Article Text
PDF
Statistics from Altmetric.com
Efforts to counter marketing and promotion strategies by the tobacco industry in the United States have been sponsored primarily by mainstream health sector organisations. African Americans and Latinos are under-represented in such organisations. Although women are well represented in their memberships, they are largely absent from positions of leadership. This is despite the fact that tobacco companies have heavily targeted these groups with specific brands of cigarettes, extensive and comprehensive advertising campaigns, and marketing and promotion initiatives.1–4
There is a general lack of activity and interest in tobacco control among African American, Latino, and women’s organisations and their leadership. Explanations for this have been largely anecdotal. A major question, however, concerns the large amounts of money received by these groups from tobacco marketing and promotion initiatives, and whether the leadership of these organisations has been thus compromised. There has been little systematic review of this. One reason is that research priorities are established by the mainstream, reflecting the interests of its members. Indeed, although health advocates protested over the targeted marketing of cigarettes to African Americans living in the inner cities of America, the issue did not get appreciable attention until the aborted attempt of R J Reynolds to develop and market Uptown cigarettes that were specifically designed for African Americans.5
This paper, developed as a companion document to that prepared by the Group on Marketing and Promotion (p SI9), specifically reviews the marketing and promotion activities of the US tobacco industry in relation to African Americans, Latinos, and women and describes specific areas worthy of policy research and analysis.
Background
Tobacco prevention and control priorities
Tobacco control initiatives in the United States have traditionally focused on changing behaviour. Comparatively little attention has been directed to examination of the interaction of the tobacco industry with organisations and institutions in the community that influence social, political, and intellectual life. This is particularly true for African Americans, Latinos, and women, who typically stand outside of the mainstream and who are more likely to rely on cultural-based institutions for expression and definition of their world views. By contrast the tobacco industry has made an enormous investment in civic, social, political, media, and fraternal organisations serving these respective populations.2,3-6 In this regard, the industry is decades ahead of the health community.
The importance of focusing on the interrelation of tobacco industry marketing and promotion strategies targeted at African Americans, Latinos, and women is predicated on the fact that these populations remain at high risk for tobacco use and will often suffer disproportionately from smoking-related disease and death.3 Also, because the health of individual persons is interrelated with the health of their communities, it is important to develop a better understanding of how the tobacco industry has influenced community infrastructures, and how this can be altered.
Social and economic characteristics
Tobacco marketing and promotion activities that target African Americans, Latinos, and women are best understood in the context of their social history and economic position in US society. Such society is culturally heterogeneous and has broad inequities with respect to social and economic opportunity. In 1990, white people comprised 80.3% of the population of the United States, African Americans 12.1%, and Latinos 9%.7 In 1990, the median income of African Americans was $10328, $10683 for Latinos, and $15035 for white people. The median income of women compared with men in each population group was significantly less.8 In 1984 the median net worth of African Americans was $3397, compared with $4913 for Latinos and $39135 for white people.9 Net worth is a more substantive indicator of inequality than median income because it attempts to account for the value of property and other material wealth. At no time between 1966 and 1990 have the poverty rates for African Americans been below 30%.10 By contrast, the rates for white people during this period have never gone above 12.1%.
Marketing and promotion
It is important to distinguish marketing and promotion from advertising. Advertising uses various themes and images to positively characterise tobacco and tobacco-related behaviour. Marketing and promotion activities encompass not only traditional promotion activities that stimulate interest in the product, but most significantly, investments in community infrastructure. These include support for scholarship and fellowship programmes, conferences, and conventions, and the targeting of large sums of money to political representatives, caucuses, and individual leaders.
