Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study

Abstract

AimTo examine whether government‐funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption.DesignAnalysis of monthly cross‐sectional surveys using generalised additive models.SettingEngland.ParticipantsMore than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey.MeasurementsCurrent smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs—a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio‐demographic variables.FindingsAfter adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400‐point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual‐level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400‐point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002–09.ConclusionGovernment‐funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption.

Commentary on Simset al. (2014) and Langleyet al. (2014): Mass media campaigns require adequate and sustained funding to change population health behaviours

“…Considering the influence of these critical factors in the success of tobacco control campaigns aired in the United Kingdom over the past 10 years, the recent papers by Sims et al [4] and Langley et al [5] are a welcome addition to the literature. Sims and colleagues' study [4] indicates that each person in the population needs to be exposed to approximately four anti-smoking advertisements per month to result in a detectable impact on smoking prevalence. These findings have a remarkably high degree of consistency with previous studies from Australia [6,7] and the United States [8,9], which indicate that moderate to high levels of intensity (i.e.…”

Cost‐effectiveness of possible future smoking cessation strategies in Hungary: results from the EQUIPTMOD

“…This (prospective scenario 1) was therefore planned to be designed on the basis of these social marketing campaigns. The relative increase in quit attempts is the measure of effectiveness of interventions included in the EQUIPT model, and we used the value for this model input from an English population‐based cross‐sectional study 18.…”

The impact of TV mass media campaigns on calls to a National Quitline and the use of prescribed nicotine replacement therapy: a structural vector autoregression analysis

“…There is a growing body of international evidence that MMCs can prevent both the uptake of smoking in young people and promote smoking cessation in adults 2, 3, 4, 5, 6. Most recently, evidence from England has shown that TV MMCs are effective in triggering quitting behaviour in adults and were responsible for an 11.2% decline in cigarette consumption and 13.5% of the decline in prevalence between 2002 and 2009 7. However, English studies also found that while the broadcast of TV MMCs was associated with an increase in calls to the national Quitline, there was no significant impact on either prescribed or over‐the‐counter (OTC) nicotine replacement therapy (NRT) 8.…”

“…Instead, both types of campaign had an effect upon important measures of quitting behaviour—quitline calls, quit attempts and prevalence. However, consumption among smokers was affected only by campaigns evoking negative emotions 7.…”

“…The focus has now shifted to smaller, less expensive community‐based events which have much less reach into the smoking population. An analysis of the impact of the English freeze found that it was associated with a reduction in quitting behaviour 7. This change in strategy is also at odds with evidence from a systematic review of 10 economic evaluations which, although unable to conduct a meta‐analysis due to heterogeneity, concluded that MMCs still represent ‘good value for money’ 14.…”