Young adults: vulnerable new targets of tobacco marketing

OBJECTIVES: We examined young adult smoking patterns and receptivity to cigarette advertising to assess vulnerability to tobacco marketing strategies. METHODS: We obtained data from a telephone survey of 12,072 Massachusetts adults. RESULTS: Smokers aged 18 to 30 years were more likely than older adults to smoke only occasionally and to consume fewer than 10 cigarettes per day. They also were more receptive to cigarette marketing and were more likely to be frequent patrons of bars and clubs. CONCLUSIONS: Many young adult smokers are in the initiation phase of smoking and are likely to undergo a transition to either nonsmoking or heavier smoking. If unimpeded by regulation, tobacco promotion in bars and clubs is likely to lead to increased adult smoking prevalence.     

Perceptions of fashion images from youth magazines: does a cigarette make a difference?

This paper reports the findings of the first study which hasinvestigated young people's perceptions of non-advertising smokingimages in youth magazines. A self-completion questionnaire wasadministered to a total of 897 people from three age groups(12–13, 15–16 and 18–19 years). Respondentsrated perfectly matched (other than the presence/absence ofa cigarette) smoking and non-smoking pictures taken from youthand style magazines on a range of attributes. They also ratedtheir self, ideal and socially desirable images on the sameattributes. It was found that the presence of a cigarette affectedhow the pictures were rated and that the nature of this effectdiffered between pictures. In general, smoking images were ratedas being more druggy, wild and depressed. In contrast the matchednon-smoking images were rated as being more healthy, rich, nice,fashionable, slim and attractive. Smokers and non-smokers differentiallyrated themselves in the same way that they differentiated betweensmokers and non-smokers in the photographs. It is argued thatthese magazine images of smoking may be acting to reinforcesmoking among young people.     

Perceptions of plain cigarette packaging among smokers and non-smokers in Andalusia (Spain)

ObjectivesEach year tobacco is responsible for 650,000 deaths in Europe and 55,000 in Spain. With tobacco advertising and promotion banned in Spain and most of Europe, the last bastion of marketing is the packaging. Plain tobacco packaging —which involves packs having a standardised appearance— has been proposed to counter this. The objective of this study is to research perceptions arising from the plain packaging of tobacco products.MethodsWe employed a qualitative research methodology -focus groups- with smokers and non-smokers in in two medium-sized Andalusian towns (Spain).ResultsResults show the importance of plain cigarette packaging as a form of promotion, particularly among women and young people, how pack colour influences product perceptions, and how removing full branding increases the salience of the warnings.ConclusionsPlain packaging, combined with pictorial health warnings, may reduce the capacity of packaging to be distinctive and a badge product. Altering pack design in such a way would make it more difficult for tobacco companies to create a favourable image of their brands and may help to reinforce the ability of the population to protect themselves from the dangers of smoking.     

Adolescents' perceptions of print cigarette advertising: a case for counteradvertising

Cigarette smoking is a major preventable cause of serious chronic disease. The majority of smokers begin smoking during their adolescent years. Print cigarette advertising plays an influential role in encouraging young people to smoke. Eight hundred and forty-three middle/junior high-school-aged students from a large midwestern metropolitan area participated in this study of adolescents' recognition of and belief in messages associated with print cigarette advertising. Results indicated no significant difference between smokers and nonsmokers in their recognition of messages associated with print cigarette advertising. However, smokers and nonsmokers differed significantly in the degree to which they believed the messages communicated by print cigarette advertising. Consistent with social cognitive theory, students who smoke at least occasionally were more likely to believe messages conveyed by print cigarette ads than were students who had never smoked. Implications of these findings for research and practice are discussed, including specification of guidelines for effective counteradvertising.     

Tobacco use among women in Dharan, eastern Nepal

The study was undertaken to assess the prevalence and patterns of tobacco use and also assess the factors affecting tobacco use among the female population of Dharan. A cross-sectional survey of a representative sample of 2,340 female participants aged 15 years and above was conducted in Dharan municipality in 2001. Cluster sampling with probability proportionate to size technique was used. Of the 2,340 subjects, 12.9% were cigarette smokers and 14.1% were smokeless tobacco users. The smoking habit had a significant relationship with the habit of tobacco chewing. About 50% of the smokers had been continuously smoking for more than 20 years. Smokers aged 50 years and above were more likely to smoke more than 10 cigarettes per day than those at the reproductive age (15-49 years). Health problems among females did not have any significant relationship with tobacco-chewing, but smokers were nearly twice as likely to suffer from any health problem than non-smokers. Gastrointestinal problems were the most common complaint among the tobacco users. An effective awareness programme is required to discourage the use of tobacco and encourage women to take regular health check-ups.     

