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Stanford Research into the Impact of Tobacco Advertising

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Growing Up In Smoke – img12729

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Many anti-smoking advertisements use children as a motivation for adults to quit smoking. The two most common themes in this category are 1) your children are suffering from your secondhand smoke, and 2) that you are being a poor role model for your children.

These ads remind smokers that their “choice” to smoke not only negatively affects themselves as individuals, but also harms innocent bystanders and those whom the smokers love most.

Children are particularly vulnerable because they have no say in the smoking habits of the adults in close proximity to them. Children exposed to secondhand smoke wheeze and cough more often, get sick more often, and experience more frequent and more intense life-threatening asthma attacks than children not exposed to secondhand smoke. (1)

Other ads in this category concentrate on the example smokers set for their children. Multiple studies have shown that children whose parents smoke are much more likely to start smoking themselves than are their peers. These ads thus force smokers to think about the consequences of smoking not just for themselves, but for others as well.

While the primary goal of these ads is to increase the number of adult quitters, the ads may also have cascading effects on adolescents. Unfortunately, literature on the effectiveness of these children-themed ads on adult quitting rates is lacking, and there has not been extensive research on whether the ads persuade adults to talk to their children about smoking.

However, there is research on how parental smoking and parental behaviors affect smoking behaviors in children. Smoking socialization, which can include both directly transmitted knowledge of smoking through parental conversations with children and indirectly transmitted knowledge through parental smoking habits, has been shown to influence children’s future smoking habits. Exposure to second-hand smoke and a lack of anti-smoking expectations and smoking-specific rules are parenting behaviors associated with current smoking in adolescents and the likelihood of children to pick up smoking later in life.

Interestingly, one study noted that while parenting behaviors had a significant impact on smoking patterns in adolescents, actual parental smoking did not (2). The results of this study suggest that perhaps ads that focus on the health of children should be supplemented with parenting advice for adult smokers. A second study also supports the claim that “higher quality” parenting, which in this case was defined as “positive in affect and tone, responsive, directive, and empathetic,” was associated with a lower likelihood of smoking initiation in adolescents, further indicating the importance of smoking socialization between parent and child (3).

Though the primary purpose of these children-themed ads may not be to prevent smoking in adolescents, the ads may raise awareness in families about the influence parents can have on their children’s smoking behaviors. If these ads are supplemented with support and advice on parenting and how to talk to children about smoking, they may have the potential to reduce smoking not just in adults, but also in adolescents as well.

REFERENCES:

1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General: Secondhand Smoke: What It Means To You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2011 Mar 11].

2. Waa A, Edwards R, Newcombe R, Zhang J, Weerasekera D, Peace J, McDuff I. Parental behaviors, but not parental smoking, influence current smoking and smoking susceptibility among 15 and 15 year-old children. Aust NZ J Public Health 2011; 35: 530-536.

3. Richmond MJ, Mermelstein RJ, Wakschlag LS. Direction Observations of Parenting and Real-Time Negative Affect Among Adolescent Smokers and Nonsmokers. Journal of Clinical Child & Adolescent Psychology 2012; 0:1-12.

 

Bad Influence – img12726

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Many anti-smoking advertisements use children as a motivation for adults to quit smoking. The two most common themes in this category are 1) your children are suffering from your secondhand smoke, and 2) that you are being a poor role model for your children.

These ads remind smokers that their “choice” to smoke not only negatively affects themselves as individuals, but also harms innocent bystanders and those whom the smokers love most.

Children are particularly vulnerable because they have no say in the smoking habits of the adults in close proximity to them. Children exposed to secondhand smoke wheeze and cough more often, get sick more often, and experience more frequent and more intense life-threatening asthma attacks than children not exposed to secondhand smoke. (1)

Other ads in this category concentrate on the example smokers set for their children. Multiple studies have shown that children whose parents smoke are much more likely to start smoking themselves than are their peers. These ads thus force smokers to think about the consequences of smoking not just for themselves, but for others as well.

While the primary goal of these ads is to increase the number of adult quitters, the ads may also have cascading effects on adolescents. Unfortunately, literature on the effectiveness of these children-themed ads on adult quitting rates is lacking, and there has not been extensive research on whether the ads persuade adults to talk to their children about smoking.

However, there is research on how parental smoking and parental behaviors affect smoking behaviors in children. Smoking socialization, which can include both directly transmitted knowledge of smoking through parental conversations with children and indirectly transmitted knowledge through parental smoking habits, has been shown to influence children’s future smoking habits. Exposure to second-hand smoke and a lack of anti-smoking expectations and smoking-specific rules are parenting behaviors associated with current smoking in adolescents and the likelihood of children to pick up smoking later in life.

