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August 2007, Vol 97, No. 8 | American Journal of Public Health 1357-1367
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2006.094128

GOVERNMENT, POLITICS, AND LAW

Attempts to Undermine Tobacco Control: Tobacco Industry "Youth Smoking Prevention" Programs to Undermine Meaningful Tobacco Control in Latin America

Ernesto M. Sebrié, MD, MPH and Stanton A. Glantz, PhD

The authors are with the Center for Tobacco Control Research and Education, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Stanton A. Glantz, PhD, Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390 (e-mail: glantz{at}medicine.ucsf.edu).


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 SOURCES OF INFORMATION
 FINDINGS
 COMMENTS
 References
 

We sought to understand how the tobacco industry uses "youth smoking prevention" programs in Latin America. We analyzed tobacco industry documents, so-called "social reports," media reports, and material provided by Latin American public health advocates.

Since the early 1990s, multinational tobacco companies have promoted "youth smoking prevention" programs as part of their "Corporate Social Responsibility" campaigns. The companies also partnered with third-party allies in Latin America, most notably nonprofit educational organizations and education and health ministries.

Even though there is no evidence that these programs reduce smoking among youths, they have met the industry’s goal of portraying the companies as concerned corporate citizens and undermining effective tobacco control interventions that are required by the World Health Organization Framework Convention on Tobacco Control.


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
SOURCES OF INFORMATION
 FINDINGS
 COMMENTS
 References
 
CIGARETTE ADVERTISING AND sponsorship that target young people are highly prevalent in Latin America. The Global Youth Tobacco Survey revealed that youths’ exposure to cigarette ads on billboards was high (e.g., 95.5% in Uruguay, 92.7% in Mexico, 91.9% in Costa Rica, and 90.1% in Argentina), as was their exposure to ads in newspapers and magazines and at sporting and other events.1 At the same time, smoking rates among South American youths are high: among 13- to 15-year-olds, 30-day smoking prevalence (i.e., percentage of a population smoking at least 1 cigarette in the past 30 days) was 39.6% in Coquimbo, Chile, in 2000; 26.5% in Monte-video, Uruguay, in 2001; and 25.3% in Buenos Aires, Argentina, in 2000.1 (Smoking prevalence among Venezuelan youths, which was 7.4% in 1999, was the lowest in Latin America.1)

Except for Brazil and Uruguay, tobacco control legislation in Latin America is weak and restricted in scope.2–5 As of May 2007, 12 Latin American countries (Bolivia, Brazil, Chile, Ecuador, Guatemala, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela) had ratified the World Health Organization’s Framework Convention on Tobacco Control, the first health treaty with binding obligations to implement national tobacco control legislation among the parties. Despite widespread support for the treaty in Latin America, there are likely to be numerous obvious and subtle challenges to full implementation of its provisions.

The Latin American cigarette market is almost entirely controlled by British American Tobacco (BAT, 60%) and Philip Morris International (PMI, 40%).4 In addition, RJ Reynolds Tobacco (RJR) has a market presence in Puerto Rico, and RJR International had licensing agreements with BAT to market Camel cigarettes until 1999, when RJR International was bought by Japan Tobacco to form Japan Tobacco International (JTI). Beginning in the United States in the early 1980s, the tobacco industry has promoted 4 types of "youth smoking prevention" programs to avoid effective tobacco control policies6: programs directed at parents (e.g., the Tobacco Institute’s "Helping Youth Decide," 1984), youths (e.g., RJR’s "Right Decisions, Right Now," 1991), and retailers (e.g., Philip Morris USA’s "Action Against Access," 1995) and programs providing funding to youth organizations (e.g., 4-H’s "Health Rocks").

During the 1980s and 1990s, the industry spread these programs to the United Kingdom, Canada, Japan,6 Australia,7 Malaysia,8 Singapore,9 Eastern Europe,6 Bangladesh,10 and Argentina.5 PMI, BAT, RJR, and JTI have promoted similar "youth smoking prevention" programs throughout Latin America since the early 1990s. We extend previous research conducted in Latin America2,6 to detail the different types of industry youth prevention programs, their continuing evolution, and how these programs help the tobacco industry to undermine the effective implementation of the Framework Convention on Tobacco Control.


