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We investigated tobacco companies' knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities.
We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results.
Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use.
Tobacco companies' numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use.
Smoking remains the leading preventable cause of premature mortality in the United States, accounting for more than 440 000 deaths annually.1 Alcohol consumption is the third-leading cause of mortality in the nation.2 Each year, approximately 79000 deaths are attributable to excessive alcohol use.3 The concurrent use of cigarettes and alcohol further increases risks for certain cancers, such as cancer of the mouth, throat, and esophagus.4,5 In addition, the use of both tobacco and alcohol makes it more difficult to quit either substance.6
Smoking and drinking are strongly associated behaviors.7–13 Smokers are more likely to drink alcohol,11 drink more frequently,8,11 consume a higher quantity of alcohol,8,11,14 and demonstrate binge drinking (5 or more drinks per episode) than are nonsmokers.9,11,12 Alcohol drinkers, especially binge drinkers, are also more likely to smoke7,8,10 and are more likely to smoke half a pack of cigarettes or more per day.10
The association between tobacco use and alcohol use becomes stronger with the heavier use of either substance.8,15,16 Alcohol consumption increases the desire to smoke,17,18 and nicotine consumption increases alcohol consumption.19 Experimental studies have demonstrated that nicotine and alcohol enhance each other's rewarding effects.16,18 Alcohol increases the positive subjective effects of smoking,8,15,16,20 and smoking while using alcohol is more reinforcing than is smoking without concurrent alcohol use.8 Smokers smoke more cigarettes while drinking alcohol,8,15,18 especially during binge-drinking episodes.8,15 This behavior has also been observed among nondaily smokers8,15 and light smokers.17
The concurrent use of alcohol and tobacco is common among young adults,8,10,12,21 including nondaily smokers,19,22–24 nondependent smokers,8 and novice smokers.13 Young adult smokers have reported that alcohol increases their enjoyment of and desire for cigarettes8,25 and that tobacco enhances the effect of alcohol: it “brings on the buzz” or “gave you a double buzz.”13,23,26 Young adult nondaily smokers described the pairing of alcohol and cigarettes as resembling “milk and cookies” or “peanut butter with jelly.”24 Young adults have also been the focus of aggressive tobacco promotional efforts in places where alcohol is consumed, such as bars and nightclubs.27,28
Consumer products often fall into cohesive groups (sometimes referred to as “Diderot unities”) that may reinforce certain patterns of consumption,29 and these groupings may be influenced by marketing activities. In the case of tobacco and alcohol, these product links may have been further enhanced by cooperation between tobacco and alcohol companies (e.g., cosponsorship) or corporate ownership of both tobacco and alcohol companies (e.g., Philip Morris's past ownership of Miller Brewing Company).
We used tobacco industry documents to explore tobacco companies' knowledge regarding linked tobacco and alcohol use and the companies' marketing strategies that linked cigarettes with alcohol. We were interested in 3 basic issues: (1) what tobacco companies knew about the association between drinking and smoking, especially about smokers' drinking behaviors, (2) how tobacco and alcohol companies developed cross promotions featuring cigarettes and alcohol, and (3) how tobacco companies linked cigarettes with alcohol in their marketing activities and the benefits they expected to gain from those activities.
From July 2009 through July 2010 we used the Legacy Tobacco Document Library (http://legacy.library.ucsf.edu) to systematically search archived internal tobacco industry documents. Tobacco industry document research presents unique methodological challenges,30 and we followed standard techniques to conduct document research that combined traditional qualitative methods31 with iterative search strategies tailored for this data set.32
Document research is typically not a hypothesis-driven experiment. Thus, we initially posed exploratory, open-ended research questions, such as “What did tobacco companies know about people's preferences and patterns of alcohol use?” or “What did tobacco companies understand about the relationship between alcohol use and smoking?” Previous studies have documented increasingly frequent tobacco promotional activities in bars during the last few decades,27,28,33 so exploratory research questions related to marketing activities included such questions as “Was it a coincidence that tobacco and alcohol companies seemed to sponsor similar special events, or was it an intentional marketing strategy?” and “What marketing activities did tobacco companies conduct featuring alcohol?”
