|Advocates for minors, minorities, women, and the poor are on the
offensive, scoffing at tobacco company claims that cigarette
promotions are not aimed at the groups most at risk for acquiring
nicotine additction. Antismoking activists are adopting what they
see as the industry's own tactics, moving away from wide-angle
warnings about the long-term health threats and focusing instead
on specific brands, the smoker's self-image, and the short-term
social consequences in messages tailored to specific
"We've done a good job of reaching middle-class white
America, but not the groups most at risk," says American
Cancer Society (ACS) spokesman Steve Dickinson. So new ACS ads
twist the tobacco industry's images of success and
sophistication. As a beautiful, darkskinned woman smoking a
cigarette becomes covered with a gloppy substance, the ad asks,
"If what happened on your insides happend on your outsides,
would you continue to smoke?"
Initiative in the black community has been ignited by a
virtual wallpapering of inner-city areas with tobacco and alcohol
billboards and by now-aborted plans to market a brand of
cigarettes, called Uptown, to urban blacks.
"When our people desperately need the message of health
promotion, Uptown's message is more disease, suffering, and death
for a group already bearing more than its share of
smoking-related illness and mortality," complains Department
of Health and Human Services Secretary Louis W. Sullivan, MD, who
helped keep the brand off the market--though a similar campaign
is being used for a brand called Salem Box.
Nicotine addiction afflicts 34% of black adults vs 28% of
whites and 27% of Hispanics, according to a 1989 survey by the
Simmons Market Research Bureau. That is why lung cancer and heart
disease rates are higher among blacks, says Sullivan, who hopes
the vitory against Uptown is "just the beginning of an
Women's groups are similary out-raged over a campaign for
Dakota cigarettes that said they would be marketed to
"virile females." Native Americans, who suffer very
high addiction rates to many substances, are also incensed at the
misuse of the word Dakota, which means friend, says Shirley
Butts, RN, of Fort Totten, ND, a Turtle Mountain Chippewa and
member of Dakotans Against Dakota Cigarettes. Uptown and Dakota
"made it very clear tobacco companies are targeting, and
gave us something we can rally around as women and
minorities," says Virginia Ernster, PhD, an epidemiologist
at the University of California, San Francisco, who has testified
before Congress on the tobacco industry's efforts at recruiting
"The industry does target women, minorities, and youth.
They know the statistics on who's going to replace the 2.5
million smokers the industry loses each year," 400 000 of
them to tobacco-related deaths, says Michele Bloch, MD, PhD,
director of the Women vs Smoking Network in Washington, DC.
"Those replacement smokers are always children," with
the average age for starting now 12.5 years, she says.
"If present trends continue, by 1995 women will outnumber
men because more girls start smoking than boys and women quit
less often," says Bloch. Among high school seniors, 20% of
females smoke vs 16% of males, with higher rates for high school
dropouts. By 2000 only 5% of college graduates will smoke vs 30%
of high school dropouts, all largely due, says Bloch, to
Opposition to Uptown and Dakota, though, created "a
one-two punch that has made the climate in Congress acceptable
for legislation limiting tobacco ads in a way no one would have
anticipated a year ago," she says, particularly a bill that
would ban pictures of people.
"Adults respond to claims of low tar and nicotine,
whereas kids respond to the Marlboro man," says John Madigan,
a spokesman for the cancer society's Washington office.
Those associations can last a lifetime, as organizers of a
boycott against Marlboro cigarettes and Miller beer are finding
out. AIDS (acquired immunodeficiency syndrome) activists want gay
and lesbian bars to stop stocking both products because of parent
company Philip Morris' support for Sen Jesse Helms (R, NC). But
while patrons "don't bat an eye" when a bartender says
there is no Miller, they go next door to buy Marlboro when it is
removed from vending machines, says Frank Smithson, boycott
coordinator in NewYork. "People are very fond of their
cigarette brands. The graphics are part of who and what they
A total ad ban is not likely soon because there is little
grassroots support, says Mark Pertschuk, executive director of
Americans for Nonsmokers Rights in Berkely, Calif.
Canada and other countries do have such bans, but Sheila
Banks, media affairs director for Philip Morris USA, says the
bans do not cut youth smoking rates. Finland, for example, has
the world's highest rate of smoking among teenage boys despite a
dozen years without tobacco advertising, she says.
And in the United States there is "a very basic First
Amendment issue," says David Fishel, senior vice president
for public relations for the R. J. Reynolds Tobacco
Pertschuk says banning ads for products that are deadly or
harmful "in no way violates the First Amendment."
But Fishel warns that such an effort would engender a
"backlash from smokers. It's getting to the point where you
have to say, 'Hey, this is still America.'"
Fishel and Banks both insist they scrupulously avoid any pitch
to the underaged. Banks says the fact that teens and preteens
account for nearly 90% of new smokers is "probably true
because kids try that which they associate with being an adult.
The harder you tell them not to do something the more they want
to do it."
