The concession, made by tobacco companies as part of a Master Settlement Agreement of 46 states’ lawsuits against them, called for the companies not to "take any action, directly or indirectly, to target youth…" in their advertising or marketing, the researchers point out.

"But, targeting isn’t defined in the agreement, and the companies still are finding ways to reach kids with the message to smoke," says lead study researcher Michael Siegel, MD, MPH, associate professor at Boston University’s School of Public Health.

The study found cigarette ad dollars in youth magazines actually increased the year after the settlement, from $219 million in 1998 to $291 million in 1999. Then in 2000, it dropped back to $216 million — a drop of less than 2% from 1998 levels.

"And we found that cigarette brands that are popular among youth smokers are more likely to advertise in magazines that have higher levels of youth readership," Siegel adds.

"If they weren’t trying to reach kids, you wouldn’t expect to find that the specific brands that are popular among youth are precisely those brands that are advertising most heavily in those magazines read by large numbers of kids; it just doesn’t make sense," notes Siegel.

One company, Philip Morris, promised in the 1998 agreement that starting in September 2000, it would advertise only in magazines with less than 15% of readers between ages 12 and 17 and fewer than two million readers.

But even if other tobacco companies did the same, it wouldn’t stop the cigarette ads from reaching kids, the researchers found, because over half the nation’s youth are getting the tobacco companies message that smoking is cool from other ad placements.

"Even if Marlboro hadn’t put any ads at all in youth-oriented magazines in the year 2000, they still would have reached 57% of the nation’s youth that year, just through ads in adult magazines," notes Siegel.

The researchers’ data showed as well that in the year 2000, an average of 82% of kids were exposed to magazine ads for youth cigarette brands, brands that are popular among youth smokers.

"There was kind of a perception out there among the public that the Philip Morris policy was going to substantially reduce youth exposure to cigarette ads in magazines, and our study suggests that this simply is not the case," emphasizes Siegel.

Unfortunately, says Siegel, research has also shown that ads enticing kids to smoke are very effective, regardless of where they are published.

In an accompanying editorial, two prominent tobacco control advocates point out that as the tobacco companies reduced spending for magazine ads, the amount they spent on displays in stores, discounts on brands popular with kids and free gifts that appeal to young people, "skyrocketed," resulting in kids still being bombarded with tobacco company ads.

The editorialists — Yale University School of Medicine’s David A. Kessler, MD, who was the former head of the US Food and Drug Administration (FDA), and the National Center for Tobacco-Free Kids’ Matthew L. Myers, JD, agree with Siegel. Since tobacco ads are still enticing kids to smoke after the 1998 Agreement, stronger actions — including placing tobacco products under control of the FDA — make sense.

The American Cancer Society (ACS) advocates that and more.

"The tobacco companies continue to try to hook new generations of customers on their addictive and lethal products because they need to do that for the very survival of their industry," says Dileep G. Bal, MD, president of the ACS.

"Over 400,000 Americans die each year from tobacco use and the tobacco companies need to recruit new addicts to maintain their balance sheets," Bal notes.

"By ostensibly targeting adults (especially vulnerable 18 to 24 year olds), tobacco companies know that kids will get the message that it is cool and sophisticated to smoke and so they do. It is a known advertising fact that kids "aspire up" and this is used ingeniously by the Tobacco Industry in their Madison Avenue blitz," says Bal.

"As a vital part of its mission to reduce suffering and death from cancer," Bal says, "the ACS strongly advocates a wide range of actions to reduce tobacco’s impact on public health." Those actions entail not only effective restrictions on tobacco marketing to kids, notes Bal, but also include support for:

• strong regulation of tobacco by the US Food and Drug Administration (FDA);
• effective clean indoor air laws and restrictions on smoking in public places; and,
• congressional passage of the newly-introduced Medicare, Medicaid, MCH Smoking Cessation Act, to expand Medicare and Medicaid coverage for smoking cessation materials and services.

Bal adds that we must strip the veneer away from the Tobacco Industry’s deception. More than 80% of adult smokers began smoking at 18 or younger, according to the Centers for Disease Control and Prevention (CDC). The ACS estimates that between 80% and 90% of all lung cancers, and lesser proportions of other cancers, are caused by smoking.

The ACS sponsors quit-smoking classes, which distribute free information on smoking and how to quit.

The American Cancer Society Quit Line is the new phone-in program that is currently being tested. Callers wanting to quit may receive information, referrals, and telephone counseling to help them in their quit attempt. In addition, a Youth Smoker’s Quit Line will be tested within the next few years. For more information, call 1-800-227-2345.