The phrases sound empowering, life-affirming: "Don't be a maybe," "Make your move," "My day now." The people posting them on Twitter and Instagram and Facebook write the slogans under photos of themselves looking youthful, athletic, attractive. The people are in Europe, Asia, South America, all over the world, but their words are in English, and the hashtags sound cheerfully American: "#youdecide," one encourages.
These posts are seen and shared globally by young people -- including millions of U.S. teens -- who have grown up influenced by social media. But they've been coordinated by major tobacco companies,(www.takeapart.org) and the message they're designed to convey is an old one: Smoking is cool; start, then don't stop.
Now, the AAFP and eight fellow medical and public health organizations are calling on the Federal Trade Commission (FTC) to halt these social media campaigns, which they say are deceptive and, in violation of U.S. law, target American youth.
Besides the Campaign for Tobacco-Free Kids, the Academy's co-signers are the American Academy of Pediatrics, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association, the Truth Initiative, the International Union Against Tuberculosis and Lung Disease, and Vital Strategies.
The petition to the FTC(www.takeapart.org) cites a multi-year investigation by the Campaign for Tobacco-Free Kids and the consumer research firm Netnografica LLC, whose findings were sent in a petition to the FTC.
- The AAFP joined in a petition to the Federal Trade Commission that says major tobacco companies circumvent U.S. law with international campaigns that reach Americans via Facebook, Instagram and Twitter.
- The petition says cigarette makers pay social media influencers overseas to make smoking appeal to American teens.
- Just 123 hashtags associated with campaigns for tobacco products have been viewed 8.8 billion times in the United States on Twitter alone.
In an accompanying press release,(www.tobaccofreekids.org) the Campaign for Tobacco-Free Kids says that, according to its investigation, the tobacco companies named in the petition "seek out young people who have significant numbers of followers online and pay them to post photos featuring Marlboro, Lucky Strike and other cigarette brands." These "social media influencers," the campaign says, "are trained on what cigarette brands to promote, when to post pictures for maximum exposure and how to take 'natural photos' that do not look like staged advertisements."
The petition says that the four largest publicly traded multinational tobacco companies -- Philip Morris International, British American Tobacco, Japan Tobacco International and Imperial Brands -- "flood social media platforms with images and videos depicting cool, hip and young people promoting tobacco brands without clearly informing consumers that the content is in fact paid advertising."
The investigation notes that "just 123 hashtags associated with these companies' campaigns for tobacco products have been viewed 8.8 billion times in the United States (and 25 billion times globally) on Twitter alone."
As the number of U.S. smokers has decreased,(www.cdc.gov) cigarette companies have spent more on advertising and promotion in this country. The FTC 's most recent report(www.ftc.gov) on cigarettes said tobacco companies spent $8.7 billion on cigarette advertising and promotion in 2016, up from $8.3 billion the previous year.
According to a 2014 Surgeon General's report,(www.surgeongeneral.gov) "Promotional activities by the tobacco companies cause the onset and continuation of smoking among adolescents and young adults."
Such activities include "using foreign influencers with substantial U.S. followers" -- a violation of FTC rules, the petition argues.
The investigation says the named tobacco companies reached young people by
- "directly entering into a material relationship with young influencers to post tobacco brand images and campaign hashtags related to their tobacco brands;
- creating parties and events with tobacco brand sponsorship and promotion, often in conjunction with distribution of (free or paid-for) tobacco products, and encouraging event attendees to post to their social media accounts specific hashtags and images as instructed at the party or event; and
- engaging in brand-sponsored contests and encouraging participants to post information, including specific hashtags, about their participation to their social media accounts."
According to a Pew Research Center report(www.pewinternet.org) issued in May, 95 percent of U.S. teens have access to a smartphone and 45 percent say they are online "almost constantly." Seventy-two percent of U.S. teens surveyed for the report say they use Instagram, 51 percent say they use Facebook, and 32 percent use Twitter.
Data cited by HHS(www.hhs.gov) indicate that "nearly 90 percent of adult smokers began smoking before age 18."
"Without a doubt," the petition reads, the tobacco companies' "online deceptive global marketing has a substantial U.S. reach on Twitter, Instagram and Facebook beyond what one may anticipate as 'leakage' due to the global and porous nature of social media." The influencer marketing reach into the American market "is deliberate."
And without a doubt, U.S. teens continue to smoke.
A CDC report(www.cdc.gov) issued in June found that, in 2017, 19.6 percent of U.S. high school students and 5.6 percent of middle school students reported using a tobacco product at least once in the previous month. Among these users, 46.8 percent of those in high school and 41.8 percent of those in middle school used two or more tobacco products. E-cigarettes were the most commonly used tobacco product among high schoolers (11.7 percent) and middle schoolers (3.3 percent).
In a statement(www.fda.gov) about the 2017 National Youth Tobacco Survey, FDA Commissioner Scott Gottlieb said: "Protecting our nation's youth from the dangers of tobacco products is among the FDA's most important responsibilities, and we're taking aggressive steps to make sure all tobacco products aren't being marketed to, sold to, or used by kids."
The FTC petition and a lawsuit filed in March against the FDA argue that the government's approach isn't aggressive enough when it comes to protecting American youth from tobacco, nicotine and product marketing.
The plaintiffs argue that the FDA's delay until 2022 of e-cigarette product review applications constitutes a severe threat to public health. Several of the organizations that co-signed the FTC petition are among the litigants in that case.
Related AAFP News Coverage
Rise of 'JUULing' Among Youth Sparks Sharp Response
Academy Offers Members Physician/Patient Resources
CDC: Youth and Tobacco Use(www.cdc.gov)