Changes in the Cigarette Brand Preferences of Adolescent Smokers -- United States, 1989-1993

Approximately three million U.S. adolescents are smokers, and they smoke nearly one billion packs of cigarettes each year (1). The average age at which smokers try their first cigarette is 14- 1/2 years, and approximately 70% of smokers become regular smokers by age 18 years (2). Evaluating the changes in the brand preferences of young smokers can help identify factors that influence adolescents' brand choice and may suggest smoking-prevention strategies (3,4). This report examines changes in the brand preferences of teenaged smokers from 1989 to 1993 using data from CDC's 1993 Teenage Attitudes and Practices Survey (TAPS-II) and comparing them with data from the 1989 TAPS.

For TAPS, data on knowledge, attitudes, and practices regarding tobacco use were collected from a national household sample of adolescents (aged 12-18 years) by telephone interviews. For TAPS-II, interviews were conducted during February-May 1993. Of the 9135 respondents to the 1989 TAPS, 7960 (87.1%) participated in TAPS-II (respondents were aged 15-22 years when TAPS-II was conducted). * In addition, 4992 (89.3%) persons from a new probability sample (n=5590 persons aged 10-15 years) participated in TAPS-II. Data for the 12-18-year-olds in each survey were analyzed (n=9135 for TAPS; n=7311 for TAPS-II). Because numbers for other racial groups were too small for meaningful analysis, data are presented for black, white, and Hispanic adolescents only. Data were weighted to provide national estimates, and confidence intervals (CIs) were calculated by using the standard errors estimated by SUDAAN (5). Adolescent current smokers ** were asked if they usually bought their own cigarettes, and if so, which brand they usually bought.

Of the 1031 current smokers aged 12-18 years interviewed in 1993, 724 (70%) reported that they usually bought their own cigarettes; the brand they usually bought was ascertained for 702 (97%). Marlboro, Camel, and Newport were the most frequently purchased brands for 86% of the adolescents (Table_1). Marlboro was the most commonly purchased brand for both male (59% {95% CI= plus or minus 6.0%}) and female (61% {95% CI= plus or minus 5.8%}) adolescents; the second most commonly purchased brand among males was Camel (16% {95% CI= plus or minus 5.0%}) and among females was Newport (15% {95% CI= plus or minus 3.9%}). Marlboro was the most commonly purchased brand among white (64% {95% CI= plus or minus 4.3%}) and Hispanic (45% {95% CI= plus or minus 14.9%}) adolescents; black adolescents most frequently purchased Newport (70% {95% CI= plus or minus 14.1%}). Younger smokers (aged 12-15 years) were more likely than older smokers (aged 16-18 years) to buy Newport and less likely to buy Marlboro; purchasing frequency for Camel cigarettes was similar among all adolescents.

Among adolescents nationwide, Marlboro was the most commonly purchased brand (Table_1). However, by region ***, Camel was most commonly purchased in the West (27% {95% CI= plus or minus 10.8%}), and Newport, in the Northeast (30% {95% CI= plus or minus 8.8%}).

From 1989 to 1993, substantial changes in brand preference occurred among adolescents (Table_2). The percentage of adolescents purchasing Marlboro cigarettes decreased 8.7 percentage points (13% decrease), the percentage of adolescents purchasing Camel cigarettes increased 5.2 percentage points (64% increase), and the percentage purchasing Newport cigarettes increased 4.5 percentage points (55% increase). These changes did not completely correlate with changes in overall cigarette market share during 1989-1993. During this period, the overall market share for Camel and Newport remained nearly unchanged, but the overall market share for Marlboro decreased by 2.8 percentage points (11% decrease).

For Marlboro cigarettes, the decreases in brand preference were greatest among white adolescents, younger smokers, and adolescents residing in the Northeast, Midwest, and West (Table_1) (6). Increases in brand preference for Camel cigarettes were greatest among white adolescents and adolescents residing in the Midwest and West, and increases for Newport cigarettes were greatest among younger smokers and adolescents residing in the Northeast.

