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CORK Bibliography: Advertising

xxx citations. January 2004 to present

Prepared: June 2008

Andreeva TI; Krasovsky KS. Changes in smoking prevalence in Ukraine in 2001-5. Tobacco Control 16(3): 202-206, 2007. (14 refs.)

Objectives: To analyse trends in smoking prevalence in Ukraine from three surveys conducted in 2001-5, and to explore correlates of observed changes, in order to estimate the stage of tobacco epidemic in Ukraine. Design: Repeated national interview surveys in Ukraine in 2001, 2002 and 2005. Main outcome measure: Prevalence of current smoking among the population aged >= 15 years. Results: The age-standardised prevalence of current smoking in Ukrainian men was 54.8% in 2001 and 66.8% in 2005. Among Ukrainian women, prevalence increased from 11.5% in 2001 to 20.0% in 2005. ORs for yearly increase in prevalence were estimated as 1.164 (95% CI 1.111 to 1.220) for men and 1.187 (1.124 to 1.253) for women, which implies that, on average, 3-4% of men and 1.5-2% of women living in Ukraine join the smoking population each year. Conclusions: In Ukraine, smoking prevalence is increasing in most population groups. Among men, the medium deprivation group with secondary education has the highest smoking prevalence. Among women, while the most educated, young and those living in larger cities are the leading group for tobacco use, other groups are also increasing their tobacco use. Tobacco promotion efforts appear to have been significantly more effective in Ukraine than smoking control efforts. The decrease in real cigarette prices in Ukraine in 2001-5 could be the main factor explaining the recent growth in smoking prevalence.

Andreeva TI; Krasovsky KS; Semenova DS. Correlates of smoking initiation among young adults in Ukraine: a cross-sectional study. BMC Public Health 7(article 106), 2007. (23 refs.)

Background: Aim: To estimate the impact of smoking restrictions in homes and schools, and tobacco advertising and information on smoking initiation by young people in Ukraine. Methods: Data of 609 young people aged 15-29 was taken from the national representative survey conducted in June 2005. Outcome measures: The reported age of cigarette initiation was used to characterize the start of smoking experimentation, and the reported age of daily smoking initiation was considered to be a characteristic of established smoking. Analysis: survival analysis Cox proportional hazard regression models were used. Results: Age of smoking initiation was reported by 87% of young men and 61% of young women, the beginning of daily smoking by 71% and 33% respectively. Being frequently exposed to second-hand smoke and having no household smoking restrictions was associated with a higher risk of earlier smoking initiation both for men and women. For women, this risk was associated with age, HR = 0.95, (95% CI 0.91-0.98), that is, younger girls were more likely to smoke their first cigarette earlier in their lifetime. Those women had a higher risk of early smoking initiation who reported to receive tobacco-related information from magazines, HR = 1.40 (1.01-1.92), and outdoor tobacco advertising, HR = 1.99 (1.45-2.75). With both men and women, the risk of establishing daily smoking was higher in those with lower levels of tobacco-related knowledge and less household smoking restrictions. For women, the risk was higher in those who live in larger cities HR = 1.77 (1.10-2.86), and who received information about tobacco smoking from colleagues or friends HR = 1.83 (1.13-2.95). Conclusion: Encouraging people to eliminate their homes of tobacco smoke and tobacco advertising bans can be effective measures in preventing the initiation of smoking among young people. Young female smoking initiation is of special concern in Ukraine, since they are more responsive to tobacco marketing and pro-smoking peer influence.

Bala M; Strzeszynski L; Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database of Systematic Reviews 1(e-article CD004704), 2008. (220 refs.)

Background Mass media tobacco control campaigns can reach large numbers of people. Much of the literature is focused on the effects of tobacco control advertising on young people, but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Campaigns may be local, regional or national, and may be combined with other components of a comprehensive tobacco control policy. Objectives To assess the effectiveness of mass media interventions in reducing smoking among adults. Search strategy The Cochrane Tobacco Addiction Group search strategy was combined with additional searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL) and a number of electronic databases. The last search was carried out in March 2007. Selection criteria Controlled trials allocating communities, regions or states to intervention or control conditions; interrupted time series. Adults, 25 years or older, who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes. The primary outcome was change in smoking behaviour. This could be reported as changes in prevalence, changes in cigarette consumption, quit rates, odds of being a smoker. Data collection and analysis Two authors independently assessed all studies for inclusion criteria and for study quality. One author (MB) extracted data, and a second author (LS) checked them. Results were not pooled due to heterogeneity of included studies and are presented narratively and in table form. Main results Eleven campaigns met the inclusion criteria for this review. Studies differed in design, settings, duration, content and intensity of intervention, length of follow up, methods of evaluation and also in definitions and measures of smoking behaviour used. Among nine campaigns reporting smoking prevalence, significant decreases were observed in the California ornia and Massachusetts statewide tobacco control campaigns compared with the rest of the. Some positive effects on prevalence in the whole population or in the subgroups were observed in three of the remaining seven studies. Three large-scale campaigns of the seven presenting results for tobaccoconsumption found statistically significant decreases. Among the seven studies presenting abstinence or quit rates, four showed some positive effect, although in one of them the effect was measured for quitting and cutting down combined. Among the three that did not show significant decreases, one demonstrated a significant intervention effect on smokers and ex-smokers combined. Authors' conclusions There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign, while another (California) showed positive results only during the period of adequate funding and implementation. Six of nine studies carried out in communities or regions showed some positive effects on smoking behaviour and at least one significant change in smoking prevalence (Sydney). The intensity and duration of mass media campaigns may influence effectiveness, but length of follow up and concurrent secular trends and events can make this difficult to quantify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.

Braun S; Mejia R; Ling PM; Perez-Stable EJ. Tobacco industry targeting youth in Argentina. Tobacco Control 17(2): 111-117, 2008. (65 refs.)

Background/ aim: Argentina has one of the highest cigarette smoking rates among both men and women in the Americas and no legislated restrictions on tobacco industry advertising. The tobacco industry has traditionally expanded markets by targeting adolescents and young adults. The objective of this study was to determine whether and how the tobacco industry promotes cigarettes to adolescents in Argentina. Methods: We conducted a systematic search of tobacco industry documents available through the internet dated between 1995 and 2004 using standard search terms to identify marketing strategies in Argentina. A selected review of the four leading newspapers and nine magazines with reported high readership among adolescents was completed. The selected print media were searched for tobacco images and these were classified as advertisements if associated with a commercial product or as a story if not. Results: The tobacco industry used market segmentation as a strategy to target Argentinean consumers. British American Tobacco ( BAT) undertook a young adult psychographic study and classified them as "progressives'', "Jurassics'' or "conservatives'' and "crudos'' or "spoiled brats''. BAT marketed Lucky Strike to the "progressives'' using Hollywood movies as a vehicle. The tobacco industry also targeted their national brands to the conservatives and linked these brands with "nationalistic values'' in advertising campaigns. Philip Morris promoted Marlboro by sponsoring activities directed at young people and they launched the 10 cigarettes packet as a starter vehicle. Conclusions: The tobacco industry used psychographic segmentation of the population and developed advertising strategies focused on youth. Tobacco control researchers and advocates must be able to address these strategies in counter-marketing interventions.

Carter OBJ; Donovan RJ; Weller NM; Jalleh G. Impact of smoking images in magazines on the smoking attitudes and intentions of youth: An experimental investigation. Tobacco Control 16(6): 368-372, 2007. (15 refs.)

Objective: To determine the effect of magazine incidental smoking imagery on youths' smoking intentions. Methods: A magazine was developed incorporating photographs of smokers ( Smoking Magazine). A second version of the magazine (Non-smoking Magazine) included these photographs with the tobacco paraphernalia digitally erased. Equal numbers of smokers and non-smokers aged 14-17 years (n = 357) were randomly assigned to look through one version of the magazine and then asked a series of questions. Results: Smokers made more unprompted mention of smoking imagery than non-smokers after viewing Smoking Magazine (52% vs 34%; p, 0.05). Smokers viewing Smoking Magazine were more likely to report an urge to smoke (54% vs 40%; p, 0.05). Female non-smokers who viewed Smoking Magazine were more likely than those who viewed Non-smoking Magazine to state a future intention to smoke (13% vs 0%; p, 0.05). Female smokers were more attracted to the male models appearing in Smoking Magazine than Non-smoking Magazine (49% vs 24%; p, 0.05) and the opposite was true for female non-smokers (28% vs 52%; p, 0.05). Female smokers were also marginally more likely to desire looking like the female models in Smoking Magazine (64% vs 46%; p = 0.06) but no difference was observed in the non-smoking females ( 46% vs 46%). Male smokers and non-smokers did not differ in their responses by magazine type. Conclusions: Incidental positive smoking imagery in magazines can generate the same sorts of consumer effects attributed to advertising in general, including tobacco advertising. Sex specific results of our study may be explained by the choice of smoking images used.

Chapman S. Erectile dysfunction and smoking: Subverting tobacco industry images of masculine potency. (editorial). Tobacco Control 15(2): 73-74, 2006. (14 refs.)

Chen XG; Stanton B; Fang XY; Li XM; Lin DH; Zhang JT et al. Perceived smoking norms, socioenvironmental factors, personal attitudes and adolescent smoking in China: a mediation analysis with longitudinal data. Journal of Adolescent Health 38(4): 359-368, 2006. (40 refs.)

Purpose: To gather information on inter-relationships among risk factors affecting adolescent, smoking for tobacco control in China, the world's largest tobacco producer and consumer. Method: Longitudinal data were collected six months apart in 2003 from 813 students in grades 7, 8, 10, and 11 from two schools in Beijing, China. Linear regression was used to assess both the direct effect from predictor variables (smoking among influential others, pro-tobacco media. and attitudes toward smoking) on cigarette use and the indirect effect mediated through the perceived smoking norms (percentage of smokers among peers). Results: Among the 803 subjects (mean age of 15.5 years. SD = 1.7: 52.1% female), 18.3% of males and 1.7% of females smoked in the past 30 days. Smoking among influential others (best friends, father, mother, male teachers. female teachers, and adults in general) and perceived positive psychological and social rewards from smoking at baseline were associated with number of cigarettes smoked at follow-up, whereas exposure to pro-tobacco media was not significantly associated with smoking. The mediated effect was greater for adult smoking (70% to 90%) than for best friend smoking (11% to 16%). Conclusion: Smoking among influential others and attitudes toward smoking influence adolescent smoking both directly and indirectly. The finding of file indirect effect mediated through perceived smoking norms expands our knowledge on smoking etiology. Effective adolescent smoking intervention programs in China need to include a component targeting adult smoking to reduce perceived smoking norms.

Cohen DA; Schoeff D; Farley TA; Bluthenthal R; Scribner R; Overton A. Reliability of a store observation tool in measuring availability of alcohol and selected foods. Journal of Urban Health 84(6): 807-813, 2007. (10 refs.)

Alcohol and food items can compromise or contribute to health, depending on the quantity and frequency with which they are consumed. How much people consume may be influenced by product availability and promotion in local retail stores. We developed and tested an observational tool to objectively measure in-store availability and promotion of alcoholic beverages and selected food items that have an impact on health. Trained observers visited 51 alcohol outlets in Los Angeles and southeastern Louisiana. Using a standardized instrument, two independent observations were conducted documenting the type of outlet, the availability and shelf space for alcoholic beverages and selected food items, the purchase price of standard brands, the placement of beer and malt liquor, and the amount of in-store alcohol advertising. Reliability of the instrument was excellent for measures of item availability, shelf space, and placement of malt liquor. Reliability was lower for alcohol advertising, beer placement, and items that measured the "least price" of apples and oranges. The average kappa was 0.87 for categorical items and the average intraclass correlation coefficient was 0.83 for continuous items. Overall, systematic observation of the availability and promotion of alcoholic beverages and food items was feasible, acceptable, and reliable. Measurement tools such as the one we evaluated should be useful in studies of the impact of availability of food and beverages on consumption and on health outcomes.

