Commentary

POWERWALLS PREY ON THESUSCEPTIBLE

The paper ‘The effect of retail cigarette pack displays onimpulse purchase’, by Wakefield, Germain and Henriksen,reveals fascinating insights into the immensely difficulttask of quitting smoking and also into the sophisticationof tobacco marketers who target the smoker [1].

It should be noted that in Australia, where this studywas conducted, retail displays consist only of an array ofpackets of cigarettes with brand-name trademarks andgarishly illustrated health warnings carefully calculatedto diminish the attractiveness of the packet. They are alsolimited in size, but can nevertheless constitute whatDewhirst [2] has categorized rather accurately as a‘powerwall’.

Nothing underlines the position of the smoker as avictim better than this exposé of their vulnerability tosuch simple cues as the sight of a display of cigarettepackets. This affects would-be quitters to the extent that19.4% avoid subjecting themselves to such displays and37.7% declare that the mere sight of the displaysproduces an urge to smoke.

The paper also demonstrates the power of tobaccoaddiction and the difficulties that society and individualshave in dealing with it. Thirty years ago the political cam-paign to remove tobacco advertising and sporting spon-sorship was scoffed at, as the causal link with smokinginitiation was doubted. Our early gut instincts that adver-tising and sponsorship led to smoking were right, but ittook a long time for researchers to prove it.

Other work by Pierce [3] has shown that smoking ini-tiation was more likely in adolescents who possessed orwere willing to possess a tobacco promotional item—seemingly a small issue, but given the power of tobaccoaddiction, even such simple items as brand-labelled Tshirts have become weapons of war between publichealth and the tobacco merchants whose product killshalf its long-term users [4].

Fortunately, early campaigns based partly on gutinstincts had another basis—the view that promotion ofsomething deadly was unethical and should not be giventhe benefit of the doubt. This view did resonate withour supporters and tobacco promotion has diminishedgradually in the developed world. However, even inAustralia, a 40-year campaign has not eradicatedtobacco promotion completely, as evidenced by the workof Wakefield et al. [1].

The need to remove unnecessary cues to smoke is aclear message from Wakefield’s research. The conclusion

from the work is that international policy that proposesoutlawing all forms of tobacco promotion, as laid out inthe Framework Convention on Tobacco Control (FCTC),should be taken to what might once have been catego-rized as extremes. Tobacco sales should be allowed, butsupplies should be under the counter, outlets minimizedand plain generic packaging should replace trademarks.This should be in addition to controlling orthodox adver-tising. Removing the facility of routine ability to smokein pleasant sociable environments is a similarly clearmessage from the experience of Ireland and other coun-tries with smoke-free legislation [5]. Legislation that wasonce seen as socially draconian is actually too permissive,as the sophistication of the industry has kept ahead of thelaw.

These measures will be labelled as ‘social engineering’,and correctly, because that is what they are. However, thetobacco industry has been infinitely better at this thanhas public health. We need an environment free of smokeand smoking cues, and this means that our politicalbattles are far from over.

Another interesting issue arises from the paper. Of2996 people sampled, only 17.6% (526 people) weresmokers (of manufactured cigarettes). Of these, 53.2%smoked less than 10 cigarettes daily; 40.7% had tried toquit within the last 6 months and 59% were consideringquitting within the next 6 months. This is a vastly differ-ent social portrait compared to that of a decade or twoago. Smokers are showing strong signs of dissonancewith their addiction and the pool of smokers is in a con-stant state of dynamic change. This is due presumably tothe public health pressures we have been able to apply,and represents a considerable degree of success. However,the analogy of the smoker as a ping-pong ball bouncingbetween the bats of public health and the tobacco indus-try is a fair one. Obviously it is essential to keep up thepublic health pressure as the battle is going our way, butis far from won.

Keeping up the pressure means continuing carefullytailored legislative restrictions and covering all the fieldsof promotion; removing exposure to second-hand smoke;and restricting sales outlets. However, this is not enough.We need to use the weapons against the industry theyonce used so freely on the public. This means money—Coca Cola- or Macdonald’s-style money—spent on well-researched programmes. This funding should be sourcedfrom tobacco levies, earmarked legislatively for tobaccocontrol. Given the price elasticity of tobacco, there isplenty of funding there for the taking. All that is lacking ispolitical will.

© 2007 The Author. Journal compilation © 2007 Society for the Study of Addiction Addiction, 103, 329–330

Keywords Dissonance, legislation, point-of-sale,powerwalls, promotion, tobacco.

NIGEL GRAY

Voluntary Senior Associate with the Cancer Council,Victoria, Australia. E-mail: ng742059@bigpond.net.au

References

1. Wakefield M., Germain D., Henriksen L. The effect of retailcigarette pack displays on impulse purchase. Addiction 2008;103: 322–28.

2. Dewhirst T. POP goes the power wall? Taking aim at tobaccopromotional strategies utilised at retail. Tob Control 2004; 13:209–10.

3. Pierce J. P., Choi W. S., Gilpin E. A., Farkas A. J., Berry C. C.Tobacco industry promotion of cigarettes and adolescentsmoking. JAMA 1998; 279: 511–5.

4. Peto R., Lopez A. D., Boreham J., Thun M., Heath C. Mortalityfrom Smoking in Developed Countries 1950–2000. Oxford:Oxford University Press; 1994

5. Fong G. T., Hyland A., Borland R., Hammond D., Hastings G.,Mcneill A. et al. Reductions in tobacco smoke pollution andincreases in support for smoke-free public places followingthe implementation of comprehensive smoke-free workplacelegislation in the Republic of Ireland: findings from the ITCIreland/UK Survey. Tob Control 2006; 15: iii51–8.

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© 2007 The Author. Journal compilation © 2007 Society for the Study of Addiction Addiction, 103, 329–330