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Mass media interventions for smoking cessation in adults

  1. Malgorzata M Bala1,*,
  2. Lukasz Strzeszynski2,
  3. Roman Topor-Madry3,4,
  4. Kate Cahill5

Editorial Group: Cochrane Tobacco Addiction Group

Published Online: 6 JUN 2013

Assessed as up-to-date: 28 FEB 2013

DOI: 10.1002/14651858.CD004704.pub3

How to Cite

Bala MM, Strzeszynski L, Topor-Madry R, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD004704. DOI: 10.1002/14651858.CD004704.pub3.

Author Information

  1. 1

    Jagiellonian University Medical College, 2nd Department of Internal Medicine, Krakow, Poland

  2. 2

    Szpital Miejski Specjalistyczny im. Gabriela Narutowicza, Krakow, Poland

  3. 3

    Institute of Public Health, Jagiellonian University Medical College, Department of Epidemiology and Population Studies, Krakow, Poland

  4. 4

    Medical University of Wroclaw, Wroclaw, Poland

  5. 5

    University of Oxford, Department of Primary Care Health Sciences, Oxford, UK

*Malgorzata M Bala, 2nd Department of Internal Medicine, Jagiellonian University Medical College, 8 Skawinska St, Krakow, 31-066, Poland. gosiabala@mp.pl.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 6 JUN 2013

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Background

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

It is estimated that nearly 20% of the world's population smokes cigarettes, accounting for about 800 million men and 200 million women (Eriksen 2012). World wide, tobacco is the leading cause of preventable death, killing nearly 6 million people each year, with 80% of deaths occurring in low- and middle-income countries (WHO 2011). It is estimated that if no additional measures are introduced the smoking prevalence in 191 countries included in the Global InfoBase Database of the World Health Organization (WHO) will be 22.7% in 2020 and 22% in 2030, accounting for 872 million smokers (Mendez 2012). In 2003 the World Health Assembly adopted the Framework Convention on Tobacco Control (FCTC), which now includes 174 countries, covering 85% of the worlds population (WHO FCTC 2003). To assist those countries in implementation of effective interventions to reduce the demand for tobacco in 2008, the WHO disseminated recommendations called MPOWER, which included the following strategies: monitor tobacco use, protect people from tobacco smoke, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising promotion and sponsorship, and raise taxes on tobacco (WHO 2008). Article 12 of the FCTC requires signatories to promote and strengthen public awareness of tobacco control issues using available communication tools, including mass media campaigns (WHO 2011).

Mass media interventions consist of the dissemination through television, radio, print media and billboards, of cessation-related messages, informing smokers and motivating them to quit. Mass media campaigns can be effective in keeping tobacco control on the social and political agenda, in legitimising community action and in triggering other interventions. Campaigns are designed either directly to change individuals' smoking behaviour (the risk factor model), or to catalyse other forces of social change (the social diffusion model), which may then lead to a change in social norms about smoking (Wellings 2000). Social diffusion campaigns, such as those run in Australia, Canada, Thailand, the United Kingdom and some US states, are designed to de-normalise smoking, so counteracting the tobacco industry's message that smoking is desirable and harmless (WHO 2001).

Research into the effectiveness of mass media campaigns is generally conducted through community trials. This term includes both randomised and non-randomised studies which involve whole communities as the unit of assignment, with data collection from individuals within the communities. Murray 1998 has identified four main features which differentiate the designs of such studies, and which are generally determined by the nature of the research question:
(i) Main effects (to assess the impact of a single intervention) versus factorial (to assess the impact and sometimes the interaction of two or more variables).
(ii) Data collection schedules: these can range from a single post-intervention measurement of the groups, through two or more series of assessments (including pre-intervention baseline measures), to continuous surveillance.
(iii) Cross-sectional versus cohort: Cross-sectional designs are appropriate when the investigators are concerned with the impact of the intervention on the population as a whole, while cohort designs are more suited to measuring behaviour change in individuals over time.
(iv) A priori matching and stratification may help to limit bias and improve precision.
 Analysis 1.1, 'Response and Retention Rates', summarises the design characteristics of the studies included in this review.

Mass media tobacco control campaigns in the USA began in 1967, following the publication of the 1964 Surgeon General's report on smoking and health (Surgeon General 1964). The Federal Communications Commission enforced the Fairness Doctrine, obliging radio and television stations to broadcast one tobacco control message for every three cigarette commercials (equivalent to a media value today of USD 300 million (WHO 2001)). This policy lasted until 1970, when a ban on broadcast cigarette advertising came into effect. Cigarette consumption had declined by 37% during the campaign, but began to rise again after the advertising ban ended free access to broadcast time for tobacco control messages (USDHHS 1991; Warner 1977).

Mass media campaigns in the 1970s tended to be based on the premise that information and heightened public awareness would of themselves effect changes in cultural norms and smoking behaviour. This assumption was challenged by the social learning theory approach, which held that public attitudes to smoking were more successfully translated into behaviour change if the mass media campaign was combined with well-targeted interpersonal interventions conducted by healthcare workers or other credible agencies. This approach also acknowledged the importance of role models and peer-group pressure and support in changing behaviour (Bandura 1977; Flay 1987b; NCI 1991). Later campaigns, the 'second generation' model, concentrated more on developing personal skills to cope with social and media pressure, and to recognise and resist tobacco industry advertising; they were also more likely to help smokers and non-smokers to improve their decision-making and problem-solving abilities (Logan 1999). Such an approach, however, did not address the continuing dissonance between 'expert' opinion (scientists, healthcare providers, policy-makers, many non-smokers) and those smokers who resented the paternalism of campaigners, and who may have had complicated cultural and emotional attachments to their smoking, independently of their physical addiction (Yankelovich 1991; Logan 1999; Hastings 2002).

A number of studies suggest that media-supported cessation campaigns can be an effective part of comprehensive and synergistic tobacco control programmes, reaching individuals directly with cessation messages and influencing their knowledge, attitudes and behaviour. Campaigns have been run and evaluated in a number of countries, including Australia, Canada, France, Iceland, New Zealand, the Philippines, Poland, Singapore and the UK, and in Arizona, California, Kansas, Massachusetts, Florida, Minnesota and Oregon within the USA (Flay 1987a; USDHHS 1991; WHO 2001). According to a 2011 WHO report, 23 countries, covering 28% of the world's population, run national anti-tobacco media campaigns fulfilling all the WHO requirements (WHO 2011), while a further 30 countries conduct campaigns fulfilling most but not all of those requirements.

Previous reviews of the literature lend some support to tobacco control media campaigns as a component of comprehensive tobacco control programmes (World Bank 1999; Fiore 2000). Much of the literature is focused on the effects of tobacco control advertising on young people (Reid 1995; Tyas 1997; Pechmann 2000; Wakefield 2000; Wakefield 2003), but there are also a number of evaluations of campaigns targeting adult smokers, which show mixed results. Some national and state-wide interventions have been shown to be effective in reducing smoking rates, while the outcomes are less consistent for community and local campaigns (Flay 1987a; Flay 1987b; Levy 2000; NCI 2000; Hopkins 2001; WHO 2001; Friend 2002; Siegel 2002a; Siegel 2002b).

 

Objectives

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

To assess the effectiveness of mass media interventions in reducing smoking among adults.

We addressed the following questions:

1. Do mass media campaigns reduce smoking (measured by prevalence, cigarette consumption, quit attempts and quit rates) compared with no intervention in comparison communities?

2. Do mass media campaigns run in conjunction with tobacco control programmes reduce smoking, compared with no intervention or with tobacco control programmes alone?

3. Which characteristics of these studies are related to their efficacy?

4. Do mass media tobacco control campaigns cause any adverse effects?

 

Methods

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms
 

Criteria for considering studies for this review

 

Types of studies

  • Randomised or quasi-randomised controlled trials allocating communities, regions or states to intervention or control conditions.
  • Controlled trials without randomisation, allocating communities, regions or states to intervention or control conditions.
  • Interrupted time series.

Uncontrolled before-and-after studies, and uncontrolled studies with post-intervention measurements but no baseline measurement were excluded.

 

Types of participants

Adults, 25 years or older who regularly smoke cigarettes. Studies which cover all adults as defined in studies were included. Studies addressing only adolescents and 18- to 25-year-olds are covered in a separate Cochrane review (Brinn 2010).
Interventions for pregnant women were excluded, since this topic is covered by a separate Cochrane review (Lumley 2009).

 

Types of interventions

Mass media are defined here as channels of communication such as television, radio, newspapers, billboards, posters, leaflets or booklets intended to reach large numbers of people, and which are not dependent on person-to-person contact. The purpose of the mass media campaign must be primarily to encourage smokers to quit. They could be carried out alone or in conjunction with tobacco control programmes. Studies of comprehensive programmes were included, provided that the comparison was structured in such a way that the contribution and efficacy of the mass media component could be assessed.

Interventions comprising competitions and incentives or quit and win contests are covered by other Cochrane reviews (Cahill 2008; Cahill 2011). Internet-based interventions and mobile-phone interventions are covered by other Cochrane reviews (Civljak 2010; Whittaker 2012).

 

Types of outcome measures

Measures of smoking behaviour:

  • Primary: Tobacco cessation, covered by prevalence rates, quit rates
  • Secondary: Tobacco reduction, covered by changes in the number of cigarettes purchased or smoked, prevalence of daily smoking, quit attempts

We prefer outcomes measured at the longest follow-up, and at least six months from the beginning of the intervention. It is generally not feasible for community trials to conduct biochemical validation of their smoking cessation results, and we do not require this of the included studies in this review.

Intermediate measures:

  • Attitudes to smoking
  • Knowledge about smoking, including smoking norms, and effects of tobacco on health
  • Adverse side effects

Process measures:

  • Descriptions of formative research, pilot studies and ongoing evaluation and modification of the intervention
  • Media weight (reach, frequency and duration), campaign awareness/exposure
  • Dose-response relationships (e.g. volume of calls to telephone helplines)
  • Maintenance of programmes after the interventions were completed
  • Intervention costs

Mass media campaigns that have only been reported in terms of intermediate outcomes or process measures are excluded.

 

Search methods for identification of studies

The Cochrane Tobacco Addiction Group search strategy was combined with ad hoc searches for any studies that referred to tobacco/smoking cessation, mass media and adults. We also searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, Dirline, Hstat, Healthstar, Science Direct, EIFL Direct, IBZ, IDEAL, Addiction Abstracts, ASSIA, ISI, ERIC, IBSS, Sociological Abstracts, Conference Paper Index, ProQuest, Springer Link, Swetsnet, and the ASH (Action on Smoking and Health) Database. In addition, we searched the reference lists of identified studies and checked the web sites of included mass media campaigns for additional data. The most recent search was carried out in February 2013.

 

Data collection and analysis

One reviewer prescreened all search results (abstracts), for possible inclusion or as useful background. Three reviewers (MB, LS and RTM) independently assessed relevant studies for inclusion. Discrepancies were resolved by consensus. The editorial base would have resolved any persistent disagreements. Reasons for the non-inclusion of studies were noted.
One reviewer (MB) extracted data, and a second reviewer (LS) checked them. This stage included an evaluation of quality. Two reviewers independently assessed each study according to the presence and quality of the randomisation process, whether the analysis was appropriate to the study design, and the description of withdrawals and drop-outs. Interrupted time series studies were assessed according to criteria defined by the Cochrane Effective Practice and Organisation of Care Group (EPOC 2006). These require a minimum of three assessments before the intervention and three afterwards for the study to be included in the review.

We extracted data on:

  • Country and community status (e.g. state, city)
  • Participants (baseline demographic, clinical and smoking characteristics)
  • Intervention (duration, intensity, message development)
  • Outcomes, and how they were measured
  • Length of follow-up
  • Completeness of follow-up
  • Definition of smoking cessation
  • Biochemical confirmation of abstinence, if present.

In cases of missing data, we contacted the authors of the study where possible.
Results were not pooled due to expected heterogeneity of included studies, and are presented narratively and in the Results Tables. Eligible studies differed significantly in design, setting, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used.

We include in this review the Tobacco Addiction Group glossary of tobacco-related terms in Appendix 1.

