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CORK Bibliography: Advertising

90 citations. 2007 to present

Prepared: June 2009

Al-Mulla AM; Helmy SA; Al-Lawati J; Al Nasser S; Rahman SAA; Almutawa A et al. Prevalence of tobacco use among students aged 13-15 years in Health Ministers' Council/Gulf Cooperation Council Member States, 2001-2004. Journal of School Health 78(6): 337-343, 2008. (9 refs.)

BACKGROUND: This article examines differences and similarities in adolescent tobacco use among Member States of the Health Ministers' Council for the Gulf Cooperation Council (HMC/GCC) using Global Youth Tobacco Survey (GYTS) data. METHODS: Nationally representative samples of students in grades associated with ages 13-15 in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen. Schools were selected proportional to enrollment size, classes were randomly selected within participating schools, and all students in selected classes were eligible to participate. RESULTS: GYTS results confirmed that boys are significantly more likely than girls to smoke cigarettes or use shisha (water pipe). Students had higher rates of tobacco use than adults in Bahrain, Oman, and United Arab Emirates. For boys and girls, shisha use was higher than cigarette smoking in almost all countries. Susceptibility to initiate smoking among never smokers was higher than current cigarette smoking in all countries. Exposure to secondhand smoke in public places was greater than 30%, direct protobacco advertising exposure was greater than 70% on billboards and in newspapers, and more than 10% of students were influenced by indirect advertising. Finally, less than half of the students were taught in school about the dangers of tobacco use in the past year. CONCLUSIONS: For boys and girls, high prevalence of cigarette smoking, high prevalence of shisha use, and high susceptibility of never smokers to initiate smoking in the next year are troubling indicators for the future of chronic disease and tobacco-related mortality in the Member States of the HMC/GCC.

Alpert HR; Koh H; Connolly GN. Free nicotine content and strategic marketing of moist snuff tobacco products in the United States: 2000-2006. Tobacco Control 17(5): 332-338, 2008. (41 refs.)

Background: From 2000 to 2006, moist snuff sales have increased and now account for 71% of the smokeless tobacco market. Previous research has shown that major manufacturers of smokeless tobacco products manipulated free nicotine, the form most readily absorbed, to promote tolerance and addiction. Aim: This study examines the possibility that company-specific and brand-specific strategies of the major moist snuff manufacturers involve controlling free nicotine content and ease of dosing with products that are designed and targeted to specific groups. This study looks at the current total US moist snuff market with product design data from the Massachusetts Department of Public Health; moist snuff use from the National Survey on Drug Use and Health; market data from ACNielsen; and magazine advertising expenditures from TNS Media Intelligence. Results: (1) The levels of free nicotine of moist snuff products have increased over time for several major manufacturers; (2) the number and variety of sub-brands have increased over time; (3) changes in design, as reflected by variation in free nicotine associated with pH or tobacco leaf, or both, have enhanced the ease and uniformity of dosing; (4) marketing through price and advertising has increased; and (5) youth use has increased. Conclusion: A combination of factors including brand proliferation, control of free nicotine and product design has most likely resulted in the expanded consumption of moist snuff, particularly among young people.

Alpert HR; Koh HK; Connolly GN. After the Master Settlement Agreement: Targeting and exposure of youth to magazine tobacco advertising. Health Affairs 27(6): W503-W512, 2008. (36 refs.)

Targeting and exposure of youth to magazine advertising of tobacco products is associated with increased smoking initiation. National magazine advertising and youth exposure declined in the period following the Master Settlement Agreement (MSA). However, tobacco companies continued targeting youth with brands that were popular among them through magazine advertising and placement of ads in magazines with high youth readership. Existing restrictions, followed by enforcement through litigation, have achieved a marked reduction in overall magazine advertising but may be less adequate compared with pending federal legislation to fully protect youth from the marketing of tobacco products designed to appeal to them.

Anderson P. Is it time to ban alcohol advertising? Clinical Medicine 9(2): 121-124, 2009. (20 refs.)

Children and adolescents are particularly vulnerable to the harmful effects of alcohol, with heavy drinking risking impaired brain development and future alcohol dependence. Advertisements increase expectancies about alcohol, leading to a greater likelihood of drinking. A systematic review of 13 longitudinal studies of over 38,000 young people found convincing evidence of an impact of media exposure and alcohol advertising on subsequent alcohol use; including initiation of drinking and heavier drinking among existing drinkers. All European countries, with the exception of the UK, have a ban on one or more types of advertising. Since self-regulation is reported as failing to prevent marketing which has an impact on younger people, and since advertising commonly crosses country borders, there is an argument to approximate advertising rules across Europe banning alcohol advertising targeted at young people, a highly cost-effective measure to reduce harmful alcohol use, and one supported by European citizens and case law.

Anderson SJ; Ling PM. "And they told two friends...and so on": RJ Reynolds' viral marketing of Eclipse and its potential to mislead the public. Tobacco Control 17(4): 222-229, 2008. (81 refs.)

Objective: To explore viral marketing strategies for Eclipse cigarettes used by the RJ Reynolds Company (Winston-Salem, North Carolina, USA). Methods: Analysis of previously secret tobacco industry documents and multimedia materials. Results: The failure of RJ Reynolds' (RJR) 1988 "smokeless'' cigarette, Premier, was in part due to widespread bad word of mouth about the product's flavour, quality and difficulty of use. In 1994 RJR introduced an updated version of Premier, the ostensibly "reduced risk'' Eclipse cigarette. RJR developed viral marketing channels to promote Eclipse using (1) exploratory interviews to motivate consumers to spread the word about Eclipse prior to market release, (2) promotional videos featuring positive feedback from test group participants to portray majority consensus among triers, (3) "Tupperware"-like parties for Eclipse where participants received samples to pass around in their social circles and (4) the Eclipse website's bulletin board as a forum for potential users to discuss the brand in their own words. These strategies targeted the brand's likeliest adopters, recruited informal and credible representatives of the product unaffiliated with RJR, and controlled the information spread about the product. Conclusions: Viral marketing techniques may be particularly useful to promote new tobacco products such as Eclipse that have limited appeal and need a highly motivated audience of early adopters and acceptors. Such techniques help evade the mass rejection that could follow mass promotion, circumvent marketing restrictions, and allow tobacco companies to benefit from health claims made by consumers. Cigarette manufacturers must be held accountable for perceived health benefits encouraged by all promotional activities including viral marketing.

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.

Assunta M; Chapman S. The lightest market in the world: Light and mild cigarettes in Japan. Nicotine & Tobacco Research 10(5): 803-810, 2008. (71 refs.)

This article reviews the history of the introduction and use of light and mild labeled cigarettes in Japan, the "lightest" market in the world. Systematic keyword and opportunistic Web site searches were conducted on tobacco industry internal documents relevant to Japan, supplemented with relevant material from the tobacco trade and sociological literatures. Certain "market quirks" of the Japanese society benefited the tobacco industry in promoting its light and mild cigarettes. Japan's is a trend-conscious society with a penchant for new fashion and products. The Japanese are innovative, with the propensity to transform concepts into something characteristically their own marked by a distinct cultural style, such as the concept of keihaku tansho ("light-thin-short-small"). With big-budget sophisticated advertising, tobacco companies developed a lucrative market for mild, light, and ultra-low-tar cigarettes. Smokers had a preference for charcoal filters, which they believed protected them. Tar numbers meant little to smokers. The transnational tobacco companies capitalized on consumer concerns about the health hazards of smoking to promote low-tar cigarettes as a safer alternative. This may be one factor that explains why smoking prevalence in Japan remains high. Light and mild cigarettes are popular in Japan because Japanese smokers believe low tar/nicotine cigarette with charcoal filters protect them and help mollify their health concerns about smoking.

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.

Bhana A. Alcohol advertising, movies and adolescents. (editorial). Addiction 103(12): 1935-1936, 2008. (6 refs.)

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.

Capella ML; Taylor CR; Webster C. The effect of cigarette advertising bans on consumption: A meta-analysis. Journal of Advertising 37(2): 7-18, 2008. (75 refs.)

Because previous research and reviews on the effect of cigarette advertising bans on cigarette consumption have reported mixed results, the effectiveness of cigarette advertising bans has been a point of controversy. To ascertain the efficacy of cigarette advertising bans, the current research is a quantitative integration (meta-analysis) of the entire available published cigarette advertising ban research conducted to determine what impact, if any, advertising bans have on cigarette smoking behavior. Results of the meta-analysis show that cigarette advertising bans do not have a significant effect on cigarette consumption.

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.

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.

Cousins K; Kypri K. Alcohol advertising in the New Zealand university student press. Drug and Alcohol Review 27(5): 566-569, 2008. (10 refs.)

