Talking Tobacco

Interpersonal, Organizational, and Mediated Messages

by Stuart L. Esrock (Volume editor) Kandi L. Walker (Volume editor) Joy L. Hart (Volume editor)
©2014 Monographs X, 255 Pages
Series: Health Communication, Volume 2


Despite the widely recognized toll of tobacco and increasing action to curb tobacco use (e.g., increased excise taxes, smoking bans), smoking continues. Numerous messages about tobacco, smoking, and health circulate throughout society, but in spite of the prevalence of such messages and the importance of how they are constructed and interpreted, too little communication research has been dedicated to understanding and assessing tobacco-related messages. Talking Tobacco addresses the shortcoming. Featuring the work of top communication scholars, the volume advances theoretical knowledge, reviews state-of-the-art research, and shares new findings and insights on a variety of tobacco-related areas ranging from tobacco control efforts to corporate representations.

Table Of Contents

  • Cover
  • Title
  • Copyright
  • About the Editors
  • About the Book
  • This eBook can be cited
  • Dedication
  • Contents
  • Acknowledgments
  • 1 What’s All the Talk About? Communication Perspectives on Tobacco Issues Joy L. Hart, Stuart L. Esrock, and Kandi L. Walker
  • The Communication Context of Talking Tobacco
  • References
  • Section One: Interpersonal
  • 2 Social Identity and Antismoking Campaigns: How Who Teenagers Are Affects What They Do and What We Can Do About It Meghan Bridgid Moran and Steve Sussman
  • Identity and Smoking among Teenagers
  • Peer Crowd Identification
  • Social Identity Theory
  • The Branding of Cigarettes
  • Integrating Branding Strategy into Antismoking Campaigns
  • Truth® Campaign
  • Commune Campaign
  • Virginia Tobacco Settlement Foundation
  • XPOZ
  • Recommendations
  • Identify and Define Relevant Peer Groups
  • Create Campaign Materials
  • Pretest Campaign Materials
  • Refining Campaign Materials
  • Evaluate the Campaign
  • Conclusion
  • References
  • 3 A Complicated Conversation: Tobacco Use and Misuse in Native American Communities Kelly Mella
  • Native Americans and Tobacco
  • Theoretical Background
  • Psychological Reactance
  • Social Group Identity
  • Hypotheses and Research Questions
  • Method
  • Participants
  • Study Design
  • Measures
  • Results
  • Induction Check: Perceived Threat to Freedom of Choice
  • Psychological Reactance
  • Attitude Toward Smoking
  • Behavioral Intention to Smoke
  • Discussion
  • Racial/Ethnic Group Identity Effects
  • Message Source and Cultural Frame Effects
  • Suggestions for Further Research
  • Challenges and Conclusions
  • References
  • 4 Smoking Cessation as a Relationship: A Narrative Analysis of Internet Discussions on Tobacco Use and Smoking Cessation Joshua Hillyer and Mary Helen Brown
  • Narratives, New Technologies, and Tobacco Use
  • Message Boards and Health Communication
  • Reading the Stories
  • Results
  • Your Quit
  • The Battle
  • Villainous Tobacco
  • Retrain Your Brain
  • Discussion and Conclusions
  • Rhetorical Vision: Smoking Cessation Is a Relationship
  • Making Sense: Interpreting Experience and Anticipating Future Experience
  • References
  • 5 “In a Group of Our Own”: Talking about Tobacco-Related Stigma in Internet Lung Cancer Support Groups Tamar Ginossar
  • The Impact of Stigma on Coping with Lung Cancer
  • Method
  • Selection of Email Messages
  • Authors of Messages
  • Results
  • Self-Blame
  • Other-Blame
  • Resisting Individual Blame and Stigma
  • Discussion
  • Conclusions
  • References
  • Section Two: Organizational
  • 6 Blowing Smoke: The Flawed Process of the Tobacco Industry’s “Junk Science” Discourse Edward Panetta, Ryan Galloway, and Donald L. Rubin
  • The Tobacco Document Archives
  • Argumentation Theory and Fallacy Analysis
  • Rhetorical Fallacies in Industry Arguments
  • Ad Hominem Fallacies
  • False Analogy Fallacies
  • Hasty Generalization Fallacies
  • Slippery Slope Fallacies
  • Conclusion
  • References