Pertschuk's group uses that fact to turn tobacco ads inside
out. "Children hate to be manipulated. We harness that and
use the industry's own ads to ridicule" the ideas in
Only ridicule can countereact the seductive adult mystique
surrounding cigarettes, says Alan Blum, MD, founder of Doctors
Ought to Care (DOC), which attacks specific brands on a Mad
Magazine level, for example, "Barfboro" and "Wimpston."
"People say it's so sophomoric, but how else are we
supposed to appeal to kids other than to be juvenile?" asks
Blum, a family practitioner and assistant professor at Baylor
College of Medicine in Houston. "I've never seen a kid go
into a store and say 'A pack of cigarettes, please.' Kids are
'branded' for Marlboro and Camel," says Blum. "You're
not going to get to kids by talking about the danger or the
smell. But no one wants to be associated with a brand name that's
In the adult world, no one wants to be associated with a brand
promoting itself to children. That fact is helping DOC get
tobacco ads off popular Rocky Mountain ski slopes.
The Jackson Hole Ski Resort at Teton Village in Wyoming is
removing Marlboro flags from a coin-operated racecourse there
after DOC surveyed all the fourth and fifth graders in town, says
DOC member Brent Blue, MD, a family practitioner in Jackson Hole.
"We got a much higher correlation of kids who raced at Teton
Village knowing Marlboro than those who did not." The Aspen
Skiing Company in Colorado is also dropping Marlboro sponsorship.
And Jackson Hole Ski Corp president Paul McCollister plans to
proposes a nationwide ban on tobacco sponsorship to the United
Ski Industries Association. "When you stop and think about
it, it's ridiculous not to," he says.
That sentiment is not shared by many other sports businessmen,
though. Houston Astrodeome officials had security guards remove
Blum and other protestes at a Camel-sponsored Cinco de Mayo
clebration there, which Blum says was aimed at Hispanic
DOC is campaigning against tobacco billboards in sports arenas
as well, on the grounds that they constitute illegal television
advertising. A protest in August against such ads in San
Francisco's Candlestick Park got support from many smokers, says
Susan Smith, administrator of Tobacco-Free California. "They
don't want their kids exposed even if they themselves
A letter-writing campaign to US Attorney General Richard
Thornburgh is under way, asking him to assess the $10
000-per-violation fines. Blum says the world Marlboro was
televised during virtually half the 93-minute Marlboro Grand
"If they'd keep track of all sporting events over the
next 6 months we could erase the national deficit," says DOC
president Rick Richards, MD, of Augusta, GA. "The Federal
Trade Commission ignores the ads, even though the amount
companies pay is based on the number of exposures they are likely
to get during the telecast," says Richards. Enforcement
would "require no new legislation, just sitting down with a
videotape player." Existing legislation is one tool black
leaders in Baltimore, Md, are using against the ubiquitous
billboards pushing legal drugs in low-income areas there. Many
billboards came down when neighborhood organizations found a
20-year-old residential area zoning restriction, says Robert
Blackwell, an inspector in the city's zoning office.
Whitewashing of billboards by black leaders in New York helped
get the attention of Philip Morris, which plans to turn over some
billboards it rents to community groups, says Banks.
Advertising to minorities is a "catch-22" issue,
says RJ Reynolds' Fishel. "In the past we've been criticized
for not including blacks, now they're saying we funnel too
Tobacco support for minority organizations is also under fire.
The National Association of Black Journalists turned down a $40
000 Philip Morris donation.
"It was a tough decision because tobacco companies have
long been supporters of black media when very few others have.
But we couldn't take money from an organization deliberately
targeting minority populations with a substance that clearly
causes cancer," says the group's president, Thomas Morgan.
"We simply because more aggressive in our fund-raising so we
could do without it."
That option does not exist for many minority publications,
which would fold without tobacco dollars.
Tobacco revenues cause self-censorship of antismoking stories,
says Kenneth Warner, PhD, professor of public health policy at
the University of Michigan School of Public Health, Ann Arbor.
Last April, at the Seventh World Conference on Tobacco and Health
in Perth, Australia, he presented an analysis of 99 magazines
over 25 years that found a statistically significant negative
correlation between cigarette ad revenue and coverage of smoking,
especially in women's magazines.
A "favorite tactic" of the American Medical Women's
Association is "cleaning these magazines out of our waiting
rooms," says president Susan Stewart, MD. (See JAMA.
Women's organizations also often take tobacco money because
"so little other money is available. Many corporations that
earn money from women do not support womens' groups," says
Bloch. Both she and Banks agree that Virginia Slims put women's
tennis on the map when no one else would. "It is ironic that
a product which causes major damage to the heart and lungs is
associated with a sport requiring top physical fitness and
aerobic capacity," says Stewart, accusing Virginia Slims of
"taking advantage" of the inadequate funding of women's
DOC's answer is its own tenns tournament, the Emphysema Slims,
held September 15 and 16 in Santa Fe, NM. It is billed as the
world's largest throw-tobacco-out-of-sports protest.
Morgan feels other organizations will drop tobacco sponsorship
"as time goes on, simply for the sake of principle."
But tobacco company attempts at targeting will also intensify, he
says. "Where are they going to turn but to the people least
equipped to fend off the attractions of advertising, the poor and