HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (22) Citing Articles via Google Scholar Google Scholar Articles by Niederdeppe, J. Articles by Haviland, M. L. Search for Related Content PubMed PubMed Citation Articles by Niederdeppe, J. Articles by Haviland, M. L. Related Collections Tobacco Control Media Prevention Other Tobacco

Jeff Niederdeppe, MA, Matthew C. Farrelly, PhD and M. Lyndon Haviland, DrPH

Jeff Niederdeppe and Matthew C. Farrelly are with RTI International, Research Triangle Park, NC. M. Lyndon Haviland is with the American Legacy Foundation, Washington, DC.

Correspondence: Requests for reprints should be sent to Jeff Niederdeppe, MA, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC 27612 (e-mail: jniederdeppe{at}rti.org).

	ABSTRACT

TOP ABSTRACT INTRODUCTION METHODS RESULTS DISCUSSION References

 

This study provides additional evidence that Florida’s "truth" tobacco countermarketing campaign was successful in reducing smoking among Florida teens. Smoking rates were substantially lower among Florida teens between fall 2001 and spring 2002, whereas previous studies found that smoking rates were comparable before the launch of "truth." Florida teens had higher levels of "truth" campaign awareness and were more likely to agree with campaign-targeted beliefs; 2 of these beliefs were the only items associated with current smoking.

	INTRODUCTION

TOP ABSTRACT INTRODUCTION METHODS RESULTS DISCUSSION References

 
The Florida Tobacco Control Program began in April 1998 with the launch of the "truth" countermarketing campaign, which was funded by Florida’s 1997 settlement with the tobacco industry. "truth" messages have described the tobacco industry’s purposeful attempts to market a harmful product to teens and its denial of cigarettes’ addictive and deadly effects. "truth" also has sought to empower teens by urging them to join the statewide youth antitobacco group, Students Working Against Tobacco, to disseminate campaign messages interpersonally, and to rally support for tobacco control policy. Florida youth smoking rates declined rapidly,¹ and evidence suggests that the "truth" campaign contributed to these reductions in the first year of the program.^2,3 However, the program has faced substantial budget cuts in recent years.⁴ In this report, we provide additional evidence of the success of Florida’s tobacco countermarketing campaign more than 2 years into the program using data from the Legacy Media Tracking Survey (LMTS), a national survey of teens that includes a large sample from Florida.

Published reports indicate that Florida teens and their national counterparts (excluding states with comprehensive programs) had comparable industry beliefs and smoking behavior before the launch of the Florida Tobacco Control Program (42.1% of Florida teens were lifetime smokers and 13.8% were current smokers; nationally, the figures were 40.7% and 12.6%, respectively).² The national "truth" campaign, modeled closely after Florida’s "truth" campaign and featuring a similar counterindustry message strategy, was debuted in early 2000 and was responsible for notable changes in beliefs about the tobacco industry and smoking intentions. However, the magnitude of effects was consistent across states.⁵ Thus, any differences observed in Florida in late 2000 and early 2001 are probably attributable to the efforts of the state campaign.

A possible campaign effect can be inferred if the following are found to exist: (1) campaign awareness was higher among Florida youths, (2) Florida youths held stronger campaign-targeted attitudes and beliefs, (3) nontargeted attitudes and beliefs were comparable among Florida teens and among teens nationwide, and (4) campaign-targeted attitudes and beliefs were strongly associated with smoking behavior among Florida teens.⁶

	METHODS

TOP ABSTRACT INTRODUCTION METHODS RESULTS DISCUSSION References

 
The LMTS, a national random-digit-dialed telephone survey of teens and young adults sampled from US households, was designed to gauge the effectiveness of the American Legacy Foundation’s national "truth" campaign (see Farrelly et al.⁵ for a description of the methodology). In addition, representative samples were drawn from states with existing countermarketing campaigns (including Florida) to examine potential synergies with the national "truth" campaign. The number of surveys conducted between fall 2000 and spring 2001 permit comparisons between Florida teens aged 12 to 17 years (n = 1097) and teens from states without established comprehensive tobacco control programs (n = 6381; excludes respondents from Arizona, California, Massachusetts, Mississippi, and Oregon). Florida and national samples were comparable in the distribution of age and gender, although the Florida sample contained a higher proportion of African Americans and Hispanics. All analyses were weighted to adjust for age and oversampling by racial/ethnic group and residence in countermarketing campaign states. Standard error calculations were adjusted for racial/ethnic group and geographic oversampling.

