Study Suggests Causal Association Between Cigarette Promotional Gear and Smoking in Adolescents

LEBANON, N.H. � A study of some 400 fourth through eleventh graders in three rural Vermont schools over a 20 month period, revealed that students who never smoked were likely to start smoking if they owned or were willing to use cigarette promotional gear. Results of the study, conducted by Dartmouth Medical School researchers, will be presented on May 3, at the annual meeting of the Pediatric Academic Societies (American Pediatric Society, the Society for Pediatric Research and the Ambulatory Pediatric Association), being held in San Francisco.

Tobacco companies, spend $4-$6 billion annually marketing cigarettes in the United States. A portion of that is spent on promotional gear give-aways that are distributed by tobacco companies in exchange for cash or value-added coupons, or purchased through gear catalogues distributed through retail grocers.

"Adolescents who never smoked and later took up smoking, were first receptive to cigarette promotional gear," says James D. Sargent, MD, principal investigator for the study, a researcher at the Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center and pediatrician at Children�s Hospital at Dartmouth. Being receptive to promotional gear means being willing to own, wear, or use such items as cigarette logo-emblazoned clothing, backpacks, camping gear, and electronics.

Results from the study showed that there is a strong and statistically significant association between receptivity to cigarette promotions and smoking uptake in adolescents. The researchers also found that loss of receptivity to cigarette promotions appears to protect adolescents from becoming smokers.

"The fact that the stuff�s out there and the kid�s desire it is a problem," says Sargent. "It�s powerful because it�s all tied into their identity."

Previous studies, including one by Sargent published in Archives of Pediatric and Adolescent Medicine in December 1997, have shown a strong relationship between ownership of promotional items and children smoking. In that study of 1,300 sixth through twelfth graders in New Hampshire and Vermont, it was shown that children who owned promotional items were four times more likely to be smokers that those who did not, even when results were adjusted for the effects of factors such as friends and family smoking.

"Don�t let the tobacco companies hoodwink you or your children into being a billboard for cigarette marketing," Sargent advises parents. "Doctors should caution their patients not to allow cigarette promotional items in their homes." He continues with advice to legislators, "We should be tracking whether these items are coming into our states and stop them."

Other Dartmouth Medical School researchers involved with the study include: Madeline Dalton, PhD, research assistant professor of pediatrics; Michael Beach, MD, PhD, assistant professor of anestheisology and community and family medicine; Marguerite Stevens, PhD, associate professor of community and family medicine; and Amy Bernhardt.

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