Televised state-sponsored antitobacco advertising and youth smoking beliefs and behavior in the United States, 1999-2000 (2005)

Background: Recent state budget crises have dramatically reduced funding for state-sponsored antitobacco media campaigns. If campaigns are associated with reduced smoking, such cuts could result in long-term increases in state health care costs. Methods: Commercial ratings data on mean audience exposure to antitobacco advertising that appeared on network and cable television across the largest 75 media markets in the United States for 1999 through 2000 were combined with nationally representative survey data from school-based samples of youth in the contiguous 48 states. Multivariate regression models were used to analyze associations between mean exposure to state antitobacco advertising and youth smoking-related beliefs and behaviors, controlling for individual and environmental factors usually associated with youth smoking and other televised tobacco-related advertising. Results: Mean exposure to at least 1 state-sponsored antitobacco advertisement in the past 4 months was associated with lower perceived rates of friends smoking (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.58-0.88), greater perceived harm of smoking (OR, 1.25; 95% CI, 1.11-1.42), stronger intentions not to smoke in the future (OR, 1.43; 95% CI, 1.17-1.74), and lower odds of being a smoker (OR, 0.74; 95% CI, 0.63-0.88). Conclusions: To our knowledge, this study is the first to explore the potential impact of state-sponsored antitobacco media campaigns while controlling for other tobacco-related advertising and other tobacco control policies. State-sponsored antitobacco advertising is associated with desired outcomes of greater antitobacco sentiment and reduced smoking among youth. Recent cuts in these campaigns may have future negative health and budgetary consequences. (Author' s abstract)