ReviewMonitoring the tobacco use epidemic IV. The vector: Tobacco industry data sources and recommendations for research and evaluation
Introduction
Tobacco use is difficult to prevent, in part because of organized, competing efforts by the tobacco industry to promote the unhealthy behavior (Slade, 2001). In an epidemiological model, the industry can be characterized as the vector: an organism that distributes disease-causing toxins to hosts (Last, 2001). More specifically, the vector includes the corporations that produce and market cigarettes, cigars, pipes, and smokeless tobacco; as well as their strategies to persuade users, and their distribution systems. Public health anti-tobacco efforts may be overshadowed by the more intensive efforts of this vector. Federal Trade Commission (FTC) reports reveal the major tobacco companies spent $13.4 billion on advertising and promotions in 2005 in the United States (Federal Trade Commission (FTC), 2007a, Federal Trade Commission (FTC), 2007b). Despite the size of the industry's marketing budgets, there have been few systematic efforts by tobacco control practitioners and researchers to understand the strength, quality, direction and intended outcomes of the industry's efforts.
In 2002 the National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), the Robert Wood Johnson Foundation (RWJF) and the American Legacy Foundation (Legacy) convened the National Tobacco Monitoring, Research and Evaluation Workshop to review gaps and best practices in tobacco surveillance. During 2 days of meetings the Vector Work Group, composed of a small group of researchers and practitioners with expertise in tracking tobacco industry activities (see Acknowledgments section), reviewed and discussed tobacco industry monitoring and surveillance needs. The group first identified priority indicators for monitoring tobacco industry marketing, then listed data sources for several of the indicators. Based on their assessment of current resources and gaps, they made recommendations for short- and long-term improvements in evaluation approaches. In this review, the data sources for the priority indicators are updated and expanded and the workgroup's recommendations are outlined for a national research network to monitor the tobacco industry.
Other working groups at the 2002 meeting also produced recommendations for improving the national system of monitoring the tobacco use epidemic. Their ideas are updated in this issue with an introduction (Giovino et al., 2009) and discussion of surveillance systems for the epidemic's hosts (Delnelvo and Bauer, 2009), agents (Stellman and Djordjevic, 2009), and environment (Farrelly, 2009).
Section snippets
Identification of priority indicators
Surveillance and research on tobacco marketing addresses a wide variety of industry forces driving tobacco use, including marketing (planned efforts to convince people to desire, buy or support tobacco) and its subset of activities that include paid advertising, less obvious product promotions, public relations, and distribution. The types of industry activities that were ranked by the Vector Work Group as the highest priority to track were: (1) tobacco pricing strategies, (2) retail
Pricing strategies and retail environment
Store environments have been mapped in studies that record, code and analyze the presence of tobacco advertisements and price promotions, and, in some cases, interview store managers (Feighery et al., 2001, Feighery et al., 2003, Wakefield et al., 2002b). These investigations can provide in depth information on local retail practices, trends in retail advertising by brand and store type, and the practices used by distributors to assure prime placement of tobacco products. However the sampling
Discussion
Data available to monitor the vector include commercial marketing reports, available for a fee from private research groups, public lists available from advocacy organizations, and individual studies completed over a limited period of time by public health and communications researchers. The individual research studies are often rich in data about specific marketing activities, but unique to the locale and time in which they are collected. These investigations can take a long time to gather,
Conflict of interest statement
There are no conflicts of interest to declare.
Acknowledgments
The author thanks Gary Giovino, Lois Biener, and Anne Hartman for comments on previous drafts; and the participants of the Vector Working Group for their review of tobacco industry monitoring methods and recommendations for improvement: Lois Biener, Ph.D., University of Massachusetts Boston; Michael Cummings, Ph.D., Roswell Park Cancer Institute; Ellen Feighery, M.S., Public Health Institute; Jane Lewis, Dr.P.H., University of Medicine and Dentistry of New Jersey; Jerie Jordan, Centers for
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