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标题：Why and How the Tobacco Industry Sells Cigarettes to Young Adults: Evidence From Industry Documents
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作者：Pamela M. Ling ; Stanton A. Glantz
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2002
卷号：92
期号：6
页码：908-916
语种：English
出版社：American Public Health Association
摘要：Objectives. To improve tobacco control campaigns, we analyzed tobacco industry strategies that encourage young adults (aged 18 to 24) to smoke. Methods. Initial searches of tobacco industry documents with keywords (e.g., “young adult”) were extended by using names, locations, and dates. Results. Approximately 200 relevant documents were found. Transitions from experimentation to addiction, with adult levels of cigarette consumption, may take years. Tobacco marketing solidifies addiction among young adults. Cigarette advertisements encourage regular smoking and increased consumption by integrating smoking into activities and places where young adults' lives change (e.g., leaving home, college, jobs, the military, bars). Conclusions. Tobacco control efforts should include both adults and youths. Life changes are also opportunities to stop occasional smokers' progress to addiction. Clean air policies in workplaces, the military, bars, colleges, and homes can combat tobacco marketing. (Am J Public Health. 2002;92:908–916) Virtually all tobacco control programs emphasize primary prevention for children and teens or smoking cessation for adult smokers. Tobacco control efforts aimed at young adults (aged 18–24 years) are generally limited to cessation for pregnant women, 1– 8 military personnel, 9– 14 or college students. 15– 17 Despite the widely accepted view that smoking initiation occurs only before age 18, smoking frequently began during young adulthood in the early and mid-20th century and still does among some ethnic groups. 18– 21 Rates of current cigarette use among young adults increased steadily, from 34.6% in 1994 to 41.6% in 1998, 20 and then declined slightly, to 39.7% in 1999 and to 38.3% in 2000. 22 The prevalence of current smoking among college students increased from 22.3% in 1993 to 28.5% in 1998. 23 The number of young people at moderate to high risk for established smoking increases throughout the teen years, with more people in the early stages of smoking initiation (open to smoking, experimenting, and nonregular smoking) at ages 14 to 19 than at 11 to 14. 24 The number of 18- to 19-year-olds in the early stages of smoking initiation is more than twice the number of 18-year-old established smokers. 24 These youths are at risk to become established smokers as young adults and thus are prime targets for interventions to make them nonsmokers again. Since 1998, more than 40 million pages of previously secret tobacco industry documents have been made available to the public. Previous investigations with these documents concentrated on proving that tobacco industry marketing targeted youths. 25– 27 We analyzed the documents to find why and how the tobacco industry markets to young adults and drew 3 conclusions. First, the industry views the transition from smoking the first cigarette to becoming a confirmed pack-a-day smoker as a series of stages 28– 30 that may extend to age 25, 31 and it has developed marketing strategies not only to encourage initial experimentation (often by teens) but also to carry new smokers through each stage of this process. 28, 32– 36 Second, industry marketers encourage solidification of smoking habits and increases in cigarette consumption by focusing on key transition periods when young adults adopt new behaviors—such as entering a new workplace, school, or the military–and, especially, by focusing on leisure and social activities. 33, 37, 38 Third, tobacco companies study young adults' attitudes, social groups, values, aspirations, role models, and activities and then infiltrate both their physical and their social environments. 37, 39– 43 Understanding this process can help public health practitioners to develop better tobacco control programs and physicians to encourage nonsmoking among young adult patients.