Initial keyword searches combined terms related to:
Initial searches yielded thousands of documents. For example, a search of all tobacco industry document collections on the Legacy Tobacco Documents Library for the keyword “cosponsor” yielded 10172 documents. Additional keywords were added to narrow searches. For example, a search of “cosponsor” and “Miller” yielded 1734 documents, and “cosponsor” and “Miller” and “soccer” yielded 164 documents. Searches were narrowed until they generally yielded fewer than 400 documents.
After we narrowed the searches, we read all the documents retrieved to determine their relevance to the exploratory research questions. We removed duplicate documents and documents that were clearly unrelated to our research questions (such as tobacco companies' research on behaviors other than alcohol consumption and tobacco companies' joint sponsorship with companies that did not sell alcohol). Documents containing the same text but different marginalia were counted as separate documents instead of duplicates.
Both authors then reviewed the documents in detail to discern their themes and contexts, such as the names of marketing studies, marketing promotional project titles, the time lines of these activities, and the relations between marketing studies and promotional activities. We wrote summary memoranda while reading the documents and listed more specific search terms from the documents retrieved, such as study titles (e.g., MMI Lifestyle Research, PSC Survey, GF Survey), marketing promotional project titles (e.g., Marlboro Soccer Cup, Winston-Budweiser Heritage Cup World Softball Tournament, Canadian Mist and Viceroy Rich Lights Designer Fashion Showcase), and other important information (e.g., key individuals responsible for these activities, third parties involved, dates of meetings, locations and dates of events).
We then asked a series of subsequent questions to guide further searches to help us better understand the context and implications of each document, such as “What was the purpose of the GF study?” “Did the results of this study affect marketing and promotional activities?” “What criteria did tobacco companies use to select alcohol companies and types of alcoholic beverage for joint sponsorship and joint promotion?” “What benefits did tobacco companies expect to gain from alcohol co-marketing activities, and did they obtain these benefits?” and “What were the job titles of the individuals mentioned in the documents, and what were the relationships among those people?”
We followed reviews of relevant documents with “snowball” searches to find related documents using additional search terms such as consecutive reference (Bates) numbers, file locations, dates, and individuals' associates. Through iterative searches, we attempted to gain a more comprehensive understanding of the research and marketing activities. We wrote additional memos incorporating the newly retrieved documents, noting the theme and context of each document, and we organized the documents in clusters by topic (e.g., research study, promotional project, guideline for marketing activities).
We repeated the iterative search process until we reached saturation of both keywords and documents. We based the present analysis on a final collection of 128 documents relevant to tobacco companies' research on alcohol consumption, concurrent use of tobacco and alcohol, and joint promotion of cigarettes and alcohol, and 358 documents related to marketing activities that linked cigarettes with alcohol. The documents we located ranged in date from 1974 to 1999. We limited our analysis to documents describing marketing activities in the United States.
To triangulate findings in the documents, we used additional data that we obtained from general online search engines (e.g., Google), news coverage (e.g., Google News or Lexis-Nexis), and advertising archives (e.g., the Trinkets and Trash archive at the School of Public Health of the University of Medicine and Dentistry of New Jersey, or the Pollay advertising collection at http://tobaccodocuments.org). We used these adjunctive sources to validate and contextualize the marketing activities discussed in tobacco industry documents. Triangulation is a standard method that qualitative researchers use to check for validity and consistency of information among various independent sources; specific triangulation strategies using tobacco industry documents and advertising archives have been described previously.34
Conversely, we also retrieved advertisements with alcohol-related content from advertising archives; then, to find plans for these campaigns, we searched tobacco industry documents for these advertisements' taglines, slogans, or other descriptors. To build a comprehensive picture of how the different activities were related to each other both historically and conceptually, we made a summary of all research memos containing all major clusters of documents, summaries of all relevant documents, and direct quotes from the documents.
