NEW YORK, Jul 23 (Reuters) -- Anti-smoking advertising campaigns are extremely effective when they are long-term, and consistently portray smoking as hazardous for adults and children alike, according to an article in the current Annals of Internal Medicine.
"The most aggressive media campaigns generate the most controversy, but they are also likely to be the most effective," writes the author, Dr. Michael Siegel, of Boston University School of Public Health in Massachusetts.
But over the last 20 years funding for anti-smoking ad campaigns has been inconsistent, according to Siegel. At the same time, various special interest and political groups have tried to influence the content of the campaigns by limiting the scope of the ads to "themes that do not challenge the 'normality' of tobacco use," he writes.
"These programs need a consistent source of funding that is not subject to legislative diversion," Siegel argues. "They also need an aggressive , unrelenting strategy for marketing nonuse of tobacco that is protected from erosion by political forces."
Mass media anti-smoking campaigns trace their history back to 1967, when the Federal Communications Commission required broadcasters to run one anti-smoking ad for every three cigarette commercials, Siegel explains.
"The spots were so effective that in 1970, the tobacco industry agreed to congressional legislation to ban tobacco advertising on television and radio (and thus to eliminate the free anti-smoking ads,)" he writes.
Studies found that the anti-smoking ads were actually six times as effective as cigarette spots, Siegel reports. Between 1967 and 1970, the number of cigarettes smoked per person declined at least 5% overall in the US, and by 3% among teenagers.
Since then, a number of states have introduced legislation earmarking cigarette tax revenues for mass media anti-tobacco campaigns. "The effects of these media campaigns, especially those in California and Massachusetts, have been striking," writes Siegel. The California campaign, for instance, was associated with a 10% to 13% drop in smoking in that state.
Despite these successes, funding for the ad campaigns has never been a sure thing. In some states, officials have introduced regulations restricting the content of the campaigns. In Arizona, for example, officials have stipulated that the campaigns must "focus specifically on preadolescents, adolescents, and pregnant women" and have "forbidden commercials that attack the tobacco industry or focus on the issues of secondhand smoke or cigarette addiction," he writes.
Research, however, suggests that ads that focus exclusively on discouraging teenagers from smoking may actually have the opposite effect, Siegel reports. These ads "may reinforce adolescents' perceptions of smoking as a symbol of maturity," he writes. Moreover, ads attacking the tobacco industry, and focusing on addiction and the health hazards of secondhand smoke, have been shown to be particularly effective.
"Anti-tobacco media campaigns can be a powerful tool for reducing tobacco use, and earmarking cigarette tax revenue to run such campaigns has been a useful strategy," Siegel concludes.
One way to guarantee consistent funding for anti-smoking campaigns would be to follow Minnesota's lead, comments Siegel. After settling a lawsuit with the tobacco industry, the state used the resulting settlement to set up an endowment. Interest from the endowment will fund a variety of anti-tobacco programs, including a mass media anti-smoking campaign. A non profit foundation, rather than a government agency, will monitor the campaign.
SOURCE: Annals of Internal Medicine 1998;129:128-132.
