Seeing and Liking Cigarette Advertisements: Is There a ‘Mere Exposure’ Effect?

Abstract

Aims: We aimed to explain the association between exposure to a cigarette advertisement and favorable attitudes towards the advertisement. Methods: We used data from an observational cross-sectional study with a sample of 3,415 German schoolchildren aged 10–17 years. Cigarette advertising exposure was assessed with an image of a Marlboro ad, asking for contact frequency (number of times seen the ad) and brand name. Liking of the ad was measured with two items (alpha = 0.78). Results: We found a positive linear association between exposure to the Marlboro ad and liking it. This association remained significant (standardized β = 0.09; p < 0.001) even after statistical control for smoking status, smoking of friends and parents, attitudes towards smoking in general, cigarette advertising receptivity (having a favorite cigarette ad), exposure to other advertisings, age, sex, socioeconomic status, rebelliousness and sensation seeking, self-reported school performance, and study region. Conclusions: The association between exposure to an advertisement and liking it was robust and could not be fully explained without referring to either unmeasured confounding or implicit advertising effects (e.g. mere exposure). Implicit effects have implications for prevention strategies as it may be very difficult to counteract unconscious advertising effects.