Influence of cigarette promotion on mediators of smoking

Despite various efforts to reduce tobacco use among youth, the prevalence is on the rise (Johnston, 1996). In the meantime, the expenditures of the tobacco industry for advertising and promoting cigarettes are also on the rise. It is estimated that the tobacco industry spends over US$ 6 thousand million to advertise and promote cigarette consumption. According to data from the Federal Trade Commission, the industry has been spending more money on promotion than on advertising since 1983. Although studies of advertising patterns and young people’s tobacco use demonstrate a positive association between advertising and adolescent smoking (Evans et al., 1995; Pierce & Gilpin, 1995; Altman et al., 1996; Schooler et al., 1996), there has been some concern about the direction of causality. First, the direction may be reversed: adolescents who smoke are more likely to be exposed to and to recognize tobacco marketing than those who do not smoke. Secondly, exposure to tobacco marketing may be associated with general problematic behaviour such as rebelliousness and risk-taking. Hence, it may be argued that it is not the marketing per se, but personal characteristics that account for differential exposure to marketing as well as smoking. To establish a causal link between tobacco marketing and smoking, we used data from a large student survey conducted in Tucson, Arizona, to explore the relative impacts of tobacco marketing and other key risk factors associated with uptake in a single analysis.