The Influence of the National truth campaign on smoking initiation.
Level 3 - non-randomized controlled study
Quasi-experimental longitudinal cohort study evaluating media market-level intervention exposure over time
PubMed 19211213 · doi:10.1016/j.amepre.2009.01.019
What was done
Analyzed a nationally representative cohort of 8,904 US adolescents aged 12–17 years interviewed annually from 1997 to 2004. Researchers used a quasi-experimental design linking smoking initiation to variation in TV commercial exposure to the national truth campaign across 210 media markets. A discrete-time hazard model controlled for confounders to assess the campaign's impact on initiation and to model the total number of youth prevented from smoking through 2004.
What was found
Exposure to the truth campaign was associated with a decreased risk of smoking initiation (relative risk = 0.80, p = 0.001), equating to an estimated 450,000 adolescents prevented from trying smoking nationwide through 2004. Other factors associated with reduced initiation were African-American race (relative risk = 0.44, p < 0.001), Hispanic ethnicity (relative risk = 0.74, p < 0.001), completing high school (relative risk = 0.69, p < 0.001), and living with both parents at baseline (OR = 0.79, p < 0.001).
Why it matters
It provides longitudinal, market-level quasi-experimental evidence that national media counter-marketing campaigns effectively reduce adolescent smoking initiation beyond previous cross-sectional associations.
Limits
Exposure was measured by media market delivery rather than verified individual-level viewing. The non-randomized observational design cannot completely rule out residual confounding from concurrent local tobacco policies or state-level pricing changes.
Cited by
- supports Anti-tobacco industry advertising campaigns in the 1990s and early 2000s effectively reduced smoking among adolescents.