Cigarettes are Very Kool - Center for the Study of Tobacco and Society

Cigarettes
are
Very Kool
byAIan Blum, M.D.
Whenyou'rea Jet,you'rea J€t all the way,
'tilyourlastdyingday. . . .
Fromyourfirstcigaretle,
- l,YeslSide Slory, 1957
Alan Blum, M.D., is a family physicianin
Chicago, He is also president of DOC
( Doctors Ought to Care), a national
organization that assistscommunitles in
developingncw approaches to health
education lor children and leenagers.
(OPPosite)CourtesY,DOC Archive
T h e p i c t u r eo f a c i g a r e t t e - s m o k i ns g
t r e e tg a n g m e m b e ri s n o t q u i t e a n
anachronismin the 1980s, but comparedwith the range of hard drugs
availableto teenagerstoday,cigarettesseem like little more than leftover
forbiddenfruit of lhe halcyonfifties.Hardlya day passes without a news
reportaboutangeldust,alcohol,marijuana,
cocaine,or Quaaludes.Newspapers print"The AlarmingTruthAboutMarijuanaand YourChild";professional athletesvisitschoolsto denouncedrugabuse;politiciansrailagainstdope
dealerson schoolgrounds;and parentsgroups mobilizeto rid their communityof "head shops" that sell drug paraphernalia.
The seriousness
of illicitdruguse amongyoungpeoplecannotbe denied.
Althoughthe mediaare fearlessin their zeal to exposeteenagedrug and
alcoholabuse,theyare conspicuously
silentaboutwhatWilliamPollin,director of the NationalInstituteon DrugAbuse,has calledthe nation'snumber
one form of drug dependence:cigarettesmoking.
Tobacco, of course,is a drug. Althoughit is not known just how its
principalactivecomponent,nicotine,acts on the brain,people do become
"addicted" to cigarettesmoking.As many as 90% of cigaretteus6rs say
they wish they had not started,and they wish they could stof-tut for some
reasonthey cannotsucceed.On the other hand,the unpredictabilityof those
who do win the battle-most say they did it on their own (without fancy
programs,hypnotism,or other gimmicks),many by going "cold turkey" without experiencingthe withdrawalone would expect in a true addictionsuggeststhat socialand psychological
factorsmay play a far greaterrole in
perpetuatingcigarettesmokingthan physiological
dependence.
ls there anotherproductas irredeemablyharmfulthat is as eKensively
promoted?In spiteof cigarettesmoking'sdevastatingphysicaland financial
toll-350,000 deaths in the UnitedStates each year, includingmore than a
quarterof all deathsdue to heart disease,and at least one out of every five
dollars spent on health cara-the manufacturersof cigarettes still recelve
tax write-offsfor advertisingexpenses.
148
Phorog.aohs
M!seufi
ol Modorn
A.l
Cigarette advertising : creating complacency
Advertising,it wouldseern,has helpedmakesure that cigarettesrnokingis
not even consideredmuch of a healthissue.By encouraging
the publicto
believethat "everythingcausescancer,"the cigaretteindustryhelpsportray
its productas iust anothervictimof Big Brother'stryingto tell peoplohow
to run theirlives.The massmedia,whichcarrythe cigaretteads,havedone
nothingto alter the situation.Publicoutcry(eggedon by bannerheadlines)
over a mere handfulof casesof botulism,toxicshocksyndrome,or Legionn a i r e sd' i s e a s ec a n c l o s eb u s i n e s s eO
s .n em i l l i o nc a r sc a n b e r e c a l l e da f t e r
Yet newspapersrun
one death due to a malfunction
of a singleautomobile.
full-pagecolor advertisements
for the productthat has been describedby
t h e W o r l d H e a l t hO r g a n i z a l i oans t h e s i n g l em o s t p r e v e n t a b lcea u s e o f
dealhand disability.
" E v e r yc i g a r e t t ea d c a r r i e st h e s u r g e o ng e n e r a l ' w
s a r n i n gt h a t s m o k i n g
may be harmfulto your health,"saidone executiveof a leadingnewspap€r
when asked why his paper could not exert more controlover cigaretle
advertising."We remainconfidentthat the public,lully informed,ultimately
w i l l m a k e t h o s ed e c i s i o n tsh a ta r e i n i t s o w n b e s ti n t e r e s t s .T" h e p u b l i s h e r
lVhy do adolescents take up smoking?
Identif cation wirh role models who
symbolize ronence and sophistication is
one undeniable motivating factor.
( OverleaJ) Counteradvertisement is lhe
creation of sixth-grader Helen Kernodle
lrom Des Moines, Iowa.
ol Better Homes & Gardens,whosemagazineaimsto be a health-oriented
familypublication,has statedthatin his opinion"thosereaderswho do not
smoke will turn past the cigaretteadvertisements
that are of no interestto
them."
Just as emphysema,heartdisease,and lung cancerhave reachedepidemicproportionsin the UnitedStates,the tobaccoindustryhastriedto see
to it that cigjarette
smokingis notviewedas a healthissue.The June 1, 1981
issue of fime, with a cover story on heart attacks,featureda six-page
fold-outad iust insidethe cover for Vantagecigarettes.The back cover
promotedWinstonLights;Eelair,Carlton,Kentlll, and Marlborow€readvertised withinthe magazine.Adolescents,
lookingfor role rnodelsand at the
same time rebellingagainstauthorityfigures,are a particularlyimpressionable group.Any adolescentwho readsa magazineor a newspaperlearns
with goodlooks,sexiness,
from the advertising
that smokingis synonymous
athleticprowess,sophistication,
individuality,
and even(with"low tar") good
health.The purposeof cigaretteadvertising
is not just to sellcigarettesbut
also to create complacencyaboutthe dangersof smokingthem.
At leastthis is the gamethe tobaccoindustryhas been playing,particularly
since 1964,when U.S.SurgeonGeneralLutherTerry and a committeeof
physiciansreleased th€ report that irrefutablylinked cigarettesmoking to
emphysema(a generallyincurable
diseasein whichthe patientslowlysuffe
cates to death-fully aware of what is happening'over months or years)
and lung cadcer (the literaleatingaway of the lungs and possiblyother
organssuch as the brainto whichthe cancerspreads).The RoyalCollege
of Physicians
in the UnitedKingdomhadreleaseda massivereporton thes€
dangerseven earlier-in 1962.
"Everybody'sdoingit"
It is a myth that cigarettesmokingis thousandsof years old and a tim€'
honoredtradition,if not an inalienabte
right.Actually,whereastobaccohas
r50
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OOC Arch,yo
.
u.&'.lto*t+*le?
