• Journal Article

Effect of the first federally funded US antismoking national media campaign

Citation

McAfee, T., Davis, K., Alexander, R. L., Pechacek, T. F., & Bunnell, R. (2013). Effect of the first federally funded US antismoking national media campaign. Lancet, 382(9909), 2003-2011. DOI: 10.1016/S0140-6736(13)61686-4

Abstract

Background
Every year, smoking kills more than 5 million people globally, including 440 000 people in the USA, where the long-term decline in smoking prevalence has slowed. The US Centers for Disease Control and Prevention (CDC) delivered a national, 3-month antismoking campaign called Tips From Former Smokers (Tips) that started in March, 2012, in which hard-hitting, emotionally evocative television advertising was featured, depicting smoking-related suffering in real people. We aimed to assess the effects of the Tips campaign.

Methods
We undertook baseline and follow-up surveys of nationally representative cohorts of adult smokers and non-smokers. The national effect of the Tips campaign was estimated by applying rates of change in the cohort before and after the campaign to US census data.

Findings
3051 smokers and 2220 non-smokers completed baseline and follow-up assessments. 2395 (78%) smokers and 1632 (74%) non-smokers recalled seeing at least one Tips advertisement on television during the 3-month campaign. Quit attempts among smokers rose from 31·1% (95% CI 30·3—31·9) at baseline to 34·8% (34·0—35·7) at follow-up, a 12% relative increase. The prevalence of abstinence at follow-up among smokers who made a quit attempt was 13·4% (95% CI 9·7—17·2). Nationally, an estimated 1·64 million additional smokers made a quit attempt, and 220 000 (95% CI 159 000—282 000) remained abstinent at follow-up. Recommendations by non-smokers to quit grew from 2·6% at baseline to 5·1% at follow-up, and the prevalence of people talking with friends and family about the dangers of smoking rose from 31·9% (95% CI 31·3—32·5) to 35·2% (34·6—35·9), resulting in an estimated 4·7 million additional non-smokers recommending cessation services and more than 6 million talking about the dangers of smoking.

Interpretation
The high-exposure Tips media campaign was effective at increasing population-level quit attempts. The growth in smokers who quit and became sustained quitters could have added from a third to almost half a million quality-adjusted life-years to the US population. Expanded implementation of similar campaigns globally could accelerate progress on the WHO Framework Convention on Tobacco Control and reduce smoking prevalence globally.