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February 17, 1993, Vol 269, No. 7 >
ARTICLE | February 17, 1993

Criteria for Evaluating a Ban on the Advertisement of Cigarettes: Title and subTitle BreakBalancing Public Health Benefits With Constitutional Burdens FREE

Lawrence O. Gostin, JD; Allan M. Brandt, PhD
[+] Author Affiliations

Reprint requests to the Office of the Executive Director, American Society of Law, Medicine, and Ethics, 765 Commonwealth Ave, 16th Floor, Boston, MA 02215 (Mr Gostin).


JAMA. 1993;269(7):904-909. doi:10.1001/jama.1993.03500070084034
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Published online
Article
References

THE American Medical Association has long recommended a ban on promotional advertising of cigarettes, as has a broad range of public health organizations.1 The tobacco industry, in an uneasy alliance with civil libertarians and the media, argues that a ban would violate the constitutional right to free expression. The debate has been bitter and vehement, impeding adequate examination of the complex public health and constitutional questions engendered by such a policy.

In this article, we offer criteria for evaluating a national ban on tobacco advertising. First, we explore modern case law to determine whether the Supreme Court, applying the commercial free speech doctrine, would uphold a ban. Second, we critically evaluate existing empirical claims about the nature and impact of tobacco advertising on smoking behavior. Third, we assess the unique aspects of the cigarette as a consumer product to see whether it can be distinguished from other hazardous products.