Reported by: D Barker, MHS, Robert Wood Johnson Foundation, Princeton, New Jersey. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: Because cigarette sales to adolescents constitute a small percentage of the total market, overall market share can only be used to estimate the brand preferences of adults. TAPS and TAPS-II indicate that brand preference is more tightly concentrated among adolescents than among adults. In both surveys, at least 85% of adolescent current smokers purchased one of three brands (i.e., Marlboro, Camel, or Newport); however, the three most commonly purchased brands among all smokers accounted for only 35% of the overall market share in 1993.

The three most commonly purchased brands among adolescent smokers were the three most heavily advertised brands in 1993 (7), suggesting that cigarette advertising influences adolescents' brand preference. In 1993, Marlboro, Camel, and Newport ranked first, second, and third (7), respectively, in advertising expenditures. However, Camel and Newport ranked seventh and fifth, respectively, in overall market share (8 ).

Similarly, the increases in adolescents' brand preference for Camel cigarettes and the decrease in preference for Marlboro cigarettes from 1989 to 1993 are not explained by changes in overall market share for these brands. These changes reflect variability in brand-specific advertising expenditures: from 1989 to 1993, Marlboro advertising decreased from $102 million to $75 million (7,9), while Camel advertising increased from $27 million to $43 million (7,9). In contrast, the increased preference for Newport cigarettes does not reflect the decrease in Newport advertising expenditures from $49 million to $35 million from 1989 to 1993 (7,9). The regional differences in brand preference of adolescents and changes in those preferences during 1989-1993 suggest that analysis of the relation between regional advertising expenditures and brand preferences may help to clarify the role of cigarette advertising in influencing adolescents' brand preference.

The findings that black adolescents most commonly purchased mentholated brands (i.e., Newport and Kool) and that Hispanic adolescents most commonly purchased Marlboro are consistent with a previous report (6). Racial/ethnic differences in brand preferences of adolescents may be influenced by differences in socioeconomic status and by social and cultural phenomena that require further explanation.

The findings of TAPS-II are subject to at least two limitations. First, the potential exists for nonresponse bias in the follow-up of TAPS respondents. For example, smoking prevalence estimates derived from TAPS-II are lower than those based on other national surveys; TAPS respondents who were successfully followed up in TAPS-II were less likely to be smokers in 1989 than those who could not be reinterviewed (Office on Smoking and Health, unpublished data, 1994). Second, the small number of black and Hispanic adolescents in TAPS-II lessens the reliability of the brand preference estimates for these subgroups.

Because cigarette advertising may influence brand choice of adolescents (an important component of smoking behavior), legislation may be needed to restrict cigarette advertising to which young persons are likely to be exposed (10). In addition, antitobacco advertising may be an effective public health strategy to prevent smoking initiation and encourage smoking cessation among adolescents. Understanding the influence of advertising on adolescent smoking behavior may assist in clarifying the potential role of antismoking advertisements. At least two states (California and Massachusetts) have allocated resources derived from state excise cigarette tax for paid antismoking advertising campaigns aimed at young persons.

References

1. DiFranza FR, Tye JB. Who profits from tobacco sales to children? JAMA 1990;263:2784-7.

2. US Department of Health and Human Services. Preventing tobacco use among young people: a report of the Surgeon General. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994.

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

4. Hunter SM, Croft JB, Burke GL, Parker FC, Webber LS, Berenson GS. Longitudinal patterns of cigarette smoking and smokeless tobacco use in youth: the Bogalusa Heart Study. Am J Public Health 1986;76:193-5.

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

6. CDC. Comparison of the cigarette brand preferences of adult and teenaged smokers -- United States, 1989, and 10 U.S. communities, 1988 and 1990. MMWR 1992;41:169-73,179-81.

