Tobacco Control

 

E-cigarette Marketing: Current Research and Policy (2016)
(Funded by Cancer Research UK)

Electronic cigarettes are currently consumer products in the UK and latest estimates suggest there are more than 2.6 million current users. These products are promoted in a variety of ways through broadcast, print and digital media. Currently marketing is regulated by a framework developed by the Committee on Advertising Practice. This is due to change in May 2016 when the European Tobacco Products Directive will require the UK to introduce a range of restrictions on promotion including prohibiting many current forms of marketing.

This study built on previous work by the applicants for Cancer Research UK. It involved three elements:

  • First, it updated two previous literature reviews on e-cigarette marketing, one for CRUK (2013) and a second for Public Health England (2014).
  • Secondly, it examined the current configuration of the e-cigarette market including the role of independent manufacturers and of the tobacco industry, based on desk based research and available market data.
  • Thirdly, it involved semi-structured interviews with professionals involved in monitoring current e-cigarette marketing and in implementing the Tobacco Products Directive.

ISM Staff: Linda Bauld, Kathryn Angus and Allison Ford

External: Marisa de Andrade, University of Edinburgh

Publications:
Bauld L, Angus K, de Andrade M and Ford A (2016). Electronic Cigarette Marketing: Current Research and Policy - Executive Summary. Commissioned by Cancer Research UK. E-cig Marketing Exec Summary

Bauld L, Angus K, de Andrade M and Ford A (2016). Electronic Cigarette Marketing: Current Research and Policy - Report. Commissioned by Cancer Research UK. E-cig Marketing Report

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Retail Audit to Evaluate Standardised Packaging and its Impact in the UK (2015-2018)
(Funded by Cancer Research UK)

From May 2016, standardised packaging of cigarette packs and rolling tobacco products were implemented across all four nations of the UK. It was suggested that the implementation of standardised packaging may result in a drop on tobacco prices leading to an increase in consumption, and that there would also be an increase in the amount of counterfeit products on the market.

Based on research conducted in Australia, this study will examine:

  • Whether the price of tobacco products changes during and after the introduction of standardised packs
  • Whether new brands of lower price packs are introduced
  • Whether there is a change in “price per stick” of any brands?

 Two main methods will be used to gather data:

  • Desk based monitoring and analysis of retail marketing and prices.
  • Purchase of price data from a sample of 500 UK retailers.

ISM Staff: Martine Stead, Douglas Eadie, Anne Marie MacKintosh, Crawford Moodie, Kathryn Angus, Nathan Critchlow and Linda Bauld

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Development of Tools to Measure Norms Towards Ordinary Cigarettes and Nicotine Use (2015-2016)
(Funded by the Public Health Research Consortium, Department of Health)

The aim of the study was to develop a tool to measure norms around smoking ordinary cigarettes (including exposure to second-hand smoke exposure and the tobacco industry) in the UK. The purpose was to produce a tool that would allow the Department of Health (DH) to collect data to monitor norms towards ordinary cigarettes, essentially enabling DH to respond to increases in positive norms. DH was concerned that an increase in positive norms may increase the uptake of ordinary cigarettes, decrease cessation, and increase exposure towards second-hand tobacco smoke.

We assessed norms around nicotine use, and measured norms in both adults (18 years and above) and youth (11-17 years).

This was achieved through, desk review, question development (for the tool), cognitive interviewing and small scale pilot testing.

ISM Staff: Martine Stead and Anne Marie MacKintosh

External: Ann McNeill, King’s College London; Sara Hitchman, KCL; Debbie Collins, NatCen

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Tobacco Industry Denormalisation Survey (2014-2015)
(Funded by Cancer Research UK)

ISM provided input around shaping a public opinion survey to provide data to help inform the development of a tobacco industry denormalisation campaign. Specifically ISM provided input/feedback to the survey instrument, cleaned and analysed survey data and prepared and submitted a publication to Nicotine & Tobacco Research.

ISM Staff: Lesley Sinclair and Crawford Moodie

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Youth Tobacco Policy Survey / A Monitor of the Tobacco Advertising Ban in the UK (1999-ongoing)
(Funded by Cancer Research UK)

In February 2003, a comprehensive ban on tobacco promotion came into effect in the United Kingdom, which prohibited tobacco marketing through print and broadcast media, billboards, the Internet, direct mail, product placement, promotions, free gifts, coupons and sponsorship. This study (known as the Youth Tobacco Policy Survey), initiated in 1999, monitors young people's awareness and involvement with tobacco marketing, alongside their smoking knowledge, attitudes and behaviour before, during and after the implementation of these controls on tobacco advertising and promotion. It represents a shift away from the reliance upon econometric models to assess the impact of implementing controls on tobacco marketing. This research involves repeat cross-sectional surveys administered to adolescents in Scotland, England, Wales and Northern Ireland. Measures are taken approximately every two years and the first two surveys, conducted in 1999 and 2002 provide baseline measures, collected prior to the new regulations on tobacco advertising and promotions. Surveys have been conducted in 2004 (18 months after the first stage of the ban), 2006, 2008 and again in 2011. Key measures within the surveys include, awareness of a range of forms of tobacco marketing, awareness of cigarette brands, perceptions of prevalence of smoking, smoking behaviour and smoking intentions.

A second strand to the research is an audit of the industry's marketing activities which takes place on an ongoing basis. It aims to identify and detail any innovations or changes in tobacco industry marketing to both consumers and retailers.

CTCR Staff: Anne Marie MacKintosh, Crawford Moodie, Allison Ford, Linda Bauld, Gerard Hastings, Gayle Tait (left 2009), Louise Hassan (left 2007), Susan Anderson (left 2005) and Elinor Devlin (left 2005)

Selection of related publications

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Electronic Cigarettes: Tobacco Industry Business Plans or Strategies (2015-2016)
(Funded by Cancer Research UK)

The aim of the project was to systematically examine the business strategies being deployed in the UK e-cigarette market by both tobacco multinational and independent companies. Specifically, to compare their respective business approaches; targeting strategies; positions on harm reduction and health claims; and marketing plans.