Exploring young people's perceptions of smoking images in youth magazines

Although research has shown that cigarette advertising can influencesmoking among young people, no studies have looked at youngpeople's perceptions of other media images of smoking. Thispaper describes how focus groups were used to explore the wayyoung people in two age groups (12–13 and 15–16years) interpreted fashion photographs from youth magazineswhich contained smoking images, their perceptions of smokingand non-smoking imagery, and their views on smoking. It appearsthat the interpretative process consisted of relating a representationof the image to the content of the photo and comparing the congruenceof this representation with the participant's model of reality.Most references to the presence of a cigarette were negativeor neutral, with the perceived congruence of the cigarette withinthe portrayed image varying between photographs. Differenceswere detected between the age groups in the way they interpretedthe pictures and in their perceptions of smoking. The 12–13year olds were characterized by concrete thought and interpretationwhich produced very anti-smoking accounts, painting a pictureof a cultural role for smoking in their lives which they foundintimidating. The older teenagers employed a more abstract interpretativeprocess which reflected smoking in a more ambivalent light.The possible effect of these media images on young people'ssmoking behaviour is discussed.     

Evaluating the Emotional Impact of Warning Images on Young Adult Smokers and Susceptible Non-Smokers

On-pack tobacco warnings typically feature long-term health risks, which many young adults rationalize or reject. We examined the emotions generated by more proximal warnings to see if we could identify common features among the most effective warnings. Respondents in a sample of 474 smokers and 476 susceptible non-smokers used a modified Geneva Emotion Wheel (GEW) to assess cigarette packs displaying 12 test warnings and one current warning. The strongest emotions aroused in smokers were disgust, disappointment, and regret. Three warnings showing the effect of smoking on babies and animals had significantly higher emotional potency scores than a current health warning. Among susceptible non-smokers, warnings showing harm to animals, child labor, and a dying smoker had the highest emotional potency. Stronger negative emotions were elicited from both smokers and susceptible non-smokers by warnings that featured more proximal outcomes than are typically shown in on-pack tobacco warnings. On-pack warnings that resonate with young people, the group most at risk of smoking and most likely to benefit from quitting, could promote cessation and deter initiation more effectively than warnings depicting long-term health outcomes. The GEW could be used to screen potential warning images to identify those most likely to be worth evaluating.     

Children's perceptions of advertisements for cigarettes

Groups of children aged between 6 and 16 years discussed a series of advertisements, including those for cigarettes. Clear patterns emerged in their recognition of cigarette brand imagery. For example, in response to an advertisement for holidays which also presents the brand imagery of John Player Special cigarettes, 22% of primary school children and 91% of secondary school children said it advertises cigarettes. There were consistent trends in responses to the symbolism portrayed. Younger children were very much tied to what was specifically shown in the advertisements; older ones tended to perceive more complex imagery. For example, whereas 10-year-olds said people who like the advertisement for Kim cigarettes (which has symbols for drinking) would smoke and drink, some 12-year-olds and most 14- and 16-year-olds saw Kim as feminine, sociable, trendy and sporty. It seems that some 12-year-olds and most 14- and 16-year-olds perceive cigarette advertisements much in the way that young adults do; therefore advertising campaigns targeted at older teenagers and young adults are likely to present qualities which younger teenagers find attractive.     

The potential effectiveness of warning labels on cigarette packages: the perceptions of young adult Canadians

BACKGROUND: Since 1989 when health warning labels appeared on Canadian cigarette packages, the labels have changed from text only covering less than one quarter of the package to text and graphics covering over half the package. This study examines how Canadians in their 20s feel about the current graphic warning labels and their potential to prevent smoking and encourage quitting. METHODS: Participants between 20 and 24 years of age were part of a 10-year cohort study begun when the group was in Grade 6, with the purpose of examining factors that may affect smoking. Five questions about warning labels were added to the 2002 questionnaire requesting information on perceptions of the labels and their potential impact on smoking behaviours of young adults. One item had been included in previous questionnaires. RESULTS: 32.8% (n = 1267) of the respondents were smokers, with males (35.6%) being more likely to smoke than females (30.4%). Current smokers were less likely than experimental/ex-smokers to believe that warning labels with stronger messages would make people their age less likely to smoke. Female current smokers were more likely to think about quitting. CONCLUSION: Despite the efforts taken in developing the labels, some young adults are skeptical about their effects. Warning labels may have to be modified to target issues that are relevant to young adults; gender differences are important in this modification. Warning labels can offer an additional component to a comprehensive tobacco control program, in that they provide health information.     