University students drink more heavily than their non-student peers in New Zealand. The promotion of alcohol via advertising is a known contributor to heavy drinking. The aim of this paper was to determine the nature and extent of alcohol-related advertising and related policies at New Zealand universities. We sought to obtain all issues for 2005, of student newspapers at five New Zealand universities that had participated in an ongoing research project examining alcohol-related harm. The number of alcohol-related advertisements was determined and counts were weighted by the proportion of the page they took up. We surveyed senior university administrators to determine whether policies existed to regulate alcohol advertising on campus. The number of alcohol-related advertisements in student publications ranged from 1 to 129 across the academic year (median: 74 advertisements, 34 full-page equivalents). At three universities, most advertisements promoted bars, pubs and restaurants, while at the other two universities, most alcohol-related advertising was for events sponsored by a brewery, alcohol company or local pub. At one university with almost no advertising, a brewery sponsorship agreement with the student association forbade other parties from advertising alcohol and related events. Alcohol-related advertising is pervasive in the New Zealand university student press. Student associations should consider the ethics of alcohol industry sponsorship in light of the high prevalence of heavy drinking in this population group.

Crespo A; Cabestrero R; Grzib G; Quiros P. Visual attention to health warnings in tobacco advertisements: An eye-tracking research between smokers and non-smokers. Studia Psychologica 49(1): 39-51, 2007. (25 refs.)

Using a physiological eye-tracking approach, previous research has suggested that novel health warnings inserted in tobacco ads capture visual attention better than mandated ones. Nonetheless, no up-to-date studies have analyzed the eye movement behavior between smokers and non-smokers to examine the presence of attentional biases towards the warnings. The main objective of this research was to evaluate the effectiveness of new text-only warning labels in capturing and holding visual attention, taking into account the presence or absence of smoking habit (smokers vs. non-smokers). Three versions of an ad were used: version 1 was the original ad including the mandated warning message, and versions 2 and 3 were modifications of the original message. A sample of 132 Spanish participants (50% smokers and 50% non-smokers) freely explored one version of the ad while eye movements were recorded. Eye tracking was used as an index of the attentional deployment towards the health message. Immediately after ads presentation, participants also completed a masked memory task. Results indicated a better recall of the original version of the warning than newer ones. Moreover, contrary to previous research, eye movement data showed that new warnings inserted in tobacco ads were neither more quickly attended than mandated message nor cognitively processed to a greater extent. Finally, our results did not reveal the presence of attentional biases for warning labels embedded in the ad, suggesting that the time spent looking at the warning message, as well as the ability to remember it, appear to be identical for smokers and non-smokers, Overall, our research offers some significant implications for the development of tobacco advertising policies.

Davis RM. British American Tobacco ghost-wrote reports on tobacco advertising bans by the International Advertising Association and J J Boddewyn. Tobacco Control 17(3): 211-214, 2008. (31 refs.)

In 1983 and 1986, the International Advertising Association (IAA) published an original version and then a revision of a report entitled "Tobacco Advertising Bans and Consumption in 16 Countries," which were edited by J J Boddewyn, a marketing professor. The reports concluded that tobacco advertising bans have not been accompanied by any significant reduction in tobacco consumption. Opponents of tobacco advertising restrictions trumpeted the IAA reports in print materials, media communications and legislative hearings during the 1980s and beyond. A new analysis of tobacco industry documents and transcripts of tobacco litigation testimony reveals that British American Tobacco ghost-wrote the IAA reports and that the Tobacco Institute (the trade association then representing the major US cigarette manufacturers) helped to arrange for Boddewyn to present the findings to the US Congress and the media. Further research on tobacco industry documents and tobacco litigation transcripts should assess whether tobacco industry sources were responsible for ghostwriting other studies favourable to the industry.

de Silva Lopaz T. Global Brands: The Evolution of Multinationals in Alcoholic Beverages. New York: Cambridge University Press, 2007

This book, by a business historian examines, the large multinational alcoholic beverage firms and their brands. It traces the origins of the best-known brands and examines the diversification, acquisition, and global expansion of the industry. It is organized around five themes: (1) the general patterns that explain growth and independent survival of multinational firms in alcoholic bever-ages; (2) why most of the leading multinational firms are family owned and/or controlled; (3) the channel relationships between producers, wholesalers, and retailers; (4) the diversification strategies used by the leading firms; and (5) the impact of firms in the life of the brands. The author makes a strong case that unlike most other industries, technology is rather unimportant to the success of these firms. Rather the key to success is marketing and brands.

Dilley JA; Spigner C; Boysun MJ; Dent CW; Pizacani BA. Does tobacco industry marketing excessively impact lesbian, gay and bisexual communities? Tobacco Control 17(6): 385-390, 2008. (24 refs.)

Background: Tobacco industry documents have revealed marketing plans specifically to reach lesbian, gay and bisexual (LGB) populations. Research supports a causal linkage between receptivity and exposure to tobacco industry marketing and tobacco use uptake among adolescents. Pro-tobacco messages may diminish the effectiveness of tobacco control activities and contribute to the high smoking prevalence among LGB populations. Objective: To compare receptivity and exposure to tobacco industry marketing between LGB and heterosexual populations. Methods: Nearly 400 gay or bisexual men and more than 600 lesbian or bisexual women were identified in the 2003-2006 Washington State Behavioral Risk Factor Surveillance System (BRFSS), a state-wide, population-based telephone survey of adults. The BRFSS included questions measuring receptivity and exposure to tobacco industry marketing. Multiple logistic regression models stratified by gender were used to assess differences for lesbians, gays and bisexuals separately, in comparison to their heterosexual counterparts. Results: As expected, smoking prevalence was higher among LGB populations than among heterosexuals. After adjustment for demographic differences and smoking status, gay and bisexual men reported more exposure to tobacco industry marketing (free sample distribution) than straight men, but were equally receptive to it. Lesbian and bisexual women were more receptive to and reported more exposure to tobacco industry marketing than straight women. Conclusion: LGB communities, especially lesbian and bisexual women, appear to be effectively targeted by tobacco industry marketing activities. Strategies to limit tobacco industry marketing, and increase individuals' resistance to marketing, may be critical to reducing smoking among LGB populations.

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.

Donovan K; Donovan R; Howat P; Weller N. Magazine alcohol advertising compliance with the Australian Alcoholic Beverages Advertising Code. Drug and Alcohol Review 26(1): 73-81, 2007. (38 refs.)

The purpose of this study was to assess the frequency and content of alcoholic beverage advertisements and sales promotions in magazines popular with adolescents and young people in Australia, and assess the extent to which the ads complied with Australia's self-regulatory Alcoholic Beverages Advertising Code (ABAC). Alcohol advertisements and promotions were identified in a sample of 93 magazines popular with young people. The identified items were coded against 28 measures constructed to assess the content of the items against the five sections of the ABAC. Two thirds of the magazines contained at least one alcohol advertisement or promotion with a total of 142 unique items identified: 80 were brand advertisements and 62 were other types of promotional items (i.e. sales promotions, event sponsorships, cross promotions with other marketers and advertorials). It was found that 52% of items appeared to contravene at least one section of the ABAC. The two major apparent breaches related to section B-the items having a strong appeal to adolescents (34%) and to section C-promoting positive social, sexual and psychological expectancies of consumption (28%). It was also found that promotional items appeared to breach the ABAC as often as did advertisements. It is concluded that the self-regulating system appears not to be working for the alcoholic beverages industry in Australia and that increased government surveillance and regulation should be considered, giving particular emphasis to the inclusion of promotional items other than brand advertising.

Dubray JM; Schwartz RM; Garcia JM; Bondy SJ; Victor JC. Vendor compliance with Ontario's tobacco point of sale legislation. Canadian Journal of Public Health 100(2): 109-112, 2009. (14 refs.)

Objective: On May 31, 2006, Ontario joined a small group of international jurisdictions to implement legislative restrictions on tobacco point of sale promotions. This study compares the presence of point of sale promotions in the retail tobacco environment from three surveys: one prior to and two following implementation of the legislation. Method: Approximately 1,575 tobacco vendors were randomly selected for each survey. Each regionally-stratified sample included equal numbers of tobacco vendors categorized into four trade classes: chain convenience, independent convenience and discount, gas stations, and grocery. Data regarding the six restricted point of sale promotions were collected using standardized protocols and inspection forms. Weighted estimates and 95% confidence intervals were produced at the provincial, regional and vendor trade class level using the bootstrap method for estimating variance. Results: At baseline, the proportion of tobacco vendors who did not engage in each of the six restricted point of sale promotions ranged from 41%, to 88%. Within four months following implementation of the legislation, compliance with each of the six restricted point of sale promotions exceeded 95%. Similar levels of compliance were observed one year later. Grocery stores had the fewest point of sale promotions displayed at baseline. Compliance rates did not differ across vendor trade classes at either follow-up survey. Point of sale promotions did not differ across regions in any of the three surveys. Conclusion: Within a short period of time, a high level of compliance with six restricted point of sale promotions was achieved.