In collaboration with: Dr Marisa De Andrade (Primary Investigator), University of Edinburgh

ISM Staff: Gerard Hastings and Kathryn Angus

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Young Adult Smokers’ Perceptions of Dissuasive Cigarettes and Pack Inserts (2015-2016)
(Funded by NHS Health Scotland)

Cigarette pack inserts are an inexpensive means of communicating with smokers, and widely used by tobacco companies, however few studies have explored how they could be used to communicate health messages. Similarly, while cigarettes are an increasingly important promotional tool for tobacco companies, the potential to use them to deter use has been overlooked until recently. This online survey explored young adult (16-34 years) smokers’ perceptions of cigarette pack inserts with positively framed messaging and standard and dissuasive cigarettes (an unattractively coloured cigarette and a cigarette displaying a health warning).

ISM Staff: Crawford Moodie and Linda Bauld

External: Rosemary Hiscock, University of Bath

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Young Adult’s Perceptions of Cigarette Design (2015-2016)
(Funded by Cancer Research UK)

With health warnings on cigarette packs increasing in size, and thus leaving less available space for displaying branding, the cigarette itself is becoming an increasingly important promotional tool. Unlike the cigarette pack however, the potential for using the cigarette to communicate health risks and deter smoking has been largely overlooked. This online survey explored young adult (16-24 years) smokers and non-smokers perceptions of standard and dissuasive cigarettes (an unattractively coloured cigarette and a cigarette displaying a health warning).

CTCR Staff: Crawford Moodie, Susan Murray and Anne Marie MacKintosh

External: Janet Hoek and Philip Gendall, University of Otago

Publication:
Moodie C, MacKintosh AM and Hastings G (2015). Adolescents’ response to pictorial warnings on the reverse panel of cigarette packs: a repeat cross-sectional study. Tobacco Control, 24: e93-97. 10.1136/tobaccocontrol-2013-050999

Moodie C (2017 Online). Adult smokers’ perceptions of cigarette pack inserts promoting cessation: A focus group study. Tobacco Control, online 4th January. doi: 10.1136/tobaccocontrol-2016-053372

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Adult Tobacco Policy Survey (2014-2018)
(Joint funded by Cancer Research UK and the British Heart Foundation)

The Adult Tobacco Policy Survey is a longitudinal web-based survey with adult smokers. It will explore the impacts of forthcoming tobacco control policies among smokers and recent ex-smokers in the UK, with a particular focus on tobacco packaging.

CTCR Staff: Crawford Moodie, Anne Marie MacKintosh and Allison Ford

External: Sara Hitchman and Ann McNeill, King's College London

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Consumer Perceptions of Tobacco Companies in the UK (2014-2015)
(Funded by Cancer Research UK)

This study involved an online cross-sectional survey with adults to explore perceptions of, and attitudes towards, tobacco companies. This included awareness of tobacco companies, views on tobacco companies’ practices (targeting the most vulnerable, encouraging smoking to replace those who quit or die, making cigarettes more addictive) and values (honesty, ethics, interest in harm reduction), perceptions of regulation of tobacco companies (whether tobacco companies have the same marketing rights as other companies, should be allowed to promote cigarettes, be required to sell cigarettes in plain packs, and pay for associated health costs), and locus of responsibility for health problems caused by tobacco use.

ISM Staff: Lesley Sinclair, Crawford Moodie and Linda Bauld

External: Emily Power, Cancer Research UK

Publications:
Moodie C, Sinclair L, MacKintosh AM, Power E and Bauld L (2016). How tobacco companies are perceived within the United Kingdom: An online panel. Nicotine & Tobacco Research, 18(8): 1766-1772. doi:10.1093/ntr/ntw024

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Local Champions and Community Snowballing: Applying Principles of Co-production in Deprived Neighbourhoods (2014)
(Funded by NHS Greater Glasgow and Clyde)

The project aimed to:

  1. Test co-produced social marketing messages on the use of illicit tobacco in deprived communities in Glasgow.
  2. Move from theory to practice by testing whether NHS Greater Glasgow and Clyde employees, systems and partners were applying asset-based approaches and co-production.

This study identified potential barriers and enablers for working in this way, and provided insights and direction for a toolkit to facilitate related service improvements.

ISM Staff: Marisa de Andrade

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UK Centre for Tobacco and Alcohol Studies (UKCTAS) (2013-2018)

The UK Centre for Tobacco and Alcohol Studies is a network of 13 universities (12 in UK, 1 in New Zealand) funded by the UK Clinical Research Collaboration, which builds on the work and success of its predecessor, the UK Centre for Tobacco Control Studies (UKCTCS). 

The UKCTAS is now a leading international centre of tobacco and alcohol research and policy excellence with an extensive research programme. We have established a cohort of early career researchers, provide a teaching programme to train and engage the wider research and policy community in tobacco and alcohol research. We facilitate policy development by informing policy makers of the latest scientific research on tobacco and alcohol use, and thus contributing to the nation's public health.

The UKCTAS aims to deliver an international research and policy development portfolio, and build capacity in tobacco and alcohol research. UKCTAS work will include developing strategies for behaviour change in tobacco and alcohol use, assessing risks, identifying measures to reduce harm, monitoring the tobacco and alcohol industries, and developing effective public policies to improve public health and wellbeing.

ISM Staff: Linda Bauld and Gerard Hastings for University of Stirling

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Innovative Packaging Measures to Communicate Health Risk/Cessation Messages to Smokers (2013-2015)
(Funded by Cancer Research UK)

Tobacco companies creatively exploit packaging to communicate with consumers, through the pack graphics, pack structure (shape, style of opening) and other pack elements such as the tear-tape, cellophane, inner foil, barcodes and also through the cigarette itself. This project explored other ways, beyond the on-pack health warnings, that packaging could potentially be used to communicate health risk and cessation messages. A number of in-depth interviews were conducted with marketing and packaging experts to inform this. The objective was to explore how smokers responded to a range of novel packaging measures (pack inserts, dissuasive cigarettes, cigarette packs with audio messages, etc).

ISM Staff: Crawford Moodie, Richard Purves, Jennifer McKell and Marisa de Andrade

Publications:
Moodie C (2016). Novel ways of using tobacco packaging to communicate health messages: Interviews with packaging and marketing experts. Addiction Research & Theory, 24: 54-61.

