Studies had shown the Joe Camel campaign, which started in 1988, significantly increased purchases of the Camel brand by young people. The ad campaign eventually went up in smoke over widespread public outcry. But a precedent had been set, so the researchers decided to see if counter-marketing ? using similar cartoon characters to warn teens about the harmful effects of smoking ? might work. The results of the study by Sonia Duffy, PhD, of Veterans Administration?s Ann Arbor Healthcare System in Michigan, and Dee Burton, PhD, of the School of Public Health at the University of Illinois at Chicago, were published in the December issue of the Archives of Pediatrics and Adolescent Medicine.

The researchers hired an advertising firm to draw three cartoon characters ? a walrus, a bear, and a penguin ? and created a slide show combining the youth-appealing characters with cigarette warnings. The slides, along with the same tobacco warnings without the cartoon characters, were shown to 580 Chicago public school students from kindergarten to 12th grade. The results were encouraging. The children and teenagers rated all three cartoons as significantly more believable than the warning label without the cartoon.

"We thought that the cartoons might trivialize the message, but we did not find that. Adolescents still saw the cartoon messages as more important and believable than the plain messages," Duffy says.

Ron Todd, director of tobacco control for the American Cancer Society, sees a problem with this approach. "There is certainly some evidence that says that image-based advertising might be the way to go for kids," he says. "But warning labels are meant for everyone who consumes the product. I didn?t see anything in the study as to what the reaction of adults might be to warning labels using cartoon characters. Are they going to be more believable or less believable?"

But he says this research is a good first step. "I think they certainly found out some interesting things, but we need to do a lot more studies in this area."

Study co-author Burton says the concept of using the cartoon characters could extend beyond warning labels. "I think we need to do a lot more in the way of counter-advertising," she says. "I think it would be very plausible to use cartoon characters with the warning labels or just cartoon characters in antismoking ads."

The cartoon characters could be an important option in reaching young smokers but they are not the only option, Burton adds. "There is other evidence that youths also respond well to serious, emotionally evocative kinds of materials. So I think that we just have to be open to using a broader range of materials than we have in the past."

Lead author Duffy acknowledges that any call for warning labels would be met with hostility by the tobacco industry. But she says the battle over the long-term health of America?s youth is well worth fighting.