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Profiting from the Poor: Public Health Lessons from Tobacco Industry Targeting of Low-Income Women presented at Te Raukura Te Wharewaka o Poneke Wellington Thursday, 26 April, 2012 Stacey J. Anderson, PhD Department of Social and Behavioral Sciences University of California San Francisco [email protected]

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Page 1: Profiting from the Poor - WordPress.com

Profiting from the Poor: Public Health Lessons from Tobacco

Industry Targeting of Low-Income Women

presented at Te Raukura Te Wharewaka o Poneke

Wellington

Thursday, 26 April, 2012

Stacey J. Anderson, PhD Department of Social and Behavioral Sciences

University of California San Francisco [email protected]

Page 2: Profiting from the Poor - WordPress.com

Overview

• Smoking in low-income populations; low-income women

• Psychographics and target market segments

• Lessons for public health responses

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NZ Smoking Rates (2010 Soc Rept)

• 2009: 22% aged 15-64 current smokers

• 2008: 26% male, 22% female

– 49.3% Maori female 2009

• 2009: Maori girls 14-15 yrs 18%

– Halved from 10 yrs prior

– Am Indian teens: 41% boys, 39.4% girls (CDC, 2001)

• Most deprived (NZDep 2006 deciles 9, 10) 2.7x greater than deciles 1, 2

http://socialreport.msd.govt.nz/health/cigarette-smoking.html http://socialreport.msd.govt.nz/documents/health-social-report-2010.pdf

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Low-income populations (US)

• 31% adults below federal poverty level (FPL) smoke – 19% at or above FPL (1.45x greater for poor adults)

(CDC, Morbidity and Mortality Weekly Report 59, 2010)

• Unemployed adults: 42% smoke – c. 25% part- or full time employed (1.68x greater for

unemployed) (Halpin et al, Health Aff 2006;25(2):550-6.)

• 26% women below Fed Poverty Level smoke – 17% women at or above FPL (1.53x greater for poor

women) (CDC, Morbidity and Mortality Weekly Report 59, 2010)

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California Low-Income Women

Pechman & Wyn UCLA Health Policy Brief, 2009

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Legacy Tobacco Documents Library (LTDL) http://legacy.library.ucsf.edu

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“Downscale activity”

Int’l Committee on Smoking Issues, RJR 1977, TID pqo85d00

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“Much less educated”

Analysis of the Virile Segment, RJR 1986, TID iqd94d00

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“The less educated”

PMUSA Five year plan 91-95, PM 1991, TID cbj02a00

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“Less educated, working class”

Established brands strategic planning meeting, RJR 1985, TID yrb15d00

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“They’re more malleable”

Denicola Research report for RJR, 1989, TID pbs92d00

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Analyzing Tobacco Marketing

• Pollay 20th Century Tobacco Ad Collection – http://www.tobacco.org/ads/

• Trinkets and Trash – http://www.trinketsandtrash.org/

• Tobacco Free Kids Ad Gallery – http://www.tobaccofreekids.org/ad_gallery/

• Stanford’s “Not a Cough in a Carload” – http://http://tobacco.stanford.edu/

• Ephemeral sources

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Advertising Archives Pollay Ads

http://www.tobacco.org/ads

Trinkets and Trash

http://www.trinketsandtrash.org

Stanford

http://tobacco.stanford.edu

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Methods

• Anderson, Dewhirst, & Ling, Tob Control, 2006; 15:254-61

• Documents databases – Targeted search terms relevant to research question

– Documents analysis and snowball searching

• Advertising archives – Chronological analysis

– Theme-based analysis

• Iterative analyses of both databases

Anderson, Dewhirst, & Ling. Every Document and Picture Tells a Story. Tob Control, 2006; 15:254-61

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Pricing?

Tobacco Returns Analysis 2010 http://www.ash.org.nz/site_resources/library/Tobacco_industry/Tobacco_Return_Analysis_2010.pdf

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Psychographic Segmentation

Philip Morris report on young adult smokers, 1994. TID leg76e00

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Psychographic Segmentation

Philip Morris report on young adult smokers, 1994. TID leg76e00

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Psychographic Segmentation

1981 RJR Segmentation Study, 1981. TID bor68d00

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Price-conscious

William A. Robinson, Inc, for Philip Morris, 1974, TID nah05e00

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“Value Price” Brand for Young Women

Tatham Euro RSCG for Brown & Williamson, 1995, TID uid90f00

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“Value Price” Brand for Young Women

Tatham Euro RSCG for Brown & Williamson, 1995, TID uid90f00

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Functions of Smoking

• Little disposable income – But always $ for cigarettes

• Use cigarettes to cope with low-income circumstances – Stress of limited income

– Childcare/eldercare

– Unemployment

– Limited opportunities for recreation / boredom

– Social exclusion

MacAskill, et al. Soc Marketing Quarterly 2002; 8(1): 19-34

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Case Study: Capri

• Relaxation, escape from stresses and cares

• Experientialism, enjoyment, fulfillment

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Brown and Williamson, 1980. TID mpc43f00

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Capri Target Segments

McCann-Erickson, Inc., 1981. TID wzj13f00

Identify segments’ needs: Smoking behavior of segments:

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Capri Brand Positioning

Brown and Williamson TID mgh10f00

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Capri Ad Development

Tatham Euro RSCG, 1995. TID yhd90f00

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Capri Ad Development and Refinement

Perception Research Services, 1997. TID hut02d00

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“They call us Drum Scum”

• Psychological toll of living in economically depressed area

– “They call us Drum [Drumchapel] Scum.”

– “This is the most deprived place in Europe…. We’re living in slums.”

– “dirty, filthy, expensive habit.”

– Health professionals “nagging” or dismissing smokers

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Project SCUM

Project SCUM, RJR, 1996, TID ciw66d00

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Taking It to the Streets

Yerger, Daniel, & Malone, NTR, 2005;7:163-72

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Opportunities: Industry Denormalization

CA Dept Health Services, 1990. http://archive.org/details/tobacco_pcy99d00

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Need Age Group Brand/

Campaign

Tobacco Control

Emphasis

Independence,

rebellion,

belonging

18-24 Marlboro (esp.

Lights) Conformity, ostracization

Female

camaraderie /

belonging

20s Virginia Slims

“Woman Thing”

Smoking as women’s

issue,

caring for women

Escape,

relaxation 35-59

Eve

Satin

Capri

Ostracization, addiction,

increase in everyday

problems

Opportunities: Countermarketing

Anderson, Glantz, & Ling, Tob Control, 2005; 14:127-35

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Opportunities: Taxation, Pricing

• Price cap on pre-tax cigarettes

– Cap not on retail price

• based on assessment of actual costs each firm faces in its operations

– Address excess profits while allowing for tobacco control measure (excise taxing)

– Increase government revenue by transferring profits from companies to public health

– Could prevent down-trading to cheaper products

Gilmore, Branston, & Sweanor, Tob Control, 2010;19:423-30

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Opportunities: Macro-level

• Smoking in context of larger socio-economic problems: TC align w/ other efforts – Invest in improving/increasing educational

opportunities

– Policies to increase job opportunities

– Improve housing standards

– Access to free (and smoke-free) leisure facilities

– Childcare/eldercare support

– Community-based community improvement efforts