Tobacco Control Playbook

KEY MESSAGE: The tobacco industry has targeted children and young people for decades in its advertising, promotion and sponsorship programmes, primarily to recruit replacement smokers – to replace those who have quit or died from diseases caused by smoking – and to create new markets. In protecting children from tobacco, it is essential to restrict all tobacco advertising, promotion and sponsorship, and to take steps to normalize tobacco-free lifestyles.

There is overwhelming evidence from tobacco industry documents, academic studies, and the industry’s marketing activities that tobacco companies have been targeting children and young people in their marketing for decades. This was mainly to recruit replacement smokers, to replace those who had quit or died from tobacco-caused diseases ^[1]. For example, a 1978 tobacco industry memo states that “the base of our business is the high school student” ^[2]. The industry researched teenagers’ patterns of smoking behaviour with keen interest, knowing that, in the words of a 1981 industry memo, “today’s teenager is tomorrow’s potential customer, and the overwhelming majority of smokers first begin to smoke while still in their teens” ^[3].

Evidence indicates that the tobacco industry was deliberately targeting children as young as 13 years old ^[4], though some advertising campaigns had strong impacts on far younger children. In the 1980s, for example, marketing for the Camel cigarette brand featured a cartoon camel character named Joe Camel ^[1]. According to a 1991 study on children in the United States of America, Joe Camel had reached audiences as young as three years old. It is also striking that 91% of children aged six years recognized Joe Camel as much as they recognized Mickey Mouse, and associated Joe Camel with cigarettes ^[5].

Though the Joe Camel campaign was blatantly targeted at children, tobacco companies have also consistently targeted their products to young adults, knowing that this is essentially a strategy for attracting teenage children to smoking as a rite of passage into adulthood. In the words of a 1969 tobacco industry memo^[6],

Smoking a cigarette for the beginner is a symbolic act…
“I am no longer my mother’s child.”
“I am tough,”
“I am an adventur[er]…”
As the force from the psychological symbolism subsides, the pharmacological effect takes over to sustain the habit”.

In tobacco industry communications, terms such as young adult or new smoker became euphemisms for child or teenager, while more openly tobacco marketing was claimed to be targeted at young adults. Tobacco companies ensured, however, that their products would get exposure to young audiences. Tobacco products were heavily promoted on a wide range of media, much of it accessed by children and young people: on television, on the radio, in the press, on posters, on billboards, at the point of sale in shops, and more indirectly via promotions and the sponsorship of popular events such as music concerts. In countries with no comprehensive restrictions on all direct and indirect tobacco marketing activities, tobacco companies continue to market their products in diverse ways, reaching a wide array of young audiences.

Sports sponsorships, for example, remain a highly effective – and therefore commonly used – marketing strategy for tobacco companies. Sports sponsorships create associations with sporting idols, athleticism, success and risk-taking, and form smoker identities that promote youth smoking. Companies have also been active in sponsoring popular music events that will appeal to children and young people, as well as providing free cigarette samples to adults but in areas frequented by teenagers: rock concerts, sports events, and shopping malls ^[7]. These strategies have been very effective in encouraging smoking uptake among children, though the tobacco industry – more openly – claims that they were specifically targeted to adults ^[8][9]. Tobacco sponsorship of sports events has also been an important means for tobacco companies to generate influential support and to oppose bans on tobacco advertising and promotion.

The tobacco industry also has a long and well-documented history, dating from the 1920s to today ^[10], of collaborating with film industries to promote smoking in movies. This is a highly effective way for tobacco companies to promote their products and to create perceptions – particularly among children and young people – that smoking is a normal or desirable social activity. It also creates associations between smoking and a popular celebrity or character that children and young people look up to, or a desirable lifestyle depicted on-screen ^[11][12]. The normalization and glamourization of smoking in movies, in turn, affects the smoking-related attitudes and behaviour of children and young people: compelling evidence from population surveys, longitudinal studies, experimental studies and internal tobacco industry documents shows that depictions of smoking in movies cause smoking initiation among youth ^[13][14].