   SOURCES OF INFORMATION
TOP
 ABSTRACT
 INTRODUCTION
 SOURCES OF INFORMATION
FINDINGS
 COMMENTS
 References
 
Between February 2005 and May 2006, we searched previously secret tobacco industry internal documents in the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) and the British American Tobacco Documents Archive (http://bat.library.ucsf.edu), using the keywords "youth," "youth smoking prevention," "YSP," "prevention," "access," "youth programs," "youth initiatives," "under-age smoking," "juvenile smoking," and "Latin America." We also used the names of specific countries, specific dates, names of youth programs, names of local educational nongovernmental organizations, and reference (Bates) numbers. After identifying the first documents or words, we used a snowball strategy to locate new documents. A total of 140 documents were found to be relevant for this study.

We also reviewed other Internet-based information resources, regional newspapers and magazines, material collected from Latin American tobacco control advocates, and the so-called "social reports," which provide descriptions of the activities developed by the companies to achieve different objectives, and the stakeholders involved in the process, published by BAT’s Latin America affiliates (available on the BAT Web site: http://www.bat.com/global), which are part of its corporate social responsibility campaign.


   FINDINGS
TOP
 ABSTRACT
 INTRODUCTION
 SOURCES OF INFORMATION
 FINDINGS
COMMENTS
 References
 
Ecuador Takes the Initiative (1990–1991)
Ecuador was the first Latin American country in which the transnational tobacco companies launched a campaign to "discourage juvenile smoking."11 A 1989 monthly report by PMI’s affiliate Tanasa (Tabacalera Andina) described the development of a television advertisement in response to actions taken by the Ministry of Health to control tobacco:

This commercial will be aired on the major news programs in the key TV stations, during the month of January [1990], since the Ministry of Health constantly attacks the industry by stating that 50% to 60% of children under 18 years of age smoke. By airing this commercial with a low level support, but well focused [we] expect to create goodwill for the industry [emphasis added].12

By the following year, another PMI affiliate, Proesa (Proveedora Ecuatoriana), had partnered with the Ecuadorian Ministry of Education to air a 40-second television advertisement called "Fumar Es una Decisión de Adultos" ("Smoking Is an Adult Decision"). The ad featured a young actor that "had a popular television program for children which, according to Proesa, contributed to the understanding of its message."11 It sought to "let children know that smoking is an adult practice and to show government, media and opinion leaders that Proesa is a responsible company [emphasis added]," capitalizing on the fact that "the endorsement of the Ministry of Education adds to its credibility."13 The ad was broadcast at strategic times, such as "at the opening of the school term (twice a year for two weeks), during national holidays and congressional sessions [emphasis added]."11 According to Proesa, the campaign was "highly positive" for the tobacco industry because opinion leaders said that it "provides a community service in inviting young people to make responsible decisions."11

By 1991, Proesa developed a comprehensive campaign for radio and newspaper advertisements, and also a booklet aimed at parents.11,14,15 We could not determine if this campaign was implemented.

Spreading the Youth Campaign (1992–1994)
Increasing pressure from tobacco control activists in Latin America prompted Philip Morris Latin America (PMLA, part of PMI) to launch a regional corporate social responsibility campaign to "discourage juvenile smoking."16 In September 1993, PMI’s director of corporate affairs, Latin America Region, Cathy Leiber, sent a memorandum to PMI Executive Vice President David Dangoor requesting approval for the final production and distribution of a commercial campaign in Latin America:

Increasing pressure from anti-tobacco forces in Latin America has created the need to explore various options to counter negative publicity. One theme that has recently surfaced in several markets is that multinational companies target children in ad campaigns.

Today, several markets [local subsidiaries], especially Puerto Rico, Venezuela and Uruguay, are pressing us for a public service campaign in an effort to demonstrate corporate responsibility [emphasis added].16

Leiber went on to describe the rationale and the strategy of the youth campaign for Latin America:

Rationale

Taking into consideration the emerging adverse legislative climate in the region, we have an opportunity to create good will for the tobacco industry by going public with a campaign to discourage juvenile smoking.

