Tobacco Documents Online

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C C. C, O iW je BRITISH- AMERICAN TOBACCO COMPANY LIMITED i C C 111~ ¢mrtlmml nl~t idw I~mr~t at Bdti~-JU~icm~ ~ I~tul.am rest mt k copied m st~wn to ~ i~,~s. BAT Co LTD - MINNESOTA TOBACCO LITIGATION

CZC.AJ~TTE SMOKT~(;~ HEALTH~, .~,,p OZSSO.~L~CE (PBOJECT LIBP.A) I.. .INTRODUCTION AND ~;THOD REPORT NO. RD. 1670 RESTRICTED 23.4.1979 AUTHOR: PI. Oldman ISSUED BY: D.J. Wood PR0(;. P,,EF. 13.02.05 D ,ISTItIBUTION: l~c. S.J. Gz'een D=. Z.W. Hughes Dr. R.A. Stanford K.H, C£bb, Esq. R.S. Wade, Esq. R.G. Nicholls, Esq. Herr E. ILicCershaus DT. F. Seeho£mr ldr. A.J. Eruswynsk~ D~. C.J.P. de Siqueira Dr. D.G. Pelion LJLbrary Copy No. 1, 2, 3 99 BI 4 " " 5, 6 q'l ~I 7 " " 8, 9, 10 " " 11, 12 " " 13 " " 14 " " 15 " " 16 " " 17 " " 18, 19 COP~ NO.~~" ¢.. P~ BAT Co LTD - MINNESOTA TOBACCO LITIGATION

MO I~:AL/a 6J Group Research & Development Centre, Britlsh-Amerlcan Tobacco Co. Ltd,, SOUTHAMPTON. 23rd April 1979. CIGARETTE SMOKINGr HEALTH, AND D~SSONANCE (PP.OJECT LZB~) I. INTRODUCTION AND METHOD (Eeport No. RD.1670 Rastrlcted) ----~ SUMMARY Project LIBRA is a comprehensive quantitative survey undertaken among current cigarette smokers, ex-smokers and never-smokers in the United Kingdom. The principal objectives of the research are to explore (i) Che ways in which smokers, ex-smokers and never-smokers can be dlstlnEu~shed in terms of their attitudes to health in Sanaral, and smoking and health in part£cular, and (ll) the indices of psycholoEical difference which best predict the mode(s) of conflict resolution an individual will employ in relatio~ to smokinE and concern for health. This report describes the background to the study, the selectiou of itm for inclusion in the questionnaire, a~d details of the sampling ~nd sd~in£stration procedures adopted. The resul~s of the data analyses will ba presented in future reports, O t.n C7"- BAT Co LTD - MINNESOTA TOBACCO LITIGATION

-2- ZNTRODU CT 1014 • It is now nearly th£rty years s£nce Wynder and Graham reported that tobacco smoklnK "seems to be an important factor in the induction of bronchlogenic carcinoma" (1). Since then anal-smoking campaigns have expressed themselves in the med~s, schools, and workplaces. In the U.K. and U.S.A., and other countries, health warnings have appeared on cigarette packets. Smoking in certain public places has been restricted and advertising on television has been banned in some countries and prohibited altogether in others. As 8 consequence, the soclal climate regarding smok£ng has thanked and it is unlikely that anyone in the U.K., at least, is unaware of reasons why they should not smoke• Hence, most smokers wlsh to quit smok~nK. Results from the recent Operaclon Aquarius (2) have indicated that more than slxcy percent of the U.K. smoker population can be described as dissonant. That is, they are experiencing some conflict between what they do and what they believe they should do. Specifically, they wish to stop smokln~. For ww',re than half of those smokers who had attempted ~o qu£~, general or specific health reasons were clted. Of the forty percent of non-smokers who fused to smoke, three quarters were motivated Co Kive up smokinK by health concerns. Tt is possible to define four Kroupa within a smoker populatlon, which describes the market accordlns to the amount of consonance~dissonance expressed by their behaviour and attitudes to smokinK: Hishly Consonant - Chose who have not tried nor wish to quit; Consonant - those who have tried but do not nov wish to quit; Dissonant - those who wish to quit but have not tried; ~i~hl7 Dissonant - those who wish co quit and have attempted to do so. BAT Co LTD - MINNESOTA TOBACCO LITIGATION ¢,.j'1 O", I",o

