Examining the impact of the tobacco industry’s court-ordered anti-smoking advertisements

During the past three years, you may have seen anti-smoking advertisements sponsored by the tobacco industry on television, in newspapers, on tobacco company websites and on cigarette product packaging. These “corrective statements” were mandated by U.S. District Judge Gladys Kessler in a landmark case against major U.S. tobacco companies.

Our researchers are studying the impact of the ads on U.S. adult smokers. Last year, the team, led by senior author Sanjay Shete, Ph.D., professor of Biostatistics and Epidemiology and deputy division head of Cancer Prevention and Population Sciences, and Onyema Greg Chido-Amajuoyi, M.B.B.S., postdoctoral fellow in Epidemiology, published findings in JAMA Network Open showing that the television and newspaper ads reached just 40.6% of U.S. adults and 50.5% of current smokers in 2018.

Today, they published a new study in JAMA Network Open examining the impact of the expanded ads on quit intentions and quit attempts among current U.S. smokers. We caught up with the researchers to learn more about their work.

Are the court-ordered anti-smoking advertisements reaching the right people?

Shete: We found that the overall reach has improved in the general population. Although the ads reached over 66% of current smokers, the reach was poor among Hispanic smokers (43%) and lower-income smokers (57%).

Chido-Amajuoyi: The ads still reached less than 50% of the general public. It’s important for the general population to see the ads as well because there are individuals who aren’t smoking now, but may be at risk of future initiation.

What impact did you find the ads had on people who smoke?

Shete: We looked at individual impacts to see if the ads led to any behavior changes. Our key questions were: Are the ads associated with an intention to quit smoking? And, are the ads associated with an attempt to quit smoking? We found that if you had just seen one ad, the impact was minimal. But if you saw multiple ads, you were more likely to have intentions to quit smoking.

Chido-Amajuoyi: Although we found that people who saw multiple ads had intentions to quit, there was no statistical significance in terms of helping individuals actually actively quit smoking. The spectrum for behavioral change begins with having an intention to quit smoking. People who make a quit attempt are further along the spectrum. If all current smokers in the U.S. were exposed to multiple anti-smoking ads, we estimate an additional 3.9 million people would have intentions to quit smoking.

What lessons can be learned from these ads for future anti-smoking campaigns?

Shete: Through years of litigation, the tobacco companies substantially modified the original, more potent version of the ads before they were released, weakening the anti-smoking messages. For example, the tobacco companies successfully fought to have the phrase “here is the truth” removed from the ads. When tobacco companies advertise pro-smoking messages, those ads are quite visually appealing. However, their anti-smoking ads are less engaging. The goal of these ads should be to sustain viewers’ attention, not to bore them. The media landscape has also changed since the 2006 court ruling that ordered these ads. Social media is more prevalent now and should be included in future anti-smoking campaigns.

Chido-Amajuoyi: Another way these ads differ from more successful anti-smoking campaigns, such as Tips From Former Smokers®, is the lack of testimonials from people who used tobacco and now have cancer or other health problems. Future industry anti-smoking campaigns should include first-hand perspectives from former smokers about why individuals shouldn’t smoke.

Are there any takeaways from this study that can be applied to anti-vaping efforts?

Shete: The e-cigarette industry is highly unregulated, and there’s a lot to be learned. But the same tobacco industry players are also behind the vaping industry. We’re planning to develop a study to see if these ads have any impact on vaping behaviors as well, which could help inform future anti-vaping campaigns.

What do people who currently smoke need to know about attempting to quit?

Shete: Smoking is a major addiction and remains the leading cause of cancer. Quitting smoking is one the best things smokers can do to improve their health.

If you’re attempting to quit, the first thing you should do is to communicate with your primary health care provider to learn about resources and effective, evidence-based tools for smoking cessation.

Health care providers should also be routinely asking patients about their tobacco use. If a health care provider not only offers tools and resources, but also arranges appointments with a cessation counselor, it increases the chances of the patient successfully quitting.   

Chido-Amajuoyi: The bottom line is that it can be challenging to quit, but it is possible, and help is widely available. 

If someone is thinking about quitting smoking, what are some good resources for the next step in their quit journey?

Shete: Call 800-QUIT-NOW (800-784-8669) or visit smokefree.gov to be connected to your state’s quitline and talk to a counselor specifically trained to help you quit smoking. MD Anderson also offers a Tobacco Treatment Program for patients and employees, as well as tobacco cessation studies for Texas residents.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.