Anti-tobacco Messages Research Articles

“It's a big conversation”: Views of service personnel on systemic barriers to preventing smoking relapse among pregnant and postpartum Aboriginal and Torres Strait Islander women – A qualitative study

BackgroundProviding smoking cessation care has not successfully prevented women who quit smoking during pregnancy from relapsing due to multi-level barriers. AimThis paper explores systemic barriers to providing smoking cessation care, focusing on relapse prevention among pregnant and postpartum Aboriginal and Torres Strait Islander women (hereafter Aboriginal). MethodsTwenty-six interviews were conducted between October 2020 and July 2021 with health professionals, health promotion workers and managers working in Aboriginal smoking cessation across six Australian states and territories. Data were thematically analysed. FindingsThemes emerging from the data included: (a) limited time, competing priorities and shortage of health professionals; (b) a need for more knowledge and skills for health professionals; (c) influences of funding allocations and models of smoking cessation care; (d) lack of relevance of anti-tobacco messages to pregnancy and postpartum relapse; and (e) ways forward. Several barriers emerged from policies influencing access to resources and approaches to smoking cessation care for Aboriginal women. Individual-level maternal smoking cessation care provision was often under-resourced and time-constrained to adequately meet Aboriginal women's needs. Identified needs for health professionals included more time, knowledge and skills, better cultural awareness for non-Indigenous health professionals, and salient anti-tobacco messages for pregnant women related to long-term cessation. ConclusionTo drive smoking cessation in pregnant and postpartum Aboriginal women, we recommend adequately reimbursing midwives and Aboriginal Health Workers/Professionals to allow them to provide intensive support, build confidence in Quitline, continue health professionals’ capacity-building and allocate consistent funding to initiatives that have been efficacious with Aboriginal women.

The Effect of Anti-Tobacco Ad Length and Skippability on Perceived Message Effectiveness and Emotional Responsiveness

ABSTRACT The media landscape changes have resulted in significantly more people viewing content in shorter and skippable formats. There is limited evidence about the impact of these formats on anti-tobacco campaign effectiveness. This study examined the effect of anti-tobacco ad length and skippability on perceived message effectiveness (PME) and emotional responsiveness among people who smoke. Initially, 805 people who smoke were randomized to a message type (anti-tobacco vs. control) × message length (15 vs. 30 seconds) condition. A week later, participants saw the same message, but were randomized to a skippable or non-skippable version. Following ad exposure, outcomes were measured and examined in mixed-effects linear regression models. We found that at initial exposure, participants in the 30-second anti-tobacco condition reported significantly higher scores on personal relevance (75% cf. 68%), motivation to act (61% cf. 52%), action-oriented negative emotion (62% cf. 53%) and positive emotion (37% cf. 28%) relative to participants in the 15-second anti-tobacco condition. At repeated exposure, there was no effect of ad skippability on PME or emotional responsiveness regardless of message type condition. However, participants in the 30-second anti-tobacco condition reported significantly higher scores on action-oriented negative emotion (60% cf. 50%) and inaction-oriented negative emotion (54% cf. 46%) relative to participants in the 15-second anti-tobacco condition. Our findings suggest that initial exposure to non-skippable and longer novel anti-tobacco messages can lead to stronger personal relevance, motivation to act and emotional arousal, and ongoing negative emotional arousal, which may attenuate the negative effects of allowing individuals to skip later.

Are Anti-Tobacco Messages Delivered through Different Mass-Media Channels Effective in India? Results from GATS-II Survey.

Anti-tobacco mass-media campaigns are an integral part of tobacco control. There is still a need to understand which mode of mass-media channels aids in promoting tobacco cessation. This study aimed to examine if exposure to anti-tobacco messages delivered through different media channels is associated with tobacco user's thoughts and attempts to quit. We selected a sample of tobacco users (N=21857) from the Global Adult Tobacco Survey (GATS-2), and assessed the association of noticing the anti-tobacco information through different media channels with tobacco user's thoughts and attempts to quit. Males reported noticing anti-tobacco information more than females in almost all modes of media channels. Among males, the odds were significant and were highest with exposure to radio (1.78 (1.4-2.27)), and internet (1.68 (1.12-2.52)) for thoughts to quit smoking and to radio (2.17 (1.63-2.89) and newspaper (1.46 (1.2-1.79) for thoughts to quitting smokeless tobacco (SLT). The attempt to quit smoking and SLT use among males was significant for exposure through public transportation (1.22 (1.03-1.44)), public walls (1.44 (1.21-1.71), internet (1.68 (1.06-2.66)), and radio (1.44 (1.1-1.87)). Exposure to more than two media resulted in a higher likelihood of thoughts of quitting tobacco, and those exposed to more than one media attempted to quit tobacco among males. Females reported no influence from the media exposure. The study underscores the importance of targeted and combination of different mass-media channels to maximize the quit behaviors among male tobacco users. The current study also highlights the need for future studies to identify effective ways to communicate anti-tobacco information to women and all socio-economic groups in the country.

