Survey Shows Young Adolescents Are Highly Affected by Tobacco Industry Advertising

NEW ORLEANS--Intensive research into cigarette smoking behaviorshas offered a glimpse into the minds of many young smokers. Arecent survey shows that most preadolescent smokers already havea favorite brand, suggesting that they are highly affected bythe tobacco industry's $5 billion annual marketing budget.

The director of Cancer Prevention and Control at the Universityof California, San Diego, says that advertising is consistentlyeffective in encouraging adolescents to start smoking. In fact,receptiveness to tobacco advertising is a much stronger factorthan exposure to other smokers in predicting who becomes susceptibleto smoking, John Pierce, PhD, said at the American Cancer SocietyScience Writers Seminar.

Almost all smokers begin the process while underage, he said.In California, the age of first experimentation is 8 to 16 years,with 16 the average age of starting to smoke regularly. Most youngsmokers will smoke for 17 to 20 years, even though 80% will starttrying to quit in their 20s.

If adolescents can stop smoking before their early 30s, they canavoid many of the individual health consequences. But even amongthose who make many attempts to quit, only half will be able toquit before these consequences start to become obvious, he said.

In smoking cessation, he added, the crucial time mark occurs at3 months after quitting. Smokers who have quit for less than thattime have an 80% relapse rate. This drops to 40% for those quitfor 3 months and to around 12% to 15% for those who manage notto smoke for a year.

As with other behaviors among adolescents, peer influence is importantin beginning to smoke; however, it appears to be strongest duringthe "promotion" stage, after children have already experimentedwith cigarettes and are moving toward addiction, Dr. Pierce said.

Strong tobacco marketing, in fact, can double the chance thata teenager will smoke. Receptiveness to marketing is clear: 70%of smokers only 10 to 12 years old already have a favorite brand;30% of teenagers own a tobacco promotional product, such as aT-shirt. "The strongest impact of tobacco advertising appearsto be in getting our children started on the uptake process,"he said.

Dr. Pierce's information comes from recent surveys of 30,000 Californiahouseholds and 10,000 California adolescents, and from nationalstatistics.

"We have shown that adolescents who are not definitely surethat they would refuse a cigarette offered by a best friend aremuch more likely to experiment with cigarettes and progress onto become addicted smokers," said Dr. Pierce, who calls thisattitude "susceptibility."

Nationally, 11% of 10-year-old boys and 8% of 10-year-old girlsare susceptible, he said, with susceptibility peaking in bothsexes at age 14.

Interventions Can Be Effective

Mary Ann Pentz, PhD, associate professor of preventive medicine,University of Southern California, said that intensive interventionin young adolescents can be effective.

She described the results of an interventional program among 22,500middle school students in 107 schools in the Midwest. Schoolswere matched demographically and assigned to participate in acommunity-wide comprehensive antismoking intervention programor to receive health education as usual.

To determine cigarette use, participants were surveyed annuallyin conjunction with a biochemical measurement of cigarette smoking,Dr. Pentz said.

Preliminary analyses show that at the end of high school, therewere 10.5% fewer monthly cigarette users, 7.5% fewer weekly users,and 4.9% fewer daily users in the intervention group, comparedwith the control group. The data have not yet been adjusted forschool or demographic differences.

The antismoking program may have had other positive effects, includinga lower high school drop-out rate and less need for drug abusetreatment, she said.

According to one formula, Dr. Pentz estimates the cost savingsin terms of mortality and morbidity to be almost $13 million forthe entire cohort. The cost of delivering the intervention programwas as low as $24 per family per year, she said.