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Mass media campaigns against tobacco use

Evidence Rating

Scientifically Supported

Health Factors

Mass media campaigns seek to reach large audiences through television, radio broadcasts, print or digital media, or other displays. Such campaigns typically seek to prevent tobacco initiation or increase quit attempts by educating current and potential tobacco users and changing the attitudes and beliefs that contribute to tobacco use (CG-Tobacco use).

Expected Beneficial Outcomes (Rated)

  • Reduced youth smoking

  • Reduced number of tobacco users

  • Increased quit rates

Other Potential Beneficial Outcomes

  • Reduced tobacco consumption

  • Increased use of cessation treatment

Evidence of Effectiveness

There is strong evidence that mass media campaigns reduce tobacco use initiation and prevalence and increase quit rates (CG-Tobacco use). Evidence is strongest for high intensity, well-funded television campaigns (CG-Tobacco use) and campaigns that are part of a comprehensive tobacco control program (, AHA-Mozaffarian 2012).

Mass media campaigns reduce tobacco use prevalence among adults and youth (CG-Tobacco use, Durkin 2012), and reduce or delay tobacco use initiation among young people (CG-Tobacco use). Such campaigns can also reduce tobacco consumption, increase quit rates (, Durkin 2012), and increase use of cessation services (CG-Tobacco use). Campaigns with messages that include quitline information increase quitline use (CG-Tobacco use). Mass media campaigns may help light smokers quit more than heavy smokers ().

Intense campaigns that reach many current and potential tobacco users frequently yield proportionally stronger effects than less intense campaigns (CG-Tobacco use, Durkin 2012). CDC research suggests that campaigns must reach 75 to 85% of their target audience and run 18 to 24 months to influence behavior (AHA-Mozaffarian 2012). Effects on quit attempts may fade shortly after a campaign ends (Durkin 2012). Highly emotional messages such as personal testimonials or graphic portrayals of negative health consequences appear more effective than other approaches (CG-Tobacco use, Durkin 2012, AHA-Mozaffarian 2012).

Campaigns to prevent youth uptake may require less reach than campaigns to promote quitting to yield effects (Durkin 2012). Effective youth campaigns generally use target audience research, last more than three years, and involve multiple segments of the community (). Youth appear more responsive to messages about tobacco industry manipulation than adults (Wilson 2012).

Some campaigns appear more likely to yield stronger effects among low income persons (CG-Tobacco use); others, often those with limited reach (Durkin 2012), can increase quit rates more among high income persons (Durkin 2012, ). However, both messages targeted to disadvantaged persons and those meant for broader audiences have demonstrated effects among disadvantaged populations (CG-Tobacco use, ).

Mass media campaigns save more in averted health care costs than they cost to implement; media expenditures for such campaigns have ranged from 25 cents to $3.35 per capita per year (). Researchers estimate that campaigns cost about $577 per Quality Adjusted Life Year (QALY) saved or $213 per life year saved. Campaigns to drive quitline use are estimated to cost about $260 per additional call made to the quitline (CG-Tobacco use).

Impact on Disparities

No impact on disparities likely

Implementation Examples

Many states have implemented mass media campaigns aimed at all residents or at youth (Farrelly 2003). Campaigns that were part of comprehensive tobacco control efforts in Massachusetts and California appear to have reduced smoking prevalence, though California’s program only demonstrated statistically significant effects before its funding was reduced (). Evaluation results suggest that Tips From Former Smokers, a national antismoking campaign, can increase quit attempts () and EX, a targeted campaign, appears especially effective for low income smokers (). Truth, a national youth smoking prevention campaign, is widely considered successful (Niederdeppe 2004).

Implementation Resources

Truth Initiative-Tobacco free - Truth Initiative. Inspiring tobacco-free lives through education, research, community activism, and engagement.

CDC-MCRC - Centers for Disease Control and Prevention (CDC). Media campaign resource center (MCRC).

ACS-Stop smoking campaigns - American Cancer Society (ACS). Global dialogue for effective stop smoking campaigns.

CPHSS TCLC-Brossart 2014 - Brossart L, Moreland-Russell S, Walsh H, et al. Policy strategies: A tobacco control guide. St. Louis: Center for Public Health Systems Science (CPHSS), George Warren Brown School of Social Work, Washington University, Tobacco Control Legal Consortium (TCLC); 2014.

HealthPartners-CHA - HealthPartners Institute for Education and Research. Community health advisor (CHA): Resource for information on the benefits of evidence-based policies and programs: Helping communities understand, analyze, and model costs.

Citations - Evidence

* Journal subscription may be required for access.

CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco.

Cochrane-Secker-Walker 2002* - Secker-Walker R, Gnich W, Platt S, Lancaster T. Community interventions for reducing smoking among adults. Cochrane Database of Systematic Reviews. 2002;(2):CD001745.

Cochrane-Brinn 2010* - Brinn MP, Carson KV, Esterman AJ, Chang AB, Smith BJ. Mass media interventions for preventing smoking in young people. Cochrane Database of Systematic Reviews. 2010;(11):CD001006.

Wilson 2012 - Wilson LM, Avila Tang E, Chander G, et al. Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: A systematic review. Journal of Environmental and Public Health. 2012;2012(961724):1-36.

AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514–63.

Cochrane-Bala 2013* - Bala MM, Strzeszynski L, Topor-Madry R, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database Systematic Reviews. 2013;(6):CD004704.

Durkin 2012 - Durkin S, Brennan E, Wakefield M. Mass media campaigns to promote smoking cessation among adults: An integrative review. Tobacco Control. 2012;21(2):127–38.

Lorenc 2013* - Lorenc T, Petticrew M, Welch V, Tugwell P. What types of interventions generate inequalities? Evidence from systematic reviews. Journal of Epidemiology and Community Health. 2013;67(2):190-3.

Guillaumier 2012* - Guillaumier A, Bonevski B, Paul C. Anti-tobacco mass media and socially disadvantaged groups: A systematic and methodological review. Drug and Alcohol Review. 2012;31(5):698–708.

Citations - Implementation Examples

* Journal subscription may be required for access.

Farrelly 2003 - Farrelly MC, Niederdeppe J, Yarsevich J. Youth tobacco prevention mass media campaigns: Past, present, and future directions. Tobacco Control. 2003;12(Suppl1):i35-i47.

Niederdeppe 2004 - Niederdeppe J, Farrelly MC, Haviland ML. Confirming “truth”: More evidence of a successful tobacco countermarketing campaign in Florida. American Journal of Public Health. 2004;94(2):255-7.

Cochrane-Bala 2013* - Bala MM, Strzeszynski L, Topor-Madry R, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database Systematic Reviews. 2013;(6):CD004704.

Guillaumier 2012* - Guillaumier A, Bonevski B, Paul C. Anti-tobacco mass media and socially disadvantaged groups: A systematic and methodological review. Drug and Alcohol Review. 2012;31(5):698–708.

McAfee 2013* - McAfee T, Davis KC, Alexander RL, Pechacek TF, Bunnell R. Effect of the first federally funded US antismoking national media campaign. Lancet. 2013;382(9909):2003–11.

Date Last Updated

May 23, 2014