The Influence of Billboard-Based Tobacco Prevention Posters on Memorization, Attitudes, and Craving: Immersive Virtual Reality Study.

Health prevention campaigns often face challenges in reaching their target audience and achieving the desired impact on health behaviors. These campaigns, particularly those aimed at reducing tobacco use, require rigorous evaluation methods to assess their effectiveness. This study aims to use immersive virtual reality (iVR) to systematically evaluate recall, attitudinal, and craving responses to antitobacco prevention messages when presented in a realistic virtual environment, thereby exploring the potential of iVR as a novel tool to improve the effectiveness of public health campaigns. A total of 121 undergraduate students (mean age 19.6, SD 3.7 years), mostly female (n=99, 82.5%), were invited to take a guided walk in the virtual environment, where they were randomly exposed to a different ratio of prevention and general advertising posters (80/20 or 20/80) depending on the experimental condition. Participants' gaze was tracked throughout the procedure, and outcomes were assessed after the iVR exposure. Incidental exposure to antitobacco prevention and general advertising posters did not significantly alter attitudes toward tobacco. Memorization of prevention posters was unexpectedly better in the condition where advertising was more frequent (β=-6.15; P<.001), and high contrast between poster types led to a better memorization of the less frequent type. Despite a nonsignificant trend, directing attention to prevention posters slightly improved their memorization (β=.02; P=.07). In addition, the duration of exposure to prevention posters relative to advertisements negatively affected memorization of advertising posters (β=-2.30; P=.01). Although this study did not find significant changes in attitudes toward tobacco after exposure to prevention campaigns using iVR, the technology does show promise as an evaluation tool. To fully evaluate the use of iVR in public health prevention strategies, future research should examine different types of content, longer exposure durations, and different contexts. Open Science Framework E3YK7; https://osf.io/e3yk7.

US adolescents’ response to nicotine warning labels in influencer e-cigarette marketing social media posts: a survey-based randomised between-subject experiment

BackgroundE-cigarette promotional posts with misleading nicotine warning labels on social media may lower adolescents’ risk perceptions of e-cigarettes. A between-subject experiment assessed effects of influencers’ e-cigarette promotional posts with different...

Association between health-related social media use and E-cigarette use among current cigarette users: the roles of anti-tobacco messages and harm perception

BackgroundThe popularity of e-cigarettes is on the rise among current cigarette users. Therefore, there are concerns about their health implications. This study examined the impact of health-related social media use on e-cigarette use among current cigarette users. It assesses the mediating influence of online anti-tobacco messages and the moderating role of the harm perception of e-cigarettes.MethodsThis study was focused on 563 current cigarette users from the 2022 Health Information National Trends Survey (HINTS). Three tasks were performed: (1) assessing the direct and indirect impacts of health-related social media use on e-cigarette use among current cigarette users, (2) exploring the mediating role of exposure to online anti-tobacco messages, and (3) examining the moderating influence of e-cigarette harm perception on the path from anti-tobacco messages to e-cigarette use.ResultsHealth-related social media use was positively associated with current cigarette users’ e-cigarette use directly (bp = 0.183, p < .01) and indirectly through exposure to online anti-tobacco messages (bp = 0.023, 95% CI: [0.001, 0.051]). Harm perception of e-cigarettes moderated the relationship between online exposure to anti-tobacco messages and e-cigarette use (bp=-0.467, p < .01). The relationship appeared weaker for individuals who perceived greater harm from e-cigarettes.ConclusionsHealth-related social media use positively correlates with e-cigarette use among current cigarette users through exposure to online anti-tobacco messages. The perceived harm of e-cigarettes moderates this indirect path. These findings have implications for public health interventions aimed at smoking cessation.

Exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among adolescents in Gambia

BackgroundDespite the widespread prevalence of adolescent smoking in Gambia, a West African country, there is limited research exploring the relationships between exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among young people. This study investigates the interplay of these exposures and smoking behaviour among 11-17-year-old adolescents in Gambia.MethodsSecondary data analysis was conducted using the 2017 Gambia Global Youth and Tobacco Survey (GYTS), which included a total of 9,127 respondents. Descriptive and inferential analyses, including proportions, Pearson’s chi-squared tests, and multivariable logistic regression models, were employed to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI).ResultsThe final model revealed significant associations between exposure to anti-tobacco media messages and events and smoking behaviour. Adolescents exposed to anti-tobacco media messages had a 29% increased odds of smoking (aOR 1.29,CI = 1.08,1.53) compared to those unexposed, while exposure to anti-tobacco media events showed a 31% increased odds (aOR 1.31,CI = 1.09,1.59) compared to those unexposed. Exposure to pro-tobacco messages, such as witnessing tobacco use on TV (aOR 1.41, CI = 1.17,1.69) and owning objects with tobacco brand logos (aOR 1.49,CI = 1.19,1.86), was associated with higher odds of smoking. Covariates, including sex, age, and exposure to smoking behaviour by significant others, also demonstrated associations with smoking behaviour. Notably, male respondents showed significantly higher odds of smoking (aOR = 4.01,CI = 3.28,4.89) compared to females. Respondents aged 15 years and older had increased odds of smoking (aOR = 1.47,CI = 1.22,1.76) compared to those below 15 years old. Those whose fathers smoke displayed higher odds of smoking (aOR = 1.35, CI = 1.04,1.76) compared to individuals with non-smoking parents. Additionally, those whose closest friends smoke showed remarkably higher odds of smoking (aOR = 2.87,CI = 2.37, 3.48) compared to those without such influence.ConclusionThis study underscores the significant impact of exposure to both anti-tobacco and pro-tobacco media messages and events on smoking behaviour among adolescents in Gambia. However, pro-tobacco messages had a greater influence on smoking prevalence than anti-tobacco messages and events. Understanding these associations is crucial for devising effective public health interventions aimed at reducing tobacco use in this population.

Knowledge of smoking and influencing factors among school-going adolescents in Timor-Leste.

Knowledge of smoking is a protective factor for adolescent smoking. This study is the first to examine sociodemographic and lifestyle factors associated with adolescents' knowledge of smoking in Timor-Leste. It is also a pioneering investigation into the ways in which exposure to anti-tobacco messages and health warnings on cigarette packages, and involvement in smoking-related education at schools and home mediate the relationship between school grade levels and smoking knowledge. Data were obtained from the Global Youth Tobacco Survey Timor-Leste. Ordered logistic regressions were used to examine the associations between knowledge of smoking and sociodemographic, and lifestyle factors. Structural equation modelling was utilized to explore the mediating effects. Adolescents were less likely to have high knowledge of smoking if they were lower-secondary students, were males, had unemployed parents and had no closest friends who smoked. The relationship between grade levels and smoking knowledge was partly mediated by awareness of anti-tobacco messages on mass media, school education about the dangers of smoking and family discussion about smoking. Sociodemographic and lifestyle factors play an important role in determining knowledge of smoking among adolescents. To some extent, awareness-, education- and family-related variables explain how grade levels affect smoking knowledge.

Tobacco cessation attempts among Turkish adolescents: a structural equation model analysis

Abstract Background The Turkish Global Youth Tobacco Survey (GYTS) 2017 revealed that 17.9% of students aged 13-15 used tobacco products and 7.7% smoked cigarettes. Given the prevalence of smoking, it is important to evaluate the factors associated with quit attempts among adolescents. This study aimed to identify the factors associated with Turkish adolescents’ attempts to quit smoking. Methods This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, school-based study carried out among adolescents. The study population (n = 18,985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9,735 students remained for analysis. The outcome was an attempt to quit smoking within the past year. Structional Equation Model was used for analysis. The model included dependence level, sociodemographic factors, exposure to second-hand smoking, promoting factors for tobacco use (exposure to advertising in stores, at events, or on the internet), and anti-tobacco policies (sale restrictions, exposure to anti-tobacco media messages, TV spots) as latent factors. (The model fit; CFI=0.917, TLI=0.900, RMSEA=0.032). Results Students were 11-17 years and 66.4% were male. In the past 12 months, 56.3% (95%CI:55.3%-57.3%) of smokers attempted to quit. Dependency (ß=0.037, p = 0,008) and exposure to anti-tobacco policies (ß=0.114, p &amp;lt; 0.001) had positive direct effects, whereas sociodemographic factors (ß=-0.086, p &amp;lt; 0.001) and exposure to second-hand smoke (ß=-0.051, p &amp;lt; 0.001) had negative direct effects on quit attempts. Promoting factors weren't significant (p = 0.14). Conclusions More than half of smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to second-hand smoke decreased cessation attempts. Anti-tobacco policies as sale restrictions and warnings of the dangers of tobacco should be enforced fully since they are the strongest predictors of quit attempts. Key messages • Quit attempts are prevalent, highlighting the need for cessation programs for adolescents in Turkey. • Anti-tobacco policies are the most accurate predictor of quit attempts and should be fully enforced.

