Op-Ed Articles

Tobacco Marketing Profiteering from Children
December 11, 1991 | The Journal of the American Medical Association

By Henry A. Waxman

In 1946, the RJ Reynolds Tobacco Co. advertised that "More Doctors Smoke Camels Than Any Other Cigarette." Such a message conveyed that it was medically safe to smoke, and the tobacco companies targeted adults to receive that message. In 1991, tobacco companies don't use medical spokespersons to sell their products. Few physicians would attest to the safety of smoking, and tobacco companies are not as interested in adults anymore.

In today's cigarette advertisements, physicians in white coats have been replaced by cartoon animals in bright, pre-school colors. With straight faces, RJ Reynolds and its industry colleagues report that they've chosen figures like Old Joe Camel because they believe that such figures will appeal to adult smokers and encourage them to change brands. With the same straight faces, they will be likely to express shock that children respond to this campaign by taking up smoking. It's simple: first they wanted to believe that smoking was safe. Now they want us to believe that their advertising campaigns don't cause people to start smoking and that cartoons don't appeal to children.

Not only are these statements unbelievable, but they are also immoral and dangerous. In light of what is known about the deleterious health effects of tobacco, cigarette advertising is the moral equivalent of a national campaign to "Drive Drunk--Just for the Fun of It."

None of this should be surprising. The success of the tobacco industry is dependent on recruiting people who don't believe that smoking kills. Enticing children, Third World populations, and disadvantaged members of our own society to smoke is the only way for tobacco companies to make up for the number of smokers who quit or die. We should be particularly alarmed at the tobacco industry's effort to recruit children to nicotine addiction. Young people are encouraged to buy cigarettes, young people are able to buy cigarettes, but young people do not have the information and experience to recognize the dangers of smoking cigarettes. Such a market niche is an advertiser's dream.

The tobacco companies' success at targeting young people is apparent from data reported in this issue of The Journal. Old Joe Camel has demonstrated appeal and recognition among youth, the Kool-brand penguin, which was introduced recently by the Brown and Williamson Tobacco Company, will not be far behind, and cowboys on the open range (the Marlboro image) have long been a part of childhood fantasy. Undoubtably, some adults also respond to these campaigns, but continued avoidance of the effects on children is willful negligence. The translation of this induced interest (induced by advertising) into the purchase of cigarettes by children is also clear. Despite restrictions on the sale of tobacco to minors in most states, an investigation by the Inspector General of the U.S. Department of Health and Human Services revealed that these restrictions are seldom enforced. In fact, the 1989 Surgeon General's report on smoking concluded that the number of legal restrictions on children's access to tobacco products have decreased since 1964. Vending machines, free samples, and lack of enforcement combine to negate virtually all of the existing restrictions.

Compounding the media encouragement and the easy accessibility of tobacco is the naivete of children. While adults might read warning labels or might have experienced the death of a loved one from lung cancer or emphysema, few children have. As described by Fischer et al, many 3-to-6-year-old children were just as captivated by Old Joe Camel promoting cigarettes as they were by Mickey Mouse in advertisements for the Disney Channel. Knowledge of health consequences might dissuade adults from starting to smoke, but long-known data show that most smokers start in their teenage years. The study by Fischer et al suggests that nicotine addiction may have its roots in much earlier childhood.

The tobacco and advertising industries disclaim any responsibility or liability for youth appeal, saying that smoking is a custom for those mature enough to make choices and that they do not want children to smoke. Data reported in this issue of The Journal should sound a warning to parents that exposure to cigarette advertising can place a child at risk of smoking, whatever the tobacco industry might say.

The real question is how to respond to youths' being targeted by tobacco advertising campaigns. Strict controls on advertising would be an appropriate first step, but tough advertising control measures have found little else but rhetorical support from within the Bush administration. Last year, Rep. Mike Synar (D, Okla.) and I would have prohibited the cartoonlike, youth-oriented imagery characterized by the Camel advertising campaign. Regrettably, that legislation failed to win a majority of votes in the Subcommittee on Health and the Environment. In addition to advertising restrictions, prohibiting vending machines and free samples and strictly enforcing minimum-age laws are steps that can be accomplished at the state and local levels. Finally, federal regulators need to wake up and put a stop to continuing violations of federal restrictions against tobacco advertising on television. To its credit, the Federal Trade Commission recently took action to stop the advertising of Red Man Chewing Tobacco through its sponsorship of televised sporting events. Ironically, the Justice Department, which has had jurisdiction over cigarette advertising for 20 years, has yet to take similar action.

During the Nixon administration, Attorney General John Mitchell was credited with the remark: "You'd be better informed if instead of listening to what we say, you watch what we do." This is good advice for evaluating the tobacco industry. If exposure to cigarette advertising is a risk factor for disease, it is incumbent of the public and elected officials to deal with it as we would the vector of any other pathogen.

If we can protect our young people from nicotine addiction, they are unlikely to die of smoking-related diseases as adults. Tobacco use by young people should be treated with the same level of intolerance as the use of any other addictive drug. It is sobering to me as a legislator and recent grandfather that 6-year-olds now find Old Joe Camel as easy to recognize as Mickey Mouse.