Collins RL; Ellickson PL; McCaffrey D; Hambarsoomians K. Early adolescent exposure to alcohol advertising and its relationship to underage drinking. Journal of Adolescent Health 40(6): 527-534, 2007. (40 refs.)

Purpose: To determine whether early adolescents who are exposed to alcohol marketing are subsequently more likely to drink. Recent studies suggest that exposure to alcohol ads has a limited influence on drinking in mid-adolescence. Early adolescents may be more vulnerable to alcohol advertising effects. Methods: Two in-school surveys of 1786 South Dakota youth measured exposure to television beer advertisements, alcohol ads in magazines, in-store beer displays and beer concessions, radio-listening time, and ownership of beer promotional items during 6th grade, and drinking intentions and behavior at 7th grade. Multivariate regression equations predicted the two drinking outcomes using the advertising exposure variables and controlling for psychosocial factors and prior drinking. Results: After adjusting for covariates, the joint effect of exposure to advertising from all six sources at grade 6 was strongly predictive of grade 7 drinking and grade 7 intentions to drink. Youth in the 75th percentile of alcohol marketing exposure had a predicted probability of drinking that was 50% greater than that of youth in the 25th percentile. Conclusions: Although causal effects are uncertain, policy makers should consider limiting a variety of marketing practices that could contribute to drinking in early adolescence.

Collins RL; Ellickson PL; McCaffrey DF; Schell T; Hambarsoomians K. Multiple forms of alcohol advertising contribute to early beer-drinking initiation. (meeting abstract). Alcoholism: Clinical and Experimental Research 28(5 Supplement): 170A-170A, 2004. (0 refs.)

Cooke E; Hastings G; Wheeler C; Eadie D; Moskalewicz J; Dabrowska K. Marketing of alcohol to young people: A comparison of the UK and Poland. European Addiction Research 10(1): 1-6, 2004. (23 refs.)

This paper takes an international perspective on the marketing of alcohol to young people by examining case studies of the marketing of alcohol in the UK and Poland. It is suggested that marketing is a powerful mechanism for attracting young consumers. The alcohol industry is an innovative industry able to use a wide variety of marketing tools to achieve success in the market-place. It is important to recognise that the marketing activities of the industry are becoming increasingly transnational and that policy response has to be equally transnational.

Croghan IT; Campbell HM; Patten CA; Croghan GA; Schroeder DR; Novotny PJ. A contest to create media messages aimed at recruiting adolescents for stop smoking programs. Journal of School Health 74(8): 325-328, 2004. (13 refs.)

This project engaged adolescents in a contest to create advertising messages aimed at recruiting teens for stop smoking programs. Middle school students were invited to design a media message for television, radio, Web, or print (newspaper or billboard). Of 4,289 students in eight middle schools of Rochester, Minn., 265 (6.2%) developed 172 stop smoking messages. The quality of their work confirmed that teens can design media messages to encourage their smoking adolescent peers to enroll in a program to stop smoking.

Darling H; Reeder AI. Tobacco advertising on mini-motors. (editorial). Tobacco Control 15(1): 34-34, 2006. (0 refs.)

Dewhirst T. POP goes the power wall? Taking aim at tobacco promotional strategies utilised at retail. (editorial). Tobacco Control 13(3): 209-210, 2004. (31 refs.)

DiRocco DN; Shadel WG. Gender differences in adolescents' responses to themes of relaxation in cigarette advertising: Relationship to intentions to smoke. Addictive Behaviors 32(2): 205-213, 2007. (32 refs.)

Studies have shown that increased exposure to cigarette advertising increases adolescents' risk of smoking and moreover, that gender may play an important role in moderating how cigarette advertisements are viewed and processed. However, information about the particular features of cigarette advertising that interact with gender to promote smoking among adolescents is scarce. The purpose of this study was to examine if gender moderates the degree to which the relaxation valence (i.e., degree to which relaxing themes are emphasized) of cigarette advertisements is related to smoking intentions in a sample of never smoking adolescents. Regardless of brand type (of the seven brands studied), cigarette advertisements that displayed highly relaxing images were associated with increased intentions to smoke among female adolescents only. These results have implications for understanding what features of cigarette advertisements have the most influence among different groups of adolescents.

Ellickson PL; Collins RL; Hambarsoomians K; McCaffrey DF. Does alcohol advertising promote adolescent drinking? Results from a longitudinal assessment. Addiction 100(2): 235-246, 2005. (48 refs.)

Aims: To examine the relationship between exposure to different forms of alcohol advertising and subsequent drinking among US adolescents and assess whether exposure to an alcohol and drug prevention program mitigates any such relationship. Design Regression models with multiple control variables examined the relationship between exposure to alcohol advertising in grade 8 and grade 9 drinking for two groups of South Dakotan adolescents: (1) seventh-grade no-drinkers (n = 1206) and (2) seventh-grade drinkers (n = 1905). Interactions between the intervention program and the significant advertising predictors were tested. Setting: Forty-one middle schools in South Dakota, US. Participants: A total of 3111 seventh-graders followed through grade 9. Measurements Advertising variables were constructed for four types of alcohol advertising-television, in-store displays, magazines and concession stands. Other predictors tested included measures tapping social influences, social bonds, problem behavior, alcohol beliefs, television exposure and demographics. Findings: For seventh-grade non-drinkers, exposure to in-store beer displays predicted drinking onset by grade 9; for seventh-grade drinkers, exposure to magazines with alcohol advertisements and to beer concession stands at sports or music events predicted frequency of grade 9 drinking. Although exposure to television beer advertising had a significant bivariate relationship with alcohol use for grade 7 non-drinkers, it was not a significant predictor of drinking for either group in multivariatc analyses. Participation in the prevention program. ALERT Plus, reduced future drinking for both groups and counteracted the effect of in-store beer displays. Conclusions: Several forms of alcohol advertising predict adolescent drinking; which sources dominate depends on the child's prior experience with alcohol. Alcohol prevention programs and policies should help children counter alcohol advertising from multiple sources and limit exposure to these sources.

Epstein JA; Botvin GJ. Media resistance skills and drug skill refusal techniques: What is their relationship with alcohol use among inner-city adolescents? Addictive Behaviors 33(4): 528-537, 2008. (26 refs.)

Past research related to alcohol advertising examined whether underage adolescents were targets of the alcohol industry and what impact such adverting had on adolescent drinking. The purpose of this study was to longitudinally examine the impact of media resistance skills on subsequent drinking among adolescents residing in inner-city regions of New York City. The study also tested whether drug skill refusal techniques (knowing how to say no to alcohol and other drugs) mediated the relationship between media resistance skills and adolescent drinking. A panel sample of baseline, one-year and two-year follow-ups (N = 1318) from the control group of a longitudinal drug abuse prevention trial participated. A series of structural equations models showed that media resistance skills directly negatively predicted alcohol use 2 years later and that drug skill refusal techniques mediated this effect. Baseline media resistance skills were associated with one-year drug skill refusal techniques, which in turn negatively predicted two-year alcohol use. These findings provided empirical support for including media resistance skills and drug skill refusal techniques in alcohol prevention programs.

Eule B; Sullivan MK; Schroeder SA; Hudmon KS. Merchandising of cigarettes in San Francisco pharmacies: 27 years later. Tobacco Control 13(4): 429-432, 2004. (13 refs.)

Objective: To estimate changes since 1976 in the proportion of San Francisco pharmacies that sell cigarettes and to characterise the advertising of cigarettes and the merchandising of non-prescription nicotine replacement therapy (NRT) products in these retail establishments. Methods and setting: 100 randomly selected San Francisco pharmacies were visited in 2003. Pharmacies were characterised based on the sale of cigarettes, advertising for cigarettes, and the merchandising of non-prescription NRT products. Results: In 2003, 61% of pharmacies sold cigarettes, a significant decrease compared to 89% of pharmacies selling cigarettes in 1976 (p, 0.001); 84% of pharmacies selling cigarettes also displayed cigarette advertising. Non-prescription NRT products were stocked by 78% of pharmacies, and in 55% of pharmacies selling cigarettes, the NRT products were stocked immediately adjacent to the cigarettes. Conclusions: Since 1976, there has been a decline in the overall proportion of pharmacies in San Francisco that sell cigarettes yet most pharmacies, particularly traditional chain pharmacies, continue to merchandise the primary known risk factor for deaths.

Feighery EC; Schleicher NC; Cruz TB; Unger JB. An examination of trends in amount and type of cigarette advertising and sales promotions in California stores, 2002-2005. Tobacco Control 17(2): 93-98, 2008. (35 refs.)

Background: Cigarette companies spend more of their marketing dollars in stores than in any other venue. In 2005, they spent 88% of a total of $13.1 billion to advertise and promote product sales in stores. Aim: The purposes of this study were to identify how the amount and types of cigarette advertising and sales promotions have changed in stores in California between 2002 and 2005, and to assess neighbourhood influences on cigarette marketing in stores. Methods: Four observational assessments of cigarette advertising were conducted in approximately 600 California stores that sold cigarettes from 2002 to 2005. Trained observers collected data on the amount and type of cigarette advertising, including signs, product shelving and displays and functional items, and presence of sales promotions on these items. Longitudinal analyses were performed to estimate trends over time and identify correlates of change in the amount and type of tobacco advertising. Results: The mean number of cigarette advertisements per store increased over time from 22.7 to 24.9. The percentage of stores with at least one advert for a sales promotion increased from 68% to 80%. The amount of advertising and proportion of stores with sales promotions increased more rapidly in stores situated in neighbourhoods with a higher proportion of African-Americans. Conclusion: The results indicate increasing use of stores to market and promote cigarette sales. Further, these increases are disproportionately accelerating in neighbourhoods with more African-Americans. Legislative strategies should be pursued to control the marketing of tobacco products and promotional strategies used to reduce prices in stores.

Fernandez S; Hickman N; Klonoff EA; Landrine H; Kashima K; Parekh B. Cigarette advertising in magazines for Latinas, white women, and men, 1998-2002: A preliminary investigation. Journal of Community Health 30(2): 141-151, 2005. (23 refs.)

Cigarette ads in popular magazines play a role in smoking and in brand preferences among women and men, but few studies have analyzed ads directed at women vs men, and no study has examined ads directed at women of different ethnic groups. Hence, we examined cigarette ads in popular magazines for White women, Latinas, and men 1998 through 2002 for the first time. Significant differences in the number of cigarette ads by magazine audience were found, along with significant differences in the type and brands of cigarettes advertised to each group. These preliminary findings suggest that the tobacco industry may target women in a manner that differs from its targeting of men, and may target Latinas in a manner that it does not target White women. Results are discussed in terms of the need for further research on tobacco ads directed at women.

Fisher LB; Miles IW; Austin B; Camargo CA; Colditz GA. Predictors of initiation of alcohol use among US adolescents - Findings from a prospective cohort study. Archives of Pediatrics & Adolescent Medicine 161(10): 959-966, 2007. (77 refs.)

Objective: To identify precursors of adolescent alcohol initiation and binge drinking. Design: Prospective cohort study. Setting: Self-report questionnaires. Participants: A total of 5511 Growing Up Today Study participants aged 11 to 18 years in 1998. Main Exposures: Individual, family, and social factors. Main Outcome Measures: First whole drink of alcohol and binge drinking. Results: Between 1998 and 1999, 611 girls (19%) and 384 boys (17%) initiated alcohol use. Older age, later maturational stage, smoking, adults drinking in the home, underage sibling drinking, peer drinking, possession of or willingness to use alcohol promotional items, and positive attitudes toward alcohol were associated with an increased likelihood of alcohol initiation. Girls who ate family dinner at home every day were less likely to initiate alcohol use than girls who ate family dinner only on some days or never (odds ratio, 0.66; 95% confidence interval, 0.50-0.87). Girls with higher social self-esteem and boys with higher athletic self-esteem were more likely to initiate alcohol use than those with lower self-esteem. Among teens who initiated alcohol use, 149 girls (24%) and 112 boys (29%) further engaged in binge drinking. Among girls, positive attitudes toward alcohol, underage sibling drinking, and possession of or willingness to use alcohol promotional items were associated with binge drinking; among boys, positive attitudes toward alcohol and older age were associated with binge drinking. Conclusions: Eating family dinner at home every day may delay alcohol uptake among some adolescents. Alcohol promotional items appear to encourage underage alcohol initiation and binge drinking; this may warrant marketing restrictions on the alcohol industry.

