December 2004

Massachusetts General Hospital

Tobacco-company-sponsored parties with free cigarettes may encourage students to start smoking

Industry's youngest legal targets now 18- to 24-year olds

A widespread tobacco industry marketing strategy – sponsoring social events and giving out free cigarettes at bars, clubs, and college parties – is reaching students and may be encouraging them to take up smoking, according to a new study released today. The study, part of the Harvard School of Public Health (HSPH) College Alcohol Study (CAS), appears in the January issue of the American Journal of Public Health. The study was led by Nancy Rigotti, MD, director of the Tobacco Research and Treatment Center of Massachusetts General Hospital (MGH).

According to the study, students at all but one of the 119 U.S. colleges and universities surveyed reported attending a tobacco-industry-sponsored social event on or off campus in 2001. Although the number of students reached at many schools was relatively small, up to 27 percent of students were reached at some schools. Overall, 8.5 percent of students had attended a tobacco-industry-sponsored social event where free cigarettes were distributed. Bars and nightclubs were the most common settings, but students also reported attending events on college campuses, a site that has received less attention and provides direct access to students.

Those who had attended these tobacco promotions were more likely to be current smokers, compared to students who had not attended an event. Perhaps most notably, the study suggested that these events could be a powerful inducement to begin smoking. Students who had not started to smoke by the age of 19 were especially likely to have become smokers by the time of the survey if they had been exposed to a tobacco promotion at a bar, nightclub, or college social event.

This is the first study that has measured young adults' exposure to a tobacco industry marketing strategy that has assumed greater prominence since the 1998 Master Settlement Agreement, in which the tobacco industry agreed not to market to teenagers, making young adults (aged 18 to 24) its youngest legal targets. "By distributing cigarettes and sponsoring these events in bars and on college campuses, the tobacco industry promotes the idea that cigarettes are an essential part of young adults' social lives," said Rigotti.

The study analyzed data from the 2001 HSPH CAS, a random sample of 10,904 students enrolled in 119 nationally representative 4-year U.S. colleges and universities. The study authors were Rigotti, Susan Moran, MD, also of the MGH Tobacco Research and Treatment Center; and Henry Wechsler, PhD, director of the HSPH College Alcohol Study.

Bars and nightclubs have assumed greater importance for tobacco marketing since the Master Settlement Agreement, which limits the distribution of free cigarette samples to facilities that do not admit minors. Bars and nightclubs also are smoker-friendly environments for the tobacco industry, because they are among the few places where smoking is not generally restricted by clean-air laws.

In the study, students who reported attending these events were more likely to be current cigarette smokers (defined as having smoked a cigarette in the past 30 days) than students who had not attended one of these events. Even after statistical adjustments for a broad range of factors that might have explained the relationship, a strong association remained between attending tobacco-industry-sponsored events and current smoking, with those attending such events 75 percent more likely to be current smokers.

Furthermore, the analysis suggested that the effect of bar promotions on smoking behavior was strongest on students who had entered college as nonsmokers. Of the 8,482 students (78 percent) who did not smoke regularly before age 19, the current smoking prevalence rate was 23.7 percent among those who had attended a promotional event compared with 11.8 percent among those who had not. In contrast, in the 2,334 students who smoked regularly before age 19, there was no significant difference in current smoking prevalence between those who had and had not attended a tobacco promotional event.

"These findings should serve as a wake-up call to college and university administrators," said Wechsler. "The evidence that these events may influence a non-smoking young person's decision to start smoking is a good reason they should be alert to tobacco industry sponsorship of these events and take appropriate action on their campuses." The American College Health Association recommends that colleges ban the free distribution of tobacco products on campus, including at fraternities and sororities, and prohibit tobacco industry sponsorship of social events held by any organization that receives college funds.

"These findings also give states and communities another good reason to adopt smoking bans in bars and nightclubs," says Rigotti. "Tobacco-free bars and nightclubs are likely to be less attractive as sites for tobacco industry promotions. Decoupling smoking and drinking will likely be an effective way to counteract the tobacco industry's marketing strategies."



The study was funded by the Robert Wood Johnson Foundation, the Flight Attendant Medical Research Institute, and the National Heart Lung and Blood Institute

The full study and additional information on the Harvard School of Public Health College Alcohol Study will be available after December 28 at: http://www.hsph.harvard.edu/cas.


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