What the Marlboro Man can teach us

about tobacco control

The Marlboro story
It hasn’t always been smooth sailing…
1964 - The Surgeon General releases the first
U.S. gov’t report linking cigarettes to lung cancer

U.S. Surgeon General,

Luther Terry, M.D.
1964
 Things that were talked about then…

• Require a warning on every pack

• Ban cigarette advertising
• Ban sales to minors
• Disclose information about tar and nicotine
• Treble or quadruple the federal excise tax
• Support programs to help people quit
• Long-term nationwide program of education
• Earmark cigarette taxes to pay for programs
 January 29, 1964
Philip Morris Corporate Officers
George Weissman to Joseph F Cullman III

“. . . We must in the near future

provide some answers which will
give smokers a psychological
crutch and a self-rationale to
continue smoking.
Give consumers some hope…
some novel design solutions to calm
worried smokers…
Carlton debuted on 5
January 1964, 5 days
before the announced
release of the SGR
• at 2.7mg Tar, it was 1964
by far the lowest Tar
cigarette on the market
• at the time, the
average was over
20mg

A cigarette that is low in ‘tar’ and

nicotine—yet high in smoking
pleasure.
The art and science of marketing
 What is marketing??

• means to make a communication about a product

or service a purpose of which is to encourage
recipients of the communication to purchase or
use the product or service.

• the process of planning and executing the

conception, pricing, promotion and distribution of
ideas, goods and services to satisfy customers.

• The techniques used to attract and persuade

consumers.
 In the beginning…

Product marketing
focused on selling
what could be mass
produced, offering
consumers little
choice, but
cheapness – one
size fits all…hope
you like black

Henry Ford and the Model T

 Modern marketers have …
inverted this approach
by putting the
consumer first and
designing products
that would meet their
wants and desires,
thus revolutionizing
the way products are
produced and sold
 The key to marketing is to know
your target audience and to shape
your product and product
advertising to meet their needs,
wants, and desires
 4’Ps of Marketing
• Product
– What are you selling?
• Price
– What does your product (idea) cost?
• Placement
– How is your product distributed?
• Promotion
– How do you communicate information about the
product to your target audience
 Marketing research
• the process of systematically gathering,
analyzing and interpreting data pertaining
to the company's market, customers and
competitors, with the goal of improving
marketing decisions.
• focus of market research is identifying a
target audience and assessing their…

– Needs
– Wants
– Expectations
– Satisfactions and dissatisfactions
The tobacco documents have
revealed that nothing in the
marketing of tobacco products
has been left to chance by the
tobacco industry
 Cigarettes makers have been
masters of consumer marketing
 Start with the basics
The Four “P’s”

• Product
•Placement

• Promotion
•Pricing
Know your target audience
 Target group #1:

The worried well

Reassure smokers
 1950 Epidemiologic Evidence

Sound the alarm Richard Doll & A. Bradford Hill

(British Medical Journal UK)
Smoking and Carcinoma of the Lung;
Preliminary Report

“In other words, it must be

concluded that there is a real
association between carcinoma
of the lung and smoking.
We therefore conclude that
smoking is a factor, and an
important factor, in the
production of carcinoma of the
lung.”
1950 Epidemiologic Evidence

Ernst L. Wynder and Evarts A. Graham

(JAMA USA)

Tobacco Smoking as a Possible

Etiologic Factor in Bronchogenic
Carcinoma

“An elaborate, careful study of

687 lung cancer victims and
more than 700 ‘controls’ reveals
cigarettes to be “an important
factor in the induction of
bronchogenic carcinoma.”
 1953 Biological Evidence
- Mouse Painting
June, 1953
Ernst L. Wynder, Evarts A. Graham
& Adele B. Croninger
Experimental Production of
Carcinoma with Cigarette Tar
Cancer Research 13:855-864

Of 81tarred mice, 44 per cent developed

histologically proved carcinomas.
Of 62 mice alive at 12 months, 58 per
cent developed cancer.”
Our products cause cancer … what do we do?
Put a filter on it!

Filters accounted
100 for 1% of cig
80
sales in 1950,
but increased to
60 51% within 10
years…
40

20

0
1950 1960 2000

Unfiltered Filtered
 “The Micronite Filter . . . made of a
pure, dust-free material that is so
safe, so effective it has been selected
to help filter the air in hospital operating
rooms.”
1952 Kent
Micronite Filter
Our products cause cancer … what can we do?

Manufacture a controversy!