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.:
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So nild, athletessmoke
as illcutl as they please-arul
that's 79g! nildness!
.;;;"^"rtl
beenused for centuries,cigarettes-the only tobaccoproductthat requires
inhaling-were not mass-produceduntil a century ago; moreover,while
nearly4,000cigaretteswere smokedfor everyadultin the UnitedStatesin
1 9 8 0 ,t h e p e r c a p i t ac o n s u m p t i o n
i n 1 B B 0w a s 2 5 . W h e n t h e 1 9 t h - c o n t u r y
GermanbacteriologistRobert Koch suggestedthat spitting-such as was
practicedby cigarsmokersand plugtobaccochewers-spreadtuberculosis
(the most dreadeddiseaseof the time) and a numberof antispitting
ordinanceswere passed,the tobaccoindustryin the UnitedStatesshiftedgears
and beganto producecigarettes.To consummatethe switch,it had to use
mass mediaadvertisingto teach peoplehow to smoke cigarettes:"Do you
inhale?Everybody'sdoing itl" insistedthe AmericanTobaccoCompany.
Even well into the 20th century,cigarettesstill had not caughton-and
definitelynol among women. But with adverlising.the tobaccocompanios
beganto appealto women: "To keep a slenderfigure,reach for a Lucky
insteadof a sweet." A well-promotedaura of romanceand sophistication
made a Camel smoker-man or woman-a "social success."Throughout
the '30s, '40s,and '50s on radioand in everyleadingmagazinea plethora
of our prettiestpeoplewere the modelsin the ads: DouglasFairbanks,Jr.,
Jean Harlow,FredricMarch,JoanCrawford,ClaudetteColbert,TyronePower, Eva Gabor,FrankSinatra,MaureenO'Hara,GregoryPeck,LindaDarnell,
DeanMartin,JerryLewis,Bob Hope,the Duchessof Windsor,Mrs.John D.
Rockefeller,and Santa Claus."l'm a singer and my throat comes first. I
pickedCamelsas my steadysmoke," said Anne Jeffreysin an advertisement in Lile in the 1940s.lt is sad but poignantthat GaryCooper,Rosalind
Russell,John Wayne, Dick Haymes,RobertTaylor,and Nat King Cole all
promotedone brand or anotherof cigaretteand subsequently
developed
lung cancer or other fatal smoking-related
diseases.
The cigarettecompaniesalso appealedto the all-American
boy,who, of
course,was likelyto be an aspiringathlete.A ten-year-oldboy growingup
l5l
Up until the late 1960s,movieand sports
stars wereamongthe heroesand heroines
featured in adsfor everybrand of
cIgaret! e. Today's cigarett e-promoIi ng
modelsare active,healthy,sexy,
fas hionable, and tough-but nameless.
Prir.rl'ron:
cr,,'rdly
OOC Archvo
ll'hen they saw tha( smoking had not
caught on equally between the sexes, the
cigareue companias began to appeal to
w'onten.Today it seems astounding, bu!
cigarette ads used to appear in medical
)ournals, and snroking was promoted
by doctors.
i n l h e 1 9 3 0 sc o u l d p i c k u p t h e S u n d a yc o m i c p a g e sa n d s e e h i s f a v o r i t e
a t h l e t e s - Y a n k e e ss' t a r sJ o e D i M a g g i o r L o u G e h r i g - s a y i n gs u c ht h i n g s
a s " C a m e l sd o n ' t g e t m y w i n d " a n d " A t h l e t e ss m o k ea s m a n y a s t h e y
please."Accordingto sluggersTed Williamsand StanMusial,Chest€rli€lds
wer€ "the baseballman's cigarette."SkaterlrvingJaffee,an Olympicgold
m e d a l i s ts, a i d , " l t t a k e s h e a l t h yn e r v e st o b e a c h a m p i o nT. h a t ' sw h y I
smoke Camels."In the sportingworld,track stars,deep-seadivers,sharpshooters,archers,tightropewalkers,jet pilots,waterskiers,footballplayers,
tennischampions,speedboatracers-even chess,billiards,
and bridgeplaye r s - s e e m e d t o a t t r i b u t et h e i rs u c c e s st o s m o k i n gc i g a r e t t e s .
A n d h o w d i d t h e i n d u s t r yr e s p o n dt o e a r l yr e p o r t si n t h e I 9 4 0 s a n d ' 5 0 s
thatassociated
c i g a r e t t es m o k i n gw i t h a v a r i e t yo f l e t h a la i l m e n t s ?" M o r e
doctorssmokeCamelslhan any othercigarette,"proclaimed
R. J. Reynolds.
" N o t o n e s i n g l ec a s e o f t h r o a ti r r i t a t i o nd u e t o s m o k i n gC a m e l s . "I n t h e
J o u r n a l o l t h e A m e r i c a n M e d i c a l A s s o c i a t i o n( w h i c ha c c e p t e dc i g a r e t t e
a d v e r t i s i nugn t i lw e l l i n t o t h o 1 9 5 0 s ) ,P h i l i pM o r r i s ' sb e l l h o pl,i t t l eJ o h n n y ,
g u a r a n t e e dt h a t s m o k i n gP h i l i pM o r r i sw a s " s a f e r " a c c o r d i n gt o " m a n y
l e a d i n gn o s e a n d t h r o a ts p e c i a l i s t s . "
Advertisingfor AmericanTobacco's Lucky Strike suggestedthat some
smokersmight not realizethat they inhale.To be safe,they shouldselect
a "light" smoke,the one "found less irritatingby 20,769doctors."Lorillard
claimedits Old Gold contained"less irritatingtars and resins";it was "fresh
as a new springcrocus." For anotherbrand, Lorillardproclaimed,"More
scientistsand educatorssmoke Kent." Kent's widelypromotedMicronite
filter,which was made out of asbestos,was advertisedas containinga
material"so safe, so pure, it's used to filter the air in many hospitals."By
portrayingnewer cigarettesas "even safer" the tobaccoindustryeffectively
eliminatedearlyconcernsabout the dangersof smoking.Probablythe only
real advance was in lhe advertisingpsychology.Believingthat Americans
would regard the cigarette filter as analogousto an oil or air-conditioning
filter,Liggett& Myersproduceda white-coatedsageto assertthat L & M's
cellulosetip was "just what the doctor ordered."