Dunlop SM; Wakefield M; Kashima Y. The contribution of antismoking advertising to quitting: Intra- and interpersonal processes. Journal of Health Communication 13(3): 250-266, 2008. (50 refs.)

This study explored the roles of transportability-the tendency to become absorbed in a narrative-and interpersonal discussion in the use of televised antismoking advertising in attempts to quit smoking. We used data from a representative population survey of adults (n = 2,999), examining responses from current smokers (n = 594) and former smokers who had quit in the last 5 years (n = 167). Logistic regression analysis revealed that current and former smokers higher in transportability were more likely to recall an antismoking ad (OR = 1.08, p < .001), and to perceive they had been helped by antismoking advertising in their attempts to quit smoking (OR = 1.05, p <.01). Transportability also was related to the recall of narrative antismoking advertisements (OR = 1.06, p <.05). Among current smokers, those who engaged in interpersonal discussion about any antismoking advertising were more likely to have made a quit attempt (OR = 2.76, p <.001). Finally, individuals were most likely to discuss advertising containing information about the negative health consequences of smoking using graphic images or simulations of bodily processes. These results suggest that the effectiveness of antismoking advertising is dependent upon both intra- and interpersonal processes that are triggered by the advertisements.

Durkin S; Wakefield M. Interrupting a narrative transportation experience: Program placement effects on responses to antismoking advertising. Journal of Health Communication 13(7): 667-680, 2008. (28 refs.)

It is thought that "transportation" -- absorption into the narrative flow of a story -- may play a role in influencing resistance to persuasion. We hypothesized that advertising that disrupts the experience of narrative transportation may be adversely appraised by audiences. This study aimed to explore the influence of two types of television programs: narratives (dramas, comedies, and soap operas) versus non-narratives (light entertainment, sports, documentaries, and news), on smokers' reactions to antismoking advertisements. In preexposure interviews, daily smokers (n=779) were asked to watch a particular television program they usually watched. Postexposure interviews were conducted within 3 days of exposure. Results indicated that placing an antismoking ad within a program in which the viewer is focused on the narrative flow of a story may lead to reduced immediate cognitive and emotional impact of the ad and reduced intentions to quit, especially among those for whom the ad is most relevant, such as those preparing to quit smoking. Placing antismoking advertising in light entertainment, sports, documentaries, and news programs may make scarce public health dollars go further.

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.

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.

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.

Foulds J; Furberg H. Is low-nicotine Marlboro snus really snus? Harm Reduction Journal 5(1): e-article 9, 2008. (29 refs.)

Swedish snus is a medium/high nicotine delivery, low-nitrosamine moist smokeless tobacco product that has been estimated to be at least 90% less harmful than smoked tobacco. More men use snus than smoke cigarettes in Sweden, and a quarter of male former smokers quit by switching to snus. Leading multinational cigarette manufacturers have begun test-marketing snus-like products in the United States and other countries. The version of Philip Morris' Marlboro snus currently being marketed in the United States differs from Swedish snus in many ways; it has lower moisture content and pH, but most puzzling is its very low nicotine delivery. Philip Morris, the market-leader in United States cigarette sales, may have designed the product so that it does not satisfy nicotine cravings and fails to enable smokers to switch. In this paper we compare and contrast Swedish snus and Marlboro snus, and speculate as to why Philip Morris may have intentionally designed a product that delivers very low levels of nicotine. We recommend that Philip Morris cease using the term "snus" to refer to dry tobacco products with low nicotine delivery, so that the term be reserved for moist, low-toxin, medium/high nicotine delivery smokeless tobacco products that are qualitatively similar to the leading brands in Sweden.

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.

Freeman D; Brucks M; Wallendorf M; Boland W. Youths' understandings of cigarette advertisements. Addictive Behaviors 34(1): 36-42, 2009. (45 refs.)

This study addresses two questions: (1) when youths are exposed to advertisements for cigarettes, do they primarily see advertisements for brands or products, and (2) is there a relationship between youths' understandings of cigarette advertisements and their susceptibility to smoking? A sample of 271 participants ranging in age from 7 to 12 viewed a series of print advertisements that included cigarette and non-tobacco-related ads. While viewing each ad, participants were asked to indicate what they thought the advertisement was trying to sell. Responses were coded into one of three categories reflecting important differences in participants' comprehension of each advertisement - no understanding, product category understanding, or brand understanding. Results show that youths typically understand the type of product an advertisement is promoting; however, the levels of brand understanding observed for cigarette advertisements were low in an absolute sense, and significantly lower than brand understanding of non-tobacco-related advertisements. Results also show that understanding cigarette ads as promoting specific brands of cigarettes is positively related to susceptibility to smoking. Taken together, these findings provide a glimpse of the psychological mechanisms that may underlie the well established link between exposure to cigarette advertising and youth 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.

Gilpin EA; White MM; Messer K; Pierce JP. Receptivity to tobacco advertising and promotions among young adolescents as a predictor of established smoking in young adulthood. American Journal of Public Health 97(8): 1489-1495, 2007. (60 refs.)

Objectives. We investigated whether receptivity to tobacco advertising and promotions during young adolescence predicts young adult smoking 6 years later. Methods. Two longitudinal cohorts of adolescents drawn from the 1993 and 1996 versions of the California Tobacco Surveys were followed 3 and 6 years later. At baseline, adolescents were aged 12 to 15 years and were not established smokers. The outcome measure was established smoking at final follow-up. Receptivity to cigarette advertising and promotions was included in a multivariate logistic regression analysis along with demographic and other variables. Results. The rate of established smoking at follow-up was significantly greater among members of the 1993 through 1999 cohort (21.0%) than among members of the 1996 through 2002 cohort (15.6%). However, in both cohorts, having a favorite cigarette advertisement and owning or being willing to use a tobacco promotional item showed nearly identical adjusted odds of future adult smoking (1.46 and 1.84, respectively). Conclusions. Despite the success of tobacco control efforts in reducing youth smoking, tobacco marketing remains a potent influence on whether young adolescents become established smokers in young adulthood (18-21 years of age).

Graham AL; Milner P; Saul JE; Pfaff L. Online advertising as a public health and recruitment tool: Comparison of different media campaigns to increase Demand for smoking cessation interventions. Journal of Medical Internet Research 10(5): article e-50, 2008. (60 refs.)

Background: To improve the overall impact (reach X efficacy) of cessation treatments and to reduce the population prevalence of smoking, innovative strategies are needed that increase consumer demand for and use of cessation treatments. Given that 12 million people search for smoking cessation information each year, online advertising may represent a cost-efficient approach to reach and recruit online smokers to treatment. Online ads can be implemented in many forms, and surveys consistently show that consumers are receptive. Few studies have examined the potential of online advertising to recruit smokers to cessation treatments. Objective: The aims of the study were to (1) demonstrate the feasibility of online advertising as a strategy to increase consumer demand for cessation treatments, (2) illustrate the tools that can be used to track and evaluate the impact of online advertising on treatment utilization, and (3) highlight some of the methodological challenges and future directions for researchers. Methods: An observational design was used to examine the impact of online advertising compared to traditional recruitment approaches (billboards, television and radio ads, outdoor advertising, direct mail, and physician detailing) on several dependent variables: (1) number of individuals who enrolled in Web- or telephone-based cessation treatment, (2) the demographic, smoking, and treatment utilization characteristics of smokers recruited to treatment, and (3) the cost to enroll smokers. Several creative approaches to online ads (banner ads, paid search) were tested on national and local websites and search engines. The comparison group was comprised of individuals who registered for Web-based cessation treatment in response to traditional advertising during the,same time period. Results: A total of 130,214 individuals responded to advertising during the study period: 23,923 (18.4%) responded to traditional recruitment approaches and 106,291 (81.6%) to online ads. Of those who clicked on an online ad, 9655 (9.1%) registered for cessation treatment: 6.8% (n = 7268) for Web only, 1.1% (n = 1119) for phone only, and 1.2% (n = 1268) for Web and phone. Compared to traditional recruitment approaches, online ads recruited a higher percentage of males, young adults, racial/ethnic minorities, those with a high school education or less, and dependent smokers. Cost-effectiveness analyses compare favorably to traditional recruitment strategies, with costs as low as US $5-$8 per enrolled smoker. Conclusions: Developing and evaluating new ways to increase consumer demand for evidence-based cessation services is critical to cost-efficiently reduce population smoking prevalence. Results suggest that online advertising is a promising approach to recruit smokers to Web- and telephone-based cessation interventions. The enrollment rate of 9.1% exceeds most studies of traditional recruitment approaches. The powerful targeting capabilities of online advertising present new opportunities to reach subgroups of smokers who may not respond to other forms of advertising. Online advertising also provides unique evaluation opportunities and challenges to determine rigorously its impact and value.

