Florida's "truth" campaign: a counter-marketing, anti-tobacco media campaign

Susceptibility of youth to tobacco: a social ecological framework for prevention

For most smokers, tobacco dependence begins in childhood or adolescence. This review summarizes the state of social science with respect to the prevention of tobacco use. Social ecology is introduced as a theoretical framework useful for organizing prevention approaches. In recent years, the field has shifted from approaches directed at individuals, towards appreciation of additional, more comprehensive social and environmental influences on initiation. These range from intra-individual factors (including physiological responses to nicotine and the psychology of use) to individual, interpersonal, organizational, community, and population factors affecting access and demand. This review highlights prevention approaches that address social and societal influences, from school programs that attempt to change susceptibility of individual youth to tobacco, to community projects, media campaigns, restrictive policies, and tobacco pricing. The most promising approaches are those designed with input based on extensive formative research including studies with youth, directed at multiple levels of the social ecology, and sustained over time with significant resources and ongoing, multi-sector inputs.

Public reaction to the portrayal of the tobacco industry in the film The Insider

OBJECTIVES

To assess public perceptions of the tobacco industry and behavioural intentions for tobacco use in response to watching the film The Insider.

DESIGN

Self administered pre-film survey conducted immediately before viewing and post-film telephone survey conducted within 1-5 weeks of viewing.

SETTING

Two commercial cinemas in Melbourne, Australia.

SUBJECTS

323 cinema patrons were recruited before screening of target films. 182 watched The Insider, 141 watched Erin Brockovich.

INTERVENTIONS

Subjects watched one of two films: The Insider which featured information about unethical conduct by the tobacco industry and negative information about the health effects of smoking, or the "control" film Erin Brockovich which had an analogous plot without anti-tobacco content.

MAIN OUTCOME MEASURES

Pre-film questionnaire: assessed movie viewing habits, demographic characteristics, smoking status, attitudes towards the tobacco industry, intentions for smoking. Post-film questionnaire: assessed same attitudes and intentions plus questions on the film viewed and perceptions of smoking prevalence.

RESULTS

266 (82%) subjects completed the post-film survey. Attitudes toward the tobacco industry were unfavourable at baseline. Those who saw The Insider held more negative views of business conduct by the tobacco industry than those who saw Erin Brockovich, once pre-existing attitudes to the industry were controlled for. The Insider also appears to have promoted a short term reduction in intentions to smoke.

CONCLUSIONS

Results of this study suggest that if people were recurrently exposed to anti-tobacco content in movies there is potential for a more substantial and lasting impact on attitudes toward the tobacco industry and smoking.

Influence of a counteradvertising media campaign on initiation of smoking: the Florida "truth" campaign

OBJECTIVES

The purpose of this study was to assess the short-term effects of television advertisements from the Florida "truth" campaign on rates of smoking initiation.

METHODS

A follow-up survey of young people aged 12 to 17 years (n = 1820) interviewed during the first 6 months of the advertising campaign was conducted. Logistic regression analyses were used to estimate the independent effects of the campaign on smoking initiation while other factors were controlled for.

RESULTS

Youths scoring at intermediate and high levels on a media effect index were less likely to initiate smoking than youths who could not confirm awareness of television advertisements. Adjusted odds ratios between the media index and measures of initiation were similar within categories of age, sex, susceptibility, and whether a parent smoked.

CONCLUSIONS

Exposure to the "truth" media campaign lowered the risk of youth smoking initiation. However, the analysis did not demonstrate that all such media programs will be effective.

Cigar risk perceptions in focus groups of urban African American youth

PURPOSE

To explore cigar use perceptions among urban African American youth.

METHODS

A convenience sample (n = 50) of African American volunteer participants, ages 14- 18, participated in six audiotaped focus groups conducted in two California cities. Transcriptions were analyzed using iterative strategies.

RESULTS

Most youth believed cigars were harmful to health, yet a disjuncture existed between this abstract belief and the socially embedded understandings revealed in discussions. Some youth felt that cigars were more "natural" and therefore less harmful than cigarettes. For some, that understanding rested on a mistaken assumption that nicotine was an artificial additive not present in cigars. Youth had received little cigar-specific health education. They reported that cigars were easily obtained, noted cigars' social cachet, and drew attention to new brands targeting youth.

IMPLICATIONS

Perceptions of risk are not merely interesting "subjective" findings but are important determinants of actual use patterns and may not correlate with abstract beliefs. Recent cigarette brand repositionings, such as Winston's "no additives" campaign, have widely publicized the many substances added to cigarettes. Some youth may take lack of cigar-specific preventive education as an indication that cigars do not contain such substances, including nicotine. Misperceptions about risks of cigar and cigar/marijuana smoking must be addressed through consistent, coordinated, and comprehensive tobacco control efforts for all tobacco products.