines, $236 million; public entertainment, $195 million; and $130 million for all other forms of advertising.

There were no restrictions on cigarette advertising in the United States until the first Report of the Surgeon General was released on January 11, 1961. Because of the health hazards described therein, the report led to the Federal Cigarette Labeling and Advertising Act of 1965 and, beginning in 1966, Congress mandated that a health warning appear on all cigarette packages, although not in advertisements. On June 2, 1967, the Federal Communications Commission (FCC) ruled that the Fairness Doctrine in advertising applied to cigarette ads on television and radio and required broadcasters who aired cigarette commercials to provide "a significant amount of time" to citizens who wished to point out that smoking "may be hazardous to the smoker's health." This rule went into effect on July 1, 1967. The FCC required that there be one free public-service announcement (PSA) for every three paid cigarette commercials. During the three-year period of 1968 to 1970, in which the PSAs were mandated by the Fairness Doctrine, per capita cigarette sales decreased by 6.9 percent.

In January 1970, the cigarette industry offered voluntarily to end all cigarette advertising on television and radio by September 1970—a move that would also eliminate any PSAs, which were hurting sales. Ultimately, Congress approved the Public Health Cigarette Act of 1969, which prohibited cigarette advertising in the broadcast media as of January 1, 1971.

In September 1973, the Little Cigar Act of 1973 banned broadcast advertising of little cigars (cigarette-sized cigars). During the three-year period of 1971 to 1973, following the end of the PSAs required by the Fairness Doctrine and the beginning of the broadcast advertising ban, cigarette sales increased by 4.1 percent.

More than a decade later, smokeless-tobacco advertising in the broadcast media was banned by the Comprehensive Smokeless Tobacco Health Education Act of 1986. This ban took effect on August 27, 1986. The Federal Trade Commission (FTC) Bureau of Consumer Protection ruled in 1991 that the Pinkerton Tobacco Company violated the 1986 statute banning the advertising of smokeless tobacco and prohibited it from "displaying its brand name, logo, color or design during televised (sports) events" of its Red Man Chewing Tobacco and snuff. This was the first action of its kind by the FTC.

STAT (Stop Teenage Addiction to Tobacco), at their 1991 STAT-91 Conference, addressed the problem of tobacco companies' efforts to encourage tobacco addiction in young people. It was learned that the RJR Nabisco cartoon camel was at the center of the most extensive advertising campaign ever created to influence the values and behavior of young people. Camel's share of the teenage market rose from almost nothing to almost 35 percent in just three years by "this sleazy dromedary."

(See also: Advertising and the Alcohol Industry ; Tobacco: Dependence ; Tobacco: Industry )

Charles M. Rongey