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

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.

Henningfield JE; Santora PB; Bickel WK, eds. Addiction Treatment: Science and Policy for the Twenty-first Century. Baltimore: Johns Hopkins University Press, 2007. (Chapter refs refs.)

This edited book, with chapters provided by leaders in the field, is intended to stimulate discussion of significant issues and provoke discussion in respect to the emergent field of addiction medicine. It is divided into three sections. The first sets forth the dominant treatment models as well as the emerging science. Among the topics considered are loss of control, motivation, reward, nutrition, and evidenced based treatment models. The second section considers special populations, considering among others pregnant women, adolescents, those with HIV or at risk for acquiring HIV, and the presence and response to substance abuse problems for those in criminal justice system, as well as those seen in trauma units. The third section is directed to policy and health care issues. Among the issues covered is the divergence between popular understanding and scientific knowledge, matters related to social justice, behavioral interventions, confidentiality, the marketing of alcohol to youth, and the role of the Food and Drug Administration.

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.

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.

Hudson S; Hudson D; Peloza J. Meet the parents: A parents' perspective on product placement in children's films. Journal of Business Ethics 80(2): 289-304, 2008. (56 refs.)

The ethics of advertising to children has been identified as one of the most important topics worthy of academic research in the marketing field. A fast growing advertising technique is product placement, and its use in children's films is becoming more and more common. The limited evidence existing suggests that product placements are especially potent in their effects upon children. Yet regulations regarding placements targeted at children are virtually non-existent, with advertising guidelines suggesting that it remains the prime responsibility of the parents to provide guidance for children. This study measured the ethical evaluations of parents in the UK and Canada regarding product placements in children's films. After exposing parents to a four-type typology of product placements, results show that explicit placements of ethically charged products were perceived as the most unethical type of placements. Parents in the UK were more sensitive to the use of the technique and there was a significant difference in relativism between the two groups. Both sets of respondents would like to see more regulation on the use of placements, especially placements of alcohol, tobacco and fast foods.

Hurtz SQ; Henriksen L; Wang Y; Feighery EC; Fortmann SP. The relationship between exposure to alcohol advertising in stores, owning alcohol promotional items, and adolescent alcohol use. Alcohol and Alcoholism 42(2): 143-149, 2007. (41 refs.)

Aim: This paper describes adolescents' exposure to alcohol advertising in stores and to alcohol-branded promotional items and their association with self-reported drinking. Methods: A cross-sectional survey was administered in non-tracked required courses to sixth, seventh, and eighth graders (n = 2125) in three California middle schools. Logistic regressions compared the odds of ever (vs. never) drinking and current (vs. ever) drinking after controlling for psychosocial and other risk factors for adolescent alcohol use. Results: Two-thirds of middle school students reported at least weekly visits to liquor, convenience, or small grocery stores where alcohol advertising is widespread. Such exposure was associated with higher odds of ever drinking, but was not associated with current drinking. One-fifth of students reported owning at least one alcohol promotional item. These students were three times more likely to have ever tried drinking and 1.5 times more likely to report current drinking than students without such items. Conclusions: This study provides clear evidence of an association of adolescent drinking with weekly exposure to alcohol advertising in stores and with ownership of alcohol promotional items. Given their potential influence on adolescent drinking behaviour, retail ads, and promotional items for alcohol deserve further study.

Ibrahim JK; Glantz SA. The rise and fall of tobacco control media campaign (1967-2006). American Journal of Public Health 97(8): 1383-1396, 2007. (88 refs.)

Extensive research has demonstrated that public education through media campaigns is an effective means to reduce smoking prevalence and tobacco consumption. Aggressive media campaigns that confront the tobacco industry's deceptive practices are most effective and are therefore a prime target for attack. The tobacco industry has attacked public tobacco control media campaigns since 1967, when the first public tobacco control media advertisements ran. Through studying tobacco control media campaigns in Arizona, California, Florida, Massachusetts, Minnesota, and Oregon, and of the American Legacy Foundation, we identified industry strategies to prevent a campaign's creation, limit the target audience and the content of the messages, limit or eliminate the campaign's funding, and pursue litigation against the campaigns. Tobacco control advocates must learn from the past and continue to confront the tobacco industry and its third-party allies to defend antitobacco media campaigns or, despite evidence of their effectiveness, they will be eliminated.

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.

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 DH. The global alcohol industry: An overview. (review). Addiction 104(Supplement 1): 6-12, 2009. (40 refs.)

To describe the globalized sector of the alcoholic beverage industry, including its size, principal actors and activities. Market research firms and business journalism are the primary sources for information about the global alcohol industry, and are used to profile the size and membership of the three main industry sectors of beer, distilled spirits and wine. Branded alcoholic beverages are approximately 38% of recorded alcohol consumption world-wide. Producers of these beverages tend to be large multi-national corporations reliant on marketing for their survival. Marketing activities include traditional advertising as well as numerous other activities, such as new product development, product placement and the creation and promotion of social responsibility programs, messages and organizations. The global alcohol industry is highly concentrated and innovative. There is relatively little public health research evaluating the impact of its many marketing activities.

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

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.

Kang YH; Cappella JN; Strasser AA; Lerman C. The effect of smoking cues in antismoking advertisements on smoking urge and psychophysiological reactions. Nicotine & Tobacco Research 11(3): 254-261, 2009. (37 refs.)

Studies have found that smoking-related cues elicit smoking urges in addicted smokers. This work presents the first cue-reactivity study in the context of antismoking advertisements. Using a two (no cue vs. smoking cue) by two (high vs. low argument strength) mixed design, we tested the hypothesis that smoking cues presented in antismoking advertisements elicit smoking urges. The study tested 96 adult smokers using both self-reported and psychophysiological measures of smoking urge. It also explored gender differences during the urge elicitation. Smoking cues in antismoking advertisements elicited smoking urges in the weak argument condition. Antismoking advertisements with smoking cues and weak antismoking arguments could produce boomerang effects on smokers through urge elicitation.

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.

Lum KL; Polansky JR; Jackler RK; Glantz SA. Signed, sealed and delivered: "big tobacco"in Hollywood, 1927-1951. Tobacco Control 17(5): 313-323, 2008. (67 refs.)

Objective: Smoking in movies is associated with adolescent and young adult smoking initiation. Public health efforts to eliminate smoking from films accessible to youth have been countered by defenders of the status quo, who associate tobacco imagery in "classic"movies with artistry and nostalgia. The present work explores the mutually beneficial commercial collaborations between the tobacco companies and major motion picture studios from the late 1920s through the 1940s. Methods: Cigarette endorsement contracts with Hollywood stars and movie studios were obtained from internal tobacco industry documents at the University of California, San Francisco ( UCSF) Legacy Tobacco Documents Library and the Jackler advertising collection at Stanford. Results: Cigarette advertising campaigns that included Hollywood endorsements appeared from 1927 to 1951, with major activity in 1931-2 and 1937-8 for American Tobacco Company's Lucky Strike, and in the late 1940s for Liggett & Myers' Chesterfield. Endorsement contracts and communication between American Tobacco and movie stars and studios explicitly reveal the cross-promotional value of the campaigns. American Tobacco paid movie stars who endorsed Lucky Strike cigarettes US$218,750 in 1937-8 ( equivalent to US$3.2 million in 2008) for their testimonials. Conclusions: Hollywood endorsements in cigarette advertising afforded motion picture studios nationwide publicity supported by the tobacco industry's multimillion US dollar advertising budgets. Cross-promotion was the incentive that led to a synergistic relationship between the US tobacco and motion picture industries, whose artefacts, including "classic"films with smoking and glamorous publicity images with cigarettes, continue to perpetuate public tolerance of onscreen smoking. Market-based disincentives within the film industry may be a solution to decouple the historical association between Hollywood films and cigarettes.

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.

McCreanor T; Barnes HM; Kaiwai H; Borell S; Gregory A. Creating intoxigenic environments: Marketing alcohol to young people in Aotearoa New Zealand. Social Science & Medicine 67(6): 938-946, 2008. (58 refs.)