One of the most intriguing developments in the tobacco industry is the recent shift in marketing and promotion expenditures relative to advertising. Promotional and marketing expenditures now exceed that on direct advertising. In 1975 some 25·5% of the advertising and promotions budget was spent on promotions,11 a proportion that has risen consistently to the 1989 level of 69.3%.12 Another indicator is the drop in revenue and total advertising pages experienced by US magazines.13 In 1992, revenue for the first and second quarter from tobacco advertising was $90.8 million, a 26% decrease from the same period in 1991. The shift from advertising to promotion has occurred at a time of rising total dollars allocated for advertising and promotion.2,12
Lack of interest and the difficulty in obtaining information have combined to make analyses of advertising and promotional expenditure directed at African Americans, Latinos, and women scarce.1,3,6,14 Estimates have ranged from $4.5 million received by minority and women’s organisations in 19876 to $4.3 million for African American groups alone, received from Philip Morris and R J Reynolds in 1987.15 It is believed that African American, Latino, and women’s groups in Washington, DC, are particularly targeted.16 Recipients of money from tobacco industry are unwilling to divulge the information and the tobacco industry is renowned for refusing to disclose this information. During the past decade, however, several major newspapers have made informed estimates of contributions. The information presented here provides a broad overview of marketing and promotion investments targeting African Americans, Latinos, and women.
African americans
The visibility of African American elected officials and their power at the local, state, and federal levels have led the tobacco industry to provide strong financial support to these elected officials and their organisations. Recipients include the Congressional Black Caucus Foundation, the national Black Caucus of State Legislators, and many individual members of Congress and state legislatures.17,18
There are numerous links between social service and civil rights organisations within the African American community and tobacco companies. Substantial donations from the tobacco industry have been received by the Joint Center for Political and Economic Studies (the African American “think tank”), the National Urban League, Tuskegee Airmen Incorporated, and the National Black Police Association.19 Brown and Williamson donated $250000 to groups seeking to improve the quality of inner city life over a four year period.20 One of the most extensive directories of African American organisations, the Guide to Black Organisations, is published by Philip Morris.
Support for minority-owned business
Philip Morris has pledged significant percentages of community deposits to minority institutions and contracts to minority-owned vendors as part of a covenant with Operation PUSH, the civil rights organisation founded by the Reverend Jesse Jackson.21 Tobacco companies also have provided millions of dollars in business to African American life insurance companies and banks.11,20,22 Between 1982 and 1992 R J Reynolds sponsored seminars for persons of colour to promote working with R J Reynolds purchasing agents and purchased over $500 million in goods and services from companies owned by women and persons of colour.23
Journalism
For nearly 20 years R J Reynolds has sponsored a scholarship programme with the National Newspapers Publishing Association.20 R J Reynolds invested $250000 in this programme, making it the largest journalism scholarship programme ever funded by private industry. R J Reynolds is also an active participant in the National Alliance of Business Industry/College Cluster programme that links corporations with African American colleges and universities to assist in the development of business-related subjects and programmes.22
Cultural activity
Peter Bell, former executive director of the Institute on Black Chemical Abuse, noted: “I am not aware of any major Black cultural event that does not have a liquor or tobacco company as a primary sponsor.”24 Music is a special focus.25 Examples include the Kool Jazz Festival (sponsored by Brown and Williamson until 1985) and the Parliament World Beat Concert Series. Tobacco companies also provide financial support for on campus parties and special events sponsored by African Americans as well as support for programmes, conferences and activities sponsored by the graduate chapters which tend to be community-based.26
Art
During the 1970s, one of the first major exhibitions of African American Artists, “Two Hundred Years of Black American Artists,”21 was mounted with funding from Philip Morris. For 1990–1, Philip Morris sponsored the “Black Art: Ancestral Legacy Tour” that examined how African American artists have been influenced by their African roots.22
Employment
Individual tobacco manufacturers were among the first major American companies to hire and promote African Americans in significant numbers.27 More than 20% of the R J Reynolds workforce and 23% of that at Brown and Williamson are African Americans. Roughly 26% of the Philip Morris workforce are classified as “minority,” with 13% in officer and managerial categories. Many who work for tobacco companies in senior corporate positions have considerable recognition and influence within the African American community. They include former White House staff, nationally recognised journalists, corporate trail blazers, and sports celebrities.
