Lessons Learned from a Health and Policy-Related Secondhand Smoke Health Communication Campaign

Theoretical Background and research questions/hypothesis:  Maine is the first state to report on the increase in prevalence of reported smoke-free rules in private cars and homes before and after the passage of a smoke-free vehicle law.  To raise awareness about the effects of secondhand smoke exposure and to educate the public about the law in Maine that bans smoking in cars with minors, the Partnership for a Tobacco-Free Maine (PTM) implemented a statewide health communication campaign titled “Wherever You Live and Breathe, Go Smoke-Free” as part of its comprehensive tobacco control program.  Scientific literature supports government interventions, such as health and policy-related mass media campaigns.^1-11   As noted in the research, the promotion of smoke-free cars is becoming an increasingly important tobacco control strategy.³  

Methods: The media campaign evaluation telephone survey involved a cross-sectional population-based random sample of Maine residents age 18 or older from across the state, with an over-sample of smokers.   The study used a probability sampling approach. A total of 1,204 completed interviews were conducted across the state.

Results:  Among the 1,606 participants, two-fifths were male (42 %) and three fifths were women (58%).  More than one third of the survey population (35.2%) completed high school or a GED. Approximately two thirds (67.7%) of the survey population have smoked at least 100 cigarettes in their lifetime. Less than two thirds (62.9%) did not smoke, one third (30.4%) smoked cigarettes everyday and 6.7% smoked on some days. Among the sample, 85.9 % of the respondents had self-reported awareness of at least one component of the campaign.  As many as 72% of the sample could provide some confirmed awareness of at least one dimension of the campaign, that is accurately describe a specific advertisement or theme of an advertisement or collateral item. More than eight out of ten respondents (82.5%) knew that it is illegal in Maine to smoke in a car when children under 16 are present. Young adults had the highest correct response to this statement (98.2%).  

Conclusions:  Among the survey respondents, the two most remembered television advertisements can both be categorized as evoking negative emotions, “Trapped” and “Nowhere to Hide”.  Negative emotive tobacco counter-marketing advertisements have been shown to be effective in the literature, especially when realistic and new information is provided to the viewer.^4,7,11,15   Specifically, a study found that having a strong perception of harm from secondhand smoke exposure was associated with having smoking bans.”¹²  Advertisements that are remembered are said to have ‘staying power’, meaning that while they may not be aired often people still remember them.⁹

Implications for research and/or practice:  Health communication campaigns to educate people about the harm from secondhand smoke exposure may increase smoking bans in homes and compliance in cars, as noted in the literature.^1,12,13 Campaigns focusing on secondhand smoke may strengthen support for the protection of vulnerable populations from secondhand smoke exposure and increase the population’s knowledge about the negative effects of secondhand smoke, as well as continue the progress experienced in Maine and provide insight for other localities, states and countries.