文章基本信息

标题：Increasing Youths' Exposure to a Tobacco Prevention Media Campaign in Rural and Low-Population-Density Communities
本地全文：下载
作者：Jennifer C. Duke ; Donna M. Vallone ; Jane A. Allen 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：12
页码：2210-2216
DOI：10.2105/AJPH.2008.155127
语种：English
出版社：American Public Health Association
摘要：Objectives. We examined the effectiveness of a program to increase exposure to national “truth” tobacco countermarketing messages among youths in rural and low-population-density communities. Methods. A longitudinal survey of 2618 youths aged 12 to 17 years was conducted over 5 months in 8 media markets receiving supplemental advertising and 8 comparison markets receiving less than the national average of “truth” messages. Results. Confirmed awareness of “truth” increased from 40% to 71% among youths in treatment markets while remaining stable in comparison markets. Over 35% of all youths who were unaware of the campaign at baseline became aware of it as a direct result of the increased advertising. Youths living in rural and low-population-density communities were receptive to the campaign's messages. Conclusions. Through purchase of airtime in local broadcast media, the reach of a national tobacco countermarketing campaign was expanded among youths living in rural and low-population-density areas. This strategy of augmenting delivery of nationally broadcast antitobacco ads can serve as a model for leveraging limited tobacco control resources to increase the impact of evidence-based tobacco prevention campaigns. The national “truth” campaign is a branded smoking prevention campaign designed to reach at-risk youths aged 12 to 17 years, primarily through countermarketing messages that focus on the tobacco industry's deceptive marketing practices and efforts to deny the health risks of smoking.^{1 – 3} The campaign is grounded in behavior change theory, communication theory, and empirical evidence on the effectiveness of countermarketing strategies in tobacco use prevention.^{4 – 14} It uses messages that resonate with youths who have higher levels of a personality trait called “sensation seeking,” which has been shown to be associated with increased risk for smoking.^{15 , 16} Studies have demonstrated the effectiveness of the “truth” campaign.^{1 , 2 , 17 – 22} The campaign has generated substantive levels of exposure over time, and confirmed awareness of campaign advertisements has been associated with changes in relevant beliefs and the intention not to smoke.^{1 , 2 , 17 , 19} One study demonstrated that youths with greater exposure to the campaign were less likely to be current smokers.² A longitudinal study indicated that exposure to the campaign was associated with a decreased risk of smoking initiation.¹⁸ Research indicates that youths' affinity for the “truth” brand was associated with greater reductions in smoking initiation as compared with mere campaign awareness.^{3 , 21} The campaign has been shown to be cost-effective.²² Over the course of the national “truth” campaign, the media strategy shifted from airing television advertisements on national broadcast channels to airing advertisements primarily on national cable networks, to maximize resources and further target the intended audience. As a result of uneven cable penetration across the United States, youths in some rural and low-population-density areas of the country were exposed to the campaign's antitobacco messages less frequently than youths nationwide. This is of particular concern because rural youths are more likely to smoke than those living in urban and suburban areas.²³ To address this disparity in “truth” campaign exposure, the American Legacy Foundation (hereafter referred to as “Legacy”) responded to a program announcement from the Centers for Disease Control and Prevention (CDC) to obtain matching funds for a smoking countermarketing initiative targeted at youths. The program, called “ ‘truth’ or Consequences,” proposed to reduce disparities in smoking rates among youths by increasing the dose of “truth” messages in rural and low-population-density communities. The CDC awarded Legacy the program grant in 2006, and in the first year of the program, countermarketing messages were increased to the mean national level of advertising in 18 states across 41 Designated Market Areas, defined as geographical regions where the population receives the same, or similar, television and radio programs. In accordance with the CDC's recommendations regarding the timeline of expected outcomes for media campaigns,¹² we examined the relationship between increasing levels of paid media messages and confirmed awareness of, and receptivity to, the “truth” campaign in 8 matched media markets from April to September 2007.