Media
Tobacco and liquor advertising have been the economic mainstays of African American publications for decades. In 1950, Philip Morris was attacked by the segregationist publication White Sentinel for being “the first cigarette company to advertise in the negro press.”6 A rise in print tobacco advertising occurred after the 1971 television ban when African American publishers requested the industry to target them.28 African American- owned and oriented newspapers and magazines receive about $6 million in tobacco advertising revenues, or 1.5% of the tobacco industry’s $400 million total advertising budget.22 Cigarettes are heavily advertised in African American-oriented magazines such as Ebony, Jet, and Essence.29
Latinos
Political recipients of money for the tobacco industry include the Congressional Hispanic Caucus Institute17 and the League of United Latin American Citizens (LULAC), the oldest and largest Latino organisation in the United States.1 In general, tobacco support for Latino groups correlates with their increased representation in the population and rise in purchasing power.6 The National Council of La Raza, one of the biggest and most influential groups in the Latino community, receives $100000 from the industry (in a total budget of $3 million) annually for operating expenses and an additional $50 000 from R J Reynolds that goes directly to affiliates.1 R J Reynolds provided $20000 to the US Hispanic Chamber to publish the 1989 Hispanic Business Directory.1 Philip Morris sponsored Mexican rodeos at a cost of $600000 at state fairs throughout California and a national tour called “The Latin American Spirit: Art and Artists in the United States, 1920–1970.30 R J Reynolds sponsors a bilingual magazine, The Hispanics in the Major Leagues.23 The tobacco industry also supports the national Hispanic Scholarship Foundation.6
The National Association of Hispanic Publications estimates that 350 Hispanic newspapers receive about 20% of their advertising revenue from alcohol and tobacco companies.31 Philip Morris is the largest advertiser in Latino magazines and provides funds to the National Association of Hispanic Journalists.6
Women
Women’s organisations promoting leadership in business and politics have been courted for more than a decade.14 A survey of these showed that 13 of 53 respondents admitted receiving money, with amounts ranging from $318500 to $361500.32 The National Women’s Political Caucus received large sums of money.3,14 Estimates of Philip Morris’s contribution to underwrite the National Directory of Women Elected Officials ranged to more than $100000. Other recipients are the Women’s Campaign Fund (more than $25000), Wider Opportunities for Women, League of Women Voters Education Fund, The Center for Women Policy Studies, the American Association of University Women’s Education Foundation, and the Women Executives in State Government. The last received $30000 annually for three years.14
Efforts to target women generally include parallel strategies to reach African American and Latino women. For example, the Women’s Research and Education Institute (WREI) received six of nine of their congressional fellowships from tobacco companies in 198990. RJ Reynolds provided $75000 for three years and Philip Morris $14000 for two years to WREI for this programme.3,14 In 1990, at their awards dinner, WREI honoured Johnetta B Cole, president of Spelman College, historically a black institution. Financial contributors to the dinner were Philip Morris, R J Reynolds, and the Tobacco Institute.33 It is estimated that WREI receives $100000 annually from tobacco. Another recipient is the American Association of University Women and the Women’s Research and Education Fund.17
Women’s arts projects receive support.34 The Joffrey Ballet, considered a showcase for women, is supported by Philip Morris. The American Ballet Theater also formed a partnership with Philip Morris.2,35
Philip Morris began sponsoring the Virginia Slims tournament in 1971. So entrenched was the relationship that when Proctor and Gamble offered to take over the sponsorship in 1988 they were rebuffed. Legitimacy was provided when several newspapers joined as cosponsors of the tournament.36,37
Discussion
It is critical to understand that the tobacco industry has been investing in these communities for a long time, and that the industry has achieved a status among African ! Americans, Latinos, and women that is more than the sum of the money received. The communities are loyal to the tobacco industry partly because they have been poorly supported through other sources and do not equitably receive goods and services from other sectors of society.
