Tobacco marketing restrictions

Regulations that restrict tobacco marketing limit promotion, placement, flavoring, or pricing of tobacco products. Regulations can restrict point-of-sale (POS) advertising, signs, and displays (Robertson 2015*), require minimum package sizes (e.g., no less than 20 cigarettes), and written warnings for tobacco products (CTFK-FDA 2010). Regulations can also prohibit sales in health-oriented facilities such as pharmacies (PHLC-Tobacco in pharmacies), prohibit daytime advertising, limit the number, size, or location of ads posted by businesses (PHLC-Tobacco advertising), and prohibit print ads in child-oriented newspapers and magazines (CTFK-FDA 2010). The federal Family Smoking Prevention and Tobacco Control Act regulates sales of cigarettes and smokeless tobacco. State and local governments can further restrict promotions and pricing of cigarettes and smokeless tobacco (CTFK-FDA 2010) and restrict sales and promotion of other tobacco products such as cigars, cigarillos, and pipe tobacco (Farley 2017*), but may not restrict advertising content (CTFK-FDA 2010).

* The term “tobacco” in this strategy refers to commercial tobacco, not ceremonial or traditional tobacco. County Health Rankings & Roadmaps recognizes the important role that ceremonial and traditional tobacco play for many Tribal Nations, and our tobacco-related work focuses on eliminating the harms and inequities associated with commercial tobacco.

Expected Beneficial Outcomes (Rated)

  • Reduced tobacco use

Other Potential Beneficial Outcomes

  • Increased quit rates

  • Reduced youth smoking

Evidence of Effectiveness

There is some evidence that marketing restrictions reduce tobacco consumption, though effectiveness varies by approach (Shadel 2016*, Quentin 2007*). Exposure to tobacco advertising is strongly associated with tobacco use (Robertson 2015*, AHA-Mozaffarian 2012, Cochrane-Lovato 2011*, Paynter 2009*, Capella 2011*). However, additional evidence is needed to confirm effects of marketing restrictions and determine the characteristics of successful efforts.

Removing tobacco power wall advertising displays from checkout lines has been shown to decrease adolescents’ likelihood of smoking (Shadel 2016*). Plain packaging of tobacco products has been shown to be less appealing to youth and adults, and may also discourage smoking (Moodie 2012, Hammond 2013*); including graphic health warnings along with plain packaging may further decrease tobacco experimentation (Germain 2010*, Thrasher 2011*). A European study suggests that advertising bans may help some smokers quit (Schaap 2008*); comprehensive advertising bans appear more effective than partial bans (AHA-Mozaffarian 2012, Goel 2006*, Quentin 2007*). An assessment of New York City’s ban on all flavored tobacco products demonstrates reductions in use of flavored tobacco and decreases in youth tobacco experimentation (Farley 2017*).

Tobacco marketing increases the likelihood that youth will experiment with tobacco products or become smokers (AHA-Mozaffarian 2012, Cochrane-Lovato 2011*, Capella 2011*). Marketing through point-of-sale (POS) promotions (Robertson 2015*, Paynter 2009*), mass media, print, and in-store displays (Cochrane-Lovato 2011*) have all been shown to increase tobacco experimentation. Electronic or e-cigarette advertisements increase the likelihood that youth will try e-cigarettes (Villanti 2016*). Exposure to smoking in movies also appears to lead youth to try smoking (US DHHS SG-Smoking 2014, Sargent 2009, Charlesworth 2005).

When drafting marketing regulations, experts suggest fully documenting the need for the law, the justification for enacting the law, and the law’s intent (PHLC-Tobacco advertising). In addition to advertising restrictions, researchers suggest enacting minimum price laws (Henriksen 2012), restricting samples, discounts, and flavoring for non-cigarette tobacco products (Freiberg 2012), and restricting access to menthol flavored cigarettes (Freiberg 2014).

Tobacco advertising appears more concentrated in primarily black (Lee 2015, Primack 2007) and low income (Lee 2015, Widome 2013*, Frick 2012*) neighborhoods.