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Female Perceptions of Cigarette Packaging and Product Design (2013-2014)
(Funded by Cancer Research UK)

Packaging is a unique marketing tool that plays a key role in how consumers are attracted to and experience a product. Similarly, the cigarette itself is becoming an increasingly important advertising medium for tobacco companies. However, there remains a lack of research exploring the extent to which the appearance of cigarette packaging and the cigarettes themselves influence perceptions of appeal, taste and harm. We aimed to explore the perceptions of pack and product appearance among young females, aged 12-25 years, a key target group for public health.

CTCR Staff: Crawford Moodie, Allison Ford and Anne Marie MacKintosh

Publication:
Ford A, Moodie C, Purves R and MacKintosh AM (2016). Cigarette pack design: Female perceptions of superslims packaging. BMJ Open, 6: e010102.

Moodie C, Ford A, Mackintosh AM and Purves R (2014). Are all cigarettes just the same? Female’s perceptions of slim, coloured, aromatised and capsule cigarettes. Health Education Research, 30: 1-12. doi: 10.1093/her/cyu063.

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Illicit Tobacco: Using an Asset-based Approach and Co-production to Explore Tobacco Related Health Inequalities in NHS Greater Glasgow and Clyde (2013)
(Funded by NHS Greater Glasgow and Clyde)

The research aimed to deliver and record the process involved in co-producing a social marketing campaign to tackle illicit tobacco use across NHS GGC.

Objectives

  • To demonstrate innovation in methodology to achieve the research aim.
  • To retain principles of co-production as core to the process, achieving meaningful engagement with participants of workshops who expressed a desire to be involved in this process across the 3 identified communities.
  • To utilise the outcomes of previously conducted mixed methology findings (questionnaire responses, focus groups and radio workshops) to inform the development process.
  • To produce a Communications Plan providing direction for the campaign.

The project directly addressed calls by the Scottish Government to use asset-based approaches and were used as a case study for public health professionals and health boards.

ISM Staff: Marisa de Andrade

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The Policy Challenges of Tobacco Control: Implications for Public and Global Health (2013-2015)
(Funded by ESRC)

ESRC Seminar Series - ES/L001284/1.

In collaboration with: J Collin, A Amos, C Holden, J Pearce, C Rooke and K Smith.

ISM Staff: Linda Bauld, Marisa De Andrade and Gerard Hastings

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The Marketing of Electronic Cigarettes in the UK: Direct and Indirect Promotion through Traditional, Digital and Social Media (2013)
(Funded by Cancer Research UK)

This project analysed how electronic cigarettes (e-cigarettes) are being marketed in UK newspapers and magazines; retail trade press; tobacco journals; company press releases; through television clips and other traditional communication channels and sources. It also investigated marketing on online social network sites.

ISM Staff: Marisa de Andrade, Gerard Hastings, Kathryn Angus, Richard Purves and Diane Dixon

Publications:
Aveyard P, Lindson-Hawley N, Hastings G and de Andrade M (2014). Should smokers be advised to cut down as well as quit? British Medical Journal, 348: g2787. doi:10.1136/bmj.g2787

de Andrade M, Hastings G and Angus K (2013). Promotion of electronic cigarettes: Tobacco marketing reinvented? British Medical Journal, 347: f7473. doi:10.1136/bmj.f7473.

de Andrade M, Hastings G, Angus K, Purves R and Dixon D (2013). The Marketing of Electronic Cigarettes in the UK. Commissioned by Cancer Research UK. Stirling: Institute for Social Marketing, November. Report

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Tobacco Harm Reduction and Nicotine Containing Products: Research Priorities and Policy Directions (2013)
(Funded by Cancer Research UK)

This report identified issues associated with tobacco harm reduction and nicotine containing products in order to establish a comprehensive and unified research agenda for the tobacco control (TC) community. It expanded on existing research questions posed by various health bodies and TC experts; identified and presented additional research questions; outlined evidence gaps in the knowledge base; and gathered insights to address related policy and research implications.

ISM Staff: Marisa de Andrade and Gerard Hastings

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Something to Declare? Gathering Perceptions of Illicit Tobacco Through Radio (2013)
(Funded by NHS Greater Glasgow & Clyde)

This project used innovative methods to explore how illicit tobacco was viewed by deprived communities in Scotland. Unlike the usual survey or interview-based approach, the NHS Greater Glasgow & Clyde (GGC) funded study enabled participation via workshops on radio production and broadcasting skills. Whilst engaged in this training, participants were encouraged to discuss their perceptions of illicit tobacco and prepare radio programmes. Guided by an assets based approach, it empowered participants by teaching essential skills to improve employability and encourage creativity in communities. Findings were used to inform the development of a social marketing campaign across the NHS Greater Glasgow & Clyde area.

ISM Staff: Marisa de Andrade

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Determining the Impact of Smoking Point of Sale Legislation Among Youth (DISPLAY) Study (2012-2017)
(Funded by the NIHR Public Health Research Programme and carried out in collaboration with the Faculty of Health Sciences and Sport, University of Stirling; the School of Public Health Sciences and School of Geosciences, University of Edinburgh; Child and Adolescent Health Research Unit (CAHRU), University of St Andrews; and, Scottish Centre for Social Research)

This study aims to assess the impact of measures in The Tobacco and Primary Medical Services (Scotland) Act 2010 (that ban point of sale (POS) tobacco displays and advertising) on young people’s exposure to tobacco advertising, their attitudes towards smoking and ultimately their smoking behaviour. Data will be collected for five years in a number of communities selected to reflect two levels of urbanisation (urban vs. small town) and two levels of social deprivation (high vs. medium, low).

There are four main components to the study:

  1. Tobacco retailer mapping study;
  2. Tobacco retailer marketing audit of tobacco retailers (ISM Lead);
  3. Survey of secondary school children;
  4. Focus groups with secondary schoolchildren

The study will examine the relationship between changes in the prevalence and density of POS tobacco advertising and exposure to POS advertising, and the relationship between POS exposure and awareness of point of sale advertising; cigarette brand awareness; perceived ease of access to cigarettes; attempts to purchase cigarettes; perceived youth smoking prevalence; pro-tobacco attitudes and the uptake and prevalence of smoking (from the school surveys). The qualitative data will contextualise and enable interpretation of the school survey and retailers audit findings, as well as identifying any unexpected or unintended consequences associated with the legislation.

