WASHINGTON, DC. 30 May – The days of actors dressing up as doctors to promote cigarette brands may be long over, but if you think tobacco advertising has been effectively banned, think again. Slick ads in magazines, in stores and on the Internet still reach millions of consumers a day, perpetuating their cycle of death and disease and effectively replacing “customers” who have succumbed to tobacco use.

Globally, tobacco use kills nearly six million people each year, and about 450,000 in the United States. Unless urgent action is taken, the annual death toll could rise to more than eight million worldwide by 2030. Studies have shown that tobacco advertising, promotion, and sponsorship (TAPS) is the driver of this global epidemic.

Although the U.S. has since fallen behind in its efforts, it was among the earliest to impose various restrictions, including a ban on tobacco advertising on billboards, radio and television. However, this does not stop the industry from spending nearly $10 billion a year on domestic marketing. In fact, this money is accomplishing its goal – every day, about 3000 children try smoking, and about 1000 become long-term smokers.

While 19 countries, representing 425 million people or six per cent of the world’s population, have now established comprehensive measures to eliminate TAPS, another 74 countries  currently have no or very limited restrictions.

In addition, nearly every established global measure is challenged by the powerful multinational tobacco industry.  For example, in 2012 Australia became the first country in the world to mandate plain tobacco packages – free of manufacturers’ logos, colors, and other brand imagery, and instead dominated by graphic health warnings. The tobacco industry immediately launched legal challenges in national courts and under a trade agreement with Hong Kong. Fortunately, such challenges have galvanized public health supporters around the world leading other governments, including New Zealand, the UK, South Africa and India, to consider plain packaging.

Big tobacco has spent a century creating a dream world where attractive, young, empowered people express their individuality with a cigarette in hand. The reality is more like a nightmare – addiction, disease, and an early death.

On May 31, 2013, the 26th annual World No Tobacco Day, the global community must recognize Big Tobacco’s schemes to undermine bans on TAPS, and must support governments that are trying to protect public health.

For World No Tobacco Day 2013, ASH will release a video that showcases the nightmare world that tobacco companies strive to achieve through the use of advertising, promotion, and sponsorships.

“If done properly, bans on tobacco advertising, promotion, and sponsorship do work,” says Laurent Huber, Executive Director of Action on Smoking and Health, the nation’s oldest anti-tobacco organization. “These efforts must include monitoring opposition from the tobacco industry and other groups, and amending bans as required in response to innovations in industry tactics and media technology.”

A packet of Winfield Blues is no longer the colour its name would suggest – instead a sickly looking olive green sets the ailing backdrop for photos of health-plagued smokers in various states of decay.

The new packets, which use the same font for any brand or type of cigarette, will be the only legal packaging available from December onwards.

Free Choice Tobacconist owner Robert Anderson said his Hooper Centre store had already sold most of its old, colourful stock.

If any old packets are still in circulation when December arrives, representatives from tobacco companies will buy them back from stockists.

He believed smokers would not take the decision lightly.

“I think the new packets are obscene, but that’s what the government wants,” he said.

“If they think it’s going to stop people from smoking cigarettes, they’ve got another think coming.

“It’s the worst thing they could do if they want the votes of the smoking public . . . another nail in the government’s coffin.”

Mr Anderson said he was not worried about any negative impact on his business.

He said it would only help sales of certain smoking accessories.

“The general public feeling is that it’s a fair dinkum joke,” he said.

“I think the sale of cigarette cases (to cover the disturbing images) will really come to the fore.”

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The government on Thursday approved a landmark deal that would crack down on smoking in a country where 44 million people, or 40 percent of adults, light up.

The approval of the bill, which has yet to be discussed in parliament and signed by the president, follows a plea by Prime Minister Dmitry Medvedev, who on Tuesday called for a crackdown on tobacco companies “making money on children.”

Smoking rates have shot up in the past two decades, fueled by extremely low prices for cigarettes and largely uncontrolled advertising.

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During the 3 months that the ads aired on TV, radio, and social media, calls to a national quit line more than doubled and hits on the smoking cessation website smokefree.gov tripled, according to Nancy Rigotti, MD, of Massachusetts General Hospital, and Melanie Wakefield, PhD, of the Cancer Council Victoria in Australia.

Whether the boosted short-term response will translate to a lower smoking prevalence remains to be seen, and the CDC is watching closely. It has sponsored an ongoing longitudinal study of 5,000 adult smokers and 2,000 adult nonsmokers who completed online surveys a month before the campaign launched and immediately after it ended.

The stars of the ads were former smokers who were now living with the consequences of smoking — particularly the stoma, which turns voices robotic.

“Emotive personal testimonials and narratives are powerful strategies for reaching and influencing the broad population of smokers,” the researchers wrote. “Emotionally laden stories show the risks of tobacco use in a far more potent way than abstract information can.”

The idea was to “increase smokers’ sense of personal vulnerability to serious disease and increase their sense of urgency for quitting,” they wrote.

In the survey, respondents were asked questions about their awareness of the campaign, as well as their attitudes toward smoking cessation and secondhand smoke exposure.

Nonsmokers also were asked if they had encouraged friends or family members to quit. Survey results are expected by the end of the year, the researchers wrote.

The public health literature is on the CDC’s side, Rigotti and Wakefield wrote, with strong evidence that mass-media education campaigns can have an impact on behavior, particularly when it comes to smoking.

They warned that the campaign’s brief 3-month run will probably limit its effects. CDC said it will run another 3-month campaign in the first quarter of 2013.

Funding for the ad series, titled “Tips From Former Smokers,” came from the Affordable Care Act’s prevention and public health fund. The $54 million pricetag was an “unprecedented” amount spent on tobacco control in the U.S., the researchers said — though they warned that it “pales in comparison to the $27 million spent daily by the tobacco industry to market its products.”

FDA also has gone graphic with its anti-smoking initiatives, including a plan to make warning labels on cigarette packs much more intimidating. The new graphic labels were supposed to appear this month, but implementation was halted due to ongoing litigation with the tobacco industry.

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