addiction and no recent practice at overcoming withdrawal. The smoker who is better prepared on both of these counts has a sixfold better chance at long-term success in quitting (Farkas et al., 1996a, 1996b).
Advertising is used both to attract new consumers to tobacco products (U.S. Department of Health and Human Services, 1994a) and to convince users of alternative or competing products to switch brands (Ray, 1982). Most of the interest in tobacco advertising has focused on whether it attracts new consumers who are adolescents or minors (Albright et al., 1988; Altman et al., 1987; King et al., 1991; Mazis et al., 1992; Schooler and Basil, 1990; Schooler et al., 1991). There is little public support for the encouragement of adolescents and children to start an addictive habit, before they are old enough to appreciate its consequences. The tobacco industry strongly argues that it does not use advertising to promote smoking among minors, although it has produced little evidence to support this argument.
A recent historical analysis of cigarette advertising and the uptake of smoking in the United States examines four periods in history associated with major, different advertising campaigns.4 Cigarettes were advertised to males in two of these periods and to females in the other two. Strong evidence of the effectiveness of tobacco advertising is shown by the association of the timing of each campaign with a major increase in the uptake of smoking among the targeted gender-specific group (Pierce and Gilpin, 1995).
In recent research, we investigated the association between adolescent responsiveness to tobacco marketing and susceptibility to smoking among those who have never tried a cigarette (Pierce and Gilpin, 1995). We defined an index of receptivity that includes having a favorite cigarette advertisement and being prepared to use an item of clothing that displays a cigarette advertising logo. With this index, we demonstrated that receptivity to advertising is considerably more powerful than exposure to smokers in predicting which never-smokers will be susceptible to initiating smoking.
A viable tobacco control movement requires widespread acceptance of and concern about the health consequences of smoking (U.S. Department of Agriculture, 1985, 1989). Dissemination of information about the health effects of smoking and environmental tobacco smoke is a key element in building a constituency for tobacco control. Health professionals and schools have important roles in this dissemination process.
Societal-level interventions, such as the use of mass media, can also be an important influence. Many tobacco control programs aim to reconstruct societal