The International Agency for Research on Cancer (IARC) was established in 1965 by the World Health Assembly, as an independently funded organisation within the framework of the World Health Organization. The headquarters of the Agency are in Lyon, France. The Agency conducts a programme of research concentrating particularly on the epidemiology of cancer and the study of potential carcinogens in the human environment. Its field studies are supplemented by biological and chemical research carried out in the Agency's laboratories in Lyon and, through collaborative research agreements, in national research institutions in many countries. The Agency also conducts a programme for the education and training of personnel for cancer research. The publications of the Agency contribute to the dissemination of authoritative information on different aspects of cancer research. Information about IARC publications, and how to order them, is available via the Internet at: http:// The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The authors alone are responsible for the views expressed in this publication.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.11334

IARC Handbooks of Cancer Prevention

1. Tobacco Warfare In America: An Overview.- A Battlefield Tour.- American Principles, Public Policy, and Tobacco Warfare.- Organization of this Book.- 2. Welfare Economics, Public Policy, And Smoking.- Smoking, the Market Process, and a Free Society.- Taxation and Regulation in a Market Economy.- Welfare Economics and Tobacco Policy.- Tobacco Taxation as Corrective Taxation.- Tobacco Taxation: An Overview.- 3. The Taxation And Regulation of Smoking: Principle vs. Expediency.- Realistic Politics and Tobacco Policy.- Knowledge and the Improbability of Corrective Taxation.- Political Incentive and Actual Tobacco Taxation.- Rationale, Reality, and Tobacco Regulation.- Tobacco Policy in Constitutional Perspective.- 4. Smoking And The Economic Cost Of Lost Production.- Smoking and Health: The Method of "Attributable Risk".- How Accurate are Measures of Attributable Risk?.- Economic Measurement of Indirect Costs.- Joint Costs and Improper Cost Attribution.- Who Loses Lost Production: Smokers or Nonsmokers?.- What about the Benefits of Smoking?.- 5. Markets, Insurance, And The Medical Costs Of Smokers.- Attribution of "Medical Costs" to Smoking.- Medical Costs, Personal Responsibility, and Insurance.- Life Insurance and Nonsmoker Discounts.- Health Insurance and Smoker-Nonsmoker Parity.- Smoking and Fire Costs.- Moral Hazard and Insurance Costs.- 6. Medicare, Medicaid, And The Social Cost Of Smoking.- Smokers and the Cost of Medicare.- Transfers and Social Costs: A Clarification.- Proposals for Earmarked Cigarette Taxes.- Principle, Expediency, and Wealth Transfers.- 7. Smoking, Business Costs, And Social Cost.- Smoking and the Efficiency of Team Production.- Smoking and Workplace Efficiency.- Workplace Costs: A Further Consideration.- Smoking and Economic Productivity: A Conceptual Framework.- Smoking and Productivity: Discussion of the Data.- 8. ETS And Governmental Protection Of Consumers And Workers.- The Economics of Clean Indoor Air Acts.- The Coase Theorem, Ownership Rights, and Markets.- An Alternative Explanation.- Tobacco and "Public Health".- 9. Advertising, "Addiction," And The Denial Of True Choice.- Separating Advertising Myth from Advertising Reality.- Impact of Cigarette Advertising on Smoking by Youth.- Cigarette Advertising is a Firm-Specific Investment.- International Evidence: Cigarette Advertising Bans do not Work.- The Constitution and the Protection of Commercial Speech.- Advertising and Addiction.- The New Economics of Addiction.- Consumer Sovereignty or Health Fascism?.- 10. Self Interest, Public Interest, And Legislation.- Corrective Cigarette Taxation: An Analytical Unicorn.- An Economic Approach to Legislation and Regulation.- Democratic Politics and Tax Policy.- Rent Seeking, Tax Resistance, and Social Waste.- The Social Cost of Tobacco Taxation: A Recalculation.- Economic Principles and the Anti-Cancer Bureaucracy.- Tobacco Taxation and Regulation: A Realistic Approach.- 11. Interest Groups And The Public's Health.- Overview.- Market Processes and Personal Health.- Is Health Research a Public Good?.- Public Health and the Collective Interests of Physicians.- Self Interest in Public Interest Organizations.- 12. Principle And Expediency In Public Policy.- Principles of Constitutional Political Economy.- The Self-Ownership Foundations of a Democratic Polity.- Considerations from the Economic Theory of Legislation.- Implications for Public Policy Toward Tobacco.- Implications for Public Policy More Broadly Considered.- References.

