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US cities should feel free to pass ordinances banning cigarette advertising in many public places without fear of legal challenge. The city of Baltimore did so in 1994 and several other cities have followed suit. The only possible challenges to such laws are that they violate the First Amendment or are preempted by federal law. However, the Supreme Court has consistently given commercial advertising only limited protection. The High Court has even ruled in favor of state and municipal bans on cigarette ads, arguing that citizens are exposed to these ads against their will. And the Public Health Cigarette Smoking Act of 1969 only prohibits the regulation of the content of the ads, but not their placement. The Baltimore law only banned the placement of the ads in certain public locations. Baltimore's law was upheld by the Fourth Circuit Court of Appeals. By focusing on the placement of these billboards and not their content, cities and states can get on with the business of protecting their residents from these ads., In 1994, Baltimore, Md, became the first city to generally prohibit billboards from displaying alcohol and tobacco advertisements. The owner of most of Baltimore's billboards, Penn Advertising, sued, but the federal district court rejected the billboard company's complaint and ruled that the First Amendment had not been violated and that the federal cigarette labeling acts had not preempted the ability of Baltimore to regulate and prohibit billboard cigarette advertising. In the fall of 1995, the federal district court's judgment was unanimously affirmed by the Fourth Circuit Court of Appeals in Richmond, Va. This article analyzes the constitutional and preemption issues and concludes that states and municipalities are on firm legal ground when they restrict the location or placement of publicly visible cigarette advertisements without attempting to regulate the advertisement's content or message. States and municipalities command broad authority to protect children and to shield the public from intrusive forms of advertisement that inflict their messages on a captive audience. A billboard ban thus offers local communities a legal avenue to help curb the rising tide of juvenile smoking without raising taxes, creating bureaucracy, or angering smokers. JAMA. 1996;275:1263-1269)

Comments on various proposals to desubsidize smoking in the United States. Taxation of cigarettes to make their price commensurate to their total costs; Identification by the Public Health Service of which cigarette brands are more hazardous; Tar and nicotine tax on cigarettes.