Tobacco counter-marketing campaigns have long focused on children and teenagers, both of whom have proven highly susceptible to the lure of cigarettes and smokeless tobacco. Several recent studies indicate that young adults - typically defined as those between the ages of 18 and 24 - also are at increased risk for smoking initiation or progressing from the occasional cigarette to everyday use. That's a dangerous trend, researchers say, because young adults already have one of the highest smoking rates compared with other age groups.

It's also of concern, some tobacco control and public health researchers contend, because multiple analyses of internal tobacco industry research and other documents suggest that the industry is actively trying to nurture the increased consumption of cigarettes among young adults.

The tobacco industry has recognized the importance of making inroads among 18- to 24-year-olds at least since the 1980s, says Dr. Pamela Ling, an assistant professor of medicine at the University of California, San Francisco, who has authored several studies on smoking and young adults.

Industry focus on this group expanded considerably in the 1990s, especially in the wake of the legal restrictions against advertising and other promotions geared toward minors in the 1998 Master Settlement Agreement between U.S. states and the major tobacco firms. In fact, since that time, she explains, spending on cigarette marketing has actually increased, with a heavy concentration on 18- to 24-year-olds.

"Even though we generally think of most smokers starting before 18, more and more are starting between 18 and 25," Dr. Ling says.

In one nationwide survey done in 1999, for instance, there were two times as many 18- to 19-year-olds just beginning to smoke as there were 18-year-old established smokers.

Young adults also have the highest rates of "someday" or "occasional" smoking, notes Dr. M. Jane Lewis of the University of Medicine and Dentistry of New Jersey's School of Public Health.

"They often call themselves 'social smokers,' and don't consider themselves smokers," she says. "But we also know that young adults tend to think, 'I'm just doing this for now and I'll quit later.' They underestimate the power of nicotine and addiction."

A New Lure: Flavored Cigarettes

Young adult-focused marketing is pervasive, Dr. Ling and other researchers argue, and includes cigarette promotions in bars and clubs (including in those that are, by law, smoke free), advertising in magazines predominantly read by those 18 to 34 (such as Cosmopolitan, Maxim, and Blender), and sophisticated Web sites.

These tactics have been heavily employed for one of the most recent cigarette innovations, flavored cigarettes, which several studies have concluded target minors and young adults as the primary audience.

Currently, only R.J. Reynolds is marketing flavored cigarettes. Called Camel Exotic Blends, they include regularly available flavors, such as Twista Lime and Kauai Kolada, as well as seasonal offerings, like Winter MochaMint.

"The look and feel of the marketing around flavored cigarettes really says 'young adults,'" argues Dr. Lewis, who co-authored a paper on the marketing of flavored cigarettes last month in the American Journal of Public Health (AJPH).

Typically packaged in brightly colored tins, the cigarettes have distinctive designs on them, making them ideal "badge products" that are highly visible in social situations, the AJPH study concluded. Magazine ads and other promotional items for Camel Exotics paint them as more hip than standard cigarettes, touting them as "sophisticated indulgences" that offer a more "pleasurable smoking experience."

Camel Exotics also has a Web site (for which users must register and verify they are 18) where visitors can find stores that sell Camel Exotics and get coupons or information on soon-to-be-released seasonal varieties or other special promotions.

On its corporate Web site, R.J. Reynolds addresses the development and marketing of its "specialty cigarettes" - which includes its flavored lines. A statement on the site notes that Camel Exotics only "represent 1/10th of one percent of our annual cigarette volume," and adds that, "Our one and only audience, regardless of brand or style, is legal-age adults who have made the decision to smoke."

A paper published last November in Health Affairs argued the opposite. Researchers from the Harvard School of Public Health and the Roswell Park Cancer Institute reviewed internal tobacco industry research and patents on flavoring technology, and concluded that flavored cigarettes are, in part, intended to play the role of "starter" cigarettes - a new way to promote a shift from occasional to daily smoking.

The Health Affairs paper is the only one to date that has analyzed how the cigarettes impart flavor. Camel Exotics, they found, rely on a small bead or pellet in the filters that delivers flavor and reduces or masks "the natural harshness and taste of tobacco smoke." Little is known about the flavor pellets, says Dr. Gregory N. Connolly, part of the team that conducted the Health Affairs study. And, he adds, it would be very difficult to do studies that could fully explain how these flavor pellets work and if they are associated with any additional health risks.

Although he agrees that more research is needed, Dr. Connolly argues that flavored cigarettes are a bad idea regardless of what any future research may find.

"One basic public health principle is you don't add sugar to rancid meat," he says, referring to the FDA's ban on that practice in the 1900s. "They've tinkered with these cigarettes to make them more acceptable and more addictive, to make it easier to start and harder to quit."

By Carmen Phillips