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Home Innovations & Investing

Big Tobacco Uses the Same Strategy to Hook Kids

Nothing has changed

Jon-Patrick Allem by Jon-Patrick Allem
June 6, 2024
in Innovations & Investing
0
Big Tobacco Uses the Same Strategy to Hook Kids

Arun Sharma

Millions of current smokers became addicted when they were teens – and nicotine marketing targets adolescents today just as it did decades ago. About 37 million children ages 13 to 15 around the world use tobacco, according to a 2024 report from the World Health Organization.

In 2023, e-cigarettes were the most commonly used tobacco product in the U.S., with 7.7% of middle school and high school students reporting e-cigarette use. Cigarettes were the next most common, with 1.6% of middle- and high school students saying they had consumed them in the past month.

Research shows that most people who use tobacco start in childhood.

I am a public health researcher who studies the different ways in which corporations influence adolescent health, with current projects focused on identifying sources of exposure to tobacco marketing among adolescents and young adults.

Health harms of tobacco

Smoking is harmful to every organ in the human body and is known to cause many types of cancers and heart disease, among other problems. Nicotine, by itself, in products like e-cigarettes and oral pouches, is harmful to adolescent brain development.

The adolescent brain develops into early adulthood, especially in the prefrontal cortex. This part of the brain is involved in higher cognitive development, including functions pertaining to attention, memory and cognitive flexibility. Research has shown that nicotine exposure results in long-term functional and structural changes in the brain.

Old tactics in new US products

Decades of research have documented how tobacco companies marketed tobacco products for years to attract young customers in order to sustain and grow their businesses.

In a 2021 study, my team and I showed that exposure to e-cigarette marketing with cartoon images decreased high school students’ perceptions of harm from e-cigarettes. Research makes clear that this change in perspective can make adolescents more open to trying e-cigarettes.

In an earlier study, my team and I examined the impact of e-cigarette product placement and imagery in music videos on propensity to use e-cigarettes among young adults. We found that exposure to e-cigarette product placement in music videos increased young adults’ intentions to try e-cigarettes in the future.

Striking at an early age

While our research has largely focused on the U.S. context, several recent studies have shown how tobacco companies continue to market to children in other parts of the world.

For example, a team of researchers conducted focus groups among Chinese adolescents to understand sources of tobacco marketing exposure and what features made ads attractive. They found that adolescents reported being exposed to tobacco ad campaigns near their home and school. These young Chinese people also reported that bright colors, product packaging and price promotions featured in e-cigarette ads and other promotional materials attracted their attention.

In England, a 2022 study provided an overview of marketing claims present on the websites of popular e-cigarette brands. Most notably, the study found that U.K websites featured medicinal claims for smoking cessation, associations with youth culture and depictions of young people using e-cigarettes.

Normalizing tobacco use

The emergence of social media platforms has led tobacco companies to shift their marketing tactics from traditional channels like magazines, billboards and retail stores to online channels, capitalizing on the time that young people spend on screens.

Tobacco companies have helped normalize tobacco use online with the help of branded social media account pages and social media influencers. For example, in 2021, researchers discovered that e-cigarettes were being used and promoted by influencers on Amazon-owned Twitch, a video-sharing platform popular among adolescent gamers.

Similarly, streaming platforms normalize tobacco use. For example, in a 2022 study, my team and I analyzed Netflix original TV shows and films for e-cigarette-related content. Most notably, we documented brief representations of teenagers holding e-cigarettes in the PG-13 film “Hubie Halloween.” Our findings contradict Netflix’s no e-cigarette pledge for PG-13 content.

This suggests a need for further outside-party monitoring of e-cigarettes in Netflix programming.

Spreading awareness

Every country will have to effectively enforce and expand restrictions on cigarette and e-cigarette marketing to protect children and teenagers from messages that encourage them to try smoking and vaping. Additional efforts are needed everywhere to help discourage young people from getting hooked on tobacco.

Most parents, teachers and other authority figures are likely unaware of the extent to which young people are exposed to tobacco content online, including tobacco ads and peer-generated posts on social media that normalize tobacco use.

Campaigns focused on tobacco-related digital media literacy could create awareness about tobacco products and describe how they are being marketed in the digital environment. There are various evidence-based resources that could be built upon to help young people evaluate tobacco advertising messages, empowering digital and social media users to actively evaluate information rather than remain a passive target for the industry’s marketing.

I am certain that increased awareness could prevent young people from consuming tobacco.

Jon-Patrick Allem, Associate Professor of Social and Behavioral Sciences, Rutgers University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Jon-Patrick Allem

Jon-Patrick Allem

Jon-Patrick Allem is an Associate Professor of Social and Behavioral Sciences, Rutgers University

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Most employers are unknowingly steering their health plans toward higher costs and reduced control — until they understand how fiduciary missteps and anti-competitive contracts bleed their budgets dry. Katie Talento, a recognized health policy leader, reveals how shifting the network paradigm can save millions by emphasizing independent providers, direct contracting, and innovative tiering models.

Grounded in real-world case studies like Harris Rosen’s community-driven initiative, this episode dives deep into practical strategies to realign incentives—focusing on primary care, specialty care, and transparent vendor relationships. You'll discover how traditional carrier networks are often Trojan horses, locking employers into costly, opaque arrangements that undermine fiduciary duties. Katie breaks down simple yet powerful reforms: owning your data, eliminating conflicts of interest, and outlawing anti-competitive contract clauses.

We explore how a post-network framework—where patients are free to choose providers without restrictive network barriers—can massively reduce costs and improve health outcomes. You'll learn why independent, locally owned providers are vital to rebuilding trust, reducing unnecessary procedures, and reinvesting savings into the community. This conversation offers clarity on the unseen legal landmines employers face and actionable ways to craft health plans built on transparency, independence, and aligned incentives.

Perfect for HR pros, benefits advisors, physicians, and employer leaders committed to transforming healthcare from the ground up. If you’re tired of broken healthcare models draining your budget and frustrating your staff, this episode will empower you to take control by understanding and reshaping the very foundations of employer-sponsored health. Discover the blueprint for smarter, fairer, and more sustainable benefits.

Visit katytalento.com or allbetter.health to connect directly and explore how these innovations can work for your organization. Your path toward a healthier, more cost-effective future starts here.

Chapters

00:00 Introduction to Employer-Sponsored Health Plans
02:50 Understanding ERISA and Fiduciary Responsibilities
06:08 The Misalignment of Clinical and Financial Interests
08:54 Enforcement and Legal Implications for Employers
11:49 Redefining Networks: The Post-Network Framework
25:34 Navigating Healthcare Contracts and Cash Payments
27:31 Understanding Employer Health Plan Structures
28:04 The Role of Benefits Advisors in Health Plans
30:45 Governance and Data Ownership in Health Plans
37:05 Case Study: The Rosen Hotels' Health Model
41:33 Incentivizing Healthy Choices in Healthcare
47:22 Empowering Primary Care and Independent Providers
The Hidden Costs Employers Don’t See in Traditional Health Plans
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Policy Shift in Peptide Regulation

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Semaglutide and the Expansion Problem: When One Trial Becomes a Platform

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by Daily Remedy
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Semaglutide has moved beyond its original indication and now sits at the center of a widening set of clinical questions: cardiovascular risk, kidney disease progression, and even neurodegeneration. The question is no longer whether the drug lowers glucose or reduces weight—it does—but how far those effects extend across systems, and whether evidence from one population can be translated into another without distortion. Large, well-powered trials have produced consistent signals, yet those signals are now being applied in contexts that were...

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