Freeman B; Chapman S; Rimmer M. The case for the plain packaging of tobacco products. Addiction 103(4): 580-590, 2008. (94 refs.)

Aims: The Framework Convention on Tobacco Control (FCTC) requires nations that have ratified the convention to ban all tobacco advertising and promotion. In the face of these restrictions, tobacco packaging has become the key promotional vehicle for the tobacco industry to interest smokers and potential smokers in tobacco products. This paper reviews available research into the probable impact of mandatory plain packaging and internal tobacco industry statements about the importance of packs as promotional vehicles. It critiques legal objections raised by the industry about plain packaging violating laws and international trade agreements. Methods: Searches for available evidence were conducted within the internal tobacco industry documents through the online document archives; tobacco industry trade publications; research literature through the Medline and Business Source Premier databases; and grey literature including government documents, research reports and non-governmental organization papers via the Google internet search engine. Results Plain packaging of all tobacco products would remove a key remaining means for the industry to promote its products to billions of the world's smokers and future smokers. Governments have required large surface areas of tobacco packs to be used exclusively for health warnings without legal impediment or need to compensate tobacco companies. Conclusions: Requiring plain packaging is consistent with the intention to ban all tobacco promotions. There is no impediment in the FCTC to interpreting tobacco advertising and promotion to include tobacco packs.

Freudenberg N. Public health advocacy to change corporate practices: Implications for health education practice and research. Health Education & Behavior 32(3): 298-319, 2005. (109 refs.)

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of public health activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.

Fuchs MS. Big tobacco and Hollywood: Kicking the habit of product placement and on-screen smoking. Journal of Health Care Law & Policy 8: 343-375, 2005. (246 refs.)

It has been noted that "Film is better than any commercial that has been run on television or any magazine, because the audience is totally unaware of any sponsor involvement." Paid product placement occurs when a tobacco company pays a Hollywood studio, in some cases rather handsomely, to use the company's tobacco products in a film. On the other hand, Hollywood has long resisted efforts to change the rating system or to compel PSAs. Hollywood breaches its duty to parents by failing to take steps to neutralize movie content harmful to their children. Although smoking in movies dropped from 10.7 incidents per hour in 1950 to 4.9 in 1980-1982, this downward trend actually reversed itself in the 1990s. In 2002 the rate had increased to 10.9 incidents per hour. These smoking scenes commonly occur in movies targeting teenagers. Both the Justice Department (DOJ) and Federal Trade Commission (FTC) have expressed an interest in determining who is responsible for continued onscreen smoking. This Comment does not solve this mystery, but in Section II, it examine steps that the DOJ and FTC should take to find out if Big Tobacco product placement persists. Then, in Section III, this Comment considers the feasibility of a solution that does not require the involvement of Big Tobacco. Rather, it considers possible strategies for convincing and, if necessary, forcing Hollywood to take action to neutralize the effect of smoking in movies. Finally, this comment concludes that the best strategy is to pressure Hollywood to show antismoking Public Service Announcements (PSAs). Theaters would show these PSAs prior to movies involving smoking.

Galduroz JCF; Fonseca AM; Noto AR; Carlini EA. Decrease in tobacco use among Brazilian students: A possible consequence of the ban on cigarette advertising? Addictive Behaviors 32(6): 1309-1313, 2007. (11 refs.)

In 2000, cigarette advertising was banned from the Brazilian media [LEI N degrees 10.167, de 27 de dezembro de dezembro. (2000). http: www.planalto.gov.br/ccivil_03/Leis/L10167.htm]. Nevertheless, not enough surveys have been carried out to measure the impact of the prohibition. The objective of the present survey was to compare the use of tobacco by primary and secondary school students in 1997 and 2004, that is, before and after the ban on tobacco advertising in Brazil. Two surveys were conducted (in 1997 and 2004) using the same methodology, with a target population of primary (from the fifth grade on) and secondary public schools in ten different Brazilian capitals. The sampling was done by conglomerates, stratified, and obtained in two stages. In total, 15,501 students were surveyed in 1997, and 21,712 in 2004. The questionnaire was adapted from an instrument developed by WHO, anonymous, self-administered, and applied collectively in the classroom. In a comparison of the two surveys (1997 and 2004) tobacco lifetime use (used any psychotropic drug at least once in their life) decreased significantly in seven out of ten capitals surveyed. The 11-12 year old age group experienced the largest decrease in tobacco lifetime use. There was a decrease in lifetime use for males in nine capitals, and in eight capitals for females. A decrease was also observed in heavy tobacco use also in eight capitals. In conclusion there was a significant decrease in tobacco consumption among the surveyed students, suggesting that the decrease is related to changes in public policy in Brazil over the surveyed period.

Gardner MN; Brandt AI. "The doctors' choice is America's choice" - The physician in US cigarette advertisements, 1930-1953. (editorial). American Journal of Public Health 96(2): 222-232, 2006. (68 refs.)

In the 1930s and 1940s, smoking became the norm for both men and women in the United States, and a majority of physicians smoked. At the same time, there was rising public anxiety about the health risks of cigarette smoking. One strategic response of tobacco companies was to devise advertising referring directly to physicians. As ad campaigns featuring physicians developed through the early 1950s, tobacco executives used the doctor image to assure the consumer that their respective brands were safe. These advertisements also suggested that the individual physicians' clinical judgment should continue to be the arbiter of the harms of cigarette smoking even as systematic health evidence accumulated. However, by 1954, industry strategists deemed physician images in advertisements no longer credible in the face of growing public concern about the health evidence implicating cigarettes.

Gendreau PL; Vitaro F. The unbearable lightness of "Light" cigarettes: A comparison of smoke yields in six varieties of Canadian "Light" cigarettes. Canadian Journal of Public Health 96(3): 167-172, 2005. (32 refs.)

Background: Labelling cigarettes as "light" or "mild" is claimed to be one of the biggest marketing scams in Canadian history. Arguably, such labelling implies that these varieties of cigarettes are less harmful than "regular" cigarettes. In Canada, a food product can be labelled "light" if there is a 25% reduction from the "reference food" and if the constituent being reduced is clearly identified (e.g., light in fat). Cigarette labelling does not comply with these regulations, however. To examine whether or not some tobacco constituents meet the 25% reduction criterion, we compared yields of 41 toxic and/or carcinogenic smoke constituents in six varieties of "light" cigarettes to the yields of "regular" cigarettes. We selected cigarettes from the two most popular Canadian brands, Du Maurier and Players. Methods: Using a set of data provided by Imperial Tobacco Canada and made available to the public by the Government of British Columbia, we compared yields measured under a laboratory protocol (modified ISO) that was designed to provide a more rigorous evaluation of the differences between varieties of cigarettes and a more accurate assessment of smokers' potential smoke intake than the traditional protocol (standard ISO). Findings: For all six varieties of "light" cigarettes, the yields of nicotine were higher by an average of 5% (range: 1 % to 13%). The 25% reduction criterion was not met for any variety of "light" cigarettes concerning yields of tar. For all cigarettes tested, yields of tar were reduced on average by only 16% (range: 5% to 22%). For carbon monoxide (CO), only Player's Smooth Light had an over 25% reduction (30%) compared with Player's Regular. Conversely, yield of CO was 24% higher for Du Maurier Lights compared with Du Maurier Regular. As for the other smoke constituents, the majority (75%) were not reduced by 25% or more in "light" cigarettes, and a sizeable proportion of yields (e.g., acrylonitrile, benzene, chromium, m+p cresol, mercury, nickel, toluene) were larger in these varieties of cigarettes. Only yields of formaldehyde, crotonaldehyde, 1-aminonaphtalene, and proprionaldehyde were systematically reduced in all varieties of "light" cigarettes. Conclusion: The six varieties of "light" cigarettes examined in this study do not differ substantially from "regular" cigarettes in terms of smoke yields. We argue that the modified ISO protocol should be implemented for a more valid comparison of potential smoke yields in all varieties of cigarettes and that labelling based on this protocol should be promoted.

Gilpin EA; White VM; Pierce JP. How effective are tobacco industry bar and club marketing efforts in reaching young adults? Tobacco Control 14(3): 186-192, 2005. (47 refs.)

Objective: Recently, the tobacco industry has focused marketing efforts on young adults through bar and club promotions, such as advertising and distribution of free cigarettes in these settings. This study estimates the fraction of the California young adult population that might be exposed and potentially influenced by these efforts. Design and participants: Data were from 9364 young adult (18-29 years) respondents to the cross sectional population based 2002 California Tobacco Survey. As background, we analysed social smoking (only smoke with other smokers), and enjoyment of smoking while drinking. Our main focus was on bar and club attendance, what was observed in bars and clubs, and how this might differ according to respondents' risk for future smoking. Results: Social smokers comprised 30.0 (2.2)% of all current smokers, including experimenters. Nearly three quarters (74.5 (2.3)%) of current smokers/experimenters said they enjoyed smoking while drinking. About one third (33.8 (1.2)%) of all young adults said they attended bars and clubs at least sometimes; attendance was significantly higher among smokers and those at risk for future smoking. Close to 60% (57.9 (2.2)%) of bar and club attenders reported seeing cigarette advertising and promotions in these settings. Again, smokers and those at risk were more likely to report seeing such advertising and promotions in these settings. Conclusions: About 20% of all young adults and about 30% of those at risk for future smoking (including current smokers) were exposed to tobacco advertising and promotions in bars and clubs. These California results may be conservative, but nonetheless indicate that the group potentially influenced is sizable.

Gray N. Powerwalls prey on the susceptible. (editorial). Addiction 103(2): 329-330, 2008. (5 refs.)

Grube JW. Alcohol in the media: Drinking portrayals, alcohol advertising, and alcohol consumption among youth. IN: Committee on Developing a Strategy to Reduce and Prevent Underage Drinking; Bonnie RJ; O'Connell ME, eds. Reducing Underage Drinking: A Collective Responsibility. Washington DC: National Academies Press, 2004. pp. 597-624. (102 refs.)

There is widespread concern about the potential efffects that media portrayals of drinking, alcohol product placements may have on alcohol consumption and related problems among the young. This chapter reviews the literature on drinking portrayls in the media and the impact upon young people. The evidence on the impct of television is inconslusive, and also requrires more sophisticated research designs. In respect to movies, alcohol is typically handeld in a positie or neutral manner, and assocaited with desierble outcomes. The findings here are inclonslusive. Music videos are also considered. This discussion is followed by consideration of advertising and it's impact and restrictions on advertising.

Grube JW; Nygaard P. Alcohol policy and youth drinking: Overview of effective interventions for young people. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 113-127. (45 refs.)

Alcohol policy refers to (1) formal legal and regulatory mechanisms, rules, and procedures for reducing the consumption of alcohol or risky drinking behaviors; and (2) enforcement of these measures. Policy approaches to preventing and reducing drinking and drinking problems among youth have traditionally focused on limiting access to alcohol or on direct deterrence of young drinkers or those who supply alcohol to them. The aim of such policies is to increase the "full price" of alcohol to young people by increasing resources necessary for them to obtain it or the potential costs for possessing or consuming it. More recently, policies have begun to focus on harm reduction. Harm reduction policies attempt to prevent or reduce alcohol problems by targeting heavy drinking, drinking in risky situations, or by moderating the relationship between drinking and problem outcomes, without necessarily affecting overall consumption. Based on the available evidence, the most effective policies appear to be: (1) taxation or price increases; (2) increases in the minimum drinking age; (3) zero tolerance; and (4) graduated licensing. Random breath testing, sobriety check points, and dram shop liability appear promising for reducing drinking and drinking problems based on studies with the general population, although there is less evidence for their effectiveness specifically with young people. The evidence is growing for the effects of license restrictions (e.g., limiting outlet density or hours of sale). There is some support for responsible beverage service programs, particularly those that are mandated or motivated by reduction of liability. The evidence on advertising restrictions is conflicting. Evidence that designated driver and safe rides programs, warning labels, social host liability, and keg registration are effective strategies for preventing drinking or drinking problems among young people is lacking. Overall, there is insufficient research to evaluate the effects of many alcohol policies on alcohol consumption or problems among young people. Such research should be conducted to inform policy and evaluate policies as they are implemented. Finally, it is clear from the available research that policies cannot be effective unless accompanied by enforcement and by awareness on the part of the intended targets of the policy and enforcement efforts.