Food and nutrient intake differences between smokers and non-smokers in the US.

Data from the Second National Health and Nutrition Examination Survey were analyzed to determine food and nutrient intake differences between current smokers (also categorized as light, moderate, and heavy smokers) and non-smokers. Smokers in several age-race-sex categories have lower intakes of vitamin C, folate, fiber, and vitamin A than non-smokers, and intake tended to decrease as cigarette consumption increased, particularly for vitamin C, fiber, and folate. Smokers were less likely to have consumed vegetables, fruits (particularly fruits and vegetables high in vitamins C and A), high fiber grains, low fat milk, and vitamin and mineral supplements than non-smokers. A negative linear trend was found between smoking intensity and intake of several categories of fruits and vegetables. These data suggest that the high cancer risk associated with smoking is compounded by somewhat lower intake of nutrients and foods which are thought to be cancer protective.     

The control of sexuality in young people with Down's syndrome

Three studies were undertaken of two cohorts of young people with Down's syndrome. One cohort, of 52 people, was born in the 1960s and they were seen in their teens and again in their mid-20s. The other cohort, of 26 people, was born in the 197ds and they were seen in their teens. The studies show that while carers in both cohorts paid lip service to the rights of young people with learning disabilities to have sexual experiences and to marry, they did not necessarily feel that this applied to their own youngsters. Carers of the 1970s cohort at teenage were more permissive than carers of the 1960s cohort at adulthood. How carers controlled the sexuality of their young people is discussed. Carers in both cohorts were rarely in favour of parenthood for people with teaming disabilities and over half the carers thought that sterilization might be appropriate, in some circumstances. At teenage, about two-thirds of carers in both cohorts thought that their youngsters needed sex education. By adulthood, in the 1960s cohort, only one-third of the same group of carers continued to hold the same view. According to carers, more young people knew about events that they were unlikely to experience themselves, namely pregnancy and birth, than knew about the most likely event, sexual intercourse. So, in spite of holding permissive views on sexual expression for people with teaming disabilities, carers left their own young people iii-prepared for such experiences. Few young people were given the education or freedoms necessary to encourage sexual relationships. Reasons for this discrepancy are discussed.     

An Empirical Analysis of the Public's Attitudes Toward Advertising Hospital Services: A Comparative Cross-Sectional Study

This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents’ opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price.     

The response of young men to increased television advertising of alcohol in New Zealand

A random sample of 301 males aged 15–30 years was undertakenin New Zealand's three major urban centres, to investigate theirperception of two alcohol industry advertisements on television.Advertising of alcohol was not allowed on New Zealand televisionand these two advertisements, the first of a new wave, wereostensibly advertising alcohol companies and their sports sponsorship.However, the research identified that both were perceived asadvertising alcohol by the majorily of the young men. Both advertisementswere popular and communicated imagery that was likely to reinforcethe link between alcohol and the tough macho image that is adominant part of the traditional New Zealand male identity.It was concluded that this advertising was contributing to aclimate of opinion that was hostile to health promotion activities.These empirical data were relevant to the policy debate thatfollowed this new phase of alcohol television advertising.     

Identifying target segments of male drinkers for health promotion

Data from a 1988 national drinking survey was cluster analysedto identify different types of male drinkers, to assist in thetargeting of health promotion strategies. Of the five segmentsgenerated by the clustering, one labelled Young Heavy DrinkingMales was identified as the most appropriate target segment,because although they were the segment reporting the highestlevel of alcohol-related problems they were also the segmentmost likely to feel they were drinking too much They were thereforethe segment most likely to be responsive to advertising thatsought to support people who wanted to change their drinkinghabits. They were also the most appropriate target for the longer-termgoal of changing the climate of opinion regarding the acceptabilityof more moderate drinking. Comparisons with two previous clusteranalyses showed a high degree of similarity, suggesting thatclustering is a reliable vehicle for identifying drinker types.     