•Dec 1953: Hill & Knowlton meets with Industry heads.

•Heads confirm need for PR campaign which is positive
in nature and is entirely “pro-cigarette”
•All agree that the major problem is to get the
information out, instead of creating new research.

CTR MN 043113
1955 Timothy V. Hartnett,
TIRC Chairman

Reassure the
Question: “Suppose the
tremendous amount of
research going on…were to
reveal that there is a cancer-
causing agent in cigarettes,
what then?”

Dr. C.C. Little: “…it would be

made public immediately…and
then efforts would be taken to
attempt to remove that
substance or substances.” Dr. Clarence Cook Little
-Edward R. Murrow’s Second TV show on TIRC/CTR Scientific Director
“Cigarettes and Lung Cancer” 06/07/55 1954-1971
1971 Joseph Cullman, Philip Morris
Face the Nation
CEO, Chairman of the Board
Tobacco Institute - Executive Committee Chairman
Council for Tobacco Research - Executive Committee
1976 James C. Bowling
Philip Morris, Vice President
Helmut Wakeman
Research Director at
Philip Morris, 1976 Watch out
for the
applesauce
New products to meet consumer needs…
Vent holes in Marlboro Lights and Marlboro Red
(photographs courtesy of Lynn Kozlowski, PhD)
 Filter ventilation
• Probably the most influential design
feature of the modern cigarette
• THE major way standard tar, nicotine, and
carbon monoxide yields are reduced

VENT HOLES
 Testing Regimes using linear smoking machine:

Routine analysis of tar, nicotine, and carbon monoxide (TNCO)

High tar

Total particulate matter (TPM): Low tar

“tar”, nicotine, and water.

FTC/ISO smoking regime:

35 ml puff volume, Unused
2 s puff, 60 s interval.

In the FTC/ISO regime, the vent holes are exposed to the air, and
therefore allow the smoke to be diluted

Images courtesy CDC

Filter Cigarettes and Low Tar Cigarettes take over the
market
Replacement Smokers

Target #2:

Let’s not forget the kids

 Product
“Realistically, if our
Company is to survive
and prosper…we must get
our share of the youth
market…this will require
new brands tailored to the
youth market”
-Claude Teague, RJ Reynolds, 1973
 “Contact leading firms
in terms of children’s
research…contact
Sesame Street…contact
Gerber, Schwinn,
Mattel…”
“Determine why these
young people were not
becoming smokers.”
--Brown & Williamson Tobacco Co.
April 27, 1977.
A 1974 report to R.J. Reynolds’ Board of
Directors illustrates the company’s concern with
market shares among younger smokers defined
as those between the ages of 14 to 24 years:

“Thus, our strategy becomes clear for our

established brands:
1) Direct advertising appeal to the
younger smokers...”

---R J Reynolds Tobacco Co. “1975 Marketing Plans

Presentation.” September 30, 1974.
A 1974 summary of a
meeting held at RJR
discussed cigarettes
designed for
beginning smokers,
noting that such a
cigarette should be …

“low in irritation and

possibly contain added
flavors to make it
easier for those who
never smoked before to
acquire the taste of it
more quickly.”
-- “Conference report #23.” June 5, 1974. R.J. Reynolds
RJR document
identified the specific
characteristics to be
used in developing new
brands tailored to the
youth market
∗ Nicotine level of 1.0- 1.3 * Bland smoke to address “low
mg/cigarette; tolerance for smoke irritation”
of “beginning smoker[s] and
∗ Nicotine absorption minimized inhaler[s]”
“by holding pH down”
* Suggests 100 mm "to facilitate
∗ Tar content of 12-14 lighting”
mg/cigarette to achieve desired
taste and "visible" smoke * “Reasonably firm" rod
Brown and Williamson reviewed new
concepts for a "youth cigarette"
including cola flavor, apple flavor and a
"sweet flavor cigarette," stating "It's a
well-known fact that teenagers like sweet
products. Honey might be considered.”