Impact on Disparities

No impact on disparities likely

Implementation Examples

Federal law prohibits tobacco advertising through television (US DHHS SG-Smoking 2014) and restricts magazine and billboard advertising, but does not prohibit advertisements in stores (CTFK-FDA 2010). Tobacco companies cannot sponsor sports or entertainment events or give away branded promotional items (CTFK-FDA 2010, US FDA-Tobacco control) and free tobacco product samples are banned except in adult-only facilities (CTFK-FDA 2010). Tobacco marketing on the internet, where it remains unregulated, is increasing (Ibrahim 2010*), especially through social media (CTFK-Internet 2011) and user-generated videos (Forsyth 2013*).

Municipalities also implement regulations. Boston, for example, passed a city-wide cigar packaging and pricing regulation in 2011, requiring retail establishments to sell cigars in an original package of at least four cigars unless it meets specified pricing requirements (Sbarra 2017*, Li 2016*). New York City banned the sale of any flavored tobacco product, except menthol, which is allowed by federal law, in 2009 (Farley 2017*).

Implementation Resources

PHLC-Tobacco marketing - Tobacco Control Legal Consortium (TCLC). Advertising and marketing. Saint Paul: Public Health Law Center (PHLC).

ChangeLab-Tobacco marketing - ChangeLab Solutions. Addressing the four Ps of tobacco marketing in stores.

US FDA-Tobacco products - US Food and Drug Administration (US FDA). Center for Tobacco Products. Compliance, enforcement, & training: State, local, tribal, and territorial governments.

CPHSS TCLC-Brossart 2014 - Brossart L, Moreland-Russell S, Walsh H, et al. Policy strategies: A tobacco control guide. St. Louis: Center for Public Health Systems Science (CPHSS), George Warren Brown School of Social Work, Washington University, Tobacco Control Legal Consortium (TCLC); 2014.

PHLC-Retail environment and licensure - Tobacco Control Legal Consortium (TCLC). Retail environment and licensure. Saint Paul: Public Health Law Center (PHLC).

US FDA-Tobacco control - US Food and Drug Administration (US FDA). Tobacco Control Act. 2009.

Citations - Evidence

* Journal subscription may be required for access.

Shadel 2016* - Shadel WG, Martino SC, Setodji CM, et al. Hiding the tobacco power wall reduces cigarette smoking risk in adolescents: Using an experimental convenience store to assess tobacco regulatory options at retail point-of-sale. Tobacco Control. 2016;25(6):679-684.

Quentin 2007* - Quentin W, Neubauer S, Leidl R, König HH. Advertising bans as a means of tobacco control policy: A systematic literature review of time-series analyses. International Journal of Public Health. 2007;52(5):295–307.

Robertson 2015* - Robertson L, McGee R, Marsh L, Hoek J. A systematic review on the impact of point-of-sale tobacco promotion on smoking. Nicotine & Tobacco Research. 2015;17(1):2-17.

AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514–63.

Cochrane-Lovato 2011* - Lovato C, Watts A, Stead LF. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database of Systematic Reviews. 2011;(10):CD003439.

Paynter 2009* - Paynter J, Edwards R. The impact of tobacco promotion at the point of sale: A systematic review. Nicotine & Tobacco Research. 2009;11(1):25–35.

Capella 2011* - Capella ML, Webster C, Kinard BR. A review of the effect of cigarette advertising. International Journal of Research in Marketing. 2011;28(3):269–79.

Moodie 2012 - Moodie C, Stead M, Bauld L, et al. Plain tobacco packaging: A systematic review. London, UK: Public Health Research Consortium; 2012.

Hammond 2013* - Hammond D, Daniel S, White CM. The effect of cigarette branding and plain packaging on female youth in the United Kingdom. Journal of Adolescent Health. 2013;52(2):151-157.

Germain 2010* - Germain D, Wakefield MA, Durkin SJ. Adolescents’ perceptions of cigarette brand image: Does plain packaging make a difference? Journal of Adolescent Health. 2010;46(4):385-392.

Thrasher 2011* - Thrasher JF, Rousu MC, Hammond D, Navarro A, Corrigan JR. Estimating the impact of pictorial health warnings and “plain” cigarette packaging: Evidence from experimental auctions among adult smokers in the United States. Health Policy. 2011;102(1):41-48.

Schaap 2008* - Schaap M, Kunst A, Leinsalu M, et al. Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries. Tobacco Control. 2008;17(4):248–55.

Goel 2006* - Goel RK, Nelson MA. The effectiveness of anti-smoking legislation: A review. Journal of Economic Surveys. 2006;20(3):325–55.

