Comparison of the Cigarette Brand Preferences of Adult and Teenaged Smokers -- United States, 1989, and 10 U.S. Communities, 1988 and 1990

Tobacco use is the single most preventable cause of death in the United States (1). Approximately three fourths of adult regular smokers tried their first cigarette before the age of 18 years (National Institute on Drug Abuse (NIDA), 1988 NIDA Household Survey, unpublished data); about half had become regular smokers before their 18th birthday (2). Knowing what brands young smokers prefer may suggest what encourages them to smoke and may suggest smoking-prevention or smoking-cessation strategies (3-5). To determine brand preferences of smokers, data were reviewed from CDC's National Center for Health Statistics' 1989 Teenage Attitudes and Practices Survey (TAPS) and the National Cancer Institute surveys of adults in 1988 and 9th-grade students in 1990 in 10 U.S. communities * participating in the Community Intervention Trial for Smoking Cessation (COMMIT) evaluation (6). This report examines the findings of these surveys on the cigarette brand preferences of adult and teenaged smokers.

TAPS

For the TAPS survey, data on knowledge, attitudes, and practices regarding tobacco use were collected from a national household sample of adolescents aged 12-18 years (7) by a computer-assisted telephone interviewing (CATI) system; those who could not be reached by telephone were mailed a questionnaire. During September-December 1989, the CATI interviews were conducted; because only persons reached by telephone were asked what brand they usually purchased, the data for this report were obtained from 9135 CATI respondents (79% of 11,609 adolescents with known telephone numbers and 76% of 12,097 adolescents in the total sample). These data were weighted to provide national estimates. Confidence intervals (CIs) were calculated by using the standard errors estimated by the Software for Survey Data Analysis (SUDAAN) (8). Adolescent current smokers ** were asked if they usually bought their own cigarettes and, if so, which brand they usually bought.

Of the 1396 current smokers, 865 (62%) reported that they usually bought their own cigarettes. Smokers aged 16-18 years were more likely to buy their own cigarettes (71% (95% CI=plus or minus 2.9%)) than were smokers aged 12-15 years (45% (95% CI=plus or minus 4.9%)). Marlboro was the most commonly purchased brand for both male (69%) and female (68%) adolescents (Table 1). Camel was preferred more often by males (11%) than by females (5%). Although Marlboro was the most popular brand among white (71%) and Hispanic (61%) adolescents, black adolescents preferred the mentholated brands of Newport (61%), Kool (11%), and Salem (10%). Among 9th-grade students, Marlboro (75% (95% CI=plus or minus 8.2%)), Newport (10% (95% CI=plus or minus 5.3%)), and Camel (6% (95% CI=plus or minus 4.3%)) were the most commonly purchased brands.

In all regions, *** Marlboro was the most popular brand (Table 1). Newport was second in the Northeast (16%), and Camel was second in the West (18%). Among white adolescents, Newport was more popular in the Northeast (14% (95% CI=plus or minus 5.0%)) and the Midwest (7% (95% CI=plus or minus 3.5%)) than in the South (1% (95% CI=plus or minus 1.2%)) and the West (1% (95% CI=plus or minus 1.3%)).

COMMIT

For the COMMIT study, data on the adult preferences for cigarette brands were obtained from telephone surveys conducted during January-April 1988 of random samples of 15,415 adult current smokers **** aged 25-64 years in the 10 communities. The survey was conducted in two stages: 1) an adult household member reported the smoking status of all adults in that household and 2) all smokers in the household who were aged 25-64 years were interviewed. The overall response rate for the 10 communities was 75%; the first-stage response rate was 82% (range: 76%-86%) and the second-stage response rate was 92% (range: 85%-94%). Current brand use was measured by response to the question, "What brand of cigarettes do you usually smoke now?"

During October-December 1990, data on preferences for cigarette brands among teenaged smokers aged 13-16 years were obtained from school-based surveys of students from a random sample of 9th-grade classrooms in each of the 10 communities. The survey included both public and private schools and yielded representative samples of approximately 400 9th-grade students per community. Forty-six (96%) of the 48 eligible schools (i.e., schools with greater than or equal to 50 students in 9th grade) participated, and 4129 (86%, range: 76%-91%) of the 4783 eligible students completed the survey. Data in this report were limited to 9th-grade students who reported they were current cigarette smokers ***** and usually bought their own cigarettes. Current brand use was measured by responses to the question, "What brand do you usually buy?"