Interestingly, one study noted that while parenting behaviors had a significant impact on smoking patterns in adolescents, actual parental smoking did not (2). The results of this study suggest that perhaps ads that focus on the health of children should be supplemented with parenting advice for adult smokers. A second study also supports the claim that “higher quality” parenting, which in this case was defined as “positive in affect and tone, responsive, directive, and empathetic,” was associated with a lower likelihood of smoking initiation in adolescents, further indicating the importance of smoking socialization between parent and child (3).

Though the primary purpose of these children-themed ads may not be to prevent smoking in adolescents, the ads may raise awareness in families about the influence parents can have on their children’s smoking behaviors. If these ads are supplemented with support and advice on parenting and how to talk to children about smoking, they may have the potential to reduce smoking not just in adults, but also in adolescents as well.

REFERENCES:

1. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General: Secondhand Smoke: What It Means To You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2011 Mar 11].

2. Waa A, Edwards R, Newcombe R, Zhang J, Weerasekera D, Peace J, McDuff I. Parental behaviors, but not parental smoking, influence current smoking and smoking susceptibility among 15 and 15 year-old children. Aust NZ J Public Health 2011; 35: 530-536.

3. Richmond MJ, Mermelstein RJ, Wakschlag LS. Direction Observations of Parenting and Real-Time Negative Affect Among Adolescent Smokers and Nonsmokers. Journal of Clinical Child & Adolescent Psychology 2012; 0:1-12.

 

Brazil – img12827

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It is known that smoking cigarettes has numerous harmful effects on people’s health, and one tactic used to dissuade people from smoking is explicitly stating these effects on cigarette boxes via warning labels. People are more likely to see an anti-smoking message if it is present in the form of a label right on the outside of the cigarette box they are holding, which is why these pack warning labels can be an effective form of advertising.1

They can be text-only, like the ones on Winston cigarettes boxes in the UK that say “Smoking seriously harms you and others around you,” or also include graphic images, such as the ones in Brazil that include images ranging from a stillborn baby to a dismembered and blackened foot. One study “found that 50 percent of subjects remembered the text-only warning label, while 83 percent correctly recalled the label that contained a graphic image,” so it is a more effective advertising strategy to incorporate pictures on labels because the message will then be more memorable. In fact, “research on pictorial warnings show that they are: (i) more likely to be noticed than text-only warning labels; (ii) more effective for educating smokers about the health risks of smoking and for increasing smokers’ thoughts about the health risks; and (iii) associated with increased motivation to quit smoking.”2 Pictorial labels are also more effective at raising awareness of the health effects of smoking in areas with low literacy rates.2

However, a study on the effectiveness of Canadian warning labels shines light on the big issue of whether or not people stop to read and think about the warning labels, as people who do so are the ones who are “significantly more likely to either quit, attempt to quit, or reduce their smoking.”3 Another issue that is often brought up is the defensive and avoidant behavior that pictorial images may elicit, but in reality, “such reactions are actually indicators of positive impact” caused by the presence of graphic images.2

Resources:

1. http://www.cbsnews.com/news/study-graphic-tobacco-warning-labels-more-effective-at-delivering-anti-smoking-message/

2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733253/

3. http://tobaccocontrol.bmj.com/content/12/4/391.full.html

Industry Lies – img12279

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Many antismoking ads seek to counter the powerful tobacco industry by exposing the industry’s manipulative tactics and increasing counter-industry attitudes.

In 2006, together the five largest cigarette manufacturers spent $12.49 billion (more than $35 million a day) advertising their products, making tobacco products one of the most marketed products in the United States (1). The tobacco industry, with generations of trial, error, and experience behind it, has become increasingly persuasive. Smoking cigarettes kills about 443,000 people per year, making it the leading cause of preventable deaths in the US. Smoking kills more than HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. With these statistics, the tobacco industry needs to be relentless in its marketing efforts in order to replace the customers who die from smoking (2).

The most common approach taken by anti-industry ads is to reveal that the tobacco industry is manipulating its consumers. Many people who smoke know tobacco is bad for their health, yet they make a conscious “choice” to continue the habit. It is a “freedom” they are unwilling to relinquish, a “right” they won’t have stolen from them. However, many of these ads expose that this “choice” is not completely their own, and that in fact the tobacco industry has a significant influence on smokers through manipulative tactics.

The youth-targeted Truth Campaign, sponsored by the American Legacy Foundation, is one of the strongest advocators of this message. The campaign claims to be neither anti-smoking nor pro-smoking, stating that its mission is to “pull back the curtain” on the tobacco industry (thetruth.com).

Other counter-industry ads attempt to convince smokers that the relationship between the industry and its tobacco supporters may be more parasitic than mutualistic, with the tobacco industry reaping most of the profit and benefits while its consumers are left sick and dying. These anti-industry ads often quote internal tobacco industry documents and interviews to support their message. They also utilize statistics to put into perspective the amount of profit the tobacco industry is making from its consumers versus how many people are dying from tobacco products.

