Exposure to State-Funded Anti-Tobacco Television Advertising Since the MSA, 1999 - 2012

Theoretical Background and research questions/hypothesis: Nearly five decades after the first U.S. Surgeon General’s Report on Smoking and Health an estimated 480,000 Americans die each year from smoking-related disease, and tobacco use remains the leading preventable cause of death and disease in the U.S.  Paid TV advertising is among the most effective tobacco control strategies for health communication. Research has consistently demonstrated that higher exposure to state-sponsored anti-tobacco ads is associated with reduced smoking among youth and adults, increased anti-smoking attitudes among youth, and higher rates of quit attempts among adults. Yet in 2010, only a small number of states were able to mount a media campaign that fulfilled CDC’s Best Practices media funding recommendations.  From 1999 through 2003, many states used funding from the 1998 Master Settlement Agreement (MSA) with major cigarette manufacturers to fund media campaigns.  However, after 2003 as many states faced economic turmoil, tobacco control funding was cut substantially, forcing many states to scale back or eliminate their media campaigns.  This presentation summarizes trends in monthly average exposure to state-funded anti-tobacco television advertisements in the top 75 Designated Media Markets (DMAs) during 1999 – 2012.

Methods: Monthly advertisement exposure data from Nielsen Media Research was used in this analysis based on Gross Ratings Points (GRPs) for Total Television Households. GRPs measure exposure across households with television(s) during a defined period within a geographic media market.  Data were available for state anti-tobacco advertisements appearing on network television in the top 75 DMAs in the U.S. during 1999-2012.  These 75 DMAs were in 37 states and the District of Columbia and accounted for 78% of U.S. television-viewing households. DMAs are television broadcasting geographic regions with predominantly, but not exclusively, metropolitan audiences.  GRPs were averaged across all DMAs within a state to produce a state-level estimate.

Results: After a substantial increase in overall estimated exposure to state-funded anti-tobacco advertising from 1999 -2003, the results indicate that exposure decreased after 2003, coinciding with reduction in funding to state tobacco control programs.  Further, the substantial gains to media campaigns from the 1998 MSA have been erased.  Average rates of exposure declined from 3.35 ads in 2003 to 1.67 ads in 2008.  After ten years, the average exposure for 2008 is near the level of exposure in 1999 (1.13 ads).

Conclusions: The national trends in exposure to state-funded anti-tobacco advertising reflect early increases in exposure between 1999-2003, spurred by funding from the 1998 MSA with major cigarette manufacturers. However, the data also show a steady decline in exposure after 2003, consistent with cutbacks in funding for state tobacco prevention and control programs during this period.

Implications for research and/or practice: Traditional mass media is the best way to encourage—and sustain—behavior change in an effort to reduce the population smoking prevalence. CDC’s Best Practices recommends that states spend $1.69 per person or $532 million annually on mass-reach health communications interventions.