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How Powerful is Cigarette Advertising? Ask a Teenager

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The likelihood your teen will start smoking could depend on how much tobacco advertising he or she sees. One Stanford University School of Medicine researcher believes store advertisements work so impressively well on teens that federal regulators should consider barring such marketing from convenience stores, gas stations and small groceries.

Lisa Henriksen, PhD, and senior scientist at Stanford’s Prevention Research Center said teens who regularly visit tobacco retail outlets where the ads are pervasive—from traditional sign and product display advertising to clocks, trash cans and register mats—were at least twice as likely to try smoking as those who rarely visited. Her research findings will be published in the August issue of Pediatrics.

The tobacco industry has waged a relentless campaign to recruit new smokers; in spite of being banned from the airwaves, cigarettes are advertised more heavily than any other product except cars. Point-of-sale advertising is the bread-and-butter of tobacco marketing. In 2006, the industry used 90 percent of its $12.5 billion marketing budget to engage consumers already at the store.

Henriksen said the teen years are when the vast majority of smokers start, and if teens make it through to adulthood without smoking, they are less likely to ever become addicted.

“One particularly nefarious aspect of advertising at convenience stores is it really normalizes the product. Think about what you buy there. Cigarettes, yes, but also soup, laundry detergent, soda, cat food — normal, everyday things. So advertising there really gives teens the impression that smoking is normal,” said Seth Ammerman, a clinical professor of adolescent medicine at Stanford who researches smoking cessation, but who was not involved in the study. “Young people are very susceptible to advertising messages. Tobacco companies understand this. They're not stupid.”

The study's publication comes just as the new federal Tobacco Regulation Law goes into effect, empowering the U.S. Food and Drug Administration to regulate the manufacturing, marketing and sale of tobacco products. As of June 22, 2010 tobacco companies are banned from using terms such as "light," "low" and "mild" on advertising and packaging and sponsoring cultural and sporting events, but regulators may impose additional constraints if warranted.

In recent years, the once declining teenage smoking rate has leveled off. According to the Centers for Disease Control and Prevention, high school students who reported current cigarette use declined sharply from a peak of 36.4 percent in 1997, to 21.9 percent in 2003. In 2009, the percentage dropped a bit more to 19.5, about the same average for current adult smokers.

Previous research has shown that teens have a greater addiction to nicotine than smokers who start as adults. Telling kids the facts, that 90 percent of lung cancer in men and 80 percent in women is directly from smoking, does little to dissuade them. First, teens feel invincible and studies show only 3 percent of teens who start believe they will still be smoking in five years. In reality, 60 percent do.

To test her hypothesis, Henriksen followed 2,110 middle school students in Tracy, Calif., for three years. At the start of the study, none of the students had used cigarettes. She also assessed the amount of tobacco advertising kids were exposed to at stores near the three schools involved in the study.

One year later, a survey of these previously non-smoking students revealed 18 percent had smoked over the year, at least one puff, and that smoking initiation was much more prevalent (29 percent) among the students who had reported frequent visits to stores with the most cigarette ads compared to those (9 percent) who visited the stores infrequently.

On average, students in the study experienced 325 cigarette-brand impressions (defined as how many times they saw ads) per week, ranging from an average of 114 among infrequent shoppers to 633 among those who shopped frequently.

“I was surprised by the sheer number of cigarette brand impressions in signs and displays in convenience stores near schools,” said Henriksen. “The exposure is unavoidable. It's impossible to miss.”

To measure the effect of the advertising, the research factored in risk-taking behavior, unsupervised time after school, exposure to smoking in movies or on TV, and smoking by household members and friends, all of which have been identified as risk factors for teen tobacco use. The researchers also factored in grades and demographics including gender, race and ethnicity.

The Mayo Clinic, National Institute of Drug Abuse, and No Tobacco.org has tips on how to help your teens stay smokefree or kick the habit if they have started.

Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona.In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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