Hafez N; Ling PM. How Philip Morris built Marlboro into a global brand for young adults: Implications for international tobacco control. Tobacco Control 14(4): 262-271, 2005. (81 refs.)

Objective: To describe Philip Morris' global market research and international promotional strategies targeting young adults. Methods: Analysis of previously secret tobacco industry documents. Results: Philip Morris pursued standardised market research and strategic marketing plans in different regions throughout the world using research on young adults with three principle foci: lifestyle/psychographic research, brand studies, and advertising/communication effectiveness. Philip Morris identified core similarities in the lifestyles and needs of young consumers worldwide, such as independence, hedonism, freedom, and comfort. In the early 1990s Philip Morris adopted standardised global marketing efforts, creating a central advertising production bank and guidelines for brand images and promotions, but allowing regional managers to create regionally appropriate individual advertisements. Conclusions: Values and lifestyles play a central role in the global marketing of tobacco to young adults. Worldwide counter marketing initiatives, coupled with strong, coherent global marketing policies such as the Framework Convention on Tobacco Control, are needed to break associations between young adult values and tobacco brands. As globalisation promotes the homogenisation of values and lifestyles, tobacco control messages that resonate with young adults in one part of the world may appeal to young adults in other countries. Successful tobacco control messages that appeal to young people, such as industry denormalisation, may be expanded globally with appropriate tailoring to appeal to regional values.

Hamilton WL; Norton GD; Ouellette TK; Rhodes WM; Kling R; Connolly GN. Smokers' responses to advertisements for regular and light cigarettes and potential reduced-exposure tobacco products. Nicotine & Tobacco Research 6(Supplement 3): 353-362, 2004. (17 refs.)

This study examines smokers' responses to advertisements for potentially reduced exposure tobacco products (PREP), fight cigarettes, and regular cigarettes. A convenience sample of 600 adult smokers reviewed one actual advertisement for each type of product. Smokers ranked the products on health risk, amount of tar, and carcinogenicity, and identified the messages they perceived the advertisements to convey. Smokers perceived PREP products as having lower health risks (mean= 5.4 on a scale of 1-10) and carcinogens (6.6) than light cigarettes (5.8 and 6.9, respectively, p <.001), and fights as having lower health risks and carcinogen levels than regular cigarettes (8.2 and 8.8, respectively, p <.001). The average PREP rating for level of tar (5.3) was not significantly less than the light mean of 5.4, but both were significantly less than the regular mean of 8.4 (p <.001). Although no advertisements explicitly said that the products were healthy or safe, advertisements for PREP products and tight cigarettes were interpreted as conveying positive messages about health and safety. Most smokers believed that claims made in cigarette advertisements must be approved by a government agency. The results indicate that advertisements can and do leave consumers with perceptions of the health and safety of tobacco products that are contrary to the scientific evidence. Explicit and implicit advertising messages may be strengthened by the perceived government endorsement. This supports the Institute of Medicine's recommendation to regulate the promotion, advertising, and labeling of PREP tobacco products and light cigarettes. Effective regulation may need to focus on consumer perceptions resulting from advertisements rather than the explicit content of advertising text.

Hastings G; Anderson S; Cooke E; Gordon R. Alcohol marketing and young people's drinking: A review of the research. (review). Journal of Public Health Policy 26(3): 296-311, 2005. (60 refs.)

The influence of alcohol advertising on young people continues to be the subject of much debate. This paper presents a review of the literature showing that, while many econometric studies suggest little effect, more focused consumer studies, especially recent ones with sophisticated designs, do show clear links between advertising and behaviour. Furthermore, these effects have to be viewed in combination with the possible impact of other marketing activities such as price promotions, distribution, point of sale activity and new product development. Here, the evidence base is less well developed, but there are indications of effects. It must be acknowledged that categorical statements of cause and effect are always difficult in the social sciences; marketing is a complex phenomenon involving the active participation of consumers as well as marketers and more research is needed on its cumulative impact. Nonetheless, the literature presents an increasingly compelling picture that alcohol marketing is having an effect on young people's drinking.

Heckman JJ; Flyer F; Loughlin C. An assessment of causal inference in smoking initiation research and a framework for future research. Economic Inquiry 46(1): 37-44, 2008. (37 refs.)

Reliably identifying the causal factors underlying youth smoking initiation is an important part of developing effective smoking prevention programs and shaping other types of smoking-related policies. The establishment of reliable scientific evidence in support of a causal link between cigarette advertising and youth smoking initiation depends on both rich longitudinal data as well as careful empirical applications. We examine basic principles of empirical scientific investigation of potential causal relationships, discuss findings of recent research on causal factors of youth smoking, and evaluate evidence from the public health literature regarding the effects of cigarette advertising on youth smoking.

Hemphill TA. Alcoholic beverage industry self-regulation and youth advertising: The Federal Trade Commission Report. Business and Society Review 110(3): 321-329, 2005. (20 refs.)

In 1997 and 1998, the U.S. House and Senate Committees on Appropriations jointly requested that the FTC examine the effectiveness of the alcoholic beverage industry's voluntary guidelines for advertising and marketing to underage consumers. the FTC staff reported in its 1999 report, Self-Regulation in the Alcohol Industry: A Review of Industry Efforts to Avoid Promoting Alcohol to Underage Consumers. The annual marketing and advertising investments made by the alcoholic beverage industry to influence consumer behavior are significant. The alcoholic beverage industry is reported to have spent $1.9 billion on alcohol advertising in measured media (television, radio, print, outdoor, major newspapers, and Sunday supplements) in 2002. According to estimates made by the FTC in 1999, the alcoholic beverage industry's total expenditures to promote alcoholic beverages (including sponsorship, Internet advertising, point-of-sale materials, product placement, brand logo items, and other means) were three or more times its expenditures for measured media advertising. (That translated to a total of $5.7 billion or more in 2002.) After a review of internal and public documents related marketing and advertising strategies, the 1999 FTC report found that, while a few members of the industry do not fully comply with their respective code provisions pertaining to advertising content and placement, product placement, online advertising, college marketing, and code enforcement, the industry generally complies with its existing self-regulatory standards. This FTC report endorsed the National Advertising Division of the Council of Better Business Bureaus as a model of advertising self-regulation. The FTC recommended the following: 1) Third-party review: creating an independent external review board with responsibility and authority to address complaints from the public or other industry members. 2) Advertising placement: Raise the current standard that permits advertising placement in media where just over 50 percent of the audience is 21 or older, and members should be able to demonstrate their compliance with the higher standard. 3) Best prevailing practices: adopting enforcement policies that go beyond minimum code requirements. In March 2003, conferees of the House and Senate Appropriations Committees directed the FTC to (1) study the impact on underage consumers of advertisements for new flavored malt beverages (FMBs) called �alcopops,� which were orst marketed in the late 1990s, and (2) determine whether the alcoholic beverage industry had implemented all of the recommendations made by the FTC in its 1999 report regarding improved alcoholic beverage industry self-regulation that limits the appeal and exposure of alcohol beverage advertising to underage consumers. The FTC staff reviewed whether these were placed among non-alcoholic beverages in retail outlets; whether the advertising for these products were targeted to an underage audience; and whether consumer survey evidence proved that teens were more likely than adults to be aware of and use these products, as alleged in complaint from the Center for Science in the Public Interest. In its report, Alcohol Marketing and Advertising (2003), the FTC reported finding no evidence of intent to target minors with the flavord malt bverages. In its review of the beverage industry's efforts at industry self-regulation, the FTC found that some members of the industry had taken modest steps, but that more could be done.

Henriksen L; Feighery EC; Schleicher NC; Fortmann SP. Receptivity to alcohol marketing predicts initiation of alcohol use. Journal of Adolescent Health 42(1): 28-35, 2008. (40 refs.)

Purpose: This longitudinal study examined the influence of alcohol advertising and promotions on the initiation of alcohol use. A measure of receptivity to alcohol marketing was developed from research about tobacco marketing. Recall and recognition of alcohol brand names were also examined. Methods: Data were obtained from in-class surveys of sixth, seventh, and eighth graders at baseline and 12-month follow-up. Participants who were classified as never drinkers at baseline (n = 1,080) comprised the analysis sample. Logistic regression models examined the association of advertising receptivity at baseline with any alcohol use and current drinking at follow-up, adjusting for multiple risk factors, including peer alcohol use, school performance, risk taking, and demographics. Results: At baseline, 29% of never drinkers either owned or wanted to use an alcohol branded promotional item (high receptivity), 12% students named the brand of their favorite alcohol ad (moderate receptivity), and 59% were not receptive to alcohol marketing. Approximately 29% of adolescents reported any alcohol use at follow-up; 13% reported drinking at least 1 or 2 days in the past month. Never drinkers who reported high receptivity to alcohol marketing at baseline were 77% more likely to initiate drinking by follow-up than those were not receptive. Smaller increases in the odds of alcohol use at follow-up were associated with better recall and recognition of alcohol brand names at baseline. Conclusions: Alcohol advertising and promotions are associated with the uptake of drinking. Prevention programs may reduce adolescents' receptivity to alcohol marketing by limiting their exposure to alcohol ads and promotions and by increasing their skepticism about the sponsors' marketing tactics.

Henriksen L; Feighery EC; Schleicher NC; Haladjian HH; Fortmann SP. Reaching youth at the point of sale: Cigarette marketing is more prevalent in stores where adolescents shop frequently. Tobacco Control 13(3): 315-318, 2004. (37 refs.)

Objective: Although numerous studies describe the quantity and nature of tobacco marketing in stores, fewer studies examine the industry's attempts to reach youth at the point of sale. This study examines whether cigarette marketing is more prevalent in stores where adolescents shop frequently. Design, setting, and participants: Trained coders counted cigarette ads, products, and other marketing materials in a census of stores that sell tobacco in Tracy, California (n = 50). A combination of data from focus groups and in-class surveys of middle school students (n = 2125) determined which of the stores adolescents visited most frequently. Main outcome measures: Amount of marketing materials and shelf space measured separately for the three cigarette brands most popular with adolescent smokers and for other brands combined. Results: Compared to other stores in the same community, stores where adolescents shopped frequently contained almost three times more marketing materials for Marlboro, Camel, and Newport, and significantly more shelf space devoted to these brands. Conclusions: Regardless of whether tobacco companies intentionally target youth at the point of sale, these findings underscore the importance of strategies to reduce the quantity and impact of cigarette marketing materials in this venue.

Hickman N; Klonoff EA; Landrine H; Kashima K; Parekh B; Fernandez S et al. Preliminary investigation of the advertising and availability of PREPs, the new "safe" tobacco products. Journal of Behavioral Medicine 27(4): 413-424, 2004. (33 refs.)

The tobacco industry recently introduced a new set of "safe" cigarettes and nicotine delivery devices that purportedly entail reduced tobacco-related disease risk due to their lower level of some carcinogens and toxins. Little is know about the biological impact of these potential reduced exposure products (PREPs) and nothing is known about their advertising and availability. Hence, two pilot studies were conducted to examine the latter issues for the first time. In Study 1, we examined tobacco ads in 10 popular magazines 1998-2002 and found that only 1% of ads were for PREPs. In Study 2, we attempted to purchase PREPs in a random sample of 113 small stores and found that only 4.4% sold any PREP. These preliminary findings tentatively suggest that the industry might not yet be heavily invested in products that have the potential to increase tobacco use by decreasing its perceived harm. Studies with larger samples are recommended.

