Reductions in smoking prevalence and cigarette consumption associated with mass-media campaigns.
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This paper examines reductions in smoking prevalence and cigarette consumption associated with state and local mass-media campaigns. We review the findings of the empirical literature on campaigns targeted at the general population. We then discuss the findings on state- and community-level youth-oriented campaigns. The results suggest that well-funded and implemented mass-media campaigns targeted at the general population and implemented at the state level, in conjunction with a comprehensive tobacco control program, are associated with reduced smoking rates among both adults and youth. Studies of youth-oriented interventions specifically have shown more mixed results, particularly for smaller, community-level media programs, but they indicate strong potential to influence underage smoking rates. We conclude by examining issues that warrant additional research. The scale and duration of expenditures, the content of ad messages, and other tobacco control polices are aspects of media programs that may help explain differences among study results. In particular, tobacco control polices that are implemented during the campaign often make it difficult to identify the specific influence of media campaigns alone. (+info)
Cigarette smoking and adolescents: messages they see and hear.
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Cigarette smoking is the primary preventable cause of mortality and morbidity in the US. But in the mid-1990s, more than one-third of US teenagers were smokers, despite their awareness of the health risks and negative consequences of tobacco use. In 1996, as part of a three-year qualitative study to explore differences in adolescent smoking by gender and ethnicity, members of the Tobacco Control Network examined messages that teens receive about cigarette smoking. Consisting of 178 focus groups with 1,175 teenagers covering all levels of smoking experience, the study included teens from five ethnic groups, stratified by gender and ethnicity, from urban and rural areas across the US. The authors reviewed the sources and content of messages that teens reported were most influential in their decisions to smoke or not smoke cigarettes. Family and peers, school, television, and movies were the primary sources for both pro- and anti-smoking messages. The authors conclude that a lack of clear, consistent antismoking messages leaves teens vulnerable to the influences of pro-smoking messages from a variety of sources. Interventions need to be culture- and gender-specific. Family-based interventions appear to be needed and efficacious, but resource intensive. Building self-esteem may prove to be a promising intervention. (+info)
Not afraid to blame: the neglected role of blame attribution in medical consumerism and some implications for health policy.
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A crucial aspect of medical consumerism has been overlooked in past research and policymaking: how consumers decide whom to "blame" for bad outcomes. This study explores how, in a system increasingly dominated by managed care, these attributions affect consumers' attitudes and behavior. Using data from the experiences of people with serious mental illness, hypotheses are tested regarding the origins and consequences of blaming for medical consumerism. Blame was allocated to health plans in a manner similar, but not identical, to the way in which blame was allocated to health care professionals. Both allocations are shaped by enrollment in managed care, with blame allocation affecting consumers' subsequent willingness to talk about adverse events. Policy implications include the need for more finely tuned grievance procedures and better consumer education about managed care practices. (+info)
Impact evaluation of an oral health intervention amongst primary school children in Ireland.
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A pilot oral health programme was developed which aimed to improve dental health knowledge and behaviour amongst Irish school children aged 7-12 years. The programme comprised two integral components: a television campaign, run over a 6-week period, was incorporated into the children's programme 'Den TV' on national television, with video clips of a member of the music band Boyzone promoting key oral health messages; and a Smile of the Year contest. Concurrently, a dental nurse delivered an interactive talk with pupils, showed a video of the Den TV oral health programme and distributed posters and leaflets. The aim of this study was to assess the impact of the overall intervention on school pupils' dental health knowledge and reported behaviour. Thirty-two primary schools in two health board regions in the Republic of Ireland participated in the study. At baseline and after 6 weeks, 1534 school children completed specially developed questionnaires. There was a positive net effect of the dental nurse intervention in all but one question. The percentage of children who reported using the recommended amount of toothpaste and brushing for 3 min appeared to have been further increased having observed the television campaign. These results are in line with the argument that mass media campaigns work to supplement the one-to-one activities of health professionals in order to effect knowledge and behavioural change. (+info)
Cigarette advertising in magazines: the tobacco industry response to the Master Settlement Agreement and to public pressure.