REFERENCES

1 +
American Medical Association. American Medical Association House of Delegates Resolution 96. Interim Meeting; December 3-6, 1989; Honolulu, Hawaii.
2 +
Warner KE, Ernster VL, Holbrook JH, et al.  Promotion of tobacco products: issues and policy options. J Health Polit Policy Law . 1986;;11:367-392.
3 +
Virginia State Board of Pharmacy v Virginia Citizen's Consumer Council, 425 US 748, 762 (1976).
4 +
Valentine v Chrestensen, 316 US 52 (1942), rev'd, Schaumburg v Citizens for Better Environment, 444 US 620 (1980).
5 +
Capitol Broadcasting Co v Acting Attorney General, 405 US 1000 (1972), (mem) aff'd sub nom, Capitol Broadcasting Co v Mitchell, 333 F Supp 582 (DDC 1971).
6 +
Bigelow v Virginia, 421 US 809, 826 (1975).
7 +
Posadas de Puerto Rico v Tourism Company of Puerto Rico, 478 US 328 (1986).
8 +
Dunagin v City of Oxford, Miss, 718 F2d 738, 751 (5th Cir 1983) (en banc), cert denied, 467 US 1259 (1984).
9 +
Board of Trustees of the State University of New York v Fox, 493 US 887 (1989).
10 +
 Leading cases. Harvard Law Rev . 1986;;100:172-182.
11 +
 Alcoholic beverage advertising on the airwaves: alternatives to a ban or counteradvertising. UCLA Law Rev . 1987;;34:1139-1193. Comment.
12 +
Ile ML, Kroll LA.  Tobacco advertising and the First Amendment. JAMA . 1990;; 264:1593-1594.
13 +
Gostin L. Restrictions on the advertising of alcoholic beverages: a review of the law. Unpublished report prepared for National Institute on Alcohol Abuse and Alcoholism. 1992 draft.
14 +
Actmedia Inc v Stroh, 830 F2d 957 (9th Cir 1986).
15 +
Oklahoma Telecasters Assn v Crisp, 699 F2d 490 (10th Cir 1983), rev'd on other grounds sub nom, Capital Cities Cable v Crisp, 467 US 691 (1984).
16 +
Queensgate Invest Co v Liquor Control Com, 433 NE2d 138 (SCt Ohio 1982), cert denied, 459 US 807 (1982).
17 +
S & S Liquor Market Inc v Pastore, 497 A2d 729 (SCt RI 1985).
18 +
Rhode Island Liquor Stores Assn v The Evening Call Pub, 497 A2d 331 (SCt RI 1985).
19 +
Oklahoma Alcoholic Beverage Control Bd v Heublein Wines Intl, 566 P2d 1158 (SCt Okla 1977).
20 +
Michigan Beer & Wine Wholesalers Assn v Attorney General of Michigan, 370 NW2d 328 (Mich App 1985), cert denied, 479 US 939 (1986).
21 +
Brooks v State, through the Alcohol Beverage Control Commission, 442 A2d 93 (Del Super Ct 1981).
22 +
Central Hudson Gas & Electric Corp v Public Service Commission of New York, 447 US 557 (1980).
23 +
Ohralik v Ohio State Bar Assoc, 436 US 447, 462 (1978).
24 +
Blasi V, Monaghan HP.  The First Amendment and cigarette advertising. JAMA . 1986;;256:502-509.
25 +
Cipollone v Liggett Group Inc, 112 SCt 2608 (1992).
26 +
US Dept of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress: A Report of the Surgeon General . Washington, DC: US Dept of Health and Human Services; 1989;. Publication 10 89-8411.
27 +
Walters v National Association of Radiation Survivors, 105 SCt 3180, 3190 (1985).
28 +
US Dept of Health and Human Services, Public Health Service, Centers for Disease Control. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General . Washington, DC: US Dept of Health and Human Services; 1986;.
29 +
Davis RM.  Current trends in cigarette advertising and marketing. N Engl J Med . 1987;;316:725-732.
30 +
 Death toll from smoking is worsening. New York Times . (February 1) , 1991;:A9, A14.
31 +
Fielding JE.  Smoking: health effects and control. N Engl J Med . 1985;;313:491-498.
32 +
US Dept of Health and Human Services. Smoking and Health: A National Status Report . 2nd ed. Rockville, Md: US Dept of Health and Human Services, Office on Smoking and Health; 1990;. US Dept of Health and Human Services publication CDC 87-8396.
33 +
Boddewyn JJ.  There is no convincing evidence for a relationship between cigarette advertising and consumption. Br J Addict . 1989;;84:1255-1261, 1263-1265.
34 +
Centers for Disease Control.  Cigarette advertising: United States, 1988. MMWR . 1990;;39:261-265.
35 +
Schneider LM, Klein B, Murphy KM.  Governmental regulation of cigarette health information. J Law Econ . 1981;;24:575-612.
36 +
Seldon BJ, Dordoodian K.  A simultaneous model of cigarette advertising: effects on demand and industry response to public policy. Rev Econ Stat . 1989;;71:673-677.
37 +
Levit EM, Coate D, Grossman M.  The effects of government regulation on teenage smoking. J Law Econ . 1981;;24:545-569.
38 +
Hamilton JL.  The effect of cigarette advertising bans on cigarette consumption.  In: Proceedings of the Third World Conference on Smoking and Health . Washing ton, DC: US Dept of Health, Education, and Welfare; 1975;.
