Inequality Found In Tobacco Advertising

Smoking remains the leading cause of preventable death and disease in the United States, causing more than 440,000 deaths annually and costing more than $150 billion in direct and indirect costs each year; African-Americans currently bear the greatest burden of this morbidity and mortality. Although exposure to pro-tobacco media messages is now known to be a potent risk factor for tobacco use, whether African-Americans are in fact exposed to more pro-tobacco advertising has been unclear until now.

"This review and meta-analysis demonstrates that African-Americans are indeed disproportionately exposed to pro-tobacco mass media messages in terms of both concentration and density," said Brian A. Primack, M.D., Ed.M., senior author of the study and assistant professor of medicine and pediatrics at the University of Pittsburgh School of Medicine. "These findings will help us develop interventions and further research aimed at reducing tobacco-related health disparities."

In the study, Dr. Primack and colleagues evaluated data from both predominantly African-American and Caucasian markets using studies from peer-reviewed journals. By extracting the number of total media messages the number of tobacco-related messages, and the number of residents living in each market area, they were able to calculate the concentration and density of tobacco advertising in each market.

Concentration of tobacco advertising can be defined as the number of tobacco advertisements divided by the total number of advertisements. "According to our data, the concentration of pro-smoking signage is approximately 70 percent higher for African-Americans ," said Dr. Primack. "Our results also showed that there are about 2.6 times as many advertisements per person in African-American areas as compared to Caucasian areas."

The findings, Dr. Primack notes, suggest that African-Americans may be special targets of the tobacco industry.

"This population may require specific public health interventions to counter the effect of unbalanced pro-tobacco promotion. Knowing that they may be targeted could motivate African-Americans to refuse to fall prey to industry tactics and help them avoid smoking," he said.

The study authors point out important limitations worth noting. In particular, the studies that met criteria for inclusion in this review focused on older forms of advertising and promotion such as billboards and magazines. This suggests that additional research is needed on current media portrayals of smoking, such as tobacco promotions and smoking in films.

Co-authors of the study include James E. Bost, Ph.D., and Michael J. Fine, M.D., M.Sc., both from the University of Pittsburgh School of Medicine, and Stephanie R. Land, Ph.D., from the University of Pittsburgh Graduate School of Public Health.