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New Study Shows Clearly that Highly Emotional and Graphic Anti-Smoking Advertisements Increase Quit Attempts

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
October 09, 2012

WASHINGTON, DC — Anti-smoking ads which feature highly emotional and graphic content are very effective at motivating smokers to try to quit, researchers reported today in a study published in the American Journal of Preventive Medicine. Researchers found that both the amount and type of ads seen by New York State smokers affected their likelihood of quitting, with greater exposure to emotional or graphic ads having the greatest impact on quit attempts. The impact of the ads was similar across income and education levels, as well as for smokers with varying desires to quit.

The results offer further proof that hard-hitting media campaigns are effective at reducing tobacco use and demonstrate why it is critical for New York and other states to invest in these campaigns as part of a comprehensive effort to reduce smoking. Combined with cigarette tax increases and the state’s smoke-free law, the ads are a large part of the reason New York reduced smoking from 21.6% to 15.5% between 2000 and 2010 – well below the national rate.

The results also point to the need for the federal Centers for Disease Control and Prevention (CDC) to continue and expand its national media campaign, Tips From Former Smokers, that uses similar themes and has also demonstrated effectiveness in driving quit attempts. The Tips campaign is funded through the Prevention and Public Health Fund in the Affordable Care Act, and we urge Congress to continue funding for this life-saving campaign.

This study shows once again that we know what works to reduce tobacco use, even among those groups, like low income Americans, with the highest smoking rates. With states collecting over $25 billion each year in tobacco settlement payments and tobacco taxes, there is no excuse for the failure of most states to fund tobacco prevention and cessation, including effective media campaigns.. Collectively, the states spend less than two percent of their tobacco revenue on tobacco prevention, which is less than 13 percent of what the CDC recommends. Instead of cutting $250 million over the past four years, states should invest in these life-saving and cost-saving campaigns to counter the billions of dollars the tobacco companies spend every year marketing their deadly products. Currently, tobacco company marketing exceeds state tobacco prevention spending by a margin of more than 18 to 1.

The results of this study also suggest that the enhanced graphic warning labels for cigarette packs commanded by Congress and developed by the Food and Drug Administration’s Center for Tobacco Products will be effective at motivating smokers to try to quit. These graphic images covering the top half of the front and back of all cigarette packs would be in effect today if not for litigation by the tobacco companies to try to stop them.

Researchers at RTI International and the New York State Department of Health analyzed data from more than 8,700 smokers from 2003 to 2010 to gauge the impact of the media component of the state’s tobacco prevention and cessation program. Whether measured by potential exposure or ad recall, smokers exposed to the ads were significantly more likely to have tried to quit in the past year. Smokers who recalled seeing emotional or graphic antismoking advertisements such as personal testimonials about smoking health consequences or images of diseased lungs, had “increased odds of quitting in the previous 12 months of 29% compared to those who did not… The implications of this study are fairly straightforward: if the goal is to motivate smokers to try and quit smoking, antismoking advertisements should be designed to elicit a strongly negative emotional reaction,” said Matthew Farrelly, Ph.D., the lead author of the paper. The American Journal of Preventive Medicine is at

This important new research adds to the growing body of evidence on the effectiveness of anti-tobacco media campaigns, especially those that use personal stories to evoke strong emotions and that realistically depict the devastating health consequences of tobacco use. Public health authorities including the Surgeon General, the National Cancer Institute, the Institute of Medicine and the CDC, have all examined the evidence and concluded that these campaigns work.

  • A Surgeon General's report released in February concluded, 'Evidence indicates that mass media campaigns can be one of the most effective strategies in changing social norms and preventing youth smoking.' The report also found 'strong evidence that media ads designed for adults also decrease the prevalence of smoking among youth.'

  • A comprehensive 2008 scientific review by the National Cancer Institute concluded that 'advertisements that arouse strong negative emotions perform better than those that do not. These advertisements tend to depict serious harm done by smoking or secondhand smoke in an authentic way….'

  • States that have conducted hard-hitting media campaigns as part of their tobacco prevention and cessation programs have reduced smoking rates faster and to lower levels than the nation as a whole. Examples include California, Florida and Washington, in addition to New York.

There is also growing evidence that tobacco prevention and cessation programs — including media campaigns — save money by reducing tobacco-related health care costs. A December 2011 study found that in the first 10 years of its tobacco prevention program, which included mass media, Washington State saved more than $5 in tobacco-related hospitalization costs for every $1 spent on the program. It is truly penny-wise and pound-foolish not to invest in tobacco prevention, including media campaigns.

The tobacco industry spends $8 billion a year — almost one million dollars every hour — to entice kids, keep smokers hooked and glamorize their deadly and addictive products. Tobacco use kills 443,000 Americans and costs the nation $96 billion in health care bills each year. A large portion of these costs are passed on to taxpayers through programs such as Medicaid.