Cdc's Tips from Former Smokers (Tips) Campaign: The Effect of a National Antismoking Media Campaign and Varying Media Exposure on Nonsmokers

Theoretical Background and research questions/hypothesis:  Despite declines in smoking and mortality rates for some smoking-related diseases, smoking remains the leading cause of preventable death and disease in the U.S., killing over 480,000 Americans annually. Social support has been proven effective in helping smokers make quit attempts.  However, the impact of antismoking campaigns in motivating nonsmokers to help smokers quit is not well-documented.  In 2013, CDC launched a second round of advertisements for its “Tips From Former Smokers” (Tips) national campaign. Tips featured graphic, emotional testimonials from former smokers to motivate smokers to quit and nonsmokers to encourage family and friends to quit. A national media buy was supplemented with substantial local media buys (“heavy ups”) within 67 randomly selected small to mid-sized designated media markets (DMAs).  We assessed whether variations in media exposure to 2013 Tips would affect outcomes and report additional findings on the overall impact of the 2013 Tips campaign on nonsmokers. 

Methods:  We analyzed survey data collected from a nationally representative sample of adult nonsmokers before and after the 16-week campaign. Differences in awareness of campaign advertising, perceived effectiveness of advertising, disease knowledge, communication about the dangers of smoking and encouragement to quit were measured among nonsmokers.  In addition, we compared nonsmokers’ campaign exposure and behaviors in the heavy-up DMAs versus the regular DMAs (excluding large DMAs). We used U.S. Nielsen DMA population data to estimate the campaign’s additional population effect in the heavy-up markets.

Results: 

In the heavy-up DMAs, 85% of nonsmokers recalled the campaign compared with 72.8% in regular markets (p<0.001).  Nonsmokers in the heavy-up DMAs showed significantly higher levels of knowledge about several smoking-related conditions highlighted in the campaign, including amputations and COPD, compared with nonsmokers in regular markets.  Overall, the proportion of nonsmokers (never-smokers) talking with family and friends about smoking’s dangers rose from 18.3% before the campaign to 25.3% at follow-up (p<0.05), and the proportion of nonsmokers encouraging smokers to quit rose from 23.5% to 27.2% (p<0.05).  In heavy-up DMAs, 44.4% of nonsmokers talked with family and friends about the dangers of smoking compared with 35.6% in regular markets (p<0.05). Encouraging smokers to quit was reported by 46.9% of nonsmokers in heavy-up markets versus 38.8% in regular markets (p<0.05).  These numbers translate into an estimated additional 1.8 million nonsmokers educating family and friends and an additional 1.5 million encouraging quitting than would have without the heavy-up advertising.

Conclusions:  This national media campaign was effective in increasing nonsmoker communication about the dangers of smoking and in encouraging smoking friends or family members to quit.  Higher media exposure positively impacted outcomes, indicating that media weight is an important variable in advertising campaigns.

Implications for research and/or practice:  This research is the first to our knowledge documenting the effects of a national antismoking campaign on nonsmoker behavior.  Future antismoking campaigns should consider incorporating nonsmokers as a secondary target audience.  In addition, the conclusion that higher media levels positively affected outcomes contributes to evidence about the importance of strong campaign media weights.