Study Links Cigarette Gear, Youth Smoking

Schoolkids who sport clothing and gear emblazoned with cigarette names and logos are four times more likely to smoke than other children, according to a new study suggesting that such promotional items may foster youth smoking.

Although tobacco companies are not allowed by federal regulations to sell or give cigarette-related merchandise to people under 18, children still end up with hats, T-shirts, backpacks and other gear displaying cigarette brand names and trademarks.

Public health experts and anti-smoking advocates have sharply criticized the promotions, saying the items might function as a sort of stealth advertising that interests children in smoking.

In recent years, the tobacco industry has boosted spending on merchandise giveaways and catalog sales, from $307 million in 1990 to $665 million in 1995, according to the most recent Federal Trade Commission records. Additional hundreds of millions have been invested annually in items sold at retail stores or “purchased” with cigarette pack coupons.

Meanwhile, national youth smoking rates have risen 1% to 2% annually since 1992. In 1996, it was estimated that 34% of 12th-graders smoked.

The new study, which is the largest to test the correlation between smoking rates and ownership of cigarette merchandise among public school students, was based on a survey of 1,265 youngsters in grades six through 12 at five facilities in rural Vermont and New Hampshire. It found that the merchandise was substantially more prevalent, and more tightly linked with lighting up, than researchers previously observed.

The researchers found that 32% of the youngsters surveyed owned promotional merchandise. T-shirts and hats were the most common items, Marlboro and Camel the most popular brands. Most of the items came from parents or adult friends, but 22% of the children with an item said that stores or cigarette company catalogs sold it to them directly, in violation of federal laws.

Moreover, 4.8% of the children said they had a promotional item with them on the day of the survey, in October 1996. And because the results indicated that each item taken to school was seen by 10 other youngsters, the findings “raised the possibility that children were becoming the means through which cigarettes were being promoted to other children,” wrote the physician-researchers, who are based at Dartmouth Medical School in Hanover, N.H., and the Veterans Affairs Medical Center in White River Junction, Vt.

A youngster was more likely to smoke if he or she owned a promotional item, the researchers say. Among the 12th-graders, 32% overall were classified as smokers, meaning they admitted to having smoked more than 100 cigarettes. But 58% of those who owned a promotional item smoked, compared to 23% of those who did not own one.

The association was strongest in the lower grades, which especially concerned the researchers because that is when crucial attitudes toward smoking are being formed. Only 3% of sixth-graders were classified as smokers, but all of them said they owned a promotional item.

“This is the most powerful demonstration yet that these promotional items have a disproportionate impact on kids,” said Matthew Myers, executive vice president of the National Center for Tobacco Free Kids.

Tobacco company spokespersons disputed the findings, which were made public Sunday in an American Medical Assn. journal, the Archives of Pediatric and Adolescent Medicine.

The study also uncovered strong evidence of family and peer pressure on smoking trends: The likelihood that youngsters smoked was boosted nearly seven times if they had friends who did so, and 28 times if both friends and family members smoked.

The lead author, Dartmouth pediatrician Dr. James Sargent, said that a survey cannot prove that the promotional items caused the children to start smoking. Still, he said the results clearly show that the merchandise appears to put very young children at greater risk of experimenting with cigarettes.

John Pierce, a cancer prevention expert at UC San Diego who has studied cigarette advertisements’ effect on children, said he was impressed that about a third of the youngsters in the new study had promotional items. In a random telephone survey of California residents in 1993, Pierce and his co-workers found that 9% of people of high school age had such an item. “If it was a problem [then], it’s a much bigger problem now,” he said.

Tobacco companies pointed out that cigarette promotional items were around long before the recent increase in youth smoking. Peggy Carter, a spokeswoman for R.J. Reynolds, maker of Camel, said the “bottom line” was that the research did not establish causality.

Beyond that, she said, the company takes numerous steps to prevent minors from purchasing company merchandising. Catalog orders require a signature attesting that a customer is over 21, and the company uses five databases to protect against fraud, including motor vehicle and voter registries, she said.

“We wish that parents would not tolerate their children having items associated with our brands,” she said. “We think it’s inappropriate. But that’s an issue between parents and children.”

The FTC has a lawsuit pending against R.J. Reynolds, alleging that the now-defunct Joe Camel advertising and merchandising campaign appealed to minors, said Lee C. Peeler, associate director for advertising practices at the FTC.

A call to Philip Morris, maker of Marlboro, was referred to a public relations agency handling the tobacco companies’ side of the proposed settlement with states suing the industry for smoking-related medical costs. A ban on promotional items is also part of the industry’s settlement offer with the states.

The Food and Drug Administration moved to eliminate the merchandising as part of its sweeping new purview over tobacco products, but a federal court ruled in April that the agency had no jurisdiction over tobacco advertising issues. That ruling is being appealed.

In suggesting the link between promotional items and youth smoking, the new study appears to overstate the growth of tobacco industry spending on the items. It says that such spending went from $310 million in 1990 to $1.25 billion in 1994--a fourfold increase. But the earlier figure does not include promotional coupons redeemed for cigarettes in addition to merchandise, whereas the more recent spending figure does.

The FTC reports that combined merchandising and cigarette-promotion totals were $1.49 billion in 1990 and $2.1 billion in 1994--a 41% increase.