 

Results

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms
 

Description of studies

 

Results of the search

From our update searches, the latest of which was performed in February 2013, we identified 1443 studies. Based on titles and abstracts, 1307 references were excluded, resulting in 136 full papers to be retrieved. In addition, we found 10 references through handsearching and from the websites of included mass media campaigns. We therefore retrieved 146 full-text papers. Based on these, we excluded 142 papers.

For this update we identified three reports updating the California TCP campaign (California TCP 2003), and ten new excluded studies (Figure 1).

 FigureFigure 1. Prisma flow diagram of search results

 

Included studies

We identified 11 campaigns meeting our inclusion criteria. Detailed information about each is shown in the table Characteristics of included studies. Sixty-five excluded studies and reasons for exclusion are described in the Characteristics of excluded studies table.

Eight studies had strong designs comparing the effect of mass media campaigns in exposed areas to control areas, using indices of smoking behaviour (mainly prevalence) in the whole population (Stanford 3 City 1977; North Coast QFL 1983; Sydney QFL 1986; McPhee 1995; CORIS 1997; Jenkins 1997; McVey 2000; McAlister 2004). One study (Mogielnicki 1986) had a similar design, but assessed the effect of the intervention by examining the abstinence rates achieved in one clinic each in the intervention and control areas. Two studies (California TCP 2003; Massachusetts 2003) had strong controlled designs, but the intervention areas were exposed to mass media campaigns plus a range of other tobacco control interventions as compared to no special interventions in control areas. Study sites ranged from the USA (Stanford 3 City 1977; Mogielnicki 1986; McPhee 1995; Jenkins 1997; California TCP 2003; Massachusetts 2003; McAlister 2004) to the UK (McVey 2000), South Africa (CORIS 1997) and Australia (North Coast QFL 1983; Sydney QFL 1986).

Characteristics of study populations:
Study populations were diverse. All studies involved adults, although the age of adulthood varied between studies. Eight studies targeted both men and women, and three targeted men only (Mogielnicki 1986; McPhee 1995; Jenkins 1997). Two studies targeted male Vietnamese immigrants in the USA (McPhee 1995; Jenkins 1997). Two state-wide campaigns targeted adults, adolescents and the general population (California TCP 2003; Massachusetts 2003).

Characteristics of interventions:
In six studies the theoretical basis for the development of the intervention was described. In Stanford 3 City 1977 social marketing theory, social learning theory and communication theory underpinned the intervention, while McAlister 2004 specified social learning theory, the transtheoretical model and elements of modelling, social reinforcement for behaviour change and emotional arousal. California TCP 2003 and Massachusetts 2003 both used social diffusion theory with social marketing and social policy change. North Coast QFL 1983 cited social marketing and communication theory, and Mogielnicki 1986 specified current marketing methodology in developing its mass media campaign. In the remaining five studies no theoretical basis was specified.

Two campaigns conducted as part of tobacco control programmes involved TV, radio, print media and billboard advertising (California TCP 2003; Massachusetts 2003). One study used only TV advertising (McVey 2000); one used TV and radio advertising (Mogielnicki 1986); one study used only billboards, posters, mailings and local newspapers (CORIS 1997). The remaining studies used TV, radio and print media, billboards and/or posters (Stanford 3 City 1977; North Coast QFL 1983; Sydney QFL 1986; McPhee 1995; Jenkins 1997; McAlister 2004). Two studies aimed at the reduction of cardiovascular risk factors, such as smoking, diet, blood pressure, cholesterol, sedentary lifestyle, and stress (Stanford 3 City 1977; CORIS 1997), while the remaining nine studies aimed specifically at changing smoking behaviour (reducing smoking prevalence, reducing the number of cigarettes smoked or increasing quit rates).

The two state-wide campaigns (California TCP 2003; Massachusetts 2003) were each part of a wider tobacco control programme which implemented a number of public policy measures to reduce smoking, but we have not included those outcomes in our review.

Assessments:
Cross-sectional independent surveys were used in five studies (North Coast QFL 1983; McPhee 1995; Jenkins 1997; California TCP 2003; Massachusetts 2003), cohort follow-up in two studies (Mogielnicki 1986; McVey 2000) and both methods in four studies (Stanford 3 City 1977; Sydney QFL 1986; CORIS 1997; McAlister 2004). Three studies reported follow-up beyond the duration of the intervention and the immediate post-intervention assessment, at 12 years for CORIS 1997, at 18 months for McVey 2000, and at one year for Sydney QFL 1986. Stanford 3 City 1977 reported one additional year of follow-up for the high risk group only. Interviews were conducted in person in six studies (Stanford 3 City 1977; North Coast QFL 1983; Mogielnicki 1986; Sydney QFL 1986; CORIS 1997; McVey 2000), by telephone in four studies (McPhee 1995; Jenkins 1997; Massachusetts 2003; McAlister 2004), and by both methods in California TCP 2003. In addition to the interviews, physical examination and blood tests were carried out in three studies (Stanford 3 City 1977; North Coast QFL 1983; CORIS 1997). In most studies smoking abstinence was self-reported, and was biochemically confirmed in all participants in only two studies: Stanford 3 City 1977 checked plasma thiocyanate, and Mogielnicki 1986 checked plasma thiocyanate and exhaled carbon monoxide. Subsamples of participants were tested for salivary cotinine in Sydney QFL 1986, and for plasma thiocyanate in North Coast QFL 1983.

Outcomes measures:
Difference in smoking prevalence was the main outcome measure in seven campaigns (North Coast QFL 1983; Sydney QFL 1986; McPhee 1995; CORIS 1997; Jenkins 1997; California TCP 2003; Massachusetts 2003). One study reported it for the high risk group only (Stanford 3 City 1977). Changes in the number of cigarettes (or grammes of tobacco) smoked were reported in five studies (Stanford 3 City 1977; Sydney QFL 1986; McPhee 1995; CORIS 1997; Jenkins 1997) and was the main outcome for Stanford 3 City 1977. In seven studies quit rates or abstinence rates were reported (Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; CORIS 1997; Jenkins 1997; ; McVey 2000; California TCP 2003), and were the main outcome in two studies (Mogielnicki 1986; McVey 2000). In McAlister 2004, point prevalence of daily smoking (ceasing to smoke at all or every day) was reported as the main outcome. In the two state campaigns per capita cigarette consumption based on aggregate sales data was also presented (California TCP 2003; Massachusetts 2003).

The number of quit attempts was reported in six studies (Sydney QFL 1986; McPhee 1995; Jenkins 1997; California TCP 2003; Massachusetts 2003; McAlister 2004).

Intermediate measures:
Attitudes to smoking were assessed at baseline in nine studies (North Coast QFL 1983; Mogielnicki 1986; McPhee 1995; CORIS 1997; Jenkins 1997; McVey 2000; California TCP 2003; Massachusetts 2003; McAlister 2004) with follow-up data provided in five of them (North Coast QFL 1983; McPhee 1995; Jenkins 1997; California TCP 2003; Massachusetts 2003) but in one study only in graphical form (North Coast QFL 1983). Social pressure/influences in the decision to quit were assessed in four studies at baseline and at follow-up (North Coast QFL 1983; Sydney QFL 1986; McPhee 1995; Massachusetts 2003). Norms concerning smoking behaviour were assessed in three studies at baseline and at follow-up (McPhee 1995; California TCP 2003; Massachusetts 2003): In McPhee 1995 this was assessed by the number of friends or household members smoking and giving advice or being advised to stop smoking. In the two state-wide campaigns norms were assessed by measuring support for tobacco control legislative measures and exposure to environmental tobacco smoke at work and at home, but only within the intervention communities and not for the controls.
Information-seeking behaviour in the population was assessed at baseline and at follow-up in one study (Sydney QFL 1986).
Knowledge and/or beliefs about cardiovascular risk factors or the effects of smoking were assessed at baseline in eight studies (Stanford 3 City 1977; North Coast QFL 1983; Mogielnicki 1986; Sydney QFL 1986; CORIS 1997; California TCP 2003; Massachusetts 2003; McAlister 2004). Follow-up data were provided in six studies (Stanford 3 City 1977; North Coast QFL 1983; Sydney QFL 1986; CORIS 1997; California TCP 2003; Massachusetts 2003), but in one study only in graphical form without elucidation in the text (North Coast QFL 1983).

No study reported adverse effects of the campaigns.

Process measures:
Formative research or pilot studies were used in nine campaigns (Stanford 3 City 1977; North Coast QFL 1983; Mogielnicki 1986; Sydney QFL 1986; Jenkins 1997; McVey 2000; California TCP 2003; Massachusetts 2003; McAlister 2004). No information was provided for two campaigns (McPhee 1995; CORIS 1997). Ongoing evaluation and modification of the intervention was reported in five studies (Stanford 3 City 1977; North Coast QFL 1983; McVey 2000; California TCP 2003; Massachusetts 2003).

Detailed information regarding media weight (numbers of TV and radio spots, newspaper articles etc.) was provided in five studies (Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; Jenkins 1997; California TCP 2003), and summary information was given in four studies (Stanford 3 City 1977; CORIS 1997; McVey 2000; Massachusetts 2003). Little or no information was given in McAlister 2004 or North Coast QFL 1983.
Awareness and reach of the intervention was measured in seven studies (Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; Jenkins 1997; California TCP 2003; Massachusetts 2003; McAlister 2004) with only McAlister 2004 not reporting numerical data for this outcome.

Dose response: Some evidence on possible dose-response relationships was mentioned, either as numbers of calls to quitlines (Sydney QFL 1986; McVey 2000), as increasing knowledge with increasing intensity of the intervention (Stanford 3 City 1977), or as increasing cessation rates, number of quit attempts, or changes in social norms with increasing numbers of channels or intensity of intervention (California TCP 2003; McAlister 2004). In McVey 2000 abstinence rates were compared in two study areas which received single- or double-weight interventions. No study presented a formal dose-response analysis.

Maintenance: The campaigns were maintained beyond the intervention period in six studies (Stanford 3 City 1977; Sydney QFL 1986; CORIS 1997; McVey 2000; California TCP 2003; Massachusetts 2003). In one study (Stanford 3 City 1977) the campaign was continued beyond the final assessment point for one year, but with reduced intensity and no additional evaluation. The CORIS 1997 campaign was subsequently maintained by the community, but no details are given. The McVey 2000 campaign was continued nationally after a controlled evaluation. In Sydney QFL 1986 the mass media campaign was run in later years for a few weeks, with assessment of long-term success. The two state-wide campaigns (California TCP 2003; Massachusetts 2003) were established as constitutional amendments, so they remained in place.

Intervention costs: costs per capita were reported in four studies (CORIS 1997; California TCP 2003; Massachusetts 2003; McAlister 2004), and total campaign costs in four studies (Sydney QFL 1986; Mogielnicki 1986; California TCP 2003; Massachusetts 2003). Some cost effectiveness analysis was performed for the two state-wide campaigns (California TCP 2003; Massachusetts 2003). No economic evaluation was reported for five campaigns (Stanford 3 City 1977; North Coast QFL 1983; McPhee 1995; Jenkins 1997; McVey 2000).

 

Risk of bias in included studies

Overall, we assessed the risk of bias of the included studies as high. For an overview of the methodological quality of the included trials see Figure 2.

 FigureFigure 2. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

 

Allocation

Mogielnicki 1986 randomised clinic attenders to different interventions within each clinic assigned to intervention or control conditions. It is normally not feasible or affordable to use true randomisation in community studies of this kind. Nine were of quasi-experimental design, with intervention and control status non-randomly allocated (Stanford 3 City 1977; North Coast QFL 1983; Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; CORIS 1997; Jenkins 1997; McVey 2000; McAlister 2004). The two state-wide campaigns were assessed through an interrupted time series design comparing the effects of the campaigns as part of tobacco control programmes with other American states where there were no campaigns.

Selection of participants for outcome measures:
In most studies samples of participants were selected through random digit dialling, or through selecting from enumeration lists or telephone books. In one study the total population was surveyed (CORIS 1997).

