Determinants and Predictive Validity of Perceived Effectiveness for Antismoking Ads: Evidence from the Tips from Former Smokers Campaign

Theoretical Background and research questions/hypothesis: Research on prior state and national antismoking media campaigns has shown that minority subpopulations of smokers tend to respond more favorably than non-minority groups to antismoking ads on measures of perceived effectiveness (PE), particularly for ads that use strong graphic and emotional content. This raises the possibility that message content is a more important factor than audience targeting in antismoking ad success. While PE has been validated to predict changes in cognitive precursors of quit attempts, a predictive relationship between PE and actual quit attempts has not been validated. In this study, we analyzed smokers’ reactions and receptivity to the national Tips From Former Smokers (Tips) campaign to establish the validity of PE in predicting changes in smoking cessation behaviors, explore behavioral and demographic characteristics of smokers that predict PE, and examine whether PE is affected by the race/ethnicity of smokers featured in Tips advertising.

Methods: We used survey data from two waves of a national online cohort of adult smokers in the United States (n=7,217). Participants were shown 14 Tips campaign ads and were asked to assess each ad in terms of measures of PE. Survey data were weighted to reflect national distributions of age, gender, race/ethnicity, and education among smokers. To assess predictive validity of PE, we estimated the odds of a quit attempt at follow-up as a function of PE at baseline, controlling for baseline quit attempts and other potential confounders. We then conducted a series of models that estimated PE as a function of various behavioral and demographic characteristics (e.g., desire to quit, health conditions, race/ethnicity) while also including an indicator for matched race/ethnicity between the respondent and cast of each ad. 

Results: Baseline PE was associated with increased odds of a quit attempt at follow-up (OR = 1.29, p < 0.05). Higher appraisals of PE were associated with African American race/ethnicity (b = 0.27, p < 0.01), Hispanic race/ethnicity (b = 0.23, p < 0.01), higher desire to quit (b = 0.44, p < 0.01), and presence of a mental health condition (b = 0.10, p < 0.01). There was no relationship between matched race/ethnicity of the survey respondent and Tips ad cast with PE. 

Conclusions: This is the first study to validate PE for antismoking ads as antecedent to quit attempts at 4-month follow-up, suggesting that PE is a potentially powerful and efficient measure for judging the quality of antismoking television ads in advance of campaign implementation. This study also reaffirms previous findings that smokers that have a greater desire to quit and more experience with past quit attempts respond more favorably to tobacco education ads generally.

Implications for research and/or practice: Our findings indicate that minority subpopulations held positive ad appraisals, irrespective of race/ethnicity of the ad cast. This suggests that other message strategies (e.g., graphic and emotional content) and viewer characteristics (desire to quit, mental health status) may play a more important role than race/ethnicity of ad participants.