To the Editor.—Cigarette advertising and promotional expenditures are increasing at an alarming rate. In recent years, cigarette companies have steadily shifted these expenditures from traditional print advertising to promotional activities (eg, sponsoring sporting and entertainment events and distributing coupons and free cigarette samples).1
One promotional method used is the distribution of nontobacco products. These products may be given away with cigarettes being purchased, obtained by redeeming coupons, or distributed in other ways. In 1985, the most recent year for which data are available, cigarette companies spent $211 million for the promotional distribution of nontobacco products.2
Winston cigarettes, the country's second leading cigarette brand, have been promoted heavily through two-pack sales accompanied by "free" nontobacco products. Some of these products have special appeal to children and adolescents, such as cassette tapes and lighters bearing the name and helmet of the local professional football team (with the National Football
DAVIS RM. Oral Cancer: Causative Agent and Diagnostic 'Tool' in the Same Package. Arch Otolaryngol Head Neck Surg. 1988;114(6):683. doi:10.1001/archotol.1988.01860180097053
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