304 Tobacco Control 2001;10:304–308 Tob Control: first published as 10.1136/tc.10.4.304c on 1 December 2001. Downloaded from NEWS ANALYSIS declines in tobacco use. The states of the 1980s, the United States Tobacco All articles written by David Simp- California and Massachusetts have Company targeted non-smoking son unless otherwise attributed. conducted well funded comprehen- young males with low nicotine, snuV Ideas and items for News Analysis sive tobacco control campaigns. Both starter products. The company should be sent to David Simpson at campaigns have aggressively passed employed a “graduation” strategy that the address given on the inside tobacco control policies including intended new users to “graduate” up front cover. taxation, eliminating public smoking, to higher nicotine brands over time. aggressive counter-advertising, crack- Among US 17–18 year old males, oral downs on tobacco sales to minors, snuV use soared from 0.3% in 1970 to and treatment of smokers. In 1998, 2.9% in 1985, an eightfold increase. A Suckers today, the male smoking rate for California Washington State study found that was 15.1% and Massachusetts 15%. snuV became a nicotine entry product smokers tomorrow? In 1999, male use of chewing tobacco for young males who switched to ciga- A recent Industry Watch (Tobacco and snuV was only 2.4% in California. rette smoking as they grew older. Control; 2001;10:253–7) explored an Massachusetts stopped measuring Tobacco companies—Swedish or “experiment in progress”—the use of snuV use when it fell below 1% in American—want to make money and snus (oral snuV) by Sweden’s males as 1993. the health of people is not part of the a possible substitute for cigarette Swedish Match has recently bottom line. The Swedish experiment smoking and as a way to reduce male introduced a new brand of oral snuV could become an “increased harm lung cancer. A recent study commis- called Exalt into two test markets in experiment” where continued smok- sioned by the Massachusetts Depart- the USA, Ohio and North Carolina, ing is supported, clean indoor air laws ment of Public Health and conducted and is advertising the product on its weakened, and pharmaceutical com- by the American Health Foundation website. It is a teabag pouch of oral panies that promote cessation prod- found that levels of tobacco specific snuV that has low levels of TSNAs ucts driven out of the marketplace. nitrosamines (TSNAs), the principal and the user doesn’t have to spit. The Since tobacco products are not http://tobaccocontrol.bmj.com/ class of carcinogens in snuV, were website is marketing the product not regulated, we should be very cautious only 1.8 µg/g for ETTAN, the most as a complete substitute for cigarette in arguing that one product is “safer” popular Swedish brand versus 41.1 smoking, but as a temporary than another. It is a dynamic environ- µg/g for Copenhagen the most replacement where smoking is ment where all tobacco manufactur- popular US brand. Swedish Match banned—airlines, worksites, theatres, ers will work together to promote each selects special tobacco blends and and homes. There is little or no infor- other’s products and addiction to employs a new fermentation process mation in the site on the dangers of nicotine. We should be very careful in to prevent formation of TSNAs. It smoking, how to quit smoking, or the choosing our tobacco bedfellows. could be argued that the low levels in diVerences in health risks between GREGORY N CONNOLLY Ettan make it “safer”. However, the smoking and smokeless tobacco use. Tobacco Control Program Ettan levels (1800 parts per billion) Clearly, the product is being marketed Massachusetts Department of Public Health, are still hundreds of times greater than as a complement to continued USA on September 24, 2021 by guest. Protected copyright. what would be allowed in regulated smoking. [email protected] products; for example, the limits for Two US companies, Star Scientific NDELA, another, non-tobacco nitro- and US Smokeless Tobacco Com- samine in bacon and beer, are 5 and pany, are about to launch similar low Kenya: tobacco 10 parts per billion respectively. TSNA, spitless tobacco products. The prevalence of daily smoking Swedish Match’s strategy may be rally leaves health a among Sweden’s males has fallen appealing to cigarette manufacturers from 36.3% in 1980 to 17.1% in since it does not promote quitting and wreck 1998. However, male snus use may counteract the cessation eVects The gruelling Safari Rally, formerly increased only modestly during the generated by clean indoor air laws. the East African Safari, is said to be period from 16.6% to 18.2%, making Also, the product is cheap, costing a the world’s toughest, longest motor it diYcult to attribute the decline in fraction of the price of nicotine gum rally, and the most exciting for specta- male smoking to smokers switching to or patches. This