Tobacco companies used consumer indices to identify characteristics that appeared to distinguish quitters from other smokers. They found quitters were younger (and shared other characteristics typical of young smokers, such as light or intermittent smoking patterns), and had more negative attitudes about smoking. There was some evidence that smokers of some minority groups (black and Hispanic) had a greater propensity to quit. The data on marriage and quitting were inconsistent. Brand switchers also had a greater propensity to quit. Surprisingly, smokers of low tar cigarettes were not more likely to quit.
There is a striking contrast between tobacco industry and public health views of quitters’ demographics. Tobacco industry reports found that young adult smokers were most likely to quit, while most epidemiologic studies of smoking cessation report the highest rates among older smokers.56,57
In addition, the tobacco industry has focused on deterring potential cessation, while public health studies focused on documenting successful cessation. Part of this may be due to differences in defining quitters: tobacco industry studies generally rely on self-reported quitting in the past 6 months to 1 year to define quitting, while health studies more often specify a minimum abstinence time criteria for smoking cessation (usually at least 1 or 2 years56,58
). Public health measures most often calculate quit ratios, reporting the percentage of current (or ever) smokers who quit successfully. Tobacco industry studies compare the demographics of the quitting population to the characteristics of the smoking population in consumer indices. While consumer indices give a “snapshot” of the quitting population and ease comparison to the smoking population, they are a less useful measure to track changes in the population over time.
There are approximately 40 million pages of internal documents from the tobacco industry available to the public. The volume and often poor quality of indexing provided by the tobacco industry makes it difficult to locate all relevant documents. However, the industry strategies discussed here are consistent and replicated by several tobacco companies. These studies provide insight into the way tobacco marketers view and approach targets for multimillion dollar campaigns. The industry may have used other tactics that do not appear in this study.
Some public health studies have also documented frequent quit attempts among the youngest and oldest smokers,14,58–60
while sustained cessation is found primarily among older smokers.56,58,61,62
Tobacco companies expressly attempt to study recent quitters, while public health reports often avoid counting individuals who quit recently (and are more likely to relapse) as quitters. While public health measures of smoking cessation provide a clear measure of success in reducing smoking, the industry approach is more proactive in terms of influencing smoking behavior (in this case, deterring or reversing successful cessation). The high rate of cessation attempts (along with the high failure rate) among young adults suggests an unmet need for targeted programs tailored to address their concerns.
Many characteristics of young adult smokers suggest they may be more amenable to quitting than smokers in general. Light smoking and prior quit attempts have been shown to predict subsequent cessation attempts and success.63,64
Intermittent smokers have stronger intention to quit, and are also more likely to have quit in the past.65,66
Recent data from California suggest that intermittent and occasional patterns of smoking are increasing.14
When faced with social pressures, light smokers, social smokers, or casual smokers are more likely to choose not to smoke than to choose a more socially acceptable tobacco product. Young adults are not only more sensitive to social pressures, they are also more likely to exert social pressure on smokers by asking them not to smoke, or with outward displays of discomfort/disgust at smoking.14,48
Messages that decrease the social acceptability of smoking may be most relevant to young adults.
Applying what is known about tobacco industry young adult marketing, coupling clean indoor air policies with media campaigns that appeal to young adults’ aspirations appears to be a promising strategy. For example, the “You know you want to…” campaign at the University of Wisconsin, Oshkosh67
linked quitting smoking with images of aspirations expressed by college student smokers: “You know you want to…be strong, …be kissed, …come in out of the cold, …get ‘em off your back.” The preliminary outcomes of this intervention showed a reduction in smoking from 33.9% to 23.8% that was not seen in a comparison group.68
Finally, successful teen campaigns that are designed to appeal to the values and aspirations of specific attitudinal groups such as the “truth” campaign69
may be extended for young adults. Additional research to identify successful messages and strategies that reach young adult potential quitters is needed.
Prior tobacco industry document research reveals the tobacco industry has worked to oppose efforts to disrupt smoking cessation by opposing advertising for nicotine replacement70,71
and by pressuring pharmaceutical companies.72
In addition, we found that the tobacco industry is well aware that smokers of light or low tar cigarettes do not have higher quit rates. These data complement a prior study showing the tobacco industry developed low tar brands in order to retain health-conscious smokers73
and health research showing smokers’ mistaken beliefs about light and ultra light cigarettes reduce intentions to quit smoking.74–76
The tobacco industry also attempted to subvert cessation efforts by developing new products that decrease the social pressures on smokers. The increasing development of tobacco “mints” and other smokeless nicotine products may serve the same purpose.