7. LNA/MediaWatch Multi-Media Service. Ad dollars summary, January- December 1993. New York: Competitive Media Reporting, 1994.

8. Maxwell JC Jr. The Maxwell consumer report: fourth-quarter and year-end 1993 sales estimates for the cigarette industry. Richmond, Virginia: Wheat First Securities/Butcher & Singer, February 10, 1994.

9. LNA/Arbitron Multi-Media Service. Product vs. media report. New York: Competitive Media Reporting, 1993.

10. 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, 1991:152; DHHS publication no. (PHS)91-50212.

* TAPS respondents who completed the survey by mail questionnaire were not eligible for the TAPS-II survey. TAPS-II included household interviews of persons who did not respond by telephone. 

** 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).

TABLE 1. Percentage * distribution of cigarette brands usually bought by current smokers+ aged 12-18 years who reported usually
buying their own cigarettes, by demographic characteristic -- United States, Teenage Attitudes and Practices Survey-II, 1993,
and overall cigarette brand market shares,& 1993
=================================================================================================================================================================
                                                                                      Percentage
                       ----------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                      Benson &
                           Marlboro        Camel          Newport        Winston        Kool          Salem       Virginia Slims       Hedges      Other brands
                       --------------- --------------  --------------  ------------ -------------  ------------   --------------    ------------   ------------
Characteristics   No.    %  (95% CI @)   %   (95% CI)    %   (95% CI)   %  (95% CI)   %  (95% CI)   %  (95% CI)    %   (95% CI)      %  (95% CI)    %  (95% CI)
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Sex
  Male            370  59.2  (+/-6.0)  16.1  (+/-5.0)  10.7  (+/-3.2)  1.6 (+/-.5)   2.3 (+/-2.0)  0.4 (+/-.5)    0                 0.6 (+/-.8)    9.1 (+/-.3)
  Female          332  60.7  (+/-5.8)  10.3  (+/-3.0)  14.7  (+/-3.9)  0.7 (+/-.0)   0             1.7 (+/-.4)    2.0  (+/-.9)      0              9.9 (+/-.9)

Race **
  White           646  63.5  (+/-4.3)  14.4  (+/-3.1)   8.7  (+/-2.4)  1.2 (+/-.0)   0.5 (+/-0.8)  1.0 (+/-.8)    1.0  (+/-.0)      0.2 (+/-.4)    9.4 (+/-.8)
  Black            45   8.5  (+/-8.5)   0              70.4  (+/-4.1)  0            11.9 (+/-0.9)  1.4 (+/-.7)    0.5  (+/-.0)      1.7 (+/-.3)    5.5 (+/-.0)

Ethnicity ++
  Hispanic         50  45.4  (+/-4.9)  10.1  (+/-7.7)  34.0  (+/-5.1)  6.0 (+/-.1)   4.5 (+/-8.6)  0              0                 0              0
  Non-Hispanic    647  60.9  (+/-4.3)  13.6  (+/-3.1)  11.0  (+/-2.5)  0.8 (+/-.7)   0.9 (+/-0.8)  1.1 (+/-.8)    1.1  (+/-.0)      0.3 (+/-.4)   10.4 (+/-.9)

Age (yrs)
  12-15           140  49.5  (+/-9.2)  13.0  (+/-7.1)  19.4  (+/-6.9)  2.8 (+/-.1)   3.7 (+/-3.8)  0.4 (+/-.7)    0.1  (+/-.3)      0             11.1 (+/-.3)
  16-18           562  63.1  (+/-4.4)  13.4  (+/-3.0)  10.6  (+/-2.6)  0.7 (+/-.7)   0.4 (+/-0.6)  1.2 (+/-.9)    1.2  (+/-.2)      0.4 (+/-.5)    9.0 (+/-.9)