- 1972 Brown & Williamson memo

In the mid-1980’s marketing executives at
RJR recommended that the company…

“…use copy strategies which emphasize product

positives to younger adult smokers. Connotations
of ‘weak’, ‘concerned’, or ‘low tar’, should be
avoided and elements of ‘mild’, ‘smooth’, ‘rich’,
‘smoking pleasure’ should be emphasized.”
Camel's success among YAS
in the late 1980's followed
product design changes
affecting the brand's
smoothness and harshness
attributes, which coincided
with introduction of the
"Smooth Character" (Joe
Camel) advertising campaign.
Two key areas identified for improvement
were smoothness and sweetness
delivery. Smoothness is an identified
opportunity area for improvement versus
Marlboro, and sweetness can impart a
different delivery taste dimension which
younger adult smokers may be receptive to,
as evidenced by their taste wants in other
product areas.
-Gemma, JL
“Results of MDM Committee Meeting- August 13, 1985”
RJR Tobacco Company, August 16, 1985
Bates No.: 505520121 -0126
 Good things come in small packages
Blue Plastic-like Cylinder Embedded in Filter (Non-smoked)

“Twist” - Camel Exotic Blends – R. J. Reynolds Tobacco Company

There is as much engineering in a
cigarette as there is
under the hood of your car.
Prominent Packaging
Smokeless on the rise
Sales of Smokeless Tobacco
United States, 1986-2001

$2.0
$1.8
$1.6
Billions of Dollars

$1.4
$1.2 M oist snuff
$1.0
$0.8 Loose Leaf
Chewing Tobacco
$0.6
$0.4
$0.2
$0.0
1986 1989 1992 1995 1998 2001

Source: FTC Report to Congress, 2003

 Advertising and Promotional
Expenditures for ST
United States, 1986-2001

$250

$200
Millions of Dollars

$150 Moist snuff

$100 Loose Leaf

Chewing Tobacco

$50

$0
1986 1989 1992 1995 1998 2001

Source: FTC Report to Congress, 2001

Stock Analysts Betting on Smokeless Sector
Prevalence of Snuff Use Among Men, by Age
United States, 1970 and 2000

1970 2000
4 4 Why Wall Street sees
upside to spit tobacco –
3.5 3.5
get’em while they’re young
3 3
2.5 2.5
2 2
1.5 1.5
1 1
0.5 0.5
0 0
18-24 25-34 35-44 45-64 65+ 18-24 25-34 35-44 45-64 65+
Age Age

Source: 1970 and 2000 National Health Interview Surveys

Big Tobacco Now in the Game
Reynolds marketing 'Camel Snus'
May 1, 2006

Test markets in Austin and Portland

Philip Morris tests Smokeless,

Spitless Tobacco, July 18, 2006

Taboka
Marlboro test
Snus test market
market in Indianapolis
in Dallas, August 2007
Let’s make
sure we try
some cool
promotions
• Industry documents don’t show much
evidence of bar promotions prior to
1970’s
• After 1971 Federal Broadcast
Advertising Ban advertising spending
shifts
– Sports marketing
– events promotions (concerts, fashion, etc.)
 Why bars?
•Brand sampling
•Targeted marketing
•Reinforcement of brand image
•Bar environment is “smoker friendly”
1978
 REAL Disco – RJ Reynolds
Promotion
• Objective:
– To provide young adult smokers the
opportunity to learn about and try RJR
products in a favorable environment
• Measure the effect of different types of
disco events on Real
– Awareness, trial, and purchase
 Why Discos?
Disco – Stayin’ Alive
• Documents highlights the growth of
discos (dance clubs) which have
attracted their target group of 14-18
years, 19-25 years and 20-30 years.
• Bar/club themes appear in popular
movies
– 1977 Saturday Night Fever
– 1980 Urban Cowboy
"Newport Nights Disco Dance
Contest Research". Jan 1978.

Two main elements:

1. A Dance Contest for Prizes;
2. Free samples of Newport
cigarettes, T-shirts and lighters

Promotional concept tested in

6 discotheques on Long
Island, NY
Results: Total usage of
Newport doubled from pre to
post wave (16% to 33%).
Camel Lights Bar Promotion, 1982
“On the scheduled night, the
Camel Lights Troop would arrive
at bars near college campuses
with one RJR employee and 2 to
8 girls. The girls were either
students or models from a local
agency. On a couple of occasions
the girls wore tight shorts and
Camel Lights T -shirts.”
 Product Sampling

“The girls handled the sampling

and mostly used sample 4’s,
although 20’s were used
sometimes. The managers did not
like the 20’s since it took away
from their vending profits”
 Fun and Games
The games were “stupid” but effective…
- Free T-shirt to the tallest man
-Camel Lights visor to the shortest girl
-Remove own shirt without taking off T-
shirt
-Chug a glass of beer the fastest won a
shirt
 Bar compensation
• Permanent P.O.S. items
– Mirrors
– Ash trays
– Clocks
– Camel Lights disco sign
• Napkins, stirring sticks and straw holders
• RJR rep bought drinks if the bar wasn’t too
crowded
Marlboro Resort Program
• Promotional efforts
through 8 bars in
Daytona Beach and
Ft. Lauderdale
• Direct impact on
100,000 young adults
• Results in impulse
buying through peer
influence
 Virginia Slims Legends Bar Night
Concepts, 1994