/pdf/the-economics-of-smoking-1hd662nqi1.pdf

The economics of smoking

Context.—Whether tobacco advertising and promotion increases the likelihood that
youths will begin smoking has important public policy implications.Objective.—To evaluate the association between receptivity to tobacco advertising
and promotional activities and progress in the smoking uptake process, defined
sequentially as never smokers who would not consider experimenting with smoking,
never smokers who would consider experimenting, experimenters (smoked at least
once but fewer than 100 cigarettes), or established smokers (smoked at least
100 cigarettes).Design.—Prospective cohort study with a 3-year follow-up through November 1996.Setting and Participants.—A total of 1752 adolescent never smokers who were not susceptible to
smoking when first interviewed in 1993 in a population-based random-digit
dial telephone survey in California were reinterviewed in 1996.Main Outcome Measure.—Becoming susceptible to smoking or experimenting by 1996.Results.—More than half the sample (n=979) named a favorite cigarette advertisement
in 1993 and Joe Camel advertisements were the most popular. Less than 5% (n=92)
at baseline possessed a promotional item but a further 10% (n=172) were willing
to use an item. While having a favorite advertisement in 1993 predicted which
adolescents would progress by 1996 (odds ratio [OR] =1.82; 95% confidence
interval [CI], 1.04-3.20), possession or willingness to use a promotional
item was even more strongly associated with future progression (OR=2.89; 95%
CI, 1.47-5.68). From these data, we estimate that 34% of all experimentation
in California between 1993 and 1996 can be attributed to tobacco promotional
activities. Nationally, this would be over 700000 adolescents each year.Conclusion.—These findings provide the first longitudinal evidence to our knowledge
that tobacco promotional activities are causally related to the onset of smoking.

https://jamanetwork.com/journals/jama/articlepdf/187258/joc71624.pdf

Tobacco Industry Promotion of Cigarettes and Adolescent Smoking

OBJECTIVE To provide a comprehensive review of interventions and policies aimed at reducing youth cigarette smoking in the United States, including strategies that have undergone evaluation and emerging innovations that have not yet been assessed for efficacy. DATA SOURCES Medline literature searches, books, reports, electronic list servers, and interviews with tobacco control advocates. DATA SYNTHESIS Interventions and policy approaches that have been assessed or evaluated were categorised using a typology with seven categories (school based, community interventions, mass media/public education, advertising restrictions, youth access restrictions, tobacco excise taxes, and direct restrictions on smoking). Novel and largely untested interventions were described using nine categories. CONCLUSIONS Youth smoking prevention and control efforts have had mixed results. However, this review suggests a number of prevention strategies that are promising, especially if conducted in a coordinated way to take advantage of potential synergies across interventions. Several types of strategies warrant additional attention and evaluation, including aggressive media campaigns, teen smoking cessation programmes, social environment changes, community interventions, and increasing cigarette prices. A significant proportion of the resources obtained from the recent settlement between 46 US states and the tobacco industry should be devoted to expanding, improving and evaluating “youth centred” tobacco prevention and control activities.

https://tobaccocontrol.bmj.com/content/tobaccocontrol/9/1/47.full.pdf

Investing in youth tobacco control: a review of smoking prevention and control strategies

The tobacco industry denies that their marketing is targeted at young nonsmokers, but it seems more probable that tobacco advertising and promotion influences the attitudes of nonsmoking adolescents, and makes them more likely to try smoking.
 
The objective of this review is to assess the effects of tobacco advertising and promotion on nonsmoking adolescents' future smoking behaviour.

