More than 40 years after the landmark United States Surgeon General’s report on smoking, cigarettes and other forms of tobacco continue to be the leading cause of preventable death around the world. In the United States, alone, tobacco causes more than half a million unnecessary deaths every year from cancer and other tobacco-associated diseases. In 2010, cancer will replace all other diseases as the single greatest cause of death, worldwide. Most public health experts attribute the rising global incidence of cancer to the ongoing increase in the incidence of smoking in the developing world.
In the United States, the incidence of smoking continues to slowly decrease (although, sadly, mostly among the male half of the population) as a consequence of increased public education efforts, as well as increasingly restrictive laws against tobacco advertising and public smoking. In response to these public health policy efforts to reduce the incidence of smoking in the United States, tobacco companies have had to become more creative in their efforts to replenish the dwindling pool of smokers in America. Thus, despite their energetic denials to the contrary, tobacco companies continue to target teens and very young adults in their advertising campaigns, because the harsh and unequivocal reality of the tobacco industry is that 80 to 85 percent of all smokers become addicted to tobacco during their pre-teen or teenage years. Therefore, following the 1998 Master Settlement Agreement, in which American tobacco companies agreed to stop directly targeting pre-teens and teens with tobacco advertisements, the Big Tobacco companies have had to become more nimble and more creative in their efforts to addict a new generation of pre-teens, teens, and young adults to their deadly products, while simultaneously circumventing the restrictions imposed upon them by the Master Settlement Agreement.
R.J. Reynolds, a huge player in the international tobacco trade, recently rolled out (no pun intended) a new brand of cigarette targeted at female smokers. “Camel No. 9, like other brands previously targeted towards teen and adult women, is distinctively packaged and designed with “feminine sensibilities in mind. In 2007, Camel No. 9 cigarettes joined the stable of prior and current cigarettes designed and marketed to appeal specifically to females, including the notorious Virginia Slims brand (produced and marketed by Phillip Morris), as well as the Capri and Misty brands. While the Camel cigarette brand had previously been targeted at male smokers, Camel No. 9 was rolled out, 3 years ago, by R.J. Reynolds, with launch parties targeted specifically at women, at nightclubs and bars around the country. These launch parties have often been described as “girls’ night out parties for women smokers, and have included free massages, free hair styling, free gift bags containing cosmetics and jewelry and, of course, free samples of Camel No. 9 cigarettes. Additionally, as with the Virginia Slims brand, and other cigarettes targeted to female smokers, full-page advertisements in glamour magazines like Vogue, Cosmopolitan, and Glamour have targeted the almost exclusively female readers of these magazines with advertisements for Camel No. 9 cigarettes. These marketing campaigns are, of course, designed not only to gain new customers among women who are already addicted to tobacco, but also, and more importantly, to increase the ranks of smokers with new recruits among current nonsmokers, and in a setting (i.e., nightclubs and bars, where alcohol is also being consumed) where nonsmokers and “occasional smokers can be targeted by R.J. Reynolds.
A newly published clinical research study, in the journal Pediatrics, reveals how tobacco companies continue to effectively target highly vulnerable pre-teens and teenagers in the United States.
In this nationwide prospective study, 1,036 adolescents between the ages of 10 and 13 years were prospectively followed between 2003 and 2008.  Five sequential telephone interviews were conducted during the course of this study, which included discussions of the teens’ impressions of their favorite cigarette advertisements. The fifth and final interview was conducted after R.J. Reynolds’ roll-out of their 2007 campaign on behalf of the new Camel No. 9 brand of cigarettes.
A total of 72 percent of the teenagers participating in this public health study completed all 5 telephone interviews. Not surprisingly, the teens who reported having one or more favorite cigarette advertisements were 50 percent more likely to take up smoking during the 5-year duration of this clinical study when compared to the teens who did not have any favorite tobacco advertisements. Among the boys participating in this study, the percentage of teenagers who identified any favorite cigarette advertisements remained stable throughout the 5 sequential interviews, including the fifth interview in 2008 (after Camel No. 9 was introduced by R.J. Reynolds). However, while the percentage of girls reporting a favorite cigarette advertisement also remained stable throughout the first 4 telephone interviews, this percentage jumped by a significant 10 percentage points after the marketing campaign for Camel No. 9 was unleashed by R.J. Reynolds, at the time of the fifth and final interview. Moreover, this 10 percent increase in teenage girls reporting a favorite cigarette advertisement was almost completely associated, specifically, with advertisements for the Camel No. 9 brand.
Taken together, the results of this important public health study reveals two very concerning findings: (1) Adolescents who express a preference for any specific cigarette advertisements are at least 50 percent more likely to take up smoking during their teen years, and (2) teenage girls (but not teenage boys) appeared to be significantly impacted by R.J. Reynolds’ 2007 advertising campaign for its new “feminine Camel No. 9 cigarette brand.
One does not have to be a lawyer, or a public health expert, to put “2 and 2 together, and come up with 4, with respect to the findings and conclusions of this important public health study. In order to maintain and replenish their customer base of active smokers, tobacco companies must continuously recruit new smokers from the most vulnerable segments of our population: pre-teens, teenagers, and very young adults. Although Big Tobacco companies claim to be following the 1998 Master Settlement Agreement’s restrictions on advertising targeted to children and teens, the economic reality is that as older smokers die off (and, very often, due to tobacco-associated diseases.), these merchants of death must continually replace their shrinking pool of potential and active customers with newly-addicted young customers. As the troubling findings of this clinical research study demonstrate, the advertising campaign for Camel No. 9 has not only been effective in recruiting new female converts to this brand among current smokers, but also in attracting the essential new converts from among the tobacco companies’ prime recruiting demographic: pre-teen, teenage, and young adult females. We should not delude ourselves, therefore, by the frequent protestations of tobacco companies, that they are following both the rules and the intent of legal restrictions on advertising to pre-teen and teenage boys and girls, as their continued existence as commercially viable companies mandates that they continue to addict pre-teens and teenagers (and young adults) to their deadly products.
In addition to their ongoing efforts to addict American pre-teens and teenagers to tobacco, American and multinational tobacco conglomerates have also ramped up the same aggressive and deceptive advertising campaigns that worked so well for decades in the United States, and these Big Tobacco companies are now applying these same effective (and expensive) marketing campaigns throughout the developing world, where vast numbers of potential new and existing smokers can be targeted without significant legal restrictions against such advertising (and where little or no emphasis is placed upon public health and disease prevention by local government officials, in many cases).
To learn more about the surprising effectiveness of Big Tobacco’s campaigns to specifically target teenagers, and adult women, and the tragic public health consequences of these campaigns, look for the publication of my new landmark evidence-based book, “A Cancer Prevention Guide for the Human Race, in the summer of this year.

Weekly Health Update


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