  • 7 With Health Warnings Looming, Is a Lasting Relationship Possible? Testing the Organization-Public Relationship Model with the Tobacco Industry Richard D. Waters
  • Organization-Public Relationships
  • Relationship Management and Public Relations
  • Method
  • Results
  • Discussion
  • Conclusion
  • References
  • 8 The U.S. Family Smoking Prevention and Tobacco Control Act, 2009: Ethical Implications for Big Tobacco’s Strategic Communication Cornelius B. Pratt
  • Tobacco’s Toll Leads to the FSPTCA
  • Commitment-Trust Relationship Marketing Theory
  • Ethics, Big Tobacco, and the FSPTCA
  • Theoretical Justifications for the FSPTCA
  • The Family Smoking Prevention and Tobacco Control Act
  • Ethical Implications of the Rationale for the FSPTCA
  • Recommendations-and the Way Forward
  • Conclusion
  • References
  • 9 Classroom and Client Collaboration: An Effective Tobacco Reduction Campaign Developed by Students for Students Terry L. Rentner
  • Tobacco Use and College Students
  • Tobacco Marketing and Countermarketing
  • Changing Tobacco Reduction Communication Efforts
  • Social Norms Programs
  • New Directions in Tobacco-Reduction Communication Campaigns
  • Developing a Communication Campaigns Course
  • The Debunkify Campaigns
  • Campaign One: No More Ifs, Ands, or Butts
  • Campaign Two: Model the Majority
  • Discussion
  • Tobacco Reduction: Next Steps
  • Developing the Campaign Course: Lessons Learned
  • References
  • Section Three: Mediated
  • 10 Young People’s Attitudes and Decision Making Concerning Tobacco and Tobacco-Use-Prevention Advertising Bruce E. Pinkleton and Erica Weintraub Austin
  • Method
  • Results
  • Discussion
  • References
  • 11 Claiming a Right to Clean, Breathable Air: A Content Analysis of Newspaper Coverage of the Comprehensive Clean Indoor Air Debate in Ohio Benjamin R. Bates, Margaret M. Quinlan, and Brian L. Quick
  • Advocacy Surrounding Comprehensive Clean Indoor Air Legislation
  • Method
  • Results
  • Health as an Appeal
  • Health as a Rights Appeal
  • Conclusion
  • References
  • 12 Tobacco Control Partners: A Website Providing Online Technical Assistance to Local Tobacco Control Coalitions David B. Buller, Walter F. (Snip) Young, Erwin P. Bettinghaus, Julie A. Maloy, Peter A. Andersen, Ron Borland, and Joseph B. Walther
  • Tobacco Control Partners Websites
  • Basic Website
  • Enhanced Website
  • The Study
  • Results and Discussion
  • Summary of Community Impact of Website TA
  • Website Use
  • Evaluation of the Enhanced Website by Coalition Members
  • Depth Interviews with Coalition Leaders
  • Conclusions and Lessons Learned
  • References
  • 13 Antismoking Videos on a User-Created Content (UCC) Website: A Comparative Analysis of Persuasive Attributes Hyunmin Lee and Youjin Choi
  • User-Created Content
  • Content Analysis of Antismoking Messages
  • Responses to Antismoking Videos on YouTube
  • Method
  • Sample
  • Coding Procedure
  • Results
  • Description of Themes, Appeals, and Actor Characteristics
  • Viewers’ Responses
  • Comparison between Professional and Nonprofessional Videos
  • Discussion
  • Limitations and Future Research
  • Suggestions for Health Practitioners
  • References
  • Conclusion
  • 14 Tobacco Messages: Much to Still Talk About Kevin B. Wright
  • Theoretical and Methodological Issues in Interpersonal Contexts
  • Social Network Influences on Tobacco Use
  • Provider-Patient Interaction
  • Interpersonal Aspects of Antitobacco Campaigns
  • Theoretical and Methodological Issues in Organizational Contexts
  • Workplace Policy and Tobacco Use and Prevention
  • Inter-Organizational Communication Issues and Workplace Antitobacco Campaigns
  • Health Care Organization New Technology Usage and Continuity of Care
  • Theoretical and Methodological Issues in Mediated Contexts
  • New Media and Tobacco Research
  • Message Production
  • Message Reception and Psychological Reactance/Resistance to Persuasion
  • Moderating Variables in Antitobacco Campaigns
  • Additional Issues to Consider in Media Antitobacco Campaigns
  • Conclusion
  • References
  • About the Authors
  • Index

