Investing magazines articles on smoking

One R. The company's own public relations counsel understood that it would be critical to create questions about the reliability of the new findings and to attack the notion that these studies constituted proof of the relationship of smoking to cancer. Executives and staff canceled all holiday plans as they worked to frame and implement a full-scale campaign on behalf of the industry. Their role was exclusively limited to serving the public relations goal of their collective clients.

Because of the serious nature of the attack on cigarettes and the vast publicity given them in the daily press and in magazines of the widest circulation, a hysteria of fear appears to be developing throughout the country, Hill wrote in an internal memorandum. Ultimately, he concluded, the best public relations approach was for the industry to become a major sponsor of medical research.

The call for new research implied that existing studies were inadequate or flawed. It made clear that there was more to know, and it made the industry seem a committed participant in the scientific enterprise rather than a self-interested critic. The industry had supported some individual research in recent years, but Hill's proposal offered the potential of a research program that would be controlled by the industry yet promoted as independent. This was a public relations masterstroke.

Hill understood that simply giving money to scientists—through the National Institutes of Health or some other entity, for example—offered little opportunity to shape the public relations environment. However, offering funds directly to university-based scientists would enlist their support and dependence. The very nature of controlling and managing information in public relations stood in marked contrast to the scientific notion of unfettered new knowledge. Hill and his clients had no interest in answering a scientific question.

Their goal was to maintain vigorous control over the research program, to use science in the service of public relations. Although the tobacco executives had proposed forming a cigarette information committee dedicated to defending smoking against the medical findings, Hill argued aggressively for adding research to the committee's title and agenda.

Hill also advised the industry that continued competitive assertions about the health benefits of particular brands would be devastating. Instead, the industry needed a collective research initiative to demonstrate its shared concern for the public. Rather than using health research to create competitive products as they had been doing, the companies needed to express—above all else—their commitment to public well-being.

Hill believed that the competitive fervor over health claims had harmed the industry's credibility. No one would look for serious information about health from an industry that was making unsubstantiated claims about its product. The future of the industry would reflect its acceptance of this essential principle. From December forward, the tobacco companies would present a unified front on smoking and health; more than 5 decades of strategic and explicit collusion would follow.

We believe the products we make are not injurious to health. We always have and always will cooperate closely with those whose task it is to safeguard the public health. Hill carefully outlined the plans for a research program before a single scientist was consulted. The utility of such a strategy was its apparent commitment to objective science and its search for the truth.

As one colleague argued, A flamboyant campaign against the anti-smoking propagandists would unquestionably alienate much of the support of the moderates in both scientific and lay publics. The TIRC, from its inception, was dominated by its public relations goals. Alton Ochsner, the well-known thoracic surgeon who had conducted research on the relationship of smoking to heart disease, saw his own hopes for funding support from the industry fade as the TIRC's research agenda quickly became clear.

He noted, Of course, the critical areas of investigation, as every research scientist knows, have to do with the problem of how to make smoking a less lethal agent in lung cancer incidence and a less deadly killer in heart disease…. Yet it is precisely these areas that apparently have been declared out of bounds for the industry's research committee.

Hoyt, executive director of the TIRC, came to the position with no scientific experience whatsoever. In early , he assumed a dominant role in the day-to-day operations of the tobacco industry research program. Ultimately, Hoyt would become a full-time employee, remaining integral to the TIRC until he retired in The press release announcing his appointment read, in part, as follows: It is an obligation of the Tobacco Industry Research Committee at this time to remind the public of these essential points: 1.

There is no conclusive scientific proof of a link between smoking and cancer. Medical research points to many possible causes of cancer…. The millions of people who derive pleasure and satisfaction from smoking can be reassured that every scientific means will be used to get all the facts as soon as possible. Little came to the position as an aggressive and uncompromising skeptic of the epidemiological work that had demonstrated the relationship of smoking to lung cancer. He had strong a priori views that cancer must be essentially genetic and that ultimately this would be demonstrated.