The LMTS measured current smoking, lifetime smoking, smoking intentions, and awareness of the "truth" campaign, antismoking groups, and school-based tobacco education. In addition, the LMTS asked youths how strongly they agreed or disagreed (on a 5-point scale) with a series of belief statements about cigarette companies and the social and physical effects of smoking. Belief items were recoded 1 ("agree" or "strongly agree") or 0 (all other responses) for logistic regression analysis (reverse coded where noted).

We began by comparing Florida and national teens on smoking intentions and behavior and contrast levels of program awareness. Next, we compared levels of agreement with 4 beliefs about cigarette companies and 8 beliefs about the social and physical effects of smoking. We tested the independent associations between specific beliefs and current smoking, controlling for demographics and other known predictors of smoking, using logistic regression.

	RESULTS

TOP ABSTRACT INTRODUCTION METHODS RESULTS DISCUSSION References

 
Florida teens were less likely than their national counterparts to have smoked in the past 30 days, to have ever tried smoking, or to indicate that they could not rule out the possibility of smoking in the future (among never smokers) (Table 1). Florida teens also had substantially higher levels of "truth" and antitobacco group awareness than their national counterparts. Florida teens reported less favorable beliefs than youths nationwide about the tobacco industry but similar beliefs about the social and physical effects of smoking. Only 2 belief items, those central to "truth" campaign messages, were significant predictors of current smoking among Florida teens (Table 2).

	DISCUSSION

TOP ABSTRACT INTRODUCTION METHODS RESULTS DISCUSSION References

It is impossible to determine whether changes in beliefs preceded changes in smoking behavior owing to the cross-sectional nature of this study, and the magnitude of differences in industry beliefs between Florida teens and teens nationwide was relatively small compared with the magnitude of differences in current smoking. However, a recent longitudinal study found that Florida teens with high levels of counterindustry attitudes were 4 times less likely to initiate smoking, and more than 13 times less likely to become established smokers, than were teens with low levels of counterindustry attitudes.⁷ In addition, the success of a Massachusetts antitobacco campaign in reducing the likelihood of smoking uptake by 50% among 12- to 13-year-olds also suggests that countermarketing campaigns can reduce youth smoking substantially.⁸ These studies suggest that industry beliefs can precede changes in behavior, and they imply that the magnitude of differences in industry beliefs observed in the LMTS could lead to the observed differences in smoking behavior.

	Acknowledgments

 
This research was supported by the American Legacy Foundation.

We thank Terry Pechacek and Jeffrey McKenna for inspiring this analysis and David Sly for his contributions to the design of the survey questionnaire and methodology. We are also grateful to Don Akin for sample design and variance estimation and to Susan Murchie for editorial review.

Human Participant Protection
All questionnaires and consent forms were reviewed and approved by RTI International’s institutional review board (MPA M-1496).

	Footnotes

 
Contributors
J. Niederdeppe helped direct analyses, conducted all analyses, and prepared the original brief. M. C. Farrelly designed the survey questionnaire and methodology, helped direct analyses, and participated in preparing the original brief. M. L. Haviland participated in preparing the final brief.

Peer Reviewed

Accepted for publication June 19, 2003.

	References

TOP ABSTRACT INTRODUCTION METHODS RESULTS DISCUSSION References

 
1. Bauer UE, Johnson TM, Hopkins RS, Brooks RG. Changes in youth cigarette use and intentions following implementation of a tobacco control program: findings from the Florida youth tobacco survey, 1998–2000. JAMA. 2000;284:723–728.[Abstract/Free Full Text]

2. Sly DF, Heald GR, Ray S. The Florida "truth" anti-tobacco media evaluation: design, first year results, and implications for planning future state media evaluations. Tob Control. 2001;10:9–15.[Abstract/Free Full Text]

3. Sly DF, Hopkins RS, Trapido E, Ray S. Influence of a counteradvertising media campaign on initiation of smoking: the Florida "truth" campaign. Am J Public Health. 2001;91:233–238.[Abstract]

4. Givel MS, Glantz SA. Failure to defend a successful state tobacco control program: policy lessons from Florida. Am J Public Health. 2000;90:762–767.[Abstract/Free Full Text]

5. Farrelly MC, Healton CH, Davis KC, Messeri P, Hersey JC, Haviland ML. Getting to the truth: evaluating national tobacco countermarketing campaigns. Am J Public Health. 2002;92:901–907.[Abstract/Free Full Text]