Farley 2017* - Farley SM, Johns M. New York City flavoured tobacco product sales ban evaluation. Tobacco Control. 2017;26(1):78-84.

Villanti 2016* - Villanti AC, Rath JM, Williams VF, et al. Impact of exposure to electronic cigarette advertising on susceptibility and trial of electronic cigarettes and cigarettes in US young adults: A randomized controlled trial. Nicotine & Tobacco Research. 2016;18(5):1331-1339.

US DHHS SG-Smoking 2014 - US Department of Health and Human Services (US DHHS). The health consequences of smoking- 50 years of progress: A report of the Surgeon General; 2014.

Sargent 2009 - Sargent J, Gibson J, Heatherton T. Comparing the effects of entertainment media and tobacco marketing on youth smoking. Tobacco Control. 2009;18(1):47–53.

Charlesworth 2005 - Charlesworth A, Glantz SA. Smoking in the movies increases adolescent smoking: A review. Pediatrics. 2005;116(6):1516–28.

PHLC-Tobacco advertising - Tobacco Control Legal Consortium (TCLC). Restricting tobacco advertising. Saint Paul: Public Health Law Center (PHLC).

Henriksen 2012 - Henriksen L. Comprehensive tobacco marketing restrictions: Promotion, packaging, price and place. Tobacco Control. 2012;21(2):147–53.

Freiberg 2012 - Freiberg M. Options for state and local governments to regulate non-cigarette tobacco products. Annals of Health Law. 2012;21(2):407–45.

Freiberg 2014 - Freiberg M. The minty taste of death: State and local options to regulate menthol in tobacco products. Catholic University Law Review. 2014;64:949-974.

Lee 2015 - Lee JGL, Henriksen L, Rose SW, Moreland-Russell S, Ribisl KM. A systematic review of neighborhood disparities in point-of-sale tobacco marketing. American Journal of Public Health. 2015;105(9):e8-e18.

Primack 2007 - Primack BA, Bost JE, Land SR, Fine MJ. Volume of tobacco advertising in African American markets: Systematic review and meta-analysis. Public Health Reports. 2007;122(5):607–15.

Widome 2013* - Widome R, Brock B, Noble P, Forster JL. The relationship of neighborhood demographic characteristics to point-of-sale tobacco advertising and marketing. Ethnicity & Health. 2013;18(2):136–51.

Frick 2012* - Frick RG, Klein EG, Ferketich AK, Wewers ME. Tobacco advertising and sales practices in licensed retail outlets after the Food and Drug Administration regulations. Journal of Community Health. 2012;37(5):963-967.

Citations - Implementation Examples

* Journal subscription may be required for access.

US DHHS SG-Smoking 2014 - US Department of Health and Human Services (US DHHS). The health consequences of smoking- 50 years of progress: A report of the Surgeon General; 2014.

CTFK-FDA 2010 - Campaign for Tobacco-Free Kids (CTFK). The impact of the new FDA tobacco law on state tobacco control efforts. Washington, DC: Campaign for Tobacco-Free Kids (CTFK); 2010.

US FDA-Tobacco control - US Food and Drug Administration (US FDA). Tobacco Control Act. 2009.

Ibrahim 2010* - Ibrahim JK. The tobacco tug-of-war: Advertising and counteradvertising tobacco products to youth. Pediatric Allergy Immunology, and Pulmonology. 2010;23(2):105–11.

CTFK-Internet 2011 - Campaign for Tobacco-Free Kids (CTFK). Tobacco product marketing on the internet. Washington, DC: Campaign for Tobacco-Free Kids (CTFK); 2011.

Forsyth 2013* - Forsyth SR, Kennedy C, Malone RE. The effect of the internet on teen and young adult tobacco use: A literature review. Journal of Pediatric Health Care. 2013;27(5):367–76.

Sbarra 2017* - Sbarra C, Reid M, Harding N, Li W. Promising strategies to remove inexpensive sweet tobacco products from retail stores. Public Health Reports. 2017;132(1):106-109.

Li 2016* - Li W, Gouveia T, Sbarra C, et al. Has Boston’s 2011 cigar packaging and pricing regulation reduced availability of single-flavoured cigars popular with youth? Tobacco Control. 2016;0:1-6.

Farley 2017* - Farley SM, Johns M. New York City flavoured tobacco product sales ban evaluation. Tobacco Control. 2017;26(1):78-84.

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