Does marketing really matter? When it comes to cigarettes and other tobacco products, the answer appears to be “yes.” And the decisions consumers make as a result of that marketing can, in fact, be deadly.
That’s why researchers in New Jersey will continue to work with academic partners to study the impact of cigarette advertising, packaging, labeling, and more, including potentially misleading marketing. And thanks to a new round of federal funding announced this week, the group will explore how misunderstandings about the health impacts of these items affects how people buy and use these products.
Rutgers University’s Center for Tobacco Studies will share with medical researchers at the University of Pennsylvania an $18 million grant from the U.S. Food and Drug Administration and the National Institutes of Health to supplement its work on tobacco marketing and regulation.
The center — which is focused on cigarettes, cigars, and cigarillos, not electronic smoking devices (vapes) or marijuana products — is one of nine Tobacco Centers of Regulatory Science nationwide to share in this new funding. The groups are expected to collaborate on their efforts.
The funding, which stretches over five years, will enable researchers from the Rutgers program, which is part of Rutgers School of Public Health, and Penn’s Perelman School of Medicine to identify areas of public misconception when it comes to tobacco marketing and packaging and test ways to more effectively educate people on the true risks of smoking. Previous work has been supported by other federal grants and contracts with the state Department of Health, the group said.
In the past, the center’s research has informed local, state, and federal officials as they craft tobacco regulations, officials said. It also serves as a counterbalance to the power of the tobacco industry, which they said spends more than $14 billion annually on marketing and related efforts. For example, work by Rutgers scientists on so-called filtered cigars made clear that the flavored products met the criteria of cigarettes, which led the FDA to take action in 2016 against four companies that were selling the items illegally, with improper labeling.
“Tobacco regulatory science can inform FDA on future steps that can reduce harm from the most dangerous tobacco products and have the greatest potential to improve public health,” said Christine Delnevo, the center’s director and co-leader of cancer prevention and control programs at the Rutgers Cancer Institute of New Jersey.
NJ adults still lighting up
Roughly one in six adults in New Jersey smokes cigarettes, close to 15 percent of those over 18, according to 2014 data posted by the state Department of Health’s tobacco control office. But tobacco use remains the leading cause of preventable death in America; smoking has been linked to 80 percent of lung cancers and nearly half of bladder cancers, diseases that are diagnosed in more than 8,500 state residents each year, federal data shows.
(The specific culprit seems to be chemicals called aldehydes, present in tobacco smoke in high quantities, according to separate work by a team of researchers that includes Rutgers’ pharmacy professor Chung S. Yang, director of the university’s Center for Cancer Prevention Research.)
New Jersey has been criticized for not spending enough on anti-smoking campaigns, although it laid out close to $10 million annually in recent years on various smoking prevention and cessation efforts. Beginning this year, the Murphy administration chose to divert more of its tobacco tax revenue — estimated at $7 million annually — to support this work. This summer, the state chose to expand Medicaid coverage for programs and products designed to help smokers kick the habit.
The Garden State also has some of the toughest regulations nationwide when it comes to buying and using tobacco products; as of November 2017, 21 became the legal age to purchase cigars and cigarettes. Smoking is now banned in almost all indoor and outdoor public spaces, including parks and beaches. In addition, it is one of nearly two-dozen states to outlaw tobacco use in restaurants and workplaces, according to a recent report by anti-smoking advocates.
Smoking’s ripple effects
Healthcare leaders also stress that smoking negatively impacts public health, harms both smokers and their family members, and exacerbates other chronic medical conditions over time. Reducing the number of tobacco smokers has health, economic, environmental and other benefits, they note.
Researchers at the Rutgers tobacco center will use the latest funding to build on their previous work, which shows that a consumer’s initial interaction with the packaging and marketing material does make a difference. The work — which will next focus on low-nicotine products, cigarillo packaging, and the language used on smoking products, among other elements — involves monitoring public behavior, surveys, and other data collection to determine existing policy, risk perception, and patterns of use.
“Risk perceptions, beliefs about quality and contents, addiction and harm levels, can be both explicitly and implicitly conveyed through advertising and packaging,” said Andrew Strasser, director of the Biobehavioral Smoking Laboratory at Penn’s Center for Interdisciplinary Research on Nicotine Addiction, and works with Delnevo and other members of their team on the federally funded project.
“As a counterstrike (to the tobacco industry), one of the goals of our center is to identify these areas of misperception, then experimentally identify how correctives can be used so the population is properly informed about product risk,” Strasser continued. “We propose to take this line of work a step further and examine how these false health perceptions impact adoption and intensity of use of these products, as well as measure nicotine and toxin exposures to quantify levels of harm.”
The Rutgers program is rooted in the Tobacco Surveillance and Evaluation Research Project, formed in 2000 to conduct a baseline assessment of smoking and tobacco use for state health officials. It has since grown in scope and mission and now monitors the tobacco industry, conducts research and data analysis, and provides policy input. The center also runs Trinkets & Trash, an online effort to monitor and document tobacco products and marketing materials for scholarly research.