/pdf/impact-of-tobacco-advertising-and-promotion-on-increasing-146fgqxejn.pdf

Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours

Objectives. —To determine if RJR Nabisco's cartoon-theme advertising is more effective in promoting Camel cigarettes to children or to adults. To determine if children see, remember, and are influenced by cigarette advertising. Design. —Use of four standard marketing measures to compare the effects of Camel's Old Joe cartoon advertising on children and adults. Subjects. —High school students, grades 9 through 12, from five regions of the United States, and adults, aged 21 years and over, from Massachusetts. Outcome Measures. —Recognition of Camel's Old Joe cartoon character, product and brand name recall, brand preference, appeal of advertising themes. Results. —Children were more likely to report prior exposure to the Old Joe cartoon character (97.7% vs 72.2%;P Conclusion. —Old Joe Camel cartoon advertisements are far more successful at marketing Camel cigarettes to children than to adults. This finding is consistent with tobacco industry documents that indicate that a major function of tobacco advertising is to promote and maintain tobacco addiction among children. (JAMA1991;266:3149-3153)

RJR Nabisco's cartoon camel promotes camel cigarettes to children.

Objective - The Camel Cash promotion is a programme marketed by the RJ Reynolds Tobacco Company in the United States, which rewards purchasers of Camel cigarettes with a coupon, called Camel Cash or "C-notes". The aim of this study was to determine the level of knowledge of and participation in the Camel Cash promotion among adoles cents in 1992. Design - School survey Subjects - A total of 616 students (mean age = 15.5 years) in two high schools, one in New Mexico and one in Massachusetts. Results - 241 students (39.1 %) had heard of Camel Cash, and 53 (8.6%) had col lected Camel Cash. The proportions who had heard of Camel Cash and who had collected Camel Cash were highest among current smokers, followed by ex perimenters and then students who had never smoked (p <$c 0.001). 32 students aged 17 or younger stated that they purchased Camel cigarettes specifically to get Camel Cash; 15.6% were 14 years old, 37.5% were 15, 25.0% were 16, and 18.7% were 17. Conclusions - Whether or not it is RJ Reynolds9 intention, some underage smokers are illegally purchasing Camel cigarettes specifically to collect Camel Cash. (Tobacco Control 1995; 4: 258-260)

RJ Reynolds' "Camel Cash": another way to reach kids

In Reply. —Teens and preteens somehow get the idea that smoking makes one sexy, athletic, cool, or macho. The tobacco industry says these ideas come from their peers. No one asks where these peers—other kids—get these ideas. Yet, about the only place in our society where these silly images occur is advertising. So-called peer pressure explains little. It is merely a clever term used to shift blame from the manufacturer and advertiser to the user. Like peer pressure, "parental example" does not just spontaneously occur. Parents of today started smoking as children, and no doubt had similar silly ideas about what smoking would do for their images. So few parents used spitting tobacco two decades ago that parental example cannot be used to explain the current epidemic of spitting tobacco use among children. 1 The dramatic increase in the number of children addicted to this form of tobacco followed an

Tobacco: Promotion and Smoking-Reply

Tobacco : promotion and smoking. author's reply

Men 18 years and older seeking medical care in a private, full-service, well-established family practice in New Mexico were offered evaluation as to circumcision status and examined with regards to documentable surgical damage from circumcision. Despite the fact that every circumcised man had visible and definable obvious and undesired surgical side-effects, ranging from minor scarring to extreme twisting and bending, only a tiny fraction of these men, including gay men, were aware of any penile abnormalities, and almost all believed their own penises were “normal”. The vast majority of the circumcisions had occurred in the newborn period and had been done for standard non-medical reasons. Contrary to assumptions by parents and physicians, most, if not all, newborn circumcisions leave the victim of the surgery in an obvious physically damaged state, which is universally ignored by the patient, his parents, and the physicians performing the surgery or caring for the male child or adult male victim of circumcision.

Christopher Fletcher

Papers

RJR Nabisco's cartoon camel promotes camel cigarettes to children.

RJ Reynolds' "Camel Cash": another way to reach kids

Tobacco: Promotion and Smoking-Reply

Tobacco : promotion and smoking. author's reply

Penile Wounding: Complications of Routine Male Circumcision in a Typical American Family Practice