The possible targeting of cigarette manufacturer advertisements to minors has been a hot topic of debate in recent years, as tobacco advertisements have portrayed such cartoonish characters as RJ Reynold's Joe Camel. Although it is difficult to isolate the relationship between media exposure and smoking behavior among adolescents, there is a body of evidence that is suggestive of a link between tobacco industry promotion efforts and adolescent smoking. For example, Pierce, Choi, Gilpin, Farkas, and Berry (1998) conducted a longitudinal study based on a representative sample of California adolescents. In this study, adolescents who reported at baseline that they owned or were willing to own a tobacco promotional item, such as a tobacco company t-shirt, were more likely than their peers to progress toward smoking by follow-up three years later. Based on these results, the authors suggest that exposure to tobacco promotional activities increases the likelihood that an adolescent will progress toward smoking. It is also possible that the possession of or willingness to possess a tobacco promotional item is simply a marker of a more general susceptibility to or acceptance of smoking, and that it is this more general susceptibility or acceptance that increases the probability of progression toward smoking.

In other suggestive studies, researchers have found that, historically between 1890 and 1997, sizable increases in smoking initiation in a given gender group in the United States tend to coincide with the introduction of tobacco marketing campaigns targeted to that group (Pierce & Gilpin, 1995). Further, Pucci and Siegel (1999) studied a random sample of 627 Massachusetts adolescents, who were 12 to 15 years old at baseline and 15 to 20 years old at follow-up. This study found that the distribution of brand-specific cigarette advertising in the magazines that adolescents report reading is associated longitudinally with the brand of cigarettes that new adolescent smokers choose to smoke. It is important to note that each of these findings is consistent with competing explanations, and so none is definitive. That media has proved a successful medium for preventing smoking in some cases (e.g., Siegel & Biener, 2000; Worden, et al., 1996), however, suggests further that media messages may indeed have the potential to modify adolescent smoking behavior-perhaps in either direction.