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Authors: Toyyib Abdulkareem, Huda Alabed, Louise Johansson, Sophie Manoy
Regions:
Nigeria, Jordan, Sweden, Australia, Recommendations
Tobacco consumption is the leading cause of preventable death worldwide, accounting for more
than eight million deaths per year, with the majority occurring in low- and middle-income countries.
Over time, progress has been made in the reduction of tobacco consumption through mass
media campaigns, warning labels, advertising restrictions and other more “traditional” methods
of control supported by the World Health Organization Framework Convention on Tobacco
Control (WHO FCTC), but the tobacco industry has now entered a new era and is using subtle
and misleading marketing strategies to target young people, where 90% of regular tobacco
users start smoking before adulthood. As young people living in different parts of the world –
Nigeria, Jordan, Sweden and Australia – we are drawing attention to the innovative marketing
strategies of the tobacco industry from each of our regions to raise the awareness of young
people and to call on policy-makers to prevent this new wave of tobacco marketing that is
targeting a new generation of tobacco users.
By: Toyyib Abdulkareem
In Nigeria, tobacco smoking generally decreases with increasing age, highlighting the need to
protect children and young people from taking up tobacco use with the prevalence of smoking
cigarettes being 13.3% among adolescents in Enugu State, Nigeria. Tobacco consumption
among young people is driven partly by industry normalization of tobacco products – depicting
tobacco as the new “cool”. Attractive campaigns using celebrities influence behaviour and the
attractiveness of tobacco. From public display of smoking habits to scenes in movies, Nigerian
celebrities are contributing to the growing incidence of tobacco consumption among young
people. This normalization is pushed using different pro-tobacco advertising tactics with young
people perceiving smoking as socially acceptable once again.
By: Huda Alabed
Jordan has topped the tobacco prevalence scale among the Middle East region and throughout
the world including for young people with 18% of adolescents having smoked a form of tobacco.
The most common forms of smoking in Jordan are cigarettes, shisha and more recently, vaping.
In Jordan, tobacco products remain accessible for young people as tobacco taxation has not
been introduced and the cost of tobacco products is not a major barrier to the uptake of
smoking. Decreasing the affordability of these products has been effective in similar countries
such as Bahrain, Saudi Arabia and the United Arab Emirates and should be enforced in Jordan
to reduce accessibility for young people. Taxation works the most for younger consumers and
these countries have had the highest improvements in cigarette tax policy in recent times.
In Jordan, the legislation prohibits smoking in public places but it is not fully enforced, making it
challenging to reduce exposure to second-hand smoke. Consequently, the implementation of
broader legislation such as a tobacco taxation plan is yet to be seriously discussed by Jordan’s
policymakers. A focus on broader tobacco control methods such as comprehensive legislation
and tobacco taxation is vital to building strong foundations in Jordan in addition to considering
the new ways the tobacco industry is targeting young people.
By: Louise Johansson
Sweden is perceived as a successful country for tobacco control, but with lowering smoking
rates in adults, the tobacco industry is on the offence towards young people. In Sweden, 92% of
all tobacco users start in adolescence or earlier, and the most common age to try tobacco
products is between 13-16 years. Apart from smoking traditional cigarettes, ‘snus’ is a way to
use tobacco, a pouch to put under the upper lip. It is a highly addictive product that men have
primarily used, something that the industry currently is seeking to change. The tobacco industry
targets girls and women by marketing their products as part of feminist liberation and
confidence.
The Swedish snus industry expands worldwide, calling their new products “nicotine pouches”. In
Sweden, this is done through carefully targeted marketing strategies and new products not
covered by the law. The Swedish snus industry extracts nicotine from the tobacco leaf and calls
their new products “white” and “tobacco-free”. This strategy has enabled companies to portray
these products as less harmful alternatives to cigarettes while simultaneously circumventing
legislation regulating tobacco products. These products now exist in a legal loophole and are
exempted from marketing, taxation and sales permits. In addition to the lack of knowledge
regarding the health risks of the new snus, it is often perceived as less harmful to the
environment, which is false given nicotine is extracted from the same tobacco as other tobacco
products. According to one investigation, between 2019 and 2020, the proportion of young
people in Sweden aged 14-18 who stated that they had used white snus increased from 7 to
19%.