Response rates and retention rates:
Response rates (applicable to nested cross-sectional analyses) were reported in nine campaigns. Three of them reported the combined rates for the intervention and control communities (Sydney QFL 1986; California TCP 2003; McAlister 2004) and five reported them separately (Stanford 3 City 1977; North Coast QFL 1983; McPhee 1995; CORIS 1997; Jenkins 1997). Massachusetts 2003 reported combined and separate response rates. In those studies reporting separately for intervention and control communities, the response rates at baseline ranged from 70% to 84% in the intervention communities, and from 64% to 82% among the controls. The follow-up response rates for those studies ranged from 68% to 94% for intervention communities, and from 62% to 88% for the controls. The response rates combined for intervention and control community varied between 42.7% and 99.4%.

Retention rates (applicable to cohort analyses) were reported in six studies (Stanford 3 City 1977; Mogielnicki 1986; Sydney QFL 1986; CORIS 1997; McVey 2000; McAlister 2004), and ranged from 53.5% to 76% in the intervention communities and from 52% to 73% in the controls. Two studies (McVey 2000; McAlister 2004) provided some information on participants lost to follow-up, and Sydney QFL 1986 surveyed non-responders in Sydney and Melbourne at baseline, for evidence of selection bias. Among the cohort studies, CORIS 1997 reported on demographic differences between cohort and non-cohort participants (i.e. those who had only responded to one of the surveys), and Stanford 3 City 1977 identified higher smoking prevalence and heavier daily smoking among non-cohort participants than in the cohorts. Study design, with detailed response and retention rates, are shown in  Analysis 1.1.

Comparability of intervention and control community at baseline:
Nine studies described the demographic characteristics of participants at baseline (Stanford 3 City 1977; Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; CORIS 1997; Jenkins 1997; McVey 2000; Massachusetts 2003; McAlister 2004), with six of them conducting statistical tests for comparability (Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; Jenkins 1997; Massachusetts 2003; McAlister 2004). In North Coast QFL 1983 the statistical comparisons are reported without numerical detail. California TCP 2003 did not provide any information on comparability of the population. The intervention and control communities were shown to be demographically disparate in three studies, with analyses controlling for those differences (McPhee 1995; Jenkins 1997; Massachusetts 2003). Sydney QFL 1986 tested for possible confounding by sex, age, education, marital status, and socio-economic status, but found none of them to be predictive of quitting.

 

Blinding

Only one study reported blinding participants and personnel (McVey 2000), in other studies it was unclear or they were not blinded. Three studies reported on blinding outcome assessors (McAlister 2004; McVey 2000; Mogielnicki 1986), in other studies it was unclear or they were not blinded.

 

Incomplete outcome data

None of the included studies reported attrition rates or losses to follow-up.

 

Selective reporting

Only one trial did not report the outcomes as prespecified in the Methods section (McAlister 2004), with all the other studies reporting outcomes as prespecified.

 

Other potential sources of bias

Other sources of bias were not identified in most studies. The California TCP 2003 and the Massachusetts 2003 campaigns were interrupted time series studies. Both had clearly defined time points when the intervention was conducted, with at least three data points before and three after the intervention. It was unclear whether other quality assessment criteria for interrupted time series had been fulfilled.

Evaluation process:
In six campaigns the evaluation was done by study investigators (Stanford 3 City 1977; North Coast QFL 1983; Mogielnicki 1986; McPhee 1995; CORIS 1997; Jenkins 1997). In the remaining five included studies independent organisations conducted the evaluation or surveys or some parts of the work (Sydney QFL 1986; McVey 2000; California TCP 2003; Massachusetts 2003; McAlister 2004). For the Californian and Massachusetts state-wide campaigns national surveys were conducted.

Statistical analysis:
Two of the 11 included studies (McPhee 1995; McVey 2000) reported sample size calculations. However, because of the variability of the effect sizes, we do not consider that the absence of a power calculation should be interpreted as a marker of lower quality. All the studies except CORIS 1997, which reported use of t-tests with and without covariance adjustments, used regression analyses to produce their results. Two studies reported one-sided P value tests (Stanford 3 City 1977; McAlister 2004) and CORIS 1997 used two-sided P value tests.

The Californian and Massachusetts campaigns were described using an interrupted time series design. We assessed the reports according to the Cochrane Effective Practice and Organisation of Care Group criteria (EPOC 2006). All the studies identified a clearly defined point in time when the intervention occurred, and at least three assessment points before and after the intervention. However, the impact of the intervention independent of other changes was not clearly established. The TCP studies used regression models for data analysis. The intervention was deemed unlikely to affect data collection, and sources and methods of data collection were consistent before and after the intervention. Smoking prevalence was self-reported and unvalidated. In two of the studies (one for each campaign) aggregated cigarette sales data were used as an objective measure. None of the studies reported on completeness of data sets, but did report response rates for outcome surveys.

 

Effects of interventions

Detailed results are presented in 'Intermediate measures' ( Analysis 1.2) and 'Primary measures of smoking behaviour' ( Analysis 1.3). Summary findings on theoretical orientation, costs and outcomes are reported in 'Study summary by type of outcome' ( Analysis 1.4). Baseline differences and possible confounders are reported in  Analysis 1.5.

Smoking prevalence:
Among the nine campaigns reporting smoking prevalence, two studies (North Coast QFL 1983; CORIS 1997) reported smoking prevalence separately for men and women, and by age group in North Coast QFL 1983. Two studies reported prevalence for the whole population and for men and women separately (Sydney QFL 1986; Massachusetts 2003). Two studies targeted and reported on men only (McPhee 1995; Jenkins 1997), and the Stanford 3 City 1977 study reported in detail only on the high risk cohort. In two studies smoking prevalence was not reported (Mogielnicki 1986; McVey 2000).

Decreases in smoking prevalence were observed in both the state-wide programmes (California TCP 2003; Massachusetts 2003) compared with the rest of the USA, but in California the decrease was statistically significant only during the early period of the campaign, before cuts in funding. The final assessments of the California TCP showed greater decline of smoking prevalence since the beginning of the programme compared with the rest of the USA and lower smoking prevalence, but the statistical significance of the differences was not reported. In the Massachusetts campaign the decrease was statistically significant for the population as a whole and for men, but not for women. It should be noted that the mass media campaigns in both states were part of a comprehensive programme of tobacco control measures.

Among those studies which analysed men and women separately, both the Australian studies (North Coast QFL 1983; Sydney QFL 1986) detected significantly decreased prevalence among men and women, while two studies found significant reductions in men's but not women's smoking at long-term follow-up (Sydney QFL 1986; CORIS 1997 at 12 years). For the two studies which examined Vietnamese men's smoking, Jenkins 1997 detected a significant decrease in prevalence at two year follow-up, while McPhee 1995 failed to detect a significant reduction. Stanford 3 City 1977 failed to detect a significant effect of the media-only intervention on prevalence compared with controls at three years, although the declining trend favoured the control community.

Cigarette consumption:
Among the seven campaigns reporting cigarette consumption, one study (CORIS 1997) presented cigarette consumption separately for men and women, two studies (McPhee 1995; Jenkins 1997) for men only, two studies (Stanford 3 City 1977; Sydney QFL 1986) for the population as a whole. Stanford 3 City 1977 detected a significant reduction in cigarette or tobacco consumption for the high risk group, but not in the media-only intervention community compared with controls. The remaining studies failed to detect significant differences.

In the two state-wide campaigns cigarette consumption was measured on the basis of aggregated sales data. In California a significant decline was observed compared with the rest of the USA. In Massachusetts, declines in consumption were reported, but without statistical comparisons.

Quit attempts:
Of the five studies which assessed quit attempts, two found no significant differences between the intervention and control communities (McPhee 1995; Jenkins 1997) and McAlister 2004 only assessed quit attempts among continuing smokers. The two state-wide campaigns assessed quit attempts only in the intervention community. In Massachusetts they increased in line with campaign duration but not to a statistically significant extent, while in California rate changes were reported, but without statistical comparisons.

Quit rates:
Seven studies reported quit rates or abstinence rates, with only one study (CORIS 1997) reporting separately for men and women. Three of the studies included men only (Mogielnicki 1986; McPhee 1995; Jenkins 1997). The California TCP 2003 presented the quit ratio, i.e. the percentage of ever-smokers (current and former) who were ex-smokers in a given year, and McVey 2000 gave quit rates for smokers and abstinence rates for ex-smokers. McAlister 2004 reported point prevalence of daily smoking (ceasing to smoke at all or every day). This study also detected a benefit of 3% in quit rates (8% versus 5%) between study areas that received a media campaign and no cessation services, compared with areas without either intervention. This difference, however, was not statistically significant.

CORIS 1997 found significant differences in intervention quit rates for women but not for men, compared to controls. Two studies found significant intervention effects (Mogielnicki 1986; Jenkins 1997), while in Sydney QFL 1986 the quit rate was not reported separately from the smoking reduction rate. Significant differences were not detected in California TCP 2003 or McPhee 1995. McAlister 2004 reported no significant change in the point prevalence of daily smoking. McVey 2000 detected a significant intervention effect of the media campaign on abstinence rates for smokers and ex-smokers combined at 18 months.

Intermediate measures:
Five of six studies presenting follow-up results for knowledge or beliefs data found some increases in knowledge about smoking or cardiovascular risk factors (Stanford 3 City 1977; Sydney QFL 1986; CORIS 1997 [women only]; California TCP 2003;; Massachusetts 2003), with only North Coast QFL 1983 failing to detect a significant change.

Among five studies presenting follow-up data on attitudes to smoking or cardiovascular risk factors, three found no significant differences between the intervention and control communities (North Coast QFL 1983; McPhee 1995; Jenkins 1997). The Californian and Massachusetts TCP campaigns found significant change compared with the period before the campaign, but there were no comparisons with other states.

Information-seeking behaviour, measured as the number of calls to quitline, enrolments in 'quit centres' and the number of 'quit kits' sold, was reported as increased in Sydney QFL 1986.

Social influences or pressure to quit compared with baseline rates did not change in one study (North Coast QFL 1983), and increased in three studies (Sydney QFL 1986; McPhee 1995; Massachusetts 2003); in McPhee 1995 there was no difference between the intervention and control communities at the follow-up, while in the Massachusetts and Sydney studies no comparison with the control community was reported. Norms concerning smoking changed compared to baseline in all three studies which measured them (McPhee 1995; California TCP 2003; Massachusetts 2003), but McPhee 1995 found no difference between the intervention and control communities, and in the state-wide campaigns no comparison was made with non-intervention states.

Process measures:
Details of mass media campaign awareness in the intervention community comparison with the control community was presented in two studies (McPhee 1995; Jenkins 1997) and in both was significantly higher in the intervention community. None of the studies presented formal dose-response analysis of intervention effects.

Intervention costs:
Cost-effectiveness data were presented for two state-wide campaigns (California TCP 2003; Massachusetts 2003). They indicated that both campaigns brought benefit in terms of decreases in the number of cigarette packs sold per capita per year for each per capita dollar spent on the media campaign. The effect was more pronounced in California than in Massachusetts. Per capita media expenditure was reported in four studies (CORIS 1997; California TCP 2003; Massachusetts 2003; McAlister 2004) and ranged from USD 0.25 and USD 3.35 per person per year. Two studies reported raw campaign costs (Mogielnicki 1986: copy development and production USD 7480, broadcast time USD 15,150; Sydney QFL 1986: AUD 620,000 for media and a 'Quit Centre'), but without attempting any cost benefit analysis.

 

Discussion

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms
 

Summary of main results

Eleven mass media campaigns met our inclusion criteria for this review. Two state-wide tobacco control programmes with mass media campaigns (California TCP 2003; Massachusetts 2003) and six out of nine community studies (Stanford 3 City 1977; North Coast QFL 1983; Mogielnicki 1986; Sydney QFL 1986; CORIS 1997; Jenkins 1997) showed some positive effects on smoking behaviour, and at least one significant change in smoking behaviour (McVey 2000), although the increase in abstinence was for smokers and ex-smokers combined.

