Bluntness, not subtlety, appears to be the key to reaching both children and adults through anti-smoking ads, according to a review of broadcast and billboard messages funded by state tobacco taxes published in the March 11 issue of the Journal of the American Medical Association.
"To compete with tobacco industry advertising, anti-tobacco advertisements need to be ambitious, hard-hitting, explicit, and in your face," according to tobacco researcher Stanton A. Glantz, PhD, professor of medicine at the University of California San Francisco, and research associate Lisa K. Goldman.
Glantz and Goldman reviewed findings from 186 focus groups involving more than 1,500 children and adults convened to evaluate 118 anti-smoking advertisements produced through anti-smoking programs in California, Massachusetts, Arizona and Michigan.
The researchers concluded that not only directness, but also content is important, with some types of messages working much better than others in kindling viewer responses.
Both children and adults are moved by ads portraying tobacco industry manipulations to hook new smokers and boost profits, as well as by ads illustrating the dangers of second-hand smoke to smokers' loved ones.
Also effective with all ages were messages aimed at concerns over addiction, especially when coupled with portrayals of tobacco industry machinations to recruit and keep smokers. For adults, ads encouraging smokers to quit were significant in many smokers' decisions to stop smoking.
On the other hand, advertising portrayals that all but declare smokers to be unsexy human beings do not make effective anti-smoking messages and, in fact, offend both teens and adults. Viewers thought the ads made superficial character judgments, the researchers found.
Although adults were moderately influenced both by ads pointing to the ease with which children can obtain tobacco and by ads emphasizing long-term health impacts, Glantz and Goldman concluded that these ads were not effective with young viewers.
Humorous ads aimed at youth that deliberately exaggerated negative, short-term cosmetic impacts of smoking--bad breath, tobacco-stained teeth, and ill-smelling hair and clothes--have an impact that is limited somewhat by the audience's real-life experiences with smokers who do not appear markedly different than non-smokers, according to Glantz and Goldman.
Directness is important, the researchers say, citing surveys of teens conducted by the Centers for Disease Control and Prevention. Youth were confused by references to "they" in ads presenting bad industry behavior. "Advertisements must clearly refer to the tobacco industry, rather than to 'they' or 'them,'" the authors state.
Glantz argues that changes in the rate at which smoking has declined in California correspond to changes in the amount and quality of anti-tobacco advertising sponsored by the state. Tobacco consumption dropped significantly during the first wave of anti-tobacco advertising in California, from April 1990 through March 1991, Glantz says, but leveled off afterwards, when the anti-tobacco campaign was briefly suspended before a second wave of ads aired.
In the early campaign, California used more of the effective advertising strategies than other states eventually adopted, according to the researchers. However, the anti-tobacco advertising campaign in California has languished recently, they say.
"From 1995 to 1998, when there has been little tobacco control advertising in California and no new advertising produced, tobacco consumption has been essentially flat," according to Glantz and Goldman.
"Despite the fact that they are effective, it is often difficult to convince politicians to approve anti-industry ads," Glantz says.
The JAMA study was funded by the National Cancer Institute.
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JAMA