In all but one community, Marlboro was the preferred brand for at least 20% of adult smokers (Table 2); in Raleigh, North Carolina, the brand most popular among adults was Salem. Winston was preferred by more than 10% in six of the 10 communities. Except for these three preferences, cigarette brand use among adult smokers varied considerably within and across communities; most brands were mentioned by less than 10% of smokers. In communities where the preference for Camels was high among adults (Santa Fe, Medford/Ashland, and Bellingham), use of Camels was highest among younger adults (i.e., aged 25-34 years). Overall, the cigarette brand preferences of adult smokers were consistent with known national market share patterns ****** (9).

Among 9th-grade smokers across all 10 communities, three cigarette brands -- Marlboro, Camel, and Newport -- were consistently preferred (84%-100%) (Table 3, page 179). Among the 424 teenaged smokers who usually purchased their own cigarettes, 180 (43%) purchased Marlboro, 126 (30%) purchased Camel, and 85 (20%) purchased Newport. In nine of the 10 communities, one third or more of all 9th-grade smokers preferred Marlboro cigarettes. The preference for Camel and Newport cigarette brands varied considerably among communities. In five communities (Santa Fe, Medford/Ashland, Bellingham, Raleigh, and Cedar Rapids) Marlboro and Camel were the most frequently mentioned cigarette brands. In four other communities (Paterson, Utica, Yonkers, and Vallejo), Newport and Marlboro were the dominant cigarette brands. Camel cigarettes were most popular among teenaged smokers in western and midwestern communities. Newport cigarettes were most popular among teenaged smokers from communities in the Northeast. Newport was the most popular brand among black 9th-grade students and third most popular among white 9th-grade students.

Reported by: KM Cummings, PhD, E Sciandra, MA, Roswell Park Cancer Institute; TF Pechacek, PhD, State Univ of New York, Buffalo. JP Pierce, PhD, Univ of California, San Diego; L Wallack, DrPH, Univ of California, Berkeley. SL Mills, MD, Div of Cancer Prevention and Control; WR Lynn, DR Shopland, National Cancer Institute, for the Community Intervention Trial for Smoking Cessation Research Group; SE Marcus, PhD, National Institute of Dental Research, National Institutes of Health. Epidemiology Br, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; Div of Health Interview Statistics, National Center for Health Statistics, CDC.

Editorial Note

Editorial Note: In both the TAPS and COMMIT surveys, at least 84% of the adolescent current smokers who usually bought their own cigarettes purchased one of three brands--Marlboro, Newport, or Camel. Brand preference is much more tightly concentrated among adolescent smokers than among adult smokers in the 1988 COMMIT baseline survey of adults and in the 1986 Adult Use of Tobacco Survey (AUTS) (3) as well as in the overall market (9). Marlboro, Camel, and Newport were among the most heavily advertised cigarette brands in the United States during 1990 (10); therefore, these data suggest that tobacco advertising may influence teenagers in their choice of brands.

In both surveys, Marlboro was the predominant brand used by adolescents. Teenaged smokers may be attracted to the brand's image of strength and independence promoted in the long-running "Marlboro man" advertising campaign.

The regional preferences for Camel and Newport brands among teenaged smokers (regardless of race) were consistent in both surveys. A recent report from California showed a high rate of Camel use among adolescent current smokers in that state (4). These findings may reflect regional differences in exposure to cigarette brand advertising and promotion.

The preference of black adolescent and adult smokers for Newport is also consistent across surveys and may reflect the increased occurrence of mentholated cigarette advertisements targeted to blacks (11). Further research is needed to determine whether preference preceded or followed such targeted advertising.

