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The role of media in smoking initiation and cessation

Institution: University of California, San Diego
Investigator(s): David Burns, M.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6RT-0250 Award: $433,880
Subject Area: Epidemiology
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
Currently, individuals who reach adulthood without starting to smoke are unlikely to ever become cigarette smokers. Over 95% of the initiation of regular tobacco use occurs prior to age 25, and the highest rates of initiation occur between the ages of 15 17 years. Public health advocates, and more recently the FDA, have suggested that restricting or eliminating tobacco advertising may be an essential step in reducing adolescent initiation. The tobacco industry has countered this suggestion by claiming that data linking advertising and initiation do not exist, and that advertising only influences brand preference.

We will examine the association between specific advertising campaigns and adolescent initiation to establish that the advertising campaigns preceded both brand specific increases in cigarette sales and increases in smoking initiation. We will show that increases in brand specific sales are not explained by brand switching and must have been accompanied by brand specific initiation. Three specific advertising campaigns have been linked to increases in adolescent initiation: the "Reach for a Lucky instead of a sweet" campaign in the late 1920s and 1930s, the Virginia Slims advertising campaign in the late 1960s and 1970s and the "Smooth Joe" Camel campaign in the mid 1980s. We will demonstrate that the changes in advertising and market share of these brands are quantitatively and temporally linked to changes in age specific rates of smoking initiation. Finally, we will examine the message content of those advertising campaigns associated with initiation compared to campaigns which altered brand preference, but were not associated with changes in initiation.

Data are available to examine the impact on cessation rates of two media led tobacco control efforts: the 1967 70 national anti tobacco television broadcasts under the Fairness Doctrine and the media-led tobacco control campaign conducted in California. Clearly, no media campaign occurs in a vacuum, and both of these campaigns were part of a comprehensive effort promoting smoking cessation in the general environment. The question of policy relevance is whether media led tobacco control campaigns can significantly enhance cessation, rather than whether media alone is an effective intervention. We will define temporal trends in birth cohort specific long term successful smoking cessation controlling for the co variates of age and cost of cigarettes. We will then examine rates of long term successful smoking cessation during these years among different demographic groups. These analyses will better quantify the changes in smoking cessation that occurred during the 1967-70 period and are currently occurring in California, as well as demonstrate which demographic subgroups were most effected

Final Report
There were two major aims of this grant: l) collect cigarette advertising from popular magazines in the United Stated from 1900 to the middle of the 1990s and to examine the temporal association between cigarette advertising and smoking initiation and 2) examine the rates of adolescent smoking initiation over time for males and females and for adolescents from different racial/ethnic backgrounds.

For this grant we assembled a database of cigarette advertising from 13 of the largest circulating magazines in the United States. Three research assistants reviewed cigarette advertising from 1900 to 1996. The data set included quantitative estimates per magazine issue of the number of ads, size and location of the ads (e.g. front or back cover), brand advertised, slogan used, and age, gender and ethnicity of those portrayed in the ads. The themes of the ads were also coded.

Using the advertising database we were able to show large increases in cigarette advertising in the magazines used for this study immediately following the broadcast advertising ban in 1971 despite that fact that the cigarette companies vowed that they would not increase advertising following the ban. We also showed that increases in advertisements for brands with low tar or low nicotine themes preceded increases in market share of these brands. We also showed that increases in advertisements for brands that had a theme related to the filter of the cigarette also preceded increases in the market share of these brands. Although the advertising of the "Smooth Joe" Camel did not appear to influence adolescent initiation rates in the mid 1980, we did show that an increase in advertising for Virginia Slims in the late 1960s and early 1970s was associated with an increase in smoking initiation for non-Hispanic white females between the ages of 12 and18.

We also examined adolescent initiation rates using data from the Tobacco Use Survey of the Current Population Survey. Examination of the adolescent initiation data showed that rates of initiation for boys and girls were markedly different earlier in the 20`x' century and that rates converged during the middle of the 1980s with initiation rates declining for boys and increasing for girls. From, 1940 to 1992, Non-Hispanic white males generally initiated at higher rates than Hispanic or African-American adolescent males. A similar pattern of initiation was also observed for adolescent females during the same time period.
Publications

Primary prevention, smoking, smoking cessation - implications for future trends in lung cancer prevention
Periodical: Proceedings of the International Conference on Prevention and Early Diagnosis of Lung Cancer Index Medicus:
Authors: Burns D ABS
Yr: 1998 Vol: Nbr: Abs: Pg: 164-171

Patterns of adolescent smoking initiation rates by ethnicity and sex
Periodical: Tobacco Control Index Medicus:
Authors: Anderson CM, Burns DM ART
Yr: 2000 Vol: 9 Nbr: Suppl. II Abs: Pg: ii4-ii8