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Am Fam Physician. 2006;73(6):1084-1088

Over the past few years, the number of antitobacco advertisements on television has increased. Thirty-five states had initiated antitobacco media campaigns by 2002, through a cigarette excise tax or the Master Settlement Agreement with tobacco companies. However, recent state budget shortfalls and other political issues have resulted in some antitobacco campaigns being reduced or, in some cases, cut entirely. There is some evidence that these state-sponsored media campaigns reduce the rate of adult smoking, but there is limited information on how they affect smoking rates in adolescents 12 to 17 years of age. At times when these programs are being reduced or cut, there are few published data to support their effectiveness on changing smoking beliefs and behaviors among adolescents. Emery and colleagues assessed the effect of state antitobacco advertisements on smoking among adolescents.

Data on antitobacco advertisements were obtained from Nielsen Media Research in the 75 largest U.S. media markets from 1999 through 2000. The researchers divided these advertisements into state tobacco control, American Legacy Foundation, tobacco parent, tobacco youth, pharmaceutical, and “other” antitobacco advertisement categories. Student data were obtained from the Monitoring the Future Study, which surveyed school samples of adolescents in grades 8, 10, and 12. Researchers calculated the average price per pack of cigarettes by state and year. A smoke-free air index, which measures the strictness of smoke-free air laws, was used for each state. The index score ranged from −22.5 to 51.0. The data then were analyzed to determine the association between state-supported antitobacco advertisement and smoking beliefs and behaviors of adolescents while controlling for other variables.

There were 51,085 students who participated in the Monitoring the Future Study. In the four months before the survey, 14 percent of the students had no exposure to state-supported antitobacco advertisements, 65 percent had a mean exposure to more than zero but less than one advertisement, and 21 percent had a mean exposure to one or more antitobacco advertisements. Pharmaceutical and tobacco companies sponsored the majority of the antitobacco advertisements. After controlling for variables, students who had a mean exposure to at least one state-sponsored antitobacco advertisement within the previous four months had lower perceived rates of friends’ smoking, greater perceived harm from smoking, stronger intentions not to smoke, and lower odds of being a smoker.

The authors conclude that state-sponsored antitobacco advertisement is associated with greater antitobacco sentiment and reduced rates of smoking among adolescents. These results are consistent with desired outcomes from the antitobacco campaigns. The authors add that this information shows that recent cuts in antitobacco media programs may have negative health and budgetary consequences in the future.

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Copyright © 2006 by the American Academy of Family Physicians.

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