Given his scientific pedigree, national standing, and propensity for public conflict, he was extremely well chosen from a public relations perspective. Although Little favored basic science investigations into the mechanism of cancer, often using animal models, he never confronted the critical issue of the relationship of translating such research from the laboratory to humans. Bradford Hill, whose research had been crucial to linking smoking to lung cancer.

It seems astonishing to me that a man of his eminence in the field of cancer and genetics would condescend to take a position like that. Blurring the boundaries between industrial public relations and academic science was critical to the industry's interests. The TIRC settled into a program of funding research principally on the basic science of cancer, with little or no relevance to the critical questions associated with the medical risks of smoking. Most of the TIRC's program centered on basic questions in immunology, genetics, cell biology, pharmacology, and virology.

This focus apparently suited all concerned. It was certainly ideal from a public relations standpoint because research unrelated to smoking would not condemn cigarettes. SAB members could assert that they were offering valuable resources to important scientific questions yet distance themselves from the specific question of the harms of tobacco and thus avoid accusations of bias.

The SAB cemented the relationship between academic researchers and industrial interests. By steering funds away from the effects of tobacco toward basic science in cancer, the TIRC avoided the implication that it served industry interests. SAB members were frequently in a position to secure funding from the industry to support the work of colleagues and associates, as well as other research at their home institutions.

Such arrangements gave them considerable influence and clearly sustained their loyalty to the TIRC. As Hill anticipated, researchers associated with the TIRC typically avoided taking any position on the tobacco controversy. Little became the industry's primary spokesman in obscuring this question.

The sharp disjuncture between the research agenda of the TIRC and the commitment to resolving the controversy about smoking and health is a major indicator of the committee's essential public relations goals. In the end, the TIRC was designed to direct attention away from the issue of immediate concern to the American public and American medicine: the health effects of smoking. In this way, the tobacco industry managed to sustain the widespread perception of an active and highly contested scientific controversy into the s despite overwhelming evidence and scientific consensus that smoking caused serious disease.

According to the TIRC, many independent and responsible scientists continued to voice opposition to these findings. In reality, over the course of the decade, such views were increasingly marginal and limited to those with financial ties to the TIRC.

But skepticism does not indicate that there is not consensus. With each passing year, skepticism concerning the relationship between smoking and cancer was increasingly dominated by industry resources and public media. Doubt was no longer a matter of culture or training but the carefully crafted centerpiece of an industry effort to sow confusion and heighten debate through explicit attempts to disrupt the process of normative science.

The TIRC marks one of the most intensive efforts by an industry to derail independent science in modern history. And, as shown subsequently, others would follow the tobacco industry's road map, drawn in the s. Thus, it seems obvious that reviews of such programs for scientific relevance and merit in the smoking and health field are not likely to produce high ratings.

In general, these programs have provided some buffer to the public and political attack of the industry, as well as background for litigious strategy. Hill understood that the success of any public relations strategy was highly dependent on face-to-face interpersonal relations with important media outlets.

In these entreaties on behalf of the industry, the firm's staffers repeated several key themes. First, they would note that the industry completely understood its important public responsibilities. Second, they would affirm that the industry was deeply committed to investigating all of the scientific questions relevant to resolving the controversy. Third, they urged skepticism regarding statistical studies. Given the penchant of the press for controversy and its often naive notion of balance, these appeals were remarkably successful.

In this sense, the public relations campaign advantaged 2 critical aspects of midcentury media practice. First, journalists favored reporting on controversy. Second, by providing opposing positions as if they were equal they affirmed their commitment to balance. The problem in this formulation was that science was treated as the analog of common political debate and social controversy.

At that time, few journalists had any sophisticated scientific education or training. The agency took pride in its extensive network of scientific informants. At its headquarters in New York, the TIRC developed a large, systematically cross-referenced library on all issues tobacco related. And that we would make every effort to have an answer in the same day—not the next day or the next edition. This calls for knowing what is going to come out both in publications and in meetings.