Our objective is to communicate that the tobacco industry is not interested in having young people smoke and to position the industry as "a concerned corporate citizen" in an effort to ward off further attacks by the anti-tobacco movement.

Our goal is to have the commercial "in the can" and available for use, as market conditions warrant.

Strategy

To convince the target group (young people aged up to 18 years and their parents), that smoking is not appropriate for young people. The focus is on increasing parental awareness on the subject of youth smoking and promoting open discussion with their children.16

The commercial was produced by the Leo Burnett Puerto Rico adverting agency, which used animated characters (matches) to represent a family having a conversation about adult issues such as smoking. The text read, "Help your kids make the right choices. Smoking is an adult decision."16 The commercial was complemented by 2 print advertisements and a brochure telling parents how to talk to their kids.17 The US $85 000 cost was split between PMI (US $50 000) and PMLA (US $35 000).18 Reflecting its success in Ecuador, PMLA strongly recommended seeking the endorsement of the minister of health or other governmental authority in all markets.16 In December 1993, the commercial, "Smoking Is an Adult Decision," was tested on focus groups. After final approval, PMLA proceeded with production and sought BAT’s cosponsorship to share the costs.19 We were unable to determine whether BAT served as cosponsor.

In December 1993, Leo Burnett Puerto Rico sent a qualitative research proposal to PMLA to evaluate its youth campaign in Argentina, Brazil, and Puerto Rico.20,21 The objectives of the research were as follows:

  • To obtain positive and negative reactions of the execution.
  • Evaluate likes and dislikes.
  • Determine the main message being communicated.
  • Gain insight as to the image this execution communicates for the Tobacco Industry [emphasis added].21

In May 1994, PMLA Corporate Affairs wrote the "‘Matches’ Copy Research"22 report, which described the results of 20 in-depth interviews in Argentina, Brazil, Costa Rica, and Puerto Rico of smoking and nonsmoking parents of adolescents to evaluate perceptions and opinions about the commercial "Smoking Is an Adult Decision." According to the PMLA report, the main message was "viewed positively as a responsible action by the sponsor."22

At the same time, research conducted by PMLA reported that describing smoking as an "adult behavior" could promote smoking because "if ‘smoking is an adult behavior’ and adolescents want to be adults, adolescents may want to smoke.22

Puerto Rico Leads the Market (1994–1995)
As previously reported,2 in March 1994, Philip Morris and RJR launched the "Es la Ley" ("It’s the Law") campaign in Puerto Rico to support the recently passed minimum purchase age18 law. The campaign supplied retail outlets with materials—displays and stickers—promoting the minimum age for smoking. The Puerto Rican treasury and education departments required that these materials be provided "to establishments close to schools, as a part of their community school program called ‘Free of Drugs and Crime School Zones.’"23 In addition, Philip Morris Puerto Rico printed a booklet, based on Philip Morris USA free-sampling guidelines, on how to distribute free samples of cigarettes.23 In August 1995, RJR and Philip Morris launched "Aprende a Decidir por ti Mismo," ("Learn to Decide for Yourself") an equivalent of Philip Morris USA’s school-based education program "Right Decisions—Right Now," with endorsements by the Puerto Rican Department of Education and the Junior Chamber of Commerce of Puerto Rico. The program was nominally "designed to teach children how to resist peer pressure on a variety of lifestyles"23; materials were sent to key government officials and trade organizations.23

Youth Initiatives (1995)
From April 18 to 21, 1995, Leiber participated in a session on "youth initiatives" at a PMLA Corporate Affairs workshop in Washington, DC. The participants identified a set of required elements for any youth program:

  • Need for a [voluntary industry] Marketing Code.
  • Self-regulation as the basis for law and enforcement. "Be ahead of the government."
  • Commitment of PM to an initiative and willingness to do it alone; if the industry is not interested.
  • Aggressively communicate to appropriate audiences what is being done.
  • Gain government endorsement/ involvement.
  • Use allies (i.e., retailers).24