• Generate names for

data base
• Reinforce brand
image
• Create trial
• Leverage the brand
equity in tennis
 Virginia Slims Legends Bar Night
Concepts, 1994
“The top lifestyle index
for single females 21-
44 years of age is
fashion clothing,
therefore the use of V-
Wear incentives and
sampler dress
consideration. Playing
tennis ranks #4 on
lifestyle index.”
“Marlboro has signed a two year
agreement with the owner of
Americas Original Sports Bar as
an exclusive tobacco sponsor and
promoter in a chain of 8 large
sports bars”
• Place Marlboro permanent signage in
high impact locations
• Design Marlboro sports themed wall in
each club
• Provide bar Marlboro bar accessories
• Conduct special promotions around
auto racing and adventure team themes
1998
Buffalo, NY, 2003
 Data based marketing
• compiling, analyzing and using data held
about customers in order to create better
tailored, better timed offers that will
maximize customer value and loyalty.
Got mail…

Tailoring communications to the wants

and needs of consumers…..
Debit-Boro
Moscow, January 2007
Product Placement
Let’s go to a movie…

Of the top 50 box office hits in

2000, 66% featured tobacco use
Superman II October 18, 1979

No.103
No.105
Point of sale marketing
Exterior Interior
Get your drugs and your smokes…
Price is
important
Higher taxes put the
squeeze on smoking
So how about some cheap smokes?
…or some free stuff to make it
seem like your not spending so
much cash!!
Adapt to changing circumstances…
However, when
profits are the
motive you
should expect
adaptation
STRATEGIC PLAN
• Image enhancement
• Corporate alliances
• FDA regulation
• Pharmaceutical model
• University partnerships
• USA complacency
Philip Morris College Recruitment
“Ambassadors” Program
Tobacco consumption is
increasing in the developing
world, especially in India and
SE Asia and Eastern Europe
 Where is the burden increasing the
fastest, 1990 to 2020?

Formerly Socialist
Economies of Europe
+120%
Established Market
Economies China
+18% +175%
Other Asia
India and Islands
Middle+1400% +250%
Eastern
Latin Crescent
Sub-
American +700%
Saharan
and Africa
Caribbean +200%
+300%
Why should the devil have all
the best tunes?
We can learn a lot about how
to become more successful
marketing tobacco control
by understanding how
commercial marketers, like
Philip Morris have gone
about selling cigarettes
 How should we market cessation treatments?
The Four “P’s”

• Product
•Placement

• Promotion •Pricing
20 years ago….
smokers were told…

What they
say about
nicotine
addiction
Treatment options for smokers
were pretty limited…

Gum

Patch
20 years later, things have improved
 New programs, policies, and attitudes…

Insurance

Network of Quit Lines

Provider Counseling

Practice guidelines Tobacco industry credibility

OTC medications
…and new efficacious medications
…but, it is unclear if any of this has
contributed to increased quitting
Further complicating things is a
blurring of the lines taking place
between tobacco products and
cessation products
Weird smokes for the worried well…
 FDA-
Approved
NRT

Ariva
Tobacco
Lozenge:
CVS,
Not FDA- Washington,
Approved DC, Spring
2002
maybe we should
start by asking the
consumer what
they want…
 Would “think seriously about stopping
smoking in the next 6 months”
Because of…
Smoking ban at work 21
Smoking ban at bars 22
Graphic warnings on packs 23
Graphic TV ads 26
Phone support line 28
Pay taxes on reservation 32
Win money by quitting 49
Free nicotine patches/gum 53

0 20 40 60 80
Call volume to the Quit Line in response to New
York City Free patch Give Away Program
(>425,000 calls in 1st 3-days!!!)
236840

250000

200000

150000
99558

100000
41182

50000
5877

5374
3010

2342
1526
1258
1326

1269

1025

1984

1368
2034
844

801

856
799

810

862

910
969

991

749

875

993

874

894
389

301

661

287

636

613
251

674

391

705

595

611

428

613
0

/0 3 /0 3 /03 /03 /03 /0 3 /03

4/2 4/9 4/1
6
4/2
3
4/3
0 5/7 5/1
4
 Average weekly call volume to the Quitline Before,
During, and After the Offer for Free NRT

