Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Communication |

Evaluation of Antismoking Advertising Campaigns

Lisa K. Goldman, MPP; Stanton A. Glantz, PhD
JAMA. 1998;279(10):772-777. doi:10.1001/jama.279.10.772.
Text Size: A A A
Published online

Context.— Active and passive smoking are the first and third leading preventable causes of death. Many states are running or initiating antitobacco media campaigns.

Objective.— To review research on the effectiveness of different antismoking messages and published evidence of the effectiveness of paid antismoking advertising.

Data Sources.— Focus group studies conducted by professional advertising agencies that contract with California, Massachusetts, and Michigan to run their antismoking advertising campaigns, the Centers for Disease Control and Prevention's Media Campaign Resource Book, and copies of the advertisements. In total, we reviewed the results of 186 focus groups involving more than 1500 children and adults dealing with 118 advertisements that had actually been aired and additional concept advertisements that were not produced. Published literature was located using MEDLINE and standard bibliographic sources on the effectiveness of large, paid antitobacco media campaigns. We also reviewed reports and studies conducted by, or for, the California and Massachusetts health departments on program effectiveness, and conducted our own comparison of California vs Massachusetts using cigarette consumption data from the Tobacco Institute.

Study Selection.— All available studies.

Data Synthesis.— Eight advertising strategies to prevent people from starting to smoke and persuading them to stop were reviewed: industry manipulation, secondhand smoke, addiction, cessation, youth access, short-term effects, long-term health effects, and romantic rejection. These focus groups identified strategies that would be expected to be effective and ineffective. Regression analysis was used to compare the cost-effectiveness of the California and Massachusetts programs.

Conclusions.— Focus group participants indicated that industry manipulation and secondhand smoke are the most effective strategies for denormalizing smoking and reducing cigarette consumption. Addiction and cessation can be effective when used in conjunction with the industry manipulation and secondhand smoke strategies. Youth access, short-term effects, long-term health effects, and romantic rejection are not effective strategies. More aggressive advertising strategies appear to be more effective at reducing tobacco consumption.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?


Graphic Jump Location
Figure 1.—The long-term pattern of decline in tobacco consumption in California tracked the presence or absence of the media campaign. Reproduced from Glantz36 with permission of American Journal of Public Health.
Graphic Jump Location
Figure 2.—"Nicotine Soundbites" is a California advertisement that uses footage from the April 14, 1994, Congressional hearings before Henry A. Waxman's Subcommittee on Health and Environment in which the chief executive officers of the 7 major tobacco companies testified before Congress that they did not believe nicotine was addictive. The advertisement contained messages about industry deception, nicotine addiction, and secondhand smoke. Shortly after "Nicotine Soundbites" aired, lawyers for RJ Reynolds threated to sue both the California Department of Health Services and the television stations airing the advertisement on the basis that the spot implied RJ Reynolds' chief executive officer, James Johnston, perjured himself before Congress. When the California Department of Health Services stood by the advertisement and continued to run it, Reynolds dropped its complaint. The department later quietly dropped the advertisement from its rotation and has refused to run it despite repeated requests from the American Heart Association and Americans for Nonsmokers Rights and later the American Cancer Society45 and the Tobacco Education and Research Oversight Committee, which has statutory oversight over the California antitobacco program.46 Photograph courtesy of the California Department of Health Services.



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

213 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Is This Woman Perimenopausal?