BackgroundThe mass media have been used as a way of delivering preventive health messages. They have the potential to reach and to modify the knowledge, attitudes and behaviour of a large proportion of the community.ObjectivesTo evaluate the effectiveness of mass media interventions to prevent smoking in young people in terms of reduced smoking uptake, in addition to secondary outcomes including improved smoking outcomes, attitudes, behaviours, knowledge, self‐efficacy and perception.Search methodsWe searched the Cochrane Tobacco Addiction Group Specialised Register and conducted additional searches of MEDLINE and EMBASE in July 2010.Selection criteriaRandomized trials, controlled trials without randomization and time series studies that assessed the effectiveness of mass media campaigns (defined as channels of communication such as television, radio, newspapers, bill boards, posters, leaflets or booklets intended to reach large numbers of people and which are not dependent on person to person contact) in influencing the smoking behaviour (either objective or self‐reported) of young people under the age of 25 years.Data collection and analysisInformation relating to the characteristics and the content of media interventions, participants, outcomes, methods of the study and risk of bias was abstracted by two independent reviewers. Studies were combined using qualitative narrative synthesis.Main resultsSeven out of a total of 84 studies reporting information about mass media smoking campaigns met all of the inclusion criteria. All seven studies used a controlled trial design. Three studies concluded that mass media reduced the smoking behaviour of young people. All of the effective campaigns had a solid theoretical basis, used formative research in designing the campaign messages, and message broadcast was of reasonable intensity over extensive periods of time.Authors' conclusionsThere is some evidence that mass media can prevent the uptake of smoking in young people, however the evidence is not strong and contains a number of methodological flaws.Plain Language SummaryCan mass media campaigns (television, radio, newspapers, billboards and booklets) deter young people from starting to smokeCampaigns which researched and developed their message to reach their target audience had a higher success rate than those which did not. Overall, effective campaigns lasted longer with a minimum of three consecutive years, and were also more intense than less successful ones for both school based lessons (minimum eight lessons per grade) and media spots (minimum 4 weeks' duration across multiple media channels with between 167 and 350 TV and radio spots). The timing and type of broadcast made a difference to their success, with older youths in one study preferring radio to television. Implementation of combined school based curriculum/components (i.e. school posters) and the use of repetitive media messages delivered via multiple channels (i.e. newspapers, radio, television) over a minimum period of three years contributed to successful campaigns. Changes in attitudes, knowledge or intention to smoke did not generally seem to affect the long‐term success of the campaigns.