Leiber reported that the objective was to "maintain and proactively protect our ability to advertise, promote and market our products via a juvenile initiative [emphasis in original]."24 PMI’s employees, the government, opinion leaders, retailers, and the general public—not children—were identified as critical audiences. Leiber summarized the session as follows:

Finally, the ultimate challenge to maintaining and proactively protecting our ability to advertise, promote and market our products rests with our ability to seek enforcement of laws which deny youth access to tobacco produces. While enforcement technically is not our job, we realize that if we are unable to develop a system for enforcement, we will continue to be subjected to the threats of the anti-tobacco movement and the restrictive legislation which results [emphasis added].24

On May 18, 1995, Leiber distributed a memo to PMLA subsidiaries announcing the creation of a mini task force to deal with the youth initiatives. Local subsidiaries would choose between 2 programs according to their needs and priorities: the Philip Morris marketing code (a set of guidelines for the company’s voluntary self-regulation of advertising) or the prohibition of the sales of cigarettes to minors.25 According to Leiber, "the first building block to a successful, fully integrated program is an ‘It’s the Law’ [retailer] Program. This is fundamental to our long term strategy for stopping the proliferation of anti-tobacco legislation [emphasis added]."25 PMLA affiliates were expected to develop a plan of action on youth initiatives for the rest of 1995 and 1996.

The 5-Point "Youth Smoking Prevention" Programs (1997–2000)
Anticipating new regulations on tobacco marketing activities outside the United States, Geoffrey C. Bible, the chairman of the board and chief executive officer of Philip Morris, the parent company, asked PMLA, as well as other regional officials of PMI, to prepare a report describing what had been done on the issue of preventing youths’ access to tobacco.26 He probably was concerned about discussions over the national litigation settlement then being conducted in the US Congress and the White House,27 which were "touching on international implications."26

All PMI regions were requested to demonstrate they had "credible [youth smoking prevention] programs in place, and that [they] work cooperatively with governments on the issue."26 In response, in August 1997, Leiber prepared for Bible the "Latin America Report: Youth Access Prevention and Education Programs."26 The report summarized the actions taken to support 5-point "youth smoking prevention programs," the points being (1) local cigarette marketing codes, (2) sampling guidelines, (3) minimum age of purchase laws and voluntary underage labels, (4) retailer programs, and (5) education programs.28–30

These programs aimed to protect PMI’s marketing activities by anticipating and deflecting any regulations in the Latin American region. Leiber emphasized the importance of getting public officials in each country to support the programs: "In order to continue to protect our ability to market and advertise to adults, we must be pre-emptive, proactive, communicative and cooperative with government officials."26 As a public relations tactic to achieve this support, Leiber said, PMLA representatives "regularly meet with presidents, first ladies, prime ministers, ministers of education, ministers of health and presidents of congressional commissions to seek their support, endorsement and, . . . their co-sponsorship."28

In October 1998, PMLA released a second annual report highlighting the activities taken to support "youth access prevention and education initiatives."31 According to Leiber, the report "will be used by our affiliates in their meetings with government officials and regional media to demonstrate our leadership on the youth access prevention issue."31 Earlier the same year, the guidelines that nominally restricted giving away free samples of cigarettes to children were incorporated into the cigarette marketing codes. In addition, voluntary "underage labels" (warning that the sale of cigarettes to minors was forbidden) printed on cigarette packages were adopted to support the minimum age of purchase laws.31 PMLA also sought the support of local third parties and BAT to implement its program.31

The 5-point programs developed for the Latin American region had some specific characteristics in each country, and not all of the countries adopted all 5 programs.

Cigarette marketing codes. Tobacco industry codes for the voluntary self-regulation of advertising have been established worldwide since the 1970s, nominally to "restrict" tobacco advertising, sponsorship, and sampling aimed at minors.32–36 Using the 1993 PMI Marketing Code as a model, the company’s Latin American subsidiaries issued codes that promised to "market their cigarettes responsibly and only to adults"30,37 to prevent the approval of effective governmental tobacco control regulations. Generally, the codes were endorsed by the local national manufacturer’s association, the local advertising agency association, the International Advertising Association, and the media trade association,37 and were signed by PMI and BAT.30 In 1996, Philip Morris Paraguay was to launch the code at a meeting; the company invited the president of Paraguay, government ministers, and the media because "It’s a good moment to show everybody that we [Philip Morris Paraguay] act with responsibility."38 We were not able to determine if the invited guests were actually present at the launch of the code.