ISM Staff: Douglas Eadie, Anne Marie MacKintosh, Martine Stead, Laura Macdonald (left 2013) and Richard Purves

Publications:
Stead M, Eadie D, MacKintosh AM, Best C, Miller M, Haseen F, Pearce JR, Tisch C, Macdonald L, MacGregor A, Amos A, van der Sluijs W, Frank JW and Haw S (2016 Online). Young people’s exposure to point-of-sale tobacco products and promotions. Public Health, online 10th May. doi:10.1016/j.puhe.2016.03.032

Eadie D, Stead M, MacKintosh AM, Murray S, Best C, Pearce J, Tisch C, van der Sluijs W, Amos A, MacGregor A and Haw S (2016). Are retail outlets complying with national legislation to protect children from exposure to tobacco displays at point of sale? Results from the first compliance study in the UK. PLoS One, 11(3): e0152178. doi:10.1371/journal.pone.0152178

Best C, Haseen F, van der Sluijs W, Ozakinci G, Currie D, Eadie D, Stead M, MacKintosh AM, Pearce J, Tisch C, MacGregor A, Amos A, Frank J and Haw S (2016). Relationship between e-cigarette point of sale recall and e-cigarette use in secondary school children: a cross-sectional study. BMC Public Health, 16: 310. doi:10.1186/s12889-016-2968-2

van der Sluijs W, Haseen F, Miller M, MacGregor A, Sharp C, Amos A, Best C, Stead M, Eadie D, Pearce J, Frank J and Haw S (2016). ‘It looks like an adult sweetie shop’: point-of-sale tobacco display exposure and brand awareness in Scottish secondary school students. Nicotine & Tobacco Research, online Feb 16th. doi: 10.1093/ntr/ntw032

Best C, van der Sluijs W, Miller M, Haseen F, Eadie D, Stead M, MacKintosh AM, Pearce J, Tisch C, MacGregor A, Amos A, Miller M, Frank J and Haw S (2016).Does exposure to cigarette brands increase the likelihood of adolescent e-cigarette use? A cross-sectional study BMJ Open 2016;6:e008734. doi:10.1136/bmjopen-2015-008734

Eadie D, Stead M, MacKintosh AM, Macdonald L, Purves R, Pearce J, Tisch C, van der Sluijis W, Amos A, MacGregor A and Haw S (2015). E-cigarette marketing in UK stores: An observational audit and retailers’ views. BMJ Open, 5(9):e008547, doi: 10.1136/bmjopen-2015-008547.

Haw S, Amos A, Eadie D, Frank J, Macdonald L, MacKintosh AM, MacGregor A, Miller M, Pearce J, Sharp C, Stead M, Tisch C and van der Sluijs W (2014). Determining the impact of smoking point of sale legislation among youth (Display) study: A protocol for an evaluation of public health policy. BMC Public Health, 14(1): 251. doi:10.1186/1471-2458-14-251

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Addictions and Lifestyles in Contemporary Europe - Reframing Addictions Project (ALICE RAP) (2011-2016)
(Funded by the European Commission)

ALICE RAP aims to study and analyse the development and place of well-acknowledged and new addictions as a major societal trend in Europe in relation to governance and public policies and responses. The study involves 67 research institutions from 25 European countries covering the humanities, social sciences and biological and medical sciences. Its scientific objectives are:

  1. To describe the ownership of addictions through an historical study of addiction over the ages, an analysis of public and private stakeholder views and through image analyses, of professional and citizenship views.
  2. To study how addictions are classified and defined, followed by estimates of their health, social and economic impact.
  3. To investigate determinants of addiction through a coordinated and cohesive social, economic and biological analysis of initiation, transition into problem use and transition into and out of dependence.
  4. To analyze the business of addiction through studies of revenues, profits and participants in legal and illegal trade, the impact of suppliers on addictive substance use and behaviours, and analyses of webs of influence on policy responses.
  5. To study addictions governance by describing the views and forces that determine the ways societies steer themselves and by stock taking of present governance practices to old and emerging addictions.
  6. To analyze youth as customers through considering the impacts of new technologies on promoting and mitigating use, by studying the interrelations of culture and biology, and by determining features that promote resilience and nudge young people to reduce problematic use.

ISM is contributing specifically to Objectives 1 and 4. 

ISM Staff: Martine Stead, Kathryn Angus, Richard Purves, Gerard Hastings, Anne Marie MacKintosh and Crawford Moodie

Publications:
Stead M, Dobbie F, Angus K, Purves RI, Reith G and Macdonald L (2016). The online bingo boom in the UK: A qualitative examination of its appeal. PLoS ONE, 11(5): e0154763. doi:10.1371/journal.pone.0154763

McLeod J, Gell L, Holmes J, Allamani A, Bjerge B, Bühringer G, Forberger S, Frank V, Lingford-Hughes A, Meier P, Neumann M, Room R, Baumberg B, Eiroa-Orosa FJ, Lees R, Meerkerk G-J, Schmidt L, Stead M, van de Mheen D, and Weirs R (2016). Determinants of risky substance use and risky gambling.  Chapter 3 in:  Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press, pp35-76. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0003

Gell L, McLeod J, Holmes J, Allamani A, Baumberg B, Bjerge B, Bühringer G, Eiroa-Orosa J, Forberger S, Frank V, Lingford-Hughes A, Meerkerk G-J, Meier P, Neumann M, Room R, Schmidt L, Stead M, van de Mheen D, Weirs R, and Withington P (2016).  Determinants of harmful substance use and gambling. Chapter 4 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0004

McLeod J, Gell L, Holmes J, Allamani A, Baumberg B, Bjerge B, Bühringer G, Eiroa-Orosa FJ, Forberger S, Frank V, Lingford-Hughes A, Meerkerk GJ, Meier P, Neumann M, Room R, Schmidt L, Stead M, van de Mheen D, Wiers R and Withington P (2016). Determinants of transitions from harmful to low-risk substance use and gambling. Chapter 5 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0005

Gell L, Bühringer G, Room R, Allamani A, Eiroa-Orosa FJ, Forberger S, Holmes J, Lingford-Hughes A, McLeod J, Meier PS and Stead M (2016). Discussion and Integration of Key Findings. Chapter 6 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0006

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Young Adult Women Smokers’ Response to Using Plain Cigarette Packaging: A Naturalistic Approach (2011-2012)
(Funded by Cancer Research UK)

In the UK, smoking prevalence among women is in long-term decline but prevalence remains particularly high for young women. The high smoking rates among young women represents a significant future burden of both mortality and morbidity should this trend not be reversed. As bans on tobacco advertising, promotion and sponsorship have accentuated the importance of packaging as a marketing tool, and given that past research and tobacco industry documents suggest that women are more concerned than men about the aesthetic appeal of tobacco packaging, plain packaging may have a role to play in helping young women smokers change their smoking behaviour. This study explored young women’s experiences using plain cigarette packaging, rather than their own fully branded packaging, as they went about their everyday lives.

