News Release

First ever federally-funded national smoking cessation campaign in USA helps at least 100,000 smokers to quit

Peer-Reviewed Publication

The Lancet_DELETED

The Tips from former smokers campaign, delivered by the US Centers for Disease Control and Prevention (CDC), used a series of hard-hitting television advertisements, in addition to print, radio and online advertising, to draw attention to the dangers of smoking, as well as publicising national smoking cessation telephone helplines and online resources.

Broadcast between March 2012 and June 2012, the US$54 million initiative was the first ever national, federally-funded smoking cessation campaign in the USA, and the new study reveals the results of the first ever comprehensive evaluation of a national anti-smoking campaign in the USA.

A team of researchers led by Dr Tim McAfee, director of the CDC's Office on Smoking and Health, in Atlanta, USA, analysed survey results taken from a randomly-selected, nationally representative group of more than 5000 people surveyed before and after the campaign, around three fifths of whom were smokers (3051 respondents), and the remainder (2220 respondents) non-smokers.

Around three quarters of smokers and non-smokers surveyed (78•5% and 73•5%, respectively) recalled having seen at least one of the Tips television advertisements during the three months that they were broadcast, and there was a 12% relative increase – from 31•1% to 34•8% – in the percentage of smokers who tried to quit during the campaign period. Over one in ten (13•4%) of these people were still abstinent at follow-up, upon completion of the campaign.

By extrapolating these percentages to the total USA population, the researchers estimate that 1•6 million smokers made a quit attempt due to the campaign, with over 200 000 of them still abstinent upon completion of the campaign. Among these smokers, approximately 100 000 were estimated to remain abstinent long-term. During the campaign, there was also a 132% increase in calls to 1-800-QUIT-NOW, a national smoking cessation helpline, with 200 000 more calls than were recorded for the same period in 2011, and an even larger increase in traffic to a quit-assistance website.

What is more, the campaign appears to have had a positive effect on non-smokers, with the proportion of non-smokers who made recommendations to friends or family to quit nearly doubling, from 2•6% prior to the campaign to 5•1% after the campaign ended. The proportion of non-smokers who reported talking with friends or family about the dangers of smoking also increased, from 31•9% prior to the campaign to 35•2% after the campaign ended.

According to Dr McAfee, "This campaign saved lives and was cost-effective. The growth in smokers who quit, and stayed quit, after the Tips campaign added over a third of a million years of life to the USA population in total. These strong findings show a clear public health benefit and the need to sustain campaigns like Tips."*

While the researchers caution that a causal relationship between the Tips campaign and the positive results revealed by their survey cannot be definitively established, the rigorous statistical analyses in the study control for as many possible outside influencing factors as possible, strongly suggesting that the campaign did have a positive effect overall.

"The Tips campaign has helped more than 100 000 smokers to quit," says Dr McAfee, "But sustaining progress in tobacco control will require persistent hard-hitting advertisements, effective policy and regulatory interventions, and health-care leadership to help millions of smokers live longer, healthier lives."*

In a linked Comment, Dr Dan Xiao of Chao-Yang Hospital and Capital Medical University in Beijing, China, and co-authors write that the findings should "encourage low-income and middle-income countries that are facing major tobacco epidemics—such as China, India, Bangladesh, Egypt, Malaysia, Indonesia, and Russia—to develop appropriate and cost-effective strategies for tobacco control."

"The Tips campaign cost US$54 million, which is around 0•7% of the total annual expenditure by tobacco companies on cigarette advertising and promotional activities in the USA. In China, all tobacco companies are state-owned; in 2012, around $137•6 billion in tobacco tax revenue passed to the Chinese Government…If a small proportion of this income could be allocated by the government for tobacco control, various effective tobacco-control measures could be implemented in China. Such interventions would save millions of lives and substantially cut health-care expenses for tobacco-related diseases."

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