Whensurveysshowedthat filtersmokersmightbe lookeduponas sissies
-since, after all, cigarettesmoking was meant to show adult courage,
risk-taking,and antiauthoritarianism-Philip
Morris led the way with a
tattooed cowboy, an inhabitantof "Marlboro Country."Just a few months
earlierMarlborohad been advertisedas a ladiessmoke,"mild as May." A
babywas shown in one advertisement
saying,"Gee, mommy,you surelike
your Marlboros."Throughoutthe 1950sand '60s, th€ cigarettecompanies
were the most predominantadvertiserson youth-orientedtelevisionshows
such as "Seventy-Seven
SunsetStrip,""The Rebel,"and most maiortelevised sportsev6nts.
Followingthe famed surgeongeneral'sreport,all cigarettessold in the
U.S.beginningin 1966had to carrythe warning"Caution:CigaretteSmoking
May Be Hazardousto YourHealth."In 1971that messagowas strengthened
to: "Warning:The Surgeon General Has DeterminedThat CigaretteSmoking ls Dangerousto Your Health."ln 1970the governmentbannedclgarette
is the
advertisingfrom radioand television.But forgottenor misunderstood
152
f a c tt h a ti t w a s t h ec i g a r e t t ec o m p a n i e st h e m s e l v e s - a g h a satt t h es u c c e s s
o f c o u n t e r a d v e r l i s i tnhga t a p p e a r e df r o m 1 9 6 7 t o 1 9 7 0a s t h e r e s u l to f a
s i n g l ec o m p l a i nbt y t h e f o u n d e ro f A c t i o no n S m o k i n ga n d H e a l t h J, o h n
Banzhaf-who removedtheir own ads to avoid havingto be shownup by
the cleverads that spoofedcigarettesrnoking.KennethWarnerof the Univ e r s i t yo { M i c h i g a np o i n t e do u t i n t h e A m e r i c a nJ o u r n a l o l P u b l i cH e a l t h
t h a t t h e c o u n t e r a d v e r t i s e m e nf e
t sa, t u r i n gs o m e f a m o u sp e r s o n a l i t i ebsu t
jingles
runningin off-hoursand in low frequencycomparedto the prime-time
f o r M a r l b o r oK, e n t ,S a l e m ,a n dW i n s l o nc, u t e x p e c t e dc i g a r e t t sea l € sg r o w t h
b y u p w a r d so f 3 0 % i n j u s t t h r e ey e a r s .
Smokingin the 1980s
T h e 1 9 8 0 sa r e m a r k i n ga n e w e r a .A m e r i c a n sa r e h e a l t h i etrh a ne v e r ,s a y s
t h e U . S .g o v e r n m e nTt .h e i m p r e s s i oins w i d e s p r e a d
t h a tp e o p l ea r eq u i t t i n g
s m o k i n gi n d r o v e sa, n d t h e n u m b e ro f t e e n a g e r tsa k i n gu p c i g a r e t tsem o k i n g
is going down.Cigaretteadvertisingno longerappearson television.
Cigar e t t e c o m p a n i e sa r e d i v e r s i f y i n sgo r a p i d l y ,i t i s s a i d ,t h a t t h e c i g a r e t t e
i n c o m ed o e s n o t e v e n m a t t e r .B e s i d e st,h e c i g a r e t t e st h e ya r e m a k i n ga r e
s a f e rt h a ne v e r .T h e n o n s m o k e r rsi g h t sm o v e m e n its w i n n i n gi t s b a t t l e sf o r
clean indoorareas,and the women'shealth movementis in the vanguard
. o d a y ' sa t h o f t h o s ed i s c o u r a g i ncgi g a r e t t es m o k i n ga m o n gt e e n a g eg i r l s T
l e t e sd o n o t p o s e f o r c i g a r e t t ea d s .J o e D i M a g g i oi s b e t t e ri d e n t i l i e w
d ith
"Mr. Coffee"thanwith baseball,and MickeyMantleand LouGehrigareonly
names jn lhe recordbook to today'steenagers.
Theseimpressions
are, for the most part,wrong.ln fact,the problemmay
be worsethaneverbefore.lt is so discouraging
to contemplatethe problem
of cigarettesmokingamongadolescentsthat the AmericanCancerSociety,
for example,has concentratedthe greaterpart of its antismoking
campaign
on adults.Althoughthere have been scatteredeffortsto developcurricular
materialsconcerningthe dangersof smokinglor gradeschools,thereis not
a singlepenny'sworthof paidadvertising
aimedat teenagersto counlerthe
While
cigarettecompanies'nearlyone billiondollars'worth of advertising.
teamsof medicalresearchersare well subsidizedto studyways of combating iuvenileonset diabetesand .juvenilerheumatoidarthritis-seriousdiseases that affect thousandsof childreneach year-there is not a single
physicianemployedfull-timein the UnitedStatesto counterjuvenile onsel
cigarette smoking-a conditionafflictingone millionteenagersa year.
Overlookedin the much-heraldedstatementsabout Americans'supposedlyimprovedhealthstatusis that the problernof heartdiseaseamong
womenis on the rise-an increasethat closelyparallelsnot onlythe number
ol womenenteringthe workplacebut alsothe numberwho take up cigarette
smoking.A Californiastudy of 17,000women publishedin lhe Journal ol
the American Medical Assoclalion in 1980 found that the risk of heart
attackamongwomenwho smokeis threetimesthat of nonsmokers;
the risk
of strokeis fivefold.Althoughthe total numberof malesmokersis lessthan
it was in'l 964, black and Hispanicteenageboys have probablyincreased
theircigarettesmoking.Per capitaconsumptionof cigaretteshas declined
only slightlyin the last few years,and total sales are undiminished.
153
Smoking has long been equated with
r i sk- t a ki ng and ant i aut hori tarianism. T his
counleradverlisemenl mimics the macho
Winston smoker who boasts " I smoke
lor taste."
(L6lt) Vandef Cobb. (r€hr) Rchlr(l Ydnkor
In 1970the U.S. government banned
clgarette advertlslng [rom radlo and
television, but the cigarette companies
found other ways !o convince people to
smoke; today their ads are bigger,
brighter, more persuasive, and more in
e v i d e n c el h a n e v e r .