Hingson R. Sex differences in adolescent exposure to alcohol advertising in magazines. (editorial). Archives of Pediatrics & Adolescent Medicine 158(7): 702-704, 2004. (20 refs.)

Hoek J. Tobacco promotion restrictions: Ironies and unintended consequences. Journal of Business Research 57(11): 1250-1257, 2004. (34 refs.)

As the health consequences of tobacco smoking have become more apparent, governments have regulated the types of promotion available to cigarette manufacturers. Yet despite these efforts, the tobacco industry has continued to develop highly visible promotions that make greater use of youth role models and of new media known to have high penetration among youth. Attempts to reduce the impact of the tobacco industry's promotions seem unintentionally to have stimulated the development of more subtle initiatives that are harder to regulate and that reach and influence young people even more effectively. Alternative means of controlling the health-related consequences of smoking include further promotion restrictions and tighter controls on the sale and distribution of tobacco. Social marketing programmes based on techniques developed by the tobacco industry may yet provide the richest irony: use of the industry's own tactics to counter its messages.

Hollingworth W; Ebel BE; McCarty CA; Garrison MM; Christakis DA; Rivara FP. Prevention of deaths from harmful drinking in the United States: The potential effects of tax increases and advertising bans on young drinkers. Journal of Studies on Alcohol 67(2): 300-308, 2006. (39 refs.)

Objective: Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality. Method: We first estimated the effect of public health interventions to decrease harmful drinking among youth from literature reviews and used life table methods to estimate alcohol-attributable years of life lost by age 80 years among the cohort of approximately 4 million U.S. residents aged 20 in the year 2000. Then, from national survey data on transitions in drinking habits by age, we modeled the impact of interventions on alcohol-attributable mortality. Results: A tax increase and an advertising ban were the most effective interventions identified. In the absence of intervention, there would be 55,259 alcohol-attributable deaths over the lifetime of the cohort. A tax-based 17% increase in the price of alcohol of $1 per six pack of beer could reduce deaths from harmful drinking by 1,490, equivalent to 31,130 discounted years of potential life saved or 3.3% of current alcohol-attributable mortality. A complete ban on alcohol advertising would reduce deaths from harmful drinking by 7,609 and result in a 16.4% decrease in alcohol-related life-years lost. A partial advertising ban would result in a 4% reduction in alcohol-related life-years lost. Conclusions: Interventions to prevent harmful drinking by youth can result in reductions in adult mortality. Among interventions shown to be successful in reducing youthful drinking prevalence, advertising bans appear to have the greatest potential for premature mortality reduction.

Hrywna M; Delnevo CD; Lewis MJ. Adult recall of tobacco advertising on the Internet. Nicotine & Tobacco Research 9(11): 1103-1107, 2007. (25 refs.)

This study examined the prevalence and characteristics of New Jersey adults who reported seeing tobacco products advertised on the Internet and described the means by which these products were advertised. Data were analyzed from the New Jersey Adult Tobacco Survey (NJATS), a repeated, cross-sectional, random-digit-dial telephone survey conducted with a statewide representative sample. We used logistic regression to determine factors associated with recall of tobacco Internet advertising, adjusting for demographics, smoking behavior variables, and receipt of tobacco industry direct mail. Participants included 3,930 adults who completed the 2001 NJATS, 4,004 adults who completed the 2002 survey, and 3,062 adults who completed the 2005 survey. The proportion of adult Internet users reporting exposure to tobacco product advertising on the Internet has increased each year (6.9% in 2001, 15.6% in 2002, 17.8% in 2005). Based on 2005 data, recall of tobacco product advertising on the Internet was higher among males young adults aged 18-24 years, Asians, adults who reported receipt of direct mail advertising, and adults with a postcollege education. In addition, adult Internet users most often reported seeing tobacco products advertised on the Internet via pop-up or banner ads (60.7%), followed by E-mail messages (24.6%), and Web sites (14.9%). Recall of tobacco advertising by Internet users increased between 2001 and 2005 and was particularly high among certain subgroups. An urgent need exists for expanded surveillance of Internet tobacco sales and marketing practices.

Inness M; Barling J; Rogers K; Turner N. De-marketing tobacco through price changes and consumer attempts to quit smoking. Journal of Business Ethics 77(4): 405-416, 2008. (40 refs.)

Using panel data from three Canadian provinces, this article examines the relationship between the de-marketing of tobacco products through provincial-level price increases and consumers' attempts to quit smoking as measured by the uptake of tobacco replacement therapies. We ground our hypotheses in the rational addiction model and the theory of planned behavior. Our analyses suggest a positive, one-month lagged effect of a price increase of tobacco products on the uptake of tobacco replacement therapies. This effect dissipates 3 months later, suggesting that there is a critical period for aggressive de-marketing of tobacco products. We discuss the implications of these results for theory and future research into de-marketing harmful consumer products.

Jason LA; Pokorny SB; Mikulski K; Schoeny ME. Assessing storefront tobacco advertising after the billboard ban. Evaluation & the Health Professions 27(1): 22-33, 2004. (15 refs.)

This study examined storefront tobacco advertisements in 11 towns in Illinois from 1999 through 2001 to assess possible, changes in these types of advertisements since the master tobacco settlement, which banned tobacco advertisements on billboards. Observers assessed the number of merchant- and industry-made tobacco storefront advertisements in Illinois stores and whether these advertisements were either brand- or price-focused. The relationship between the amount of tobacco advertisements and underage tobacco sales to minors was also explored. Findings indicated no significant relationships between tobacco advertisements and underage tobacco sales. However, industry, price advertisements decreased over time because of tobacco price increases resulting from the master settlement, whereas industry brand advertisements increased over time, perhaps in an effort by the tobacco industry to retain sales of their products through brand recognition.

Jernigan D. The need for restraint. (editorial). Addiction 102(11): 1747-1748, 2007. (10 refs.)

This is a commentary on the article "Young Australians and alcohol: the acceptabllity of ready-to-drink (RTD) alcoholic beverages among 12-30-year-olds." Ready-to-drink beverages include beverages that often are mixed with soft drinks and thereby disguise the taste of alcohol that is often unpleasant to early drinkers.

Jernigan D; O'Hara J. Advertising and promotion. IN: Committee on Developing a Strategy to Reduce and Prevent Underage Drinking; Bonnie RJ; O'Connell ME, eds. Reducing Underage Drinking: A Collective Responsibility. Washington DC: National Academies Press, 2004. pp. 625-653. (75 refs.)

This chapter begins with a brief summary of the shape and trends in the alcohol market in the United States, with particular attention to youth consumption. In 2001, Americans paid more than $135 billion for alcoholic beverages. The advertising budget was around $4 billion in 2001. Of this, under half -- 1.57 billion -- was in the traditional measured media -- television, radio, print, and outdoor. the remainder is spent on "non-traditional" advertising, such as promotions, sponsorships, point-of-sale materials, product placement. With sales essentially flat for two decades, increasingly attention is directed to expanding the market, encourage drinkers to switch brands or increase consumption, as well as persuading nondrinkers to begin drinking. Adolescents and young adults are a target. This chapter describes the nature and trends in alcohol marketing, with particular attention to young people. The paper concludes with a discussion of public policy needs.

Jernigan DH. Importance of reducing youth exposure to alcohol advertising. (editorial). Archives of Pediatrics & Adolescent Medicine 160(1): 100-102, 2006. (21 refs.)

Jernigan DH; Mosher JF. Editors' introduction: Alcohol marketing and youth. Public health perspectives. (editorial). Journal of Public Health Policy 26(3): 287-291, 2005. (20 refs.)

Jernigan DH; Ostroff J; Ross C. Alcohol advertising and youth: A measured approach. Journal of Public Health Policy 26(3): 312-325, 2005. (32 refs.)

Where alcohol industry self-regulation is the primary protection against youth exposure to alcohol advertising, independent, systematic monitoring of youth exposure can promote public awareness of and greater accountability in the industry's practices. Using commercially available databases, the Center on Alcohol Marketing and Youth has combined occurrence and audience data to calculate youth (aged 12-20 years) and adult (above the United States legal drinking age of 21 years) exposure to alcohol advertising on television and radio, in magazines and on the Internet. This research in the United States shows that alcohol companies have placed significant amounts of advertising where youth are more likely per capita to be exposed to it than adults. Further analyses by the Center have demonstrated that much of this excess exposure of youth to alcohol advertising in the United States could be eliminated if alcohol companies would adopt a threshold Of 15 % (roughly the proportion of 12-20-years-old in the population in and above) as the maximum youth audience composition for their advertising. Although adoption of such a threshold would still leave much youth exposure to alcohol marketing in such "unmeasured" activities as sponsorships, on-premise promotions and campus marketing, it would assist alcohol companies in reaching their intended audiences more efficiently while reducing overall youth exposure to their advertising.

Jernigan DH; Ostroff J; Ross C; O'Hara JA. Sex differences in adolescent exposure to alcohol advertising in magazines. Archives of Pediatrics & Adolescent Medicine 158(7): 629-634, 2004. (35 refs.)

Objectives: To measure girls' and boys' exposure to alcohol advertising in magazines and to compare this exposure with that of legal-age persons. Design, Setting, and Subjects: Alcohol advertisements (N = 6239) in 103 national magazines for which placement, audience, and cost data for 2001 and 2002 were available, categorized by year, beverage type, and brand. Placement and readership (age and sex) data generated estimates of media exposure for the age groups 12 to 20, 21 to 34, And 21 years and older. Main Outcome Measures: Gross rating points, an advertising industry standard measure of the level of media exposure of a given population, and gross rating point ratios comparing exposure of different demographic groups. Results: Alcohol companies spent $590.4 million to place 471 beer and ale advertisements (8%), 4748 distilled spirits advertisements (76%), 116 low-alcohol refresher advertisements (2%), and 904 advertisements for wine (14%) in magazines in 2001 and 2002. In 2002, underage youth saw 45% more beer and ale advertising, 12% more distilled spirits advertising, 65% more low-alcohol refresher advertising, and 69% less advertising for wine than persons 21 years and older. Girls aged 12 to 20 years were more likely to be exposed to beer, ale, and low-alcohol refresher advertising than women in the group aged 21 to 34 or women in the group aged 21 years and older. Girls' exposure to low-alcohol refresher advertising increased by 216% from 2001 to 2002, while boys' exposure increased 46%. Conclusion: Exposure of underage girls to alcohol advertising is substantial and increasing, pointing to the failure of industry self-regulation and the need for further action.

Jernigan DH; Ostroff J; Ross CS; Naimi TS; Brewer RD. Youth exposure to alcohol advertising on radio --- United States, June--August 2004. MMWR. Morbidity and Mortality Weekly Report 55(34): 937-940, 2006. (9 refs.)

Recent studies have emphasized the contribution of alcohol marketing to underage drinking and have demonstrated that a substantial proportion of alcohol advertising appears in media for which the audience composition is youth-oriented (i.e., composed disproportionately of persons aged 12--20 years). To determine the proportion of radio advertisements that occurred on radio programs with audiences composed disproportionately of underage youth and the proportion of total youth exposure to alcohol advertising that occurs as a result of such advertising, researchers at the Center on Alcohol Marketing and Youth (Health Policy Institute, Georgetown University, District of Columbia) evaluated the placement of individual radio advertisements for the most advertised U.S. alcohol brands and the composition of audiences in the largest 104 markets in the United States. Among the findings are that alcohol advertising is common on radio programs which have disproportionately large youth audiences. Furthermore, advertisements on such programs accounted for nearly three quarters of all youth exposure to alcohol advertising. Were advertising eliminated from programs that exceeded the more permissive current voluntary standard used by the alcoholic beverage industry, which stipulates that a program's audience be <30% youth aged 12--20 years, total youth exposure to alcohol advertising would decrease by approximately one third. Brand-specific exposure to radio advertising also varied by the sex and racial/ethnic composition of the audience. Also of note, the amount of alcohol advertising placed in programming that exceeded the 30% threshold has decreased since the summer of 2003, in part, that year the Beer Institute and Distilled Spirits Council joined the Wine Institute in adopting the 30% youth threshold for advertising placement; their previous voluntary threshold had been 50%. The change from 2003 to 2004 suggests that companies selling alcohol can change their advertising placement policies and that these changes have an impact on the exposure of youth to alcohol advertising.