Alcohol consumption among young people in New Zealand is on the rise. Given the broad array of acute and chronic harms that arise from this trend, it is a major cause for alarm and it is imperative that we improve our knowledge of key drivers of youth drinking. Changes wrought by the neoliberal political climate of deregulation that characterised the last two decades in many countries including Aotearoa (Aotearoa is a Maori name for New Zealand) New Zealand have transformed the availability of alcohol to young people. Commercial development of youth alcohol markets has seen the emergence of new environments, cultures and practices around drinking and intoxication but the ways in which these changes are interpreted and taken up are not well understood. This paper reports findings from a qualitative research project investigating the meaning-making practices of young people in New Zealand in response to alcohol marketing. Research data included group interviews with a range of Maori and Pakeha young people at three time periods. Thematic analyses of the youth data on usages of marketing materials indicate naturalisation of tropes of alcohol intoxication. We show how marketing is used and enjoyed in youth discourses creating and maintaining what we refer to as intoxigenic social environments. The implications are considered in light of the growing exposure of young people to alcohol marketing in a discussion of strategies to manage and mitigate its impacts on behaviour and consumption.

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. Litigation and alcohol policy: Lessons from the US tobacco wars. (review). Addiction 104(Supplement 1): 27-33, 2009. (19 refs.)

This paper explores the role of litigation in preventing alcohol-related harms, identifying lessons from the use of litigation in tobacco control policy in the United States. It analyzes the key components of litigation in an international context, provides a case study of its potential use in addressing the marketing of alcopops to youth and offers recommendations for pursuing litigation strategies in future alcohol policy efforts. The paper's analyses are based on both original and secondary legal research. State and federal case law and secondary sources are reviewed in assessing lessons learned from tobacco litigation in the United States and the potential role of litigation in alcohol policy, both in the United States and internationally. Assessment of alcohol litigation cases and state and federal laws and regulations provides the foundation for the alcopops case study. The tobacco litigation experience demonstrates that litigation is a powerful tool in addressing aggressive marketing by purveyors of addictive products such as alcohol. To be effective at both national and international levels, litigation should encompass a broad array of legal tactics designed to identify and restrict unfair, deceptive and misleading alcohol marketing tactics and should be utilized in conjunction with complementary prevention strategies. Research conducted on the impact of alcohol marketing on youth alcohol consumption and problems is needed to support potential litigation claims. Developing litigation expertise within the alcohol policy field and building collaboration with litigation specialists in tobacco control should also be considered a high priority.

Murphy-Hoefer R; Hyland A; Higbee C. Perceived effectiveness of tobacco counter-marketing advertisements among young adults. American Journal of Health Behavior 32(6): 725-734, 2008. (44 refs.)

Objectives: To measure relative effectiveness of tobacco counter-marketing advertisements by category and emotive execution style among young adults. Methods: Participants (n=1011) from 2 US 4-year colleges, one southern and one northern were surveyed before and after viewing advertisements in one of 3 categories: social norms, health consequences, or tobacco industry manipulation and with 4 emotive execution styles: drama, testimonial (negative emotive) and humor, sarcasm (positive). Results: Health consequences and negative emotive advertisements were rated significantly most persuasive. Conclusions: This is the first study to support the effectiveness of tobacco countermarketing advertisements emphasizing the negative emotive health consequences of smoking among young adults.

Nichter M; Padmawati S; Danardono M; Ng N; Prabandari Y; Nichter M. Reading culture from tobacco advertisements in Indonesia. Tobacco Control 18(2): 98-107, 2009. (45 refs.)

Background: Tobacco advertising in Indonesia is among the most aggressive and innovative in the world, and tobacco advertisements saturate the environment. Tobacco companies are politically and financially powerful in the country because they are one of the largest sources of government revenue. As a result, there are few restrictions on tobacco marketing and advertising. National surveys reveal that 62% of men and 1% to 3% of women are smokers. Over 90% of smokers smoke clove cigarettes (kretek). This paper examines the social and cultural reasons for smoking in Indonesia and discusses how the tobacco industry reads, reproduces and works with culture as a means of selling cigarettes. An analysis is provided of how kretek tobacco companies represent themselves as supporters of Indonesian national identity. This analysis is used to identify strategies to break the chains of positive association that currently support widespread smoking. Methods: Between November 2001 and March 2007, tobacco advertisements were collected from a variety of sources, including newspapers and magazines. Frequent photographic documentation was made of adverts on billboards and in magazines. Advertisements were segmented into thematic units to facilitate analysis. In all, 30 interviews were conducted with smokers to explore benefits and risks of smoking, perceptions of advertisements and brand preferences. Focus groups (n = 12) were conducted to explore and pretest counter advertisements. Results: Key themes were identified in tobacco advertisements including control of emotions, smoking to enhance masculinity and smoking as a means to uphold traditional values while simultaneously emphasising modernity and globalisation. Some kretek advertisements are comprised of indirect commentaries inviting the viewer to reflect on the political situation and one's position in society. Conclusions: After identifying key cultural themes in cigarette advertisements, our research group is attempting to engage the tobacco industry on "cultural ground'' to reduce consumption and social acceptability. To do this, we need to take back social spaces that the tobacco industry has laid claim to through advertising. Active monitoring and surveillance of tobacco advertising strategies is necessary and legislation and enforcement to curb the industry should be put in place.

Niederdeppe J; Farrelly MC; Wenter D. Media advocacy, tobacco control policy change and teen smoking in Florida. Tobacco Control 16(1): 47-52, 2007. (41 refs.)

Objective: To assess whether media advocacy activities implemented by the Florida Tobacco Control Program contributed to increased news coverage, policy changes and reductions in youth smoking. Methods: A content analysis of news coverage appearing in Florida newspapers between 22 April 1998 and 31 December 2001 was conducted, and patterns of coverage before and after the implementation of media advocacy efforts to promote tobacco product placement ordinances were compared. Event history analysis was used to assess whether news coverage increased the probability of enacting these ordinances in 23 of 67 Florida counties and ordinary least square (OLS) regression was used to gauge the effect of these policies on changes in youth smoking prevalence. Results: The volume of programme- related news coverage decreased after the onset of media advocacy efforts, but the ratio of coverage about Students Working Against Tobacco ( the Florida Tobacco Control Program's youth advocacy organisation) relative to other topics increased. News coverage contributed to the passage of tobacco product placement ordinances in Florida counties, but these ordinances did not lead to reduced youth smoking. Conclusion: This study adds to the growing literature supporting the use of media advocacy as a tool to change health- related policies. However, results suggest caution in choosing policy goals that may or may not influence health behaviour.

Niederdeppe J; Lliang X; Crock B; Skelton A. Media campaigns to promote smoking cessation among socioeconomically disadvantaged populations: What do we know, what do we need to learn, and what should we do now? (editorial). Social Science & Medicine 67(9): 1343-1355, 2008. (56 refs.)

Little is known about whether media campaigns are effective strategies to promote smoking cessation among socioeconomically disadvantaged populations or whether media campaigns May unintentionally maintain or widen disparities ill smoking cessation by socioeconomic Status (SES). This paper presents a systematic review of the literature on the effectiveness of media campaigns to promote smoking cessation among low SES populations in the USA and Countries with comparable political systems and demographic profiles such as Canada, Australia and Western European nations. We reviewed 29 articles, summarizing results from 18 studies, which made explicit statistical comparisons of media campaign effectiveness by SES, and 21 articles, summarizing results from 13 studies, which assessed the effectiveness of media campaigns targeted specifically to low SES populations. We find that there is considerable evidence that media campaigns to promote smoking cessation are often less effective, sometimes equally effective, and rarely more effective among socioeconomically disadvantaged populations relative to more advantaged populations. Disparities in the effectiveness of media campaigns between SES groups may occur at any of three stages: differences ill meaningful exposure, differences in motivational response, or differences in Opportunity to sustain long-term cessation. There remains a need to conduct research that examines the effectiveness of media campaigns by SES; these studies should employ research designs that are sensitive to various ways that SES differences in smoking cessation media effects might occur.

O'Brien KS; Kypri K. Alcohol industry sponsorship and hazardous drinking among sportspeople. Addiction 103(12): 1961-1966, 2008. (20 refs.)

To examine the nature and extent of alcohol industry sponsorship of sportspeople, and its association with drinking. A purposive sample of participants (n = 1279) from various sporting codes were asked whether they personally, their team, or club received free and/or discounted alcohol or funding from an alcohol industry body (e.g. pub, brewery, wholesaler); how much they received; and whether they felt they should drink their sponsor's product and/or at the sponsor's premises. Drinking behaviour was assessed with the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Alcohol industry sponsorship was reported by 47.8% of the sample. Of those sponsored, 47% reported receiving free and/or discounted alcohol products. In multivariate models, those receiving sponsorship at the individual, team and club level had AUDIT scores that were, on average, 2.4 points higher [95% confidence interval (CI): 0.70-4.09] than those who received no sponsorship. Receiving free and/or discounted alcohol (beta(adj) = 0.95, 95% CI: 0.01-1.88) and feeling that they should go to the sponsor's pub/club to drink (beta(adj) = 1.91, 95% CI: 0.85-2.98) were also associated with higher AUDIT scores. Provision of free or discounted alcoholic beverages was associated more strongly with AUDIT scores (beta(adj) = 1.56; 95% CI: 0.62-2.51) than other forms of sponsorship from the alcohol industry (e.g. provision of uniforms). Alcohol industry sponsorship of sportspeople, and in particular the provision of free or discounted alcoholic beverages, is associated with hazardous drinking after adjustment for a range of potential confounders. Sports administration bodies should consider the health and ethical risks of accepting alcohol industry sponsorship.