image Acknowledgments image

We wish to thank everyone at Peter Lang Publishing for the encouragement and support of this project. We particularly acknowledge the dedicated work of Mary Savigar and Gary Kreps. Their assistance was invaluable. We also want to thank the scholars who contributed to this volume. Their original writings enriched the project immensely. We appreciate their timely edits and valuable insights on the many communication issues surrounding tobacco.

Stuart Esrock especially appreciates the support of his relentlessly positive wife Margue, laughter-inducing kids Hannah and Drew, and the family’s human-like Goldendoodle Millie (who insists on hand-holding) as they continue together on a rather long, strange trip.

Kandi Walker acknowledges her “smokin’” hot husband for his ability to be a spontaneous thesaurus no matter what football game is on T.V. And there are no “butts” about it that Kameron and Kennedy, her beautiful and spirited daughters, successfully managed to get her out for symbolic “smoke breaks” to play basketball, have tea parties, and make big piles of girls on the couches. Their efforts to distract made working almost impossible—and she wouldn’t have it any other way.

Joy Hart thanks her three favorite ethnographers, Sam, Butter Bean, and Swagger, for grabbing their leashes and getting her out regularly for field studies of smoking behavior (or was it squirrel behavior?). ← ix | x →

image ONE image

What’s All the Talk About?

Communication Perspectives on Tobacco Issues

Joy L. Hart, Stuart L. Esrock, and Kandi L. Walker

People have done quite a bit of talking about tobacco for some time now. Today conversation continues. Whether individuals discuss their rights as smokers or nonsmokers, organizations bemoan perceived negative effects to their bottom line or advocate for improved public health when smoking is restricted, or media disseminate information on tobacco use, these interpersonal, organizational, and mediated messages about tobacco continue to permeate society. Thus, although communication about tobacco is not new, there is still much to be understood about these messages. The essays in this book advance understanding of these frequent, sometimes complicated conversations, and the authors make important suggestions for furthering research in this area.

Assessing the toll of tobacco on health and society is challenging. Clearly, staggering amounts of public monies are spent each year to care for current and former smokers. Further, exposure to secondhand smoke causes a number of health problems and raises issues of individual rights. Organizations footing or assisting with the cost of health insurance coverage debate how to encourage worker health, through programs such as smoking cessation, and how to reduce absenteeism due to illness. And, of course, the effects of tobacco-related illness and premature death on individuals, families, and friends are incalculable.

Although the health and social effects of tobacco use are far-reaching and impossible to chronicle in a brief introduction, we provide a few statistics to illustrate the magnitude of the current situation and the need to continue talking about tobacco. Both in the United States and across the globe, the use of tobacco ← 1 | 2 → is the leading cause of preventable, premature deaths (U.S. Department of Health and Human Services [USDHHS], 2010; World Health Organization [WHO], 2008). Research indicates that 100 million deaths were caused by tobacco use worldwide during the past century, and that an additional billion deaths from tobacco use may occur in this century unless actions are taken to lessen consumption of tobacco products (WHO, 2008). Since the 1964 U.S. Surgeon General’s publication on smoking, tobacco use has resulted in over 12 million deaths in the United States, and each year over 430,000 additional deaths are added to that total (Bonnie, Stratton, & Wallace, 2007; Centers for Disease Control and Prevention [CDC], 2008; USDHHS, 2004).