According to dace derived from Operation Aquarius. the relative sizt8 of these segments are as foIZows: , lighly Consonant 2OZ Consonant 16Z Dissonant 13Z Highly Dissonant 50Z The highly dissonant smoker is most likely Co be in the age range 25 Co 34 years and co smoke 1S to 29 cigarettes per day. In contrast, sixcy percent of all h£&hZy consonant smokers ace ased at Zeasc 45 years ~- and one qmLrCer of chlm smoke five or less clgarectes per day. When asked "what were chf reasons Chat made you glve up?" (ex-smokers), or "what were the reasons that made you cry co give up?" (smokers), the follc~r£u&d£scributlon o£ zesponses was obtained: Ex-smokers Smokers (Z) (~) Cost 33 43 BeaZ Ch (speciJE £c) 35 30 Baalch (&emeral) 30 28 Ocher 9 13 Of particular interest in Chase dace is the apparent difference in the relaclve iJnporCance o£ cost and health. For smokers who had failed co quit, cost was cited-most often as the mociveCion co attempt, whereas less ex-mnokers were prompted by this reason. The obvious interpretation o£ this finding is chac Chose for whom quiccinS is the only satisfactory means to resolve the conflict between smoking and health concern have already done so. Therefore, the difference beCveen smokers and ex-smokers BAT Co LTD - MINNESOTA TOBACCO LITIGATION r,,o

-4- in th£s regard, 4s h£sto:£cal. An alternative hypoChesls can, however, be advanced: that those who have attempted to quit but failed, deny the importance of concern for health as a motive in order to assuage the dissonance which ra~alns. Whilst such an hypothesis i• only :mnt~Itive, it hlghllghts an important sap in our Imowl@dse of the consumer: how does he remain a smoker despite the apparmntly good reasons for him to stop fmokins? ~t £s our contention that all dissonant smoker•, and probably some apparently consonant smokers, maintain their behavlour only by making some psychological adjustments to t@ducs the con£1£ct between smoking and concern for health. It has already bee~ suggested that one way of reduc£n8 con£1£ct is to deny or devalue Oh• health &rL~unent. We vould suggest that there are st least £ive mode• through vhich such • defense mJy be obta£ned. (a) By raclonsllsLn§ the health £ssue. For example, a smoker may ma£ntaln thaC there is Coo much fuss be£ng made about the r£sks actmchLng to smoklng, or he may assert that "mnokins does not hurt anyone •o Ions as they show no s£gns of health probIIms". (b) B7 "stat£st£ca1" rat£onalisat£ou of the health issue. This mode would be reflected in agreement with such statements as: "Cigarette smoklns only makes it more l£kely that you would Set an i11nasm you would gee anyway" and "Many non-smokers die of illnesses Chat are o£t4m sald to be ceusmd by smoking c£sarettes". Soch modes (a) and (b) share • fatel£stlc disposition and offer the raCiona1£zatlon that, through accidents or ageing, people die an)~ay ..... P cr~ r~J .mamab mmmb BAT Co LTD - MINNESOTA TOBACCO LITIGATION

-5- (c) By w~difyinl smoking behaviour. This is • ,,ore truly rational • approach and would elicit concordance with such statements as: "There ts nothing wrong with smoking so Long as it £s in moderation", and "Low tar c£ga~ettes are sa£ar than high tar cigarettes". Roarer, belle£ and action may not match. Faith in "safer" smoklns £s probably not sufficLenc to resolve conflict and would need to be supported by appropriate buying and consumption behaviour to be effective. (d) By danyinZ the authorit7 of anti-smoking information. Evidence from Operation Aquarius (op.c~t.) suKgests that smokers are less likely than non-smokers to believe "the th~nKs that the Kovernment says about cigarette smok£nK and £ts effects on health" and less llkely to accept "the thlnss doctors say about cigarette smoking and its effect on health" - the latter because doctors themselves smoke and "doctors don't always asree wlth one another". It is not suggested that these modes of conflict resolution or reduction are axclus4ve or /~dspandent. Recent Canadian data (3) supports the existence of smv~ral factors 4n th:Ls area. The fifth sugsested mode of dealins with conflict is perhaps the most rational and is likely to be found &mouKst apparently consonant smokexs •leo. (a) By a~knowledsins the risks attached to smoking. Such a mode would ba expressed in agrement wlth a statement such as "smokinK mtsht be harmful but: I cannot stop" or "the enjoyment Z geC £rom smokinK is worth any small risks it might involve". In the latter case, aKre~ent presupposes that the risks are Kenuinely perceived as "s~IL" or that some rat£onal~smtion has allowed that conclusion to be reached. cr~ r~ BAT Co LTD - MINN~TA TOBACCO LITIGATION

