When the Centers for Disease Control (CDC) first proposed graphic anti-smoking ads, it resulted in heated debate whether they should be aired. However, in March 2012, the CDC launched a national, three-month antismoking campaign called Tips From Former Smokers (Tips). The CDC paid approximately $50 million to produce and place the advertisements. It was the first time the federal government funded a nationwide tobacco education ad campaign. It appears that the campaign was worth the CDC investment. According to a study published online on September 9 in the journal Lancet, the campaign was effective in getting Americans to kick the habit.
The study authors note that every year, smoking kills more than 5 million people globally, including 440 000 people in the USA, where the long-term decline in smoking prevalence has slowed. According to the Los Angeles County Department of Public Health, the four leading causes of death in the county are coronary heart disease, stroke, lung cancer, and emphysema. Many of these deaths are related to smoking or second-hand smoke. The CDC campaign featured hard-hitting, emotionally evocative television advertising was featured, depicting smoking-related suffering in real people. The ads featured real people living with amputated limbs, breathing through stomas and dealing with other smoking-related health problems. One of the featured individuals was North Carolina resident, Terrie. In high school, Terrie was a pretty cheerleader who competed on the cheer circuit. Her father smoked, and with more and more of her friends smoking, Terrie soon found herself lighting up in social settings. Eventually she was smoking up to two packs a day. In 2001, at the age of 40, Terrie was diagnosed with oral cancer, and later that same year, with throat cancer. Doctors informed her that they would need to remove her larynx. It was then that she quit smoking for good. Today, at 52, Terrie speaks with the aid of an artificial voice box that was inserted in her throat. She continues to battle cancer.
The goal of the study was to assess the effects of the Tips campaign. The investigators conducted baseline and follow-up surveys of nationally representative cohorts of adult smokers and non-smokers. (Cohorts are a group of individuals with similar characteristics.) The national effect of the Tips campaign was estimated by applying rates of change in the cohort before and after the campaign to US census data.
The authors noted that 3,051 smokers and 2,220 non-smokers completed baseline and follow-up assessments; 2,395 (78%) smokers and 1,632 (74%) non-smokers recalled seeing at least one Tips advertisement on television during the three-month campaign. Quit attempts among smokers rose from 31.1% at baseline to 34.8% at follow-up, which marked a 12% relative increase. The prevalence of abstinence at follow-up among smokers who made a quit attempt was 13.4%. Nationally, an estimated 1.64 million additional smokers made a quit attempt, and 220,000 remained abstinent at follow-up. Recommendations by non-smokers to quit grew from 2.6% at baseline to 5.1% at follow-up, and the prevalence of people talking with friends and family about the dangers of smoking rose from 31.9% to 35.2%, resulting in an estimated 4.7 million additional non-smokers recommending cessation services and more than 6 million talking about the dangers of smoking.
The researchers concluded that the high-exposure Tips media campaign was effective at increasing population-level quit attempts. The growth in smokers who quit and became sustained quitters could have added from a third to almost half a million quality-adjusted life-years to the US population. Expanded implementation of similar campaigns globally could accelerate progress on the WHO Framework Convention on Tobacco Control and reduce smoking prevalence globally.
For details on the Tips campaign, click on this link.