Association Between The Real Cost Media Campaign and Smoking Initiation Among Youths — United States, 2014–2016

Farrelly, Matthew C.; Duke, Jennifer; Nonnemaker, James; MacMonegle, Anna; Alexander, Tesfa N.; Zhao, Xiaoquan; Delahanty, Janine; Rao, Pamela; Allen, Jane

doi:10.15585/mmwr.mm6602a2

Cited by 121 publications

(95 citation statements)

References 6 publications

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“…The results from this study provide evidence consistent with published evaluations of The Real Cost campaign (Farrelly et al, 2017; Huang et al, 2017). Our analysis is the first to show discriminating associations between recall of The Real Cost anti-smoking campaign and targeted, rather than non-targeted, beliefs in a sample of adolescents.…”

Section: Discussionsupporting

confidence: 90%

“…Given recent evidence suggestive of campaign effects on smoking initiation (Farrelly et al, 2017) and the theoretical models upon which the campaign was developed (Duke et al, 2015), our findings are consistent with the idea that campaign ads indirectly reduced youth smoking initiation through ad-targeted beliefs. Though we have speculated about how the cross-sectional associations might translate into an effect of exposure to each ad on intention, we do not think such cross-sectional data can support a formal analysis of whether ad-targeted beliefs mediated this relationship.…”

Section: Discussionsupporting

confidence: 86%

“…One evaluation shows a cross-sectional association between aided recall of campaign ads and increased risk perceptions about adverse health problems due to cigarette smoking (Huang et al, 2017). Another evaluation, conducted with longitudinal survey data, demonstrates that frequent recall of campaign advertisements resulted in decreased odds of subsequent smoking initiation, which accounted for an estimated 348,398 U.S. youths aged 11–18 who did not initiate smoking between February 2014–March 2016 (Farrelly et al, 2017). Thus, there is evidence that the campaign has been effective at reducing smoking initiation.…”

Section: “The Real Cost” Campaignmentioning

confidence: 99%

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Recall of “The Real Cost” Anti-Smoking Campaign Is Specifically Associated With Endorsement of Campaign-Targeted Beliefs

Kranzler

Gibson

Hornik

2017

Journal of Health Communication

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Though previous research suggests the FDA's “The Real Cost” anti-smoking campaign has reduced smoking initiation, the theorized pathway of effects (through targeted beliefs) has not been evaluated. This study assesses the relationship between recall of campaign television advertisements and ad-specific anti-smoking beliefs. Respondents in a nationally representative survey of nonsmoking youths age 13–17 (n = 4,831) reported exposure to four The Real Cost advertisements and a fake ad, smoking-relevant beliefs, and nonsmoking intentions. Analyses separately predicted each targeted belief from specific ad recall, adjusting for potential confounders and survey weights. Parallel analyses with non-targeted beliefs showed smaller effects, strengthening claims of campaign effects. Recall of four campaign ads (but not the fake ad) significantly predicted endorsement of the ad-targeted belief (Mean β = .13). Two-sided sign tests indicated stronger ad recall associations with the targeted belief relative to the non-targeted belief (p < .05). Logistic regression analyses indicated that respondents who endorsed campaign-targeted beliefs were more likely to have no intention to smoke (p < .01). This study is the first to demonstrate a relationship between recall of ads from The Real Cost campaign and the theorized pathway of effects (through targeted beliefs). These analyses also provide a methodological template for showing campaign effects despite limitations of available data.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 86%

Section: “The Real Cost” Campaignmentioning

confidence: 99%

See 1 more Smart Citation

Recall of “The Real Cost” Anti-Smoking Campaign Is Specifically Associated With Endorsement of Campaign-Targeted Beliefs

Kranzler

Gibson

Hornik

2017

Journal of Health Communication

View full text Add to dashboard Cite

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“…Existing health communication strategies known to influence behavior change in adolescents (e.g., appeals to vanity and social norms marketing) can be applied to communication efforts focusing on contact lens hygiene behaviors in this population ( 10 ). Additionally, encouraging adolescents to adopt healthy contact lens wear and care habits early might help them maintain these habits into young adulthood, when the frequency of reported risk behaviors increases.…”

Section: Discussionmentioning

confidence: 99%

Risk Behaviors for Contact Lens–Related Eye Infections Among Adults and Adolescents — United States, 2016

Cope

Collier

Nethercut

et al. 2017

MMWR Morb. Mortal. Wkly. Rep.

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“…Our results indicate the average age of first trying an e-cigarette was around 14 years old, although many youth reported trying e-cigarettes even earlier, so targeting younger adolescents may be critical for preventing initiation of e-cigarette use. Evidence suggests mass media campaigns (e.g., Real Cost, Truth) are effective at reaching both youth and young adults to prevent the initiation of conventional cigarette smoking and reduce progression to established smoking (Farrelly et al, 2017), so future efforts should consider extending these campaigns to address e-cigarette use as well. Additionally, it may be important to design interventions tailored to impulsive youth to prevent continued or heavier e-cigarette use among this high-risk group.…”

Section: Discussionmentioning

confidence: 99%

Early age of e-cigarette use onset mediates the association between impulsivity and e-cigarette use frequency in youth

Bold

Morean

Kong

et al. 2017

Drug and Alcohol Dependence

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Background Identifying risk factors for youth e-cigarette use is critical, given high rates of e-cigarette use and unknown health effects of long-term use. The current study examined whether an early age of onset of e-cigarette use mediates the association between impulsivity and e-cigarette frequency. Methods Cross-sectional survey data of e-cigarette users (n=927) were collected from 8 high schools in southeastern Connecticut. The sample was 44.7% female (mean age 16.2 [SD=1.2], mean age of e-cigarette onset 14.7 [SD=1.6]). Two domains of self-reported, trait impulsivity were assessed using the abbreviated Barratt Impulsiveness Scale: impaired self-regulation (e.g., problems with concentration or self-control) and behavioral impulsivity (e.g., doing things without thinking). Mediation was tested with Mplus, and the model included school as a cluster variable and controlled for covariates related to e-cigarette use (i.e., sex, age, race, peer use, and other tobacco products ever tried). Results The hypothesized mediation was supported for both domains of impulsivity (impaired self-regulation a1b=.09, SE=.02, 95%CI [.03–.14], p=.002; behavioral impulsivity a2b=.07, SE=.03, 95 CI [.01–.14], p=.03). Specifically, impaired self-regulation (B=−.33, SE=.06, p<.001) and behavioral impulsivity (B=−.26, SE=.11, p=.02) predicted trying e-cigarettes at an earlier age, and earlier initiation was associated with more days of e-cigarette use in the past month (B=−.28, SE=.08, p<.001). Conclusions Adolescents who endorse aspects of impulsivity, such as acting without thinking, are at greater risk for more frequent e-cigarette use through an early age of e-cigarette initiation. Further research is needed to evaluate these relationships longitudinally and to develop targeted e-cigarette interventions for impulsive youth.

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Association Between The Real Cost Media Campaign and Smoking Initiation Among Youths — United States, 2014–2016

Cited by 121 publications

References 6 publications

Recall of “The Real Cost” Anti-Smoking Campaign Is Specifically Associated With Endorsement of Campaign-Targeted Beliefs

Recall of “The Real Cost” Anti-Smoking Campaign Is Specifically Associated With Endorsement of Campaign-Targeted Beliefs

Risk Behaviors for Contact Lens–Related Eye Infections Among Adults and Adolescents — United States, 2016

Early age of e-cigarette use onset mediates the association between impulsivity and e-cigarette use frequency in youth

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