Intervention Voucher for 1-Week 2-Week 6-Weeks

2-week supply of supply supply of
supply nicotine of nicotine nicotine
of NRT patches patches patches
Ratio of calls to the 4.95 4.97 15.5 13.1
Quitline during the free
NRT program and
4-weeks before the
offer

Ratio of calls to the 4.39 3.82 9.13 13.4

Quitline during the free
NRT program and
4-weeks after the offer
A little bribery doesn’t hurt…
Background
A dozen Quit & Win contests conducted in
NYS offering smokers a chance to win cash

Results
•Several thousand smokers signed up to quit
•Most were heavy smokers
•>80% said they made a quit attempt
•1/3rd reported not smoking
Anticipate new and improved products…
– Rimonabant (Acomplia™,
sanofi-pastuer) – NDA
filed June 2005

– Nicotine Conjugate
Vaccine (NicVAX™ Nabi,
Cytos)
 …new product line-extensions to make
treatments more attractive for consumers….

Nicotine beer

designer patches Flavored gum Nicotine lipstick

…how about a national quit brand?
 …new initiatives that will impact
tobacco use behaviors

New practice
guidelines FDA regulation of tobacco products
due out in 2008
Find out what people think….
Problems in risk perception
General rule:
People don’t always perceive risk correctly

Differences in …..

Awareness of a a risk
Belief that the risk is real
Acceptance that one is at risk
Large
graphic
warnings
now are
mandated by
over a dozen
countries
Put it all together
Test your communications
Study comparing two mailings to prompt calls to the Quitline
 Dread
Every cigarette you
smoke does your body
damage
Personal testimonials work well
Victim identified
test new ways to make quitting assistance
accessible to tobacco users…

www.Bobquits.com
 Come up with clever ways to
promote the product to consumers

Call 1-800-QUIT NOW

for help to stop smoking

Calls to the New Zealand Quit Line increased by 16% when

the number was printed on packs
 Cold call study
Random sample of
121 smokers called
and asked…

“The Quit Line • 41% said YES

provides a free starter • Females 2x more
kit of nicotine patches likely than males to
and counseling. accept offer
Would you like me to • No other differences
transfer you?”
Broaden the target audience

Tobacco control is more than

smoking cessation
 Reframe the problem so it is
simple for people to understand
Evil-doers
Pablo Escobar

Narco-Terrorist
Osama bin Laden

Religious-Terrorist
Philip Morris

Tobacco-Terrorist
Civil Rights
“The world is accustomed to
thinking of the law as an
instrument of justice, but not as an
instrument of health.
We expect epidemics to be
defeated in the clinic or the
community, not in the
courtroom . . .
It is time that the tools of law be
harnessed in the service of global
health and global justice.”
Be prepared to fight for what
you believe…
 John Banzhaf
Action on smoking or health
Think about ways to speed up
the diffusion process?

FASTER, FASTER, FASTER!!!

Need to disseminate policies more quickly.
Framework Convention on Tobacco Control
(FCTC) adopted in 2003
Key requirements of treaty
• Ban tobacco advertising, sponsorship and promotion,
where constitutions allow, within five years
• Tobacco packaging must include health warnings
covering at least 30% of packet within 3 years
• Introduce measures to protect people from second-
hand tobacco smoke in public places
• Draw up strategies to combat smuggling
• Adopt tax policies which discourage smoking
• Product regulation
• In the 20th century, smoking caused
an estimated 100 million deaths
worldwide.

• In the 21st century, if current usage

patterns persist, smoking will cause
approximately 1 billion deaths
 Potential of Policies to Flatten the Curve
Estimated cumulative tobacco deaths
1950-2050
520 Impact of policies
500 500 depends on two
Tobacco deaths (millions)

factors:
400
– Intervention date
340
300
– Effect size
220
200
190

100
70
0
1950 2000 2025 2050
Year
World Bank. Curbing the epidemic: Governments and the economics of
tobacco control. World Bank Publications, 1999. p80.
 Make use of communications channels
(pictures speak louder than words)
100 "Have you noticed information that talks about the
90 dangers of smoking or encourages quitting…."
80 88%

70
60
Yes (%)

65% 64%
50 56%
40
30 39%
33%
20
25%
10
11%
0
TV Cigarette Print Poster Radio Leaflets Stores Internet
Packs

