The Economics of Tobacco and Tobacco Control

Chapter 8: The Impact of Information on the Demand for Tobacco Products
among some populations (i.e., low-education, low-income), which contributes to persistent social
inequalities in tobacco-related morbidity and mortality. To date, in the only study of the impact of
banning “light” and “mild” descriptors in LMICs, Siahpush and colleagues 22 found that removal of
“light” descriptors on cigarette packages in Thailand led to a decrease in the belief that “light” cigarettes
are less harmful, particularly among individuals in lower income and education groups. However, the
authors note that even after the descriptors’ removal, the belief that “light” cigarettes are less harmful
remained more widely held in Thailand than in some other countries.
Additional ITC Project Survey Findings
Data from the ITC Project enable researchers to examine differences across countries of various income
levels on measures of adult smokers’ knowledge and beliefs. Table 8.2 presents a summary of ITC
survey results showing percentages of respondents (adult smokers and former smokers) who did not
know or believe the health impacts of smoking and SHS exposure for specific diseases. Countries vary
considerably in the level of knowledge/belief about the harms of smoking and tobacco use, with
respondents in HICs being more knowledgeable than those in LMICs in some areas but not others. The
knowledge/belief that smoking causes lung cancer was the most consistently observed across all
countries surveyed. The knowledge/belief that smoking causes heart disease and stroke was far less
widely held. Even lower levels of knowledge/belief were observed about the health harms (lung cancer
and heart attack/heart disease among nonsmokers) caused by SHS exposure.
Tobacco Industry Efforts to Limit and Distort Public Knowledge
The peer-reviewed literature, internal tobacco industry documents, and findings of litigation have
conclusively shown that the tobacco industry has for many decades engaged repeatedly and consistently
in a pattern of withholding, denying, and distorting information so that the hazards of their products
would not be known—or if known, minimized in the minds of consumers. 23–29 These practices have
directly contributed to the information failures associated with consumers’ knowledge of the risks of
disease and addiction, and thus provide sufficient grounds for government action to enhance consumers’
knowledge and awareness of the health harms of tobacco use and SHS exposure. Tobacco industry
strategies to limit and distort public knowledge have included:
Denying and distorting evidence (1) on the health harms of smoking and SHS exposure, (2) that
cigarette smoking is addictive, and (3) that cigarettes are designed to maximize addiction
Marketing cigarettes in ways designed to assuage consumers’ fears about smoking and disease
Falsely promoting filtered, “light,” “low-tar,” and “mild” cigarettes (i.e., with low machinemeasured
amounts of tar and nicotine) as less hazardous than other cigarettes
Funding and publicizing research aimed at denying, distorting, and/or distracting the public from
the health effects of smoking and SHS exposure
Influencing media coverage of smoking and health so as to limit public knowledge of the health
effects of smoking and SHS exposure.
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