Sampling guidelines. A set of instructions regarding the distribution of free samples in accordance with the industry’s voluntary marketing code, which states that "no sample products shall be offered to minors,"30 were developed to "indicate how to verify age, explain the role of the sampler, and list local restrictions to which samplers must adhere."30

Minimum age of purchase laws and voluntary underage labels. In April 1997, to support the implementation of minimum age of purchase laws in Latin America, PMLA drafted model legislation that "prohibits the sale of cigarettes to minors, requires the retailer to check for identification and provides penalties for non-compliance" (to be determined by the government of each country).30

In Ecuador in 1997, local Philip Morris management proposed the law to the minister of health, who approved it and forwarded it to President Fabián Alarcón, who, after signing it, stated, "This is a clear example of cooperation and goodwill between the private sector and the government to reach a common goal."30 In Paraguay in August 1998, after intense lobbying efforts by local Philip Morris representatives, President Raúl Cubas Grau and the minister of health signed an amendment of Presidential Decree 8314 of 1995, to prohibit the sale of cigarettes to minors under 18 years of age.39 In Guatemala, after an active push by local Philip Morris representatives, the minister of health agreed to include the Philip Morris–drafted law in the new health code, which was approved by Congress in October 1997. Philip Morris’s affiliate in Guatemala received a diploma from the president of the Congress of Guatemala "in recognition of its valuable participation in the development of the new health code."39

In Venezuela between 1992 and 1997, the industry had meetings with congressmen, including the president of the Lower House, to support Philip Morris’s proposals.30 In early 1998, PMI "successfully lobbied to have a minimum age provision included in the Bill for the Protection of Minors and Adolescents,"39 which was approved by the Congress in September of that year. In Peru, a minimum age law was discussed with the minister of agriculture, and the law was approved in May 1998.39 In 1998, Philip Morris representatives presented model legislation to the president of the Congress of El Salvador and then worked with the minister of health to get approval.39 By 2000, almost all countries (except for Bolivia and Chile) of the region had passed minimum age of purchase laws.40

As Philip Morris USA had done since 1995, in early 1998, PMLA started to voluntarily place underage labels on cigarette packages. Depending on the legal status in each country, 3 different legends were established: "Venta Prohibida a Menores" ("Sale Prohibited to Minors") for countries with minimum age of purchase laws, "Sólo para Adultos" ("Only for Adults") for those without federal laws or with a minimum age law that fell below 18 years (such as Colombia), and "Underage Sale Prohibited" for Puerto Rico and for standard export products.39

Retailer programs. A fourth component was the launching of retailer programs, "retail signage campaigns for the point-of-sale to discourage youth access."28 As mentioned earlier, in 1994, Puerto Rico was the first country in Latin America in which the tobacco companies launched a retailer program ("It’s the Law"). The industry rapidly spread similar programs throughout the region, often with the cooperation of the government and other elements of the business sector. Retailer programs were endorsed by ministries of health (Table 1Go; e.g., in Costa Rica, Ecuador, and Guatemala), the Office for the Protection of Children and Adolescents (Dominican Republic), the Congressional Committee of Health and Press (Paraguay), and the Office of the First Lady (Panama).


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  		TABLE 1—— Tobacco Industry Retailer Programs in Latin America, 1994–2005
 
These retailer programs are the Latin American equivalents of the US "We Card"42 program (begun in 1995) developed by the tobacco industry’s Coalition for Responsible Tobacco Retailing.43 Sponsored by Philip Morris, Brown & Williamson, Lorillard, and RJR, the "We Card" program provides retailers with signs, stickers, and other print materials with the message "Under 18 No Tobacco: We Card."43 The program was later adapted into the Spanish-language program "A Menores de 18, Tabaco No: Identifícate" for the US Hispanic population.44,45 The Latin American signs, which are placed at points of purchase, are similar to the US signs. Neither the US nor the Latin American programs are accompanied by any enforcement mechanism or sanctions for violations.

