The tobacco industry is deliberately targeting children with nicotine products, using targeted marketing to lure the younger generation into smoking while publicly promoting e-cigarettes as a less harmful alternative for smokers, according to a new report by the World Health Organization (WHO) and STOP, a tobacco industry watchdog.

The report, released ahead of World No-Tobacco Day on May 31, analyzes ways in which tobacco and nicotine companies design products, implement digital marketing campaigns, and shape policy environments to help them addict youth globally.

“The industry is peddling a narrative that denies or underplays youth addiction,” Jorge Alday, Director of STOP at Vital Strategies, told Health Policy Watch. “If we don’t establish a comprehensive approach and work across agencies, the industry will exploit any loophole or any new opportunity to reach young audiences.”

The report accuses the tobacco industry of targeting children and young people with over 16,000 e-cigarette flavours, employing colourful branding, influencer partnerships, and innovative digital marketing tactics, including the Metaverse.

“The Metaverse could eventually become a virtual shop window like physical or e-commerce stores,” Alday told Health Policy Watch about how the tobacco industry is using new digital forms of marketing.

The tobacco industry is attempting to “replace tobacco users lost to death and disease with a fresh wave of users trapped in addiction,” said Rüdiger Krech, WHO’s Director of Health Promotion, during the report’s launch press conference.

“We see tobacco products taking the shape of chocolates and sweets, candy, taking the form of toys,” Given Kapolyo, the global youth ambassador of the year and an anti-tobacco activist, told reporters. “They’re going out of their way to ensure that they make this product seem very cool.”

The tobacco industry bombards youth with branding, Kapolyo added, targeting areas close to schools, along routes used by young people, and in the digital space.

“These industries are actively targeting schools, children and young people with new products that are essentially a candy-flavoured trap,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, commenting on the youth-targeting strategies of tobacco firms. “How can they talk about harm reduction when they are marketing these dangerous, highly addictive products to children?”

Fewer smokers, more vapes

While the global number of smokers is declining, with one in five adults smoking in 2020 compared to one in three in 2000, eight million people still die annually because of tobacco use.

The number of e-cigarette users, meanwhile, is growing, especially among the youngest generation. Globally, 37 million children aged 13–15 years use tobacco, and in many countries, vaping is more popular than traditional cigarettes among adolescents. In the WHO European Region, one in five 15-year-olds surveyed reported using e-cigarettes in the past month.

The tobacco industry often frames vaping as a way to reduce the harmful health effects of carcinogenic substances present in cigarettes, but research shows e-cigarette use actually increases conventional cigarette use nearly three times, according to the WHO.

The US Food and Drug Administration says that nicotine-mimicking substances used in vapes to avoid product regulation can be even more addictive than normal nicotine, Reuters reported.

Curbing the industry’s influence

Controlling marketing strategies, including digital ones, is an important way to limit tobacco firms’ influence on youth, the report’s authors said.

“How we define terms like advertising, promotion and sponsorship set the stage for what can be regulated now and in the future. This means that regulators should update rules to cover any and all platforms – physical and virtual,” Alday told Health Policy Watch.

Alday cited the recent example of Nigeria, which announced new regulations that will require health warnings for films that contain tobacco imagery. The regulation covers movies, music videos and skits produced in Nollywood, one of the world’s biggest movie industries, Alday said.

The WHO recommends not only a ban on marketing, advertising, and promotion but also creating 100% smoke-free indoor public places, banning flavoured e-cigarettes, and imposing higher taxes, among other strategies.

The latter strategy has shown significant results, as Vital Strategies’ Jeffrey Drope, co-author of the Tobacco Atlas, demonstrated during the State of Tobacco Control press briefing on May 21.

“Raising taxes [is] arguably the most effective and most straightforward solution,” said Drope. With higher prices, “young people don’t start to use tobacco products [and] people who already smoke or use tobacco stop, or cut down.”

New Zealand’s tax policy effectively drove down youth smoking prevalence as prices doubled between 2009 and 2019. It was also able to make a step towards bridging societal gaps between the general and Maori smoking populations.

The UK’s total ban on cigarettes for people born after 2009 is another example of an ambitious health policy, aiming to gradually raise the minimum age required for buying cigarettes until eventually, they become illegal. The regulation law passed its second reading in April, but has been postponed until after the general elections, BBC reported.  The bill has support from the opposition Labour party, a likely winner of the vote, which gives it much chance to be passed in the next term.

“This really has an enormous effect on consumption,” Drope said.

In their closing remarks, speakers at the press conference emphasized the essential role of youth leaders in shaping the future of global tobacco consumption and policy. “Youth leaders have a key role to play in communicating their reality to policymakers, that use of nicotine products is growing rapidly and these products are harming youth, now,” Alday told Health Policy Watch.

“What young people have is … they have each other,” Kapolyo added. “When young voices unite, even governments listen.”