Examining Truth and State-Sponsored Media Campaigns as a Means of Decreasing Youth Smoking and Related Disparities in the United States

Abstract

Introduction To analyze the impact of Truth and state-sponsored anti-tobacco media campaigns on youth smoking in the U.S., and their potential to reduce tobacco-related health disparities. Methods Our study included data from the 2000-2015 Monitoring the Future study, an annual nationally representative survey of youth in 8 th (n=201,913), 10 th (n=194,468), and 12 th grades (n=178,379). Our primary exposure was Gross Ratings Points (GRPS) of Truth or state-sponsored anti-tobacco advertisements, from Nielsen Media Research. Modified Poisson regression was used to assess the impact of a respondent’s GRPs on smoking intentions, past 30-day smoking participation, and first and daily smoking initiation. Additive interactions with sex, parental education, college plans, and race/ethnicity were used to test for differential effects of campaign exposure on each outcome. Results Greater campaign exposure (80 th vs. 20 th GRP percentile) was associated with lower probabilities of smoking intentions among 8 th graders, smoking participation among 8 th and 12 th graders, and initiation among 8 th graders. Greater exposure was associated with a greater reduction in the likelihood of smoking participation among 10 th and 12 th grade males than females; 10 th and 12 th graders with parents of lower education versus those with a college degree; and 12 th graders who did not definitely plan to go to college relative to those who did. Conclusions Media campaign exposure was associated with a lower likelihood of youth smoking behaviors. Associations were more pronounced for groups disproportionately affected by smoking, including youth of lower socioeconomic status. Media campaigns may be useful in reducing smoking disparities and improving health equity. Implications Few recent studies have investigated the impact of anti-tobacco media campaigns on youth smoking and their potential to reduce tobacco-related health disparities in the U.S. We found media campaigns – specifically state-sponsored media campaigns – reduced the likelihood of several smoking outcomes among youth, with some evidence that they mitigate disparities for disproportionately affected groups.

Optimising tobacco control campaigns within a changing media landscape and among priority populations

“…A recent study indicated the likelihood of youth recalling a YouTube antismoking message doubled with each completed ad view, but not with the number of ads served, with around three-quarters of the skippable videos served skipped. 41 Other priority questions include: are some people, including audiences campaigns most want to reach, more likely to skip than others? ; which kinds of messages are more likely to be skipped?…”

“…48 49 There is also evidence that greater levels of exposure to youth antitobacco campaigns has been associated with more pronounced effects on lowering smoking rates among 10th and 12th graders from lower compared with higher socioeconomic backgrounds. 41 Given the tobacco industry's targeting of Indigenous, black, LGBT and other ethnic minority communities, 50 achieving antitobacco campaign reach that exceeds that of other lower prevalence communities is particularly important. Allen and colleagues' 5 review urges that 'the media purchase should ensure exposure among racial/ethnic minority populations' and suggests it is important to '…supplement national media… through channels that reach a large proportion of at-risk minority individuals'.…”

“…Research is also needed to understand the impact of ‘skippability’ on campaign reach and whether the lower cost is worthwhile. A recent study indicated the likelihood of youth recalling a YouTube antismoking message doubled with each completed ad view, but not with the number of ads served , with around three-quarters of the skippable videos served skipped 41. Other priority questions include: are some people, including audiences campaigns most want to reach, more likely to skip than others?…”

“…More studies are needed to determine whether higher levels of exposure can increase equity among disadvantaged populations, given some evidence that increasing the intensity of exposure of a general mass media campaign within these communities may increase quit attempts to higher than those from less disadvantaged communities 48 49. There is also evidence that greater levels of exposure to youth antitobacco campaigns has been associated with more pronounced effects on lowering smoking rates among 10th and 12th graders from lower compared with higher socioeconomic backgrounds 41. Given the tobacco industry’s targeting of Indigenous, black, LGBT and other ethnic minority communities,50 achieving antitobacco campaign reach that exceeds that of other lower prevalence communities is particularly important.…”

Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis

“…Elements such as availability, level of exposure to social media in targeted geographical region, appointing effective communication channels, presenting appropriate slogans or messages or visualized contents such as pictures or videos, also having a regular schedule, the determination of a target community and considering the educational level, age and gender of audiences [220][221][222][223] play critical role in a fruitful viral hepatitis campaign. In addition, one of the most important elements in campaigns is the choice of an appropriate message (warning, fear, excitement and pleasure) in line with the campaign goals.…”