Cigarette use and exposure to second-hand smoke and tobacco advertising among Tunisian adolescents.

The Global Youth Tobacco Survey was conducted in Tunisia in 2001, 2007, 2010 and 2017. It is the only national survey that examined exposure to second-hand smoke and tobacco advertising among young people, and there has been no description of the trend. To describe cigarette use trends among Tunisian adolescents and their exposure to second-hand smoke and tobacco advertising from 2001 to 2017. The Global Youth Tobacco Survey is a school-based cross-sectional survey conducted by the World Health Organization. It uses a two-stage cluster sampling design to obtain a representative sample of students aged 13-15 years. A standardized questionnaire is used for data collection. We compared the prevalence and 95% confidence intervals (CI) of ever and current cigarette use, exposure to second-hand smoke in and outside the home, and exposure to tobacco advertising, over 4 years (2001, 2007, 2010 and 2017). Current cigarette use decreased from 11.1% (95% CI: 10.0-12.3%) in 2001 to 7.7% (95% CI: 6.5-9.0%) in 2017 (P < 0.001). Exposure to second-hand smoke at home decreased from 62.5% (95% CI: 60.7-64.2%) to 46.7% (95% CI: 44.5-49.0%) over the same period (P < 0.001), but exposure outside the home increased from 65.4% (95% CI: 63.7-67.1%) in 2001 to 73.3% (95% CI: 71.2-75.3%) in 2017 (P < 0.001). Exposure to anti-tobacco messages in the media decreased from 87.8% (95% CI: 86.3-89.1%) in 2001 to 64.4% (95% CI: 62.2-66.5%) in 2017 (P < 0.001). While the prevalence of cigarette use and second-hand smoke exposure at home decreased, exposure outside the home increased. Efforts are needed to ensure compliance with smoke-free laws to decrease the prevalence of exposure to second-hand smoke.

Sexual orientation and gender identity differences in perceptions and product appeal in response to e-cigarette advertising.

E-cigarette use is disparately high among sexual minoritized populations. As e-cigarette advertising may influence product appeal, this study tested sexual orientation- and gender-based differences in response to e-cigarette advertisement exposure on advertisement perceptions and product appeal. We recruited 497 adults (mean age=31.9 years, 45.1% women, 54.3% heterosexual, 71.2% Non-Hispanic White) living in the United States via the crowdsourcing platform Prolific. Participants viewed two randomly selected e-cigarette advertisements (from n=173 advertisements). Post-exposure, participants rated the perceived advertisement effectiveness, relevance, and product use intention. Associations between sexual orientation and outcomes were estimated using multivariable linear mixed-effects models. We tested interaction effects between sexual orientation, gender, and advertisement feature (e.g. presence of humans, flavors, and product packaging), and ran Tukey post hoc tests for pairwise comparisons. Post-exposure, heterosexual women, sexual minoritized men, and sexual minoritized women (reference group: heterosexual men) rated perceived advertisement effectiveness and relevance lower after viewing advertisements featuring flavors (vs no flavors; all p<0.001). Sexual minoritized men and sexual minoritized women rated perceived advertisement relevance lower after viewing advertisements featuring humans (all p<0.001) or fruit (all p<0.001). Heterosexual women, sexual minoritized men, and sexual minoritized women reported lower product use intention after viewing advertisements featuring an e-liquid bottle (vs no e-liquid bottle; all p<0.05). Sexual minoritized women and men reported lower e-cigarette advertisement appeal and product use intentions than heterosexual men. More evidence is needed to understand advertisement perceptions and product appeal in this group to inform e-cigarette advertising regulations and anti-tobacco messaging campaigns that aim to reduce tobacco-related health inequities.

