Tobacco companies spend more than $5 billion annually to advertise and promote cigarettes and other tobacco products. Tobacco companies claim that the purpose and desired effect of marketing are merely to provide information and to influence brand selection among current smokers, although only about 10 percent of smokers switch brands in any one year. Since more than one million adult smokers stop smoking every year and almost half a million other adult smokers die from smoking-re-lated diseases, the tobacco companies must recruit an average of 3,300 new young smokers every day to replace those who die or otherwise stop smoking. Tobacco companies contend that smoking is an ''adult habit'' and that adult smokers ''choose'' to smoke. However, many medical researchers assert that cigarette smoking is primarily a childhood addiction or disease and that most of the adults who smoke started as children and could not quit.
Unlike the pharmaceutical companies, which are tightly regulated as to their advertising and promotion, the tobacco industry has had few regu lations. The basic restrictions have been that companies cannot use paid advertising on television or radio, they cannot claim what they cannot prove (e.g., that low-tar cigarettes are less hazardous to health), and they must include one of four warnings on cigarette packages and ads. The fact that warning labels are printed on a pack of cigarettes has been successfully used by the tobacco companies as a defense against tobacco victims' lawsuits.
The whole picture changed when Florida, Minnesota, Mississippi, and Texas were able to reach an agreement in 1997 and early 1998 with the major tobacco companies and won compensation for the effects of smoking on their health-care expenses. Minnesota was able to obtain copies of long-secret memos, reports, letters, and other documents that were made public as part of the $6.6 billion settlement reached in their lawsuit against cigarette makers.
On November 23, 1998, the major tobacco companies entered into an agreement with the other forty-six states. This agreement, which is known as the Master Settlement Agreement (MSA), settled litigation brought by the states and other entities that were seeking the reimbursement of expenditures related to smoking and health. Under this agreement, the states and tobacco companies jointly agreed to concrete provisions to reduce youth smoking, new public health initiatives, and important new rules for governing a tobacco company's way of doing business.
The cigarette companies agreed to pay $368.5 billion over 25 years. Of this, $246 billion goes to the states, and they have started to receive payments under this agreement. The state of Florida receives $450 million each year under this agreement, Iowa $54.9 million, and the other states differing amounts. Iowa, Kansas, and Washington have agreed to set aside this money entirely for health care. Iowa has passed a law that their money shall go to three areas: access to health care, public health and smoking prevention, and substance-abuse treatment and prevention. In other states, this new-found money has created hot political battles over how much of their tobacco settlement to spend on tobacco prevention programs.
A two-year education effort and ad campaign has lowered the number of teen smokers in Florida. The campaign reduced middle-school smoking by more than half and lowered smoking among high-school students by 24 percent. This multimillion-
The Marlboro man, a controversial tobacco icon, on a billboard in downtown Denver, June 20, 1997. (Archive Photos, Inc.)
dollar campaign was financed by Florida's $11.3 billion tobacco settlement, of which Florida has already received $2 billion.
The MSA has changed the way cigarette companies can market, advertise, and promote their cigarettes. The agreement specifically includes the following:
• No participating manufacturer may take any action, directly or indirectly, to target youth in the advertising, promotion, or marketing of tobacco products. It also prohibits any action the primary purpose of which is to initiate, maintain, or increase the incidence of youth smoking.
• Effective April 23, 1999, billboards, stadium signs, and transit signs advertising tobacco are banned. However, this does not apply to retail establishments selling tobacco. They may have signs up to 14 square feet inside or outside their stores.
• Effective May 22, 1999, the use of cartoon characters in advertising, promoting, packaging, or labeling of tobacco products is banned. (This applies only to ''exaggerated depictions, or depictions of entities with superhuman powers''. It does not cover the standard camel logo or simple drawings of a camel. It does not prohibit the continued use of the Marlboro man or other human characters.)
• Beginning July 1, 1999 participating manufacturers and others licensed by them may no longer market, distribute, offer or sell, or license any apparel or merchandise bearing a tobacco brand name.
• Free product sampling is banned anywhere, except for a facility or enclosed space where an operator may ensure that no minors are present.
