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Direct tobacco marketing linked to teen and adult smoking

People smoke during a break outside an office building in midtown New York September 3, 2013. REUTERS/Carlo Allegri
People smoke during a break outside an office building in midtown New York September 3, 2013. REUTERS/Carlo Allegri

By Shereen Jegtvig

NEW YORK (Reuters Health) - Direct to consumer marketing of tobacco products is reaching significant numbers of teens, as well as young adults, according to a new study.

Young people who have seen the promotions are also more likely to take up smoking, the researchers found.

The U.S. Food and Drug Administration regulates marketing of tobacco products, including mailings and Internet advertising. Consumers, for example, must be 18 years old to view tobacco company websites. But according to the study, kids younger than that are seeing tobacco promotions anyway.

"About one in 10 adolescents and about one in four young adults are somehow exposed to direct-to-consumer tobacco marketing," the study's lead author Samir Soneji told Reuters Health.

"The younger group is especially worrisome, they're less than 18, they ostensibly shouldn't be on or wouldn't be allowed on tobacco websites or receiving direct mail, so there's lots of gaps in the regulation," he said.

Soneji, who is with the Norris Cotton Cancer Center at the Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire, also found that the greater a young person's exposure was to direct-to-consumer marketing, the stronger their likelihood of smoking.

That held true for first-time smoking and established smoking, which the researchers defined as having smoked at least 100 cigarettes in one's lifetime.

The findings of the new study were published in the Journal of Adolescent Health.

Between the fall of 2010 and the spring of 2011, Soneji and colleagues surveyed a total of 2,541 young people aged 15 to 23 years from across the U.S.

The researchers asked participants if they had ever received anything in the mail promoting tobacco products, even if it wasn't addressed to them specifically.

Participants were also asked if they had seen any of the home pages of five brands of cigarettes, even though those home pages are age-restricted.

The researchers asked about smoking history and categorized the participants as non-smokers, current smokers if they had smoked at least one cigarette in the previous month and established smokers.

Soneji and colleagues found that 12 percent of the 15- to 17-year olds and 26 percent of 18- to 23-year olds had been exposed to direct-to-consumer mail or Internet marketing of tobacco products.

Those who had seen either the direct mailings or websites were 50 percent more likely to have ever tried smoking than participants who hadn't seen the marketing material, and twice as likely to be current or established smokers.

Participants who reported seeing both direct mailings and websites were five times more likely to have ever smoked, three times as likely to be current smokers and eight times as likely to be established smokers, compared to those who had not seen the material.

"With the mail, we've wondered about whether or not the adolescents are receiving the direct mail themselves - to Johnny Smith - or is it to his dad or his mom or his older sibling and he sees it and he thinks that this might be meant for him or he just looks at it," Soneji said.

He pointed out that while adult smokers may have quit smoking, their names might still be on tobacco mailing lists.

"So what we're thinking is one way to prevent inadvertent exposure to direct mail is to make sure that when parents quit smoking they actively seek to take themselves off mailing lists to prevent that inadvertent exposure to tobacco mail," Soneji said.

The researchers acknowledge in their report that they did not know the exact timing of exposure to tobacco marketing or when some of the young people began smoking. So they cannot say whether some young people who already smoked were more likely to visit the tobacco company websites, for example, seeking promotional material or coupons.

Shanta Dube told Reuters Health that the new results are in keeping with what is already known - that a high percentage of youth continue to be exposed to pro-tobacco marketing.

Dube, a researcher in the Division of Epidemiology and Biostatistics at the School of Public Health at Georgia State University in Atlanta, wasn't involved in the study.

"It's confusing to youth because on one hand they're being told it's not good - obviously smoking is not a healthy thing to start - but then they're seeing these flashy ads, especially on the websites," she said.

Dube said that even if young people don't visit the tobacco company websites because of the age restrictions, they're still exposed to advertising on other sites.

"I think we still need to do mass media campaigns and educate everyone about the dangers of smoking, including for youth," Dube said.

"I know they do some of this educational messaging around how tobacco industry promotes their product, especially tobacco products and smokeless tobacco products, which for decades have been shown to cause adverse health effects like cancer and cardiovascular disease," she said, "so I think that eliminating youth exposure to pro-tobacco ads has to be part of comprehensive regulatory and tobacco control."

Source: http://bit.ly/1qDV4xe Journal of Adolescent Health, online March 24, 2014.

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