They could be so nimble because they aggressively solicited a small group of doubters and broadcast their misgivings as if they were based on rigorous and systematic research. So long as skepticism survived and of course it would , the industry possessed the basis for its aggressive defense. Now—can we, from this experience, answer this fundamental public relations question: Is such preparation and effort for simultaneous comment on attacks on your client worth the effort it requires?

We say the answer is unequivocally yes! Well, how do you prove it? From time to time, man-on-the-street interviews ask about the smoking question. In almost every one of these, there will be a quotation that is almost an exact paraphrase of some statement issued for the tobacco accounts. Without their claims of no proof and doubt, the companies would be highly vulnerable in 2 crucial venues: regulatory politics and litigation. Its credibility and influence rested on perceptions of restraint and a narrow scientific mission.

In the words of an industry attorney, the creation of a separate organization for public information was hit upon as a way of keeping Little inviolate and untainted in his ivory tower while giving a new group a little more freedom of action in the public relations field. After its founding in , the Tobacco Institute quickly emerged as one of Washington's most powerful, well-heeled, and effective political lobbies.

Just as the industry had made critical innovations in advertising and public relations, it now pioneered new and aggressive approaches to managing its regulatory and political environment. In , using a combination of skills, resources, and Washington insiders, the Tobacco Institute assiduously prepared for the political fights that would follow in the wake of the first surgeon general's report on smoking and health.

The institute anticipated that the ground on which the tobacco wars were fought would shift, at least in part, from the scientific realm to the political. Certainly, these battles would engage scientific questions, but Congress would be the new primary site of conflict. It was terrain that greatly favored the tobacco industry, with its lobbying largesse and the strong geopolitical interests of tobacco-growing states.

Indeed, looking back at the half-century that followed the path-breaking science clearly linking cigarettes to disease and premature death, it is striking to note the utter lack of serious and effective regulatory action on the part of the federal government. It is also critical to note that the lobbying and public relations efforts of the Tobacco Institute rested fundamentally on the claims of the scientific doubt and uncertainty generated by the TIRC.

LAW Without regulatory intervention, some smokers turned to the courts for redress. By , more than 30 lawsuits accusing the industry of negligence and other malfeasance had been filed in American courts. Although most had been dismissed or dropped, the risks associated with liability litigation were considered potentially disastrous. Again, the efforts of the Hill campaign were used on behalf of the legal program of the companies.

Little himself, were frequently deployed as expert witnesses in the industry's uniformly effective legal defenses in civil litigation. Defending such litigation required that the companies continue to rely on the no-proof strategy.

According to 2 British tobacco executives 38 : In consequence of the importance of the lawsuits, the main power in the smoking and health situation undoubtedly rests with the lawyers…. The leadership in the U. Even as the industry's insistence on a continuing controversy became increasingly untenable from a scientific and public relations perspective, the companies remained wedded to it for legal reasons.

All of this was dependent on maintaining the notions of controversy, uncertainty, and doubt. The total number of cigarettes sold annually had risen from billion in , the company's first full year of service to the industry, to billion. Per capita consumption had risen from a year in to in , the highest ever. As noted journalist Joseph Lelyveld concluded in the New York Times, Surprisingly, the furor over smoking and health failed to send the industry into a slump.

Instead, it sent it into an upheaval that has resulted in unforeseen growth and profits. He went on to quote an unnamed American Cancer Society official who claimed, When the tobacco companies say they're eager to find out the truth, they want you to think the truth isn't known…. They want to be able to call it a controversy.

This explains, in part, why the industry would so tenaciously cling to the notion of scientific controversy. Indeed, given the widespread acceptance of the conclusion, especially among those who had analyzed and evaluated the research most closely, the persistence of debate about the harms of smoking is a striking demonstration of the powerful impact of the tobacco industry's public relations campaign.

But the firm had also taken its clients across a critical moral barrier that would have 2 important effects on American science and society. By making science fair game in the battle of public relations, the tobacco industry set a destructive precedent that would affect future debates on subjects ranging from global warming to food and pharmaceuticals.