Researchers as well as health advocates conclude that curbing tobacco use is vital in reducing illness and premature death. For example, some assert that stopping tobacco use is the key action needed to significantly cut illnesses and death from cancer (Reuben, 2008) and that “if the population ceased smoking, this single behavior change would be tantamount to a vaccine against one-third of cancer deaths” (Reuben, 2007, p. vi). Tobacco-related illness(es) will claim the lives of half of all long-term smokers, especially ones who started smoking when they were teenagers, often shaving off 20-25 years from expected lifespans (Peto, Lopez, Boreham, & Thun, 2006). In 2011, approximately 19% of adults (CDC, 2012a) and 16% of high school students (CDC, 2012b) in the United States smoked.

Decades of research findings have amassed an unassailable conclusion that tobacco use damages and kills, leading Brundtland (1999), WHO’s Director-General, to proclaim that

If we do not act decisively today, a hundred years from now our grandchildren and their children will look back and seriously question how people claiming to be committed to public health and social justice allowed the tobacco epidemic to unfold unchecked. (para. 47)

Despite the widely recognized toll of tobacco and increasing action to curb tobacco use, smoking continues—and the associated health problems remain as critical challenges to public and individual well-being. The contributors to this volume, published a decade and a half after Brundtland’s call to action and resultant steps in tobacco control, show that much more talk, as well as action, on tobacco use is needed.

The Communication Context of Talking Tobacco

Numerous messages about tobacco, smoking, and health circulate throughout our culture. The sources of these messages are individuals, organizations, and media outlets. Some of the messages encourage smoking and the use of tobacco products. Other messages attempt to discourage use, educate the public about the dangers of tobacco, or impact public policy. Communication between individuals may involve trying to help others who are attempting to kick the cigarette habit or ← 2 | 3 → offering support to people afflicted by tobacco-related illnesses. Alternately, communication may center in encouraging friends to try tobacco or provide support through social smoking. Many workplace organizations have initiated programs to help employees eliminate their dependence on tobacco products. And certainly, both protobacco and antitobacco organizations generate innumerable messages advocating their viewpoints and positions. Further, countless communications take place via the media. Ranging from more traditional media sources, such as advertisements and public information messages, news programs, and embedded discussion in entertainment programming, to newer media avenues, such as social media and the Internet, there is seemingly an endless stream of tobacco-related messaging. Despite the prevalence of such messages and the importance of how they are constructed and interpreted, too little communication research has been dedicated to understanding and assessing these types of tobacco-related messages. This book seeks to address that shortcoming.

Rooted in communication, Talking Tobacco highlights the assumptions, message strategies, negotiations, individual and social understandings, public arguments, and other key concepts that illustrate why understanding discourse about tobacco is paramount in interpersonal, organizational, and mediated contexts. A communication perspective is uniquely positioned to unpack individual, relational, social, and cultural issues associated with tobacco use.

In this book, chapter authors discuss the impact that tobacco and smoking have had on a wide variety of audiences, ranging from teens and college students to Native Americans. The book covers topics that run the gamut; from public policy and rhetoric about smoking to advertising and newspaper coverage of tobacco-related issues. We consider the perspectives of individuals, such as lung cancer patients, as well as organizations, including the tobacco companies themselves. The chapters include research on traditional mediated messages as well as the use of newer media, such as the Internet and emerging online technologies, to disseminate tobacco-related messages.

Three sections form the core of the book. Each section explores a key context of tobacco talk: interpersonal, organizational, and mediated messages. Further, several of the chapters interrelate and authors frequently extend their ideas into additional contexts; thus, ideas across the volume are interlinked, rather than independent.

