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Fighting fire with fire

ALLURE, sophistication, kick-ass empowerment: cigarettes have been used to symbolise all these things. Back in 1928, American psychoanalyst AA Brill dubbed them "torches for freedom", adding that smoking in public signified women's equality with men, thus lending the pursuit a powerful appeal. Brill had been asked by the American Tobacco Company to explain the psychological basis for women's smoking, and the industry wasted no time in using his insight towards pursuing the female market. "It will be like opening a new gold mine right in our front yard," said American Tobacco Company president, George Washington Hill.

Big Tobacco has since turned the exploitation of women's hopes, desires, fears and vulnerabilities into a form of precision engineering. It is an industry that "gets" women, and the commercials deployed throughout the last century offer a variety show of female aspiration. Stay slim; be mysterious; turn heads; travel the world; do as men do; embrace your freedom; be zany; be yourself.

The anti-smoking lobby has responded in kind, with campaigns showcasing the less palatable consequences of smoking, such as lung and mouth cancer, heart disease and premature death. Often, ads aimed at young women home in on girls' preoccupation with their looks in the same way as tobacco advertising. But can they succeed in beating the tobacco industry at their own game and, more to the point, is it acceptable for them to use similar tactics, exploiting young women's anxieties about their appearance and sex appeal? In short, do the ends – preventing teenagers taking up smoking – justify any means?

The question comes to the fore next Thursday – No Tobacco Day – when the World Health Organisation will highlight the ways in which commercial organisations attempt to undermine global efforts to control the promotion of cigarettes. Here in the UK, overt tobacco advertising was banned in 2003, and smoking is in decline in Scotland. According to the most recent Scottish Household Survey, 5.5% fewer adults smoke now than in 1999, while ASH Scotland surveys show smoking among 13 and 15-year-olds is at its lowest level since surveys began in 1982.

However, as many as 13% of 15-year-olds do smoke, with more girls than boys taking up the habit. And while advertising is illegal, marketing continues on a subtler plane, through packaging at point of sale. The counter-attack continues, therefore, and consultation is under way to assess the impact of introducing plain, uniform cigarette packs. Then there is advertising. Since the turn of the millennium, NHS Health Scotland and its predecessor, the Health Education Board for Scotland, have produced ads targeted specifically at teenage girls. One old offering, which lives on on the internet long after being made, parodies a Britney Spears music video with a band called Stinx and the song Why Do You Keep Running Boy? (which made it into the Scottish charts). It portrays skinny young female smokers as a turn-off to boys, with smelly breath, clothes and hair; another more recent ad shows a very young girl washing cigarettes out of her hair and kissing a boy at a party only to pass on a mouthful of fag ends.

For anyone concerned about young girls' self-esteem in our looks-obsessed culture, these ads make for uncomfortable viewing. But their creators could argue that in trying to break the perceived link between smoking and sexual allure, they have to fight fire with fire. After all, the image has been peddled by cigarette companies with great sophistication for nearly a century.

In the Victorian era, smoking was associated with prostitution, and according to Amanda Amos, professor of health promotion at Edinburgh University, the link persisted into the 1920s. To help make female smoking in public more socially acceptable, the American Tobacco Company paid women to smoke during an Easter Sunday parade in New York in 1929. Later, Hollywood stars such as Joan Crawford and Bette Davis would be paid thousands of dollars to smoke certain brands.

The marketing worked. Within 20 years of the first commercials targeting women, more than half of young British women smoked. Over time, the marketers diversified to target different women in a variety of ways. One was by stressing equality with men: a German ad from 1988 shows a pretty young woman with short hair and a stylishly mannish jacket, drinking a huge glass of beer; another from the late 1990s shows two female fighter pilots, just back from a mission. Others stressed individuality: a Dutch ad from 10 years ago shows a cartoon woman doing a headstand in order to look at a painting upside-down, the text reading: "Enjoy it your way" and "Be an original".

Slimming, though, has been a perennial theme. As early as 1925, the notion that smoking keeps women thin was being peddled in a poster for Lucky Strike cigarettes, with the slogan: "Reach for a Lucky instead of a sweet." By the 1960s and 1970s, "slims" – used ostensibly to describe the cigarettes but carrying an unmistakeable subtext – had come onto the market.

BY the 1990s, with skinny supermodels on the rise, some companies in adverts for superslims started elongating photographs to make their models seem even thinner. An American ad from 1998 reads: "Cigarettes are like women. The best ones are thin and rich."

Smoking keeps you slim: the message has been repeated over and over again. And there is some truth in it. Numerous studies show that smokers tend to be leaner than non-smokers of the same age and sex. Nicotine acts as an appetite suppressant and chewing nicotine gum and smoking have a similar effect. Quitting smoking without nicotine replacement therapy is associated with weight gain, though compared with excess pounds, smoking poses a greater health risk.

All this poses a challenge for the anti-smoking lobby. Advertising may be a thing of the past, but speaking to young female smokers makes clear that health campaigners still have a major task on their hands in countering the effects of a century of pro-smoking propaganda.

