For every 10 tobacco advert sightings, a teenager’s risk of starting smoking rises by 38%, German researchers reported in the journal BMJ Open. They added that the ten ad sightings increase the probability that teens become regular daily smokers by 30%.

These findings go against the tobacco industry’s assurance that cigarette advertising only influences existing smokers to change brands and has no effect on encouraging non-smokers to start.

Dr. Matthis Morgenstern, of the Institute for Therapy and Health Research in Kiel, Germany, and team based their findings on more than 1,300 children aged from 10 to 15 years. They were all non-smokers at the start of the study. Their exposure to tobacco advertising was monitored for 2.5 years, as was their subsequent behavior regarding smoking.

Pupils from 21 public schools in three different areas of Germany were asked in 2008 how often they had viewed specific advertisements. These included pictures of the six most popular brands for cigarettes in Germany, as well as ads for chocolates, cars, cellphones, clothes, etc. (eight other products).

Thirty months later, in 2011, they were asked the same question again. They were also asked whether they had smoked any cigarettes, if so how many, and whether smoking had become a regular habit.

During the 30-month period, out of 1,300 kids:

  • 406 said they had tried smoking – i.e., one in every three kids
  • 138 said they had smoked tobacco during the previous thirty days – i.e., one in every ten kids
  • 66 of them (1 in 20) had smoked over 100 cigarettes. They were classed as “established” smokers
  • 58 children said they were regular daily smokers
  • One third of the regular smokers were aged 14 years or less, while 1 in 4 were aged at least 16

Although kids appeared to be exposed to many fewer tobacco ads compared to other products, the authors found that one particular brand of cigarettes was viewed by nearly half the children at least once – 13% of them reported seeing the ad at least ten times.

After taking into account several known influences for starting smoking, peer pressure/compliance was found to be the strongest influence, followed by tobacco ad exposure.

The researchers identified a correlation between how much tobacco advertising children were exposed to, and their likelihood of taking up smoking – the greater the exposure the more likely they were to smoke.

Children who saw between 11 to 55 tobacco ads had double the risk of becoming regular smokers, compared to those who saw between 0 and 2.5 ads.

The likelihood of becoming an established smoker went up by 38% for every 10 additional sightings of tobacco ads, they were also 30% more likely to become daily smokers.

Marlboro-Ferrari
Malboro has a long history of sponsoring motor racing. Blatant advertising, as seen here, has now been replaced by a variety of barcodes.

After factoring in other variables which may influence smoking, Dr. Morgenstern and team reported that the overall probability of a teen becoming an established smoker was between 3% and 7% greater, depending on their tobacco ad exposure. In the same way, the risk of becoming a regular daily smoker was 3% to 6.4% greater.

The team acknowledges that out of the 2,300 students who started off in the study, about one thousand dropped out. They therefore emphasize that this is an observational study which may have some unmeasured factor that could explain the results.

However, it is possible to conclude that the study’s findings confirm the link between tobacco advertising and smoking behavior in teenage children. They favor the total ban on tobacco advertising, which is recommended by the WHO (World Health Organization) Framework Convention on Tobacco Control.

Dr. Morgenstern wrote:

“Data from this study support this measure, because only exposure to tobacco advertisements predicted smoking initiation, which cannot be attributed to a general receptiveness to marketing.”

Should smoking in movies be “R” rated? – in 2012, the Norris Cotton Cancer Center examined the cause-and-effect relationship movie smoking might have on adolescent smoking. The researchers suggest that if movies with smoking content were R rated, the number of adolescents taking up smoking could decrease significantly.

James Sargent, MD, co-director of the Cancer Control Research Program said “Smoking is a killer. Its connection to cancer, heart attacks, and chronic lung disease is beyond doubt. Kids start to smoke before they’re old enough to think about the risks; after starting they rapidly become addicted and then regret it. Hollywood plays a role by making smoking look really good. By eliminating smoking in movies marketed to youth, an R rating for smoking would dramatically reduce exposure and lower adolescent smoking by as much as one-fifth.”

Teen tobacco smoking falls, but marijuana usage rises – tobacco usage among 14, 16 and 18 year-olds in the USA dropped to their lowest level since 1975, researchers from The National Institute on Drug Abuse reported in December 2011. However, the consumption of marijuana and non-medical prescription drugs rose.

Written by Christian Nordqvist