It is well known that cigarette smoking is injurious to health. Regardless, cigarette and smokeless tobacco companies spend billions of dollars advertising their products. An area of particular concern is the marketing campaigns targeting the youth, despite the fact that major cigarette companies and a spit tobacco company have signed the “Master Tobacco Settlement Agreement” in 1998, where they agreed to not take any action directly or indirectly targeting youth.

Releasing her final opinion in a landmark case against tobacco companies in 2006, U.S. District Court Judge Gladys Kessler contended that the tobacco companies continued to target youth with their marketing campaigns. In 2014, the U.S. Surgeon General reasserted this finding, stating that, “...the tobacco industry aggressively markets and promotes lethal and addictive products, and continues to recruit youth and young adults as new consumers of these products.” This is particularly disturbing, given that the youth are vulnerable to such campaigns.

A study conducted with non-smoking 6^th and 8^th graders in Germany reported in BMJ Open in 2013 that “exposure to tobacco advertisements predicted established smoking and daily smoking, whereas exposure to non-tobacco advertising did not.” The authors believe that the kids’ exposure to marketing, in general, could account for their exposure to cigarette advertisements. The authors further stated, “..after controlling for age, gender, socioeconomic status, school performance, television screen time, personality characteristics and smoking status of peers and parents, each additional 10 tobacco advertising contacts increased the adjusted relative risk for established smoking by 38%.”

Although it does not state if adolescents were enrolled, a study published online on March 11, 2015 in Health Communication looked at the effect of advertisements for e-cigarettes in the vulnerable population. In this investigation, a number of daily smokers, former smokers, and intermittent smokers viewed the commercials for e-cigarettes with or without visuals showing vaping (inhaling an e-cigarette). The authors report that:

1. The commercials with vaping visuals acted as a cue for smokers in their urge to smoke tobacco cigarettes
2. The commercials with vaping visuals seen by former smokers may undermine their abstinence efforts
3. Exposure to non-vaping visuals or no advertisement watching lacked a significant reaction.

Thus, commercials with visuals play a significant role in a person’s behavior, specifically in the vulnerable population. In this age of constant exposure to advertisements through various outlets, more regulations and campaigns are required to shield the vulnerable and impressionable population from falling prey. This measure needs to be undertaken immediately if we are to avoid future health care costs associated with the diagnosis and treatment of respiratory disorders. Not to mention, this is likely to have an impact on the economy, due to loss as a result of reduced labor productivity.

Written by Mangala Sarkar Ph.D.