Education programs. The fifth and final point of the PMLA’s "youth smoking prevention" strategy was the development of education programs. As with the "It’s the Law" retailer program, in 1995, RJR and Philip Morris Puerto Rico first launched the education program "Aprende a Decidir por ti Mismo" ("Learn to Decide for Yourself") in Puerto Rico30 (the equivalent of the US "Right Decisions—Right Now" program). In 1996, PMI developed in Latin America a school-based educational program called "Yo Tengo P.O.D.E.R. (Propósito, Orgullo, Determinación, Entusiasmo, Responsabilidad)" ("I Have Power: Purpose, Pride, Determination, Enthusiasm, Responsibility"), a "broad-based youth education program intended for educators to help children handle peer pressure on a variety of lifestyle decisions and/or customary adult practices."46

These programs failed to address issues like tobacco-related diseases, environmental tobacco smoke, or addiction and nicotine. By 2000, most Latin American countries had launched similar educational programs (Table 2Go) with the active cooperation of many governments. According to a PMLA report, "Youth Smoking Prevention 1999–2000," the program was "developed by ‘Lifetime Learning Systems,’ an American company specialized in educational materials, [it] was created for use with students ages 10 to 15, and [it] is designed as a supplement to their social studies, health or social skills curriculum."40


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  		TABLE 2—— Tobacco Industry Youth Education Programs in Latin America, 1995–2005
 
"Yo Tengo P.O.D.E.R." was first launched in Paraguay in July 1996, cosponsored by the Ministry of Education and Centro de Regulación, Normas y Estudios de la Comunicación (CERNECO, the national media association)30; the program had the full support of the president of Paraguay, Juan Carlos Wasmosy, who stated in the press conference announcing the program, "Young people should practice responsibility and consideration."30

On September 11, 1997, the Lower House of Paraguay passed a bill to regulate tobacco and alcohol advertising and promotion.48 On October 15, CERNECO sent a letter to the president of the Senate (with copies to the Health Commission and the Legislative Commission) "suggesting" modifications to the bill49 to eliminate the requirement that the minister of education survey high school students to determine the effect of tobacco and alcohol advertising and promotion on consumption. The results of such surveys could be used to end advertising deemed harmful to youths, which CERNECO said "would drastically infringe the freedom of commercial expression."50 As a counterproposal, CERNECO offered to work with the minister of education to continue implementing the tobacco industry’s education program "Yo Tengo P.O.D.E.R." ("I Have Power") and the retailer program "Es lo Correcto" ("It’s the Right Thing").50

CERNECO also suggested weakening enforcement by eliminating the paragraph sanctioning advertising agencies that violated the law.50 According to Philip Morris Paraguay, CERNECO’s representatives were organizing periodical lunches with key senators, giving them materials and lobbying for these changes.51 The law was defeated.

In October 1998, a different proposal regulating tobacco and alcohol advertising was approved in accordance with the industry’s self-regulating code.52

In September 1997, "Yo Tengo P.O.D.E.R." was presented in Argentina and implemented by Conciencia (Consciousness), a local nonprofit educational organization founded in 1982. The program was completely financed by Massalín-Particulares (PMI’s affiliate), which spent $611 395 from 1997 to 2000.53 The program was first piloted in the Province of Buenos Aires with 250 students and was later launched simultaneously in Buenos Aires, San Juan, Necochea, and Bariloche; 600 teachers were initially trained.40,54 "Yo Tengo P.O.D.E.R." was endorsed by the Ministry of Education, which requested that the "program reach 80% of the nation’s public-school students between the ages of 12 and 15."40 By 1999, 3 million students and 50 000 teachers were reported to be participating in the program.40 According to Massalín-Particulares, in September 2001 the United Nations Educational, Scientific and Cultural Organization (UNESCO) recognized the program as "the best educational practice in Argentina"55 at the International Conference on Education in Geneva.

In some countries, such as Venezuela, the program was renamed "Yo Tengo V.A.L.O.R. (Vida, Acción, Logro, Orgullo, Responsabilidad)" ("I Have Courage: Life, Action, Achievement, Pride, Responsibility").56,57

School-based education programs were supported by the Ministry of Education in most of the countries, the Ministry of Justice in Venezuela, and the president in Paraguay (Table 2Go).

