Tobacco (51) Q3. What is the role of the tobacco industry?

12 March, 2023

Dear HIFA colleagues,

Hello! My name is Monthe Kofos. I'm in my final year of psychiatry residency at the Texas Institute of Graduate Medical Education and Research (TIGMER) located in San Antonio TX, USA, and I will be starting an addiction psychiatry fellowship at Yale University this summer. It is highly moving to see so many bright minds coming together from across the world to discuss addiction and learn from each other. As a member of the HIFA working group that is facilitating our discussion on Tobacco, I am delighted to introduce Question 3:

Q3. What is the role of the tobacco industry? What can be done to address misinformation from the tobacco industry?

According to the U.S. Centers for Disease Control and Prevention (CDC), in 2019, the largest cigarette and smokeless tobacco companies spent $8.2 billion marketing cigarettes and smokeless tobacco just in the United States, about $22.5 million each day. A report from Grand View Research (Report ID: GVR-2-68038-412-3) estimated “the global tobacco market size to be 849.9 billion dollars in 2021 with a predicted compound annual growth rate of 2.4% from 2022 to 2030.”

The CDC summarizes the following population - targeting themes in U.S. tobacco advertising:

1) Women are targeted by thin, attractive, and athletic models promising social desirability, empowerment, and independence.

2) Latinx and American Indians / Alaska Natives are targeted by “rugged” brand names – such as Rio, Dorado, and American Spirit.

3) African-American Communities are targeted through urban and hip hop culture especially to promote menthol cigarettes, as well as direct mail promotions.

4) Asian-American communities are targeted primarily through urban in-store advertisements and specifically through sponsorship of Asian American community organizations, heritage festivals, and financial donations to the Asian American community.

With the Tobacco industry spending so much money and effort embedding themselves within a culture, how can comparatively under-resourced health professionals counter those deceptions effectively? Other countries suffer from similar marketing strategies. When confronting such a powerful marketing machine, what can we do to address this health - destroying misinformation? Do people in communities with more resources have greater responsibility to help or is this a task to be shared equally? What are the challenges that people may face from various communities, and how might they overcome them?

We look forward to hearing your thoughts!

Dr. Monthe Kofos

Psychiatry, PGY-4

University of the Incarnate Word

Texas Institute of Graduate Medical Education and Research

HIFA profile: Monthe Kofos is in his final year of psychiatry residency at Texas Institute of Graduate Medical Education and Research (TIGMER) located in San Antonio TX, and he will be attending a fellowship in Addiction Psychiatry next year at Yale. He is a former chief resident and has participated in, founded, and chaired several of TIGMER’s committees. Dr. Kofos is a champion of increasing addiction awareness and education throughout his residency program, affiliated hospital, and the University of the Incarnate Word School of Osteopathic Medicine; he has worked hard on an administrative level with all three groups leading to significant change. Prior to his psychiatry residency, Dr. Kofos completed a transitional year residency program at MountainView Regional Medical Center in Las Cruces, NM, and attended medical school at the Edward Via College of Osteopathic Medicine – Carolinas Campus. Following his addiction fellowship, Dr. Kofos plans to attend a forensics fellowship. He is an avid ballroom dancer, cook / baker, gardener, reader of fantasy adventure novels, biker, and well known among his friends for his love of elaborate entertaining.