The Centers for Disease Control (CDC) is launching the latest strike in a long-running media battle between public health authorities and the tobacco industry to sway Americans’ feelings about cigarettes. Starting on March 30, the CDC will roll out a $68 million ad campaign designed to help smokers quit. The campaign expands on the CDC’s 3-year-old “Tips from Former Smokers” series, which enlists real people who've been ravaged by smoking. And for the first time, the new ads will also include former e-cigarette users.
The message wars between the CDC and Big Tobacco have intensified since the rise of electronic cigarettes, which face none of the advertising restrictions that have kept cigarette ads off television since 1971. Before Richard Nixon signed a ban on broadcast advertising, tobacco companies spent 60 percent of their marketing dollars on TV and radio, even using cartoon characters like Fred Flintstone to market cigarettes to kids.
The industry’s legal settlement with states in 1998 imposed further marketing limits, including a ban on cartoons and billboards. But now that the big tobacco companies all own e-cigarette brands, anti-smoking advocates fear unfettered e-cigarette advertising will encourage puffing on both nicotine vaporizers and old-fashioned burning tobacco.
“This is really an industry, the larger tobacco industry with e-cigarettes, that threatens to get another generation addicted to nicotine,” said Erika Sward, the American Lung Association’s assistant vice president for national advocacy. Seventeen percent of American high school seniors reported using e-cigarettes in the last month, compared to 14 percent who smoked tobacco cigarettes, according to a national survey published by the University of Michigan in December.
Among North Carolina’s middle and high school students, cigarette smoking has fallen about 2 percent since 2011, but use of “emerging tobacco products,” such as e-cigarettes, hookahs and flavored cigarettes, has grown nearly fourfold, according to the 2013 N.C. Youth Tobacco Survey released last fall.
Advocates worry that widespread e-cigarette marketing reaches kids and teenagers, and could reverse decades of public health efforts to portray smoking as uncool. Lorillard’s blu eCigs brand put its logo on a model’s bikini bottom in an ad in last year’s Sports Illustrated swimsuit issue, “a magazine probably read by more teenage boys than any other magazine,” noted Matthew Myers, president of the Campaign for Tobacco Free Kids. Television ads for e-cigarettes are “introducing the glamor and sex appeal to adolescents today that have never been exposed to cigarette advertising on TV,” he added.
An analysis of Nielsen rating data published in the journal Pediatrics last year found that the blu brand was responsible for about 80 percent of the TV e-cigarette ads that reached teens and young adults over nine months in 2013. Blu eCigs, a subsidiary of Greensboro-based Lorillard, did not respond to questions from Bloomberg.
Richard Smith, a spokesman for Winston-Salem-based R.J. Reynolds, said that “adult tobacco consumers have a right to be fully and accurately informed about the risks of serious diseases, the significant differences in the comparative risks of different tobacco and nicotine-based products, and the benefits of quitting.” (Reynolds and Lorillard are asking regulators to approve a merger.)
Brian May, a spokesman for Philip Morris parent Altria, said the company supports policies to prevent tobacco sales to children. “Philip Morris USA works hard to market its products to adult smokers and limit the reach of its marketing materials” to youth, he said. Last year Richmond, Va.-based Altria took its e-cigarette brand MarkTen national. It’s advertised in magazines targeting adults. The brand doesn’t advertise on TV now, May said, but “as the category evolves, our marketing programs might evolve.”
The CDC’s new campaign will run for 20 weeks, and include broadcast, print, billboards and online ads. One radio and print ad features a 35-year-old named Kristy “who tried using e-cigarettes to quit smoking cigarettes but ended up using both products instead,” according to the CDC’s announcement. Her lung collapsed and she was diagnosed with pulmonary disease before she quit.
A peer-reviewed analysis by CDC researchers of the first year of their Tips From Former Smokers Campaign estimates that it helped 100,000 more people quit than would have without the ads, preventing more than 17,000 premature deaths. At a cost of $480 per person who quit, CDC Director Tom Frieden has called it a “best buy for public health,” because of the savings from avoiding smoking-related disease and deaths.
The CDC has spent about $230 million since 2012 on Tips From Former Smokers, its first national anti-smoking ads. Other public health ads target younger audiences. The FDA’s “Real Cost” campaign began in 2014 to target teens, and cost about $230 million over two years, according to the agency. The Truth ads, funded by the American Legacy Foundation, has pushed anti-smoking messages to youth since 2000 and reported spending $29 million on marketing and government affairs in its latest financial report.
But health authorities say they’re outgunned by tobacco companies. The CDC points out that the tobacco industry spends $23 million on domestic cigarette marketing and promotion every day, or $8.4 billion a year in 2011, according to the Federal Trade Commission’s latest Cigarette Report, based on 2011 data. Most of that 84 percent is in price discounts that wholesalers and retailers pass to consumers.
The FDA is weighing new rules for regulating e-cigarettes and other tobacco products. The proposed rule the agency published last year doesn’t bar e-cigarette advertising or flavors that critics say appeal to children. Myers said the same public health agencies that advertise to help people quit smoking should step in to limit the marketing of e-cigarettes. ”The failure of FDA to address the advertising issue is a gaping hole in fulfilling its mandate to protect our nation’s youth,” he said.
Observer reporter Katherine Peralta contributed.