Other reasons for the disinterest in tobacco control among these communities are less obvious. For example, women’s leadership groups have focused strongly on issues such as reproductive freedom and have been disinclined to be diverted, particularly when the price would be to deplete their resources and undermine their ability to wage aggressive struggles on well defined agendas. Latino organisations, because they are newly arrived members in the political milieu, may be more marginal than more established interest groups and, consequently, less able to take a risk in alienating corporate sponsors. Latino organisations, similar to African Americans, tend to give priority to economic and education issues ahead of health.1 These factors are often underestimated by advocates of tobacco control who often exhort community leaders to simply relinquish the “blood money.”
The nature of the loyalty felt for the tobacco industry is well illustrated by the quotes:
I think the sponsor has been there a long, long time. I’m thankful they were there when no one else wanted women’s tennis, when no one came to watch, no one cared.
MARTINA NAVRATILOVA defending the Women’s International Tennis Association’s refusal to desert tobacco sponsorships36
They know that they’re perceived negatively by representatives who are concerned about health issues... to tell the truth, I’m not that interested. I’m just glad they fund us.
ALISON DINEED, fellowship director for the Women’s Research and Education Institute6
I’m less concerned about taking money from Philip Morris... then the fact that a lot of these big media companies don’t give us a dime.
FRANK NEWTON, president of the National Association of Hispanic Journalists6
I think the Hispanic community cannot afford to just turn their back on these companies who have been our friends over the years by saying well, now that we know that the product you sell can be injurious to our health, we don’t want your help.
TONY BONILLA, former director of LULAC6
The dismal record of financial support for Hispanic organisations and institutions has created a situation of vulnerability... It is very difficult for any of our groups to refuse contributions from the tobacco industry when so few options are available.
JANE DELGADO, executive director of the national Coalition of Hispanic Health and Human Services Organisations1
What’s more important, that the United Negro College Fund receives hundreds of thousands of dollars in contributions from R J Reynolds for scholarships or that it advertises in one of the fund’s publications? I don’t see any of the people who are criticizing us for accepting money beating down a path to our doors offering contributions.
JAMES WILLIAMS, current spokesperson for the National Association for the Advancement of Colored People (NAACP) defending the United Negro College Fund3
They have nothing to lose. They don’t know about the problems of black media and what it has to do to survive. They [media] don’t get their fair share of ad revenue anyway. So, should they [government] decide to ban tobacco ads, a lot of publications might as well close their doors and auction off the furniture.
GEORGE EDWARDS, president and chief executive officer of the National Black Network, an African American owned radio news and feature network, referring to critics of sponsorships
‘ Enlightened... generous patrons.’ A nation has a cultural health as well as a physical health.
ALVIN AILEY, leader of the African American Dance Company, writing to the Surgeon General in 1988 on tobacco executives
The consequences of sponsorship: pro-tobacco activity
There is no doubt that representatives from the African American, Latino, and women’s communities, despite encouraging signs of change in recent years, have been less than progressive in adopting anti-tobacco positions. Despite the fact that African American leaders claim that the contributions from tobacco interests do not “buy” their support,38,39 proindustry positions have clearly been evident on major issues such as legislation for “smokers’ rights,” clean air legislation, and efforts to raise cigarette taxes. For example, the NAACP worked with tobacco companies to urge African American journalists to oppose clean air acts because of alleged discrimination against African American workers and opposed grants to universities to study African American smoking patterns.41 Representative Charles Rangel has used his position to consistently advocate for the interests of the tobacco industry by opposing excise taxes and promoting allocation of funds to support the tobacco price support system.18 Certainly the unfortunate support of African American, Latino, and women legislators is partially responsible for the remarkable record of less than 15% passage of anti-tobacco bills in 1986 and 1987.6
In a 1986 memo the Tobacco Institute reflected on its success with women’s organisations with the admission that most key representatives had assured them that smoking was not a priority issue for their organisation. The Congressional Caucus on Women’s Issues introduced the Women’s Health Equity Act in 1991, and of 22 bills, including six that targeted prevention, none explicitly dealt with smoking. Similarly, only six of 115 women’s organisations endorsed Senator Edward Kennedy’s tobacco control bill, and only one of the six receives tobacco money.14
