Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: A review of the literature

Tess Boley Cruz, Shyanika W. Rose, Brianna A. Lienemann, M. Justin Byron, Helen I. Meissner, Lourdes Baezconde-Garbanati, Li Ling Huang, Dana M. Carroll, Claradina Soto, Jennifer B. Unger

Research output: Contribution to journalReview articlepeer-review

48 Scopus citations


INTRODUCTION We reviewed research literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps. Results can inform tobacco policy and control efforts and the design of public education campaigns for these groups. METHODS Five journal databases in medicine, communication, and science, were used to identify 8875 peer-reviewed, original articles in English, published in the period 2004-2018. There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/ Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities. We summarized the number of articles for each population, type of tobacco, and pro-tobacco or anti-tobacco focus. Narrative summaries were organized by population and by pro-tobacco or anti-tobacco focus, with key strategies and gaps by group. RESULTS There were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products. Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities. Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in antitobacco studies. Common tobacco industry methods used were tailoring of product and package design and messages that were used to reach and appeal to different sociodemographic groups. Studies varied by research design making it difficult to compare results. CONCLUSIONS We found major research gaps for specific groups and tobacco products. Public education campaigns need a stronger foundation in empirical studies focused on these populations. Research and practice would benefit from studies that permit comparisons across studies.

Original languageEnglish
Article number68
JournalTobacco Induced Diseases
Issue numberSeptember
StatePublished - 2019

Bibliographical note

Funding Information:
This study was completed as part of the collaborative research being conducted by the National Institutes of Health (NIH) and Food and Drug Administration (FDA) Tobacco Centers of Regulatory Science (TCORS) Vulnerable Populations Workgroup. The review reported in this publication was supported by grant numbers P50CA180905 and U54CA180905 from the National Cancer Institute (NCI) and the FDA Center for Tobacco Products (CTP) for Cruz, Unger, Lienemann, Baezconde-Garbanati and Soto; grant number T32CA009492-29 from NCI for Lienemann; grant number U54CA189222 under a subcontract to Westat from NCI, FDA and the Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science for Rose; grant number P50 CA180907 from the NCI and FDA CTP for Byron and Huang and the National Research Service Award T32 DA007097 from the National Institute on Drug Abuse for Carroll. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the FDA.

Publisher Copyright:
© 2019 Cruz T.B.


  • Anti-tobacco
  • Campaigns
  • Marketing
  • Pro-tobacco
  • Vulnerable populations

ASJC Scopus subject areas

  • Health(social science)
  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health


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