News Release

Anti-tobacco ads associated with reduced smoking and increased anti-smoking attitudes among youth

Peer-Reviewed Publication

JAMA Network

CHICAGO — Reduced cigarette smoking and more favorable anti-smoking attitudes were found among youth exposed to state-sponsored anti-tobacco advertising, according to a study in the July issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The U.S. population has been exposed to an increasing number and variety of televised anti-tobacco advertisements since the early 1990s, according to background information in the article. However, given recent state budget crises and other political influences, many states have severely cut their anti-tobacco campaigns. Despite early evidence suggesting that state-sponsored anti-tobacco media campaigns may reduce adult smoking, few studies have explored their effect on youth.

Sherry Emery, Ph.D., from the University of Illinois at Chicago, and colleagues examined the association between exposure to state anti-tobacco advertising and youth smoking-related beliefs and behaviors. The researchers used targeted ratings point (TRPs) to assess the ratings of an advertisement among U.S. teen audiences. An ad with 80 TRPs per month is estimated to have been seen an average of one time by 80 percent of this age group. This information was combined with survey data from school-based samples of 51,085 students in the contiguous 48 states.

The researchers found that among survey respondents, 14 percent had an average of zero exposures to state-sponsored advertisements in the last four months, 65 percent of the students had an average exposure greater than zero, but less than one, and 21 percent had an average exposure of one or more state-sponsored anti-tobacco advertisements. Students in states with a TRP measure of one or higher were significantly less likely to report having smoked in the past 30 days (18.6 percent) compared with those in markets with no exposure to anti-tobacco advertisements (26.7 percent). Those with one or more state TRPs were more likely to perceive great harm from smoking one or more packs of cigarettes per day (72.1 percent vs. 65.1 percent). Also, students living in areas with an average exposure of at least one state-sponsored anti-tobacco advertisement were more likely to say that they believed they would definitely not be smoking in five years (64 percent vs. 55.3 percent).

"Our analyses suggest that state-sponsored anti-tobacco media campaigns were associated with more favorable antismoking attitudes and beliefs among youth and reduced youth smoking," the authors write. "The strong associations between antismoking attitudes and beliefs, as well as reduced smoking, among students with a state TRP measure of at least one suggest that it is important to maintain a minimal mean exposure level of at least one cumulative state-sponsored anti-tobacco ad per four-month period for the general teen viewing audience."

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(Arch Pediatr Adolesc Med. 2005; 159: 639-645. Available pre-embargo to the media at www.jama.com.)

Editor's Note: This study was funded by grants from the State and Community Tobacco Control Initiative of the National Cancer Institute, Bethesda, Md., the National Institute on Drug Abuse, Bethesda, Md., and from the Robert Wood Johnson Foundation, Princeton, N.J.

State Tobacco Counteradvertising and Adolescents

In an accompanying editorial, David E. Nelson, M.D., M.P.H., from the Centers for Disease Control and Prevention, Atlanta, writes about state-sponsored anti-tobacco advertising, "Despite tremendous strides in reducing youth tobacco use, and substantial research demonstrating that counteradvertising and other components of comprehensive programs are effective in reducing prevalence, as well as being cost-effective, it is obvious that tobacco prevention activities are not institutionalized and that state program expenditures in this area are viewed by many as discretionary."

"Given the magnitude of the tobacco problem, and the fact that most regular smokers begin by age 18 years, preventing tobacco use among children and adolescents is one of the most important pediatric successes imaginable," he writes. "Pediatricians and other health care providers, either individually or collectively through professional or other organizations, need to actively support sustaining state comprehensive tobacco control and prevention activities that include counteradvertising. Failing to do so could mean losing the hard-won gains achieved in tobacco prevention over the past several years, and unfortunately, that would be deadly for many people."

(Arch Pediatr Adolesc Med. 2005; 159: 685-687. Available pre-embargo to the media at www.jama.com.)

For more information, contact the JAMA/Archives Media Relations Department at 312-464-JAMA (5262) or email mediarelations@jama-archives.org.


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