Each of the three sections of Talking Tobacco contains four chapters. The first section of the book examines interpersonal communication about tobacco. Key topic areas covered in this section are teenager identity, tobacco as both healer and killer in Native American communities, use of message boards and forums, and participation in an Internet cancer support group.

In Chapter 2, Moran and Sussman explore the role of identity in teenagers’ decisions to smoke. In particular, these authors are interested in how social iden- ← 3 | 4 → tity (i.e., group membership) influences use of tobacco and how desired identities can be used to reduce smoking. Most media messages targeted at curbing teen smoking have emphasized negative health effects from smoking and some have focused on skills for refusing invitations to smoke, with each approach resulting in limited success. In this chapter, examples of recent approaches targeted toward specific at-risk groups (i.e., truth®, Commune, Y Street, 2UP2DOWN, and XPOZ), which draw on social identity theory, are examined. After reviewing tobacco company branding strategies, Moran and Sussman conclude with recommendations on using identity-based approaches in antitobacco efforts.

Chapter 3 examines tobacco use and misuse in Native American communities and the complexities of the ensuing conversation. In this chapter, Mella overviews the rich cultural traditions associated with tobacco in Native American communities and how this backdrop may be linked to views on, and use of, tobacco as well as responses to antitobacco campaigns. For example, the smoking rate for Native American adults exceeds that of other racial/ethnic groups (CDC, 2012a) and has been resistant to change. Drawing on social group identity, akin to Moran and Sussman in the opening chapter of this section, and psychological reactance, Mella examines responses to antitobacco messages. Mella’s study expands the discussion of how cultural beliefs associated with racial/ethnic group identity influence reactions to health messaging. This chapter also highlights the role that message source plays and the importance of taking culture into consideration when developing persuasive messages.

In Chapter 4, Hillyer and Brown turn to the Internet to explore discussion of smoking cessation. With the proliferation of online communication, especially the increasing popularity of message boards, as well as the growing body of work on health narratives, their timely analysis unpacks themes in cessation discussions. Employing fantasy theme analysis, Hillyer and Brown describe three fantasy types, each reflecting facets of the challenge of giving up smoking. These themes assist with sense-making and provide encouragement. Further, they anthropomorphize smoking cessation—creating a multi-dimensional relationship with smoking. Taken together, these fantasy types reveal a shared rhetorical vision that evidences the need to continually manage one’s relationship with smoking.

Chapter 5 continues analysis of communication via the Internet. In this chapter, Ginossar analyzes stigma-related discussion of lung cancer support groups. As Ginossar notes, people diagnosed with lung cancer are frequently stigmatized because of assumptions about tobacco use and the results of this stigmatization are damaging. Included in the analysis were both comments of individuals with lung cancer and their family members. Results of the thematic analysis reveal an overarching theme of attempting to manage and cope with stigma from perceived tobacco use. Three subthemes—self-blame, other-blame, and stigma-resistance—illustrate the multilevel nature of coping with this stigma. Self-blame evidences ← 4 | 5 → the effects of internalizing stigma. Other-blame includes both grappling with perceptions of blame from others as well as tendencies to want to blame the individual diagnosed. Stigma-resistance conveys methods of resisting stigma. Ginossar’s findings support and extend past research and make important suggestions for future inquiry and health care provision.

The second section focuses on organizational tobacco-related messages. Chapters address industry attempts to discredit scientific studies and resistance to government oversight, the relationship between tobacco consumers and cigarette makers, ethics and corporate relationship marketing, and social norms campaigns and college students.