CTCR Staff: Crawford Moodie, Anne Marie MacKintosh and Gerard Hastings

Publications:
Moodie C, Bauld L, Ford A and MacKintosh AM (2014). Young women smokers’ response to using plain cigarette packaging: Qualitative findings from a naturalistic study. BMC Public Health, 14: 812. doi:10.1186/1471-2458-14-812.

Moodie C and Mackintosh AM (2013). Young adult women smokers’ response to using plain cigarette packaging: A naturalistic approach. BMJ Open, 3:e002402. Article

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The Packaging of Tobacco Products / Novel Ways of using Tobacco Packaging to Communicate Health Risks (2011-2012)
(Funded by Cancer Research UK)

Packaging is an important multi-functional marketing and communications tool. The report provided a summary of the marketing function of packaging for consumer goods, including tobacco products. It also outlined how packaging is perceived and used by the tobacco industry. This was done in two ways: 1) a review of research exploring tobacco industry documents in respect to tobacco packaging; and, 2) a summary of all changes to tobacco packaging mentioned in the retail press from 2009 to 2011. Focus groups were also conducted, exploring young people’s perceptions of packaging for consumer products, including tobacco packaging and also plain packaging.

Given the importance of the packaging as a communications tool, for not only tobacco companies but also governments, a second set of focus groups were conducted with young women smokers to explore novel ways of using tobacco packaging to communicate the health risks associated with smoking. These included pack inserts with health messaging, cigarettes displaying a health warning on the cigarette paper, packs with Quick Response barcodes (which when scanned with mobile phones directed them to a stop-smoking website) and packs that played audio health messages when opened.

ISM Staff: Allison Ford, Crawford Moodie, Anne Marie MacKintosh and Gerard Hastings

Publications:
Moodie C, Purves R, McKell J and de Andrade M (2015). Novel means of using cigarette packaging and cigarettes to communicate health risk and cessation messages: A qualitative study. International Journal of Mental Health and Addiction, 13: 333-344.

Moodie C, Purves R, McKell J and de Andrade M (2014). Young women smokers’ perceptions of counterfeit cigarettes: Would plain packaging make a difference? Addiction Research and Theory22: 263-270. doi:10.3109/16066359.2013.836505

Centre for Tobacco Control Research (2012). The Packaging of Tobacco Products. Stirling: Centre for Tobacco Control Research, University of Stirling.

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Plain Tobacco Packaging: A Systematic Review (2011-2012)
(Commissioned by the Department of Health)
 
This project was commissioned by the Department of Health via ISM's involvement in the Public Health Research Consortium. Colleagues from the University of Nottingham and the EPPI Centre at the University of London were also involved. The project consisted of a systematic review of all the available published evidence on standardised (or 'plain') packaging of tobacco products. The review set out to answer the following questions:

What effect, if any, does plain packaging have on:

  • the appeal of packaging or product
  • the salience and effectiveness of health warnings
  • perceptions of product strength and harm

It also set out to identify any other potential benefits, whether the effects differ between groups and what the facilitators and barriers to impact are.

The review included studies from 1980 and from over 4,000 initial citations, 37 studies met the inclusion criteria.

ISM Staff: Crawford Moodie, Martine Stead, Linda Bauld, Kathryn Angus, Gerard Hastings, Richard Purves and Stuart Bryce (left 2011).

Publications:
Stead M, Moodie C, Angus K, Bauld L, McNeill A, Thomas J, Hastings G, Hinds K, O’Mara-Eves A, Kwan I, Purves RI and Bryce SL (2013). Is consumer response to plain/standardised tobacco packaging consistent with Framework Convention on Tobacco Control guidelines? A systematic review of quantitative studies. PLoS One, 8(10): e75919. doi:10.1371/journal.pone.0075919

Moodie C, Bauld L and Stead M (2013). UK government’s delay on plain tobacco packaging: how much evidence is enough? BMJ347: f4786. doi:10.1136/bmj.f4786

Final report: Moodie C, Stead M, Bauld L, McNeill A, Angus K, Hinds K, Kwan I, Thomas J, Hastings G and O’Mara-Eves A (2012). Plain Tobacco Packaging: A Systematic Review. Available: http://phrc.lshtm.ac.uk/papers/PHRC_006_ Final_Report.pdf

Protocol: Moodie C, Hastings G, Thomas J, Stead M, Angus K and Bauld L (2011). Protocol for plain tobacco packaging: a systematic review. Available: http://phrc.lshtm.ac.uk/papers/PHRC_006_ Protocol.pdf

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Young People’s Access to, and Use of, Tobacco in Scotland (2011-2012)
(Funded by SHEFCE)

This study was funded by SHEFCE through the Scottish School of Public Health. The research explored the views of between 70 and 80 14-16 years olds in three disadvantaged areas of Scotland regarding use of and access to tobacco, with a focus on current smokers and those who had tried smoking. The interviews with young people were put in the context of tobacco supply and tobacco control efforts in these communities as perceived by professionals who were also interviewed as part of the study.

ISM Staff: Linda Bauld and Douglas Eadie

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Piloting the Use of Plain Packs in a Real Life Environment: Experiences of Young Adult Smokers (2010) 
(Funded by Cancer Research UK) 

Despite bans on tobacco advertising in many countries, the tobacco industry has shown both remarkable resilience and marketing ingenuity to continue promoting their wares, and offset the loss of prohibited marketing channels by creatively exploiting unregulated marketing channels; most notably packaging. Plain tobacco packaging, which involves removing all branding (including logos, trademarks, colours) from tobacco packs, would perform three key functions according to research in this area: (1) prevent the use of misleading colours, which consumers often equate to product safety; (2) remove the promotional appeal of the pack; and, (3) prevent health warnings being undermined. This study explored adult smokers' perceptions of packaging and plain packaging using a mixed methods approach, comprising focus groups, interviews and, for the first time, naturalistic research - that is smokers using plain cigarette packs rather than their normal branded packs in everyday settings, for a period of two weeks. 