The following criteria guided iterative analyses to maximize our confidence in the credibility, dependability, and confirmability of the findings: we emphasized activities that were conducted repeatedly over time, activities that were pursued by multiple tobacco companies, plans that were created by or sent to people in positions of power within the tobacco companies (and thus were more likely to be carried out or to be representative of company policy), and activities that were supported both by internal documents and outside data sources.
We selected quotes that were consistent with the general themes across the multiple tobacco companies, that were consistent with their specific context in a document cluster, and that represented themes that were discussed repeatedly. We conducted this analysis to gain a greater understanding of tobacco industry research and marketing activities related to tobacco and alcohol, rather than to generate theory or to test specific hypotheses about these activities.
We found that tobacco companies did extensive research on smokers' alcohol-related behaviors, and they pursued a wide variety of marketing strategies to capitalize on those behaviors.
Tobacco companies researched the cross usage of cigarettes and alcohol and the impact of the 2 substances on each other. In 1974, Brown and Williamson Tobacco Company (B&W) hired Kenyon and Eckhardt Advertising to conduct a consumer research study to investigate “the perceptions, attitudes and behavior of younger, recently starting smokers regarding initial products usage, current smoking and health concerns.”35 They found that smoking increased with consumption of alcoholic beverages and that beer and cigarettes could each enhance the taste sensations of and increase the desire for the other.35–37 Kenyon and Eckhardt observed concurrent use most frequently at social events, and they used the term “social smoking”35 to describe this phenomenon of smoking with alcohol use:
Almost all of the respondents claimed an increase in smoking when at parties or on dates. In most cases, this increase in smoking was related to consumption of alcoholic beverages, most particularly beer. The general feeling seemed to be that the two tastes and sensations tended to enhance one another, making each more pleasurable when done together. In these social smoking situations, the cigarette was described as a contributor to their relaxation and enjoyment.37
In 1986, Philip Morris (PM) hired Callé and Company to conduct a qualitative study among menthol smokers to learn about their needs and lifestyles, including behaviors related to drinking and smoking together. PM intended this study to identify a framework of consumer-desired products for future menthol cigarettes and other cigarette products, and to identify potential new cigarettes that would extend the perceived benefits of existing menthol products to “go beyond the existing menthol/regular product categories.”38,39 Callé and Company's research summary included the finding that smoking menthol cigarettes while drinking alcohol served to “greatly reduce perceived harshness and to increase the `throat moisturizing' effects desired.”38,39 The summary included discussions about smoking and drinking, saying that a menthol cigarette, in particular, “goes with drinks better. A nice sensation—like a chaser.”38,39 The summary also included the observation that “possibly drinking acts as a cigarette stimulant.”38,39
From November 1988 to May 1989, PM used the General Foods Corporation (GF) consumer database to conduct 3 analyses of cross usage of cigarettes, beer, and other food products. PM acquired GF in 1985.40 The purpose of these analyses was to determine cross usage and “investigate potential promotional tie-in partners” if any cross-usage links were identified.41–44 The database size ranged from 131000 consumers in 1988 to 199000 consumers in 1989. PM found that “monthly household beer consumption predicted incidence of smoking.”41,45 People whose households consumed smaller quantities of beer were less likely to smoke than were households consuming larger quantities of beer; as household beer consumption increased, the percentage of smokers increased.44–50 Nonsmoker households consumed the smallest quantities of beer, full-flavor-smoker households consumed the largest quantities of beer, and low-tar-smoker households were in between.47,51
R. J. Reynolds Tobacco Company (RJR) also researched the cross usage of alcohol and cigarettes. In November 1980, RJR conducted a qualitative study to “investigate consumer attitudes and perceptions toward menthol and non-menthol cigarettes, reasons for smoking a menthol, and level of interest in `menthol-alternatives.”'52 While investigating menthol alternatives, RJR asked about reactions to liqueur, liquor (bourbon, rum), or a white wine taste in a cigarette. They found that the responses were mixed:
“Good idea–drinks and cigarettes go together!”