Association between pro-tobacco and anti-tobacco media and messaging exposure and support for smoke-free policy among adults in Armenia and Georgia

Association between pro-tobacco and anti-tobacco media and messaging exposure and support for smoke-free policy among adults in Armenia and Georgia

Social determinants of tobacco use among tribal communities in India: Evidence from the first wave of Longitudinal Ageing Study in India.

Evidence on tobacco use among indigenous communities is scarce with available literature based either on a specific region or a particular tribe. Considering the large tribal population in India, it is pertinent to generate evidence on tobacco use among this community. Using nationally representative data, we aimed to estimate the prevalence of tobacco use and assess its determinants and regional variations among older tribal adults in India. We analysed data from Longitudinal Ageing Study in India (LASI), wave-1 conducted in 2017-18. A sample of 11,365 tribal individuals aged ≥ 45 years was included in this study. Descriptive statistics was used to assess the prevalence of smokeless tobacco (SLT), smoking, and any form of tobacco use. Separate multivariable regression models were executed to assess the association of various socio-demographic variables with different forms of tobacco use, reported as adjusted odds ratio (AOR) with 95% confidence interval. The overall prevalence of tobacco use was around 46%, with 19% of smokers and nearly 32% smokeless tobacco (SLT) users. Participants from the lowest MPCE quintile group had a significantly higher risk of consuming (SLT) [AOR: 1.41 (95% CI: 1.04-1.92)]. Alcohol was found to be associated with both smoking [AOR: 2.09 (95% CI: 1.69-2.58)] and (SLT) [AOR: 3.05 (95% CI: 2.54-3.66)]. Relatively higher odds of consuming (SLT) were associated with the eastern region [AOR: 6.21 (95% CI: 3.91-9.88)]. This study highlights the high burden of tobacco use and its social determinants among the tribal population in India, which can help tailor anti-tobacco messages for this vulnerable population to make tobacco control programs more effective.

Inoculating Black/African American and LGBTQ Communities Against the Tobacco Industry: The Role of Community Connectedness and Tobacco Denormalization Beliefs.

The purpose of this study was to explore how connectedness to Black/African American or lesbian, gay, bisexual, transgender and queer (LGBTQ) communities can promote anti-tobacco industry beliefs and to examine the role of targeted anti-tobacco industry messaging (i.e., tobacco industry denormalization [TID] messages).We hypothesized that community connectedness would predict anti-tobacco industry motivation (H1) and that this effect would be mediated by community-specific anti-industry beliefs (H2). We also hypothesized that these effects would be greater (i.e., moderated) for individuals exposed to targeted TID messages (H3). This study was a secondary analysis of data from a web-based experiment focused on the effects of counter-industry messages (data collected in 2020). The sample consisted of 430 Black/African Americans and 458 LGBTQ young adults. Hypotheses were tested using structural equation modeling. In support of hypothesis 1, community connectedness was associated with anti-tobacco industry motivation for both the LGBTQ and Black/African American subsamples. Hypothesis 2 was also supported. The associations between community connectedness and anti-industry motivations were partially mediated by anti-industry beliefs. Hypothesis 3 was not supported. Exposure to counter-industry messages did not modify the structural model; however, counter-industry messages increased anti-industry beliefs in both subsamples. Fostering community connectedness may help to mobilize community-based tobacco control efforts. Furthermore, interventions targeting anti-tobacco industry beliefs may be effective at reducing tobacco-related disparities. Anti-tobacco industry beliefs can be increased using brief targeted TID messages. Collectively, these findings suggest that community-based approaches rooted in consciousness-raising action may provide a useful model for future tobacco control interventions.

Motivation to quit tobacco; Impact of different types of Anti-tobacco state-sponsored media propaganda messages.