Public Domain

Jernigan DH; Ostroff J; Ross CS; Naimi TS; Brewer RD. Youth Exposure to Alcohol Advertising in Magazines --- United States, 2001--2005. MMWR. Morbidity and Mortality Weekly Report 56(30): 763-767, 2007. (10 refs.)

This report describes the first study of alcohol advertising in magazines since the trade associations for the beer and liquor industries adopted and implemented a new standard in which they agreed to restrict advertising in media in which the youth audience composition exceeds 30%. The surveillance system used in this report is the only independent source of brand- and company-specific data regarding youth exposure to alcohol marketing and has been used to document levels of youth exposure to alcohol advertising in magazines by sex. The placement of advertisements in the nine publications with >30% youth readership decreased approximately 90% during 2001--2005; however, almost 45% of alcohol advertisements were still placed in magazines with a disproportionately large youth readership (i.e., >15%). Furthermore, advertisements in magazines with >15% youth readership accounted for approximately 80% of all youth exposure to alcohol advertising in magazines overall. Of the 201 alcohol brands advertised in magazines in 2005, a total of 36 brands placed all of their advertising in magazines with >15% youth readership, 38 brands placed more than half of their advertising in these magazines, 39 had half or less of their advertising in these magazines, and 88 brands had no advertising in these magazines (listing of brands available at http://www.camy.org). These data indicate that although alcohol companies have modified their advertising practices to meet >30% target thresholds, youth exposure to alcohol advertising would be further reduced if these companies followed the NRC/IOM recommendation and did not advertise in magazines in which youth readership exceeds 15%. It is noted too, that although alcohol advertising in magazines decreased from 2001 to 2005, alcohol advertising on television increased 41% for youth and 48% for adults during this same period (9). This increase is largely attributable to increased advertising by liquor producers on cable television programs, which are more likely than broadcast television program to have disproportionately large youth audiences (9). The Distilled Spirits Council of the United States changed its voluntary marketing practices code in 1996 to allow television advertising.

Public Domain

Johnston LD; Terry-McElrath YM; O'Malley PM; Wakefield M. Trends in recall and appraisal of anti-smoking advertising among American youth: National survey results, 1997-2001. Prevention Science 6(1): 1-19, 2005. (53 refs.)

Public health efforts to reduce the harms related to tobacco use currently include a significant emphasis on anti-smoking media campaigns. This paper provides (a) data on the overall extent of exposure to anti-smoking media among American youth from 1997 to 2001, (b) an appraisal of general youth reactions to such advertising, and (c) an examination of how exposure levels and reactions vary by socio-demographic characteristics. Data were obtained from the Monitoring the Future study, an ongoing nationwide study of youth. Data were collected each year from nationally representative separate and nonoverlapping school samples of 8th, 10th, and 12th grade students (N = 29,724; 24,639; and 12,138, respectively). Self-reported levels of recalled exposure to both electronic and print anti-smoking advertising were measured, as well as the judged impact and perceived exaggeration of such advertising. Data indicate that significant increases in overall exposure to anti-smoking advertising occurred over the study time period. These increases were associated with (a) increases in the self-reported likelihood that anti-smoking advertising diminished the probability of individual smoking behaviors, and (b) increases in the perceived level to which anti-smoking advertising exaggerates the risks associated with smoking. Further, these trends were significantly associated with various characteristics-most notably, ethnicity, smoking behaviors, and residence in a state with an ongoing tobacco-control program having a media component.

Jones SC; Hall D; Munro G. How effective is the revised regulatory code for alcohol advertising in Australia? Drug and Alcohol Review 27(1): 29-38, 2008. (16 refs.)

Introduction and Aims. Australia, like several other countries, has a self-regulatory approach to advertising. However, in recent years the effectiveness of the regulatory system has been questioned, and there have been increasing public calls for an overhaul of the system. Following a formal review in 2003, the Ministerial Council on Drug Strategy proposed a revised Alcoholic Beverages Advertising Code (ABAC), which came into operation in 2004. Design and Methods. The purpose of the present study was to examine the effectiveness of this revised system. From May 2004 until March 2005 television and magazine advertising campaigns were monitored for alcohol products. Over this period 14 complaints against alcohol advertisements were lodged with the self-regulatory board, and the authors recruited an independent expert panel to assess the advertisements and complaints. Results. In eight of the 14 cases a majority of the judges perceived the advertisement to be in breach of the code, and in no cases did a majority perceive no breach. Conversely, however, none of the complaints were upheld by the Advertising Standards Board and only one by the Alcoholic Beverages Advertising Code Panel. Discussion and Conclusions. The results of this study suggest that the decisions made by the Advertising Standards Board in relation to complaints against alcohol advertisements are not in harmony with the judgement of independent experts, and that the Advertising Standards Board may not be performing an adequate job of representing community standards or protecting the community from offensive or inappropriate advertisements. Further, it appears that the revisions to the Alcoholic Beverages Advertising Code, and associated processes, have not reduced the problems associated with alcohol advertising in Australia.

Jones SC; Lynch M. Non-advertising alcohol promotions in licensed premises: Does the Code of Practice ensure responsible promotion of alcohol? Drug and Alcohol Review 26(5): 477-485, 2007. (34 refs.)

Introduction and Aims. Binge drinking is a major public health issue in Australia, particularly among young people. There has been a considerable focus on alcohol advertising, among both researchers and policy makers, resulting in efforts to bring about some level of regulation of unacceptable advertising practices. However-despite the existence of a Code of Practice for Responsible Promotion of Liquor Products which provides 'a framework of practices which are considered acceptable and reasonable for licensed premises-there are few, if any, data on the nature and extent of promotions which could arguably fall under either 'acceptable' or 'unacceptable' practices. Design and Methods. Over an 8-week period we monitored promotions offered by licensed venues (pubs, bars and clubs) in the Wollongong central area. Seventeen venues were identified, and each venue was visited daily for I week. Trained research assistants took notes on all promotions/events in visited venues, including both manufacturer- and management-initiated. Results. We identified a range of different types of promotions, including low cost and free drinks. Some of the promotions identified could be seen to have a positive public health impact, such as free food and free transport. However, the majority of promotions were of a nature likely to increase the likelihood of excessive drinking. Discussion and Conclusions. It is evident from this review that there are numerous examples of promotions which breach both the spirit and the letter of the Code. It is equally evident that the system for monitoring compliance with the Code is fundamentally inadequate.

Jones-Webb R; Mckee P; Wall M; Pham L; Erickson D; Wagenaar A. Alcohol and malt liquor availability and promotion and homicide in inner cities. Substance Use & Misuse 43(2): 159-177, 2008. (51 refs.)

We investigated the role of the alcohol environment in explaining disparities in homicide rates among minorities in 10 cities in the United States using 2003 data from the Malt Liquor and Homicide study. We hypothesized that (a) higher concentrations of African Americans would be associated with higher homicide rates, as well as higher alcohol and malt liquor availability and promotion, and (b) the relationship between neighborhood racial/ethnic concentration and homicide would be attenuated by the greater alcohol and malt liquor availability and promotion in African American neighborhoods. Hypotheses were tested using separate Poisson, linear and logistic regression models that corrected for spatial autocorrelation. Census block groups served as the unit of analysis (n = 450). We found that higher concentrations of African Americans were associated with higher homicide rates as well as greater alcohol availability, especially malt liquor availability. The promotion of malt liquor on storefronts was also significantly greater in African American than in other neighborhoods. However none of the measures representing alcohol or malt liquor availability and promotion variables changed the effect of neighborhood racial/ethnic concentration on homicide. Limitations and implications of our findings are discussed.

Joseph AM; Muggli M; Pearson KC; Lando H. The cigarette manufacturers' efforts to promote tobacco to the US military. Military Medicine 170(10): 874-880, 2005. (70 refs.)

This article describes findings from review of tobacco industry documents regarding promotion of tobacco to the military, and efforts to influence Department of Defense policies regarding the use and sale of tobacco products. The documents reveal that the industry has targeted the military for decades for reasons including: (1) the volume of worldwide military personnel; (2) the opportunity to attract young men who fit a specific socioeconomic and cultural profile; (3) potential carry-over of profits to civilian markets; and (4) the unusual price structure of commissaries and exchanges. The industry used distinctive promotion methods such as in-store merchandising, sponsorships, and even brand development to target the military, both in the United States and abroad during times of conflict. Legislative activity to protect tobacco promotion to this vulnerable population was carried out in response to smoking policy changes proposed by the Department of Defense. The tobacco industry has contributed to the high prevalence of smoking in the military and among veterans.

Kessler DA. Alcohol marketing and youth: The challenge for public health. (editorial). Journal of Public Health Policy 26(3): 292-295, 2005. (11 refs.)

Kim YJ. The role of regulatory focus in message framing in antismoking advertisements for adolescents. Journal of Advertising 35(1): 143-151, 2006. (42 refs.)

The present research addresses how framing may influence the effectiveness of advertising messages aimed at preventing smoking among adolescents. The research applies regulatory focus theory to explore the effectiveness of message framing in antismoking advertisements. The finding reveals that adolescents demonstrate (1) lower intentions to smoke, (2) lower perceived pharmacological benefits of smoking, and (3) lower perceived psychological benefits of smoking when the fit between the regulatory goal and the antismoking message frame is congruent (versus incongruent). Therefore, antismoking messages for adolescents with a promotion focus should emphasize promotion-related merits of abstaining from smoking, whereas antismoking messages for adolescents with a prevention focus should emphasize prevention-related merits of abstaining from smoking.

Kunkel D. Inching forward on tobacco advertising restrictions to prevent youth smoking. Archives of Pediatrics & Adolescent Medicine 161(5): 515-516, 2007. (10 refs.)

Kwate NOA; Jernigan M; Lee T. Prevalence, proximity and predictors of alcohol ads in Central Harlem. Alcohol and Alcoholism 42(6): 635-640, 2007. (27 refs.)

Aims: This study examined the prevalence of alcohol ads, the spatial relationship between alcohol ads and schools, churches and playgrounds, and area-level determinants of alcohol ad density in Central Harlem, New York City. Methods: Alcohol advertising was quantified using street observation. Data on city demographics and infrastructure were obtained from the census and municipal databases. Results: Alcohol ads were densely distributed; almost half of ads fell within a 152 m buffer of schools, churches and playgrounds; and ad density was positively associated with retail liquor outlet density. Conclusions: Predominantly Black neighbourhoods continue to face high exposure to outdoor alcohol advertising, including around sites at which youth congregate.

Lambert A; Sargent JD; Glantz SA; Ling PM. How Philip Morris unlocked the Japanese cigarette market: Lessons for global tobacco control. Tobacco Control 13(4): 379-387, 2004. (39 refs.)

Background: The Framework Convention on Tobacco Control includes tobacco advertising restrictions that are strongly opposed by the tobacco industry. Marketing strategies used by transnational tobacco companies to open the Japanese market in the absence of such restrictions are described. Methods: Analysis of internal company documents. Findings: Between 1982 and 1987 transnational tobacco companies influenced the Japanese government through the US Trade Representative to open distribution networks and eliminate advertising restrictions. US cigarette exports to Japan increased 10-fold between 1985 and 1996. Television advertising was central to opening the market by projecting a popular image (despite a small actual market share) to attract existing smokers, combined with hero-centred advertisements to attract new smokers. Philip Morris's campaigns featured Hollywood movie personalities popular with young men, including James Coburn, Pierce Brosnan, Roger Moore, and Charlie Sheen. Event sponsorships allowed television access despite restrictions. When reinstatement of television restrictions was threatened in the late 1980s, Philip Morris more than doubled its television advertising budget and increased sponsorship of televised events. By adopting voluntary advertising standards, transnational companies delayed a television advertising ban for over a decade. Conclusions: Television image advertising was important to establish a market, and it has been enhanced using Hollywood personalities. Television advertising bans are essential measures to prevent industry penetration of new markets, and are less effective without concurrent limits on sponsorship and promotion. Comprehensive advertising restrictions, as included in the Framework Convention for Tobacco Control, are vital for countries where transnational tobacco companies have yet to penetrate the market.

