Short communication
The reach of a youth-oriented anti-tobacco media campaign on adult smokers

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Abstract

Background

It remains unclear whether youth-targeted anti-tobacco media campaigns reach adults. We examined the reach of the youth-oriented Florida “truth” campaign to (a) determine the extent to which adult smokers were aware of the campaign and (b) test if that awareness was associated with an intention to quit smoking in the next 30 days.

Methods

Data included 781 adult smokers who in 2001 participated in a 20-min telephone survey designed to examine the effects of the “truth” campaign in Florida. Participants were asked numerous questions aimed at measuring their awareness of the campaign and about their tobacco use.

Results

Awareness of the campaign was mixed with 21% confirming the “truth” campaign theme, 45% the “truth” logo, 62% “truth” advertising events, and 68% the “truth” advertising theme. Awareness of industry manipulation was the only variable significantly associated with smokers’ intentions to quit (OR = 1.66; 95% CI = 1.34–2.05) in the multivariate model.

Conclusions

The “truth” anti-tobacco campaign targeted 12–17 year olds in an effort to prevent them from starting to smoke. Despite the awareness, the campaign did not have the “unintended consequence” of influencing adults’ intentions to smoke. To change the behavior of adults it is not sufficient to have a youth-focused program.

Introduction

Tobacco use is the most preventable cause of death. Fortunately, tobacco use can be reduced through anti-tobacco messaging (Hopkins et al., 2001, Lantz et al., 2000, Popham et al., 1994, Siegel and Biener, 2000, Sly et al., 2005, Wakefield and Chaloupka, 2000). By using counter-advertising media campaigns, public health advocates have been able to reach large audiences to promote a public health message. Before the Florida anti-tobacco “truth” campaign, statewide media campaigns such as in California, Massachusetts, Oregon, Minnesota, and Arizona, focused on the general population. In California and Massachusetts, for instance, adult cigarette consumption declined during the campaign years in the early 1990s but initially no such effects were observed on youths (Siegel, 2002). It was not until 1995 that smoking trends for youths began to decline somewhat and have since remained fairly stable, though it remains unclear if these changes can be attributed to the campaigns (Siegel, 2002). Rather than targeting the general population, the Florida “truth” campaign focused exclusively on youths. The anti-tobacco television media campaign consisted of running two to three advertisements at a time statewide (Sly et al., 2001a). These anti-tobacco advertisements used an empowerment model directing youths to take action against the tobacco industry (Bauer et al., 2000, Sly et al., 2001b). These advertisements also used a counter-advertising approach; they portrayed the tobacco industry as manipulative—lying to youth and hiding the truth (Sly et al., 2001a). Following the CDC empowerment model (CDC, 2003), it was assumed that the more youths were exposed to the advertisements, the more they would be influenced by the message with such exposure resulting in a stronger anti-tobacco attitude, in turn reinforcing anti-tobacco behaviors (CDC, 2003, MacDonald et al., 2001, Sly et al., 2001a).

Despite the positive effects on youths, it remains unclear whether a youth-targeted anti-tobacco television campaign would reach adults. The issue of reach is important because if advertisements developed to reach one population (youths), also reaches other populations (adults), anti-tobacco campaigns can use limited resources on one campaign. In this paper, we examined the reach of a youth campaign by (a) examining the extent of adult smoker campaign awareness and (b) testing if that awareness was associated with an intention to quit smoking in the next 30 days.

Section snippets

Sample

Data are from an Adult–Youth Survey designed to examine the effects of the “truth” campaign in Florida. Interviews were conducted in 2001, with the intention to interview 1000 adults ages 30–50 years old with children ages 12–17 years. The study also sought to interview 1000 adults without children. Using a public list of telephone numbers, 17,860 numbers were called via random dialing. A total of 3337 adults met eligibility criteria and 2368 fully completed the 20-min survey (70% completion

Intention to quit smoking

The study's dependent variable is smokers’ intentions to quit. Smokers were asked if they were “planning to quit smoking cigarettes in the next 30 days”, with Yes = 1 No = 0.

Confirmed “truth” campaign theme

Respondents were asked two questions: “Are you aware of any anti-tobacco or anti-smoking campaign that is now taking place in Florida?” and “What is the theme or slogan of this campaign?” Those who positively identified the “truth” campaign theme/slogan were considered to have confirmed the “truth” campaign theme. Broad or

Data analysis

First we calculated the percent of respondents who confirmed campaign characteristics. Then, we used bivariate and multivariate logistic regression to examine the association between awareness of the youth-oriented anti-tobacco media campaign and expressed intention to quit smoking in the next 30 days. Demographic characteristics included in this study and used as controls in the multivariate logistic regression analyses were gender, age, race/ethnicity, marital status, and education (see Table

Results

The sample consisted of 781 adult current smokers, 31% of the interviewed sample. Of these, 29% were men and 71% women. The average age was 41 years (S.D. = 5.58). Most respondents identified as White/non-Hispanic (87%) followed by Hispanic (5%) and of other backgrounds (5%), and Black/non-Hispanic (3%). About two-thirds were married while 20% divorced or separated. Educationally, 6% had not completed high school, 34% had a high school degree, and nearly 60% had a college or higher degree.

Discussion

The “truth” anti-tobacco campaign targeted 12–17 year olds in an effort to prevent them from starting to smoke. We examined the reach of the campaign to adult smokers, specifically whether that was associated with intentions to quit within the next 30 days. Interestingly, a larger percentage of adults confirmed the actual anti-tobacco advertisements than the overall theme of the campaign. This finding may reflect that the advertisements are clear in their messages, though respondents may not be

Conflict of interest

All authors declare that they have no conflicts of interest.

Acknowledgements

This study was funded by a grant from the Swedish Council for Medical Tobacco Research and the Florida Department of Health, James and Esther King Biomedical Research Program.

Role of funding source: Funding for this study was provided by the Swedish Council for Medical Tobacco Research Grant No. 200608 and by the Florida Department of Health, James and Esther King Biomedical Research Program Grant No. 3666-566-34; the Swedish Council for Medical Tobacco Research and the Florida Department of

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