The tobacco industry's public relations campaign permanently changed industry—science relationships and public culture. Their disinformation campaign, built on a foundation of conflicts of interest, demonstrates a series of problems that continue to evolve regarding the relationship between medical science and industrial influence. Indeed, the exposure of this strategy is among the factors that have drawn such suspicion and mistrust to industry-sponsored science since the s.

Certainly every industry does not have the attributes and character of big tobacco, deeply committed to continuing to market a deadly product throughout the world. In this sense, tobacco is unique. At the same time, however, the significance of industrial interests in shaping scientific discourse and outcomes remains undeniable.

Conflicts of interest—such as those invented by the tobacco industry—have the potential to undermine and corrupt the scientific enterprise in ways that do significant damage to what we know and how we deploy the knowledge we possess. The impact of the relationships that the industry built and developed during the s and afterward were of truly great significance for public health.

The industry had bought not only critical time but a new generation of smokers who would succumb to the multiple harms of its product. If, in fact, it could not be known whether smoking was a serious risk to health, the companies argued that it would be up to consumers to decide whether to smoke in this context. As a result, the companies insisted that any risks associated with their product were now the responsibility of the individual smoker.

The companies would repeatedly use this argument to avoid liability in litigation as well as regulation. The presumption of personal responsibility for the harms of smoking has underscored all tobacco promotion and sales since the s. Without a robust notion of scientific uncertainty, such claims would have been impossible.

In large measure, this story emerged only as a result of whistle blowers and litigation that led to the revelation of millions of pages of internal tobacco documents that both laid out this strategy and documented its implementation. This, however, was a factor well understood by John Hill and the public relations teams that advised the companies.

They carefully documented what the scientific investment would buy and how best for the companies to protect and defend that investment. A wide range of other industries have carefully studied the tobacco industry strategy.

As a result, they have come to better understand the fundamentals of influence within the sciences and the value of uncertainty and skepticism in deflecting regulation, defending against litigation, and maintaining credibility despite the marketing of products that are known to be harmful to public health.

Also, they have come to understand that the invention of scientific controversy undermines notions of the common good by emphasizing individual assessment, responsibility, and judgment. I am grateful to participants of the November Drug, Alcohol, Food, and Tobacco Symposium for their insightful comments on an earlier version of this article. The larger national study found a significant increase in quit attempts and a trend towards higher quit rates at follow-up. A time series analysis of monthly smoking prevalence over an year period found greater population exposure to televised MMCs increase of GRPs 2 months earlier was associated with acceleration in the decline in adult smoking prevalence 0.

Since the last reviews of concluded that MMCs have beneficial effects, five of eight additional studies examining effects of MMCs on behaviour quit attempts, sustained quitting or smoking prevalence found beneficial effects, one found a mediated effect, one found a trend towards an effect and one did not find any effects.

Overall, these studies further strengthen the evidence that MMCs can improve attitudes and intentions, promote quitting and reduce adult smoking prevalence. Some mixed findings indicate not all campaigns are equally successful, and factors including the reach, intensity, duration and type of messages used are likely to determine overall impact. Campaign decay, intensity and duration An important aspect of determining optimal campaign investment is campaign decay, or the extent to which effects are detectable after the campaign broadcast ends.

A recent cohort study 21 found quit attempts were associated with MMCs in the most recent 3 months, but not with exposure in earlier months. A time-series analysis showed the beneficial effect of MMCs on smoking prevalence lasted only up to 2 months after exposure. Sustained smoking behaviour change requires frequent longer-term campaign exposure. Few studies have considered the intensity of campaign investment that can most efficiently achieve population changes.