In Chapter 6, Panetta, Galloway, and Rubin investigate rhetorical strategies used by the tobacco industry to discredit scientific research findings on the use of tobacco. Employing textual analysis on a set of previously restricted documents, Panetta et al. explore how the tobacco companies worked to mold public opinion by invoking a “junk science” approach to viewing and interpreting research findings. Set on unmasking flaws in reasoning and disjoints between message producers and their audiences, these authors employ a theory of fallacy. In their analysis, four fallacies were frequently employed: ad hominem, false analogy, hasty generalization, and slippery slope. Their findings reveal shortcomings in the tobacco industry’s rhetorical arsenal as well as footholds to improve tobacco control discourse.

Chapter 7 continues discussion of the deceptive practices of the tobacco industry. More specifically, Waters uses the organization-public relationship model to examine views of the tobacco industry by smokers and nonsmokers. From a relational vantage point, the goal of public relations is to cultivate and maintain positive relationships between individuals and organizations. However, in the case of tobacco, past industry behavior has resulted in negative relational evaluations from stakeholders. Waters examines the views of both smokers and nonsmokers on several relational dimensions. Smokers’ perceptions are, of course, crucial as they purchase and use tobacco products. However, nonsmokers’ perceptions are also of interest as they provide points of comparison and may influence both tobacco control policies and programs. Perhaps not surprisingly, both nonsmokers and smokers held negative views of the tobacco industry. Further, consumption of cigarettes, as a measure of involvement, could be predicted for nonsmokers and heavy smokers based on their evaluations of this relationship. At its base, Waters’ study makes clear that the tobacco industry has much to overcome if it hopes for a better relationship with key publics.

Extending discussion of problematic behavior by the tobacco industry and a focus on relationships and ethics, Chapter 8 explores the U.S. Family Smoking Prevention and Tobacco Control Act (FSPTCA). In this chapter, Pratt grapples with projections on government attempts to inhibit questionable promotion ← 5 | 6 → practices by the tobacco industry and applies two theoretical contexts—commitment-trust relationship marketing theory and classical ethics—to the FSPTCA. After reviewing the historical context that led to passage of the FSPTCA and key elements in implementation, Pratt presents an ethical framework for evaluating actions of the tobacco industry. Then, he addresses elements of the act according to ethical principles and makes recommendations for tobacco industry communication practices.

In Chapter 9, Rentner details a project involving college students in smoking reduction efforts. Project U, a collaboration between the Ohio Tobacco Prevention Foundation and a PR agency, pitted PR classes at a variety of Ohio colleges against each other in developing and implementing programs to reduce smoking. Because students often begin smoking during their college years and then simply continue smoking after graduation, tobacco messaging is especially important during this life phase. Putting theory into practice, students devised and subsequently implemented campaigns on their campuses. Renter describes the structure of the course, addressing opportunities and challenges, and two student-developed campaigns. She also details misperceptions and efforts to dispel them as part of these campaigns. The chapter concludes with considerations for tobacco control efforts and constructing and leading similar courses as well as provides an example of collaboration across groups and organizations.

The final section of the volume considers mediated messages. Both traditional and newer forms of media are addressed. In this section, authors explore advertising, newspaper content, websites, and YouTube videos.


X, 255
ISBN (Hardcover)
ISBN (Softcover)
Publication date
2014 (December)
smoking communication research theoretical knowledge
New York, Bern, Berlin, Bruxelles, Frankfurt am Main, Oxford, Wien, 2014. 255 pp., num. ill.

Biographical notes

Stuart L. Esrock (Volume editor) Kandi L. Walker (Volume editor) Joy L. Hart (Volume editor)

Stuart L. Esrock (PhD, Bowling Green State University) is Associate Professor in the Department of Communication at the University of Louisville. His research focuses on tobacco issues, strategic communication campaigns, and digital technologies. Kandi L. Walker (PhD, University of Denver) is Professor in the Department of Communication at the University of Louisville. Her research explores the intersection between health, culture, and interpersonal communication. Joy L. Hart (PhD, University of Kentucky) is Professor in the Department of Communication at the University of Louisville. She teaches courses and conducts research on organizational and health communication.


Title: Talking Tobacco
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