39 +
Reuijl JC. On the Determination of Advertising Effectiveness: An Empirical Study of the German Cigarette Market . Boston, Mass: Kluwer-Nijhoff; 1982;.
40 +
Goldstein AO, Fischer PM, Richards JW, Creten D.  Relationship between high school student smoking and recognition of cigarette advertisement. J Pediatr . 1987;; 110:488-491.
41 +
DiFranza JR, Richards JW, Paulman PM, et al.  RJR Nabisco's cartoon camel promotes Camel cigarettes to children. JAMA . 1991;;266:3149-3153.
42 +
Fischer PM, Schwartz MP, Richards JW, Goldstein AO, Rojas TH.  Brand logo recognition by children aged 3 to 6 years: Mickey Mouse and Old Joe the Camel. JAMA . 1991;;266:3145-3148.
43 +
Pierce JP, Gilpin E, Burns DM, et al.  Does tobacco advertising target young people to start smoking? evidence from California. JAMA . 1991;;266:3154-3158.
44 +
Aitken PP, Eadie DR, Hastings GB, Haywood AJ.  Predisposing effects of cigarette advertising on children's intentions to smoke when older. Br J Addict . 1991;; 86:383-390.
45 +
Aitken PP, Eadie DR.  Reinforcing effects of cigarette advertising on under-age smoking. Br J Addict . 1990;;85:399-412.
46 +
Aitken PP, Leather DS, O'Hagan FJ.  Children's perceptions of advertisements for cigarettes. Soc Sci Med . 1985;;21:785-797.
47 +
Klitzner M, Gruenewald PJ, Bamberger E.  Cigarette advertising and adolescent experimentation with smoking. Br J Addict . 1991;;86:287-298.
48 +
Albright CL, Altman DG, Slater MD, Maccoby N.  Cigarette advertisements in magazines: evidence for a differential focus on women's and youth magazines. Health Educ Q . 1988;;15:225-233.
49 +
Warner KE.  A ban on the promotion of tobacco products. N Engl J Med . 1987;; 316:745-747.
50 +
Warner KE, Goldenhar LM.  The cigarette advertising broadcast ban and magazine coverage of smoking and health. J Public Health Policy . 1989;;10:32-42.
51 +
Warner KE, Goldenhar LM, McLaughlin CG.  Cigarette advertising and magazine coverage of the hazards of smoking: a statistical study. N Engl J Med . 1992;;326: 305-309.
52 +
Neuberger MB. Smoke Screen: Tobacco and the Public Welfare . Englewood Cliffs, NJ: Prentice-Hall International Inc; 1963;:49-51.
53 +
Whelan E. A Smoking Gun . Philadelphia, Pa: George F Stickley; 1984;.
54 +
Warner KE. Selling Smoke: Cigarette Advertising and Public Health . Washington, DC: American Public Health Association; 1986;.
55 +
Brandt AM.  The cigarette, risk, and American culture. Daedalus . 1990;;119:115-176.
56 +
Trade Regulation for the Prevention of Unfair or Deceptive Advertising and Labelling of Cigarettes in Relation to the Health Hazards of Smoking and Accompanying Statement of Basis and Purpose of Rule 99-113 (1964).
57 +
Banzhaf v Federal Communications Commission, 405 F2d 1082 (DC Cir 1968), sub nom, Tobacco Institute Inc v Federal Communications Commission, cert denied, 396 US 842 (1969).
58 +
Fritschler AL. Smoking and Politics: Policymaking and the Federal Bureaucracy . New York, NY: Appleton-Century-Crofts; 1969;.
59 +
Gostin LO, Brandt AM, Cleary PD.  Tobacco liability and public health policy. JAMA . 1991;;266:3178-3182.
60 +
Elliot S.  Top health official demands abolition of 'Joe Camel' ads. New York Times . (March 10) , 1992;:D1, D21.
61 +
Rogotti NA, Pashos CL.  No-smoking laws in the United States: an analysis of state and city actions to limit smoking in public places and workplaces. JAMA . 1991;; 266:3162-3167.
62 +
Hearings Before the Subcommittee on Health and the Environment, House Committee on Energy and Commerce on Proposals to Ban or Restrict Tobacco Product Advertising (1987) (statement of Martin H. Redish).
63 +
Redish M.  Product health claims and the First Amendment: scientific expression and the twilight zone of commercial speech. Vanderbilt Law Rev . 1990;;43:1433-1461.
64 +
Chapman S.  Tobacco excise and declining tobacco consumption: the case of Papua New Guinea. Am J Public Health . 1990;;80:537-540.
65 +
Peterson DE, Zeger SL, Remington PL, Anderson HA.  The effect of state cigarette excise tax increases on cigarette sales, 1955 to 1988. Am J Public Health . 1992;;82:94-96.
66 +
Bal DG, Kizer KW, Felten PG, Mozar HN, Niemeyer D.  Reducing tobacco consumption in California: development of a statewide anti-tobacco use campaign. JAMA . 1990;;264:1570-1574.
67 +
Erickson AC, McKenna JW, Romano RM.  Past lessons and new uses of the mass media in reducing tobacco consumption. Public Health Rep . 1990;;105:239-244.

