• Article

Effect of a national tobacco public education campaign on youth's risk perceptions and beliefs about smoking

PURPOSE: To assess the relationship between youth's exposure to the Food and Drug Administration's national tobacco public education campaign, The Real Cost, and changes in campaign-targeted beliefs.

DESIGN: Longitudinal design with baseline survey and 2 postcampaign follow-up surveys.

SAMPLE: Youth from 75 US media markets (N = 1680) who completed all 3 surveys and had experimented with or were susceptible to future cigarette smoking.

MEASURES: Exposure was measured by self-reported frequency of ad exposure and media market-level target rating points. Agreement with 30 self-reported tobacco-related beliefs was assessed in 3 categories: (1) beliefs specifically targeted by campaign messages (campaign-targeted belief), (2) beliefs not targeted by the campaign (nontargeted beliefs), and (3) beliefs corresponding to other media campaigns on air concurrent with The Real Cost (ambiguous beliefs).

ANALYSIS: Descriptive analyses of aggregate changes in beliefs and logistic regressions to examine the association between campaign exposure and beliefs.


RESULTS: Agreement with campaign-targeted beliefs increased from baseline to first and second follow-ups, with a mean relative increase of 10.4% and 11.5%, respectively. Nontargeted beliefs did not change substantially. Both measures of campaign exposure were positively associated with increased odds of agreeing with 5 of 8 campaign-targeted beliefs. Exposure was not significantly associated with 12 of 14 nontargeted tobacco-related beliefs.

DISCUSSION: A sustained national tobacco public education campaign can change population-level perceptions of tobacco-related harms among youth.


Duke, J. C., Farrelly, M. C., Alexander, T. N., MacMonegle, A. J., Zhao, X., Allen, J. A., ... Nonnemaker, J. (2018). Effect of a national tobacco public education campaign on youth's risk perceptions and beliefs about smoking. American Journal of Health Promotion, 32(5), 1248-1256. https://doi.org/10.1177/0890117117720745

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