E v e n t h e g o v e r n m e n t 'osw n f i g u r e ss h o w t h a t t h e r ea r e e i g h tt i m e sa s
m a n y g i r l sa g e d 1 2 t o I 4 w h o a r e s m o k r n gt o d a ya s i n 1 9 7 0 - t h e y e a r i n
o n t e l e v i s i oann d r a d i o - a n d f o r
w h a c hc i g a r e t t e
commerciala
s s ta p p e a r e d
t h e f i r s tt i m em o r ef e m a l e si n a m a j o ra g e g r o u p( 1 7 - 1 8 )a r e s m o k i n gt h a n
m a l e s .A n e d i t o r i ai n
l C a - A C a n c e rJ o u r n a ll o r C l i n i c i a n si n 1 9 8 1e x p r e s s e da l a r mt h a t s o m a n yg i r l sw e r e s t a r t i n gt o s m o k eb e f o r e1 3 , a n d
f o r t e e n a g eg i r l s . "I n C o n n e c t i c u t ,
c a l l e ds m o k i n g" t h e t i c k i n gt i m e - b o m b
where the Departmentof Healthhas kept the most accuraterecordsin th€
U n i t e dS t a t e s t, h e d e a t hr a t e{ r o ml u n gc a n c e ra m o n gw o m e nh a s a c t u a l l y
thatof men.
surpassed
g u s i n e s sw
l r o n i c a l l yt,h e p u b l i s h i n b
, h i c h h a d r a i l e da g a i n s t e l e v i s i o n
years,
grew
as it becamethe chiefbeneficiary
advertising
for
silent
cigarette
of the switch into print advertising.Today the cigarettecompaniesar€
spendingthreetimeswhat they spentin the last year of televisedcigarette
advertising.
But the cigarettecompaniesnever reallywent off the air. They shifted
insteadto the sponsorship
of sportingeventsthat are televised-a far less
costly,subtler,and possiblymore effectivesellingtechnique.The showing
of PhilipMorris'sVirginiaSlimsTennisCircuit,far from being opposedby
w o m e n ' sg r o u p s ,h a s b e e n p r a i s e dl o r h e l p i n gt o b r i n gw o m e n i n t o t h e
big-time,big-moneysportsera. Eventhoughno maiorleaguebaseballclub
wouldadmitto directsponsorship
by a cigarettecompany,nearlyeveryclub
receiveslucrativeincomefrom cigaretteadvertisingin programsand on
scoreboards(at the bestcameraangles).The MarlboroCup horserac€has
becomeone of the top sportseventsof the year.lts annualtelecastincludes
dozens of mentionsof the brandname,picturesof the familiarlogo, and
even the old Marlborojingle.The insertionof the Marlborobrandname on
that is not even perceivedas advertising
race cars is low-costadvertising
as the cars flasharoundthe trackand acrossthe viewers'screensdozens
cigarettecompanieshave
of times during a telecast.Not coincidentally,
or reb€l'
becomethe leadingsponsorsoi eventsthat appealto risk-taking
lious adolescentinstincts:racingof dirt bikes,motorcycles,and hot rods'
r o d e o ,a n d b a l l o o n i n g .
154
A l t h o u g ho n e m i g h tt h i n kt h a t t e l e v i s i o p
n l a y st h e m a j o rr o l ei n m o l d i n g
leenagelife-styles,
thepowerol theprintedmediumshouldnot be underestimated.Perhapsbecausethe tobaccoindustryknowsthat the incidenceof
l u n gc a n c e ri s l i k e l yt o s u r p a s st h a to f b r e a s ct a n c e ra m o n gw o m e nb y 1 9 8 3 ,
it has become the numberone financierof women'smagazines,with th€
n o t a b l ee x c e p t i o nos f G o o d H o u s e k e e p i n gP, a r e n t sM a g a z i n e a
, ndthe
variousbrides magazines.The more ostensiblyhealth-oriented
women's
magazinesbecome,the mor€ cigaretteads crop up alongsidethe health
columns,as if to denythe verynotionthatsmokingis a majorhealthproblem.
Magazinesthat appealexpresslyto teenagegirls,such as Mademoiselle,
are full of ads that exhortthem to "smoke prettyEve," be "a Thinnerwith
S i l v aT h i n s , " " c o m e a l o n g w a y ,b a b y " w i t h V i r g i n i aS l i m s ,a n d " w e a r a
M a x - G r e a t l o o k i n gG
. r e a tt a s t i n gt,o o . L o n g ,l e a n ,a l l - w h i t M
e a x 1 2 0 ' s . "A
girldoes not evenhavelo smokethem-she canjustwearlhem.Mademoipromotesitself to advertiserswith the slogan,"Good
se//e, incidentally,
h e a l t h ,g o o d l o o k s ,g o o d l i v i n g . "
W h e n R o l / i n g S t o n e , a m a g a z i n ew i d e l yr e a d b y t e e n s ,r a n a c o v e r
photographof John Lennonin the nude,it receivediratemailfrom parents.
One wonderswhetherparentshave expressedany outrageover the Marlboro cowboyon the back coveror the many otherads for differentbrands
o f c i g a r e t t e s - a sw e l l a s f o r l i q u o rr, o l l i n gp a p e r s a, n d s n u f f( f e a t u r i ntgh e
witha day'sworthof angrytelephonecalls,
CharlieDanielsBand).Similarly,
Chicagoanssucceededin removingfrom all city busesa BonjourAction
Jeansad campaignthat featureda youngfemale'sunzippedpantsand bare
s k i n b e n e a t h .U n o p p o s e ds,t i l l ,a r e t h e a d s f o r c i g a r e t t e tsh a t a p p e a ri n
almost every bus and subwaycar of the transitsystem.
One is temptedto suggestthat the leadinghealtheducatorin Americaby virtueof its positive,
excitingappealto consumers-isthe cigaretteindustry.The companieseven outdoone anotherto become"lowestin tar" and
to proclalmthishonoron the sportsand lashionpagesof dailynewspapers.
But what does "low tar" mean?Low poison."Tar" is a compositeof over
4,000 separatesolid poisons,includingat least 35 known carcinogens.
Would one go into a supermarketand buy a loaf ot breadthat contained
"only two ouncesof poison"or a can of soup that was "lowestin carcinogens"? AmericanBrands says that 17 packs of Carltonare equal in tar
(poison)to just one pack of Kent.Does that mean that the consumercan
smoke 17 packsa daywithoutan increasedriskof disease?The hoaxis that
certainbrandsaresafer.Saferthanwhat?Thanfreshair?Studiesshowthat
smokerswho switchto a low-larin the beliefthat theywillbe saferare likely
to smokemorein orderto maintainthe levelof nicotine.Evenon a pack-perpack basis,low-tarsmokerstradeoff slightlyless tar (carcinogen)
for more
carbon monoxide(heartdiseaserisk factor).