• Manufacturers may not sell or distribute cigarette packs containing less than twenty cigarettes until the year 2001.
• There shall be no payment for the use of tobacco products in movies, TV programs, live performances, videos, or video games. (Does not apply to media viewed in an adult-only facility or to media not intended for distribution to or display to the public.)
• There shall be no licensing of third parties to use or advertise any brand name in a way that would constitute a violation of the MSA if done by the participants.
• No nonbranded item may be given in exchange for the purchase of tobacco products or redemption of coupons or proof of purchase without proof of age.
• No use of a tobacco brand name as part of the name of a stadium shall be allowed.
• Tobacco sponsorships are limited to one per year, after a three-year grace period (from November 1998). Such brand-name sponsorship may not include concerts, events in which any paid participant or contestants are youth, or any athletic event between opposing teams in any football, basketball, baseball, soccer, or hockey league.
The previous voluntary cigarette advertising and promotion code rules are also still in effect:
• Cigarette smoking is an adult custom. Children should not smoke. Laws prohibiting the sale of cigarettes to minors should be strictly enforced. The cigarette manufacturers advertise and promote their products only to adults smokers. They support the enactment and enforcement of state laws prohibiting the sale of cigarettes to persons under 18 years of age.
1. Cigarette advertising shall not appear in publications directed primarily to those under 21
years of age, including school, college, or university media (such as athletic, theatrical, or other programs). Comic books or comic supplements are included.
2. No one depicted in cigarette advertising shall be or appear to be under 25 years of age.
3. Cigarette advertising shall not suggest that smoking is essential to social prominence, distinction, success, or sexual attraction, nor shall it picture a person smoking in an exaggerated manner.
4. Cigarette advertising may picture attractive, healthy-looking persons provided there is no suggestion that their attractiveness and good health are due to cigarette smoking.
5. Cigarette advertising shall not depict as a smoker anyone who is or has been well known as an athlete, nor shall it show any smoker participating in, or obviously just having participated in, a physical activity requiring stamina or athletic conditioning beyond that of normal recreation.
6. No sports or celebrity testimonials shall be used or those of others who would have special appeal to persons under 21 years of age.
All the agreed-on advertising and promotional restrictions spelled out in the MSA should be very helpful in curbing underage smoking, but the tobacco companies have always found ways to bypass the bans and advertise in other venues. Billboard advertising is now banned but tobacco companies have increased their level of advertising in magazines, many of which are read by teenagers. Seventy-three percent of teens (aged 12 to 17) reported seeing tobacco advertising in the previous 2 weeks, compared to only 33 percent of adults surveyed. Since billboards were banned, 61 percent of teens who recalled tobacco advertising saw it in magazines, compared to 50 percent the year before.
A survey also revealed that 77 percent of teens say it is easy for people under the age of 18 to buy cigarettes and other tobacco products. Many displays of cigarettes in convenience stores are at waist level, making them plainly available to children. The campaign to restrict access by youths under the age of 18 to cigarettes has not been too successful.
A California suit against R.J. Reynolds Tobacco, filed on May 11, 2000, charges that the company has violated the legal settlement with state governments by improperly distributing large quantities of free cigarettes by mail. This case marks the first time an attorney general has taken a cigarette company to court to enforce the terms of the MSA. Reynolds said it was part of a program of ''consumer testing'' and was therefore allowable under the agreement. The attorney general alleges Reynolds mailed the free cigarettes ''under the guise of consumer testing or evaluation in order to market and advertise its products.'' According to the suit, Reynolds sent more than 900,000 multipack cigarette mailings to more than 115,000 California residents during 1999, some receiving as many as ten packs at a time.
In his memoirs, former Surgeon General C. Everett Koop said this about the tobacco industry, ''After studying in depth the health hazards of smoking, I was dumbfounded—and furious. How could the tobacco industry trivialize extraordinarily important public-health information: the connection between smoking and heart disease, lung and other cancers, and a dozen or more debilitating and expensive diseases? The answer was—it just did. The tobacco industry is accountable to no one.''
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