“White wine and tobacco–sounds awful.”
“I wouldn't like an alcohol flavor in my cigarette.”
“Liqueurs are too sweet to smoke.”52
In June 1990, an RJR memo noted that Simmons Market Research Bureau had conducted an analysis finding that among both genders and across almost all age groups, smokers showed a positive index of alcohol consumption.53 RJR planned to “utilize this learning which might enhance our marketing efforts” and “to develop ways to leverage the alcoholic beverage/tobacco use correlation among adults.”53
Tobacco companies also investigated specific drinking behaviors, such as the types and brands of alcoholic beverages that smokers usually drank and the locations where drinking occurred. For example, in 1980, RJR hired Multi-Marketing, Inc, to conduct a study during promotional events among young adults on spring break in the area of Daytona Beach/Fort Lauderdale, Florida.54,55 The study found that 98.3% of 1574 respondents spent money on alcoholic beverages, and 97.1% consumed alcoholic beverages. Alcoholic beverages ranked second after food in the average amount of money spent per month among both men and women. The study found that beer was the preferred type of alcoholic beverage, the most popular brands of beer were Miller and Budweiser, Riunite and Lambrusco were the top 2 favorite wine brands on campus, and Jack Daniel's was the number 1 brand of liquor on campus. About 69.3% of respondents purchased beer in bars/taverns, 14.2% consumed beer daily, and 51.9% consumed beer a few times a week.55
In March 1981, Leferman Associates conducted a qualitative study for RJR to evaluate the reactions of young male smokers (18–24 years) to Camel Lights' participation in Expo America, which was a traveling exposition combining showmanship and salesmanship targeting young adults.56–58 The study found that free or discounted beer was welcome among young male smokers, although free soft drinks might have been just as well received.56 The report included several quotes from the participants:
“It would have been nice had they had something like free beer.”
“After going on the bull, I was sweating so much I had to go out and get a beer.”
“I came for the cheap beer and music.”
“Free beer would have gone over real good.”56
In 1983, RJR mapped adults' use of cigarettes and other products, including many different alcoholic beverages, by age and education level (Figure 1). They reported that smokers of Benson & Hedges (the most “highly educated” cigarette brand in this exercise) shared a similar education level with Budweiser drinkers. Wine drinkers and imported beer drinkers were much more educated than were cigarette smokers.59 In the same year, research conducted to solicit RJR advertising in RockBill magazine (a free magazine distributed at bars and clubs) also noted that
our affluent, out-going, sociable audience regularly consumes alcohol beverages as part of their lifestyle–especially when they're out with friends at `our' clubs … and most specify the spirit by brand.60
Around 1983 and 1984, RJR conducted a study of the purchases and other activities of young adults (18–24 years), and they found that young adults had above-average consumption of many types of alcoholic beverages compared with all adults.61,62 In 1988, RJR studied the lifestyles of young adult smokers (18–24 years) and found that popular alcohol drinks among this population were regular beer, vodka, rum, tequila, gin, bubbly wines, and sweet wines; less popular alcohol drinks were light beer, scotch, and traditional wines.63 In 1989, RJR investigated the lifestyles of less educated smokers64 and found that a higher percentage of young adult smokers with low education levels attended bars and discos compared with young adult smokers who had graduated from college.64 Many other studies also showed that young adult smokers enjoyed going to bars and discos and drinking beer.65–68
PM conducted similar studies with young smokers. In 1999, the research company Golden Door, Inc, conducted a study to assist PM in generating a stronger understanding of young adult male culture and smoking experiences.69–73 They found that young adult male smokers frequently visited bars and clubs and that different cigarette brands were associated with different types and brands of alcohol.69 For example, Newport smokers were associated with “40s” (40-oz beers) and Hennessey, Marlboro Red was associated with whiskey and moonshine, and Marlboro Light was associated with wine coolers.69