Figures

Tables

Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
American Medical Association. American Medical Association House of Delegates Resolution 96. Interim Meeting; December 3-6, 1989; Honolulu, Hawaii.
2 +
Warner KE, Ernster VL, Holbrook JH, et al.  Promotion of tobacco products: issues and policy options. J Health Polit Policy Law . 1986;;11:367-392.
3 +
Virginia State Board of Pharmacy v Virginia Citizen's Consumer Council, 425 US 748, 762 (1976).
4 +
Valentine v Chrestensen, 316 US 52 (1942), rev'd, Schaumburg v Citizens for Better Environment, 444 US 620 (1980).
5 +
Capitol Broadcasting Co v Acting Attorney General, 405 US 1000 (1972), (mem) aff'd sub nom, Capitol Broadcasting Co v Mitchell, 333 F Supp 582 (DDC 1971).
6 +
Bigelow v Virginia, 421 US 809, 826 (1975).
7 +
Posadas de Puerto Rico v Tourism Company of Puerto Rico, 478 US 328 (1986).
8 +
Dunagin v City of Oxford, Miss, 718 F2d 738, 751 (5th Cir 1983) (en banc), cert denied, 467 US 1259 (1984).
9 +
Board of Trustees of the State University of New York v Fox, 493 US 887 (1989).
10 +
 Leading cases. Harvard Law Rev . 1986;;100:172-182.
11 +
 Alcoholic beverage advertising on the airwaves: alternatives to a ban or counteradvertising. UCLA Law Rev . 1987;;34:1139-1193. Comment.
12 +
Ile ML, Kroll LA.  Tobacco advertising and the First Amendment. JAMA . 1990;; 264:1593-1594.
13 +
Gostin L. Restrictions on the advertising of alcoholic beverages: a review of the law. Unpublished report prepared for National Institute on Alcohol Abuse and Alcoholism. 1992 draft.
14 +
Actmedia Inc v Stroh, 830 F2d 957 (9th Cir 1986).
15 +
Oklahoma Telecasters Assn v Crisp, 699 F2d 490 (10th Cir 1983), rev'd on other grounds sub nom, Capital Cities Cable v Crisp, 467 US 691 (1984).
16 +
Queensgate Invest Co v Liquor Control Com, 433 NE2d 138 (SCt Ohio 1982), cert denied, 459 US 807 (1982).
17 +
S & S Liquor Market Inc v Pastore, 497 A2d 729 (SCt RI 1985).
18 +
Rhode Island Liquor Stores Assn v The Evening Call Pub, 497 A2d 331 (SCt RI 1985).
19 +
Oklahoma Alcoholic Beverage Control Bd v Heublein Wines Intl, 566 P2d 1158 (SCt Okla 1977).
20 +
Michigan Beer & Wine Wholesalers Assn v Attorney General of Michigan, 370 NW2d 328 (Mich App 1985), cert denied, 479 US 939 (1986).
21 +
Brooks v State, through the Alcohol Beverage Control Commission, 442 A2d 93 (Del Super Ct 1981).
22 +
Central Hudson Gas & Electric Corp v Public Service Commission of New York, 447 US 557 (1980).
23 +
Ohralik v Ohio State Bar Assoc, 436 US 447, 462 (1978).
24 +
Blasi V, Monaghan HP.  The First Amendment and cigarette advertising. JAMA . 1986;;256:502-509.
25 +
Cipollone v Liggett Group Inc, 112 SCt 2608 (1992).
26 +
US Dept of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress: A Report of the Surgeon General . Washington, DC: US Dept of Health and Human Services; 1989;. Publication 10 89-8411.
27 +
Walters v National Association of Radiation Survivors, 105 SCt 3180, 3190 (1985).
28 +
US Dept of Health and Human Services, Public Health Service, Centers for Disease Control. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General . Washington, DC: US Dept of Health and Human Services; 1986;.
29 +
Davis RM.  Current trends in cigarette advertising and marketing. N Engl J Med . 1987;;316:725-732.
30 +
 Death toll from smoking is worsening. New York Times . (February 1) , 1991;:A9, A14.
31 +
Fielding JE.  Smoking: health effects and control. N Engl J Med . 1985;;313:491-498.
32 +
US Dept of Health and Human Services. Smoking and Health: A National Status Report . 2nd ed. Rockville, Md: US Dept of Health and Human Services, Office on Smoking and Health; 1990;. US Dept of Health and Human Services publication CDC 87-8396.
33 +
Boddewyn JJ.  There is no convincing evidence for a relationship between cigarette advertising and consumption. Br J Addict . 1989;;84:1255-1261, 1263-1265.
34 +
Centers for Disease Control.  Cigarette advertising: United States, 1988. MMWR . 1990;;39:261-265.
35 +
Schneider LM, Klein B, Murphy KM.  Governmental regulation of cigarette health information. J Law Econ . 1981;;24:575-612.
36 +
Seldon BJ, Dordoodian K.  A simultaneous model of cigarette advertising: effects on demand and industry response to public policy. Rev Econ Stat . 1989;;71:673-677.
37 +
Levit EM, Coate D, Grossman M.  The effects of government regulation on teenage smoking. J Law Econ . 1981;;24:545-569.
38 +
Hamilton JL.  The effect of cigarette advertising bans on cigarette consumption.  In: Proceedings of the Third World Conference on Smoking and Health . Washing ton, DC: US Dept of Health, Education, and Welfare; 1975;.