The response of the media to the tobacco industry warrants particular highlighting because of its critical place in determining public opinion and shaping values. When Secretary of Health and Human Services Louis Sullivan invited publishers of African American magazines to meet to discuss tobacco advertising, all refused to attend.40 Only a few African American publications, geared primarily to religious or youth audiences, have indicated any broad based refusal to accept tobacco advertising. Most African American media have provided strong support for the tobacco industry.6,41
As with the general media, there is evidence that articles in African American media related to the health consequences of tobacco are not encouraged.4,42 Between 1980 and 1986, neither Ebony nor Essence published articles specifically about smoking and health, although the subject was mentioned briefly in articles on general health.11 In a recent Ebony article on the 10 leading health problems for African Americans, cigarette smoking is mentioned briefly only twice.3
Major women’s magazines provide only brief news items about smoking,45 with one study showing that four of 10 prominent magazines carried no anti-smoking articles in the 12 years studied.44
Tobacco control activity
Recent years have shown an insurgence of activity in tobacco control. Most notable in the African American community was the Uptown Coalition and their successful struggle against R J Reynolds introduction of Uptown cigarette, a brand developed specifically for and targeted at African Americans. It was a victory that had a far reaching impact and helped set the stage for a concerted national coordination of community based mobilisation against the targeted marketing of tobacco and alcohol. The victory grew from a set of strategies that emphasised:
African American leadership
Refusal to focus on issues that might be divisive, for example acceptance of tobacco advertising by local African American newspapers
A definition of the problem that emphasised that the entire community, both smokers and non-smokers, were being targeted
A rebuttal of traditional tobacco industry arguments that portrayed anti-tobacco advocates as paternalistic and disrespectful of the intelligence of the smoking public.
Some local organisations of the Urban League and the NAACP have included tobacco control in their programme initiatives.3 Politicians Cardiss Collins from Chicago and John Conyers from Detroit have refused tobacco money and have cosponsored tobacco regulations.18 Representative John Lewis (Democrat-Georgia) has said he will not accept tobacco and alcohol-related contributions.46 Conyers favours developing alternative funding for organisations that receive significant revenues from alcohol and tobacco companies, including political organisations like the Black Congressional Caucus Foundation.27 The Secretary of Health and Human Services, Dr Louis Sullivan, the first African American to hold this position, has aggressively attacked the tobacco industry.47
The Mission Economic and Cultural Association, sponsors of the celebrated Cinco de Mayo festival in San Francisco, refused #100000 in tobacco money at its 25th annual festival.48 Most encouraging, they developed a plan and moved from 95% sponsorship from tobacco and alcohol to 35% alcohol and 10% tobacco. Also, as well as removing tobacco billboards from African American neighbourhoods as a result of community protests, these are also being removed from Latino communities.5
MS magazine, after publishing two critical articles on tobacco, withstood the punishment of no longer being offered tobacco advertising.32 A state legislator in Vermont, Ann Seibert, organised a protest campaign against Philip Morris promotional efforts that used feminist oriented date books and posters, and Bill of Rights posters.35
Policy research recommendations
(1) Systematic analysis of marketing and promotion to targeted communities
Many data gaps remain. Work should assess the nature and extent of targeted marketing and promotion within each community, determine common patterns, and draw conclusions regarding the rationale and overarching strategy of the tobacco industry. Also, we must consider how best to measure sponsorship. Is it best measured by the quantity of money, the duration of sponsorship, or other factors? Will it vary according to leadership and type of organisation? Is it true that progressive organisations are the primary recipients of tobacco money, or are these merely the organisations that receive the greatest level of publicity? What factors within different types of organisations facilitate a willingness to change behaviour relative to the tobacco industry? Will the community – that is, the attitudes and behaviours of individuals -respond differently to changes in different organisations? If so, this can influence social change strategies adopted by tobacco control advocates.