CTCR Staff: Crawford Moodie, Anne Marie MacKintosh and Gerard Hastings 

Publications:
Moodie C, Hastings GB and Joossens L (2012). Young adult smokers’ perceptions of illicit tobacco and the possible impact of plain packaging on illicit tobacco purchasing behaviour. European Journal of Public Health, 22: 251-253.

Moodie C, Hastings GB, MacKintosh AM and Ford A (2011). Young adult smokers’ perceptions of plain packaging: A pilot naturalistic study. Tobacco Control, 20: 367-373.

Moodie C and Ford A (2011). Young adult smokers’ perceptions of cigarette pack innovation, pack colour and plain packaging. Australasian Marketing Journal, 19: 174-180.

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Prisons and Tobacco Control (inc Smoking Cessation) 
Part of DH Tobacco Control Health Inequalities Pilot Projects Programme
 (2010-2011) 
(Funded by the Department of Health)

This project aimed to develop and share knowledge and learning in relation to smoking cessation in prisons and broadening this out to other organisations across the criminal justice system that also had the potential to contribute to quitting and to generic services. It encompassed broad target groups such as offenders, families and staff within the criminal justice system. It aimed to develop functioning systems for provision of support and care pathways, in prisons, on release, across the CJS, and into the community, which resulted in enhanced engagement and quit rates. A Regional Criminal Justice System (CJS) Tobacco Control Coordinator was appointed to look toward the organisational/systems perspectives across prisons, probation services, police and courts in relation to tobacco control and stop smoking support and treatment, and full process and outcomes evaluation was conducted. This was part of an overall bid coordinated by UKCTCS covering six settings in all.

CTCR Staff: Susan MacAskill, Douglas Eadie and Jennifer McKell

Publications:
Eadie D, MacAskill S, McKell J and Baybutt M (2012). Barriers and facilitators to a criminal justice tobacco control coordinator: An innovative approach to supporting smoking cessation among offenders. Addiction, 107(Suppl2): 26-38.

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TobTaxy: Tobacco Taxation in Europe (2010-2012)
(Funded by the European Commission)

This project was funded by the European Commission and led by the European Smokefree Partnership. Stirling’s input was to conduct a process evaluation of the programme. Tobtaxy is a capacity building programme that involves developing material and delivering training about tobacco taxation as a tobacco control measure to public health, advocacy and government employees from across the EU.

ISM Staff: Linda Bauld, Susan Murray and Martine Stead

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Evaluating the North of England Illicit Tobacco Programme (2009-2011) 
(Funded by Fresh (together with North West and Yorkshire and the Humber) 

The Institute for Social Marketing (ISM) acted as an advisor to the UK Centre for Tobacco Control Studies to evaluate the development and impact of a complex community initiative, ‘The North of England Tackling Illicit Tobacco for Better Health' Programme, which aimed to reduce smoking prevalence in the North East, North West, and Yorkshire and Humber regions by reducing demand and availability of illicit tobacco (both cigarettes and loose). The 18 month evaluation employed a mixed methods approach, combining quantitative, qualitative research exercises as well as review and analysis of secondary data and materials. ISM had a specific interest in advising on the social marketing components of the programme.

CTCR Staff: Douglas Eadie 

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A Brief Review of Plain Packaging Research for Tobacco Products (2009) 
(Funded by the Public Health Research Consortium) 

The aim of this project was to produce a report which reviewed the evidence base on plain packaging, does it support a move to plain packaging, and what are the gaps in the literature and areas where research could be improved? According to the literature there are three ways in which plain packaging might be expected to deliver health benefits: (1) by making health warnings more prominent and therefore stronger; (2) by reducing the promotional power of the pack (and therefore the amount of tobacco promotion); and, (3) by preventing the use of colour to deceive consumers and potential consumers about the dangers of smoking. Although there are some areas where research could be improved, the consistency of findings from many countries point to the potential benefits of plain packaging. This document was used to help inform the Department of Health's tobacco control strategy.

CTCR Staff: Crawford Moodie, Gerard Hastings and Allison Ford

Publications:
Moodie C, Hastings G and Ford A (2009). A brief review of plain packaging research for tobacco products. Report for the Department of Health.
Available here

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Independent Retailers and the Demise of Smoking: A Scoping Study (2009) 
(Funded by the Department of Health) 

This project aimed to assess the potential for recruiting independent and local retailers to assist public health manage tobacco sales decline in the UK. The study comprised three stages: (1) a literature and market review clarifying the current state of knowledge regarding local and convenience retailing, focussing specifically on tobacco, and covering possible retail-focused solutions to aid decline and enhance health promotion; (2) interviews conducted with a range of retailers (n=14 across the UK) to understand the possibilities for change; and (3), from these two data collection exercises, ideas were developed for working with retailers via an iterative process within the project team.

CTCR Staff: Douglas Eadie, Kathryn Angus and Gerard Hastings; and Leigh Sparks from the Institute of Retail Studies, Stirling University 

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UK Centre for Tobacco Control Studies (UKCTCS) (2008-2013)

The Centre is a strategic partnership of nine UK universities in England and Scotland (Nottingham, Bath, Birmingham, Edinburgh, Stirling, Queen Mary, UCL, York and Bristol) involving leading tobacco control researchers from a range of disciplines.

Each institution will work together to deliver a programme of original research, policy development, advocacy, teaching and training.

UKCTCS is part of a £20 million investment into public health research, funded by the UK Clinical Research Collaboration (UKCRC) comprising the Economic & Social Research Council, The British Heart Foundation, Cancer Research UK, the National Institute for Health Research and the Medical Research Council.

CTCR Staff: Gerard Hastings and Abraham Brown (left 2012)

Publications:
Ford A, Moodie C and Hastings GB (2012). The role of packaging for consumer products: Understanding the move towards ‘plain’ tobacco packaging. Addiction Research and Theory, 20: 339-347.

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Review ‘Forever Cool: The Influence of Smoking Imagery on Young People' (2007-2008) 
(Funded by the British Medical Association Board of Science)

This report considers the effect of smoking imagery on young people (under 25 years) in the UK. It begins by examining trends in smoking prevalence and initiation, goes on to review the different forms of pro-smoking imagery and the evidence for how they can affect behaviours and attitudes among young people. It concludes by exploring effective ways of reducing young people's exposure to positive images of smoking – and increasing their exposure to positive images of health. A number of recommendations for reducing the influence of pro-smoking imagery on young people are given.

