Marisa de Andrade & Gerard Hastings
Institute for Social Marketing; University of Stirling
Editor’s note: The United Kingdom’s health regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), is currently considering how to regulate ecigarettes. Given that marketing of these e-cigarettes is of particular concern, Marisa de Andrade and Gerard Hastings were commissioned by Cancer Research UK to conduct a rapid review of current practices and emerging trends. Here they provide highlights from the review.
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Multiple brands of e-cigarettes are being widely marketed, both online and in conventional media, as safer, ‘healthier’ and cheaper alternatives to smoking that can be used either to quit, or for dual use in places where smoking is not allowed – thereby enabling smokers to ‘take back their freedom’.
The products come in various flavours, colours and innovative packaging and have been endorsed by celebrity doctors and actors as well as fictional cartoon characters; presented as ‘must-have’ accessories; linked to charities; featured in various television programmes and films and been pictured in the hands of celebrities. The ads frequently use images of young, attractive men and women and, in one case, sponsor a 19 year old British Touring Car professional racing driver. Much imaginative use is made of online marketing – including social networking platforms; online consumer forums and internet-affiliate schemes which turn users into sellers.
The advertising regulator – the Advertising Standards Authority – is struggling to tackle this plethora of marketing communication. It has taken steps to remove claims on e-cigarette websites suggesting that the products are harmless (this remains unproven), and is monitoring television advertising – which cannot, for instance, make reference to the act of smoking. However, the regulatory challenges are significant.
Early efforts to regulate tobacco advertising showed how difficult it is to control the content of imagery-rich appeals; thus the fact that smoking cannot be directly mentioned does not mean that it is not being indirectly invoked using pictures or associations. Even with the best intentions, transgressions slip through the net; for example many e-cigarettes are being promoted as smoking cessation aids although they are not currently licensed for this in the UK. Furthermore, online publicity presents particular difficulties – websites can be set up outside UK jurisdiction, for instance, and website age protection remains rudimentary. The potential appeal of ecigarettes to the young is a particular concern, with at least one baseline study suggesting that younger, non-minority smokers with higher incomes have a high awareness of these products.
These developments have recently taken a more sinister turn because the tobacco industry has acquired large stakes in the e-cigarettes business. As a corporation, a tobacco company’s overriding objective is to maximise profits. It is possible that this could be benefit public health by enabling them to diversify away from burned tobacco products, and so hasten the move to smokefree. However, given the market size and dominance of burned tobacco, it seems more likely that these acquisitions will be used to bolster the status quo by normalising nicotine use, providing control of the recreational (and possibly pharmaceutical) gateways to it and turning a potential competitor into a product range (or even brand) extension.
The rapid review pinpoints two key areas of e-cigarettes which urgently need more research. Firstly, we have to know much more about public, and especially young people’s (including smokers and non-smokers), response to ecigarettes and the related marketing. To what extent are these developments modelling, reinforcing, or in any way promoting smoking? Secondly, it is vital that we learn much more about the tobacco industry’s intent. The current swathe of ecigarette marketing in the UK is chillingly reminiscent of the early days of tobacco advertising; this past experience suggests there is good reason to be deeply concerned.