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.

Pulido C; Mok A; Brown SA; Tapert SF. Heavy drinking relates to positive valence ratings of alcohol cues. Addiction Biology 14(1): 65-72, 2009. (47 refs.)

A positive family history of alcohol use disorders (FH) is a robust predictor of personal alcohol abuse and dependence. Exposure to problem-drinking models is one mechanism through which family history influences alcohol-related cognitions and drinking patterns. Similarly, exposure to alcohol advertisements is associated with alcohol involvement and the relationship between affective response to alcohol cues and drinking behavior has not been well established. In addition, the collective contribution that FH, exposure to different types of problem-drinking models (e.g. parents, peers) and personal alcohol use have on appraisal of alcohol-related stimuli has not been evaluated with a large sample. We investigated the independent effects of FH, exposure to problem-drinking models and personal alcohol use on valence ratings of alcohol pictures in a college sample. College students (n = 227) completed measures of personal drinking and substance use, exposure to problem-drinking models, FH and ratings on affective valence of 60 alcohol pictures. Greater exposure to non-familial problem-drinkers predicted greater drinking among college students (beta = 0.17, P < 0.01). However, personal drinking was the only predictor of valence ratings of alcohol pictures (beta = -0.53, P < 0.001). Personal drinking level predicted valence ratings of alcohol cues over and above FH, exposure to problem-drinking models and demographic characteristics. This suggests that positive affective responses to alcohol pictures are more a function of personal experience (i.e. repeated heavy alcohol use) than vicarious learning.

Ray R; Chugh G. Portrayl of alcohol consumption in films: Does it influence? (commentary). Addiction 103(12): 1933-1934, 2008. (10 refs.)

Rehm J; Kanteres F. Alcohol and sponsorship in sport: Some much-needed evidence in an ideological discussion. (commentary). Addiction 103(12): 1967-1968, 2008. (6 refs.)

Ringold DJ. Responsibility and brand advertising in the alcoholic beverage market - The modeling of normative drinking behavior. (review). Journal of Advertising 37(1): 127-141, 2008. (108 refs.)

This review compares alcoholic beverage advertising, responsibility advertising, and media advocacy; considers their actual and desired impacts; describes and evaluates the controversy surrounding industry-sponsored responsibility campaigns; and identifies a number of issues that would benefit from additional research. Results indicate that alcoholic beverage advertising does not exert a material influence on total consumption or abuse, but models normative drinking behavior, and thus may actually inhibit alcohol misuse. Industry-sponsored responsibility efforts, like those sponsored by government and nonprofits, appear to affect desired changes, are perceived to be similar to government and nonprofit efforts, model desired drinking behaviors, and may be more effective with heavier drinkers.

Russell CA; Russell DW. Alcohol messages in prime-time television series. Journal of Consumer Affairs 43(1): 108-128, 2009. (78 refs.)

Alcohol messages contained in television programming serve as sources of information about drinking. To better understand the ways embedded messages about alcohol are communicated, it is crucial to objectively monitor and analyze television alcohol depictions. This article presents a content analysis of an eight-week sample of eighteen prime-time programs. Alcohol messages were coded based on modalities of presentation, level of plot connection, and valence. The analysis reveals that mixed messages about alcohol often coexist but the ways in which they are presented differ: whereas negative messages are tied to the plot and communicated verbally, positive messages are associated with subtle visual portrayals.

Russell DW; Russell CA. Embedded alcohol messages in television series: The interactive effect of warnings and audience connectedness on viewers' alcohol beliefs. Journal of Studies on Alcohol and Drugs 69(3): 459-467, 2008. (43 refs.)

Objective: This research investigates whether warning viewers about the presence of embedded messages in the content of a television episode affects viewers' drinking beliefs and whether audience connectedness moderates the warning's impact. Method: Two hundred fifty college students participated in a laboratory experiment approximating a real-life television viewing experience. They viewed an actual television series episode containing embedded alcohol messages, and their subsequent beliefs about alcohol consequences were measured. Experimental conditions differed based on a 2 (Connectedness Level: low vs high) x 2 (Timing of the Warning: before or after the episode) x 2 (Emphasis of Warning: advertising vs health message) design. Connectedness was measured, and the timing and emphasis of the warnings were manipulated. The design also included a control condition where there was no warning. Results: The findings indicate that warning viewers about embedded messages in the content of a program can yield significant differences in viewers' beliefs about alcohol. However, the warning's impact differs depending on the viewers' level of connectedness to the program. In particular, in comparison with the no-warning control condition, the advertising prewarning produced lower positive beliefs about alcohol and its consequences but only for the low-connected viewers. Highly connected viewers were not affected by a warning emphasizing advertising messages embedded in the program, but a warning emphasizing health produced significantly higher negative beliefs about drinking than in the control condition. Conclusions: The presence of many positive portrayals of drinking and alcohol product placements in television series has led many to suggest ways to counter their influence. However, advocates of warnings should be conscious of their differential impact on high- and low-connected viewers.

Sargent JD; Gibson J; Heatherton TF. Comparing the effects of entertainment media and tobacco marketing on youth smoking. Tobacco Control 18(1): 47-53, 2009. (46 refs.)

Objectives: To examine the concurrent effects of exposure to movie smoking and tobacco marketing receptivity on adolescent smoking onset and progression. Methods: Cross-sectional study of 4524 northern New England adolescents aged 10-14 in 1999 with longitudinal follow-up of 2603 baseline never-smokers. Cross-sectional outcomes included ever tried smoking and higher level of lifetime smoking among 784 experimenters. The longitudinal outcome was onset of smoking among baseline never-smokers two years later. Movie smoking exposure was modelled as four population quartiles, tobacco marketing receptivity included two levels having a favourite tobacco advert and wanting/owning tobacco promotional items. All analyses controlled for sociodemographics, other social influences, personality characteristics of the adolescent and parenting style. Results: In the full cross-sectional sample, 17.5% had tried smoking; both exposure to movie smoking and receptivity to tobacco marketing were associated with having tried smoking. Among experimental smokers, the majority (64%) were receptive to tobacco marketing, which had a multivariate association with higher level of lifetime smoking (movie smoking did not). In the longitudinal study 9.5% of baseline never-smokers tried smoking at follow-up. Fewer never-smokers (18.5%) were receptive to tobacco marketing. Movie smoking had a multivariate association with trying smoking (receptivity to tobacco marketing did not). Conclusions: The results suggest separate roles for entertainment media and tobacco marketing on adolescent smoking. Both exposures deserve equal emphasis from a policy standpoint.

sBelstock SA; Connolly GN; Carpenter CM; Tucker L. Using alcohol to sell cigarettes to young adults: A content analysis of cigarette advertisements. Journal of American College Health 56(4): 383-389, 2008. (49 refs.)

Advertising influences the health-related behaviors of college-aged individuals. Cigarette manufacturers aggressively market to young adults and may exploit their affinity for alcohol when creating advertisements designed to increase cigarettes appeal. Internal tobacco industry documents reveal that cigarette manufacturers understood the popularity of alcohol among young adults and sought to produce pertinent marketing strategies. Methods: The authors conducted a content analysis of cigarette and alcohol advertisements in young adult-oriented magazines to investigate portrayed associations between cigarettes and alcohol. Results: The content analysis revealed that 32 of 114 cigarette advertisements referenced alcohol and that those advertisements were more likely than others to portray active smoking. Conversely, 0 of 317 alcohol advertisements referenced cigarettes, and alcohol advertisements were only slightly more likely than cigarette advertisements feature alcohol-related settings. Conclusions: Such advertising may detrimentally affect smoking patterns of college students. An understanding of these strategies can benefit on-campus tobacco control efforts.

Scheffels J. A difference that makes a difference: Young adult smokers' accounts of cigarette brands and package design. Tobacco Control 17(2): 118-122, 2008. (47 refs.)

