Teens With Tobacco Merchandise Are Four Times More Likely to Smoke, Says New Study

TOBACCO January 1998

Teenagers who wear clothing and accessories displaying cigarette names and logos are four times more likely to smoke than children who do not, according to a study by researchers at the Dartmouth Medical School in Hanover, New Hampshire, and the Veterans Affairs Medical Center in White River Junction, Vermont. The study found that tobacco attire was substantially more prevalent, and more tightly linked with smoking, than had been previously observed. The study was based on a survey during October 1996 of 1,265 youngsters in grades 6 through 12 at five facilities in rural Vermont and New Hampshire, and was published in the Archives of Pediatric and Adolescent Medicine (James D. Sargent, MD, et al., "Cigarette Promotional Items in Public Schools," Archives of Pediatrics and Adolescent Medicine, December 1997, pp. 1189-1196; Terence Monmaney, "Study Links Cigarette Gear, Youth Smoking," Los Angeles Times (Washington Edition), December 15, 1997, p. A1; Associated Press, "Tobacco Gear `Highly Visible' Among Students," Washington Post, December 15, 1997, p. A16; Associated Press, "Pro-Smoking Gear Common in Some Schools," New York Times, December 15, 1997, p. A1).

The researchers found that 32% of the youngsters surveyed owned tobacco promotional merchandise. Among the 12th-graders, 32% overall were classified as smokers, defined as having smoked more than 100 cigarettes. Of the teenagers who owned tobacco promotional merchandise, 58% smoked cigarettes. In comparison, only 23% of those who did not own such promotional merchandise smoked cigarettes. 4.8% of the children said they had a promotional item with them on the day they were surveyed. 3% of sixth-graders were classified as smokers, but all of them said they owned a promotional item. T-shirts and hats were the most common items, and Marlboro® and Camel® were the most popular brands. Most of the items came from parents or adult friends, but 22% of the children said that retail stores or cigarette company catalogs sold the items to them directly, in violation of federal laws.

Public health experts and antismoking advocates say the items might function as "stealth advertising" intended to interest children in smoking. Because the survey indicated that each item taken to school was seen by 10 other youngsters, the findings "raised the possibility that children were becoming the means through which cigarettes were being promoted to other children," the researchers wrote. This is the most powerful demonstration yet that these promotional items have a disproportionate impact on kids," said Matthew Myers, executive vice president of the National Center for Tobacco Free Kids.

The lead author, Dartmouth pediatrician Dr. James Sargent, said that the survey does not prove that the promotional items caused the children to start smoking, but that the survey shows that the merchandise appears to put very young children at greater risk of experimenting with cigarettes. John Pierce, a cancer prevention expert at the University of California, San Diego, said he was impressed that about one-third of the youngsters in the study had promotional items. In a random telephone survey of California residents in 1993, Pierce and his co-workers found that 9% of high-schoolers surveyed had such an item. "If it was a problem [then], it's a much bigger problem now," he said. [Rural Vermont and New Hampshire are a long way, geographically and culturally, from California. -- RCT]

The study also examined family and peer pressure on smoking trends. The likelihood that youngsters smoked was increased nearly sevenfold if they had friends who did so, and 28 times if both friends and family members smoked. National youth smoking rates have risen 1% to 2% annually since 1992, and in 1996, an estimated 34% of 12th-graders smoked (see story).

In recent years, the tobacco industry has boosted spending on merchandise giveaways and catalog sales, from $307 million in 1990 to $665 million in 1995, according to Federal Trade Commission (FTC) records. The FTC reports that combined merchandising and cigarette-promotion totals increased 41% from $1.49 billion in 1990 to $2.1 billion in 1994.

Tobacco companies pointed out that cigarette promotional items were around long before the recent increase in youth smoking. Peggy Carter, a spokeswoman for R.J. Reynolds, said the "bottom line" was that the research did not establish causality. She said that R.J. Reynolds takes many steps to prevent minors from purchasing company merchandise. "We wish that parents would not tolerate their children having items associated with our brands," she said. "We think it's inappropriate. But that's an issue between parents and children."

The FTC is suing R.J. Reynolds, alleging that the Joe Camel® campaign appealed to minors, said Lee C. Peeler, associate director for advertising practices at the FTC. A ban on promotional items is also part of the industry's settlement offer with the states who are suing the tobacco industry for reimbursement of tobacco-related medical expenditures. The Food and Drug Administration proposed to bar the merchandising as part of new regulations of tobacco products (see "President Clinton and the FDA Announce New Tobacco Regulations," NewsBriefs, September 1996). However, a federal court in Greensboro, North Carolina ruled in April that the FDA had no jurisdiction over tobacco advertising issues. That ruling is being appealed.

Matthew Myers, National Center for Tobacco Free Kids - 1707 L Street, NW, Suite 800, Washington, DC 20036, Tel: (202) 296-5469.

Dr. James Sargent, Dartmouth Medical School - (603) 650-8819.

Federal Trade Commission - Pennsylvania Ave. & 6th St., NW, Washington, DC 20580, Tel: (202) 326-2000, Web: http://www.ftc.gov.