CTCR Staff: Gerard Hastings and Kathryn Angus

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Qualitative Study of Changes in Smoking (and Drinking) Behaviour following Implementation of the Prohibition of Smoking in Enclosed Public Places (2005 - 2008) 
(Funded by NHS Health Scotland / Scottish Executive)

Following the introduction of smoke-free legislation in Scotland in March 2005, researchers at the Institute for Social Marketing were commissioned by the Scottish Executive, under the direction of NHS Health Scotland, to undertake a community level study examining the impact of the legislation on smoking and drinking behaviour in bars and in the home. The study, the first of its kind, employed a pre- post design, combining in-depth qualitative interviewing and covert observation techniques. The study was in collaboration with the University of Strathclyde. The results were reported in Autumn 2007 as part of the NHS Health Scotland CLEAN Collaboration, a consortium of research projects examining different a range of outcomes, including economic, behavioural and cultural impacts of the ban in Scotland.

CTCR Staff: Douglas Eadie

Publications: 
Eadie DR, MacAskill SG, Heim D and Hastings GB (2010). Responding to change:  How did bar workers adapt to the smoke-free legislation in Scotland? International Journal of Environmental Health Research, 20(1): 13-26.

Heim D, Ross A, Eadie D, MacAskill S, Davies JB, Hastings G and Haw S (2009). Public health or social impacts? A qualitative analysis of attitudes towards the smoke-free legislation in Scotland. Nicotine & Tobacco Research, 11(12): 1424-1430.

Eadie D, Heim D, MacAskill S, Ross A, Hastings G and Davies J (2008). A qualitative analysis of compliance with smoke-free legislation in community bars in Scotland: Implications for public health. Addiction, 103(6): 1019-1026. Article

Petticrew M, Semple S, Hilton S, Creely KS, Eadie D, Ritchie D, Ferrel C, Christopher Y and Hurley F (2007). Covert observation in practice: Lessons from the evaluation of the prohibition of smoking in public places in Scotland. BMC Public Health, 7: 204.

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Tobacco or Health in the European Union: Past, Present and Future - The ASPECT Consortium Report (2004)
(Funded by the European Commission, Directorate-General for Health and Consumer Protection)

Enormous progress has been made in European tobacco control over the last 20 years: pack warnings; the curtailment of tobacco advertising; restrictions on smoking in public places; rising prices; smuggling is being addressed; and initial attempts have been made to tackle harm minimisation. Yet well over half a million Europeans are still being killed every year by tobacco and smoking remains by far the biggest threat to our public health. The ASPECT (Analysis of the Science and Policy for European Control of Tobacco) Consortium's report drew together analysis of tobacco control policy in the European Union from the past 20 years, the present and provided a set of recommendations to feed into and inform policy discussions to define a European tobacco-control strategy for the future.

As part of the Consortium's Expert Committee, we co-ordinated Chapter 6 "The Influence of the Tobacco Industry on European Tobacco-Control Policy" which demonstrated the lengths to which the tobacco industry had gone to undermine and influence policy making at all levels, and the considerable success it had achieved over the last couple of decades. Presented as the tobacco industry's 'stakeholder marketing plan', the evidence was collected from industry documents, with input from a network of European and International tobacco control experts, and the findings of a number of expert workshops and international conferences.

CTCR Staff: Gerard Hastings and Kathryn Angus

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TobaccoPapers.com - Online Database and series of Marketing Case Studies based on UK Tobacco Industry Advertising Agency Documents
(Funded by NHS Health Scotland (formerly Health Education Board for Scotland)) 

In 1999, the House of Commons Health Select Committee acquired access to internal documents of the main advertising agencies of the UK tobacco industry as part of its investigation into the conduct of the tobacco industry. Previously only accessible to the public through the House of Commons library, this fully searchable database is now available to a global audience. Launched in December 2003 the site has attracted a huge amount of interest with over 350,000 hits and 8,500 downloads in its first week.

The resource provides some fascinating insights into the strategies used by the UK tobacco industry. A series of marketing Case Studies examining issues such as tobacco sponsorship and tobacco marketing and young people have been developed using relevant search terms. Each Case Study contains many extracts from the internal documents demonstrating how the UK tobacco industry and their advertising agencies market their products.

CTCR Staff: Douglas Eadie, Elinor Devlin (left 2005) and Kathryn Angus

Publications:
Devlin E, Hastings GB, Eadie DR, Angus, K and Stead M (2004). Smoking prevention: where social and critical marketing meet. Presentation to the Academy of Marketing conference, Cheltenham, UK 7-9th July.

URL: http://www.tobaccopapers.com

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International Tobacco Control Policy Survey (ITC) (2002-ongoing)
(Grants awarded from Roswell Park Cancer Institute (NY), Canadian Institute for Health Research, National Institutes of Health (USA), Health Research Inc (HRI) and Cancer Research UK)

The Framework Convention on Tobacco Control is a public health landmark: it sets down for the first time agreed international standards for protecting public health. ITCPS has been established to ensure that it is backed by a rigorous evidence base. It will greatly enhance our understanding of the impact and mechanisms of national level policy interventions such as advertising bans or public places smoking controls. The study uses a prospective cohort design, and a random sample of 8,000 smokers were recruited in four countries (UK, Canada, Australia, USA). This has provided vital feedback on such tobacco control policies as: (a) the introduction of graphic tobacco package warning labels; (b) the elimination of "light" or "mild" as descriptors of cigarette brands; (c) the elimination of advertising and promotion of tobacco products.

The project was also expanded to cover Ireland, which introduced comprehensive controls on smoking in public places, and Thailand. Other countries around the world are considering joining the study.

The research team includes internationally recognized experts in tobacco control in each of the four countries that are working together to design and conduct this international tobacco control policy survey. The CTCR and Dr Ann McNeill form the UK arm of the project.