The COMMIT data for adolescents indicate a slightly different pattern of brand preference than do the TAPS data. The higher preference for Camel among the COMMIT respondents compared with the TAPS respondents may reflect the difference in age composition (adolescents aged 13-16 years compared with 12-18 years) and sample frames (the 10 U.S. communities compared with the overall U.S. population). The difference may, however, reflect a growing effect of the "Old Joe" advertising campaign. Recent evidence suggests that the advertising campaign for Camel that began in 1988 and features a dromedary cartoon character appeals more to children than to adults (5). In 1986, Camel ranked seventh among the youngest age group (17-24 years) of smokers responding to the AUTS (3); in 1989, 1 year after the advertising campaign began, the brand ranked third among teenagers surveyed in TAPS. Other studies, conducted after TAPS, report even higher rates of Camel preference among adolescents (4,5), consistent with the COMMIT survey results. Cigarette brands that appeal to children and teenagers also use promotions such as displays at sports and youth-oriented events and distribution of promotional items (e.g., T-shirts, posters, and caps) that may appeal more to children and teenagers than to adults (12). One of the national health objectives for the year 2000 is to eliminate or severely restrict all forms of tobacco product advertising and promotion to which persons aged less than or equal to 18 years are likely to be exposed (objective 3.15) (13).

The forces that influence smoking initiation are complex and may include advertising, peer influence, and habits of family members (1,4,5). The exposure of youth to tobacco advertising can be reduced by 1) prohibiting the use of imagery in advertisements by allowing only words and a picture of the product itself (i.e., "tombstone" advertising); 2) prohibiting tobacco sponsorship of sporting and other events that have a substantial youth audience; 3) prohibiting tobacco advertising in publications that have a substantial teenaged readership; 4) prohibiting tobacco billboards located near schools and other areas where youths congregate (e.g., parks and shopping malls); 5) prohibiting paid tobacco placements in movies and videos; and 6) prohibiting tobacco advertising on promotional items (12,13). In addition, school tobacco-prevention programs can play a key role in reducing smoking initiation and should include information about the media's influence on smoking (13).

References

1. CDC. Reducing the health consequences of smoking: 25 years of progress -- a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no. (CDC)89-8411.

2. CDC. Differences in the age of smoking initiation between blacks and whites -- United States. MMWR 1991;40:754-7.

3. CDC. Cigarette brand use among adult smokers--United States, 1986. MMWR 1990;39:665,671-3.

4. Pierce JP, Gilpin E, Burns DM, et al. Does tobacco advertising target young people to start smoking? JAMA 1991;266:3154-8.

5. DiFranza JR, Richards JW, Paulman PM, et al. RJR Nabisco's cartoon camel promotes Camel cigarettes to children. JAMA 1991;266:3149-53.

6. COMMIT Research Group. Community Intervention Trial for Smoking Cessation (COMMIT): summary of design and intervention. J Natl Cancer Inst 1991;83:1620-8.

7. Allen K, Moss A, Botman S, Winn D, Giovino G, Pierce J. Teenage attitudes and practices survey "TAPS": methodology and response rates (Abstract). In: Program and abstracts of the 119th annual meeting of the American Public Health Association. Washington, DC: American Public Health Association, 1991.

8. Shah BV. Software for Survey Data Analysis (SUDAAN) version 5.30 (software documentation). Research Triangle Park, North Carolina: Research Triangle Institute, 1989.

9. Maxwell JC. The Maxwell consumer report: 1991 year-end sales estimates for the cigarette industry. Richmond, Virginia: Wheat First Securities, 1992.

10. Endicott RC. The top 200 brands. Advertising Age 1991;Nov 11:41-2.

11. Cummings KM, Giovino G, Mendicino AJ. Cigarette advertising and black-white differences in brand preference. Public Health Rep 1987;102:698-701.

12. Richards JW Jr, Fischer PM. Smokescreen: how tobacco companies market to children. World Smoking and Health 1990;15:12-4.

13. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

• Four of the 10 communities surveyed are located in the Northeast (Fitchburg/Leominster, Massachusetts; Paterson, New Jersey; and Utica and Yonkers, New York); three in the West (Vallejo, California; Medford/Ashland, Oregon; and Bellingham, Washington); and one each in the South (Raleigh, North Carolina), Southwest (Santa Fe, New Mexico), and Midwest (Cedar Rapids, Iowa). ** Adolescents who reported smoking cigarettes on 1 or more of the 30 days preceding the survey. *** The four regions were Northeast (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont), Midwest (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin), South (Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia), and West (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming). **** Adults who answered "yes" to the question "Have you smoked at least 100 cigarettes in your entire life?" and then answered "yes" to the question "Do you smoke cigarettes now?" ***** Adolescents who reported smoking cigarettes on 1 or more of the 30 days preceding the survey. ****** Percentage of all cigarettes sold in the United States, by brand. Market share data are collected quarterly by a tobacco industry analyst (9).

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