 

Overall completeness and applicability of evidence

The inclusion criteria for this review (requiring a comparison community) were designed to help us to identify and assess the specific contribution of the mass media to changing smoking behaviour. However, mass media campaigns are rarely the only component of a community-based smoking cessation intervention, and it is often difficult or impossible to disentangle the contribution that the separate elements make to the overall impact of a comprehensive tobacco control programme. The advantage of assigning a community to control (no campaign) status should be that broad secular trends in smoking behaviour may more easily be distinguished from the specific effect of the intervention being tested. Despite this methodological strength, several of the studies in our review reported confounding of their findings by extraneous or concurrent events. For example, the findings of the baseline survey for the CORIS 1997 study directly contributed to the establishment of the Heart Foundation of Southern Africa, which then set up a number of tobacco control initiatives that may have contaminated CORIS's subsequent findings. The North Coast QFL 1983 campaign came under attack from the tobacco industry and was briefly suspended, with the resulting national publicity assumed to have influenced smoking behaviour in the control community. During the Sydney QFL 1986 programme, which led to a 2.8% decrease in local prevalence, cigarette prices in Sydney rose less than in the rest of Australia, which may have masked some of the positive effects of the campaign. While such interactions may demonstrate the synergy between campaigns and societal changes, they compromise our ability to measure the impact of such research.

Mass media campaigns are inherently difficult to evaluate, since large samples are required to detect relatively small effects on individual members of the target community. However, even small changes may deliver significant benefits at the population level. McVey 2000 extrapolated that the odds ratio (1.53) for being a non-smoker following the HEA tobacco control TV campaign would yield a decline in prevalence of 1.2% in a stable population with a smoking rate of 28% (the approximate prevalence rate in the UK at that time (ASH 2007)). There is also evidence that a memorable media campaign, particularly a TV-based one, may increase calls to quitlines, the distribution of quit kits and enrolment in treatment programmes, but that these may be transient responses, and do not necessarily translate to an increase in successful quit attempts. Low success rates and high drop-out rates may be a consequence of unrealistically high expectations raised by a successful campaign (Sydney QFL 1986).

None of our included studies tested simply a mass media intervention. Some compared groups receiving a mass media intervention alone with groups receiving mass media and community interventions. In these cases only the mass media groups were included in our review (Stanford 3 City 1977; North Coast QFL 1983; CORIS 1997; McVey 2000; McAlister 2004). In some studies the intervention was led by a mass media programme but also included components such as quit lines, physician involvement and clinics (Mogielnicki 1986; Sydney QFL 1986; McPhee 1995; Jenkins 1997). We decided to include all studies in which a mass media programme led the intervention, but this has involved complex processes of evaluation and comparison.

The definitions of smoker, ex-smoker and quitter varied from study to study, making between-study comparisons problematic. In addition, the surveys used in both the state-wide tobacco control programme (TCP) campaigns modified their definition of a smoker during the course of the campaigns. Because of those differences, people who were defined as smokers, ex-smokers or quitters might not have fallen into those categories in another study. Some studies included both smoking cessation and smoking reduction as primary objectives, and in one study (McAlister 2004) the criterion for success changed retrospectively from complete cessation to no longer smoking every day.

The state TCP campaigns were both introduced as constitutional amendments, and are funded from tobacco excise tax increases. They are to be continued, but with reduced funding and less aggressive advertising. Compared with smoking prevalence before the programme and in other states before and after the programme, the early campaign in California was associated with significant decreases in smoking prevalence. However, the early success was not sustained through the later stages of the campaign. The final evaluation up to 2008 showed a faster decline in smoking prevalence compared with the rest of the USA population. In addition smoking-attributable cancer mortality rates declined more in California than in the rest of the USA (18.8% vs 2.4%) during 1979-2002 (California TCP 2003)

Fichtenberg 2000 reported a correlation between changes in funding, per capita cigarette consumption and mortality from heart disease in California during the 1990s, and estimated that over the first eight years of the campaign 33,000 deaths from heart disease were avoided. Goldman et al calculated that a decline of 12.2% following the second wave of media activity could be directly attributed to the campaign rather than to fiscal pressures (California TCP 2003). In Massachusetts the programme budget was also cut. Friend 2002 notes that the gradual tapering off of the effectiveness of the California and Massachusetts campaigns may be an inevitable reduction in impact over time, irrespective of fluctuating trends in funding.

The impact of campaign duration and intensity is difficult to ascertain. The Flay 1987b and Friend 2002 reviews both detected an effect of longer duration and higher intensity campaigns, but our own assessment has less clearcut findings. McVey 2000, comparing the impact of single- and double-weight TV campaigns on quit rates, found no significant differences at six months, with the single-weight region (Granada) at 6.3% and double-weight (Tyne Tees, Yorkshire) at 6.6%, yielding an adjusted OR of 1.02 (P = 0.94). The Vietnamese-American men studies I (McPhee 1995) and II (Jenkins 1997) ran for a total of 24 and 39 months respectively, with the latter producing positive effects, but other factors in the study design (a 15-month pilot phase, physician input, Saturday schools, student and family involvement) may have confounded the mass media effect. North Coast QFL 1983 lasted for three years, but after early success the campaign was scaled down and prevalence rose again during the second year; the intervention effects may have been masked by a concurrent substantial decline in smoking in the control community. In the Stanford 3 City 1977 study, it is difficult to disentangle the effects of the mass media campaign from face-to-face counselling in the intervention communities. However, significant declines in cigarette consumption were observed only within the community in which the whole population was exposed to a mass media campaign with high-risk smokers receiving intensive counselling, and not in the community that received the media campaign alone. In the Sydney QFL 1986 study, a significant decline in smoking prevalence was observed in the intervention city at the end of the first year, but from that point on both cities (Sydney and Melbourne) over four years received complex interventions which included mass media campaigns. It was not possible to separate out the independent effect of the mass media from co-interventions such as physician input, smoking clinics, school programmes and shopping mall displays. From the studies in our review, there was no consistent relationship discernible between campaign duration and effectiveness.

Differences by age, gender, ethnicity and education presented similar problems. During the assessment period (1989 to 2000) for the California TCP 2003, the decline was significant for women but not for men during the last phase only. The trend was significant for older smokers (45+) throughout the campaign. Changes in male smoking prevalence were similar between ethnic groups, with the highest smoking prevalence reported in African Americans. In women, significant declines in prevalence were observed for Hispanic and non-Hispanic white women. The greatest decline in male smoking prevalence was observed for college graduates, while in women the largest declines were noted in those who did not graduate from high school. In the Massachusetts campaign, the decline in smoking prevalence between 1990 and 2000 was significantly different from the rest of the USA for men but not for women. The effect was also more pronounced for people aged between 18 and 34, for those who graduated from high school but not college, and for white non-Hispanics.

After four years follow-up CORIS 1997 detected significantly higher quit rates for women than for men, but after 12 years this difference was no longer apparent, with prevalence for men significantly lower in the intervention than in the control community, but not for women. The North Coast QFL 1983 study found no difference between men and women, but a significant trend by age, with greater declines in prevalence among younger smokers. The Sydney QFL 1986 study detected no significant associations between changes in prevalence and demographic characteristics, other than a long-term decline in prevalence for men but not for women. The impact of age was contradictory, with three campaigns detecting positive effects among older smokers, and three among younger smokers (up to 34 years). Gender indications were also inconclusive, with three studies showing positive long-term effects for men, and one for women. This mixed picture casts doubt upon the widely-held assumption that targeted campaigns are likely to be the most effective. Chapman 2007 points out that the tobacco industry, although nuancing much of its promotion to appeal to different subgroups within a population, does not tailor its packaging or advertising of the major brands (e.g. Camel, Marlboro) to different cultural groups or countries.

 

Quality of the evidence

Overall the included studies were assessed as being at high risk of bias. All the included studies used some kind of control group, but did not randomise communities to intervention and control conditions. Baseline demographic characteristics were statistically compared in five studies (three with positive outcomes and two with a negative outcome). Studies with declared baseline differences between compared groups controlled for those differences in the analyses. Six studies did not conduct statistical tests for comparability between groups or did not describe details of demographic characteristics of the population. Since comparison groups were not randomised, there could be baseline differences between them which could have confounded the results. Most of the studies with positive findings had problems with drop-outs and missing data. Response rates ranged from 42.7% to 99.4%, with retention rates between 52% and 76%. Most studies with positive findings did not provide information on participants lost to follow-up. Any of these limitations could have confounded the results of the studies.  Analysis 1.5 gives information on those studies which identified possible confounders, the analytical measures taken to control for these, and the changes in effect where reported.

 

Agreements and disagreements with other studies or reviews

There is a broad consensus that comprehensive tobacco control interventions which include mass media campaigns can be effective in reducing smoking consumption and prevalence (Flay 1987a; Flay 1987b; COMMIT 1995; Levy 2000; Friend 2002; Biener 2006; NICE 2007; NCI 2008; Niederdeppe 2008; Ontario 2009; Durkin 2012; Wilson 2012). The NICE 2007 review found little high quality evidence of the effectiveness of targeting mass media interventions at high-risk groups such as pregnant women, men only or young smokers. Durkin 2012 assessed mass media interventions in adults on the basis of 26 population-based studies (cohort, cross-sectional and time series, with no control group). They concluded that the evidence supports the use of mass media campaigns as a part of comprehensive tobacco control programmes. In addition the authors evaluated different message types and different media channels using subgroup analysis. NCI 2008 reported on the role of the media in promoting and reducing tobacco use. They included studies of various designs, and concluded that mass media campaigns may encourage adult smoking cessation and lead to decreases in smoking prevalence. Niederdeppe 2008 conducted a systematic review of the effectiveness of media campaigns in smoking cessation in socio-economically disadvantaged populations. They included 50 studies, and concluded that media campaigns are less or equally effective in populations with low socio-economic status compared with populations with higher socio-economic status. In addition they observed that media campaigns in disadvantaged populations are most effective when combined with tobacco control programmes. The Ontario 2009 Health Technology Assessment report examined the efficacy and cost effectiveness of selected population-based interventions for smoking cessation, including mass media interventions. They agreed with the conclusions of our review. Wilson 2012 evaluated several tobacco control interventions outlined in the WHO MPOWER Package, including mass media interventions in adults and youth. They included 19 studies with and without control groups, some of which were also included in our review, but excluded studies assessing multicomponent interventions. They concluded that there is moderate evidence that mass media can be effective in reducing smoking prevalence in adults.

 

Authors' conclusions

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

 

Implications for practice

  • Tobacco control programmes that include mass media campaigns may change smoking behaviour in adults, but the evidence comes from studies of variable quality and scale. The specific contribution of the mass media component is unclear.
  • The duration and intensity of an intervention may affect its impact on smoking behaviour, but evaluations need to last long enough to detect lasting changes, and to allow for confounders and for secular trends.
  • No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender.

 
Implications for research

  • Evaluations of mass media campaigns should include adequate planning.
  • Evaluations should include control groups matched to intervention groups, or at least with between-group baseline differences noted and adjusted for in the analysis.
  • Formative research is also essential to test the value of targeting intended populations.

 

Acknowledgements

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

We thank Dr Paul Aveyard for comments and suggestions at the draft stage of this review.

 

Data and analyses

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms
Download statistical data

 
Comparison 1. Mass media versus no mass media

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Response and retention ratesOther dataNo numeric data

 2 Intermediate measuresOther dataNo numeric data

 3 Primary measures of smoking behaviourOther dataNo numeric data

 4 Study summary by type of outcomeOther dataNo numeric data

 5 Baseline differences and possible confoundingOther dataNo numeric data

 

Appendices

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms
 

Appendix 1. Glossary of terms


TermDefinition

AbstinenceA period of being quit, i.e. stopping the use of cigarettes or other tobacco products, May be defined in various ways; see also:
point prevalence abstinence; prolonged abstinence; continuous/sustained abstinence

Biochemical verificationAlso called 'biochemical validation' or 'biochemical confirmation':
A procedure for checking a tobacco user's report that he or she has not smoked or used tobacco. It can be measured by testing levels of nicotine or cotinine or other chemicals in blood, urine, or saliva, or by measuring levels of carbon monoxide in exhaled breath or in blood.

BupropionA pharmaceutical drug originally developed as an antidepressant, but now also licensed for smoking cessation; trade names Zyban, Wellbutrin (when prescribed as an antidepressant)

Carbon monoxide (CO)A colourless, odourless highly poisonous gas found in tobacco smoke and in the lungs of people who have recently smoked, or (in smaller amounts) in people who have been exposed to tobacco smoke. May be used for biochemical verification of abstinence.