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OBJECTIVE: The Master Settlement Agreement (MSA) of November 1998 prohibited participating tobacco companies from directly or indirectly targeting youth in marketing. Widely publicised information in May 2000 showed increased cigarette advertising in magazines with substantial youth readership and companies were pressed to change their practices. The responses of the tobacco industry to the MSA and to the public pressure are examined. DESIGN: Expenditures on cigarette advertisements in national magazines in the USA are compared for three periods: January to November 1998, December 1998 to June 2000, and July 2000 to November 2001. Magazines in which at least 15% of readers are youth under age 18 are focused upon. Regression models test for the significance of period differences after controlling for seasonal and long term patterns. DATA SOURCES: Commercially maintained data on advertising in US magazines and on magazine readership by age. KEY MEASURES: Monthly cigarette ad expenditures in magazines with 15%+ youth readership, and monthly proportion of ad expenditures in 15%+ youth magazines. RESULTS: Cigarette advertising expenditures in magazines with 15%+ youth readership increased dramatically after MSA implementation and fell dramatically after public pressure. The percentage allocation of expenditures to 15%+ magazines fell significantly in both periods. Results differ somewhat by company. CONCLUSIONS: The tobacco industry response to the MSA was at best modest, reducing proportional allocations of advertising to youth magazines but increasing the absolute amount of such advertising. The value of public pressure was seen in substantial reductions in both absolute and proportional spending on youth magazines, although not by all companies. (+info)
Getting to the truth: evaluating national tobacco countermarketing campaigns.
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OBJECTIVES: This study examines how the American Legacy Foundation's "truth" campaign and Philip Morris's "Think. Don't Smoke" campaign have influenced youths' attitudes, beliefs, and intentions toward tobacco. METHODS: We analyzed 2 telephone surveys of 12- to 17-year-olds with multivariate logistic regressions: a baseline survey conducted before the launch of "truth" and a second survey 10 months into the "truth" campaign. RESULTS: Exposure to "truth" countermarketing advertisements was consistently associated with an increase in anti-tobacco attitudes and beliefs, whereas exposure to Philip Morris advertisements generally was not. In addition, those exposed to Philip Morris advertisements were more likely to be open to the idea of smoking. CONCLUSIONS: Whereas exposure to the "truth" campaign positively changed youths' attitudes toward tobacco, the Philip Morris campaign had a counterproductive influence. (+info)
Why and how the tobacco industry sells cigarettes to young adults: evidence from industry documents.
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OBJECTIVES: To improve tobacco control campaigns, we analyzed tobacco industry strategies that encourage young adults (aged 18 to 24) to smoke. METHODS: Initial searches of tobacco industry documents with keywords (e.g., "young adult") were extended by using names, locations, and dates. RESULTS: Approximately 200 relevant documents were found. Transitions from experimentation to addiction, with adult levels of cigarette consumption, may take years. Tobacco marketing solidifies addiction among young adults. Cigarette advertisements encourage regular smoking and increased consumption by integrating smoking into activities and places where young adults' lives change (e.g., leaving home, college, jobs, the military, bars). CONCLUSIONS: Tobacco control efforts should include both adults and youths. Life changes are also opportunities to stop occasional smokers' progress to addiction. Clean air policies in workplaces, the military, bars, colleges, and homes can combat tobacco marketing. (+info)
Tobacco industry youth smoking prevention programs: protecting the industry and hurting tobacco control.
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OBJECTIVES: This report describes the history, true goals, and effects of tobacco industry-sponsored youth smoking prevention programs. METHODS: We analyzed previously-secret tobacco industry documents. RESULTS: The industry started these programs in the 1980s to forestall legislation that would restrict industry activities. Industry programs portray smoking as an adult choice and fail to discuss how tobacco advertising promotes smoking or the health dangers of smoking. The industry has used these programs to fight taxes, clean-indoor-air laws, and marketing restrictions worldwide. There is no evidence that these programs decrease smoking among youths. CONCLUSIONS: Tobacco industry youth programs do more harm than good for tobacco control. The tobacco industry should not be allowed to run or directly fund youth smoking prevention programs. (+info)