What elsewillthesmokergetbesidesa strongriskfor lungcanceror heart
disease?Ammonia,formaldehyde,
and hydrogencyanideare just a few of
in cigarettesmoke.
the noxiousgasesfound in significantconcentrations
just
These gasesare not
the resultof burningtobaccobut also a resultof
chemicaladditives-mor€than 1,500of them,includingnitratesas preservatives and propyleneglycol,the solvent used as antifreeze--designedto
155
Emphysema, hear! dlsease, and lung
cancer have become epldemlc ln the
Unlted States and other coun(ries.
Meanwhile, lhc tobacco lndustry ls trylng
to see that smoHng ls not vlewed as a
health lssue-ln part, by placlng clgarette
ads alongside artlcles that discuss these
very killers,
Cdlory.
OOC Arctivr
k e e p t h e c i g a r e t t eb u r n i n gs m o o t h l ya n d e v e n l y .B e c a u s ec i g a r e t t e sa r e
designedto burn so well,in the UnitedStateseachyear they are the leading
cause of home, hospital,and hotelfires,whichtake the lives of moro than
2 , 0 0 0 p e r s o n sa n d m a i ma n d i n j u r em a n ym o r e
The failure to reachteenagers
! r o n i e s a b o u n d , a s i n t h e s c e n ea b o v e . N o !
only do cigarettes couse concer and hearl
disease,but becausethey are designed to
burn so v,ell, they are a leading cause of
fres in the United Stares
With all that is known aboutthe dangersol cigaretlesmokingand all the
publicheaithhand-wringing,
why havewe failedto preventteenagers--gids
especially-from takingup cigarettes?
How do we explainthe reasoningof
a 16-year-oldgirlwho choseto keepsmokingratherthan receivea fr€€ trip
to Washington,D.C.,paidfor by formerHEW secretaryJosephCalifano?"l
could have quit for good,but I didn'twant to," she said."lt's somethingto
do with my hands."
Obviously,smokingis initjaledby many social influences.lmitationof
peers,and significantadults (parents,teachmodels-media stereotypes,
most school-basedcigar€tte
ers, doctors)-plays a big role.Unfortunately,
educationprogramslackimmediacy
lor students.
The programsspellout the
Yet to any adolescentwho
dangers and emphasizeeventualdisabilities.
feels fine and has good health,illness-especiallycancer-js an abstract
thing.lt is difficultto sellhealthto someonewho alreadybelieveshe has it.
Moreover,adolescenceis a highlystressfulperiod of developmentcomplicatedby reactionsto puberty.Teensmay not be able or willingto see
beyondthe immediatepresent.And when lookingfor role modelsthe disciplinarianparentor teacheror doctordoes not hold a candle to the cattlegal who gets her Barclayciga-,
ropingMarlboroman or sleek,clear-skinned
rette lit by a dashinggentleman.(Brown& Williamson,incidentally,spent
$150,000,000in less than a year to introduceBarclay,a new brand, an
amounl that is probably grealer than all the money that has €ver
r56
g o n e i n t o r e s e a r c ho n t h e e f f e c t so f s m o k i n ga n d e f f o r t st o p r e v e n itt .
S c h o o l sh a v ea l s oc o n c e n t r a t eodn t h e i d e at h a ts m o k i n gi s s e l f - d e s t r u c t i v e b e h a v i o ra n d e m p h a s i z e d" n o t b e c o m i n go n e o l t h e c r o w d . "B u t a s
D a n i e lH o r n ,a l e a d e ri n t h e f i e l do f s m o k i n ge d u c a t i o nh,a s c o m m e n t e idn
r e g a r dt o s c h o o l - b a s epdr o g r a m s":T h e r ea r e s e r i o u sd i f f i c u l t l ei ns a t t e m p t i n g t o i n f l u e n c ey o u n gp e o p l eb y t e a c h i n gt h e m i n t h e c l a s s r o o m
to adopt
b e h a v i o ro p p o s e dt o p r a c t i c e st h a t a r e e n c o u r a g e idn t h e l a r g e re n v i r o n m e n t . "C i g a r e t t e
c o m p a n i e sc a n k e e pu p w i t h t h e l a t e s tf a d s( a n di n s o m e
i n s t a n c e sc r e a t et h e m )i n t h e i rd e p i c t i oonf s m o k i n ga n ds o r e m a i ni n v o g u e
far better than the schools.Indeed,the tobaccoindustryalliancehas put
t o g e t h ea
r s e e m i n g luy n c h a l l e n g e a bm
l eu l t i b i l l i odno l l a rs m o k i n gp r o p a g a n da effort. Camouflagedin all the cigaretteads and often laughedat by
t e e n a g e r si s t h e h e a l t hj o k e o f t h ec e n t u r y":W a r n i n gT: h e S u r g e o nG e n e r a l
H a s D e t e r m i n eT
d h a t C i g a r e t t eS m o k i n gl s D a n g e r o u tso Y o u r H e a l t h . "
As it there were any doubt, the U.S. FederalTrade Commission(FTC)
c o n c l u d e di n m j d - 1 9 8 1l h a t l h e m e s s a g eo n c i g a r e t l ep a c k a g e sh a d n o t
discouragedsmokers.The FTC proposedchangesin the sizeand shapeof
the printedwarningas well as a moredirectstatement,referringspecifically
to cancer and heart attacks.
The tobaccoindustryhas been stunningly
successfulin its oppositionto
any government-sponsored
smokingeducationprogramsdirectedat young
people,in its refutationof evidencethatsmokingis particularly
damagingin
pregnantwomen,in its contention-havingnever admittedthat smokingis
dangerousin the first place-that it can be made safer,and in its attempt
to cover up the cripplingtoll takenby smoking.Fear arousalhas not been
(lt does appearto havesome
suflicientto thwartsmokingin adolescents.
years
effect in childrenunderten
of age.)lt is the veryrisk-taking,
antisocial
tendencyof adolescentsto whichtheindustryis appealing.
Teenagersprob-
157
It is hoped that concerned citizens from
every age group will join in !he crusade to
prevent smoking among Joung people. But
leenagers themselvesmust be in lhe
vanguard of eforts to unsell cigaretles, as
!hey were in designing this ad bench in
S pa r !anburg, Sout h Carolina.
