Fight Fire With Fire, Smoking Foes Urged

TUESDAY, June 11, 2002 (HealthDayNews) -- To ease Big Tobacco's grip on America's young people, two researchers argue that public health crusaders must fight fire with fire by turning the industry's own highly successful marketing tactics against it.

The goal of the campaign is clear: People, and especially the young, need to know that smokers harm not only themselves but those around them.

"There are certain areas that are weak spots for the industry, and public health advocates should exploit those weak spots more," said Dr. Pamela Ling, a tobacco policy researcher at the University of California at San Francisco (UCSF).

Ling and her UCSF colleague, Stanton Glantz, pored over roughly 100 marketing research reports and other industry documents in their analysis, which appears in tomorrow's Journal of the American Medical Association.

Much of the nation has come to view smoking as an obnoxious, dangerous habit. Yet Ling and Glantz found that cigarette makers facing this threat to profits have deployed ever more sophisticated -- and even scientific -- advertising tactics. Their efforts are aimed especially at young adults age 18 to 24, whose long-term brand loyalty means years of revenue.

Companies have broken their potential markets into detailed segments, from "female wallflowers" to "enlightened go-getters" and savers worried about the rising price of a pack of smokes. Mining those segments for their likes, dislikes, motivations, and hopes, the companies maximize the impact of their marketing messages. Pitches targeting one group, for example, present smoking as a tattoo of rebellion; to another, it's a hallmark of conformity, the researchers say.

This kind of "psychographics" hasn't been a part of the public health repertoire, Ling said, but it should be. "If you compare what the industry does to what the tobacco control movement does, there's a big gap," she said.

By straying a bit from data and demographics into the realm of marketing and lifestyle choices, she said, advocates could make a major dent in smoking rates. Since youth smoking habits are closely tied to those of slightly older adults, easing the industry's hold on the 18-to-24 segment is crucial.

Studies also show that young people, and particularly teens, smoke less when the cost of tobacco jumps. (The industry's introduction of discount brands reinforces this conclusion.) So, the researchers said, raising taxes on tobacco will further reduce smoking rates among young adult and teens.

About one in four American adults now smokes, according to the Centers for Disease Control and Prevention. Smoking is blamed for 430,000 deaths a year in this country, from lung cancer, heart disease, and other causes.

The U.S. Supreme Court has generally given public health measures little leeway when they impinge on commercial speech. Last year, for example, the court ruled that a Massachusetts law aimed at preventing underage use of tobacco violated the First Amendment.

The state had tried to impose a ban on outdoor tobacco ads within 1,000 feet of schools or playgrounds, and stop indoor ads posted less than five feet off the ground -- measures the Court found invalid for several reasons.

Ronald Bayer, a Columbia University tobacco researcher, and his colleagues have offered a way around the judicial quagmire. In a separate article also appearing in the journal, the Columbia researchers propose a set of restrictions on tobacco advertising they believe would meet the Supreme Court's free-speech standards.

Their three-pronged approach calls for taxes -- either on the ads themselves or a federally imposed tariff on packs of cigarettes -- to fund aggressive antismoking campaigns. It also seeks a requirement that ads in magazines and other print media devote at least half their space to warnings about the dangers of smoking. Finally, it wants a full side of every pack bearing a detailed list (and even images) of smoking's potential harms, from bad teeth to impotence. Such an approach is now being tried in Canada, though it's too soon to tell its impact.

Bayer said such measures are needed to transform smoking "into a behavior viewed as mad. It will take a kind of counter-advertising campaign that grabs people at the gut. It will take time, and a massive ad campaign will meet enormous resistance on the part of industry. But the time is ripe in the U.S."

Smoking has become so unpopular with the upper middle class that it has nearly ceased among the wealthy, despite Hollywood depictions to the contrary. An effective antismoking effort with counter-advertising could drive the nation's smoking rate below 10 percent, Bayer predicted.

Yet at least one First Amendment expert said the proposals are either impractical or on thin Constitutional ice. In an editorial accompanying the journal articles, the lawyer, Alan Morrison, argued that a trust fund from a federal tax would likely suffer the same fate as the billions the industry paid out in the Master Settlement Agreement -- pillaged by revenue-starved states for purposes having nothing to do with antismoking efforts.

As for the counter-advertising in tobacco ads, Morrison said, compelling a company to pay for a government sponsored message with which it "vehemently disagrees" has clear free speech conflicts. It may violate the Fifth Amendment, too, by raising the cost of company ad spending and giving nothing in return.

However, Bayer said he disagreed with that skepticism. The country is undergoing a "denormalization" of smoking that made once-radical constraints on the tobacco industry more palatable, Bayer said. "As the number of people who smoke continues to decline, the possibility of imposing greater restrictions may intensify."

Even if the current Supreme Court won't tolerate an all-out ban on tobacco ads, ultimately, Bayer said, only that drastic step will stop underage smoking -- and adult smoking, too, for that matter. "The evidence now is pretty clear that the kind of restrictions on ads that have been meat and potatoes for many years don't really work," he said, serving instead to shift marketing dollars from one medium to another. "The only restrictions that work are those that are total."

What To Do

For more on tobacco-control efforts, try the American Legacy Foundation or the Centers for Disease Control and Prevention.