The MTV Advertising Campaign
In 2001, JTI together with BAT and PMI launched a television advertising campaign on the MTV European network for 18 weeks, "featuring young, hip and active people who don’t smoke."58 The message of the campaign was, "You can be ‘cool’ and not smoke."58 Encouraged by the campaign’s good publicity, PMI and JTI ran a new campaign on MTV in 2002 in 80 countries in Europe, Asia, Australia, and Latin America. The campaign was broadcast in Argentina, Bolivia, Brazil, Colombia, Chile, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Uruguay, and Venezuela. The Latin American MTV campaign consisted of 3 commercials showing 1 of 3 different adolescents (aged 14 to 15) dancing, shopping, or surfing; each commercial concluded by saying, "He [or she] doesn’t smoke." As usual, the tobacco industry did not communicate the health dangers of smoking and blamed peer pressure for adolescent smoking initiation, without saying anything about tobacco industry marketing strategies.

JTI made the following public statement on its Web site:

The research confirmed the positive impact of this campaign in making a contribution to creating an environment in which kids are less likely to smoke. This campaign marked an important milestone in our company’s and the industry’s commitment to the Youth Smoking Prevention cause. By using creative visuals and media, we were able to effectively communicate our messages to help young people resist peer pressure to smoke.58

The Web site did not provide citations to scientific studies that documented that these statements were correct and we did not find any such evidence. On the contrary, a nonindustry study carried out in the United States among adolescents aged 14 to 17 who were exposed to industry-sponsored antismoking ads (including the MTV campaign) concluded that the ads had a boomerang effect, engendering more favorable attitudes toward the tobacco companies, which did more to promote corporate image than to prevent youth smoking.59


   COMMENTS
TOP
 ABSTRACT
 INTRODUCTION
 SOURCES OF INFORMATION
 FINDINGS
 COMMENTS
References
 
The tobacco industry first developed its "youth smoking prevention" programs in the early 1980s in the United States to deflect attention from the industry’s marketing practices and to allow the industry to argue that government measures to control tobacco were not necessary.6 In response to increasing pressure from the tobacco control movement during the early 1990s, the tobacco companies introduced "youth smoking prevention" programs in Latin America2 as well as other regions of the world.6–9

Similar strategies were developed in the United States and in Latin America. The US media campaigns "Think, Don’t Smoke" (Philip Morris) and "Tobacco Is Whacko" (Lorillard) were similar to "Fumar Es una Decisión de Adultos" (PMI) and the MTV campaign (PMI and JTI). The US school-based education programs "Right Decisions, Right Now" (RJR), "Helping Youth Decide" (Tobacco Institute), "Helping Youth Say No" (Tobacco Institute, Philip Morris), and "Health Rocks" (Philip Morris) were similar to "Aprende a Decidir por ti Mismo" (RJR), "Yo Tengo P.O.D.E.R." (PMI), and "Yo Tengo V.A.L.O.R." (PMI). Finally, the US retailer program "It’s the Law" (Tobacco Institute, PM) was equivalent to the Latin America "Es la Ley" (RJR) or "Es lo Correcto" (PMI).

As in the United States, the industry’s Latin American "educational" programs concentrated on promoting "adult choices" that reinforce the central message of tobacco advertising to youths, which is to present smoking as a way for adolescents to "grow up."22,60–63 The emphasis on peer pressure and parental behavior also shifts the focus away from the industry’s responsibility for tobacco use by youths. Indeed, Philip Morris’s own research on its "Matches" campaign found evidence that these messages could indirectly encourage smoking.22 As in the United States, school-based industry-sponsored education programs in Latin America avoid the health consequences of smoking, environmental tobacco smoke, and nicotine addiction. In addition, they compete with or displace governmental and nongovernmental public health campaigns that address the health consequences of smoking, environmental tobacco smoke, and the industry’s behavior. Retailer programs have not been effective at restricting youths’ access to cigarettes; the Global Youth Tobacco Survey showed that almost 90% of youths from Chile, Argentina, and Uruguay were able to buy cigarettes.1 Even the industry’s nominal emphasis on limiting youths’ access to cigarettes would not be expected to reduce their smoking, because restricted access is not associated with reduced smoking rates among youths.64–66

