Mass media campaigns against tobacco use

There is strong evidence that mass media campaigns reduce the number of tobacco users, increase quit rates², and reduce youth initiation and smoking^{2, 3}. Evidence is strongest for high intensity, well-funded television campaigns² and campaigns that are part of a comprehensive tobacco control program^{3, 4}.

Mass media campaigns reduce tobacco use among adults and youth^{2, 5, 6}, and reduce or delay tobacco use initiation among young people². Such campaigns can also reduce tobacco consumption, increase quit rates^{4, 5}, and increase use of cessation services². Campaigns may be more effective for light smokers than heavy smokers⁷.

Campaigns with messages that include quitline information increase quitline use^{2, 8}. Such campaigns have been shown to increase calls to quitlines in communities with majority black populations⁹. State-sponsored campaigns can increase quitline registrations and the use of internet-based cessation interventions¹⁰.

Intense campaigns that reach many current and potential tobacco users typically yield stronger effects than less intense campaigns^{2, 5}. Research from the Centers for Disease Control and Prevention (CDC) suggests that campaigns must reach 75% to 85% of their target audience and last at least 18 to 24 months to affect behavior³. Effects on quit attempts may fade shortly after a campaign ends⁵. Emotional messages such as personal testimonials with compelling narratives, intense images, and sounds¹¹, or graphic portrayals of negative health consequences appear more effective than other approaches^{2, 3, 5}. Studies of the CDC’s Tips From Former Smokers, an example of such an approach, suggest such efforts can increase beliefs about the harms of smoking¹², calls to quitlines^{8, 13}, quit attempts^{14, 15}, and cessation^{6, 15}; greater exposure to such a campaign may contribute to a stronger intent to quit¹².

Overall, effective youth campaigns generally last more than three years, are based on target audience research, and include school-based lessons, media spots, and multiple media methods (e.g., newspapers, radio, television). Additional evidence is needed about the use of social media and novel forms of technology for tobacco prevention campaigns for youth¹. Youth appear more responsive to messages about tobacco industry manipulation than adults¹⁶. Studies of the U.S. Food and Drug Administration’s (FDA’s) The Real Cost campaign suggest that youth-targeted campaigns can alter population-level perceptions of tobacco-related harms¹⁷ as well as reduce smoking initiation by youth¹⁸. Campaigns to prevent youth uptake may require less reach than campaigns to promote quitting to yield effects⁵.

Some campaigns appear more likely to yield stronger effects among low income individuals than higher income individuals². Other campaigns, often those with limited reach⁵, increase quit rates most among high income individuals^{5, 19}. However, both messages targeted to disadvantaged populations and those intended for broader audiences have demonstrated effects among disadvantaged populations^{2, 20}. Campaign effects may also vary by race and ethnicity¹¹.

Mass media campaigns included in comprehensive tobacco control programs appear to reduce smoking prevalence⁴.

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 year⁴. An evaluation of the FDA’s The Real Cost Campaign found a return on investment of $128 for every dollar spent²¹. Campaigns to increase quitline use are estimated to cost about $260 per additional call made to the quitline².

Mass media campaigns against tobacco use can be implemented on the national, state, and local levels. The Centers for Disease Control and Prevention’s (CDC’s) Tips From Former Smokers includes stories from real people living with tobacco-related diseases and disabilities; it features tips, tools, and connections to quitlines to support quitting²². The Real Cost, from the U.S. Food and Drug Administration (FDA), is a youth-oriented campaign with materials focused on the cosmetic effects of tobacco, the loss of control caused by addiction, and the dangerous mix of toxic chemicals in tobacco products²³. The Truth campaign uses its website, social media platforms, and text messages to share information on the dangers of tobacco and methods to prevent youth use²⁴.

The Massachusetts Tobacco Cessation and Prevention Program (MTCP) is an example of a state-based effort that uses a comprehensive approach to reduce tobacco and nicotine use which includes social media²⁵.

CDC-Tips - Centers for Disease Control and Prevention (CDC). Tips From Former Smokers.

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.

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

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.

US FDA-Real Cost resources - U.S. Food and Drug Administration (U.S. FDA). Center for Tobacco Products. The Real Cost Campaign: Campaign resources.