Objective: To explore young adult smokers' construction of meaning and identity in accounts of cigarette brands and cigarette package design, and the processes by which positive associations with a brand may be reinforced and sustained. Methods: Qualitative in-depth interviews with 21 smokers aged 18-23 in Norway, where advertising for tobacco has been banned since 1975. Results: Cigarette brand and cigarette package design appear as an integrated part of young smokers' constructions of smoker identities, enabling the communication of personal characteristics, social identity and positions in hierarchies of status. Conclusion: Through branding and package design tobacco companies appear to be able to promote their products in a country where advertising is banned, by means of similar principles that make advertising effective: by creating preferences, differentiation and identification.

Sheron N; Olsen N; Gilmore I. An evidence-based alcohol policy. Gut 57(10): 1341-1344, 2008. (30 refs.)

In the last 30 years of the 20th century deaths from liver cirrhosis steadily increased, in people aged 35 to 44 years the death rate went up 8-fold in men and almost 7-fold in women, in 25-34 year-olds a 4-fold increase was seen over the 30 year period. The UK situation is in stark contrast to the decrease in liver mortality in Mediterranean countries over the same period of time. So why is the UK facing this increase in liver deaths when mortality elsewhere is falling? According to death certification data more than 80% of UK liver deaths are due to alcohol-related cirrhosis. Other causes of liver disease are also increasing; for example, steatosis and viral hepatitis, but only 205 out of 6889 reported liver deaths in 2005 were due to viral hepatitis.2 While viruses and, more importantly, steatosis secondary to obesity may be co-factors in some cases, the evidence suggests that it is our drinking habits that are the problem. Alcoholic drinks have also increased in strength, 5% alcohol by volume (bv) lager has largely replaced 3.5% bv beer, a 40% increase. Similarly, most wine sold at supermarkets is no longer 10-12% but 14-15% bv, the point at which duty increases to the next threshold. Promotion includes �250 million spent on direct alcohol advertising and a greater sum spent on other forms of marketing, much of it directed towards young people. These marketing techniques include the sale of alcohol in larger measures, a large pub measure of wine contains around 3.5 units, an increase of 350%. Similarly, spirits measures in many pubs have gone up from 25 to 35 cl, a 40% increase. Finally, the retail outlets have changed markedly. Pubs, particularly in city centres, have become standing-only (vertical drinking) establishments with extended hours, and off-sales outlets have become dominated by supermarkets, whose purchasing power encourages heavy discounting and loss-leaders. Traditional pubs and independent wine and spirit merchants have struggled against this competition.

Siahpush M; Wakefield M; Spittal M; Durkin S. Antismoking television advertising and socioeconomic variations in calls to Quitline. Journal of Epidemiology and Community Health 61(4): 298-301, 2007. (34 refs.)

Objective: To assess the socioeconomic variations in call rates to the Quitline (Victoria, Australia) and in the impact of anti-tobacco television advertising on call rates. Design: The outcome measure was the number of calls to the Quitline in Victoria for each week for each socioeconomic group for the period January 2001 to March 2004. Socioeconomic status (SES) was derived from the caller's postcode using the Index of Socioeconomic Disadvantage provided by the Australian Bureau of Statistics. The exposure measure was weekly Target Audience Rating Points (TARPs, a standard measure of television advertising weight) for anti-tobacco advertising broadcast in Victoria over the same period. Negative binomial regression was used to examine the interaction of SES and TARPs in their effect on the number of Quitline calls. Results: SES and call rates were positively associated. Adjusted call rate was 57% (95% CI 45% to 69%) higher in the highest than the lowest SES quintile. SES differences in call rates were stable over time. In the study period, the effect of the presence or increasing levels of antismoking TARPs on call rates did not vary across categories of SES. Conclusions: In the study period, different SES groups had a similar level of responsiveness to antismoking television advertisements, at least as measured by the rate of calls to the Quitline. However, the present media campaigns are not likely to diminish SES differences in call rates, and more needs to be done to encourage disadvantaged groups to call the Quitline.

Slater SJ; Chaloupka FJ; Wakefield M; Johnston LD; O'Malley PM. The impact of retail cigarette marketing practices on youth smoking uptake. Archives of Pediatrics & Adolescent Medicine 161(5): 440-445, 2007. (31 refs.)

Objective: To examine the differential associations of cigarette retail marketing practices on youth smoking uptake. Design: Analyses from annual, nationally representative, cross-sectional surveys of 8th, 10th, and 12th graders in the United States. Setting: The February 1999 through June 2003 Monitoring the Future surveys involved 109 308 students and data on retail cigarette marketing collected from 966 communities in which the students reside, as part of the Bridging the Gap Initiative: Research Informing Practice and Policy for Healthy Youth Behavior. Participants: A total of 26 301 students were selected for this study. Main Exposures: Point-of-sale advertising, promotions, prices, and placement. Outcome Measure: Using a smoking uptake measure to account for stages that identify the process by which adolescents begin smoking, we calculated odds ratios and confidence intervals through generalized ordered logit analyses, with weighted data that controlled for demographic and socioeconomic characteristics and accounted for clustering at the community level. Results: Higher levels of advertising, lower cigarette prices, and greater availability of cigarette promotions were associated with smoking uptake. Advertising increased the likelihood of youth initiating smoking, price increased the likelihood of smoking at most levels of uptake, and availability of promotions increased the likelihood that youth will move from experimentation to regular smoking. Conclusions: Cigarette retail marketing practices increase the likelihood of smoking uptake. These findings suggest that specific restrictions on retail cigarette marketing may reduce youth smoking.

Smith EA; Thomson K; Offen N; Malone RE. "If you know you exist it's just marketing poison": Meanings of tobacco industry targeting in the lesbian, gay, bisexual, and transgender community. American Journal of Public Health 98(6): 996-1003, 2008. (39 refs.)

In the public health literature, it is generally assumed that the perception of "targeting" as positive or negative by the targeted audience depends on the product or message being promoted. Smoking prevalence rates are high among lesbian, gay, bisexual, and transgencler (LGBT) individuals, but little is known about how they perceive tobacco industry targeting. We conducted focus groups with LGBT individuals in 4 US cities to explore their perceptions. Our findings indicated that focus group participants often responded positively to tobacco company targeting. Targeting con-noted community visibility, legitimacy, and economic viability. Participants did not view tobacco as a gay health issue. Targeting is a key aspect of corporate-community interaction. A better understanding of targeting may aid public health efforts to counter corporate disease promotion.

Strasser AA; Cappella JN; Jepson C; Fishbein M; Tang KZ; Han E et al. Experimental evaluation of antitobacco PSAs: Effects of message content and format on physiological and behavioral outcomes. Nicotine & Tobacco Research 11(3): 293-302, 2009. (59 refs.)

Antitobacco media campaigns using public service announcements (PSAs) have shown promise in reducing smoking initiation and increasing intentions to quit. Research on what makes an effective PSA has had mixed outcomes. The present study tested the effects of specific message features in antitobacco PSAs, using theory-based physiological and self-report outcomes. PSAs were categorized as high or low in message sensation value (MSV) and strength of argument and presented to 200 current smokers in a 2 x 2 factorial design. Physiological responses-025EFspecifically, heart rate, skin conductance, zygomaticus major, and corrugator supercilii-025EFwere assessed while participants viewed the PSAs. Beliefs, attitudes, efficacy, norms, and intentions to quit were assessed immediately following viewing. Corrugator activity was significantly greater in the high MSV condition. Among those low in sensation seeking, low MSV PSAs elicited higher self-efficacy, whereas the reverse was true for high sensation seekers. High MSV PSAs elicited higher negative beliefs in low sensation seekers. Adding physiological measures to a model predicting intention to quit did not improve the explained variance. The present study represents the first comprehensive theory-based experimental investigation of the effects of different features of antitobacco PSAs and provides a framework for future research in identifying effective features of such PSAs. Results illustrate the importance of considering individual differences, characterizing both PSA content and format, and outcome and response measures when evaluating antitobacco PSAs.

Strasser AA; Tang KZ; Tuller MD; Cappella JN. PREP advertisement features affect smokers' beliefs regarding potential harm. Tobacco Control 17(Supplement 1): i32-i38, 2008. (27 refs.)

Background: The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective: To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. Methods: A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red'' condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text'' condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect,'' "unsure'' and "correct'' as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results: Participants randomised to the "no text'' advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Conclusions: Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Tangari AH; Burton S; Andrews JC; Netemeyer RG. How do antitobacco campaign advertising and smoking status affect beliefs and intentions? Some similarities and differences between adults and adolescents. Journal of Public Policy and Marketing 26(1): 60-74, 2007. (56 refs.)