Staying slim, for instance, remains a significant reason why young women continue to smoke. Katrina, 15, and Becky, 16, are two bright, articulate Scottish teenagers, who both smoke around 10 a day. Katrina has been smoking since she was 13. Why did she start? "I think it starts as a social thing because everyone around you is smoking," she says, adding that many of her friends smoke at parties. A lot of girls she knows started in order to stay slim. She herself didn't eat as much when she started, though the effect didn't last.

Image is another big part of the appeal. Becky and Katrina can't remember the days of free tobacco advertising, but they are very brand-conscious. Katrina smokes Lambert & Butler. When L&B brought out a pop-up pack, a lot of her friends bought them "as a one-off to get this special packet, because it was quite cool".

Becky used to smoke L&B but stopped because of the cost. She now smokes Richmond, JPS (John Player Special) or roll-ups, though she's not thrilled with her choice. She says: "JPS are considered to be quite low and trampy, so quite a lot of the time I'll try to hide that packaging. If I wanted to go to a party and impress people, I'd probably buy Marlboro or L&B, something like that."

The girls are also conscious of the more contemporary feminised brands of ultra-slims that are on the market, like Vogue Arome, which features pastel-coloured flower designs on the packs. "I've only had ultra-slims a few times, because you can't really get them in corner shops," says Katrina, "but the packaging is more feminine and I can see why girls like them. It's pink and it looks like a perfume box."

What about the celebrity factor? According to Amos, famous smokers do influence young girls, though many famous women don't choose to be pictured smoking; they are usually "papped" outside their gym or studio. The girls reel off the names of female celebrities who have been snapped surreptitiously smoking – women like Kristen Stewart of the Twilight films, and actress Miley Cyrus.

So what would lead them to stop? Becky and Katrina say they have been told of the health risks "millions of times". Katrina plans on quitting, citing the cost as a major downside, while Becky says she expects she'll stop after her student years. Anti-smoking ads have made an impression on them – Katrina remembers the one where the girl washes cigarette butts out of her hair, and her purse is full of fag ends, while Becky remembers the one where a mother's cigarette smoke closes like a snake round her baby's neck – but they claim that the idea it makes their hair, clothes and breath smell isn't something they really think about.

Would plain packs make smoking seem less cool and desirable? They are highly sceptical about that. "It would stop the stigma that went with the different class of cigarettes," says Becky. Perhaps some people who smoke socially wouldn't do it as much, concedes Katrina, because buying an expensive brand wouldn't be a status symbol any more.

Amos believes that plain packs would help make smoking less appealing, and thinks the tobacco industry's opposition to it is a strong indicator of that. However, if plain packs come in, the fight isn't over. Cigarettes will remain very widely available and affordable, even to teenagers, and it might only be a matter of time before the cigarettes themselves become the marketers' focus – pink super-slims, anyone?

Against this backdrop, anti-smoking adverts are being deployed to drive down smoking rates. But do they work? "There is very good evidence that there's a correlation between people trying to give up and advertising," says Professor Gerard Hastings, professor of social marketing at Stirling University.

But are there limits to the tactics health campaigners should employ in driving home the anti-smoking method? Does the end – stopping people smoking – justify any means? This question matters, since the likelihood is that fresh campaigns will be developed to prevent teenage smoking.

In other countries, successful campaigns have focused on the physical damage wreaked by cigarettes.

In the UK, young girls' preoccupation with their sexual attractiveness is the subject of an increasingly anguished debate; do future campaigns aimed at tackling teenage smoking need to take this into account?

Public health campaigners, points out Hastings, are subject to more scrupulous standards than tobacco companies. "One of the difficulties public health advertising has in comparison to tobacco advertising is that it has to do everything by the book and be as good as gold," he says. "The exploitation of femininity is just one issue. Commercial advertisers can take far more risks. That said, I think it is right that public health thinks about what it is doing; this doesn't license it to act in a way that is unacceptable."

Amos agrees. She has looked at anti-smoking campaigns worldwide and says that while playing on people's insecurity about their looks can be a powerful tool, "in general, we should be empowering young women. We should not be using sexist imagery that undermines young girls. We shouldn't be manipulative, we should be ethical and straight with them".

That does not preclude pointing out the ill-effects of smoking for the hair, clothes and breath – indeed, Amos points out that NHS Health Scotland's Think About It campaigns were "straight and young people liked the tone of them" – but the most important message of all, to smokers of 15 or 50, is that smoking can kill. It is this, perhaps, that should be the focus of the next campaign for young people as there is growing evidence that both young people and adults are becoming less aware of those risks.

Overt tobacco marketing may be gone, but its lingering influence can still be felt; what legal marketing remains is as sophisticated in targeting young women as it ever was.

As the history of women's smoking shows, though, it is possible to fundamentally change its image. "Can we stamp out smoking? Absolutely we can," says Hastings. "Literally millions have walked away from tobacco in recent years."

Ninety years ago, the tobacco industry overturned the taboo on women's smoking and made it socially acceptable. The signs are that the same process is now gradually happening in reverse.

www.ashscotland.co.uk

www.who.int/tobacco/en/

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