To improve tobacco control efforts, physicians and health professionals should apply tobacco industry marketing strategies that target actual and potential smokers according to their lifestyles, activities and consumer attitudes, according to the Journal of the American Medical Association (JAMA).

For example, young adults have been targeted by the tobacco industry and therefore deserve special attention from health officials, JAMA says.

Dr. Pamela M. Ling and Stanton A. Glantz, Ph.D., of the University of California, San Francisco, searched tobacco industry document archives on the Web between August 2000 and February 2002. They also conducted a detailed analysis of about 100 marketing research reports, contractors' presentations, strategic planning documents, consumer data files, memorandums and brand reviews focused on young adult smokers in the United States.

"In contrast to public health, the tobacco industry divides markets and defines targets according to consumer attitudes, aspirations, activities and lifestyles," the researchers said. "Tobacco marketing targets smokers of all ages; young adults are particularly important. Physicians and public health professionals should use tobacco industry psychographic approaches to design more relevant tobacco control interventions."

The researchers said their analysis of tobacco industry documents showed that cigarette cost impacted increasing numbers of young and older smokers during the 1980s. During the 1990s, eroding social acceptability of smoking emerged as a major threat to the industry, largely due to growing awareness of the dangers of second-hand smoke, they added.

The research team said the industry conducts extensive research on adults, particularly young adults between the ages of 18 to 24, since this group is the youngest legal marketing target.

"Efforts to counter tobacco marketing campaigns should include people of all ages, particularly young adults, rather than concentrating on teens and young children," the researchers said.

The team added that physician counseling and public health campaigns that identify with the psychological needs and values of smokers and non-smokers may improve smoking prevention and cessation efforts.

"Interventions that affect cigarette prices, acceptance of the tobacco industry, the social acceptability of smoking and second-hand tobacco smoke particularly threaten the industry," the researchers said.

In an accompanying article in JAMA, Ronald Bayer, Ph.D., and colleagues from the Mailman School of Public Health, Columbia University, proposed a comprehensive system of taxation and constitutionally acceptable regulations designed to increase public appreciation and comprehension of the health risks of cigarettes.

"First, we consider a tax to be levied on tobacco advertising and promotion or, as an alternative, a new excise tax, the proceeds of which would be used to exclusively to fund a Centers for Disease Control and Prevention-directed national anti-tobacco campaign," said the team.

"Second, all print advertising should be required to carry public health warnings equivalent to 50 percent of the space devoted to the advertisement," they added. "Third, manufacturers should be required to devote one full side of cigarette packages to graphic pictorials displaying the dangers of smoking."