T o b a c c o c o m p a n l e sk n o w h o w t o r e o c h
teenagers. They sponsor ma)or sporting
ond muslcal eventssuch as the Kool Jazz
Festlvals, >+,hlchtake place ln many clties
a c r o s s t h e U n l t e d S t a t e s .T h l s , t o o , l s
advertising.
a b l yd o n o t h a v ea n o v e r w h e l m i ndge s i r et o b r e a t h ei n h o t c a r c i n o g e nasn d
p o i s o n o u ss,m e l l yg a s e s R
. a l h e rt,h e ya r es i m p l yi d e n t i f y i nwgi t ht o u g hc o w b o y sa r d s o p h j s l i c a t el d
a d i e sl t i s n c t l u s ta r n a l t e ro f s m o k i n ga c i g a r e t t e
b u t o f p i c k i n ga n i m a g e - - - - o nbeu y s M a r l b o r o so r V i r g i n i aS l i m s ,a n d o n e
s e l e c t so n e ' s b r a n dc a r e f u l l y .
O n er e p o r td o n efo r t h e N a t i o n alln s t i t u t e
o n D r u gA b u s eb y U n i v e r s i toyf
M i c h i g a rne s e a r c h e rssh o w e da d e c l i n eI nt e e n a g es m o k i n gO
. f 1 7 , 0 0 0h i g h
s c h o o ls e n i o r s2 9 % s m o k e di n 1 9 7 7 ;2 i ' , ' "i n 1 9 8 0 .E v e nt h o u g hg i r l sw e r e
'l
s m o k i n gl e s s j n 9 8 0 l h e y c o n t i n u e dt o b e h e a v i e rs m o k e r st h a n b o y s
( 3 0 1% s m o k e di ^ 1 9 7 7 ,2 3 5 " h i n 1 9 8 0 ) A
. m o n gb o y s ,2 7 . 2 " hs m o k e di n
1 9 7 7 , 1 8 . 5 %i n 1 9 8 0 .T h e r e s e a r c h e rast t r i b u t etdh e o v e r a ldl e c l i n ei n t h i s
g r o u p i,n p a r l ,t o g r e a l e p
r u b l i cd i s a p p r o v a
o lf s m o k i n gT. h i ss u r v e yu n f o r t u n a t e l ym a y n o t a c c u r a t e l rye f l e c t h e h a b i t so l c e r t a i np o p u l a t i o n sw,h e r e
p e r c e n t a g eosf s m o k e r sa r e p r o b a b l ys t g n i f i c a n thl yi g h e r - s u c ha s a m o n g
, i s p a n i c sa,n d i n n e r - c r tbyl a c k s .
s c h o o ld r o p o u t sH
p
M o r e o v e rt ,h e r o b l e mi s b y n o m e a n sg o n e .A n d a n y g o o dn e w ss h o u l d
n o t l u l lt h e p u b l i ci n t o b e l i e v i n vgi g i l a n c ea n d c o u n t e r a t l a cakr e n o l o n g e r
c r u c i a l .E v e r yo n e o f t h e t h o u s a n d so f u n o p p o s e db i l l b o a r d sa n d o t h e r
a d v e r t i s e m e nat sc h i l dg r o w su p s e e i n gr e p r e s e n ttsh e c i g a r e t t ceo m p a n i e s '
d e n y i n gt h ef a c t sa n du n d e r m i n i nmge d i c asl c i e n c eE. d u c a t i nw
g i t ht h e f a c t s
l s i m p o r t a nat n d n e c e s s a r yB. u l b e c a u s et e e n s a r e t e e n s ,b e c a u s st h e
tobaccoindustryis rich, powerful,and unwillingto acknowledgethat lts
p r o d u c it s a m a j o rk i l l e r a
, n d b e c a u s ea d v e r l i s i nigs s u c h a p e r v a s i v ea n d
f o r mo f p e r s u a s i o ns,o m ee f l c r t sm u s tb e m a d et o u n d oc i g a r e t t e
effective
promotion.
I t g o e sw i t h o u ts a y i n gl h a t t h o s ew h o c h o o s et o d e a lw i t ht h e p r o b l e m and it is hopedthat theywill come from everyage groupand occupatiorlm u s t b e m i n d f u lt h a t c i g a r e t t es m o k i n gi s t h e n u m b e ro n e t e e n a g €d r u g
p r o b l e mB
. u t t h e y n e e da l s o r e m e m b etrh a ts m o k i n gi s a s m u c ha s e r l o u s
p
r
s o c i e t a l o b l e ma s a h e a l t hp r o b l e mT. h ec i g a r e t t ies a s y m b ofl o rw h a l e v e r
t h e t o b a c c oi n d u s t r yw a n t si t t o b e .
158
\t
\\
Ad.olrd l.m'O.ng.r!
ol Sfrkiog. ganclit! ol Ouilhg..
amdf,rn Crncd 56ty
Spreadingthe antismoking
message
How does the UnitedStatesmeasureup to othercountriesin the eflort to
discouragecigarettesmokingamongyoung people?Fair,al best. In spite
of activist€ffortsfor clean indoorair by the organization
ASH (Actionon
Smokingand Heatth)and variouschaptersof GASP(GroupAgainstSmokers' Pollution)as wellas the development
of poslersand othermaterialsby
such groupsas lhe AmericanCancerSocietyand lhe AmericanLungAssociation,and repeatedpublic statementson the cigaretteproblemby surgeons generalLutherTerry,JesseSteinfeld,and JuliusRichmond,and by
a few outspokenphysicians
likeAltonOchsner,the UnitedStateshas largely
failedto reachlargenumbersof childrenand teenagers.In fact,the United
Statesappearsto lagbehindnumerousothercountries-onlysomeof which
are mentionedhere-in providingincentiveslor a smoke-freegeneration.
Canadahas laredsomewhatbetter,largelydue to the outspokenCanadian Councilon Smokingand Health,which is supportedby both gov€rnmental and charitablegroups from every province.The governm€ntsof
Quebecand Saskatchewan
havepioneeredin paid advertisements
on radio
and lelevisionthat discouragesmoking(as well as other lethallife-styles
such as drunkendrivingand poornutrition).
Toronto'sNon-Smokers'
Rights
Association,
whichhas widelypublicizedthe hazardsto childrenof secondhand smoke, succeededin lobbyingfor one of the most restrictivebans
anywhereon smokingin publicplacesas well as a ban on cigaretteadvertising on the city'stransitsystem.Winnipegwill be the site of the lifth World
C o n f e r e n c eo n S m o k i n gi n 1 9 8 3 .