Antitobacco media messages can easily reach the mass and play a very positive and significant role in changing the motivational stages among recent quitters. Motivation is the key to changing human behaviour. Motivation can be intrinsic and extrinsic. To modify tobacco-related behaviour, one must have an inherent motivation to quit tobacco. However, the outside factors, for example, protobacco advertisements, antitobacco advertisements, peer pressure, celebrity influence, and family members' influence cannot be ignored. A total of 400 recent tobacco quitters were enrolled from four colleges via a multistage sampling method. Time series research design was used for data collection at three time periods 0, 1, and 3 months. Study participants were divided into four groups: 1) personal testimony group, 2) health warning group, 3) celebrity-influenced public service announcements, and 4) natural exposure group. Media messages containing antitobacco video clippings and pictures were delivered to the participants via phone thrice a week, as per the groups assigned. All four groups were assessed for the motivational stage via contemplation ladder at 0, 1, and 3 months of intervals. Antitobacco personal testimonial media messages are most effective in enhancing the motivation to quit tobacco, followed by the antitobacco health warning messages, which are also proven to be effective in maintaining high motivation levels to remain abstinent from smoking. However, public service announcements are ineffective in keeping the motivation to quit tobacco at higher smoking. Overall, the antitobacco state-sponsored media messages, personal testimonials, and health warnings about tobacco products effectively maintain and enhance motivation to quit tobacco.

An Observational Study of the Implementation of the Tobacco-Free Film and Television Policy in India.

Positive portrayals of tobacco use in entertainment media can normalize and perpetuate use. In 2012, the Government of India implemented the Tobacco-Free Film and Television Rules, a first-of-its-kind comprehensive regulation to restrict tobacco depiction in films and television programs. Two complementary studies were undertaken to assess the implementation of the film rules on television and in movie theaters. In the first part, movie theater observations and exit surveys were conducted from Feb. 3 to March 24, 2015. In total, 308 movie theaters were selected for the observation of films. A total of 3080 exit surveys were conducted to assess moviegoers' reactions toward the film rule. The second part comprised the systematic observation of 424 prerecorded television programs that aired from Nov. 20 to Dec. 30, 2015. Compliance with the Tobacco-Free Film and Television Rules policy was lower on television than in movie theaters. While 66% of television programs with tobacco scenes implemented at least 1 of the 3 elements of the film rule, not a single program executed all required elements correctly. In movie theaters, 99% of films that contained tobacco scenes implemented at least one element of the film rule. However, all elements of the film rules were implemented correctly during 27% of the films observed. Exit surveys showed that among moviegoers who recalled viewing at least one element of the film rule, there was increased concern about tobacco's harms and intentions to quit. Implementation of the film rules was higher in movie theaters than on television, though there were gaps in implementation for both. Despite inconsistent application, audience reactions to the anti-tobacco messages were favorable, with increased concern about tobacco's harms and intention to quit. Overall, the film rules offer a strong tool for countering tobacco promotion, reaching hundreds of millions with anti-tobacco messaging.

Perception of Tobacco Use among School-Going Early Adolescent Children in Udupi District: A Cross-sectional Study.

Tobacco use among school-going children is a significant public health concern worldwide. Studies on perception and knowledge about harmful effects of tobacco use among early adolescent children are limited. To assess the knowledge, attitude, and perception of tobacco use among rural and urban school-going early adolescent children. A cross-sectional study design was used. Using mixed method multi-stage sampling, a sample of 218 eighth grade students were selected randomly using the simple random technique from two government schools (rural and urban schools were chosen purposively), Udupi district, Karnataka. Data were collected using the questionnaire method. The Global Youth Tobacco Survey was used for the data collection. Descriptive statistics were used to express the data and Chi-square test and Fisher's exact test were used to compare the categorical variables. More than one-third (39%) of middle school children have used tobacco in the past. About 44% of boys felt guilty about their tobacco use. About two percent tried using other forms of tobacco products. Less than 1% of them had used tobacco more than once in the past 30 days. Urban children had significantly more knowledge about the harmful effects of tobacco use (p = .001), quitting tobacco (χ2 = 11.6, p = .008), and reasons for quitting tobacco use was, noticing anti-tobacco messages. More urban children think using tobacco makes boys more attractive (χ2 = 9.07, p = .01) and girls more attractive (χ2 = 10.80, p = .004). The prevalence of tobacco use was 1.5% among middle-school children in the last month. Urban school children have significantly more knowledge and awareness about the harmful effects of tobacco use than rural students.

Counterproductive effects of overfamiliar antitobacco messages on smoking cessation intentions via message fatigue and resistance to persuasion.

