Table 3

Summary of evidence regarding impact of media-based anti-tobacco messages for Indigenous populations

Reference (lead author, year)Study and specificityPopulationType of studySIGN rankingsQualitative rankings (Daly et al)Summary of evidence relevant to review
Wilson, 200530 TV media campaign, Maori specificNew Zealand MaoriQuantitative database2−N/AMore calls to Quitline after generic graphic advert compared to holistic Maori advert
Grigg, 200833 TV media campaign, Maori specificNew Zealand MaoriQuantitative BAS2−N/AIncreased recall of adverts and calls by Maori to Quitline
Fernandez, 200839 TV media campaign, Maori specificNew Zealand MaoriQualitative focus groupsN/AIIPositive feedback to IAW campaign, compared with generic graphic TV adverts
Ivers, 200535 TV campaign and community interventions, Mostly genericAboriginal and/or Torres Strait IslandersMixed methods BAS pre/post-intervention surveys2−Insufficient information to assessHigh recall of adverts. Exposure to any of the various interventions did not influence cessation.
Boyle, 201031 TV and radio media campaign, genericAboriginal and/or Torres Strait IslandersQuantitative survey interviews2–N/AHigh recall of adverts. In all, 25% attempted to quit, 1.5% successful.
Johnston, 201040 TV campaign and other interventions, genericAboriginal and/or Torres Strait IslandersQualitative study semistructured interviewsN/AIIIBest recall of graphic imagery in TV adverts. Health staff believe adverts need to be culturally targeted.
Stewart, 201146 TV advertisements, mostly genericAboriginal and/or Torres Strait IslandersMixed methodology questionnaire and discussion2+IIIStrong graphic adverts and first person narratives rated highly by Indigenous smokers
Vogeltanz-Holm, 200932 TV and radio media campaign, genericAmerican Indian (youth)Quantitative study structured interviews2−N/AConfirmed recall and perceived effectiveness highest to ‘Artery’ advert
Daley, 200640 and Choi, 200644 Program curriculum and printed resources, American Indian specificAmerican Indian/Alaska NativeQualitative focus groupsN/AII Daley, III ChoiModifications provided for the ‘Second Wind’ smoking cessation program to improve pan-tribal cultural suitability
Daley, 200943 Health promotional pamphlets, American Indian specificAmerican Indian/Alaska NativeMixed methodology: expert opinion, readability scores and focus group4IIIScientific and cultural content, and readability scores appropriate: minor changes advocated
Doorenbos, 201128 Native calendar, American Indian/Alaska Native specificAmerican Indian/Alaska NativeSingle-blind randomised controlled trial1+N/ACalendar with health messages did not increase smoking cessation related outcomes compared to calendar without messages
Wilson, 201030 Pack health warnings, genericNew Zealand MaoriQuantitative BAS pre/post telephone surveys2−N/ASignificant increase in Quitline number recognition from improved PHWs
Swartz, 200626 Internet website, targeted contentAmerican Indian subsetNon-blinded randomised controlled trial1+N/ANo significant difference in cessation rates between ethnic groups
Taualii, 201041 Internet website, American Indian specificAmerican Indian/Alaska Native (youth)Qualitative focus groupsN/AIIIFavourable response to targeted website
Bramley, 200525 Mobile phone text messages, targeted for Maori, generic for othersNew Zealand Maori and non-Maori (youth)Single-blind randomised controlled trial1++N/ANo significant difference in response between Maori and non-Maori
Whittaker, 200842 Mobile phone video messages, targeted choiceNew Zealand Maori subset (youth)Mixed methodology questionnaire2−IIIFavourable attitudes to content. High self-reported quit rate; not stratified to population group
Whittaker, 201129 Mobile phone video messages, targeted choiceNew Zealand Maori subset (youth)Single-blind randomised controlled trial1+N/ANo significant difference in cessation rates between intervention and control; results not reported by ethnic group
Johnston, 199837 CD-ROM and other community interventions, Indigenous specificAboriginal and/or Torres Strait Islanders (youth)Mixed methodology BAS questionnaires and informal feedback2−Insufficient information to assessNo change in smoking behaviour, increased knowledge, CD favourably viewed
Mitschke, 201036 Education-entertainment drama, Pacific Islander/Native specificPacific Islander and native Hawaiian subset (youth)Mixed methodology, BAS pre/post-intervention2−IIIEvidence of high-level engagement of viewers. Participants' knowledge increased and intentions to smoke decreased.
Patten, 201038 Video and educational materials, Alaska Native specificAlaska Native pregnant womenMixed methodology, BAS pre/post-intervention randomised control2−Insufficient information to assessIntervention deemed not acceptable or feasible as low interest and recruitment. No significant difference between intervention and control groups.
  • Scottish Intercollegiate Guidelines Network (SIGN) levels of evidence rankings (descriptors taken from SIGN 50)22: 1++, high quality meta-analyses or systematic reviews of RCTs, or RCTs with very low risk of bias; 1+, well conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias; 1−, meta-analyses, systematic reviews, or RCTs with a high risk of bias; 2++, high quality systematic reviews of case-control/cohort studies or high quality case-control/cohort studies: very low risk of confounding/bias and a high probability of causal relationship; 2+, well conducted case-control/cohort studies: low risk of confounding/bias and moderate probability of causal relationship; 2−, case-control/cohort studies with a high risk of confounding/bias and significant risk relationship is not causal; 3, non-analytic studies, for example case reports, case series; 4, expert opinion.

  • Daly et al rankings for Qualitative Studies24: level I, generalisable studies: high quality, well reported analytical studies based on comprehensive literature review and conceptual framework with diverse sample; level II, conceptual studies: comprehensive study based on conceptual framework, sample may not be diversified but selected on theoretical basis; level III, descriptive studies: atheoretical, no diversification, descriptive only, sample selected to illustrate practical rather than theoretical issues; level IV, single case study: single or small number interviews, may provide rich data or insights.

  • BAS, before and after study; IAW, ‘it's about whanau’ (campaign title); N/A, not applicable; PHW, pack health warnings.