CAN AUS UK US

84% 69% 56% 47%*

“Have you noticed information that talks about the dangers of smoking or
encourages quitting on CIGARETTE PACKS?”
Invest in research…

Special
Projects
No. 105
• Simple studies can anchor advocates in
data
– Consistent message
– Anchored in science  more credibility
• Can generate earned media
• Push decision makers to face real data
instead of anecdotes
WWW.tobaccofreeair.org
Don’t forget about home…
 Home Air Monitoring

• Air Quality Measured via TSI SidePak AM510 Personal Aerosol Monitor
• Single and Multi-Unit Houses in Erie and Niagara Counties
• Assessment Conducted Between February and August 2006
Air Quality PM2.5 (µ g/m3)
100
84
Hazardous ≥251
80
PM2.5 Levels (μg/m3)

67 Very 151-250
Unhealthy
60
Unhealthy 66-150
s

40
Unhealthy for 41-65
20 9 11 Sensitive Groups

0 Moderate 16-40
Smoking Areas Distal Areas Smoke-Free Outdoor Air
Homes
Good ≤15
 ID#03smoking room and non-smoking room, superimposed
Start: 4/13/06 End: 4/16/06
7:35pm smoking room non-smoking room 2:15pm
1800
1600
1400
PM2.5 level

1200 Woke up, opened

window and smoked
1000
6 cigarettes, day 4
800
600

400
200
0

Time

Went to bed, day 3

Started with Woke up day 3, opened

window open, Woke up day 2, opened window and smoked 7
then closed window and started cigarettes in the day
window here smoking (17 cigarettes time
for day 2) before closing
Smoked 10 cigarettes, then window and retiring to Smoked 1 cigarette, then shut
went to bed, day 1 bed window and smoked 17 more
cigarettes before retiring to bed

728 sq ft
Band together with your friends
22 countries have adopted
comprehensive smoke-free
laws
Learn from those who are the
early adopters
 Smoke-free Ireland
Reported Smoking in Bars/Pubs—Last Visit
100
Weighted % of Respondents

Conclusions:
80

1. The60smoke-free law led to near-total

elimination of smoking in key public U.K.

venues Ireland
in Ireland (especially in pubs)
40

2. A very high proportion of U.K. workers

20
continue to be exposed to tobacco
smoke
0
Pre- Post-
Legislation Legislation

Source: Fong et al. Tobacco Control 2005.

 Record Drop in Consumption in
New York City
- Confluence of clean air, tax increase,
media campaign, free NRT

- 11% consumption drop 1 year after New

York City smoke-free law took effect
 If the California and Massachusetts tobacco
Control programs were cigarette brands
they would represent 6% of the market share
2.0 (3rd only to Marlboro and Newport)
1.45
1.5
Relative Risk

1.13
1.00
1.0

0.5

0.0
HIGH: MEDIUM: LOW:
CA, Mass NY, NJ, Ore, WA IA, NC, NM,
 Lung cancer incidence
in California
73

71
Age adjusted incidence (cases/100,000/year)

69

67

65

63

61
14% reduction
59

57

55
Anti-tobacco
program
1975 1980 1985 1990 1995 2000
Keep it simple
 A few Take Home Points

Tobacco
Control is
like
plumbing
 The Tobacco Industry – 5Ps
•Promotions & advertising

tobacco •Product placement

•Price marketing
•Product manipulation

industry •Political contributions

turns on
the
faucet
 Tobacco Industry

Replacement
smokers
(mainly teens)
flow into
the sink
 Tobacco Industry
Nicotine •Health reassurance
•Filters
addiction •low T&N
•PREPs
and
marketing
make it hard
for those
caught
in the
sink to get Nicotine Addiction
out alive
Tobacco
Control
Plumbing
(call roto-rooter)

Tobacco Control Vaccine

Increase tobacco taxes Nicotine Addiction
Smoke-free policies
Comprehensive ad ban
Public education
Meaningful product warnings
Common sense product regulation
Access to smoking cessation services
 Some lessons learned…
• We can learn a lot from business
– marketing principles and research

• Information matters, but is usually not enough

– incentives, convenience, context, skills

• The world is always changing

– anticipate and exploit new modalities for communicating (internet, text
messaging, direct mail)

• Small effects matter (market share)

– reach vs. efficacy
– short vs. long-term view
In the United States….
 d N e w s
Ba
fo r
Big
We’re making progress…
The End