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This past June the California Department of Health Services announced its latest assault on tobacco—a $22 million advertising campaign aimed in part at young men 18–30 years of age. Funding for the campaign comes from Proposition 99, the 1988 ballot initiative which increased cigarette taxes and dedicated much of the revenue to tobacco control efforts. Among the 25 new radio, television, and print ads produced are a few that emphasise the link between smoking and impotence.
In announcing the campaign, Kim Belshé, the agency’s director, noted rather discreetly that “The Marlboro Man may not be everything he’s cracked up to be.” Journalists were a bit more playful, picking up on the heavy media coverage surrounding Viagra (sildenafil), the new medication for male impotence. “The Marlboro Man needs Viagra”, quipped the Associated Press. “What Viagra may give, tobacco taketh away,” chimed in the Los Angeles Times. The San Francisco Chronicle reported that the campaign “takes aim at smokers—directly below the belt”.
In a television ad (entitled “Gala Event”), a tuxedo-clad man and a woman in a low-cut gown are casually flirting across the room at a private party. When the man lights up a cigarette, it goes limp in his mouth. The woman looks puzzled, then smiles derisively and walks away, while the narrator reports that “medical researchers believe cigarettes are a leading cause of impotence”. A big-band version of the song “I ain’t got nobody” plays in the background. The tagline at the end reads, “Cigarettes. Still think they’re sexy?” A companion print ad shows an attractive man with a flaccid cigarette hanging from his lips (figure).
“The recent extensive public discussion about male impotence has focused on the available remedies, especially Viagra,” noted Dr Christopher Evans, assistant professor of urology at the University of California, Davis, School of Medicine, in a press release about the campaign. “This discussion has ignored the fact that many of the causes of erectile dysfunction are preventable. One of the leading preventable causes is smoking, which can adversely affect the circulatory system—an essential component of normal male sexual function.”
The California campaign is not the first time, of course, that the link between smoking and impotence has been covered in the media or featured in an anti-tobacco campaign. A cover story in the April 1988 issue of Reader’s Digest carried the headline “Warning: smoking endangers your sex life.” Around the same time the Cleveland, Ohio television station WKYC ran a story about smoking and impotence (“another reason why your loved ones want you to quit smoking”). A print ad promoting the WKYC story (reproduced in Tobacco Control 1992;1:241) featured phallic imagery similar to that used in the California campaign. The University of Central England gallery of anti-tobacco artwork, produced in conjunction with the Smoke Free Birmingham campaign (see the cover essay in the last issue of Tobacco Control), includes a drawing suggesting the beneficial effect of smokingcessation on sexual performance (figure).
Beyond these fleeting examples, the California campaign is probably the most ambitious attempt to link smoking and impotence in a public health campaign. If firm evidence shows that the campaign is producing its intended effect, tobacco control advocates in other venues may embrace the strategy in their own programmes. “Frankly”, said health director Belshé, “it’s our hope that men who won’t quit to save their lives, to save their lungs, to save their hearts, may be more inclined to quit to save their sex lives.”
All articles written by David Simpson unless otherwise attributed. Ideas and items for News Analysis should be sent to David Simpson at the address given on the inside front cover.