It is the tobacco industry’s insidious marketing of its product that fuels this increase in tobacco use. Growing numbers of deaths from tobacco will follow, stifling economic development, with the poorest countries hardest hit.
Evidence shows that tobacco marketing drives the uptake of smoking, especially among young people. While the tobacco industry continues to argue that it only markets to persuade adult smokers to switch brands, overwhelming evidence links the industry’s use of marketing to spiralling rates of tobacco use. Before the Soviet Union opened up to “big tobacco”, very few women smoked. Within 10 years of the major tobacco companies flooding the Russian market with marketing, female smoking rates in Russia had doubled and the age of smoking uptake had fallen.
If this epidemic is to be halted, comprehensive bans on tobacco marketing are essential. One hundred and eighty countries are now legally obliged to implement such bans. They are parties to the World Health Organisation’s Framework Convention on Tobacco Control (FCTC). This global treaty, which came into force 10 years ago, sets out evidence-based tobacco control measures which parties must implement.
Yet the latest evidence shows that tobacco industry marketing remains a significant global problem, particularly for people in the poorest countries who are the most exposed to it. Our study, published this week, examined tobacco marketing across 462 communities in 16 countries. It compared levels of marketing in high-, middle- and low-income countries while accounting for differences in access to television, radio and the internet and in the respondents’ gender, age, education, smoking status and whether they have close friends who smoke.
People living in poorer countries were exposed to significantly more tobacco marketing than those living in affluent countries. In communities in low-income countries, 81 times more tobacco adverts were observed than in high-income countries. People in lower-income countries also reported far higher exposure to tobacco adverts over the previous six months. For example, they were 46 times more likely to hear radio adverts, 11 times more likely to see poster adverts and nine times more likely to see television adverts than those living in high-income countries. Overall, those in low-income countries were almost 10 times more likely to report exposure to at least one form of traditional tobacco marketing.
Access to tobacco was also higher in poorer countries. In low-income countries, we observed two and a half times more stores selling tobacco in the communities in the low-income and lower-middle-income countries than in the high-income countries. Worryingly, 64% of stores visited sold single cigarettes compared with just 2.8% in high-income countries. The availability of single cigarettes is a key means of targeting young smokers who often cannot afford to buy a full pack. It is also outlawed in the WHO’s framework convention.