Anti-smoking advertising campaigns targeting youth: case studies from USA and Canada

Objective-To assist in planning antismoking advertising that targets youth. Using five US state campaigns, one US research study, and a Canadian initi ative as exemplars, an attempt is made to explain why certain advertising c ampaigns have been more cost effective than others in terms of reducing ado lescent smoking prevalence. Several factors which prior research and theory suggest may be important to cost effectiveness are examined. Specifically, three variables pertaining to the advertising message (content, consistenc y, and clarity) and two variables related to the advertising execution or s tyle (age of spokesperson and depiction of smoking behaviour) are studied. Design-A case study approach has been combined with supplemental data colle ction and analysis. To assess campaign effects, published articles and surv eys of adolescent smoking prevalence in campaign versus control (non-campai gn) locations were utilised. Adolescent subjects provided supplemental data on the advertising message variables. Trained adults content analysed each advertisement to assess the executional variables, Subjects-A total of 112 8 seventh grade (age 12-13 years) and 10th grade (age 15-16 years) students participated in the supplemental data collection effort. Results-An anti-smoking advertising campaign initiated by Vermont researche rs was found to be the most cost effective in that it significantly reduced adolescent smoking prevalence at a low per capita cost. Next in order of c ost effectiveness were California, Massachusetts, and Florida because behav ioural outcomes were inconsistent across time and/or grades. California was ranked higher than the other two because it spent less per capita. Minneso ta and Canada were ineffective at reducing adolescent smoking prevalence, a nd no comparison outcome data were available for Arizona. Four factors were found to be associated with increased cost effectiveness: (1) a greater us e of message content that prior research suggests is efficacious with youth ; (2) a more concentrated use of a single efficacious message; (3) an avoid ance of unclear messages; and (4) an increased use of youthful spokespeople that with. No indication was found that depictions of smoking undermined c ampaign effectiveness by inadvertently implying that smoking was prevalent. Conclusions-The highly cost effective Vermont campaign can be used as a mod el for future efforts. It is estimated that 79% of the Vermont: advertiseme nts conveyed efficacious messages, 58% concentrated on a single efficacious message, 70% showed youthful spokespeople, and only 4% contained unclear m essages. The results suggest that, in the less effective campaigns, as few as 25% of the advertisements contained messages that prior research indicat es should be efficacious with youth, as few as 10% of the advertisements fo cused on one efficacious message, and up to 32% of the advertisements