As in the United States,6 the industry’s evaluation of "effectiveness" was not based on any evidence that its "youth smoking prevention" programs actually reduced smoking by youths; rather, it was based on whether they had a positive (from the industry’s perspective) impact on how the public and public policymakers perceived the tobacco industry. The fact that adults—not youths—were the primary audience for the campaigns is evident in how they were promoted. We could not locate any evaluations of the programs’ effectiveness at reducing smoking among youths in Latin America, either in the published literature or industry documents. A large-scale evaluation of the LifeSkills Training Program, a school-based drug prevention program promoted by Philip Morris and BAT in the United States, showed no effects in terms of reducing youths’ smoking.67

The tobacco industry has been successful in partnering with third-party allies in Latin America. In addition to allies in the business community, such as tobacco retailers and the hospitality industry,68 the tobacco industry identified a local nonprofit educational organization in each country to recruit its education programs. One of the most prominent examples is Conciencia, an Argentinean educational organization, which also has branches in Uruguay and Paraguay. "Yo Tengo P.O.D.E.R." has been implemented by this organization with funds from PMI. This association was valuable to the tobacco companies because it helped legitimize them. In some countries, the industry also obtained the cosponsorship of the national media associations.37 These efforts helped portray the tobacco companies as concerned corporate citizens69 and have created an opportunity in which some politicians (e.g., in Ecuador) allowed the tobacco industry to draft and water down "antitobacco" legislation.

The most important outcome that tobacco companies achieved in several countries was the endorsement by public officials and national authorities, in particular the education and health ministries. This tactic both legitimizes the tobacco industry and helps it build ties with government that could be valuable in opposing future tobacco control policies.

The industry strategy in Latin America undermines the implementation of more effective tobacco control measures, including those required by the Framework Convention on Tobacco Control,70 by allowing BAT, PMI, and JTI to continue marketing tobacco products to young people in accordance with their International Marketing Standards for Tobacco Products (adopted in September 2001). These actions allow the companies to claim that the measures required by the Framework Convention on Tobacco Control—increased tobacco taxes, a complete ban on tobacco advertising and sponsorship, aggressive countermarketing media campaigns, strong picture-based health warning labels printed on cigarette packages, and the creation of 100% smoke-free enclosed environments—are unnecessary (Table 3Go).


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  		TABLE 3—— Comparison of the World Health Organization Framework Convention on Tobacco Control Regulations on Smoking Among Youths and the Tobacco Industry’s "Youth Smoking Prevention" Programs
 
Tobacco control and health advocates and policymakers in Latin America need to understand and expose the real intentions of tobacco industry–sponsored "youth smoking prevention" programs. Local nonprofit youth and educational organizations need to avoid being co-opted by tobacco companies, whose only purpose is to preserve their markets. Because the tobacco industry replicates programs throughout the region that are ineffective (in terms of actually reducing smoking), other effective mass-media campaigns72 could be adapted to social and cultural realities in Latin America. The US counter-marketing campaign "Truth" showed evidence of success in reducing tobacco use among youths.73,74 In light of the momentum for tobacco control that the Framework Convention on Tobacco Control creates in Latin America, government officials charged with implementing the Framework Convention on Tobacco Control should avoid endorsing ineffective and distracting industry-sponsored programs to fully comply with the intent and spirit of the Framework Convention on Tobacco Control.


   Acknowledgments
 
This study was funded by the National Cancer Institute (grant CA-87472).

We thank Thomas Novotny, Pamela Ling, and Anne Landman for their helpful comments on this article.

Note. The National Cancer Institute had no involvement in the conduct of the research or preparation of this report.

Human Participant Protection
No protocol approval was needed for this study.


   Footnotes
 
Peer Reviewed

Contributors
E. M. Sebrié collected the data. Both authors drafted the article, prepared the response to reviewers, and revised the article.

Accepted for publication September 19, 2006.


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