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No smoke without ads?
  1. I D Wacogne
  1. Dr Wacogne was on secondment at the Royal Children’s Hospital, Brisbane for two years and is now completing his SpR training at the North Staffordshire Hospital, UK.

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Reading a British magazine imported into Australia I suddenly noticed the profusion of cigarette advertisements. Smoking advertising has been banned in Australia since the early nineties and its absence—like the resolution a headache or the departure of an unwelcome guest—is refreshing but soon forgotten.

The BMJ Publishing Group has a whole journal, Tobacco Control, devoted to smoking and related issues. I'd recommend anyone with a social conscience and a sense of humour to read their editorial following Nottingham University’s acceptance of cash from British American Tobacco with which to establish a chair of International Business Ethics.1 Much research is published there and elsewhere, but I'd like to make a couple of observations from my time in Australia.

Firstly, it hasn't been immediately obvious to me that fewer people are smoking. In fact, visitors from the UK feel that there are more, especially in restaurants, which may simply be a feature of outdoor cafe society where the need to segregate smokers is less keenly demanded

Secondly, Australians seem less aware of when they were being exposed to cigarette advertising, although this may reflect my own (hyper aware) biases. My colleagues seem almost oblivious to cinema product placement and sponsorship of international sports like cricket and, if we believe the propaganda, the otherwise impoverished Formula 1 motor racing.

This leads to the third observation, which is that people seem unaware of product or brand-creep. Camel will always be a cigarette brand while they produce cigarettes, however trendy or well made the clothing. British American Racing will always be British American Tobacco, with the interests of their paymasters at heart. Kraft products will now always be, essentially, a front for Phillip Morris, to the extent where some people regard them in the same light as Nestlé products in the eighties.

These are no reasons to allow tobacco advertising to recommence, quite the contrary. But they are a reason to think more broadly about how to combat the tobacco industry. We should never forget that we are dealing with organisations which are fighting for their corporate lives—if not those of their customers—and that they know how to fight. In the past the interesting point has been made that negotiation with the tobacco lobby is a mistake; we should simply legislate since they will, ultimately, listen to nothing less. (And, demonstrably, sometimes not even that). If we are taking these issues seriously we should look at media literacy as our strongest weapon—teaching people to understand the subtext and motives behind advertisements, as distinct from the actual message.

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We need also to bear in mind the action/reaction dynamics in large multinationals. A third of a trillion dollar payout by the tobacco companies in the US is gratifying to us, and will hurt the industry, but it won't worry too much while it has unregulated access to 2.3 billion potential customers in India and China alone. It will just shift its market, and then up the price slowly.

Whatever data eventually emerge from the gradual banning of tobacco advertising in the non USA developed world, we should ignore the industry’s fallacious arguments about advertising being aimed at brand shift rather than recruitment. It only takes a couple of neurones to do the sick maths the industry has done: if your product is killing 100 000 of your customers prematurely a year in the UK alone, and you want to sell the same number of cigarettes each year, you need to recruit the same number each year. Preferably this will be from the young—teenagers and early twenties—because they are busy with the business of forging a life and an identity. If you can trick them that smoking says something positive about themselves, and keep them smoking for long enough to get them addicted, then you've replaced one of your 100 000. You just need to do that every 20 minutes, for ever.

The advertising ban is a victory, and may it last forever, but it is only a small one in the context of a long, protracted, and dirty international war which we are a long way from winning. We should congratulate ourselves, and then ask which of our children they are going to recruit in the next twenty minutes, and the twenty minutes after that, and the twenty minutes after that...

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