Tobacco companies researched the potential effect of promoting cigarettes in conjunction with alcohol. In April 1987, PM developed a Joint Consumer Promotions Research program to investigate the feasibility of running joint consumer promotions that featured brands from GF, PM, and Miller Brewing subsidiaries; these companies were all owned by PM.74,75 PM confirmed that there were risks associated with promoting cigarettes with beer and other food products.76,77 In market research on the concept, both smokers and nonsmokers had negative reactions, and PM noted that “cigarette inclusion in joint programs could potentially have negative impact on other brands,” particularly food brands.76 PM subsequently considered pursuing promotional activities that only indirectly linked PM, GF, and Miller Brewing Company products via “`masked' product linkage,” such as shared free-standing inserts, shared efforts to populate direct mailing lists, or retailer-implemented corporate promotions.76,77
In August 1987, RJR studied promotion concepts appealing to young males,78 and they found that 2 of the 8 concepts with above-average appeal involved alcohol paraphernalia: “free beverage holder and mug at retail with 2-pack purchase” and “four mugs with different Camel designs free at retail with 2-pack purchase.”78
We identified 3 main types of marketing strategies that tobacco companies used to link cigarettes with alcohol: (1) joint sponsorship, (2) joint promotion, and (3) cigarette promotions featuring alcohol or alcohol paraphernalia.
Tobacco companies jointly sponsored many special events with alcohol companies. These special events mainly included sporting events (e.g., auto racing, soccer, softball, golf), art events (e.g., concerts, fashion shows, festivals), ethnic events (e.g., Hispanic and Black festivals and sporting events), resort programs (e.g., spring break), and bar and nightclub programs. Sporting events and bar nights were the most frequently sponsored events. Table 1 lists some examples of the joint sponsorship efforts involving tobacco and alcohol companies.
PM expected joint sponsorship to lower the cost of special event sponsorship, appeal more to consumers, extend the outreach of brands' special event involvement, reinforce brand identification, and generate increased sales of cigarettes.136,137 PM reported that as a result of joint sponsorship, Marlboro was able to reduce the fee for Miller's sponsorship of the Marlboro Grand Prix in 1988 by more than 25%, which benefited PM, the owner of both Marlboro and Miller at the time.87 In November 1988, PM stated that the joint sponsorship of bar nights at spring break sites in Daytona Beach, Florida, and South Padre Island, Texas, between Marlboro and Miller might save “over $50,000 for both Miller and Marlboro on materials, fees, etc.”130
RJR expected joint sponsorship to increase the awareness of their promotional events, lower the cost of event sponsorship, provide entertainment for the audience, and extend the outreach of their special event involvement.138–140 For example, RJR's 1975 plans to cosponsor California Beach Volleyball with Olympia beer mentioned that the joint sponsorship would improve event organization, garner a better reception for the event, ease promotion, and lock out any competitive cigarette or beer companies from becoming involved with beach volleyball.79
B&W also showed interest in lowering the cost of promotional events by jointly sponsoring them with alcohol companies. For example, in July 1978, Action Marketing suggested that in Kool Jazz Festival preliminary promotions, B&W should tie in with the manufacturers of liquor, liqueurs, wine, beer, and other products to maximize awareness of the festival, decrease costs, and “extend Kool direct purchase incentive programs to other types of retail outlets.”112 In January 1979, B&W reported on the conclusion of their 1978 Rich Lights Disco Program, stating that tying in with a liquor company “could be potentially beneficial in terms of cost sharing for future promotions.”141
Tobacco and alcohol companies often jointly promoted their products at their jointly sponsored events. Through joint promotion, PM expected to receive substantive benefits, such as increased sales impact, lower costs, and reinforced brand identity.76,77 For example, in a PM document reporting on the conclusion of a 1982 Marlboro spring/summer resort program that aimed to maximize Marlboro brand exposure and stimulate interest and trial among the brand's young adult target audience, the topic of “a joint promotion between Miller and Marlboro” was broached as a possible improvement.142 The document stated that “this would enhance the bar program and increase sales on both products while establishing brand loyalty and awareness.”142