CTCR Staff: Gerard Hastings, Anne Marie MacKintosh, Abraham Brown (left 2012), Susan Anderson (left 2005), and Elinor Devlin (left 2005)

Publications:
List of Publications 2006-2012
Tobacco Control Supplement 2007 

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Labelling of Tobacco Products in Europe (2001-2002) 
(Commissioned by the European Commission)

Cigarette on-pack messages are one of the principal vehicles for informing smokers about the risks of smoking and research has highlighted their role as a valid health communication tool. Furthermore, they have the potential to disrupt the powerful cigarette brand imagery associated with tobacco packaging. Responding to concerns within Europe that the old style on-pack messages were ineffective and the introduction of new tobacco product legislation across Europe (EU Directive 2001/37/EC), this study was conducted to explore European smokers' response to the changes. The research drew upon two main areas of health communication: the need to pre-test messages to ensure they are appropriate for their intended audience; and the increased effectiveness of targeting messages to specific segments of the population. Two main research areas were addressed. First, the extent to which the new messages were appropriate for smokers in Europe and second, the potential to provide targeted and personally relevant messages to smokers via tobacco packs.

Fifty-six focus groups were conducted across 7 European countries (Finland, France, Germany, Greece, Spain, Sweden and the UK) with 16-64 year old smokers, half of whom were not thinking about quitting (pre-contemplators) and half of whom were thinking of quitting in the next six months (contemplators and preparers).

The research confirmed that the EU labelling format for tobacco packs, introduced in the EU Directive 2001/37/EC, was more noticeable than the one it replaced and had the potential to help smokers who wished to quit. It was also clear that the novelty of the new format had an impact.

CTCR Staff: Susan Anderson (left 2005), Elinor Devlin (left 2005), Gerard Hastings and Lynn MacFadyen

Publications:
Devlin E, Hastings G, Eadie D and Anderson S (2002). Research into the labelling of tobacco products in Europe. Proceeding of the 3rd European Conference on Tobacco or Health, Warsaw, June.

Devlin E, Anderson S, Hastings GB, Rautalahti M, Ratte S, Beck V, Kordiolis N, Marin-Tuya D, Tomson T (2003). Targeting on-pack messages: European smokers' response. Proceedings of the 12th World Conference on Tobacco or Health, Helsinki, August.

Devlin E, Anderson S, Hastings GB and MacFadyen L (2005). Targeting smokers via tobacco product labelling: Opportunities and challenges for Pan European health promotion. Health Promotion International20(1): 41-49. 

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Developing Improved Cigarette Warning Labels for Young People (2000)
(Funded by Cancer Research UK) 

This research was conducted to examine young smokers' engagement with cigarette packaging and responses to current UK cigarette warnings labels, and to identify potential improvements in the content and design of labels. The manner in which young people engaged with health warnings, the effects of this on smoking attitudes, behaviour and brand image were also explored.

Sixteen mini-focus groups were conducted with young people aged 12-17 years. The groups were purposively sampled according to: gender, socio-economic group and smoking experience. The research was conducted in two stages. The first stage examined young people's responses to packaging concepts in general and explored how they engaged with packaging and used on-pack information. Their responses to cigarette warnings labels were examined in this context. The second stage examined their responses to cigarette warnings labels in more detail, and their response to potential improvements in content and design explored.

The research found that current health warnings are not very visible, credible or influential. Furthermore, that they lack novelty and sympathy with young people's needs. However, young people do notice health warnings and have genuine concerns for the health consequences of smoking. Health warnings, when improved, can be more visible, credible and effective and encourage greater processing of the health risks, particularly when pictorial warnings are included.

CTCR Staff: Lynn MacFadyen, Anne Marie Mackintosh, Elinor Devlin (left 2005) and Gerard Hastings

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Tobacco Control on Public Transport (2000)
(Commissioned by Argyll and Clyde Health Board)

Research was conducted to inform the development of a local initiative to reduce exposure to environmental tobacco smoke on public transport. Research was conducted with the management and drivers of local bus companies (primary mode of transport in the study area). An initiative was launched in May 2000 to raise public awareness and to support local companies in responding to ETS issues.

CTCR Staff: Lynn MacFadyen and Douglas Eadie

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"Keep Smiling, No-one's Going to Die": A Review of Internal Documents from UK Tobacco Advertisers (1999-2000) 

In 1999, the House of Commons Health Select Committee required disclosure of internal documents from the UK tobacco industry's main advertising agencies as part of their investigation into tobacco. The documents are unique because they come from ad agencies rather than the tobacco companies themselves, as is the norm with disclosed tobacco documents. They are particularly revealing because the ad agencies are not nearly so circumspect as their tobacco clients.

As special advisor to the Committee, Gerard Hastings was asked to review and report back on their contents. The results of this analysis are damning (BMJ 2000; Vol 321:366-371). They show that tobacco advertising is deliberately used to increase consumption as well as brand share, and that marketing - advertising combined with new product development, pricing and distribution - has a powerful effect on young people. Shockingly the documents also reveal calculated attempts to exploit the smuggled tobacco market and down play the health consequences of smoking. However, perhaps the most chilling aspect of the documents is their gung ho, flippant tone that raises not the slightest qualm about the consequences of their actions. "Keep Smiling, No-one's Going to Die" was how one creative director signed off his letter to a tobacco client; it also the title of the report we produced on these shameful documents:

http://www.tobaccopapers.com/keepsmiling/KeepSmilingReport.pdf

CTCR Staff: Douglas Eadie, Elinor Devlin (left 2005) and Kathryn Angus

Publications:
Hastings GB and MacFadyen L (2000). A day in the life of an advertising man: Review of internal documents from the UK tobacco industry's principal advertising agencies. British Medical Journal321(5 August): 366-371. Article 

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Tobacco Marketing and Young People (1998-1999)
(Funded by Cancer Research UK)

The tobacco industry uses a range of communications and promotional techniques to reach its key target groups with relevant and credible messages about smoking. Enduring brand images are a result of a carefully balanced mix of advertising, couponing, sampling, brand-stretching, packaging, point-of-sale communications, product placement and the internet. Research was conducted between January 1998 and December 1999 to investigate the impact of tobacco related marketing communications on young smokers in the UK. Observational, qualitative and quantitative methodologies were used.

CTCR Staff: Lynn MacFadyen, Gerard Hastings and Anne Marie MacKintosh

Related publication:
MacFadyen L, Hastings GB and MacKintosh AM (2001). Cross sectional study of young people's awareness of and involvement with tobacco marketing. British Medical Journal322(3 March): 513-517. Article

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