Concerns about the promotion of tobacco products through the Internet and social media are also increasing. Tobacco products are often promoted online, with poor controls on potential Internet sales to underage youth ^[15]. Sites promoting tobacco products often have interactive features, culture content, games and apps that may appeal to children and young people. Tobacco companies are also known to engage with highly popular websites such as iTunes, YouTube and Facebook. On iTunes, for example, the iShisha app encourages its users to “figure out your favourite tobacco!” ^[16]. Another study documented that a tobacco company was promoting cigarette brands by joining and administrating Facebook groups, joining pages, and posting photos about its tobacco products and promotional events ^[17]. The Internet and social media sites, due to their ubiquity and popularity among children and young people, have the potential to reach large youth audiences, create positive associations with smoking and ultimately encourage smoking initiation. Tobacco product placements have also been observed in video games, where smoking is portrayed as a normal or desirable adult activity. Yet, these games are legally accessible to children as young as 13 years old ^[18].

Meanwhile, the tobacco industry insists that it only markets tobacco products to adult smokers. Tobacco companies have, for example, publicly claimed that “We don’t want young people to smoke” ^[19]. More privately, however, tobacco companies acknowledged that “the base of our business is the high school student” ^[2]. They also knew that a campaign advising teenagers that smoking is strictly for adults would not be successful from a public health perspective as it reinforces the rite of passage effect, thereby encouraging smoking among children and young people ^[20]. Studies have found that youth smoking prevention campaigns funded by tobacco companies actually result in more positive attitudes towards smoking and stronger intentions to smoke among youth ^[21], and that youth exposed to these campaigns have more favourable attitudes towards tobacco companies even after the campaigns have ended ^[22][23][24]. Such corporate responsibility initiatives are also a means of improving the tobacco industry’s image while gaining access to policy-makers in a bid to ultimately delay or avoid effective tobacco control measures. For example, a 1982 internal tobacco industry document noted that: “a program to discourage teens from smoking… might prevent or delay further regulation of the tobacco industry…” ^[25].

The tobacco industry has fiercely resisted any regulations on tobacco advertising, promotion or sponsorship, and has attempted to persuade governments to instead pursue voluntary codes and restrictions ^[26]. These are invariably ineffective as tobacco companies tend to look for indirect means, such as event sponsorship, to market their products. One recent tobacco marketing campaign, for example, targeted young people in its brand, inviting them to “Don’t Be A Maybe. Be Marlboro”. This brand is widely promoted with imagery of young people and slogans such as “Maybe never fell in love” and “Maybe wouldn’t take a chance”. The brand is marketed using diverse media such as billboards, in cinemas and at promotional events, in countries with porous regulations on tobacco advertising, promotion and sponsorship ^[27]. As part of a comprehensive approach to tobacco control which in particular aims to prevent smoking initiation among children and young people, it is essential to restrict all forms of tobacco advertising, promotion and sponsorship, as well as any industry-funded corporate social responsibility programmes such as youth anti-smoking campaigns.

KEY ARGUMENTS

• In line with Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC), there should be comprehensive bans on all direct and indirect forms of tobacco advertising, sponsorships, and promotions ^[28].

• According to Article 36 of the Convention on the Rights of the Child, children have a right to be protected from any activity that takes advantage of them or that harms their welfare and development ^[29]. This includes their targeting by tobacco marketing, which is a clear impediment to their healthy development and exploitative of their young age.

• In the Roadmap of actions to strengthen implementation of the WHO FCTC in the European Region 2015–2025 ^[30], a key focus area is reshaping social norms. In the Health 2020 policy framework ^[31], focus is on creating a culture of health, in which children want to grow up healthily. Key to these is the social normalization of a tobacco-free lifestyle, and preventing tobacco industry efforts to market (and thereby normalize) smoking.