CessationAlso called 'quitting'
The goal of treatment to help people achieve abstinence from smoking or other tobacco use, also used to describe the process of changing the behaviour

Continuous abstinenceAlso called 'sustained abstinence'
A measure of cessation often used in clinical trials involving avoidance of all tobacco use since the quit day until the time the assessment is made. The definition occasionally allows for lapses. This is the most rigorous measure of abstinence

'Cold Turkey'Quitting abruptly, and/or quitting without behavioural or pharmaceutical support.

CravingA very intense urge or desire [to smoke].
See: Shiffman et al 'Recommendations for the assessment of tobacco craving and withdrawal in smoking cessation trials'
Nicotine & Tobacco Research 2004: 6(4): 599-614

DopamineA neurotransmitter in the brain which regulates mood, attention, pleasure, reward, motivation and movement

EfficacyAlso called 'treatment effect' or 'effect size':
The difference in outcome between the experimental and control groups

Harm reductionStrategies to reduce harm caused by continued tobacco/nicotine use, such as reducing the number of cigarettes smoked, or switching to different brands or products, e.g. potentially reduced exposure products (PREPs), smokeless tobacco.

Lapse/slipTerms sometimes used for a return to tobacco use after a period of abstinence. A lapse or slip might be defined as a puff or two on a cigarette. This may proceed to relapse, or abstinence may be regained. Some definitions of continuous, sustained or prolonged abstinence require complete abstinence, but some allow for a limited number or duration of slips. People who lapse are very likely to relapse, but some treatments may have their effect by helping people recover from a lapse.

nAChR[neural nicotinic acetylcholine receptors]: Areas in the brain which are thought to respond to nicotine, forming the basis of nicotine addiction by stimulating the overflow of dopamine

NicotineAn alkaloid derived from tobacco, responsible for the psychoactive and addictive effects of smoking.

Nicotine Replacement Therapy (NRT)A smoking cessation treatment in which nicotine from tobacco is replaced for a limited period by pharmaceutical nicotine. This reduces the craving and withdrawal experienced during the initial period of abstinence while users are learning to be tobacco-free The nicotine dose can be taken through the skin, using patches, by inhaling a spray, or by mouth using gum or lozenges.

OutcomeOften used to describe the result being measured in trials that is of relevance to the review. For example smoking cessation is the outcome used in reviews of ways to help smokers quit. The exact outcome in terms of the definition of abstinence and the length of time that has elapsed since the quit attempt was made may vary from trial to trial.

PharmacotherapyA treatment using pharmaceutical drugs, e.g. NRT, bupropion

Point prevalence abstinence (PPA)A measure of cessation based on behaviour at a particular point in time, or during a relatively brief specified period, e.g. 24 hours, 7 days. It may include a mixture of recent and long-term quitters. cf. prolonged abstinence, continuous abstinence

Prolonged abstinenceA measure of cessation which typically allows a 'grace period' following the quit date (usually of about two weeks), to allow for slips/lapses during the first few days when the effect of treatment may still be emerging.
See: Hughes et al 'Measures of abstinence in clinical trials: issues and recommendations'; Nicotine & Tobacco Research, 2003: 5 (1); 13-25

RelapseA return to regular smoking after a period of abstinence

Secondhand smokeAlso called passive smoking or environmental tobacco smoke [ETS]
A mixture of smoke exhaled by smokers and smoke released from smouldering cigarettes, cigars, pipes, bidis, etc. The smoke mixture contains gases and particulates, including nicotine, carcinogens and toxins.

Self-efficacyThe belief that one will be able to change one's behaviour, e.g. to quit smoking

SPC [Summary of Product Characteristics]Advice from the manufacturers of a drug, agreed with the relevant licensing authority, to enable health professionals to prescribe and use the treatment safely and effectively.

TaperingA gradual decrease in dose at the end of treatment, as an alternative to abruptly stopping treatment

TarThe toxic chemicals found in cigarettes. In solid form, it is the brown, tacky residue visible in a cigarette filter and deposited in the lungs of smokers.

TitrationA technique of dosing at low levels at the beginning of treatment, and gradually increasing to full dose over a few days, to allow the body to get used to the drug. It is designed to limit side effects.

WithdrawalA variety of behavioural, affective, cognitive and physiological symptoms, usually transient, which occur after use of an addictive drug is reduced or stopped.
See: Shiffman et al 'Recommendations for the assessment of tobacco craving and withdrawal in smoking cessation trials'
Nicotine & Tobacco Research 2004: 6(4): 599-614



 

What's new

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

Last assessed as up-to-date: 28 February 2013.


DateEventDescription

28 November 2013AmendedContribution of authors updated and support source clarified.



 

History

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

Protocol first published: Issue 2, 2004
Review first published: Issue 1, 2008


DateEventDescription

25 April 2013New citation required but conclusions have not changedReview text updated, new author added, 10 new excluded trials, no new included trials but additional information for an existing included study (California TCP). Risk of bias tables added.

21 February 2013New search has been performedNew searches conducted up to February 2013

1 August 2008AmendedConverted to new review format.

12 November 2007New citation required and conclusions have changedSubstantive amendment



 

Contributions of authors

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

MB developed the concept for the project, formulated the search strategy and carried out searches, prescreened the abstracts, assessed relevant studies for inclusion, extracted the data and wrote the text of the review.
LS assessed relevant studies for inclusion, checked data extraction, and proof read the text of the review. RTM assessed relevant studies for inclusion and proof read the text of the review.
KC assisted with the writing of the review, with study assessment and with assembling the tables.

 

Declarations of interest

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms

None known.

 

Sources of support

  1. Top of page
  2. Background
  3. Objectives
  4. Methods
  5. Results
  6. Discussion
  7. Authors' conclusions
  8. Acknowledgements
  9. Data and analyses
  10. Appendices
  11. What's new
  12. History
  13. Contributions of authors
  14. Declarations of interest
  15. Sources of support
  16. Index terms
 

Internal sources

  • Jagiellonian University Medical College, Poland.
  • Medycyna Praktyczna, Poland.
  • Department of Primary Care Health Sciences, University of Oxford, UK.
  • National School for Health Research, School for Primary Care Research, UK.

 

External sources

  • State Committee for Scientific Research, Poland.
    (2008 version of this review)
  • National Institute for Health Research, UK.