Leatherdale ST; Sparks R; Kirsh VA. Beliefs about tobacco industry (mal)practices and youth smoking behaviour: Insight for future tobacco control campaigns (Canada). Cancer Causes & Control 17(5): 705-711, 2006. (27 refs.)

Objective: To examine how student beliefs about tobacco industry behaviour and marketing practices were related to occasional and regular smoking among 9th to 12th graders. These findings can provide insight for developing new tobacco industry denormalization messages for youth smoking populations. Methods: Cross-sectional data were collected from 14,767 grade 9 to 12 students attending 22 secondary schools within one Public Health Region of Canada using the Tobacco Module of School Heath Action, Planning and Evaluation System (SHAPES). Logistic regression analyses were used to determine if different beliefs about tobacco companies were able to differentiate never smokers from occasional smokers, and occasional smokers from regular smokers. Results Occasional and regular smoking behaviour was significantly related to student beliefs about tobacco companies doing good things in the community, manipulating young people to think smoking is cool, advertising to youth, and using athletes and sports sponsorships to get young people to smoke. Conclusions: This study identified that beliefs about tobacco industry behaviour and marketing practices were related to youth smoking behaviour. In order to address the unique needs of smoking youth, discussions for future tobacco industry denormalization campaigns should consider messages tailored to focus on corporate social responsibility, sport and cultural event sponsorship and industry manipulation.

Lewis MJ; Delnevo CD; Slade J. Tobacco industry direct mail marketing and participation by New Jersey adults. American Journal of Public Health 94(2): 257-259, 2004. (17 refs.)

We examined adult participation in tobacco industry direct marketing: receipt of direct mail and use of coupons and brand reward programs. Participation was highest for direct mail; participation. in all 3 forms differed by gender, age, and race/ethnicity; current smokers, Whites, and persons aged 25 to 64 years reported greater participation. Although tobacco industry direct marketing may influence smoking initiation, its potential to increase consumption and impede cessation is unquestionable.

Lewis MJ; Wackowski O. Dealing with an innovative industry: A look at flavored cigarettes promoted by mainstream brands. American Journal of Public Health 96(2): 244-251, 2006. (35 refs.)

Product and marketing innovation is key to the tobacco industry's success. One recent innovation was the development and marketing of flavored cigarettes as line extensions of 3 popular brands (Camel, Salem, and Kool). These products have distinctive blends and marketing as well as innovative packaging and have raised concerns in the public health community that they are targeted at youths. Several policy initiatives have aimed at banning or limiting these types of products on that basis. We describe examples of the products and their marketing and discuss their potential implications (including increased smoking experimentation, consumption, and "someday smoking"), as well as their potential impact on young adults.

Loomis BR; Farrelly MC; Nonnemaker JM; Mann NH. Point of purchase cigarette promotions before and after the Master Settlement Agreement: Exploring retail scanner data. Tobacco Control 15(2): 140-142, 2006. (28 refs.)

Background: Evidence indicates that point of purchase (POP) advertising and promotions for cigarettes have increased since the Master Settlement Agreement (MSA). Retail promotions have the potential to offset the effects of cigarette tax and price increases and tobacco control programmes. Objective: To describe the trend in the proportion of cigarette sales that occur as part of a POP promotion before and after the MSA. Design: Scanner data were analysed on cigarette sales from a national sample of grocery stores, reported quarterly from 1994 through 2003. The proportion of total cigarette sales that occurred under any of three different types of POP promotions is presented. Results: The proportion of cigarettes sold under a POP promotion increased notably over the sample period. Large increases in promoted sales are observed following implementation of the MSA and during periods of sustained cigarette excise tax increases. Conclusions: The observed pattern of promoted cigarette sales is suggestive of a positive relationship between retail cigarette promotions, the MSA, and state cigarette tax increases. More research is needed to describe fully the relationship between cigarette promotions and tobacco control policy.

Lopez ML; Herrero P; Comas A; Leijs I; Cueto A; Charlton A. Impact of cigarette advertising on smoking behaviour in Spanish adolescents as measured using recognition of billboard advertising. European Journal of Public Health 14(4): 428-432, 2004. (39 refs.)

Background: Cross-sectional studies provide empirical support for associations between advertising and adolescent smoking. The aim of this study was to investigate the relationship between Spanish adolescent smoking behaviour and prior awareness of cigarette advertisements on billboards, using a prospective design. Methods: 3,664 Spanish children aged 13 and 14 years filled in self-completion questionnaires at baseline, and 6, 12, and 18 months later (cohort study). Slides of three advertisements were projected at baseline. A multivariate logistic regression analysis was carried out to detect possible association between number of identified tobacco advertisements brands at baseline and smoking status along time, controlling ASE Model smoking determinants, smoking prevention interventions, age, gender and socio-economic status. Results: The more advertisements identified at baseline, the greater was the risk of being a smoker (p<0.0001). Final percentages of smokers were 15.8%, 16.3%, 19.3%, and 32.6%, respectively, for zero, one, two and three advertisements recognized. When confounders were controlled, the probability of being a smoker increased with the number of advertisements identified [OR 1.26 (95% CI: 1.09-1.46) after 6 months, OR 1.18 (95% CI: 1.03-1.35) after 12 months and 1.15 (95% CI: 1.02-1.30)] after 18 months. It is possible the association would have been even greater if there had not been a differential loss of smokers from the sample. Conclusion: Increased awareness of cigarette advertising was associated with a higher smoking incidence and an increased risk of Spanish children becoming smokers. It is, therefore, imperative that cigarette advertising should be banned as a matter of urgency.

Machado FS; Sinha RK. Smoking cessation: A model of planned vs. actual behavior for time-inconsistent consumers. Marketing Science 26(6): 834-850, 2007. (54 refs.)

We offer a simple model of intertemporal choice to characterize how planned versus actual behaviors evolve for time-inconsistent smokers. Our results suggest that smokers' participation and cessation decisions are governed by the interplay between three effects. The cessation effect leads smokers to advance their plans to quit smoking, whereas the procrastination effect leads them to consecutively revise their planned quitting age upwards. Consequently, the duration of smoking is effectively governed by which one of these two effects is dominant. Finally, for certain consumer segments, a threshold effect causes an "all or nothing" type of extreme smoking behavior based on certain critical values of present-biased preferences. Our results provide some preliminary evidence that both marketing efforts by tobacco firms and public policy initiatives can have a significant influence on smoking behavior. In particular, we find that reductions in the age at which individuals start smoking may not only vastly extend their duration of smoking, but also convert potential "never smokers" into lifetime smokers. Finally, we estimate a hazard model using survey data from over 800 smokers to provide evidence in support of our theoretical model.

Maibach EW; Abroms LC; Marosits M. Communication and marketing as tools to cultivate the public's health: A proposed "people and places" framework. (review). BMC Public Health 7: article 88, 2007. (145 refs.)

Background: Communication and marketing are rapidly becoming recognized as core functions, or core competencies, in the field of public health. Although these disciplines have fostered considerable academic inquiry, a coherent sense of precisely how these disciplines can inform the practice of public health has been slower to emerge. Discussion: In this article we propose a framework- based on contemporary ecological models of health - to explain how communication and marketing can be used to advance public health objectives. The framework identifies the attributes of people (as individuals, as social networks, and as communities or populations) and places that influence health behaviors and health. Communication, i.e., the provision of information, can be used in a variety of ways to foster beneficial change among both people (e. g., activating social support for smoking cessation among peers) and places (e. g., convincing city officials to ban smoking in public venues). Similarly, marketing, i.e., the development, distribution and promotion of products and services, can be used to foster beneficial change among both people (e. g., by making nicotine replacement therapy more accessible and affordable) and places (e. g., by providing city officials with model anti-tobacco legislation that can be adapted for use in their jurisdiction). Summary: Public health agencies that use their communication and marketing resources effectively to support people in making healthful decisions and to foster health-promoting environments have considerable opportunity to advance the public's health, even within the constraints of their current resource base.

Marshall N. Carolina in the Carolines: A survey of patterns and meanings of smoking on a Micronesian Island. Medical Anthropology Quarterly 19(4): 365-382, 2005. (70 refs.)

Tobacco use -- especially smoking industrially manufactured cigarettes -- kills nearly 5 million people annually and is the leading preventable cause of death worldwide. Tobacco is a widely used global commodity embedded in cultural meanings, and its consumption involves a set of learned, patterned social behaviors. Seemingly, then, tobacco offers a most appealing anthropological research topic, yet its study has been relatively ignored by medical anthropologists when compared to research on alcoholic beverages and illegal drugs. To help fill this gap, this article sketches the historical background of tobacco in Micronesia, presents the results of a cross-sectional smoking survey from Namoluk Atoll, and describes contemporary smoking patterns and locally understood symbolic associations of tobacco. Intersections among history, gender local meanings, the health transition, and the transnational marketing of tobacco are addressed, and cigarette smoking is seen as part of a new syndemic of chronic diseases in Micronesia.

McDaniel PA; Malone RE. "I always thought they were all pure tobacco'': American smokers' perceptions of "natural'' cigarettes and tobacco industry advertising strategies. (review). Tobacco Control 16(6): e-article 7, 2007. (133 refs.)

Objective: To examine how the US tobacco industry markets cigarettes as "natural'' and American smokers' views of the "naturalness'' (or unnaturalness) of cigarettes. Methods: Internal tobacco industry documents, the Pollay 20th Century Tobacco Ad Collection, and newspaper sources were reviewed, themes and strategies were categorised, and the findings were summarised. Results: Cigarette advertisements have used the term "natural'' since at least 1910, but it was not until the 1950s that "natural'' referred to a core element of brand identity, used to describe specific product attributes (filter, menthol, tobacco leaf). The term "additive- free'', introduced in the 1980s, is now commonly used to define natural cigarettes. Tobacco company market research, available from 1970 to 1998, consistently revealed that within focus group sessions, smokers initially had difficulty interpreting the term "natural'' in relation to cigarettes; however, after discussion of cigarette ingredients, smokers viewed "natural'' cigarettes as healthier. Tobacco companies regarded the implied health benefits of natural cigarettes as their key selling point, but hesitated to market them because doing so might raise doubts about the composition of their highly profitable "regular'' brands. Conclusion: Although our findings support the idea advanced by some tobacco control advocates that informing smokers of conventional cigarettes' chemical ingredients could promote cessation, they also suggest that such a measure could increase the ubiquity and popularity of "natural'' cigarettes. A more effective approach may be to "denaturalise'' smoking.

McGee R; Ketchel J/Reeder AI. Alcohol imagery on New Zealand television. Substance Abuse Treatment, Prevention, and Policy 2: article 6, 2007. (21 refs.)

Background: To examine the extent and nature of alcohol imagery on New Zealand (NZ) television, a content analysis of 98 hours of prime-time television programs and advertising was carried out over 7 consecutive days' viewing in June/July 2004. The main outcome measures were number of scenes in programs, trailers and advertisements depicting alcohol imagery; the extent of critical versus neutral and promotional imagery; and the mean number of scenes with alcohol per hour, and characteristics of scenes in which alcohol featured. Results: There were 648 separate depictions of alcohol imagery across the week, with an average of one scene every nine minutes. Scenes depicting uncritical imagery outnumbered scenes showing possible adverse health consequences of drinking by 12 to 1. Conclusion: The evidence points to a large amount of alcohol imagery incidental to storylines in programming on NZ television. Alcohol is also used in many advertisements to market non-alcohol goods and services. More attention needs to be paid to the extent of alcohol imagery on television from the industry, the government and public health practitioners. Health education with young people could raise critical awareness of the way alcohol imagery is presented on television.