(2) Assessment of community factors that facilitate targeting by the tobacco industry
What are the values and norms regarding marketing and promotion activities in targeted communities? Are there differences across communities? What role does marginality, or the perception of organisations that they are vulnerable and cannot afford to take risks, have in shaping organisational-based behaviour? If similar perceptions of marginality exist among community members, do they reinforce the resistance of organisations to change? If marginality is important, it can significantly influence the nature of the solutions needed to bring about change. For example, a focus that targeted the opinions and attitudes of organisation leaders may have to be enlarged to deal with the economic environment of the enterprise. A critical element of such a strategy is how to encourage support for organisations from industries other than tobacco. How do perceptions of health risk by leaders impact receptivity to targeted marketing and promotion?
(3) The influence of marketing and promotion on individual norms and behaviours
It is relevant to explore relationships between marketing and promotion and use of tobacco by members of the respective communities. One concern is whether individuals, who appreciate the support provided by the tobacco industry to their organisations, are less supportive of tobacco control legislation and related policy issues. It may be worth while to explore the relationship of marketing and promotion to use of tobacco. Age differences may be an important variable. For example, awareness of African Americans of the importance of tobacco industry support for civil rights organisations may be stronger among older age strata in contrast to women, whose appreciation for tobacco industry support of media and sports activities may be more prevalent among younger women. Policy research can explore if marketing and promotion influences individual norms and behaviours related to public policy or tobacco use. However, in the context of targeted marketing and promotion, the critical issues concern organisational and leadership behaviour. Less critical is whether individual use of tobacco is altered.
(4) Common features in the targeted marketing and promotion strategies in the united states and in other countries
What lessons are to be learned from the experience of the United States? What lessons are to be learned from the experience of the United States in assessing tobacco industry strategies in other countries, and in particular efforts in the Third World? Will an increase in awareness provide a stronger base in the United States for resisting excessive export of cigarettes? Can this impact the regulation of health warnings to assure consistency with policy for US consumers? Evaluation of tobacco industry strategies can facilitate coordinated tobacco control efforts by international agencies such as the World Bank and WHO. How can developments in the international community be used in the United States? For example, the recent statement by Nelson Mandela advocating that all sectors of South African society adopt anti-tobacco industry policies can be juxtaposed to the position of civil rights leaders in the United States who evoke African American burdens as a rationale for continued acceptance of tobacco industry sponsorships. Policy research can determine the best methods for creating linkages across nations.
(5) Common strategies for alcohol, tobacco, and illicit drugs
The question of cross substance abuse analysis and coalition development across tobacco, alcohol, and illicit drugs remains largely unexplored. There are many similarities between the marketing and promotion strategies of the tobacco and alcohol industries. Are there advantages for prevention and control strategies to focus on both and develop an integrated analysis? Is it useful to include illicit drugs in this effort? This is important because illicit drugs, though similar to tobacco and alcohol with regard to health consequences and addictive behaviour patterns, remain controversial within communities and among public policy advocates. Nevertheless, the critical policy research issue is whether an integrated analysis will facilitate better strategies for organising communities and enabling them to coalesce around common agendas.
(6) The shift from advertising to promotion
How do we explain the shift from advertising expenditure to promotion? What is determining this shift? Are there differences between expenditures targeted at African Americans, Latinos, and women? Is the shift to promotion perceived by community and organisational leaders and will this perception alter the stakes in efforts to bring about behaviour change? Of concern to policy researchers is whether this shift is circumstantial or grounded in strategic plans of the tobacco industry. This may be a critical element in determining how resistant the industry will be to proactive attempts to shape an alternative environment with a new set of choices that is available to the economic, cultural, and organisational infrastructure of African American, Latino, and women’s communities.
Summary
Exploring issues related to marketing and promotion is fairly novel to tobacco prevention and control. It will require new tools and a liberal use of qualitative methods to formulate appropriate concepts and criteria. It will also necessitate reliance on researchers and professionals who are culturally sensitive, and ideally will be representative of the communities being researched. If historical context emerges as a significant explanatory component of this phenomena, then it is best to appreciate that context is more than the sum of a community’s historical “facts.” It encompasses as well the state of mind, the feelings, the pains, and the aspirations of the people who make up the community.