RJR also expected joint promotion to increase the awareness of their promotions, lower the cost of promotion, appeal more to consumers, and extend brand exposures.139,140 In 1989, RJR listed a series of creative marketing ideas, including “promotions in convenience outlets which offer a `specified amount off' the price of a six-pack of beer with 2 pack or 3 pack purchase [of cigarettes].”143 An RJR memo said such a promotion could affect a consumer in the following ways:
(1) Consumer who intended to purchase only one pack of cigarettes may purchase two or three packs in order to get discount on beer. (2) Consumer who intended to purchase beer and no cigarettes may purchase cigarettes to get discount on beer. Therefore, offering the discount on beer may significantly increase the number of packs of cigarettes sold.143
B&W also showed an interest in joint promotion of their cigarettes with alcohol and expected that joint promotion would lower the cost. For example, in August 1978, B&W discussed a promotional concept for “Kool Super Lights Black Market Promotions.” The concept was that the consumer would get a free 6-pack of Budweiser beer when purchasing a carton of Kool Super Lights. “Costs for this promotion would be shared between Budweiser and B&W–with each participant covering one-half the cost of the refund.”144 In 1997, Gray Advertising suggested many comarketing ideas for B&W and a spirits and wine company named Brown-Forman Corporation. One of the comarketing ideas was “Catalina Supermarket Coupon Program: purchase Jack Daniel's Country Cocktails and get a coupon for $3 off a carton of any B&W brand.”99
Tobacco marketing activities, particularly promotional events, often included
Many tobacco companies offered discounted or free alcohol at tobacco-company-sponsored bar nights, nightclub events, and other promotional events. At several Marlboro promotional events in the late 1970s and early 1980s, PM planned to offer free beer to the audience to generate excitement and please the participants.145–148 RJR also offered discounted or free beer and liquor at their bar nights and promotional events in the 1980s and 1990s,149–152 which they expected would not only provide prizes to the consumers but would also provide benefits to the managers of the bars and nightclubs, so that these managers would allow RJR to conduct their marketing activities.150,151 Similarly, B&W also offered discounted and free alcoholic drinks at their disco nights in 1978.153–155,134
Tobacco companies also sometimes developed special alcoholic drinks for their promotional events. The name, color, taste, or container of these special drinks usually would match the promotional theme and the characteristics of the promoted brands. For example, in the 1980s, RJR conducted many Salem bar nights that featured a special drink named “Salem-Sling”; this drink was colored green to match the Salem logo, and it was flavored with mint to match Salem's menthol flavoring.156,157 Special drinks were also offered at RJR's Salem Ski Scene.158,159 Similarly, B&W was encouraged to develop an official Kool “Jazz Fizz” drink in 1978 for their Jazz Festival to increase attendees' interest in and enthusiasm for the festival and to provide a unique way to tie Kools in with wine, liquor, or soft drink companies.112 In 1978, B&W developed a Rich Lights drink for the Rich Lights Disco Program.153 The marketing firm hired by B&W to develop the special Rich Lights drinks160–163 provided specific requirements that the drinks should meet:
The drink should enhance and reinforce the positioning of Rich Lights cigarettes which is distinctive in packaging and positioning, and rich in tone and manner, packaging and imagery. The drink should be light in taste and visual appearance. The drink should be rich in appearance (not thick or heavy in taste). A thin blue float, blue garnish, or blue ice cubes would be ideal. Because of our desire to compliment [sic]the light nature of the Rich Lights cigarette product, we would prefer to use a drink based on: Gin, Vodka, Rum, Tequila, Champagne, or White Wine. We do not feel that drinks based on the use of Whiskey, Bourbon, Scotch or other dark liquors would be appropriate.160
Tobacco promotional events often included alcohol-related contests, such as beer-chugging competitions. For example, in May 1989, PM's bar night program included the following beer-chug contest:
Miller Beer Chug Contest: Sign up ten people to compete against each other. The winner would be the first one to drink all the beer and place the mug upside down on his/her head and yell “MARLBORO IS NUMBER 1.”164
Wild West Contest was designed to fit the Marlboro image in a bar setting. The contest was a cross between a wild bull ride and a beer chugging contest. Since health rules prohibited a bull in the bar, a tricycle was substituted on a marked course with a beer chugging stop in the middle. Very popular contest.165
Beer-chug contests were conducted in many of PM's and RJR's sponsored bar nights and nightclub events.151,166–174 These contests were usually targeted at young males. Tobacco companies expected the contests to reinforce brand image, enhance visibility, increase brand awareness, generate entertaining excitement, provide branded incentives, and generate increased sales. PM marketers noted that a beer-chug contest was “easy to run, does not need many participants and is exciting to watch.”170 RJR noted that beer-chug contests involved skill, dexterity, strength, and other masculine qualities169,172,173; generated “peer pressure” to win Camel prizes175; and were exciting and easy to understand.176 In addition to bars and nightclubs, Lorillard conducted beer-chugging contests during Newport promotions held at the Fort Bragg army base in April 1983.177,178
Tobacco companies often provided cigarette-branded gifts to those who purchased special drinks or who won alcohol-related contests.151,156,166–169,172–174,179 For example, with alcohol purchases, RJR distributed Camel game cards that gave customers a chance to win Camel merchandise,151,169 and RJR provided Camel beach towels to participants who won Camel beer-chug contests.174 Cigarette-branded gifts included lighters, key chains, game cards, beach towels, T-shirts, and coasters.151,169,174,180,181 These gifts were intended to increase visibility, appeal more to the consumers (especially young adults), extend awareness of the brand, and provide branded incentives.147,151,169,182,183
Cigarette-branded gifts frequently were alcohol-related paraphernalia, such as bottle openers, beer mugs, beer coolers, wine skins, shot glasses, and champagne glasses.180,181,184 For example, in January 1974, PM provided a discounted wine rack to consumers who bought 2 packs of Parliament cigarettes.145 During the 1980s, PM included beer mugs in several resort promotions.171,185–187 At RJR's promotions, consumers could exchange packs of cigarettes for a free beer mug.181,188 In 1997, Gray Advertising suggested comarketing ideas for B&W and Brown-Forman Corporation, including a promotion in which customers would “collect Kool UPC's and get Lenox Glassware Set (shot glass, snifter, wine glass, martini glass, champagne flute, etc.).”99
We found that tobacco companies researched the concurrent use of alcohol and cigarettes, understood the high prevalence of couse of cigarettes and alcohol (especially beer), and intended to use these findings to enhance their marketing efforts. Tobacco companies' marketing strategies linking cigarettes with alcohol were elaborately planned and carefully executed both to connect tobacco sales with alcohol purchases and to increase cigarette sales. The link between smoking and drinking might have been strengthened by these marketing activities. This finding is consistent with previous research showing that tobacco manufacturers incorporated images of and references to alcohol in cigarette advertisements in magazines targeting young adults.189
Young adults are the most frequent target of tobacco companies' marketing activities featuring alcohol. Since at least the 1980s, tobacco companies expressed special interest in this population in both their research studies and their marketing activities.25,27,28,33,190 The companies understood that young adults spent time in bars and nightclubs and enjoyed social activities such as drinking and partying with friends in these places.36,37,54,59,60,63–69 The tobacco companies' marketing activities linked with alcohol were targeted at both male and female young adults, which is consistent with previous research on bar and nightclub events.25,27,28,33,190 Significant numbers of young adults continue to be exposed to these promotions.25 Thus, young adults should be a priority for tobacco control and cessation interventions, because young adulthood represents a unique period in the life cycle in which patterns of behaviors are established that will affect both current and future health.