Morrison MA; Krugman DM; Park P. Under the radar: Smokeless tobacco advertising in magazines with substantial youth readership. American Journal of Public Health 983(3): 543-548, 2008. (26 refs.)

Objectives. In light of the Smokeless Tobacco Master Settlement Agreement (STMSA) and the fact that smokeless tobacco advertising has received little attention, we examined industry data to assess smokeless tobacco advertising in popular magazines. Of particular interest was the level of advertising in magazines with high youth readership and the amount of reach and frequency that was generated among readers aged 12 to 17 years. Methods. We used readership data from Mediamark Research Inc, advertising expenditure data from TNS Media Intelligence, and Adplus, a media planning program from Telmar to document the composition of adult and youth readership of magazines in which smokeless tobacco products were advertised, industry expenditures on advertising, and adolescents' exposure to smokeless tobacco advertising. Results. The STMSA appears to have had a limited effect on the advertising of smokeless tobacco products to youth; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Conclusions. Popular magazines with smokeless tobacco advertising reach a large number of adolescents through a combination of both youth-oriented and adult magazines. These exposure levels have generally increased since the STMSA.

Mosbaek CH; Austin DF; Stark MJ; Lambert LC. The association between advertising and calls to a tobacco quitline. Tobacco Control 16(Supplement 1): 124-129, 2007. (29 refs.)

Objective: This study assessed the cost effectiveness of different types of television and radio advertisements and the time of day in which advertisements were placed in generating calls to the Oregon tobacco quitline. Design: Cost effectiveness was measured by cost per call, calculated as the cost of advertising divided by the number of quitline calls generated by that advertising. Advertising was bought in one-week or two-week blocks and included 27 daytime television buys, 22 evening television buys and 31 radio buys. Results: Cost effectiveness varied widely by medium, time of day and advertisement used. Daytime television was seven times more cost effective than evening television and also more cost effective than radio. The most effective advertisements at generating quitline calls were real life testimonials by people who lost family members to tobacco and advertisements that deal practically with how to quit. Conclusions: Placement of television advertisements during the day versus the evening can increase an advertisement's effectiveness in generating calls to a quitline. Some advertising messages were more effective than others in generating calls to a quitline. Quitline providers can apply findings from previous research when planning media campaigns. In addition, call volume should be monitored in order to assess the cost effectiveness of different strategies to promote use of the quitline.

Mosher JF. Transcendental alcohol marketing: Rap music and the youth market. (editorial). Addiction 100(9): 1203-1204, 2005. (3 refs.)

The writer notes that a new paradigm for advertising is not selling of a product, but promoting a brand. The writer notes that public health must be concerned that existing models for protecting young people from the harms associated with alcohol marketing are inadequate. New tools and strategies are needed to address the transformation of alcohol advertising into transcendental 'branding'.

Mosher JF; Johnsson D. Flavored alcoholic beverages: An international marketing campaign that targets youth. Journal of Public Health Policy 26(3): 326-342, 2005. (37 refs.)

Flavored alcoholic beverages (FABs) were first introduced into the alcohol market in the early 1980s in the form of wine coolers. FABs are sweet, relatively low alcohol content beverages that are designed for "entry-level" drinkers. The alcohol industry has introduced new products and production methods to expand the category's popularity. Research suggests that they are popular with underage drinkers, particularly teenage girls, and that the industry uses marketing practices that appear to target youth. FABs are now marketed globally, and their production and marketing vary by country based on national regulatory restraints. In the United States, industry representations that the products are malt beverages for regulatory purposes appears to violate many state laws because the alcohol in the FABs is derived from distilled spirits. Recommendations for regulatory reform, including new legal definitions of FABs, increased taxes, and restrictions on availability, are applicable at both national and state levels.

Munoz LG. Regulating an addictive product: The Spanish government, brand advertising and tobacco business (1880s to 1930s). Business History 47(3): 401-420, 2005. (27 refs.)

Not only are individuals dependent upon nicotine, but so too are governments. Historically governments too have been dependent upon tobacco revenues. Historically, governments have spread tobacco consumption, as was evident in the state monopolies that existed in France, Italy, and Japan, and Spain, the first to establish it 9n 1637, and the case examined in this article. The aim of the article is to analyse the impact of the regulation model, whether fiscal monopoly or highly competitive market, on consumption patterns and business activities from the 1880s to the 1930s, when the arrival of the cigarette as the main tobacco product opened the door to mass tobacco consumption. The article analyses the evolution of the Spanish tobacco monopoly during the above period, one coincident with the lease of its monopoly management to a private company in 1997. It also pays special attention to the development of modern business techniques such as brand advertising, seen by business and economic historians as a very important factor in explaining the expansion of tobacco consumption in the 20th century. The second part of the essay deals with addiction and the evolution of tobacco consumption over the course of previous centuries. The third part analyses the competitive tools used by the tobacco industry, with a special focus on the role branding and advertising. The fourth part considers the organization of the tobacco industry, with special attention to fiscal monopolies. The final part explores the lack of brand advertising the Spanish industry. The final part considers the price elasticity of tobacco and suggests that brand advertising has had an impact on market share but not on total market size.

Nelson JP. Beer advertising and marketing update: Structure, conduct, and social costs. (review). Review of Industrial Organization 26(3): 269-306, 2005. (116 refs.)

Beer advertising is a topic that has frequently attracted the attention of industrial organization economists. This update reviews major events, data trends, and research for each of three issues: (1) the importance of advertising and product differentiation for structural change in the brewing industry; (2) the manner and extent to which brewers can strategically alter market shares using advertising; and (3) the social costs of beer advertising and marketing, including advertising bans, targeting of underage youth, and recent changes in the three-tier system of alcohol distribution. Major legal decisions pertaining to commercial speech and other regulations also are discussed.

Netemeyer RG; Andrews JC; Burton S. Effects of antismoking advertising-based beliefs on adult smokers' consideration of quitting. American Journal of Public Health 95(6): 1062-1066, 2005. (24 refs.)

Objectives. We examined whether specific antismoking advertising-based beliefs regarding the addictiveness of smoking, the dangers of environmental tobacco smoke, and the tobacco industry's use of deceptive advertising practices are associated with adult smokers' consideration of quitting. We also assessed whether interactions between such beliefs and having children living in the home were associated with consideration of quitting. Methods. We used an alyses of smokers' responses to a telephone survey conducted after completion of the Wisconsin Anti-Tobacco Media Campaign to test hypotheses associated with our study objectives. Results. Results indicated that advertising-based beliefs regarding smoking addictiveness and the dangers of environmental tobacco smoke were associated with consideration of quitting. The findings also showed that consideration of quitting was positively affected by the interaction between number of children living at home and advertising-based beliefs about deceptive tobacco industry advertising practices designed to induce people to smoke. Conclusions. Creating advertisements that target specific antismoking beliefs may be the most effective approach to enhancing consideration of quitting among adult smokers, particularly those with children living at home.

O'Connor RJ; Ashare RL; Fix BV; Hawk LW; Cummings KM; Schmidt WC. College students' expectancies for light cigarettes and potential reduced exposure products. American Journal of Health Behavior 31(4): 402-410, 2007. (34 refs.)

Objectives: To determine positive and negative beliefs about light cigarettes and potential reduced exposure products (PREPs) among college student smokers and nonsmokers. Methods: A web-based survey conducted in October-November 2004 among 424 students rating 5 advertisements for cigarette brands (Marlboro Red, Light, and Ultralight; Quest; Eclipse) on 28 items tapping positive and negative product expectancies. Results: Marlboro Light and Ultralight were rated more positively and less negatively than their Red counterpart. PREPs showed low positive and negative ratings relative to Marlboro Light. Positive expectancies were significantly related to willingness to try each brand. Conclusions: Advertising plays a role in influencing how college students view light and PREP cigarette brands.

Pasch KE; Komro KA; Perry CL; Hearst MO; Farbakhsh K. Outdoor alcohol advertising near schools: What does it advertise and how is it related to intentions and use of alcohol among young adolescents? Journal of Studies on Alcohol and Drugs 68(4): 587-596, 2007. (48 refs.)

Objective: The objectives of this study were to (1) document and describe all outdoor alcohol advertisements surrounding schools and (2) examine the association between exposure to alcohol advertising in sixth grade and youth alcohol use, intentions, norms, and attitudes in eighth grade. Method: All outdoor alcohol advertisements within 1,500 feet of 63 Chicago school sites were documented and coded for content and theme. Longitudinal mixed-effects regression analysis was used to determine the association between number of alcohol advertisements around a school in sixth grade and student alcohol behaviors, intentions, norms, and attitudes at the end of eighth grade, 2 years later. Participants included 2,586 sixth-grade students in the 2002-2003 school year. The sample was 37% black, 33% Hispanic, and 15% white. Gender was evenly distributed, and the average age was 12.2 at the end of sixth grade. Results: A total of 931 alcohol advertisements were found within 1,500 feet of the 63 school sites. Exposure to alcohol advertising around schools at the end of sixth grade was found to predict alcohol intentions at the end of eighth grade. This finding held true even for those students who were nonusers of alcohol in sixth grade. Conclusions: Exposure to outdoor alcohol advertising around schools is associated with subsequent youth intentions to use alcohol. The association between exposure to alcohol advertising and youth alcohol-use intentions was found even among sixth-grade nonusers of alcohol, suggesting that even those who have not used alcohol are still influenced by alcohol advertising. These findings suggest that restrictions in alcohol advertising near schools may be warranted.

Pechmann C; Levine L; Loughlin S; Leslie F. Impulsive and self-conscious: Adolescents' vulnerability to advertising and promotion. (review). Journal of Public Policy and Marketing 24(2): 202-221, 2005. (183 refs.)

In this article, the authors review basic research on adolescent development in neuroscience, psychology, and marketing. The findings indicate that adolescents are more impulsive and self-conscious than adults. In addition, the adolescent brain's plasticity makes it more vulnerable to harm. Thus, there is emerging justification for restricting adolescents' exposure to advertising and promotions for high-risk, addictive products, especially if impulsive behaviors or image benefits are depicted.

Peters RJ; Kelder SH; Prokhorov A; Amos C; Yacoubian GS; Agurcia CA et al. The relationship between perceived youth exposure to anti-smoking advertisements: How perceptions differ by race. Journal of Drug Education 35(1): 47-58, 2005. (20 refs.)

Data on self-reported perceived exposure to anti-smoking messages were collected from 1,608 high school students surveyed through the ASPIRE (A Smoking Prevention Interactive Experience) Program in Houston, Texas. Data collection took place between October 2002 and March 2003. Logistic regression identified that African Americans perceived significantly less exposure to anti-smoking advertisements via television (OR = .50, p <= 0.05) and posters (OR = .61, p <= 0.05) than whites. However, they had nearly twice as much perceived exposure to anti-smoking advertisements at movies (OR = 1.79, p <= 0.05) and sporting events (OR = 2.1, p <= 0.05) than their white counterparts. Hispanic youth perceived significantly less exposure to anti-smoking posters (OR = .51, p <= 0.05) and significantly higher exposure to anti-smoking messages at sporting events (OR = 1.92, p <= 0.05) and school programs (OR = 3.44, p <= 0.05) compared to white youth. While the relationships tested in this study are exploratory, they provide initial evidence for an important nexus between race and communication channels that may impact perceived exposure to tobacco advertising.

Plantin-Carrenard E; Jacob N; Foglietti MJ; Derenne JP; De L'homme G. What perception have smokers of nicotine and tar yields of cigarettes? Revue des Maladies Respiratoires 21(1): 67-73, 2004. (27 refs.)

Introduction: Advertising information on cigarette package participate to the reduction of health risks from smoking. Impact on smokers has been poorly studied. This study intended to dete