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Variations in state use of antitobacco message themes predict youth smoking prevalence in the USA, 1999–2005
  1. Jeff Niederdeppe1,
  2. Rosemary Avery2,
  3. Sahara Byrne1,
  4. Tyseer Siam2
  1. 1Department of Communication, Cornell University, Ithaca, New York, USA
  2. 2Department of Policy Analysis and Management, Cornell University, Ithaca, New York, USA
  1. Correspondence to Dr Jeff Niederdeppe, 328 Kennedy Hall, Cornell University, Ithaca, NY 14853, USA; jdn56{at}


Objective This study tests relationships between the volume of advertisements (ads; public service announcements (PSAs)) employed in state antismoking campaigns, use of different themes and stylistic features in these PSAs, and state youth smoking prevalence between 1999 and 2005.

Methods We merged commercially available data on televised antismoking PSAs that aired between 1998 and 2004 with data on state tobacco control activity to test the relationship between the volume and content of youth-targeted and general-targeted/adult-targeted antismoking PSAs on youth smoking prevalence, controlling for other tobacco control efforts. We use content analysis and ordinary least squares (OLS) regression to assess which thematic and stylistic features employed in state antismoking PSAs are associated with reduced smoking prevalence.

Results A 100-ad increase in the yearly volume of youth-targeted state antismoking PSAs was associated with a 0.1 percentage point decrease in state youth smoking rates in the following year. This relationship was driven by variation in state use of PSAs emphasising health consequences to self or others and anti-industry appeals. Controlling for appearances of these themes, use of graphic imagery and personal testimonials did not predict reduced smoking prevalence. Adult-targeted/general-targeted PSAs were not associated with youth smoking prevalence.

Conclusions Youth-targeted state antitobacco PSAs that emphasise the health consequences of smoking (to oneself and others) and contain anti-industry appeals are associated with reduced youth smoking rates. Future work should avoid typologies that do not account for the co-occurrence of thematic and stylistic content in antitobacco PSAs.

  • Media
  • Public policy
  • Prevention
  • Social marketing

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