* Indicates the major publication for the study

References

References to studies included in this review

  1. Top of page
  2. Abstract
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. What's new
  13. History
  14. Contributions of authors
  15. Declarations of interest
  16. Sources of support
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. Additional references
California TCP 2003 {published data only}
  • Al-Delaimy WK, White MM, Mills AL, Pierce JP, Emory K, Boman M, Smith J, Edland S. Two Decades of the California Tobacco Control Program: California Tobacco Survey, 1990-2008.. La Jolla, CA: University of California, San Diego; 2010.
  • Bal DG. Designing effective statewide tobacco control programme - California. Cancer 1998;83(Suppl 12):2717-21.
  • Breslow L, Johnson M. California's Proposition 99 on tobacco, and its impact. Annual Review of Public Health 1993;14:585-604.
  • California Department of Health Services, Tobacco Control Section. California tobacco control update. California Department of Health Services,Tobacco Control Section 2006.
  • California Department of Public Health, California Tobacco Control Program. 2009. California Tobacco Control Update 2009: 20 Years of Tobacco Control in California:. California Department of Public Health, California Tobacco Control Program. 2009, Sacramento, CA.
  • Elder JP, Edwards CC, Conway TL, Kenney E, Johnson CA, Bennett ED. Independent evaluation of the California Tobacco Education Program. Public Health Reports 1996;111(4):353-8.
  • Gilpin EA, Emery SL, Farkas AJ, Distefan JM, White MM, Pierce JP. The California Tobacco Control Program: A decade of progress: Results from the California Tobacco Surveys, 1990-1998. La Jolla, CA: University of California, San Diego, 2001.
  • Gilpin EA, Messer K, White MM, Pierce JP. What contributed to the major decline in per capita cigarette consumption during California's tobacco control programme?. Tobacco Control 2006;15:308-16.
  • Gilpin EA, White MM, White VM, Distefan JM, Trinidad DR, James L, et al. Tobacco control successes in California: a focus on young people: results from the California Tobacco Surveys, 1990-2002. La Jolla, CA: University of California, San Diego, 2003.
  • Glantz SA. Changes in cigarette consumption, prices, and tobacco industry revenues associated with California's Propostion 99. Tobacco Control 1993;2(4):311-4.
  • Goldman LK, Glantz SA. Evaluation of antismoking advertising campaigns. JAMA 1998;279(10):772-7.
  • Hu T, Keeler TE, Sung H, Barnett PG. The impact of California anti-smoking legislation on cigarette sales, consumption, and prices. Tobacco Control 1995;4(Suppl):S34-8.
  • Hu T, Sung H-Y, Keeler TE. Reducing cigarette consumption in California: tobacco taxes vs an anti-smoking media campaign. American Journal of Public Health 1995;85(9):1218-22.
  • Independent Evaluation Consortium [The Gallup Organization]. Final Report of the Independent Evaluation of the California Tobacco Control Prevention and Education Program: Wave I Data, 1996-1997. http://www.dhs.ca.gov/tobacco/documents/eval/TCSFinal798Gallup.pdf (accessed 12/11/2007) 1998.
  • Independent Evaluation Consortium [The Gallup Organization]. Final Report. Independent Evaluation of the California Tobacco Control Prevention and Education Program: Waves 1, 2, and 3 (1996-2000) Tobacco Control Prevention and Education Program: Waves 1, 2, and 3 (1996-2000). Rockville: Maryland: The Gallup Organization, 2002. http://www.dhs.ca.gov/cdic/tcs/documents/pubs/WavesComplete.pdf (accessed 8/12/2006) 2002.
  • Independent Evaluation Consortium [The Gallup Organization]. Interim report. Independent evaluation of the California Tobacco Control Prevention and Education Program: Wave 2 data, 1998; Wave 1 and Wave 2 data comparisons, 1996-1998. http://www.dhs.ca.gov/tobacco/documents/eval/Wave2IEreport.pdf (accessed 12/11/2007) 1998.
  • Norman GJ, Ribisl KM, Howard-Pitney B, Howard KA, Unger JB. The relationship between home smoking bans and exposure to state tobacco control efforts and smoking behaviors. American Journal of Health Promotion 2000;15(2):81-8.
  • Novotny TE, Siegel MB. California's tobacco control saga. Health Affairs 1996;15:58-72.
  • Pierce JP, Burns DM, Berry C, Rosbrook B, Goodman J, Gilpin E, et al. Reducing tobacco consumption in California: Proposition 99 seems to work [letter]. JAMA 1991;265:1257-8.
  • Pierce JP, Emery S, Gilpin E. The California Tobacco Control Program: a long term health communication project. In: Hornik RC editor(s). Public health communication. Evidence for behavior change. Lawrence Erlbaum Associates, 2002.
  • Pierce JP, Evans N, Farkas AJ, Cavin SW, Berry C, Kramer M, et al. Tobacco use in California. An evaluation of the Tobacco Control Program, 1989-1993. La Jolla, CA: University of California, San Diego, 1994.
  • Pierce JP, Farkas AJ, Evans N, Berry C, Choi W, Rosbrook B, et al. Tobacco Use in California 1992. A focus on preventing uptake in adolescents. Sacramento: California: California Department of Health Services, 1993.
  • Pierce JP, Gilpin EA, Emery SL, Farkas AJ, Zhu SH, Choi WS, et al. Tobacco Control in California: Who's Winning the War? An Evaluation of The Tobacco Control Program, 1989-1996. La Jolla, CA: University of California, San Diego, 2001.
  • Pierce JP, Gilpin EA, Emery SL, White MM, Rosbrook B, Berry CC. Has the California Tobacco Control Program reduced smoking?. JAMA 1998;280(10):893-9.
  • Popham WJ, Potter LD, Bal DG, Johnson MD, Duerr JM, Quinn V. Do anti-smoking media campaigns help smokers quit?. Public Health Reports 1993;108(4):510-3.
  • Popham WJ, Potter LD, Hetrick MA, Muthen LK, Duerr JM, Johnson MD. Effectiveness of the California 1990-1991 tobacco education media campaign. American Journal of Preventive Medicine 1994;10(6):319-26.
  • Rohrbach LA, Howard-Pitney B, Unger JB, Dent CW, Howard KA, Cruz TB, et al. Independent evaluation of the California Tobacco Control Program: relationships between program exposure and outcomes, 1996-1998. American Journal of Public Health June 2002;92(6 [Tobacco and the media]):975-83.
  • Russell CM. Evaluation: methods and strategy for evaluation - California. Cancer 1998;83(12 Suppl):2755-9.
  • Siegel M, Pechacek TP, Strauss WJ, Schooley MW, Merritt RK, Novotny TE, et al. Trends in adult cigarette smoking in California compared with the rest of the United States, 1978-1994. American Journal of Public Health 2000;90:372-9.
  • Stevens C. Designing an effective counteradvertising campaign - California. Cancer 1998;83(12 Suppl):2736-41.
CORIS 1997 {published data only}
  • Rossouw JE, Jooste PL, Chalton DO, Jordaan ER, Langenhoven ML, Jordaan PC, et al. Community-based intervention: the Coronary Risk Factor Study (CORIS). International Journal of Epidemiology 1993;22(3):428-38.
  • Steenkamp HJ, Jooste PL, Jordaan PCJ, Swanepoel AS, Roussouw JE. Changes in smoking during a community-based cardiovascular disease intervention programme. South African Medical Journal 1991;79:250-3.
  • Steyn K, Steyn M, Swanepoel ASP, Jordaan PCT, Jooste PL, Fourie JM, et al. Twelve-year results of the Coronary Risk Factor Study (CORIS). International Journal of Epidemiology 1997;26(5):964-71.
Jenkins 1997 {published data only}
  • Jenkins CN, McPhee SJ, Le A, Pham GQ, Ha NT, Stewart S. The effectiveness of a media-led intervention to reduce smoking among Vietnamese-American men. American Journal of Public Health 1997;87(6):1031-4.
Massachusetts 2003 {published data only}
  • Biener L. Adult and youth response to the Massachusetts anti-tobacco television campaign. Journal of Public Health Management and Practice 2000;6(3):40-4.
  • Biener L, Harris JE, Hamilton W. Impact of the Massachusetts tobacco control programme: population based trend analysis. BMJ 2000;321(7257):351-4.
  • Biener L, McCallum-Keeler G, Nyman AL. Adults' response to Massachusetts anti-tobacco television advertisements: impact of viewer and advertisement characteristics. Tobacco Control 2000;9(4):401-7.
  • Celebucki C, Biener L, Koh HK. Evaluation: methods and strategy for evaluation - Massachusetts. Cancer 1998;83(12 Suppl):2760-5.
  • Centers for Disease Control and Prevention. Cigarette smoking before and after an excise tax increase and an antismoking campaign - Massachusetts, 1990-1996. MMWR Morbidity & Mortality Weekly Report 1996;45:966-70.
  • Connolly G, Robbins H. Designing an effective statewide tobacco control program - Massachusetts. Cancer 1998;83(supl 12):2722-7.
  • DeJong W, Hoffman KD. A content analysis of television advertising for the Massachusetts Tobacco Control Program media campaign 1993-1996. Journal of Public Health Management and Practice 2000;6(3):27-39.
  • Goldman LK, Glantz SA. Evaluation of antismoking advertising campaigns.. JAMA 1998;279(10):772-7.
  • Hamilton W, diStefano Norton G, Weintraub J. Independent evaluation of the Massachusetts Tobacco Control Program, 7th annual report - January 1994 to June 2000. Cambridge, MA: Abt Associates Inc, 2002.
  • Hamilton WL, Rodger CN, Chen X, Njobe TK, Kling R, Norton G. Independent Evaluation of the Massachusetts Tobacco Control Program. Eighth Annual Report: January 1994-June 2001. Cambridge, MA: Abt Associates Inc, 2003.
  • Miller A. Designing an effective counteradvertising campaign - Massachusetts. Cancer 1998;83(12 Suppl):2742-5.
  • Robbins H, Krakow M, Warner D. Adult smoking intervention programmes in Massachusetts: a comprehensive approach with promising results. Tobacco Control 2002;11(Suppl II):ii4-ii7.
  • Weintraub JM, Hamilton WL. Trends in prevalence of current smoking, Massachusetts and states without tobacco control programmes, 1990 to 1999. Tobacco Control 2002;11(Supplement II):ii8-ii13.
McAlister 2004 {published data only}
  • McAlister A, Morrison TC, Hu SH, Meshack AF, Ramirez A, Gallion K, et al. Media and community campaign effects on adult tobacco use in Texas. Journal of Health Communication 2004;9(2):95-109.
McPhee 1995 {published data only}
  • McPhee SJ, Jenkins CNH, Wong C, Fordham D, Lai KQ, Bird JA, et al. Smoking cessation intervention among Vietnamese Americans: a controlled trial. Tobacco Control 1995;4(Suppl 1):S16-24.
McVey 2000 {published data only}
  • McVey D, Stapleton J. Can anti-smoking television advertising affect smoking behaviour? Controlled trial of the Health Education Authority for England's anti-smoking TV campaign. Tobacco Control 2000;9(3):273-82.
Mogielnicki 1986 {published data only}
North Coast QFL 1983 {published data only}
  • Egger G, Fitzgerald W, Frape G, Monaem A, Rubinstein P, Tyler C, et al. Results of a large scale anti-smoking campaign in Australia: North Coast 'Quit for Life'. BMJ 1983;287:1125-8.
  • Egger G, Frape G, Mackay B. Applied problems of media use in health promotion - the North Coast experience. New Doctor 1981;January:25-9.
Stanford 3 City 1977 {published data only}
  • Farquhar JW, Maccoby N, Wood PD, Alexander JK, Breitrose H, Brown BW Jr, et al. Community education for cardiovascular health. Lancet 1977;4(8023):1192-5.
  • Kasl SV. Cardiovascular risk reduction in a community setting: some comments. Journal of Consulting and Clinical Psychology 1980;48(2):143-9.
  • Leventhal H, Safer MA, Cleary PD, Gutmann M. Cardiovascular risk modification by community-based programs for life-style change: comments on the Stanford study. Journal of Consulting and Clinical Psychology 1980;48(2):150-8.
  • Maccoby N, Farquhar JW, Wood PD, Alexander J. Reducing the risk of cardiovascular disease: effects of a community-based campaign on knowledge and behavior. Journal of Community Health 1977;3(2):100-14.
  • Meyer AJ. Skills training in a cardiovascular health education campaign. Journal of Consulting and Clinical Psychology 1980;48(2):129-42.
  • Meyer AJ, Maccoby N, Farquhar JW. Reply to Kasl and Leventhal et al. Journal of Consulting and Clinical Psychology 1980;48(2):159-63.
Sydney QFL 1986 {published data only}
  • Dwyer T, Pierce JP, Hannam CD, Burke N. Evaluation of the Sydney "Quit for Life" anti-smoking campaign. Part 2. Changes in smoking prevalence. Medical Journal of Australia 1986;144:344-7.
  • Pierce JP, Dwyer T, Frape G, Chapman S, Chamberlain A, Burke N. Evaluation of the Sydney "Quit For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals. Medical Journal of Australia 1986;144:341-4.
  • Pierce JP, Macaskill P, Hill D. Long-term effectiveness of mass media led antismoking campaigns in Australia. American Journal of Public Health 1990;80(5):565.

