In the past two years, the major US cigarette companies acquired smokeless tobacco companies and they are rapidly increasing both the intensity and targets of smokeless marketing, which may dramatically expand smokeless tobacco use. Most significant, new smokeless products are marketed as line extensions of major cigarette brands (Marlboro and Camel) to promote "dual use": smoking cigarettes when possible and using smokeless products where smoking is prohibited. These changes in smokeless tobacco marketing may blunt the effects of smokefree environments and the health benefits of smokers cutting down and quitting. Marketing efforts directly impact who is most likely to increase smokeless tobacco use, so it is critical to understand who the current and new targets of smokeless tobacco marketing are, and the impact of marketing activities on patterns of use, including impact on cigarette smoking. We propose to understand the design and effects of smokeless tobacco marketing based on a unique series of analyses of complementary data sources, including previously secret tobacco industry documents containing industry marketing research and plans, and content analyses of current smokeless tobacco advertising. We will then apply what we learn to develop and test new counter-marketing messages to block initiation of smokeless tobacco use among novices and the dual use of smokeless tobacco and cigarettes as an alternative to smoking cessation. Marketing insights from previously secret industry documents are a valuable and untapped source of information that has not yet been used to guide the development of smokeless tobacco interventions. We have previously used the documents to develop interventions for young adult smokers.
Specific aims of the proposal are: (1) Using previously secret tobacco industry documents, describe (a) the major factors impacting cigarette companies'decisions to enter the smokeless tobacco market, (b) consumer research on smokeless tobacco users and how this research led to the development of targeted marketing messages, and (c) how tobacco companies evaluated the effects of marketing activities on patterns of tobacco use, particularly smokeless initiation, dual use of smokeless and other tobacco products, and smoking cessation;(2) Develop advertising coding instruments based on insights from industry documents, and use these instruments to analyze current smokeless tobacco marketing messages and strategies;(3) Develop and test counter-marketing messages to decrease smokeless tobacco uptake among new users, and to discourage smokers from dual use of smokeless tobacco and cigarettes. Because smokers are one of the key targets of new smokeless marketing efforts, countering these efforts is important to reduce the health consequences of both smoking and smokeless tobacco use. Findings will be relevant to guide development of policies on smokeless marketing and advertising and creation of the first public health interventions to block the tobacco industry's efforts to expand this new smokeless market before it becomes firmly established.

Public Health Relevance

(RELEVANCE) Tobacco use is responsible for 35% of cancer deaths, and new smokeless tobacco marketing efforts threaten both to increase cancers caused by smokeless use, and to undermine the health benefits of smoking cessation by promoting dual use of cigarettes and smokeless tobacco as an alternative. Reducing this burden of disease requires understanding the design and effects of smokeless tobacco marketing, so that effective advertising policies and programs may be developed to avoid a major expansion in smokeless tobacco use and decline in smoking cessation.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Special Emphasis Panel (ZCA1-SRRB-C (M2))
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Parascandola, Mark
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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