price diVerence may tors. It has been running for nearly snus. result in the pharmaceutical industry half a century, and in recent years has Sweden has been one of the most reducing their promotion of cessation become one of the most aggressive progressive European nations in curb- medications if potential quitters turn forms of tobacco promotion in the ing smoking through bans on to “safe” snuV rather than nicotine world. When leading sponsor British advertising, taxation, and treatment of gum. American Tobacco (BAT) switched tobacco dependence. The US experi- Another possible unintended con- promotional tactics in the late 1990s ence has shown that such comprehen- sequence of a “snus experience” could to sponsor soccer, Philip Morris sive eVorts contribute to large be youth initiation into smoking. In clearly saw a major opportunity and www.tobaccocontrol.com News analysis 305 Tob Control: first published as 10.1136/tc.10.4.304c on 1 December 2001. Downloaded from Motor sports, such as the Kenyan Safari Rally, still provide massive publicity for tobacco companies such as Philip Morris (Marlboro), who took over sponsorship of the rally from BAT (555). the event became known as the Marl- standing on BAT’s 555 cigarette that remains remarkably intact is boro Rally. However, in the 1990s branded car, the majority of the tobacco. protests by health organisations hundreds of people at the finishing Not only does Spain persist in brought about changes in the name of line this year were reported to be chil- maintaining its status as one of the the event and the sponsorship dren under 18 years old. black spots of Europe in terms of arrangement—but not in the satura- With the rally achieving such tobacco consumption and disease, but tion coverage associating Marlboro massive publicity, and having such the stuV is still apparently an unques- cigarettes with courage, excitement, obvious appeal to youth, Philip tioned part of the social fabric, too. A vitality, and success. Morris must feel its investment has health advocate from the UK recently In July 2001, 41 cars set oV on the been well worthwhile. In many described her astonishment at the 2600 km (1600 mile) route across countries that received media cover- wedding of a young Spanish woman http://tobaccocontrol.bmj.com/ largely tough and inhospitable terrain. age of the event, advertising bans have who was all too well educated about Three days later, just 15 cars finished forced the traditional Marlboro tobacco: her father did not live to see the course, led by the famous Finnish cowboy to ride oV into the sunset. But his daughter married, having smoked driver Tommi Makinen and his motor sport drivers have become the all his adult life and died of lung can- co-driver Risto Mannisenmaki. cowboys of today: tough and healthy, cer at the age of 50. Around 1500 foreign journalists fearless and independent—ideal he- But at the celebratory wedding covered the rally, and among their roes of the young. meal, what was in the traditional bas- output was a daily 26 minute video Like its predecessor BAT, Philip kets of personalised gifts brought bulletin of the latest highlights, Morris says it observes strict round from table to table by the happy distributed to 186 countries and standards of responsible promotion in couple, and handed to all the guests? reaching an estimated 460 million all its markets nowadays. Boxes, beautifully hand decorated people. Not surprisingly, Kenyans with hearts and flowers and the names on September 24, 2021 by guest. Protected copyright. were among those most directly of the bride and groom, containing caught in the slipstream of all the cigarettes for all the women, and publicity. Four national television sta- Spain: wedded to cigars for the men. So much is tions beamed exciting clips of the rally tobacco a part of Spanish wedding in every news bulletin and sports pro- tobacco tradition that cigarette gift boxes gramme, day and night, and the print Spain has undergone extraordinary ready for decoration are to be found in media was drenched with pictures of changes over the past half century, Marlboro cars, not just in news metamorphosing from a dictatorship pictures, but in advertisements for governing a mainly peasant society to Mitsubishi, the Marlboro team’s car. a thriving democracy whose economy Forty five per cent of Kenyans were ranges from tourism to heavy estimated to have seen coverage of the engineering, agriculture to aerospace. rally, either on television, in newspa- In a country with such a long and pers and magazines, or as spectators. illustrious history, a fount of culture In addition to the winning car, over many centuries, and which was at Marlboro saw six of its other vehicles one time a colonial superpower complete the rally at Nairobi’s governing most of Latin America, tra- Kenyatta International Conference dition is bound to be strong.