6. Hornik RC, ed. Public Health Communication: Evidence for Behavior Change. Mahwah, NJ: Lawrence Erlbaum; 2002.

7. Sly DF, Trapido E, Ray S. Evidence of the dose effects of an antitobacco counteradvertising campaign. Prev Med. 2002;35:511–518.[ISI][Medline]

8. Siegel M, Biener L. The impact of an antismoking media campaign on progression to established smoking: results of a longitudinal youth study. Am J Public Health. 2000;90:380–386.[Abstract/Free Full Text]

This article has been cited by other articles:

				J Niederdeppe, M C Farrelly, J C Hersey, and K C Davis Consequences of dramatic reductions in state tobacco control funds: Florida, 1998-2000 Tob. Control, June 1, 2008; 17(3): 205 - 210. [Abstract] [Full Text] [PDF]

				E. M. Sebrie and S. A. Glantz Attempts to Undermine Tobacco Control: Tobacco Industry "Youth Smoking Prevention" Programs to Undermine Meaningful Tobacco Control in Latin America Am J Public Health, August 1, 2007; 97(8): 1357 - 1367. [Abstract] [Full Text] [PDF]

				J. K. Ibrahim and S. A. Glantz The Rise and Fall of Tobacco Control Media Campaigns, 1967 2006 Am J Public Health, August 1, 2007; 97(8): 1383 - 1396. [Abstract] [Full Text] [PDF]

				P. M. Ling, T. B. Neilands, and S. A. Glantz The Effect of Support for Action Against the Tobacco Industry on Smoking Among Young Adults Am J Public Health, August 1, 2007; 97(8): 1449 - 1456. [Abstract] [Full Text] [PDF]

				J. Niederdeppe, M. C Farrelly, and D. Wenter Media advocacy, tobacco control policy change and teen smoking in Florida Tob. Control, February 1, 2007; 16(1): 47 - 52. [Abstract] [Full Text] [PDF]

				J. F. Thrasher, J. D. Niederdeppe, C. Jackson, and M. C. Farrelly Using anti-tobacco industry messages to prevent smoking among high-risk adolescents Health Educ. Res., July 1, 2006; 21(3): 325 - 337. [Abstract] [Full Text] [PDF]

				L Henriksen, A L Dauphinee, Y Wang, and S P Fortmann Industry sponsored anti-smoking ads and adolescent reactance: test of a boomerang effect Tob. Control, February 1, 2006; 15(1): 13 - 18. [Abstract] [Full Text] [PDF]

				J K Ibrahim and S. A Glantz Tobacco industry litigation strategies to oppose tobacco control media campaigns Tob. Control, February 1, 2006; 15(1): 50 - 58. [Abstract] [Full Text] [PDF]

				J C Hersey, J Niederdeppe, S W Ng, P Mowery, M Farrelly, and P Messeri How state counter-industry campaigns help prime perceptions of tobacco industry practices to promote reductions in youth smoking Tob. Control, December 1, 2005; 14(6): 377 - 383. [Abstract] [Full Text] [PDF]

				S Chapman The most important and influential papers in tobacco control: results of an online poll Tob. Control, October 1, 2005; 14(5): e1 - e1. [Full Text] [PDF]

				N Hafez and P M Ling How Philip Morris built Marlboro into a global brand for young adults: implications for international tobacco control Tob. Control, August 1, 2005; 14(4): 262 - 271. [Abstract] [Full Text] [PDF]

				P A McDaniel and R E Malone Understanding Philip Morris's pursuit of US government regulation of tobacco Tob. Control, June 1, 2005; 14(3): 193 - 200. [Abstract] [Full Text] [PDF]

				M. C. Farrelly, K. C. Davis, M. L. Haviland, P. Messeri, and C. G. Healton Evidence of a Dose--Response Relationship Between "truth" Antismoking Ads and Youth Smoking Prevalence Am J Public Health, March 1, 2005; 95(3): 425 - 431. [Abstract] [Full Text] [PDF]

				J F Thrasher, J Niederdeppe, M C Farrelly, K C Davis, K M Ribisl, and M L Haviland The impact of anti-tobacco industry prevention messages in tobacco producing regions: evidence from the US truth(R) campaign Tob. Control, September 1, 2004; 13(3): 283 - 288. [Abstract] [Full Text] [PDF]

This Article Abstract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (22) Citing Articles via Google Scholar Google Scholar Articles by Niederdeppe, J. Articles by Haviland, M. L. Search for Related Content PubMed PubMed Citation Articles by Niederdeppe, J. Articles by Haviland, M. L. Related Collections Tobacco Control Media Prevention Other Tobacco