Abstract
Aim To examine whether government-funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. Design Analysis of monthly cross-sectional surveys using generalised additive models. Setting England. Participants More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. Measurements Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs—a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio-demographic variables. Findings After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400-point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual-level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400-point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002–09. Conclusion Government-funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption.
Highlights
Most of the evidence in favour of the effectiveness of mass media campaigns (MMCs) in reducing adult smoking prevalence and cigarette consumption comes from studies evaluating campaigns run for short time-periods in countries with little other tobacco control (TC) activity
Measures of cigarette consumption were based on responses to two questions: ‘How many cigarettes a day do you usually smoke at weekends?’ and ‘How many cigarettes a day do you usually smoke on weekdays?’
During the period covered by the study, average daily consumption and smoking prevalence has been declining and TC efforts have increased, with both the tobacco control score and weighted average price of a packet of 20 cigarettes increasing over time (Figs 1–3)
Summary
Most of the evidence in favour of the effectiveness of mass media campaigns (MMCs) in reducing adult smoking prevalence and cigarette consumption comes from studies evaluating campaigns run for short time-periods in countries with little other tobacco control (TC) activity. These studies, conducted in the mid-1970s to mid-1990s [1], were either community-level studies with intervention and control communities [2,3,4,5,6] or population-level studies [7,8,9,10,11,12], with most focusing on television campaigns [2,3,4,5,6,7,8,9,11,12], generally considered the most powerful medium to appeal to mass audiences. This study will provide essential evidence for determining whether the cutting of government spending on MMCs is justifiable
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