References to studies excluded from this review

  1. Top of page
  2. Abstract
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. What's new
  13. History
  14. Contributions of authors
  15. Declarations of interest
  16. Sources of support
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. Additional references
Arizona 1998 {published data only}
ASSIST 2003 {published data only}
  • Manley M, Lynn W, Payne Epps R, Grande D, Glynn T, Shopland D. The American Stop Smoking Intervention Study for cancer prevention: an overview. Tobacco Control 1997;6(Suppl 2):S5-S11.
  • Manley MW, Pierce JP, Gilpin EA, Rosbrook B, Berry C, Wun LM. Impact of the American Stop Smoking Intervention Study on cigarette consumption. Tobacco Control 1997;6(Suppl 2):S12-S16.
  • Stillman F, Hartman A, Graubard B, Gilpin E, Chavis D, Garcia J, et al. The American Stop Smoking Intervention Study. Conceptual framework and evaluation design. Evaluation Review 1999;23(3):259-80.
  • Stillman FA, Cronin KA, Evans WD, Ulasevich A. Can media advocacy influence newspaper coverage of tobacco: measuring the effectiveness of the American Stop Smoking Intervention Study's (ASSIST) media advocacy strategies. Tobacco Control 2001;10(2):137-44.
  • Stillman FA, Hartman AM, Graubard BI, Gilpin EA, Murray DM, Gibson JT. Evaluation of the American Stop Smoking Intervention Study (ASSIST): a report of outcomes. Journal of the National Cancer Institute 2003;95(22):1681-91.
A Su Salud 1990 {published data only}
  • Amezcua C, McAlister A, Ramirez A, Espinoza R. A Su salud. Health promotion in a Mexican-American border community. In: Bracht N editor(s). Health promotion at the community level. Newbury Park, CA: Sage Publications, 1990.
  • McAlister AL, Ramirez AG, Amezcua C, Pulley LV, Stern MP, Mercado S. Smoking cessation in Texas-Mexico border communities: a quasi-experimental panel study. American Journal of Health Promotion 1992;6(4):274-9.
  • Ramirez AG, McAlister AL. Mass media campaign--A Su Salud. Preventive Medicine 1988;17(5):608-21.
Barber 1990 {published data only}
Boyd 1998 {published data only}
  • Boyd NR, Sutton C, Orleans CT, McClatchey MW, Bingler R, Fleisher L, et al. Quit Today! A targeted communications campaign to increase use of the cancer information service by African American smokers. Preventive Medicine 1998;27(5 Pt 2):S50-60.
Brownson 1996 {published data only}
  • Brownson RC, Smith CA, Pratt M, Mack N, Jackson-Thompson J, Dean CG, et al. Preventing cardiovascular disease through community-based risk reduction: The Bootheel Heart Health Project. American Journal of Public Health 1996;86(2):206-13.
Chicago I 1989 {published data only}
Chicago II 1992 {published data only}
  • Flay BR, McFall S, Burton D, Cook TD, Warnecke RB. Health behavior changes through television: the roles of de facto and motivated selection processes. Journal of Health and Social Behavior 1993;34(4):322-35.
  • Warnecke RB, Flay BR, Kviz FJ, Gruder CL, Langenberg P, Crittenden KS, et al. Characteristics of participants in a televised smoking cessation intervention. Preventive Medicine 1991;20(3):389-403.
  • Warnecke RB, Langenberg P, Wong SC, Flay BR, Cook TD. The second Chicago televised smoking cessation program: a 24-month follow-up. American Journal of Public Health 1992;82(6):835-40.
Chow 2009 {published data only}
  • Chow CK, Joshi R, Gottumukkala AK, Raju K, Raju R, Reddy S, Macmahon S, Neal B. Rationale and design of the Rural Andhra PradeshCardiovascular Prevention Study (RAPCAPS):A factorial, cluster-randomized trial of 2 practical cardiovascular disease prevention strategies developed for rural Andhra Pradesh, India. Am Heart J 2009;158(3):349-55.
  • Joshi R, Chow CK, Raju PK, Raju KR, Gottumukkala AK, Reddy KS, Macmahon S, Heritier S, Li Q, Dandona R, Neal B. The Rural Andhra Pradesh Cardiovascular Prevention Study (RAPCAPS): a cluster randomized trial.. J Am Coll Cardiol 2012;59(13):1188-96.
Coeur en sante 1999 {published data only}
  • O'Loughlin J, Paradis G, Kishchuk N, Gray-Donald K, Renaud L, Fines P, et al. Coeur en sante St-Henri - a heart health promotion program in Montreal, Canada: design and methods for evaluation. Journal of Epidemiology and Community Health 1995;49:495-502.
  • O'Loughlin J, Paradis G, Meshefedijan G. Evalution of two strategies for heart health promotion by direct mail in a low-income urban community. Preventive Medicine 1997;26:745-53.
  • O'Loughlin JL, Paradis G, Gray-Donald K, Renaud L. The impact of a community-based heart disease prevention program in a low-income, inner-city neighborhood. American Journal of Public Health 1999;89:1819-26.
  • Paradis G, O'Loughlin J, Elliot M. Coeur en sante St-Henri - a heart health promotion program in a low income, low education neighborhood in Montreal, Canada: theoretical model and early field experience. Jounral of Epidemiology and Community Health 1995;49:503-12.
COMMIT 1995 {published data only}
  • Hyland A, Wakefield M, Higbee C, Szczypka G, Cummings KM. Anti-tobacco television advertising and indicators of smoking cessation in adults: a cohort study. Health Education Research 2006;21(2):296-302.
  • Sciandra RC, Wallack L, Johnson CL, Sadlik J, Thompson J. Activities to involve the smoking public in tobacco control in COMMIT. NIH Smoking and Tobacco Control Monograph No 6, Chapter 6. National Institute for Health, 1995.
  • The COMMIT Research Group. Community Intervention Trial for Smoking Cessation (COMMIT): I. Cohort Results from a Four-Year Community Intervention. American Journal of Public Health 1995;85(2):183-92.
  • The COMMIT Research Group. Community Intervention Trial for Smoking Cessation (COMMIT): II. Changes in adult cigarette smoking prevalence. American Journal of Public Health 1995;85(2):193-200.
  • Wallack L, Sciandra R. Media advocacy and public education in the Community Intervention Trial to Reduce Heavy Smoking (COMMIT). International Quarterly of Community Health Education 1990-1991;11(3):205-22.
Cummings 1987 {published data only}
Cummings 1993 {published data only}
  • Cummings KM, Sciandra R, Davis S, Rimer BK. Results of an antismoking media campaign utilizing the Cancer Information Service. Journal of the National Cancer Institute Monograph 1993;14:113-8.
  • Davis SW, Cummings KM, Rimer BK, Sciandra R, Stone JC. Response to anti-smoking campaign aimed at mothers with young children. Health Education and Research 1989;4:429-37.
Danaher 1984 {published data only}
Davidson 1990 {published data only}
  • Davidson M. Wake up. Quit! The use of mass media and community participation to reduce smoking prevalence among young adults. Drug Education Journal of Australia 1990;4(2):151-7.
Donovan 1984 {published data only}
  • Donovan RJ, Fisher DA, Armstrong BK. "Give it away for a day": an evaluation of Western Australia's first smoke free day. Community Health Studies 1984;8:301-6.
Doxiadis 1985 {published data only}
  • Doxiadis SA, Trihopoulos DV, Phylactou HD. Impact of a nationwide anti-smoking campaign. Lancet 1985;2(8457):712-3.
Dubren 1977 {published data only}
Dyer 1983 {published data only}
  • Dyer N. Evaluation of the BBC TV series "So you want to stop smoking". Conference on Smoking and Health, Fifth World Congress, Winnipeg Canada. 1983.
  • Dyer N. Smokers' Luck: Can a "shocking" programme change attitudes to smoking?. Addictive Behaviors 1983;8(1):43-6.
Eiser 1978 {published data only}
  • Eiser JR, Rutton SR, Wober M. Can television influence smoking? Further evidence. British Journal of Addiction to Alcohol and Other Drugs 1978;73(3):291-8.
  • Eiser JR, Sutton SR, Wober M. Can television influence smoking?. British Journal of Addiction to Alcohol and Other Drugs 1978;73(2):215-9.
Etter 2005 {published data only}
Etter 2007 {published data only}
EX campaign 2010 {published data only}
  • Duke J, Vallone D, Mowery P, McCausland K, Xiao H, Asche E, et al. LEGACY’S EX: Implementation and evaluation of a smoking cessation campaign. Annals of Behavioral Medicine 2008;35(1 Suppl):Paper Session 20.
  • Vallone DM, Duke JC, Cullen J, McCausland KL, Allen JA. Evaluation of EX: A National Mass Media Smoking Cessation Campaign. American Journal of Public Health 2011;101:302–9.
  • Vallone DM, Duke JC, Mowery PD, McCausland KL, Xiao H, Costantino JC, et al. The impact of EX® Results from a pilot smoking-cessation media campaign. American Journal of Preventive Medicine 2010;38(3 Suppl):S312–8.
  • Vallone DM, Niederdeppe J, Kalaydjian Richardson A, Patwardhan P, Niaura R, Cullen J. A national mass media smoking cessation campaign: Effects by race/ethnicity and education. American Journal of Health Promotion 2011;25(5 Suppl):S38–50.
Frith 1997 {published data only}
  • Frith C, Roberts C, Kingdon A, Tudor-Smith C. An evaluation of the 1996 No Smoking Day in Wales. Health Education Journal 1997;56:287-95.
GASO 2002 {published data only}
  • Centers for Disease Control and Prevention. Impact of promotion of the Great American Smokeout and availability of over-the-counter nicotine medications, 1996. Morbidity & Mortality Weekly Report 1997;46(37):867-71.
  • Freels SA, Warnecke RB, Johnson TP, Flay BR. Evaluation of the effects of a smoking cessation intervention using the multilevel thresholds of change model. Evaluation Review 2002;26(1):40-58.
  • Gritz ER, Carr CR, Marcus AC. Unaided smoking cessation: Great American Smokeout and new year's day quitters. Special Issue: Clinical research issues in psychosocial oncology. Journal of Psychosocial Oncology 1988;6:217-34.
  • Hantula DA, Stillman FA, Waranch HR. Can a mass-media campaign modify tobacco smoking in a large organization? Evaluation of the Great American Smokeout in an urban hospital. Journal of Organizational Behavior Management 1992;13(1):33-47.
Gredler 1981 {published data only}
  • Gredler B, Kunze M. Impact of a national campaign on smoking attitudes and patterns in Austria. International Journal of Health Education 1981;24:271-9.
  • Gredler B, Kunze M. You can do without smoking - a mass media campaign in Austria. Conference: Smoking and Health, Fifth World Congress, Winnipeg, Manitoba, Canada, 10-15 Jul. 1983. [: World Meeting Number 833 0083]
Heartbeat Wales 1998 {published data only}
  • Nutbeam D, Catford J. The Welsh Heart Programme evaluation strategy: progress, plans and possibilities. Health Promotion 1987;2(1):5-18.
  • Nutbeam D, Smith C, Murphy S, Catford J. Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study. Journal of Epidemiology and Community Health 1993;47:127-33.
  • Tudor Smith C, Nutbeam D, Moore L, Catford J. Effects of the Heartbeat Wales programme over five years on behavioural risks for cardiovascular disease: quasi-experimental comparison of results from Wales and a matched reference area. BMJ 1998;316(7134):818-22.
HEBS 1997 {published data only}
  • Donnan PT, Watson J, Platt S, Tannahill A, Raymond M. Predictors of successful quitting: findings from a six-month evaluation of Smokeline campaign. Journal of Smoking Related Disorders 1994;5(suppl 1):271-6.
  • Platt S, Tannahill A, Watson J, Fraser E. Effectiveness of antismoking telephone helpline: follow up survey. BMJ 1997;314(7091):1371-5.
  • Ratcliffe J, Cairns J, Platt S. Cost effectiveness of a mass media-led anti-smoking campaign in Scotland. Tobacco Control 1997;6(2):104-10.
Hill 2003 {published data only}
  • Borland R, Balmford J. Understanding how mass media campaigns impact on smokers. Tobacco Control 2003;12(Suppl II):ii45-ii52.
  • Carroll T, Rock B. Generating Quitline calls during Australia's National Tobacco Campaign: effect of television advertisement execution and programme placement. Tobacco Control 2003;12(Suppl II):ii40-ii44.
  • Donovan RJ, Boulter J, Borland R, Jalleh G, Carter O. Continuous tracking of the Australian National Tobacco Campaign: advertising effects on recall, recognition, cognitions, and behaviour. Tobacco Control 2003;12(Suppl II):ii30-ii39.
  • Hill D, Carroll T. Australia's National Tobacco Campaign. Tobacco Control 2003;12(Suppl II):ii9-ii14.
  • Hurley SF, Matthews JP. Cost-effectiveness of the Australian National Tobacco Campaign. Tobacco Control 2008;17:379–84.
  • Miller CL, Wakefield M, Roberts L. Uptake and effectiveness of the Australian telephone Quitline service in the context of a mass media campaign. Tobacco Control 2003;12(Suppl II):ii53-ii58.
  • Wakefield M, Freeman J, Donovan R. Recall and response of smokers and recent quitters to the Australian National Tobacco Campaign. Tobacco Control 2003;12(Suppl II):ii15-ii22.
  • Wakefield MA, Durkin S, Spittal MJ, Siahpush M, Scollo M, Simpson JA, et al. Impact of tobacco control policies and mass media campaigns on monthly adult smoking prevalence. American Journal of Public Health 2008;98:1443–50.
Hunkeler 1990 {published data only}
  • Hunkeler EF, Davis EM, McNeil B, Powell JW, et al. Richmond quits smoking: a minority community fights for health. In: Bracht N editor(s). Health promotion at the community level. Newbury Park (CA): Sage Publications, 1990.
IHHP 2003 {published data only}
  • Mohammadifard N, Kelishadi R, Safavi M, Sarrafzadegan N, Sajadi F, Sadri GH, Maghroon M, Alikhasi H, Heydari S, Sarmadi F. Effect of a community-based intervention on nutritional behaviour in a developing country setting: the Isfahan Healthy Heart Programme.. Public Health Nutr 2009;12(9):1422-30.
  • Sarraf-Zadegan N, Sadri G, Malek Afzali H, Baghaei M, Mohammadi Fard N, Shahrokhi S, et al. Isfahan Healthy Heart Programme: A comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta Cardiologica 2003;58(4):309-20.