Tobacco company sponsorship that involves using a tobacco brand's name, logo, symbol, motto, selling message, recognizable pattern of colors, or any other indicia of product identification of cigarettes or smokeless tobacco was recently prohibited for athletic, musical, artistic, or other social or cultural events.191 However, tobacco companies still conduct promotional events at bars and nightclubs, which represent fun, smoker-friendly places for young people to initiate and enjoy smoking in the context of drinking. These promotional events continue even after implementation of smoke-free policies in bars.
Tobacco promotions in these venues may be partly responsible for the creation and reinforcement of links between smoking and drinking by encouraging nonsmokers to initiate smoking, encouraging social and nondaily smokers to smoke more frequently, or encouraging former smokers to relapse. Nichter et al.24 found that young adults perceived smoking to be more acceptable at parties with concurrent alcohol use. Also, studies have suggested that discontinuing or reducing alcohol consumption predicts the success of smoking cessation.6,192 Therefore, tobacco control efforts should prioritize venues and settings where alcohol use is frequent, such as bars and nightclubs. Studies are needed to monitor tobacco companies' marketing activities linking tobacco with alcohol products and to determine those activities' effects on the concurrent use of the 2 substances.
Although tobacco companies have aggressively pursued joint promotion of tobacco and alcohol products, it is worth noting that PM found that negative associations with cigarettes threatened the effectiveness of joint promotion of cigarettes with other products, particularly food brands. This finding suggests that campaigns that denormalize smoking and the tobacco industry and that create negative associations with tobacco brands will limit the tobacco industry's ability to cross promote cigarettes with other products or to attach cigarette brands to other products; this effect is in addition to the strong relation that denormalization campaigns have with smoking status and intentions to quit.193 Such effects may be particularly important in countries where indirect advertising and cobranding are common.194,195
A limitation of the present study is that the internal documents we located were primarily from the 1980s and the 1990s. To the best of our knowledge, this is the first study to use internal tobacco industry documents to investigate tobacco companies' research on the concurrent use of cigarettes and alcohol, their research on smokers' drinking behaviors, and their marketing strategies linked with alcohol. Tobacco marketing reinforces the links between smoking and drinking, and these marketing activities continue today; therefore, the prevalence of tobacco and alcohol comorbidity may continue to increase.
On the basis of these findings, we make 3 recommendations. First, it should be prohibited to tie in any tobacco products, tobacco paraphernalia (such as lighters and ashtrays), or tobacco-branded products with alcohol purchase. Second, tobacco sales and promotions should be prohibited in any establishments serving or selling alcohol, including adult-only venues. The use of alcohol impairs one's ability to make an informed choice about tobacco use, and the use of both tobacco and alcohol may enhance the addictive potential of both substances, so the US Food and Drug Administration's prohibition of tobacco sponsorship should be extended to include venues and events where alcohol is served or sold. Third, given the strong association between smoking and drinking, smoking cessation programs should address the use of alcohol, and binge-drinking interventions should consider addressing tobacco use, such as evaluating tobacco-use behaviors among binge drinkers and alcoholics and including tobacco cessation strategies in drinking interventions. New efforts to break linkages between tobacco use and alcohol use are needed.
This research was supported by the National Cancer Institute (grant CA-87472).
This work was presented at the 2010 Annual Meeting of the American Public Health Association.
The authors wish to thank the members of the University of California, San Francisco Writer's Task Force for their helpful comments on the article.
Note. The funding agency had no involvement in the conduct of the research or preparation of the article.
Human Participant Protection No protocol approval was necessary because no human research participants were involved.