Region &&
  Northeast       146  54.1  (+/-0.7)   5.1  (+/-3.6)  30.1  (+/-8.8)  0.6 (+/-.2)   0             0.6 (+/-.3)    1.8  (+/-.5)      0              7.6 (+/-.5)
  Midwest         223  61.6  (+/-6.7)  15.0  (+/-4.6)  11.6  (+/-4.8)  0.9 (+/-.3)   1.2 (+/-1.6)  2.4 (+/-.9)    0.8  (+/-.1)      0.4 (+/-.7)    6.1 (+/-.1)
  South           217  67.1  (+/-6.5)   9.5  (+/-3.9)   8.0  (+/-3.1)  0.9 (+/-.3)   1.5 (+/-1.8)  0.6 (+/-.2)    1.0  (+/-.0)      0.5 (+/-.1)   10.7 (+/-.4)
  West            116  50.3  (+/-0.6)  27.1  (+/-0.8)   3.2  (+/-3.1)  2.6 (+/-.6)   2.0 (+/-3.8)  0              0.2  (+/-.4)      0             14.7 (+/-.4)


Total             702  60.0  (+/-4.2)  13.3  (+/-2.9)  12.7  (+/-2.7)  1.2 (+/-.9)   1.2 (+/-1.0)  1.0 (+/-.7)    1.0  (+/-.9)      0.3 (+/-.4)    9.5 (+/-.6)

Overall market
  share, 1993 &        23.5             3.9             4.8            6.7           3.0           3.9            2.3               2.5           49.4
---------------------------------------------------------------------------------------------------------------------------------------------------------------
 * Percentages and confidence intervals are based on weighted data.
 + Adolescents who reported smoking cigarettes on 1 or more of the 30 days preceding the survey.
 & Source: reference 8; based on total estimated brand-specific cigarette sales in the United States.
 @ Confidence interval.
** Excludes the category "other" (n=11);numbers for these racial groups were too small for meaningful analysis.
++ Excludes five persons for whom ethnicity was unknown.
&& 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.
=================================================================================================================================================================

TABLE 2. Change in self-reported cigarette brand preference among adolescents aged
12-18 years * and change in overall cigarette brand market share + from 1989 to 1993
-- United States, Teenage Attitudes and Practices Survey (TAPS), 1989 and 1993
===================================================================================================
                                                                               Change in
              Adolescent brand           Adolescent brand                      adolescent
                 preference,                preference,                     brand preference,
Brand               1989         Rank           1993             Rank         1989 to 1993
---------------------------------------------------------------------------------------------
Marlboro            68.7           1            60.0               1             --8.7
Camel                8.1           3            13.3               2              +5.2
Newport              8.2           2            12.7               3              +4.5
Winston              3.2           4             1.2               4             --2.0
Kool                 1.0           7             1.2               4              +0.2
Salem                1.5           5             1.0               6             --0.5
Benson & Hedges      1.4           6             0.3               7             --1.1
---------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------

                   Overall                                                 Change in overall
                market share,             Overall market share,              market share,
Brand               1989         Rank &         1993              Rank &     1989 to 1993
---------------------------------------------------------------------------------------------
Marlboro            26.3           1            23.5                1            --2.8
Camel                3.9           6             3.9                7              0
Newport              4.7           5             4.8                5             +0.1
Winston              9.1           2             6.7                2            --2.4
Kool                 5.9           4             3.0                9            --2.9
Salem                6.2           3             3.9                7            --2.3
Benson & Hedges      3.9           6             2.5               10            --1.4
---------------------------------------------------------------------------------------------
* Data were weighted to provide national estimates. Unweighted sample size for 1989 was 865
  and for 1993 was 702.
+ From reference 8. Based on total estimated brand-specific cigarette sales in the United States.
& Rank for brands listed is based on the Maxwell Consumer Report (8). Only brands for which
  data on adolescent brand preference were available in 1989 and 1993 are listed in the table.
  Missing ranks are for generic brands.
===================================================================================================

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