Hyland and colleagues 47 found an average of GRPs per quarter was only weakly associated with quitting. A more recent cohort study of adult smokers found a mean of GRPs per quarter was significantly associated with quitting. Greater advertising exposure may be required to influence adult than youth smoking, due perhaps to the fact that most adult smokers are hampered by addiction. For comparison, a threshold for detecting beneficial effects for reducing smoking uptake among youth may exist around teenage-targeted GRPs per quarter, 48 with effects increasing linearly 48—50 until potentially beginning to diminish above GRPs per quarter.

However, this strategy may also increase costs, as multiple adverts are required. Given finite resources, targeting messages may result in a lower proportion of funds available to broadcast these different adverts, resulting in lower rates of exposure.

The extent of targeting and segmentation therefore needs to be weighed carefully against the importance of maximising campaign exposure. Research among adolescents reported in the NCI review 7 found few differences between different demographic groups' responses to MMCs, that advert characteristics were more important than demographic characteristics, concluding that adverts that perform well do so among many population groups.

To examine these issues among adult smokers, we compared demographic subgroup differences in response to MMCs reported in previous reviews and more recent studies online table 1. In the review by Bala and colleagues, 45 two wide-reaching campaigns examined effects separately for different socioeconomic status SES groups education and ethnicity and campaign effectiveness did not differ by education or ethnicity.

Another review of MMC effectiveness among socioeconomically disadvantaged populations, 51 suggested that differences in the effectiveness of MMCs between SES groups may be due to differences in meaningful exposure, or motivational response, or opportunity to sustain cessation in the long term. Of the nine reviewed general population campaigns that were less successful among lower SES smokers, five suffered from low levels of exposure and promotion.

Underscoring the importance of adequate exposure and campaign reach, the five targeted campaigns that were not successful, were hampered by limited reach, 71—73 or very low levels of recall. An examination of high intensity televised MMCs found no significant interaction between total potential exposure to MMCs and quitting behaviour 2 years later across SES groups. The clear effects on lower SES smokers for the widely broadcast television-led campaigns 10 45 51 versus the negative and mixed effects of low-reach general population campaigns and low-SES targeted campaigns, 14 18 51 indicates that general population campaigns of at least moderate intensity and duration are effective for motivating quitting in lower SES groups.

However, this strategy is likely to produce equivalent effects across SES groups, rather than greater effects in lower SES groups. Examining differences by age and gender, Bala and colleagues 45 found three studies that showed long-term MMC effects for men and one for women, while three found MMC effects among younger smokers and another three found MMC effects among older smokers.

A recent non-televised campaign, 14 found a significant reduction in prevalence in males but not females and among those aged 40 years or older, but not in those aged 18—39 years. Overall, given only one additional study addressing demographic subgroups, we defer to the conclusion of Bala and colleagues 45 that campaign effectiveness does not consistently differ by gender and age. Effectiveness of different channels of delivery of mass media campaigns Few studies have examined the relative effectiveness of different advertising channels.

Only two reviewed studies examined comparative effects of different media types, finding television adverts were recalled by twice as many respondents as radio adverts. This review highlighted another US national adult population survey which found television provides the greatest exposure among smokers, and that smokers are more likely to be heavier users of television and radio and less likely than non-smokers to be magazine or newspaper readers.

Mosbaek and colleagues 30 examined a range of different adverts aired on television and on radio and found the 10 most cost effective adverts were aired on television, while the most cost effective radio advert was ranked 11th overall. It is difficult to determine whether the reduced effectiveness of non-televised messages is due to the channel, to lower population reach, or to differences in message effectiveness.

One recent study found a MMC message broadcast on radio generated similar levels of concern about smoking and motivation to quit as a similar message shown on television. Future research should examine the effects of a standalone radio campaign. Despite radio's lower costs its reduced population reach means that it is unlikely to be a good substitute for television in influencing population-wide smoking, and could be considered a reinforcing adjunct.

Effectiveness of different types of mass media messages MMC messages differ in informational content theme , purpose why-to-quit vs how-to-quit , method, emotional tone and stylistic features.