The WorldHealthOrganization
has declaredthat in industrialized
nations
"the control of cigarettesmokingcould do more to improvehealth and
prolong life than any other singleaction in the whole field of preventive
medicine."Butin thevastmajorityof thirdworldnations,wheregovernments
equate tobacco sales with lucrativerevenuesand where Americanand
Britishtobaccocornpanieshavesaluratedthe mediawith advertising,
there
are no governmentofficialsor charitieschargedwith tacklingthe cigarette
problem.While there is acrimoniousdebate over the ethicsof promoting
in{ant formulaand U.S.-madedrugsin developingcountries,cigaretteswith no redeeminghealthvalue--continueto be far more widelypromoted
than any other product.To cultivatesmokingamong the populationsof
impoverished
countries,the tobaccocompaniesgive awayenormousquantitiesol cigarettesand-using childrenas streetvendors-sell cigarettesnot
just by the pack but by the piece.In poorernationsof the worldsmokingis
most popularamongthe wealthier,bettereducated,and more "sophisticated." Among male medicalstudentsin Nigeriain 1976,72o/owe'e cigarette
smokers.
One of the most progressiveefforts to combat smoking among children
is under way in Nicaragua,where the governmenthas made health and
literacymajorpriorities.
ln the restof Centraland SouthAmericathe picture
is less sanguinebecausetobaccois simplytoo culturallyengrained.Although Venezuelahas banned cigaretteadvertisingfrom radio and television and Brazil is beginning to counteradvertise,Mexico is home of the
world's largestMarlborobillboards.
159
Rirks of uuoking rnd bene0tr of quitting
chorteoed life expectancy
after l0 to l5 yean cx-smoker'srisk ap
proachesthat of thoscwho neversmoked
lung cencer
after l0 to 15 yean risk approachesthat of
thosc who neversmoked
larynx cancer
gradual reduction in risk, reachingnormal after l0 years
mouth cancer
reducing or eliminating smoking,/drinking lowen risk in fint few years; risk drops to level of
norsmoken in l0 to l5 years
cancer of esopbagu.c
sincc risk is proportional to dose,reducing or
eliminating smoking/drinking should lower
risk
canctr of bladder
risk decreasesgraduslly to that of nonsmoken
over 7 yean
cancrr of pancreaS
sincr risk seernsrelated to dosc' stopping
smoking should reduceit
coronary beart di.*ar
risk decrcascssharply after one year; after l0
years risk is the same as for those who never
smoked
bronchitic and emphysema
cough sputum disappean within few weeks;
lung functionmay improvg deterioration
slowed
ctillbinh and low birth weiglt
if smoking is stopped before fourth month of
pregnancy, risk to fetus is eliminated
peptic ulccr
ex-smoken get ulcers too, but they hcal faster
and more complctely than in smokers
drug end test effects
most blod factors raiscd by smoking return
to normal; norsmokers on birth control pill
have much lower risk of hazardousclots snd
heart sttacks
Serg€ Ldmo6o-Ga|lld
Many European countries are /ar ohtat!
of the United States ln el|orts to
d i s c o u r a g es m o k i n g a m o n g t h e i r y o u r h .
Most notableare Norway, Swtden,
Fronce, and Great Britain. Prince
Chorles, an outspoken nonsmoker, has
b e e n a p e r s u a s i v em o d e l f o r B r i t i s h
younSSters
J a p a ni s s e c o n do n l yt o t h eU S i n p e rc a p i t ac i g a r e t tceo n s u m p t i oYn e. t
J a p a nh a s p u t m o r ee n e r g yi n t oc o m b a t i ncgi g a r e t t e - b u
l i t t e trh a ni t h a s i n
c o m t j a t i ntgh e p r o b l e mo f c i g a r e t t sem o k r n g
a m o n gy o u n gp e o p l eC. h i n a ,
w h r c hr a n k sh i g hi n t h ep r o d u c t r oonf t o b a c c oh, a ss e e na 1 5 - f o lrdi s ei n l u n g
c a n c e ri n S h a n g h aai n d o t h e ra r e a ss i n c et h e m i d - 1 9 6 0asn d h a s f i n a l l y
b e g u nw a r n i n gi t s c i t i z e nos f t h e h a z a r d o
s f s m o k i n gN. o n e t h e l e si sn ,' l 9 8 0
P h r l iM
p o r r i sb e c a m eo n eo f t h ef i r s tU . S .c o m p a n i epse r m i t l etdo o p e ns h o p
i n C h i n a .B i l l b o a r d sh a v e m a d e i t o f f i c i a lP: e k i n gi s M a r l b o r oC o u n t r y .
A l l h o u g ht h e U S . S R . d o e sn o t h a v ea d v e r t i s i npge r s e , t h e g o v e r n m e n t
s t r isl e e k st o p r o fi ( f r o mc i g a r e t t e
s a l e s .M o s c o wh a sb a n n e ds m o k i n gi n t h e
c i t y ' sr e s t a u r a n t sb,u t S o c h i ,a B l a c kS e a r e s o r t h a t a t t e m p t e d
to become
t h e c o u n t r y ' sf i r s tn o n s m o k i ncgi t y ,w a s n o t s u c c e s sufl . I n m a n yC o m m u n i s t
c o u n t r i e sU, . S c i g a r e t t e s e r y ea s c u r r e n c y .
P a r t l yo w i n gl o M u s l i mr e l i g i o u b
s e l i e f sA
, r a bc o u n t r i e sh a v eb e e nw o r l d
l e a d e r si n c o u n t e r a c t i ncgi g a r e t t es m o k i n ga n d p r o m o t i o nS. a u d iA r a b i a
d o e s n o t p e r m i tc i g a r e t t ea d v e r t i s i n gK.u w a i tf i n e ss t o r eo w n e r sw h o p o s t
p r o m o t i o n adli s p l a y sf o r c i g a r e f t e sB.a h r a i nb a n sa d v e r t i s i nfgo r c i g a r e t t e s ;
i n D u b a i ,a d v e r t i s e rcsa n p l a c eb i l l b o a r dfso r c i g a r e t t e isn s p o r t ss t a d i u m s ,
b u t o n l y w h e r e t h e y c a n n o tb e p i c k e du p b y t e l e v i s i o nc a m e r a s A
. nwar
S a d a t ' sw i f e ,J i h a n ,i s h e a do f t h e E g y p t i a C
n a n c e rS o c i e t ya n dh a s l e d t h e
d r i v et o e l i m i n a t ec i g a r e t t ea d v e r t i s i n lgr o m T V , r a d i o ,a n d b i l l b o a r d sI.n
returnthe cigarettecompanieshave resortedto puttinglree movietickets
in cigarettepacks to boost sales.In Turkey,with one of the world'shighest
p e r c e n t a goef s m o k e r st,h eg o v e r n m e ndto e sn o ts e e ma s w o r r i e da b o u tt h e
h e a l t ho f i t s c i t i z e n sa s i t d o e sa b o u tV i r g i n i at o b a c c o ' so v e r t a k i nTgu r k i s h
t o b a c c oa s t h e s m o k e r ' sc h o i c e .