This article presents two studies that examine similarities and differences with respect to how adults and adolescents process and respond to information in an antitobacco ad campaign. Study 1 examines (1) the effects of antitobacco advertising campaign measures (e.g., campaign advertisement integration, perceived strength of ad-based messages, attitude toward the ad campaign) on four key adult antismoking beliefs and (2) the influence of these campaign evaluations and beliefs on smokers' intentions to quit smoking, Hierarchical regression results show that antismoking ad campaign reactions explain substantial additional variance in beliefs about tobacco industry deceptiveness, smoking addictiveness, harmfulness of secondhand smoke, and restrictions on smoking at different public venues. The findings also show that the campaign variables as a whole are positively related to intentions to quit smoking, beyond the variance that is explained by demographics. In Study 2, the authors replicate and extend these findings for the campaign using similar measures and procedures for a sample of more than 900 adolescents. They draw comparisons between these adult and adolescent findings and offer some implications for potential corrective advertising for consumers' beliefs about smoking that may be required of tobacco companies based on U.S. v. Philip Morris USA, Inc.

Thombs DL; O'Mara R; Dodd VJ; Hou W; Merves ML; Weiler RM et al. A field study of bar-sponsored drink specials and their associations with patron intoxication. Journal of Studies on Alcohol and Drugs 70(2): 206-214, 2009. (25 refs.)

Objective: The study examined associations between bar-sponsored drink specials and alcohol intoxication at the patron level. Method: Data were collected in a college bar district located in a large campus community in the southeastern United States. Random and self-selected samples of patrons were interviewed after exiting college bars at night on four different nights (N = 383). Anonymous interview and questionnaire data were collected as well as breath alcohol concentration (BrAC) readings. Results: Significant gender differences existed in patron drinking practices. Women were more likely to take advantage of drink specials, whereas men reported greater alcohol expenditures, consumed more drinks, and drank for longer periods of time. Gender differences in BrAC were very small and not meaningful. Patrons who did not take advantage of drink specials reported consuming more drinks before bar entry than patrons who did participate in these promotions. Participation in "all-you-can-drink" promotions was significantly associated with higher BrAC readings after adjusting for covariates and random effects attributable to drinking establishment. Other drink specials did not have significant associations with alcohol intoxication. Conclusions: The all-you-can-drink special may be the specific discounting practice with the greatest potential for boosting patron intoxication and thus may need to be a stronger focus of alcohol-control policies aimed at improving the beverage service of drinking establishments.

Wakefield M; Germain D; Henriksen L. The effect of retail cigarette pack displays on impulse purchase. Addiction 103(2): 322-328, 2008. (43 refs.)

Aims: To assess the extent to which point-of purchase (POP) cigarette displays stimulate impulse purchases. Design: Telephone-administered population survey. Setting Victoria, Australia. Participants: A total of 2996 adults, among whom 526 smoked factory-made cigarettes and 67 were recent quitters (quit in the past 12 months). Measurements: Reported cigarette purchase behaviour; perceived effect on smoking of removing cigarettes from view in retail outlets; reported urges to buy cigarettes as a result of seeing the cigarette display. Findings When shopping for items other than cigarettes, 25.2% of smokers purchased cigarettes at least sometimes on impulse as a result of seeing the cigarette display. Thirty-eight per cent of smokers who had tried to quit in the past 12 months and 33.9% of recent quitters experienced an urge to buy cigarettes as a result of seeing the retail cigarette display. One in five smokers trying to quit and one in eight recent quitters avoided stores where they usually bought cigarettes in case they might be tempted to purchase them. Many smokers (31.4%) thought the removal of cigarette displays from stores would make it easier for them to quit. Conclusions: POP cigarette displays act as cues to smoke, even among those not explicitly intending to buy cigarettes, and those trying to avoid smoking. Effective POP marketing restrictions should encompass cigarette displays.

Wakefield MA; Germain D; Durkin SJ. How does increasingly plainer cigarette packaging influence adult smokers' perceptions about brand image? An experimental study. Tobacco Control 17(6): 416-421, 2008. (33 refs.)

Background: Cigarette packaging is a key marketing strategy for promoting brand image. Plain packaging has been proposed to limit brand image, but tobacco companies would resist removal of branding design elements. Method: A 3 (brand types) 64 (degree of plain packaging) between-subject experimental design was used, using an internet online method, to expose 813 adult Australian smokers to one randomly selected cigarette pack, after which respondents completed ratings of the pack. Results: Compared with current cigarette packs with full branding, cigarette packs that displayed progressively fewer branding design elements were perceived increasingly unfavourably in terms of smokers' appraisals of the packs, the smokers who might smoke such packs, and the inferred experience of smoking a cigarette from these packs. For example, cardboard brown packs with the number of enclosed cigarettes displayed on the front of the pack and featuring only the brand name in small standard font at the bottom of the pack face were rated as significantly less attractive and popular than original branded packs. Smokers of these plain packs were rated as significantly less trendy/stylish, less sociable/outgoing and less mature than smokers of the original pack. Compared with original packs, smokers inferred that cigarettes from these plain packs would be less rich in tobacco, less satisfying and of lower quality tobacco. Conclusion: Plain packaging policies that remove most brand design elements are likely to be most successful in removing cigarette brand image associations.

Winter MV; Donovan RJ; Fielder LJ. Exposure of children and adolescents to alcohol advertising on television in Australia. Journal of Studies on Alcohol and Drugs 69(5): 676-683, 2008. (59 refs.)

Objective: This article reports the extent to which children (0-12 years) and teenagers below the legal drinking age in Australia ( 1317 years) were exposed to alcohol advertising on free-to-air television in Sydney, Australia, during the period from March 2005 to February 2006. Method: Exposure levels were obtained from weekly Target Audience Rating Points (TARPs) data generated by OzTAM, the official Australian television audience monitoring system. (The TARPs figure for an advertisement is calculated based on the number of individuals from a target audience [e.g., 13- to 17-year-olds] exposed to the ad as a proportion of the total number of individuals within the target audience, multiplied by 100). Exposure levels were obtained for four age groups-up to 12 years, 13-17 years, 18-24 years, and 25 years and older-for 156 different ads for 50 brands. Results: Adults 25 years and older were most exposed to alcohol advertising: approximately 660 TARPs per week. The level to which underage teenagers (13-17 years) were exposed to alcohol advertising was virtually identical to that of young adults (18-24 years): 426 TARPs per week vs 429 TARPs per week. Children (0-12 years) were exposed to approximately one in every three alcohol ads seen on average by mature adults (ages 25 years and older). Conclusions: This study found that Australian children and teenagers below the legal drinking age currently are exposed to unacceptably high levels of alcohol advertising on television. These findings suggest that alcohol marketers may be deliberately targeting underage adolescents. At the very least the findings highlight the need for action to be taken to reduce levels to which underage Australians are exposed to alcohol advertising on television.

Zee AV. The promotion and marketing of OxyContin: Commercial triumph, public health tragedy. (editorial). American Journal of Public Health 99(2): 221-227, 2009. (70 refs.)

I focus on issues surrounding the promotion and marketing of controlled drugs and their regulatory oversight. Compared with noncontrolled drugs, controlled drugs, with their potential for abuse and diversion, pose different public health risks when they are overpromoted and highly prescribed. An in-depth analysis of the promotion and marketing of OxyContin illustrates some of the associated issues. Modifications of the promotion and marketing of controlled drugs by the pharmaceutical industry and an enhanced capacity of the Food and Drug Administration to regulate and monitor such promotion can have a positive impact on the public health.

Zeigler DW. The alcohol industry and trade agreements: A preliminary assessment. (review). Addiction 104(Supplement 1): 13-26, 2009. (102 refs.)

To review trade agreements, their relation to alcohol control policy and examine the role of the alcohol industry in supporting and attempting to influence trade policy. Review of peer review, public health advocacy literature (both pro and con on free trade), business, press and government documents on trade agreements, assess current and potential challenges by trade agreements to alcohol control policy and investigate the means and extent of industry influence in trade agreements. 'Free' trade agreements reduce trade barriers, increase competition, lower prices and promote alcohol consumption. However, international treaties, negotiated by free trade experts in close consultation with corporate lobbyists and without significant, if any, public health input, governments and corporations contain significant provisions that will result in increased alcohol consumption and may challenge public health measures of other nations as constraints on trade. Conversely, alcohol control measures seek to reduce access and consumption, raise prices and restrict advertising and product promotion. The prospect is for increased alcohol consumption and concomitant problems throughout the world. Trade agreements challenge effective alcohol control policies. The alcohol industry seeks to influence agreements and can be expected to work through trade agreements to reduce tariffs, increase market access and seek to restrict effective domestic regulations. Further research is needed on the impact of trade agreements and the ongoing role of the industry. Advocates must recognize the inherent conflicts between unbridled free trade and public health, work to exclude alcohol from trade agreements, counter industry influence and protect alcohol control policies.