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In response, PMI is suing the Australian government over loss of brand equity. There is also the growing focus of investors on ESG issues, although IROs in the sector seem relaxed about ethical investor pressure. The second concern is whether tobacco firms can consistently grow revenues given the secular decline in mature markets. PMI estimates that, between and , the international market excluding China and the US will range from stable to down 1. With China included, however, growth is estimated at 1.

Excluding China, the industry is heavily consolidated with JTI, BAT, PMI and Imperial accounting for three quarters of the market, according to a report from Credit Suisse, a fact that has helped tobacco players deal with the problems coming their way. Investors usually own a couple of companies in the sector, says Bloomquist.

Indeed, even the Chinese, for whose government tobacco has always been a major revenue source, have now begun to take seriously the potential costs of untold millions of gasping seniors. Notably, the IR website of Swedish Match, the global pioneers of snus, the oral snuff product, not only extols its health benefits but also does so in Chinese. Smoking substitutes Stockholders, influenced by the media and consumer buzz, are now asking about snus and e-cigarettes at investor meetings, and Bloomquist reports that all the major companies are investigating it to one degree or another.

We have, however, a slightly different approach from some of our competitors, which have put real targets on what they are going to do, spending hundreds of millions. The hypothesis that incidental smoking imagery increases smokers' immediate urge to smoke H4 was supported for both sexes. The hypothesis for which we found nil supporting evidence was that incidental smoking imagery increases the perceived prevalence of smoking H3.

There was also marginal evidence to suggest that smoking imagery tends to reinforce young smoking women's self image aspirations. Females were more likely than males to be affected by the incidental smoking imagery on many measures in our study. The previous study from which the two images of smoking female models was sourced rated each image very high on sexiness, while those for the male images promoted power, toughness and relaxation. It is therefore possible that the specific images used in our study may account for the sex differences observed and our sex specific findings may not extend beyond our experiment.

A limitation of our study was that we did not account for sex differences in our initial sample size calculations. Should any future replication of this experiment be attempted, based upon the observed differences from our results, we recommended to use at least subjects per cell. Before our study, there were data to suggest that incidental smoking imagery influenced smokers' perceptions of smoking and self image, but few data on the influence of smoking images in magazine on young people's smoking intentions.

The present study has contributed to knowledge in this field by confirming that adolescent smokers are more attuned to smoking imagery, and that such imagery influences future intentions to smoke. Given the cumulative ecological effect of such visual imagery in the entertainment media, it is quite likely that such images in magazines contribute to an increase in young smokers' consumption and prolong their smoking.

These results support the continuing call for regulation of incidental smoking imagery in popular visual media such as movies and television, but now also magazines and all other types of visual media, including billboards and posters. Certainly tobacco companies should be strongly opposed to commissioning incidental portrayals of smoking imagery in materials appearing in visual media, as they have been noted to do so in the past. Efforts to curb intentional or unintentional smoking portrayals in popular media that have until now concentrated on movie and television producers should now be extended to advertisers and magazine editors, to make them aware of the harmful effects of incidental portrayal of smoking imagery.

Monitoring of incidental smoking imagery portrayals should also continue in magazines, to ascertain whether greater regulation is warranted. What this paper adds Exposure to positive portrayals of smoking in movies and television has been demonstrated to increase adolescents' positive attitudes towards smoking and likelihood of initiation.

Previous investigations of the effect of positive portrayals of smoking in magazines has found that such imagery reinforces positive perceptions of smoking but there has been no measure of the impact of such on future intentions to smoke in an experimental setting.

The present study contributes to knowledge in this field by confirming that adolescent smokers are more attuned to smoking imagery, and that such imagery stimulates an immediate urge to smoke and lessens intentions to quit. References 1. Mekemson C, Glantz S A. How the tobacco industry built its relationship with Hollywood. Tob Control Suppl 1 81— Image advertisements' influence on adolescents' perceptions of the desirability of beer and cigarettes. J Public Policy Marketing — Predicting tobacco use to age a synthesis of longitudinal research.

Addiction — Hanewinkel R, Sargent J D. Am J Prev Med —