Few people would consider a handgun with a sustainably harvested wood stock any less lethal than one with a steel stock. The same logic doesn’t seem to apply to cigarettes – the leading preventable cause of death globally and in the United States. A new Stanford study finds that people perceive cigarettes with pro-environment marketing on the packaging as less harmful not only to the environment but also to the health of smokers and people around them.
The survey, published recently in the journal of Preventive Medicine, is the first to gauge the effect of such marketing on cigarette packaging, which is viewed about 20 times a day by the average pack-a-day smoker.
“Ecofriendly and natural food products are seen as safer for health,” said study lead author Anna Epperson, a postdoctoral fellow with the Stanford Prevention Research Center. “That couldn’t be further from the truth when it comes to cigarettes.”
On average, smokers die 10 years earlier than nonsmokers, according to the Centers for Disease Control and Prevention. While they’re alive, they’re at significantly higher risk for cancer, heart disease, stroke, lung diseases, diabetes and a raft of other maladies.
Every year in the U.S., cigarette smoking is responsible for more than 480,000 deaths (a number greater than the population of Oakland, California), including more than 41,000 deaths resulting from secondhand smoke exposure. And cigarettes aren’t just a health scourge. They are also the most commonly discarded form of litter in the world, defiling just about every kind of natural landscape and built environment with toxic chemicals that leach into soil and water supplies.
The researchers compared two major cigarette brands: Pall Mall, marketed as a discount brand, and Natural American Spirit, a super-premium brand that features a pro-environment marketing campaign – the first-ever corporate social responsibility advertising on cigarette packaging. That campaign includes a description of a manufacturing facility that is “zero-waste-to-landfill” and features a wreath of three tobacco leaves that mimics the symbol for recycling, as well as the logo for the Programme for the Endorsement of Forest Certification, an international organization that promotes sustainable forest management.
Both brands have the same health impacts, and are owned by the same company, Reynolds American. Still, survey participants – including former smokers, current smokers and people who had never smoked – consistently ranked Natural American Spirit as less harmful to health and the environment. The findings were strongest among current smokers, a factor that could discourage quitting and might encourage switching to the brand, according to the researchers. Whereas never and former adult smokers likely have developed a firmer stance than current smokers on the harms of smoking, many current smokers may be seeking a product alternative that reduces smoking harms to both humans and the planet, the researchers explained.
In 2006, a federal court concluded that the tobacco industry had deceived the American public for more than 50 years about the harms of smoking and secondhand smoke. The court suggested the word “natural” be banned from cigarette marketing and brand names. “Our findings reinforce the court’s conclusion that positioning cigarettes as ‘natural’ deceives the American public of the harms of smoking,” said study senior author Judith Prochaska, an associate professor in Stanford’s Department of Medicine with the Stanford Prevention Research Center.
Aggregating pro-environment and health-related claims is nothing new in marketing. While it may be justified for organic agriculture products, for example, it is not a generally valid principle, according to study co-author Eric Lambin, a Stanford professor of Earth system science. “People need to be made aware of the risk of being manipulated by big brands that appeal to the environmental values of consumers to sell them products that are bad for their health.”
In an earlier, related study, the researchers found that the Natural American Spirit pack design, which also features icons of an American Indian smoking a pipe and a mythological thunderbird, creates misperceptions that the brand is American Indian-owned or grown on tribal land and, in turn, healthier and more desirable.
The researchers suggest regulations to prohibit using the word “natural” in tobacco brand names or using pro-environment language and imagery on cigarette packs. Instead, they propose mandating plain packaging for cigarettes.
“All commercially available cigarettes in the U.S. are designed to create and sustain addiction and will kill half of all long-term users if smoked as intended,” the researchers write. “Marketing language that obscures these health harms, even indirectly through questionable pro-environment claims, ought to be prohibited.”
Other study co-authors include Lisa Henriksen, a senior research scholar, and Mike Baiocchi, an assistant professor of medicine, both at the Stanford Prevention Research Center; and June Flora, a senior research scholar at the Stanford School of Medicine. Lambin is also the George and Setsuko Ishiyama Provostial Professor in the Department of Earth System Science within Stanford’s School of Earth, Energy & Environmental Sciences; a senior fellow at the Stanford Woods Institute for the Environment; an affiliate of Stanford’s Center on Food Security and the Environment; and a professor at the Université Catholique de Louvain in Belgium.
Prochaska has provided consultation to pharmaceutical and technology companies that make medications and other treatments for quitting smoking and has served as an expert witness in lawsuits against the tobacco companies. The research was funded by the Stanford Woods Institute for the Environment’s Environmental Venture Projects program.