S i n c e1 9 8 0G r e e c ew
, h i c hh a s t h e h i g h e sst m o k i n gr a t eo n t h e E u r o p e a n
continent,has curbed publicsnroking,bannedmost cigaretteadvertising,
and startededucationalcounterefforts.
ltalyhas alsobannedmostadverilsing for cigarettes,but Americanand Britishcigarettecompaniesare openly
v i o l a t i n gt h e b a n , p a y i n gs m a l lf i n e si n o r d e rt o c o n t l n u et o a d v e r t i s e .
Someof the most hopefulsignsin Europecome fromGreatBritain,where
A c t i o no n S m o k i n ga n d H e a l t hi s a n o f f i c i a a
l r m o f t h e R o y a lC o l l e g eo f
160
P h y s i c r a n sa, n d w h e r e t h e B l t r s h M e d t c a l J o u r n a l a n d T h e L a n c e l h a v e
m o b r l r z ep
d h y s i c i a na t t e n t i o nt o t h e p r o b l e m .H a v i n gp o i n t e do u t t h a t o n e i n
t h r e e B r i t i s hs m o k e r ss t a r t e d b e f o r e t h e y w e r e n i n e y e a r s o l d , t h e g o v e r n m e n t - s u p p o r t e dB r i t i s h H e a l t h E d u c a t r o nC o u n c i l h a s d e v e l o p e d s e v e r a l
y o u t h - o r i e n t e dc a m p a i g n s ,i n c l u d i n go n e f e a t u r i n gS u p e r m a n . M a n y o f t h e
l e a d i n g a t h l e t e s i n G r e a t B r i t a i n h a v e t a k e n o u t p a i d a d v e r t i s e m e n t si n
n e w s p a p e r sc a l l r n go n t h e B r i t i s h - A m e r i c aTno b a c c o C o . t o g e t o u t o f a t h l e t r c s s p o n s o r s h i p .l n a d d i t i o n ,t h e B r i t i s hA r m y i s s t r o n g l yd i s c o u r a g i n gs m o k i n g i n i t s r a n k s a n d P r i n c e C h a r l e s ,p u b l i c l ys t a t i n gh i s d i s t a s t ef o r c i g a r e t t e
s m o k i n g ,h a s b e e n a s u p e r b r o l e m o d e l f o r c h i l d r e na n d t e e n a g e r s .S c o t l a n d
h a s a l s o g o n e a b o u t i t s e f f o r t v r r t hv e r v e , r e c r u i t i n gp o p u l a r r o c k s t a r s f o r i t s
a d s l r e l a n dh a s b e q u n p l a c i n ga l a r g ew a r n i n go n a i l c r g a r e t t ep a c k s a n d
a d v e r t r s e m c n t s" .S m o k e r s D i e Y o u n g e r . "
A l t h o u g h A u s t r a l i aw i e l d s o n l y a f r a c t i o no l t h e p o w e r o f t h e t o b a c c o
r n d u s t r y ,a n u m b e r o f o r g a n i z a t i o n sh a v e e x p r e s s e d c o n c e r n a b o u t t h e
h e a l l ha n d v u l n c r a b r L o
r lfyy o u n gp c o p l e I h e A u s t r a l i a nM e d i c a A
l ssociation
h a s l a k e n a l e a d i n gr o l e i n c u r t a i l i n cg i g a r e t t es m o k i n g A
. g r o u pc a l l e dM O P
t p p o s e d t o t h e P r o m o t i o no f U n h e a l t h yP r o d u c t s )s u c c e e d U P ( l v l o v e r n e nO
e d r n h a v i n g a p o p u l a rc h i l d r e n ' se n t c r t a i n e rr e m o v e d a s a c i g a r e t t eb r a n d
s p o k e s m a n .N i n e c f t h e c o u n t r y ' st o p r u g b y p l a y e r SS t a r r e di n a p o p u l a r
1 9 8 0a n t i s m o k i n gc a m p a i g n( " G i v ey o u r s e l fa s p o r t i n gc h a n c e .S t o p s m o k r n g l " ) t h a t a n g e r e dl e a g u e o f f i c i a l sc o n c e r n e da b o u t l o s i n g t o b a c c o i n d u s t r y
s p o n s o r s h i p .A l s o i n 1 9 8 O t h e E a s t T o r r e n s D i s t r i c tC r i c k e t C l u b o f S o u t h
A u s t r a l i as h o c k e d t h e s p o r l s w o r l d b y r e j e c t i n ga l l t o b a c c o s p o n s o r s h i pa n d
b y m a k i n g t h e i n t e r n a t i o n asl t o p - s m o k r n gs y m b o la p a r t o f i t s o f f i c i a lu n i f o r m .
T h e c l u b w a s c e n s u r e db y t h e I n t e r n a t i o n aC
l r i c k e tC o n l e r e n c e f o r i t s " i n g r a l r t u d e " a n d f o r t u r n i n go v e r s o r n e t o b a c c o i n d u s t r y f u n d i n g t o t h e A n t i C a n c e r F u n d . T h e m o s t v i s i b l ea c t i o n sh a v e b e e n t a k e n b y t w o A u s t r a l i a n
g r o u p s . B U G A U P ( B i l l b o a r d - U t i l i z i nGgr a f f i t i s t sA g a i n s t U n h e a l t h yP r o m o trons)a
, p h y s i c i a n - l e do r g a n i z a t i o nd, e f a c e sb i l l b o a r d sa d v e r t i s i n gc i g a r e t t e s
w i t h s p r a y p a i n t . T h e B l a c k L u n g L i b e r a t i o nF r o n t g o e s e v e n l a r t h e r ; t h i s
g r o u p c h o p s d o w n a n d b u r n s b i l l b o a r d st h a t p r o m o t e c i g a r e t t e s .P a r o d y i n g
t h e s l o g a n f o r a p o p u l a rb r a n d , t h e g r o u p ' s m o t t o i s : " L i g h t u p a b i l l b o a r d y o u ' l lb e g l a d y o u d i d . "
ln terms of widespread public support,
Australia is a leader in the fght against
cigarette advertising. A group called
BUCA U P ( Billboard-Utilizing Grafitists
Against Unhealthy Promotions) takes to
the streets al night with spray paint to
delace billboards. The police have been
tolerant of this vandalism, which is largely
practiced by doctors.