39 +
Reuijl JC. On the Determination of Advertising Effectiveness: An Empirical Study of the German Cigarette Market . Boston, Mass: Kluwer-Nijhoff; 1982;.
40 +
Goldstein AO, Fischer PM, Richards JW, Creten D.  Relationship between high school student smoking and recognition of cigarette advertisement. J Pediatr . 1987;; 110:488-491.
41 +
DiFranza JR, Richards JW, Paulman PM, et al.  RJR Nabisco's cartoon camel promotes Camel cigarettes to children. JAMA . 1991;;266:3149-3153.
42 +
Fischer PM, Schwartz MP, Richards JW, Goldstein AO, Rojas TH.  Brand logo recognition by children aged 3 to 6 years: Mickey Mouse and Old Joe the Camel. JAMA . 1991;;266:3145-3148.
43 +
Pierce JP, Gilpin E, Burns DM, et al.  Does tobacco advertising target young people to start smoking? evidence from California. JAMA . 1991;;266:3154-3158.
44 +
Aitken PP, Eadie DR, Hastings GB, Haywood AJ.  Predisposing effects of cigarette advertising on children's intentions to smoke when older. Br J Addict . 1991;; 86:383-390.
45 +
Aitken PP, Eadie DR.  Reinforcing effects of cigarette advertising on under-age smoking. Br J Addict . 1990;;85:399-412.
46 +
Aitken PP, Leather DS, O'Hagan FJ.  Children's perceptions of advertisements for cigarettes. Soc Sci Med . 1985;;21:785-797.
47 +
Klitzner M, Gruenewald PJ, Bamberger E.  Cigarette advertising and adolescent experimentation with smoking. Br J Addict . 1991;;86:287-298.
48 +
Albright CL, Altman DG, Slater MD, Maccoby N.  Cigarette advertisements in magazines: evidence for a differential focus on women's and youth magazines. Health Educ Q . 1988;;15:225-233.
49 +
Warner KE.  A ban on the promotion of tobacco products. N Engl J Med . 1987;; 316:745-747.
50 +
Warner KE, Goldenhar LM.  The cigarette advertising broadcast ban and magazine coverage of smoking and health. J Public Health Policy . 1989;;10:32-42.
51 +
Warner KE, Goldenhar LM, McLaughlin CG.  Cigarette advertising and magazine coverage of the hazards of smoking: a statistical study. N Engl J Med . 1992;;326: 305-309.
52 +
Neuberger MB. Smoke Screen: Tobacco and the Public Welfare . Englewood Cliffs, NJ: Prentice-Hall International Inc; 1963;:49-51.
53 +
Whelan E. A Smoking Gun . Philadelphia, Pa: George F Stickley; 1984;.
54 +
Warner KE. Selling Smoke: Cigarette Advertising and Public Health . Washington, DC: American Public Health Association; 1986;.
55 +
Brandt AM.  The cigarette, risk, and American culture. Daedalus . 1990;;119:115-176.
56 +
Trade Regulation for the Prevention of Unfair or Deceptive Advertising and Labelling of Cigarettes in Relation to the Health Hazards of Smoking and Accompanying Statement of Basis and Purpose of Rule 99-113 (1964).
57 +
Banzhaf v Federal Communications Commission, 405 F2d 1082 (DC Cir 1968), sub nom, Tobacco Institute Inc v Federal Communications Commission, cert denied, 396 US 842 (1969).
58 +
Fritschler AL. Smoking and Politics: Policymaking and the Federal Bureaucracy . New York, NY: Appleton-Century-Crofts; 1969;.
59 +
Gostin LO, Brandt AM, Cleary PD.  Tobacco liability and public health policy. JAMA . 1991;;266:3178-3182.
60 +
Elliot S.  Top health official demands abolition of 'Joe Camel' ads. New York Times . (March 10) , 1992;:D1, D21.
61 +
Rogotti NA, Pashos CL.  No-smoking laws in the United States: an analysis of state and city actions to limit smoking in public places and workplaces. JAMA . 1991;; 266:3162-3167.
62 +
Hearings Before the Subcommittee on Health and the Environment, House Committee on Energy and Commerce on Proposals to Ban or Restrict Tobacco Product Advertising (1987) (statement of Martin H. Redish).
63 +
Redish M.  Product health claims and the First Amendment: scientific expression and the twilight zone of commercial speech. Vanderbilt Law Rev . 1990;;43:1433-1461.
64 +
Chapman S.  Tobacco excise and declining tobacco consumption: the case of Papua New Guinea. Am J Public Health . 1990;;80:537-540.
65 +
Peterson DE, Zeger SL, Remington PL, Anderson HA.  The effect of state cigarette excise tax increases on cigarette sales, 1955 to 1988. Am J Public Health . 1992;;82:94-96.
66 +
Bal DG, Kizer KW, Felten PG, Mozar HN, Niemeyer D.  Reducing tobacco consumption in California: development of a statewide anti-tobacco use campaign. JAMA . 1990;;264:1570-1574.
67 +
Erickson AC, McKenna JW, Romano RM.  Past lessons and new uses of the mass media in reducing tobacco consumption. Public Health Rep . 1990;;105:239-244.

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