Cigarette commercials can encourage smoking among teenagers

The more that teens see cigarette ads, the greater their risk of taking a puff.

A new study shows that the particular content of tobacco marketing resonates with youth and that the vivid imagery in tobacco advertising captures their interest, although teens typically are more resistant to the promotional seduction of other products.

"Cigarettes have created a brand for every personality trait," said study lead author Reiner Hanewinkel, Ph.D., director of the Institute for Therapy and Health Research in Kiel, Germany.

"If you are looking to project independence and masculinity, think of the lonely cowboy in the Marlboro ads," added Hanewinkel, who collaborated with Dartmouth Medical School. "On the other hand, if you're looking to project a desire for romantic relationships, and friendships are playing a role, then you will choose Lucky Strike if you are a man and Virginia Slims if you are a woman."

Kids with high exposure to tobacco advertising were twice as likely to have tried smoking and three times as likely to have smoked in the past month, compared to those with low exposure. Exposure to tobacco advertising also was associated with higher intent to smoke in the future among the never-smokers, suggesting that it affects how adolescents perceive smoking even before they start.

The study, which appears online and in the April issue of the American Journal of Preventive Medicine, has relevance for the United States and other nations with partial advertising bans similar to Germany's restrictions.

The 2008 survey involved 3,415 German schoolchildren, ages 10 to 17, in rural and urban areas. Students saw images (with all the writing and brand logos removed) of six cigarette ads and eight commercial products such as clothing, cars, candy and detergent.

With the brand information missing, researchers measured adolescents' ad recognition by applying psychological assumptions about attention and memory. They inquired about how frequently students had viewed each ad image and asked about smoking habits and intentions.

"We were amazed at how often they had seen the images and could correctly recall the cigarette brand," said study collaborator James Sargent, M.D., a professor of pediatrics at Dartmouth. "For example, 55 percent had seen the Lucky Strike image and almost one quarter correctly decoded the brand."

After analyzing the data, the researchers assessed how likely nonsmokers were to try smoking. Researchers classified survey participants as current smokers if they reported smoking at least once a month.

"This is a well-done study. They controlled for all the things they needed to control for," said Stanton Glantz, Ph.D., director of the Center for Tobacco Control Research & Education at the University of California, San Francisco. Among the outside variables was whether a parent or peers smoke.

"It's a nice contribution to the literature showing that cigarette advertising is very powerful," Glantz said, noting the strong link between the amount of ad exposure and the level of youth response.