Mass media campaigns are widely used to expose high proportions of large populations to messages through routine uses of existing media, such as television, radio, and newspapers. Exposure to such messages is, therefore, generally passive. Such campaigns are frequently competing with factors, such as pervasive product marketing, powerful social norms, and behaviours driven by addiction or habit. In this Review we discuss the outcomes of mass media campaigns in the context of various health-risk behaviours (eg, use of tobacco, alcohol, and other drugs, heart disease risk factors, sex-related behaviours, road safety, cancer screening and prevention, child survival, and organ or blood donation). We conclude that mass media campaigns can produce positive changes or prevent negative changes in health-related behaviours across large populations. We assess what contributes to these outcomes, such as concurrent availability of required services and products, availability of community-based programmes, and policies that support behaviour change. Finally, we propose areas for improvement, such as investment in longer better-funded campaigns to achieve adequate population exposure to media messages.

IMPORTANCEThe public health implications of e-cigarettes depend, in part, on whether e-cigarette use affects the risk of cigarette smoking.OBJECTIVE To perform a systematic review and meta-analysis of longitudinal studies that assessed initial use of e-cigarettes and subsequent cigarette smoking.

Previous research on cancer information focused on active seeking, neglecting information gathered through routine media use or conversation ("scanning"). It is hypothesized that both scanning and active seeking influence knowledge, prevention, and screening decisions. This study uses Health Information National Trends Survey (HINTS, 2003) data to describe cancer-related scanning and seeking behavior (SSB) and assess its relationship with knowledge, lifestyle behavior, and screening. Scanning was operationalized as the amount of attention paid to health topics, and seeking was defined as looking for cancer information in the past year. The resulting typology included 41% low-scan/no-seekers; 30% high-scan/no-seekers; 10% low-scan/seekers, and 19% high-scan/seekers. Both scanning and seeking were significantly associated with knowledge about cancer (B=.36; B=.34) and lifestyle choices that may prevent cancer (B=.15; B=.16) in multivariate analyses. Both scanning and seeking were associated with colonoscopy (OR = 1.38, for scanning and OR=1.44, for seeking) and with prostate cancer screening (OR=4.53, scanning; OR=10.01, seeking). Scanning was significantly associated with recent mammography (OR=1.46), but seeking was not. Individuals who scan or seek cancer information are those who acquire knowledge, adopt healthy lifestyle behaviors, and get screened for cancer. Causal claims about these associations await further research.

Recent decades have witnessed a growing emphasis on patients as active consumers of health information. The literature about cancer-related information focuses on active and purposeful information seeking, but a great deal of exposure to cancer-relevant information may happen less purposively (termed information scanning). This article presents results from an in-depth interview study that examined information seeking and scanning behavior in the context of cancer prevention and screening decisions among a diverse sample of people living in a major metropolitan area. Results suggest that information scanning is quite common, particularly for information related to screening tests. Information seeking is rarer and occurs primarily among those who also are information scanners. Respondents report using a greater variety of sources for information scanning than for information seeking, but participants were much more likely to report that their decisions were influenced by information received through seeking than through scanning. These findings shed new light on how individuals navigate the media environment and suggest future research should examine predictors and effects of less purposeful efforts to obtain cancer-related information.

OBJECTIVES. Adolescents are increasingly at risk for infection with human immunodeficiency virus (HIV) and other sexually transmitted diseases, especially in poor urban minority communities. To aid the design of interventions in these communities, this study investigated the role of knowledge, attitudes, perceived parental monitoring, and peer behavior in the onset and progression of sexual behavior in children at risk for exposure to HIV. METHODS. A computerized personal interview was administered to 300 African-American 9- to 15-year-old children living in six public housing developments in a large US city. RESULTS. Although children's knowledge about the hazards of sex increased with age, their sexual activity also increased (from 12% sexually experienced at 9 years of age to more than 80% experienced at 15 years of age). Parental monitoring appeared able to influence sexual activity. However, the perceived behavior of friends was associated with the rate at which sexual activity progressed with age and the degree to which condom use was maintained with age. CONCLUSIONS. The early onset and prevalence of sexual behavior and the importance of peer group influence call for early interventions that simultaneously influence the parents and peers in children's social networks.