Fatal deception: the tobacco industry's "new" world standards for tobacco marketing]

Being increasingly threatened by the worldwide antismoking struggle, the major tobacco companies are eager to improve their public image. This leads the companies to adopt inconsequential "measures" such as the tobacco industry's "new" standards for tobacco marketing that were "voluntarily" issued in September 2001 by the British American Tobacco company. These measures are clearly attempts to reduce the disapproval generated by the companies' promotion and advertising campaigns, which indirectly target young people. With these standards the tobacco companies supposedly commit themselves, among other things, to not using advertising directed at youth and to not selling or distributing tobacco products in places frequented by young people. This document explains why these measures are completely ineffective, are not anything new, and are a subtle effort to feign a conscientious, responsible attitude, which is far from genuine. As long as there are marketing activities directed at adults, young people will be exposed to the influence of those activities. Many countries have completely prohibited the marketing of tobacco products, given that the "new" marketing standards do not represent progress in any way whatsoever.     

Academic performance and social factors related to cigarette smoking by schoolchildren.

Factors which may influence boys and girls aged between 10 and 121/2 years to start smoking were studied. Information was obtained from 491 schoolchildren, their parents, and headteachers. In their own view and that of their headteachers children who did not smoke were academically better than smokers. Children who smoked were more likely than non-smokers to have a parent and siblings of the same sex who smoked. No association was found between the child's own smoking and that of parents and siblings of the opposite sex. Smokers were more likely to have friends who smoked. Most children did not think smoking was enjoyable or desirable and many thought it bad for health, irrespective of their own smoking habits. The majority thought people of their own age smoked to show off.     

Do Perceptions of Direct-to-Consumer Pharmaceutical Advertising Vary Based on Urban Versus Rural Living?

This study explores the connection between perceptions of direct-to-consumer (DTC) advertising based on where people live and shop. Urban consumers were found to be more skeptical of DTC advertising, but more likely to believe that physicians select pharmaceuticals based on the efficacy of the product. Those living in rural areas were more motivated to visit a doctor and more likely to feel an equal doctor?patient relationship after exposure to DTC advertising. Interaction effects among gender, income, and education were detected, as well as an interaction effects between location and income on views of DTC advertising.     

Smoking behavior of adolescents exposed to cigarette advertising.

The purpose of the study was to explore the relationship between the exposure of adolescents in the seventh and eighth grades to cigarette advertising and their being smokers. A survey questionnaire given to 602 adolescents assessed their exposure to cigarette advertising and provided measures of their smoking behavior, demographic characteristics, and some psychosocial variables. The results indicated that exposure to cigarette advertising and having friends who smoked were predictive of current smoking status. Adolescents with high exposure to cigarette advertising were significantly more likely to be smokers, according to several measures of smoking behavior, than were those with low exposure to cigarette advertising. The findings extend previous research identifying factors that may play a role in the initiation and maintenance of smoking among adolescents.     

Mediators and moderators of magazine advertisement effects on adolescent cigarette smoking

The purpose of the present study is to examine the relation between magazine advertising for cigarettes and adolescent cigarette smoking. Participants (242 adolescents) reported their frequency of reading 46 magazines and their attention to cigarette ads. Recognition of cigarette ads, passive peer pressure (i.e., normative beliefs), and the smoker image also were assessed. Results indicate that exposure to cigarette advertising and recognition of ads augment the effect of passive peer pressure on smoking. In addition, a positive smoker image was associated with attention to advertising and mediated the relation between attention and smoking. It is suggested that the effect of magazine ads on adolescents should be considered in policymaking on cigarette advertising.     

Pleasure or pain? A profile of smokers in Northern England

OBJECTIVE: To construct a profile of smokers using multiple indices of physical, mental and social health. STUDY DESIGN: Cross-sectional study. METHODS: The setting was Wigan and Bolton Health Authority, an urban district in the North West of England. A random sample of over 15000 adults from the Health Authority adult population completed a written questionnaire. Prevalence ratios were calculated for physical, mental and social health indicators for smokers compared with non-smokers, adjusted for borough, age and deprivation score of place of residence. RESULTS: Smokers were less likely to report their current health as good, and reported a significantly higher prevalence of arthritis, bronchitis, backache and respiratory symptoms. Smokers had more mobility problems and recent severe pain. Smokers had less healthy lifestyles across many behaviours (e.g. poorer diet, taking less regular exercise and more problem drinking). Depression and the proportion of people with a high psychiatric morbidity score were increased. More women smokers reported a lack of social support, and smokers more often reported financial difficulties. Differences were exaggerated by comparing heavy smokers with non-smokers. CONCLUSIONS: Independent of the level of deprivation of their area of residence, smokers have poorer physical, social and mental health, with a dose-response effect. Smoking creates considerable pain, but little evidence of pleasure.