Tobacco promotions still reaching youth

"For several years, the emphasis in the tobacco industry has been on this sort of direct marketing, especially to young people who are highly price sensitive and who may find coupons, samples, and promotions appealing," said lead author Samir Soneji, Ph.D., an assistant professor at the Geisel School of Medicine at Dartmouth and the Dartmouth Institute for Health Policy and Clinical Practice.

The U.S. government has made efforts over time to limit tobacco advertising. In the 1960s, health concerns about tobacco prompted Congress to ban cigarette ads on television and radio. In 2010, the FDA prohibited tobacco company sponsorship of sporting and entertainment events and tobacco sales to children younger than 18, among other measures to further regulate tobacco.

Soneji's research team explored whether exposure to coupons and promotional websites would increase the chances of a youngster starting to smoke and/or being a current smoker. "We found that both direct mail [coupons] and exposure to tobacco websites were associated with increased chances of smoking initiation and current smoking." He emphasized that the study isn't showing causation, but rather a striking degree of association.

During 2011, the researchers recruited a sample of 2,541 young people between ages 15 and 23. Each participant completed both a phone-based and a web-based survey. The youths received $10 for the phone survey and additional $10 or $25 for completion of the web based survey. "Overall, 12 percent of 15- to-17-year olds and 26 percent of 18- to-23-year olds were exposed to either form of direct-to-consumer tobacco marketing," coupons received via US mail or websites, the authors wrote.

Although the websites are supposedly restricted to adults, youngsters may have gained access by using their parents' or another adult's login information. "Stricter, better enforced regulation on the recipients of direct-to-consumer tobacco marketing could reduce youth smoking." In the meantime, parents who smoke who remove their names from industry mailing lists may decrease their children's exposure to coupons and, in turn, the risk of their children smoking, the authors wrote.

"This article is important for all concerned about youth smoking," said Richard Brunswick, M.D., a physician who has written an evidence-based primer on smoking cessation entitled Can't Quit? You CAN Stop Smoking. "Much remains to be done with regards to enforcement [of FDA powers to control tobacco marketing] so that adolescents and young adults don't obtain materials or access to websites that promote the use of tobacco, the only product available that kills those who use it as directed."