-6- For the smoker, these and perhaps other ways of reconciling smoking wlCh concern for health are available and operating singly or in comb£natlon. They are, however, unsuccessful. Otherwise, half of the smoker populat£on would not express the vish to quit because of their health concern. Because denials or reduction of its importance, £s 4tsel£ a means of partially resolvin8 conflict, then concern for health, determined solely by direct queationlnK, is likely to yield an underestimate o£ its importance to some smokers. Xn terms o£ sustained contlnuatLon of smoking behavlour, only twenty percent of the current U.K. market can be considered "sage", that is they are highly consonant, neither wishing to nor ever hav£ng attempted to quit. The i~lzediate "loss potential" of dissonant smokers, who wish to buC" have not yet attempted to give up smoking, fs estimated at 13Z, with a £urther 50Z highly dissonant, who have tried to quit and failed - so far. It is our v4ew that the true loss potential gs much Kreater than those wsitin& to tz7 but Chat n do not have so£ficient means o£ ident£gying the long term behavloural £ate o£ current smokers. The present research, Project LIBRA, will begln a programme to better character£se the smoker population fn relation to concern for health, whlch d4menslon is clearly one of the most in£1u@ntial in the segmentation of e contemporary market. PKOJECT LIBRA Project LxBRA addresses iteel£ to the £ollowing questions: Zn what ways can smokers, ex-emokers and never-smokers be dlstinguished in terms of their attitudes to health in general, and smoking and health in percicul~r? (Attitudes to health.) mmmb O Cr~ mumdb BAT Co LTD - MINNESOTA TOBACCO LITIGATION

-7- 2. Wh£ch £ndices of psychological difference best distinguish between . individuals who zeduce conflict baleen smokin$ end health concern by varlousmeans (such as~odifyins their s~ok£nK behavlour, adopting various modes of dissonance red,orlon, etc.) and beL~ween these and successful quitters and never-smokers? (Individual diff•rences.) Attitudes to Health Data obtained from Operation Aquarius indicate that smokers, ex-s~okers and never-smokers express different attitudes towards smoking and health. For example, 87Z o£ ex-smokers and 89Z of never-smokers •greed with the statement that "cigarette smoking is harmful to health", ~heress only 70Z o£ smokers agreed with this asserCion. Although the majority of smokers agree w~th the proposition in a general ray, they are less concerned vhen asked about the possible effects, of smoking o~ their o~n health. Tl~is apparent contradiction is • further reflecclon of cognlcive dissonance (4). In a recent mark~ se~enC•tion study carried out in Canada (3), four major se~nts of the smoker population were identified. Concern for health, or lack 0£ it, yes a w ajar di££arentiatin8 feature £or each of the segments, members of the largest segment appear to have resolved chelr confllct by modlfy[ng their smoking behaviour. Such consumers vers found to more often vane a low tar and nicotine product, perceive ~Idness to be o£ greater importance, to smoke fewer cigarettes, and to generally present a more health conscious profile. In terms of a socio- economic index they are claesifled as predomlnantly medium-high to high. An almost dimnetrlcally opposed seK~ent was also rave•led, comprising abou¢ 25X o£ all Canadian smokers. High inner need motivation, • decided lack of concern about tar and nicotine, a high smokinK volume, • C~ C7~ r~ BAT Co LTD - MINNESOTA TOBACCO LITIGATION