Various studies have examined the effectiveness of this counter-industry approach on adolescents and teens, the ads’ primary targets audience. This population is potentially more receptive to these messages because many of them begin smoking as a form of rebellion, self-discovery, and individuality (3); thus, it is considered effective to reveal to teens that smoking is actually not a means to be independent, since smokers are “controlled” by the industry.

The Truth campaign has been studied more extensively than any other statewide counter-industry campaigns, and some studies have indicated that awareness of this campaign has lowered smoking intentions in adolescents and has increased the desire to quit in young adults (3, 4, 5). These ads have also been shown to be effective beyond the age groups they target. One study suggested that the Truth campaign, which is intended primarily for 12-17-year-olds, may continue to prevent smoking in older age groups, making these ads extremely cost-effective (6).

However, another study showed that anti-industry ads did not significantly lower smoking intention, nor did they strengthen anti-industry attitudes;.the study does not necessarily suggest that counter-industry ads are completely ineffective, but instead claims that these ads can be used in conjunction with disease-and-suffering ads, which the study claims are more effective. (7). The anti-industry and manipulation themed ads may be most effective when working alongside the disease-and-suffering ads.

If presented to the right population, anti-industry ad campaigns can have lasting effects from adolescence throughout young adulthood (7, 8).

REFERENCES:

1. Federal Trade Commission. Cigarette Report for 2006. Issued August 2009.
http://www.lung.org/stop-smoking/about-smoking/facts-figures/tobacco-industry-marketing.html

2. Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States. Morbidity and Mortality Weekly Report 2008; 57(45): 1226-8. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/.

3. Richardson AK, Green M, Xiao H, Sokol N, Vallone D. Evidence for truth: The Young Adult Response to a Youth-Focused Anti-Smoking Media Campaign. American Journal of Preventive Medicine 2010; 39(6): 500-506.

4. Bauer UE, Johnson TM, Hopkins RS, Brooks RG. Changes in youth cigarette use and intentions following implementation of a tobacco control program: findings from the Florida Youth Tobacco Survey, 1998-2000. JAMA 2000; 286(6): 2=723-8.

5. Farrelly MC, Healton CG, Davis KC, Messeri P, Hersey JC, Haviland ML. Getting to the Truth: Evaluating National Tobacco Countermarketing Campaigns. Am J Public Health 2002; 92(6): 901-907.

6. Sly DF, Trapido E, Ray S. Evidence of the Dose Effects of an Antitobacco Counteradvertising Campaign. Preventive Medicine 2002; 35(5): 511-518.

7. Pechmann C, Reibling ET. Antismoking Advertisements for Youths: An Independent Evaluation of Health, Counter-Industry, and Industry Approaches. Am J Public Health 2006; 96(5): 906-913.

8. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 1994.

Canada – img12769

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It is known that smoking cigarettes has numerous harmful effects on people’s health, and one tactic used to dissuade people from smoking is explicitly stating these effects on cigarette boxes via warning labels. People are more likely to see an anti-smoking message if it is present in the form of a label right on the outside of the cigarette box they are holding, which is why these pack warning labels can be an effective form of advertising.1

They can be text-only, like the ones on Winston cigarettes boxes in the UK that say “Smoking seriously harms you and others around you,” or also include graphic images, such as the ones in Brazil that include images ranging from a stillborn baby to a dismembered and blackened foot. One study “found that 50 percent of subjects remembered the text-only warning label, while 83 percent correctly recalled the label that contained a graphic image,” so it is a more effective advertising strategy to incorporate pictures on labels because the message will then be more memorable. In fact, “research on pictorial warnings show that they are: (i) more likely to be noticed than text-only warning labels; (ii) more effective for educating smokers about the health risks of smoking and for increasing smokers’ thoughts about the health risks; and (iii) associated with increased motivation to quit smoking.”2 Pictorial labels are also more effective at raising awareness of the health effects of smoking in areas with low literacy rates.2

However, a study on the effectiveness of Canadian warning labels shines light on the big issue of whether or not people stop to read and think about the warning labels, as people who do so are the ones who are “significantly more likely to either quit, attempt to quit, or reduce their smoking.”3 Another issue that is often brought up is the defensive and avoidant behavior that pictorial images may elicit, but in reality, “such reactions are actually indicators of positive impact” caused by the presence of graphic images.2

Resources:

1. http://www.cbsnews.com/news/study-graphic-tobacco-warning-labels-more-effective-at-delivering-anti-smoking-message/

2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733253/

3. http://tobaccocontrol.bmj.com/content/12/4/391.full.html