Yesterday, the Centers for Disease Control and Prevention released a MMWR report, “Cigarette Brand Preference and Pro-Tobacco Advertising Among Middle and High School Students.” The report explored the preferred cigarette brands among youth and the impact of advertising on their smoking behavior from 2012-2016. Not surprisingly, the report found that Marlboro tops the list of preferred cigarette brands among teenagers, followed by Newport and Camel. In 2016, 73 percent of middle school smokers and 79 percent of high school smokers used these brands. Importantly, the report found that this preference was strongly correlated with favorite advertisements — with 72 percent of participants who identified a favorite advertisement, using the same brand they were exposed to in the ad.

The powerful influence of advertising and brands, particularly the Marlboro brand, on young people reaffirms our deep concern that Philip Morris International’s IQOS product, which would be marketed by Altria in the U.S., would also include the introduction of Marlboro-branded HeatSticks to the U.S. market. Our expectation is that the marketing efforts behind IQOS and HeatSticks in the U.S. will be significant, as the company spent more than $3 billion developing the product and implemented large-scale consumer marketing programs in countries such as Japan where IQOS and Marlboro-branded HeatSticks have already launched. Because of this and the known impact of advertising on brand preference, there is a real risk that there will be a “halo effect” from Marlboro-branded HeatSticks in terms of overall promotion of the Marlboro brand and therefore all Marlboro products (including combustible cigarettes). This is why we believe that any marketing approval from the FDA for IQOS must be clear in outlining marketing and advertising restrictions for Marlboro-branded HeatStick products.  Specifically, we believe that these products should have the same restrictions as cigarettes. Additionally, based on this data, we continue to support 21 as the minimum age for buying all tobacco products, including IQOS.

The tobacco industry spends $8 billion per year, or $1 million per hour on advertising. This is why public health campaigns, including federal campaigns and the award-winning truth® campaign, which is credited with preventing more than 300,000 U.S. youth and young adults from becoming smokers during 2015-2016, are critical in off-setting this. But these campaigns alone are not enough to counter the potential impact of the Marlboro brand. That is why we urge the FDA to regulate the marketing of Marlboro branding on the HeatStick products, and for states to revisit the minimum tobacco age.

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