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Inadvertent Tobacco Advertising in Physicians' Offices
To the Editor: A study in Boston in 1988 showed that 11% of primary care physicians' offices visited were free of tobacco advertisements and that only 25% of the physicians interviewed were interested in cancelling subscriptions to magazines with cigarette advertisements.1 In 1989, the American Medical Association (AMA) House of Delegates resolved to " encourage physicians to substitute magazines without cigarette advertisements for those with cigarette advertisements in their office waiting rooms."1
Throughout the 1990s, as smoking among minors has increased, there has been an accumulation of evidence indicating that tobacco advertising targets young people and leads to an increase in consumption.3-4 We thus sought to examine the extent to which pediatricians were following the recommendations to remove cigarette advertisements from waiting rooms.
Methods
In 1999, we performed a telephone survey regarding magazines present in the office waiting rooms of pediatric practices in the Rochester, NY, area. Magazines recorded by the respondents were compared with a list of periodicals that decline cigarette advertisements.2
Results
Forty-nine of 52 practices contacted completed the survey. Only 8% of the practices subscribed exclusively to magazines that were entirely free of tobacco advertisements, but 21% had considered subscribing only to such magazines. Twenty-two percent of the practices did not subscribe to any magazines, but 67% of the practices received magazines to which they did not subscribe. Of the magazines obtained by subscription, 58% were without tobacco advertisements vs 43% of the unsolicited magazines. Of the practices that subscribed to magazines, 45% subscribed only to magazines without tobacco advertisements. However, of those, 88% of the practices that subscribed to any magazines also received unsolicited magazines that did contain tobacco advertisements. Seventy-three percent of the practices had antismoking brochures, posters, or both in their waiting rooms. Of the surveyed practices, 69% were interested in receiving a list of smoke-free magazines. While only 21% of the practices reported that they actively select magazines without tobacco advertisements, 57% did not subscribe to any magazines with tobacco advertisements.
Comments
Physicians who would never directly encourage their patients to smoke may inadvertently promote smoking by appearing to endorse tobacco advertisements in their own offices. The call by the AMA to eliminate magazines with cigarette advertisements from physicians' offices has had little apparent effect in this sample. We encourage physicians to remove unsolicited magazines that contain tobacco advertisements from their offices. We also think that medical authorities should maintain an accurate and current list of publications that refuse tobacco advertisements.
C. Andrew Aligne, MD;
Cynthia Christy, MD;
Sonia Jain
Department of Pediatrics
University of Rochester School of Medicine and Dentistry
Rochester, NY
1. Goldsmith MF. Magazines to read through while waiting ought not to contain any (tobacco) leaves. JAMA. 1989;262:1290.
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2. Radovsky L, Barry PP. Tobacco advertisements in physicians' offices: a pilot study of physician attitudes. Am J Public Health. 1988;78:174-175.
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3. King III C, Siegel M, Celebucki C, Connolly GN. Adolescent exposure to cigarette advertising in magazines: an evaluation of brand-specific advertising in relation to youth readership. JAMA. 1998;279:516-520.
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4. Kessler DA, Natanblut SL, Wilkenfeld JP, et al. Nicotine addiction: a pediatric disease. J Pediatr. 1997;130:518-524.
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Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
JAMA. 2001;285:43-44.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Am. J. Respir. Crit. Care Med. 2006;173:246-246.
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