While smoking may result in various harmful effects, such as mental health issues caused by addiction, antitobacco messages have typically focused on the physical health consequences of smoking for decades. Prolonged exposures to these conventional messages may have not only increased awareness about the harmful health effects of smoking but may have also caused message fatigue and resultant resistance to persuasion. The latter effects, however, remain largely unexamined. Addressing this gap, this study examined the effects of overfamiliar antitobacco messages focusing on the health consequences of smoking on message fatigue and resistance to persuasion. In an online experiment, current smokers (N = 296) in the U.S. were randomly assigned to one of the four message conditions that manipulated a degree of familiarity in a 2 (thematic frame: physical vs. mental health) × 2 (valence frame: loss vs. gain) factorial design. The results show that a message portraying physical health consequences of smoking in a loss frame (i.e., overfamiliar frame) induced greater message fatigue than that in a gain frame. Message fatigue, in turn, was associated with higher levels of active (i.e., reactance) and passive resistance (i.e., disengagement) toward antitobacco messages. Reactance induced by message fatigue predicted less favorable attitude and lower intentions to quit smoking. Overall, message fatigue showed both direct and indirect effects on intentions, with the latter being mediated by reactance. Overfamiliar antitobacco message frames may activate greater message fatigue and resistance to persuasion, which may dampen campaign effects. The findings caution against the habitual use of conventional antitobacco messages. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Effect of Anti-tobacco Health Messages Post-implemetation of COTPA 2003 in India

Tobacco-related deaths are rising, although it is a preventable man-made epidemic. Globally, tobacco accounts for the death of 6 million people each year. The tobacco industry very intelligently uses the mass media platform for pro-tobacco propaganda messages. India made a significant attempt to fight tobacco by endorsing the WHO Framework Convention on Tobacco Control in February 2004. The WHO has introduced the MPOWER package of six proven policies to reverse the tobacco epidemic and prevent millions of tobacco-related deaths. Surprisingly, with all the awareness about these harms related to tobacco consumption and anti-tobacco campaigns at national and international levels, tobacco users do not feel motivated to quit. Anti-tobacco health messages (ATHMs) are crucial in affecting tobacco-related health behavior. This review summarizes the effect of ATHMs on the Indian population and the influences of different types of ATHMs on motivation to quit tobacco and tobacco cessation as a whole. Depending on the group investigated, ATHM effects on smoking behavior vary. ATHMs can influence people's attitudes and beliefs, improve intentions to stop and quit attempts, and decrease tobacco use dominance. They can also play a crucial role in educating the public about the dangers of tobacco use. The government must concentrate on rational ATHMs with broad appeal, ongoing exposure, and a preference for negative health effects with visual and live testimonial ads.

The association of adolescent e-cigarette harm perception to advertising exposure and marketing type

BackgroundDespite controversy over their possible health consequences, manufacturers of e-cigarettes employ a variety of marketing media to increase their popularity among adolescents. This study analyzed the relationship between adolescent e-cigarette harm perception and five types of e-cigarette advertising exposures: social media, radio, billboard, newspaper, and television.MethodsThis study used data from Wave 4.5 of the Population Assessment of Tobacco and Health Study (PATH). PATH collects demographic data and interview individuals about issues pertaining to tobacco use, health outcomes, attitudes, and behaviors. This study applied factor analysis to three individual PATH harm perception items to develop a composite harm perception score. Using linear regression, the study explored the relationship of harm perception and participant responses to their recalled viewing of five different types (i.e., newspaper, radio, billboard, television and social media) of advertisements within the past 30 days. A second analysis explored if adjusting for exposure to anti-tobacco messaging and environmental factors such as family approval mitigated the association of harm perception and advertisement types.ResultsThe study sample consisted of 12,570 (weighted N = 23,993,149) individuals aged 12 to 17 years old. Unadjusted past 30-day exposure to newspaper, radio, billboard, and social media advertising all correlated with a reduced harm perception, but only the associations for newspaper and social media were statistically significant (p<0.05). After adjusting for environmental support factors, exposure to warning labels, and anti-tobacco advertisements, the analysis yielded statistically significant associations between increased e-cigarette harm perception and exposure to radio, billboard, and television advertisements (p<0.05). Adjusting for covariates also reduced the association of marketing and harm perception for all forms of media.ConclusionE-cigarette advertising influences adolescent perceptions of harm in e-cigarette use, particularly for social media and newspaper advertisements. This association weakens when adjusted for covariates such as environmental support and exposure to anti-tobacco marketing. These findings provide evidence for policy makers to continue anti-tobacco marketing and incorporate environmentally supportive strategies such as holistic, family-centered educational approaches to reduce e-cigarette use among adolescents.