Easing FDA tobacco advertising rules around schools could cripple law, new study finds

When the FDA proposed new rules restricting outdoor tobacco advertising near schools and playgrounds in 2009, the tobacco industry argued that such rules would lead to a near complete ban on tobacco advertising in urban areas. An article in the March 2011 issue of the American Journal of Preventive Medicine shows that the effect of these rules would be less severe than the industry contends.

“It is critical to point out one subtle, but important difference between the analysis that the tobacco industry conducted and the analysis presented here,” says lead investigator Douglas A. Luke, PhD, professor and director of the Center for Tobacco Policy Research at the Brown School at Washington University in St. Louis.

“Their analyses focused on the percentage of land area off-limits to tobacco advertising,” Luke says. “In this study, the number and proportion of retailers affected were calculated, not the land percentage. The number of retailers affected, not the land area is the more appropriate metric to use when making policy decisions.

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“First, the ‘real-world’ regulatory impact is felt by people and businesses, not by land. Second, tobacco retailers are clustered in commercial zones and showing that a high percentage of all land is unavailable for advertising under outdoor advertising bans overstates the impact of the policy. A key question is not what percentage of land is off-limits under an advertising ban, but rather, what is the additional or incremental impact of an advertising ban given existing zoning regulations.”

Using geographical information system (GIS) spatial analysis for the states of Missouri and New York, along with more detailed analyses of the urban areas of St. Louis and New York City, investigators located all tobacco retailers falling with 350-, 500- and 1,000-foot buffer zones around all schools and playgrounds.

They determined that 22 percent of retailers in Missouri and 51 percent in New York fall within 1,000-foot buffers around schools. In urban settings, more retailers are affected, 29 percent in St. Louis and 79 percent in New York City. Sensitivity analyses demonstrate that smaller buffers decrease the proportion of affected retailers. 350-foot buffers affect only 6.7 percent of retailers in St. Louis and 29 percent in New York City.

Therefore, in Missouri and New York, outdoor tobacco advertising would still be permitted in many locations even if such advertising was prohibited in a 1,000-foot buffer zone around schools and playgrounds. Much smaller buffer zones of 350 feet may result in almost no reduction of outdoor advertising in many parts of the country.

The FDA is still deciding the distance from schools where they will ban outdoor tobacco advertising. Given the lack of impact of a 350-foot ban, the authors urge the FDA to reject that as an option and implement a distance that is more effective at reducing outdoor advertising where children will routinely be exposed to it. If the 1,000-foot buffer zone were implemented, the authors estimate that up to 1.5 million pieces of outdoor tobacco advertising would be removed across the country.

Buffer zones where no outdoor advertisements are allowed have been proposed by the FDA and public comment has been solicited. The tobacco industry contends that a 1000-foot buffer zone in urban areas would be equivalent to a total ban and therefore unconstitutional on First Amendment grounds.

“Tobacco advertising reaches children and adolescents in a variety of ways,” the study authors conclude. “Given the effectiveness of tobacco advertising, efforts to restrict the exposure of young people to tobacco advertising is an important health policy goal. The current health policy analyses suggest that weakening of outdoor advertising policies may result in phantom policies that do little to reduce youth exposure to tobacco product advertising.”

The article is “Family Smoking Prevention and Tobacco Control Act: Banning Outdoor Tobacco Advertising Near Schools and Playgrounds” by Douglas A Luke, PhD; Kurt M Ribisl, PhD; Carson Smith; and Amy A Sorg. It appears in the American Journal of Preventive Medicine, Volume 40, Issue 3 (March 2011) published by Elsevier.


Editor’s note:
Full text of the article is available to journalists upon request; contact eAJPM@ucsd.edu.

About the authors:

Douglas A. Luke, PhD
Carson Smith, BA
Amy A. Sorg, MPH
Center for Tobacco Policy Research, the Brown School, Washington University, St. Louis, Mo.
Kurt M. Ribisl, PhD
The Gillings School of Global Public Health and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.

About the American Journal of Preventative Medicine:
The American Journal of Preventive Medicine (ajpm-online.net) is the official journal of The American College of Preventive Medicine (acpm.org) and the Association for Prevention Teaching and Research (atpm.org). It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.

The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women’s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services.

The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine, with an Impact Factor of 4.235, is ranked 11th out of 122 Public, Environmental & Occupational Health titles and 16th out of 132 General and Internal Medicine titles according to the 2010 Journal Citation Reports© published by Thomson Reuters.