By: Sophie Manoy
Rates of tobacco consumption in Australia remain low, with 97% of 14 to 17-year-olds having
never smoked cigarettes but e-cigarettes and vaping products are threatening Australia’s
progress with the use of e-cigarettes rising since 2016. Of those who smoke, the use of
e-cigarettes is highest in young people, with 1 in 5 students aged 16 – 17 years old having tried
e-cigarettes.
A range of products including e-cigarettes, vaping pens and nicotine pods, are directly marketed
to young people using bright colours and a range of attractive flavours, such as bubblegum and
cinnamon. These products are referred to as “smoke-free” to market a “healthier” alternative to
traditional cigarettes even though they are all nicotine-containing products. The packaging
colours and range of flavours are aimed at young people and at attracting new smokers,
threatening Australia’s successes in tobacco control to date. Recently, new legislation has been
introduced that requires all nicotine e-cigarettes and liquid nicotine to be prescribed by a
medical practitioner but these products remain attractive to young people as an alternative to
traditional cigarettes.
Globally, as outlined in Nigeria, Jordan, Sweden and Australia, the tobacco industry is using new and innovative strategies to target young people and attract new smokers among different standards of tobacco control legislation. These strategies include attractive campaigns and the marketing of new products as “healthier” and more “environmentally friendly” alternatives to traditional tobacco. The misleading marketing of products as tobacco-free has given rise to a misconception about health effects. If our decision-makers do not act to prevent the introduction and use of the tobacco industry’s new products and ensure decisions are made free from industry involvement, we will have a new generation of nicotine-addicted people.
There is a need for well-implemented and strengthened tobacco policies as the foundation for tobacco control measures to protect young people across the world from the harms of the commercial determinants of illness. There should be a ban on tobacco advertising on all forms of internet communication, product placements and media sponsorship. It is also vital that stores and outlets close to schools and recreational areas that young people frequent are safe
from sales and the advertisement of tobacco. Tobacco taxes should be considered in regions yet to adopt these and the rigorous enforcement of tobacco control legislation is vital for progress.
Tobacco companies continue to find different ways to reach new generations of young people.Their so-called innovations, fronted with a “harm reduction approach”, are only a cover—a cover to hide and support their unethical core business of keeping and initiating nicotine-addicted people. Where progress is made in advocating and highlighting to decision-makers the alarming rise of use by young people, simultaneously tobacco companies develop new strategies to
reach another generation of addicted young people while counting their profits.
Our key recommendations include:
1. Fully implement the WHO FCTC
The WHO FCTC is an evidence-based treaty and tool that protects everyone, including young people from the harms of tobacco consumption. Even though there are 182 parties to the WHO FCTC, implementation continues to be suboptimal. Strong and complete implementation of the WHO FCTC is important to limit industry activities targeting young people.
2. Restrict sales by year born for tobacco-free generations
Countries like Malaysia, Denmark and New Zealand have proposed prohibiting tobacco use for coming generations. The tobacco-free generation proposal endorses legislation preventing the sale and supply of tobacco to individuals born after a particular year. This action ought to be taken in combination with supporting initiatives.
3. Proactive legislation on tobacco and nicotine
The tobacco industry continues to innovate and rebrand itself worldwide. Through a mixture of strategies, including broadening its product portfolio, the industry aggressively grows its portfolio among young people. The tobacco industry should not be able to take advantage of the inconsistencies existing in regulations. We need decision-makers to embrace proactive legislation on these harmful and addictive substances to protect young people.
4. Include young people in tobacco prevention and control
Young people must be included in policy and decision-making about their health to enable effective and sustainable change for the next generation. Decisions in tobacco prevention and control for young people need to include targeted and industry-free representation.
5. Increase knowledge of tobacco harm among young people
Young people deserve honesty and transparency about the harms of tobacco and nicotine use on their health including with newer e-cigarette products and the innovative ways these are marketed by the tobacco industry. Education and awareness on the reality of these products, including health, environmental and financial impacts, is essential for young people to be fully informed in making healthy choices.
Young people deserve comprehensive and proactive legislation on tobacco and nicotine products worldwide. Awareness and knowledge of these marketing strategies are crucial for young people to understand the full implications of taking up these products. We demand political will and action in this area.
Centre for Global Child Health
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