Almost three months into a national antismoking ad campaign paid for by the tobacco industry, tobacco companies and antismoking advocates remain at odds over what works, what doesn't - and what constitutes a fair fight.

The dispute flared again with the return last month of the controversial "Body Bag" commercial, which depicts teenagers piling body bags outside a high-rise office building in a graphic representation of the 1,200 people on average who die each day in the United States from tobacco-related illnesses. The commercial was made at the New York headquarters of Philip Morris Cos., the nation's largest tobacco company, although the building is not identified. When "Body Bag" first aired in February, Philip Morris and others cried foul, and the ad was quickly withdrawn. The company and its allies insisted that the ad - and one showing teenagers armed with a "lie detector" trying to question tobacco executives about cigarettes' addictiveness - violated the historic 1998 settlements between the states and the nation's leading tobacco companies. The largest of the deals, the so-called Master Settlement Agreement with 46 states, established the American Legacy Foundation and charged it with running a national campaign against smoking. Among its provisions was that ads could not include "any personal attack on, or vilification of," tobacco companies. The ad battles result from a compromise at the heart of the 1998 deals: Tobacco companies agreed to turn over billions of dollars of future earnings to the states and to American Legacy. In return, they retained the right to court new smokers, albeit with restrictions on where and how they market. Now, with American Legacy's campaign in its infancy and states deciding how to spend their share of tobacco money, antismoking advocates are voicing concern about how the compromise is working. They fear politics may keep some of their best antismoking weapons locked in their arsenals while tobacco companies continue to use sophisticated hooks - some in the guise of antismoking messages themselves - to lure customers. Antitobacco groups complain that cigarette ads continue to appear in magazines with sizable youth readership, such as Sports Illustrated, People, Rolling Stone, Hot Rod, Glamour, Vibe, Motor Trend, Spin and Mademoiselle, despite the tobacco companies' promises not to pursue teenage customers. Critics say the problem is compounded by messages such as those in Philip Morris' current "Find Your Voice" campaign for Virginia Slims, which they say appeals to teenagers trying to redefine who they are. They take similar issue with antismoking messages that portray smoking as a grown-up activity because being grown-up, or at least appearing that way, is what many teens yearn for most. Countering such appeals requires a no-holds-barred effort on their part, antismoking advocates say. "We know what works," said Stanton A. Glantz, a medical professor at the University of California at San Francisco who studies antismoking campaigns and who is an outspoken critic of tobacco marketing. "The only question is whether we'll be able to use it." Glantz said hard-hitting ads do not amount to vilification. "To say that the tobacco industry kills 1,200 people a day and to present that information graphically is not vilification, it's fact," Glantz said. "To say that the tobacco industry has taken contradictory positions on whether nicotine is addictive or not isn't vilification, it's a statement of fact." Even so, the reappearance of "Body Bag" on April 19 had some of the earmarks of a compromise. The ad began airing again on cable stations such as MTV and networks such as UPN and WB that have high viewership among teenagers. But it was absent from the three major networks, which have questioned the appropriateness of the American Legacy ads. And the return of the "Lie Detector" ad is limited, for now at least, to the campaign's Web site, http://www.thetruth.com A question of timing Carlea Bauman, a spokeswoman for American Legacy's counter-marketing campaign, which goes by the name "Truth," said the ads were pulled only because of timing. "It was the beginning of the campaign, and we didn't want our message to be swamped," she said. Philip Morris vice president Michael Pfeil said the company still objected to the commercials, saying they violated the letter and spirit of the agreement establishing the American Legacy Foundation with a $1.5 billion, five-year budget of tobacco company money. "We're looking at our options," Pfeil said. Given the pressures on the American Legacy Foundation, antismoking advocates say a key question now is whether states - which are not bound by "vilification" rules - will use some of their tobacco settlement money on hard-hitting campaigns of their own. They say such campaigns in California, Florida and Massachusetts have been linked to significant reductions in smoking in those states, especially among youth. Pennsylvania, for example, expects to receive about $400 million a year under the 1998 settlement, although it could be less if smoking rates continue to show declines that have appeared in recent statistics. Gov. Ridge has proposed spending 15 percent of the money, or about $60 million a year, on antismoking efforts, including school- and community-based programs. Counter-marketing But the state has not decided how much of that will go to counter-marketing or what form any advertisements might take, Secretary of Health Robert S. Zimmerman said. He said the state would target youth smokers, pregnant women and minorities. According to a 1997 study, 29 percent of the state's 12th graders, 18 percent of ninth graders, and 7 percent of seventh graders were daily smokers, he said. Zimmerman said cutting those numbers was crucial because of the lifelong effects of youth smoking. "Eighty to 90 percent of addicted adult smokers started in their teen or preteen years," he said. Antismoking advocates say aggressive counter-marketing may be the key to reaching those groups. The Florida Department of Health said in March that smoking among middle school students had declined by 54 percent since 1998, when Florida launched its Tobacco Pilot Project. Among high school students, cigarette use declined by 24 percent. Florida officials said they had not yet studied how much of the success could be attributed to the state's blunt campaign, whose slogan is: "Their brand is lies. Our brand is truth." But antismoking advocates say they have no doubt that aggressive counter-marketing deserves much of the credit, which is why they say campaigns such as Florida's continue to be criticized by the tobacco industry and sympathetic politicians. Glantz, the California medical professor, said the themes of Florida's campaign were based on recent research. "There are three messages that are proven most effective," he said: " 'The tobacco industry lies,' 'Nicotine is addictive,' and 'Second-hand smoke kills.' " Antismoking advocates have questioned the effectiveness of other themes, including that of the recent Pennsylvania billboard campaign that sought to uglify smoking with images and slogans such as "Butt head" and "Butt munch." But they said what was more troubling were messages that suggest, directly or indirectly, that smoking is an adult activity. In that category some cite a humorous jingle on a toll-free phone line printed on Lucky Strikes packs. Critics say its sarcastic tone will appeal to many teens, but Brown & Williamson spokesman Steve Kottak said it was designed to "show that we don't take ourselves too seriously." "We as a company believe that kids should not smoke cigarettes under any circumstances," he added. Critics also cite Philip Morris' antismoking TV commercials. In one, a teenage girl talking to her father before a date is reminded of the things she's not supposed to do. "No drinking and no smoking . . . and no kissing," he says. "What teenager doesn't want to kiss?" asked Robert Sklaroff, an Elkins Park cancer specialist who is one of Pennsylvania's most vocal antismoking activists. "What [Philip Morris] is doing is guaranteed purposely not to work." Philip Morris' Pfeil defended the commercial, saying it was aimed chiefly at parents. "The message is that parents need to talk to their children. Children will listen," he said. At the same time, "we certainly believe that we ought to respect the rights of adults to make adult choices," he said Glantz said research has shown that most health-message commercials are also ineffective, as are ads intended to boost teenagers' ability to resist peer pressure, the theme of many of Philip Morris' antismoking ads on television. "All the research we have looked at says there should be a mix of messages" to be most effective, Pfeil said. "What we're trying to convince teens is that smoking is not cool, that it's not the norm, and that they don't need to do it to define who they are." Glantz and other advocates remain skeptical of the tobacco industry's motives. "It's possible to run ads that look really nice and don't work," Glantz said. "To some extent, it's like, duh, you can do a good job or a bad job. But the important thing when you talk about tobacco is that you can do a bad job on purpose. "That's the industry's whole strategy: to get people to run campaigns that look good and don't work."

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