  • Sarrafzadegan N, Kelishadi R, Esmaillzadeh A, Mohammadifard N, Rabiei K, Roohafza H, Azadbakht L, Bahonar A, Sadri G, Amani A, Heidari S, Malekafzali H. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran.. Bull World Health Organ 2009;87(1):39-50.
Jason 1988 {published data only}
  • Jason LA, Tait E, Goodman D, Buckenberger L, Gruder CL. Effects of a televised smoking cessation intervention among low-income and minority smokers. American Journal of Communit Psychology 1988;16(6):863-76.
Laugesen 2000 {published data only}
Ledwith 1984 {published data only}
  • Ledwith F. Immediate and delayed effects of postal advice on stopping smoking. Health Bulletin 1984;42(6):332-44.
  • Ledwith, F. Effectiveness of the leaflet and individualized postal advice in aiding smoking cessation with large numbers of smokers. Conference: Smoking and Health, Fifth World Congress, Winnipeg, Manitoba, Canada, 10-15 Jul. 1983. [: World Meeting Number 833 0083]
Le Net 1977 {published data only}
  • Le Net M. [Evaluation of a national campaign against smoking (France)] [Evaluation d'une campagne nationale contrel'abus du tabac (France)]. Sozial und Praventivmedizin 1977;22(5):263-75.
Leroux 1983 {published data only}
  • Leroux RS, Miller ME. Electronic media-based smoking cessation clinic, in the USA. Hygie 1983;2(1):23-37.
Lichtenstein 2008 {published data only}
  • Lichtenstein E, Boles SM, Lee ME, Hampson SE, Glasgow RE, Fellows J. Using radon risk to motivate smoking reduction II: randomized evaluation of brief telephone counseling and a targeted video. Health Education Research 2008;23(2):191-201.
McAlister 2006 {published data only}
  • McAlister AL, Huang P, Ramirez AG. Settlement-funded tobacco control in Texas: 2000-2004 pilot project effects on cigarette smoking. Public Health Reports 2006;121:235-8.
MHHP 1995 {published data only}
  • Dean AG, Shultz JM, Gust SW, Harty KC, Moen ME. Minnesota plan for nonsmoking and health: multidisciplinary approach to risk factor control. Public Health Reports 1986;101(3):270-7.
  • Glasgow RE, Klesges RC, Mizes JS, Pechacek TF. Quitting smoking: strategies used and variables associated with success in a stop-smoking contest. Journal of Consulting and Clinical Psychology 1985;53(6):905-12.
  • Harty KC. Animals and butts: Minnesota's media campaign against tobacco. Tobacco Control 1993;2:271-4.
  • Jacobs DR Jr, Luepker RV, Mittelmark MB, Folsom AR, Pirie PL, Mascioli SR, et al. Community-wide prevention strategies: Evaluation design of the Minnesota Heart Health Program. Journal of Chronic Diseases 1986;39(10):775-88.
  • Lando HA, Pechacek TF, Fruetel J. The Minnesota Heart Health Program Community Quit and Win Contests. American Journal of Health Promotion 1994;9(2):85-7,124.
  • Lando HA, Pechacek TF, Pirie PL, Murray DM, Mittelmark MB, Lichtenstein E, et al. Changes in adult cigarette smoking in Minnesota Heart Health Program. American Journal of Public Health 1995;85(2):201-8.
  • Luepker RV. An update and review of the Minnesota Heart Health Program. Annals of Epidemiology 1993;3(Suppl 5):S8-S12.
  • Luepker RV, Murray DM, Jacobs DR Jr, Mittelmark MB, Bracht N, Carlaw R, et al. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. American Journal of Public Health 1994;84(9):1383-93.
  • Mittelmark MB, Luepker RV, Jacobs DR, Bracht NF, Carlaw RW, Crow RS, et al. Community-wide prevention of cardiovascular disease: education strategies of the Minnesota Heart Health Program. Preventive Medicine 1986;15(1):1-17.
  • Pavlik J, Finnegan JR, Strickland D, Salmon CT, Viswanath K, Wackman DB. Increasing public understanding of heart disease: an analysis of data from the MHHP. Health Communication 1993;5:1-20.
Millar 1987 {published data only}
  • Millar WJ, Naegele BE. Time to quit: community involvement in smoking cessation. Canadian Journal of Public Health 1987;78(2):109-14.
Minnesota 2011 {published data only}
  • Centers for Disease Control and Prevention (CDC). Decrease in smoking prevalence--Minnesota, 1999 - 2010. MMWR. Morbidity and Mortality Weekly Report 2011;60(5):138-41.
Mudde 1995 {published data only}
Mudde 1999 {published data only}
Multicity 1997 {published data only}
  • Cernada GP, Darity WA, Chen TTL, Winder AE, Benn S, Jackson R, et al. Mass media usage among black smokers: a first look. Interantional Quarterly of Community Health Education 1989;10(4):347-64.
  • Darity WA, Tuthill RW, Winder AE, Cernada GP, Chen TTL, Buchanan DR, et al. A multi-city community based smoking research intervention project in the African-American population. International Quarterly of Community Health Education 1997;17(2):117-30.
New York {published data only}
  • Center for Disease Control and Prevention. Decline in Smoking Prevalence - New York City, 2002 - 2006. MMWR: Morbidity and Mortality Weekly Report 2007;56(24):604-8.
  • Coady MH, Jasek J, Davis K, Kerker B, Kilgore EA, Perl SB. Changes in smoking prevalence and number of cigarettes smoked per day following the implementation of a comprehensive tobacco control plan in New York City. Journal of Urban Health 2012;89(5):802-8. [DOI: doi:10.1007/s11524-012-9683-9]
  • Davis KC, Farrelly MC, Duke J, Kelly L, Willett J. Antismoking media campaign and smoking cessation outcomes, New York State, 2003 - 2009. Preventing Chronic Disease 2012;9:E40.
  • Farrelly MC, Davis KC, Nonnemaker JM, Kamyab K, Jackson C. Promoting calls to a quitline: quantifying the influence of message theme, strong negative emotions and graphic images in television advertisements. Tobacco Control 2011;20(4):279-84.
  • Farrelly MC, Duke JC, Davis KC, Nonnemaker JM, Kamyab K, Willett JG, et al. Promotion of smoking cessation with emotional and/or graphic antismoking advertising. American Journal of Preventive Medicine 2012;43(5):475-82.
North Karelia 1998 {published data only}
  • Korhonen T, Uutela A, Korhonen HJ, Puska P. Impact of mass media and interpersonal health communication on smoking cessation attempts: a study in North Karelia, 1989-1996. Journal of Health Communication 1998;3(2):105-18.
  • Puska P, Nissinen A, Tuomilehto J, Salonen JT, Koskela K, McAlister A, et al. The community-based strategy to prevent coronary heart disease: conclusions from the ten years of the North Karelia project. Annual Review of Public Health 1985;6:147-93.
  • Vartiainen E, Puska P, Jousilahti P, Korhonen HJ, Tuomilehto J, Nissinen A. Twenty-year trends in coronary risk factors in north Karelia and in other areas of Finland. Interantional Journal of Epidemiology 1994;23:495-504.
Oregon 1999 {published data only}
Osler 1993 {published data only}
  • Osler M, Jespersen NB. The effect of a community-based cardiovascular disease prevention project in a Danish municipality. Danish Medical Bulletin 1993;40(4):485-9.
Pallonen 1994 {published data only}
  • Pallonen UE, Leskinen L, Prochaska JO, Willey CJ, Kaariainen R, Salonen JT. A 2-year self-help smoking cessation manual intervention among middle-aged Finnish men: an application of the transtheoretical model. Preventive Medicine 1994;23(4):507-14.
Perkins 1986 {published data only}
  • Perkins KA, Scott RR. A low-cost environmental intervention for reducing smoking among cardiac patients. International Journal of the Addictions 1986;21(11):1173-82.
Programa Latino 1994 {published data only}
  • Marin BV, Perez-Stable EJ, Marin G, Hauck WW. Effects of a community intervention to change smoking behavior among Hispanics. American Journal of Preventive Medicine 1994;10(6):340-7.
  • Marin G, Marin BV, Perez-Stable EJ, Sabogal F, Otero-Sabogal R. Changes in information as a function of a culturally appropriate smoking cessation community intervention for Hispanics. American Journal of Community Psychology 1990;18:847-64.
  • Perez-Stable EJ, Marin BV, Marin G. A comprehensive smoking cessation program for the San Francisco Bay area Latino community: Programa Latino para dejar de fumar. American Journal of Health Promotion 1993;7(6):430-42.
Sansores 2002 {published data only}
  • Sansores RH, Giraldo-Buitrago F, Valdelamar-Vazquez F, Ramirez-Venegas A, Sandoval RA. The impact of mass media on an anti-tobacco campaign. Salud Publica Mexico 2002;44(Suppl 1):S101-S108.
Secker-Walker 2000 {published data only}
  • Secker-Walker RH, Flynn BS, Solomon LJ, Skelly JM, Dorwaldt AL, Ashikaga T. Helping Women Quit Smoking: Results of a Community Intervention Program. American Journal of Public Health 2000;90(6):940-6.
Sogaard 1992 {published data only}
Stanford 5 City 2000 {published data only}
  • Farquhar JW, Fortmann SP, Flora JA, Taylor CB, Haskells WI, Williams PT, et al. Effects of communitywide education on cardiovascular disease risk factors.The Stanford Five-City Project. JAMA 1990;264(3):359-65.
  • Farquhar JW, Fortmann SP, Maccoby N, Haskells WL, Williams PT, Flora JA, et al. The Stanford Five-City Project: design and methods. American Journal of Epidemiology 1985;122:323-34.
  • Fortmann SP, Taylor CB, Flora JA, Jatulis DE. Changes in adult cigarette smoking prevalence after 5 years of community health education: the Stanford Five-City Project. American Journal of Epidemiology 1993;137(1):82-96.
  • Fortmann SP, Varady AN. Effects of a community-wide health education program on cardiovascular disease morbidity and mortality: The Stanford Five-City Project. American Journal of Epidemiology 2000;152(4):316-23.
  • Jackson C, WInkleby MA, Flora JA. Use of educational resources for cardiovascular risk reduction in the Stanford Five Cit Project. American Journal of Preventive Medicine 1991;7:82-8.
  • Rimal RN, Flora JA, Schooler C. Achieving improvements in overall health orientation: Effects of campaign exposure, information seeking and health media use. Communication Research 1999;26(3):322-48.
  • Sallis JF, Flora JA, Fortmann SP, Taylor CB, Maccoby N. Mediated smoking cessation programs in the Stanford Five-City Project. Addictive Behaviors 1985;10(4):441-3.
  • Schooler C, Flora JA, Farquar JW. Moving Project toward synergy: media supplementation in the Stanford Five City. Communication Research 1993;20(4):587-610.
  • Winkleby MA, Flora JA, Kraemer HC. A community based heart disease intervention: predictors of change. American Journal of Public Health 1994;84(5):767-72.
  • Winkleby MA, Taylor CB, Jatulis D. The long-term effects of a cardiovascular disease prevention trial: the Stanford Five City Project. American Journal of Public Health 1996;86(12):1773-9.
Stevens 2002 {published data only}
  • Stevens W, Thorogood M, Kayikki S. Cost-effectiveness of a community anti-smoking campaign targeted at a high risk group in London. Health Promotion International 2002;17(1):43-50.
Sussman 1994 {published data only}
  • Sussman S, Dent CW, Wang E, Cruz NT, Sanford D, Johnson CA. Participants and nonparticipants of a mass media self-help smoking cessation program. Addictive Behaviors 1994;19(6):643-54.
Sutton 1987 {published data only}
  • Hallett R, Sutton SR. Factors influencing the decision to attempt to stop smoking in a media-based smoking intervention programme. Health Education Research 1986;1(3):163-73.
  • Sutton SR, Hallett R. Experimental evaluation of the BBC TV series "So You Want To Stop Smoking?". Addictive Behaviors 1987;12(4):363-6.
Terry-McElrath 2013 {published data only}
  • Terry-McElrath YM, Emery S, Wakefield MA, O'Malley PM, Szczypka G, Johnston LD. Effects of tobacco-related media campaigns on smoking among 20-30-year-old adults: longitudinal data from the USA. Tobacco Control 2013;22(1):38-45.
TV Finland 1992 {published data only}
  • Korhonen H J, Puska P, Lipand A, Kasmel A. Combining mass media and contest in smoking cessation. An experience from a series of national activities in Finland. Hygie 1993;12(1):15.
  • Korhonen HJ, Niemensivu H, Piha T, Koskela K, Wiio J, Johnson CA, et al. National TV smoking cessation program and contest in Finland. Preventive Medicine 1992;21(1):74-87.
  • Koskela K, Puska P, Smolander A. Use of TV in national smoking reduction in Finland. Conference: Smoking and Health, Fifth World Congress, Winnipeg, Manitoba, Canada, 10-15 Jul. 1983. [: World Meeting Number 833 0083]
  • McAlister A, Puska P, Koskela K, Pallonen U, Maccoby N. Mass communication and community organization for public health education. The American Psychologist 1980;35(4):375-9.
  • Puska P, Koskela K, McAlister A, Pallonen U, Vartiainen H, Homan K. A comprehensive television smoking cessation program in Finland. International Journal of Health Education 1979;22(Suppl):1-29.
  • Puska P, Wiio J, McAlister A, Koskela K, Smolander A, Pekkola J, et al. Planned use of mass media in national health promotion: the "Keys to Health" TV program in 1982 in Finland. Canadian Journal of Public Health 1985;76(5):336-42.
Valois 1996 {published data only}
  • Valois RF, Adams KG, Kammermann SK. One-year evaluation results from CableQuit: a community cable television smoking cessation pilot program. Journal of Behavioral Medicine 1996;19(5):479-99.
Van Assema 1994 {published data only}
Webb 2009 {published data only}
  • Webb MS. Culturally specific interventions for African American smokers: An efficacy experiment. Journal of the National Medical Association 2009;101:927-35.
Wewers 1991 {published data only}
Wheeler 1988 {published data only}

Additional references

  1. Top of page
  2. Abstract
  3. Background
  4. Objectives
  5. Methods
  6. Results
  7. Discussion
  8. Authors' conclusions
  9. Acknowledgements
  10. Data and analyses
  11. Appendices
  12. What's new
  13. History
  14. Contributions of authors
  15. Declarations of interest
  16. Sources of support
  17. Characteristics of studies
  18. References to studies included in this review
  19. References to studies excluded from this review
  20. Additional references
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