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J Adolesc Health. 2018 Oct;63(4):401-406. doi: 10.1016/j.jadohealth.2018.04.008. Epub 2018 Jul 25.

Estimating the Pathways of an Antitobacco Campaign.

Author information

1
Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: ehair@truthinitiative.org.
2
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; College of Global Public Health, New York University, New York, New York.
3
Schroeder Institute at Truth Initiative, Washington, District of Columbia.
4
Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
5
Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
6
Schroeder Institute at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; College of Global Public Health, New York University, New York, New York.

Abstract

PURPOSE:

This study examined mechanisms through which the truth campaign, a national mass media antismoking campaign, influences smoking-related attitudes, and progression of tobacco use over time in youth and young adults.

METHODS:

Structural equation modeling tested causal pathways derived from formative research and behavioral theory with a nationally representative longitudinal sample of 15-21-year-olds (n = 8747) over 24 months. Data were collected from 2014 to 2016, and analyses were conducted in 2017.

RESULTS:

Greater ad awareness predicted strengthening of attitudes targeted by the campaign (i.e., feelings of independence from tobacco, antitobacco industry sentiment, decreasing acceptance of social smoking, and decreasing acceptance of smoking imagery), and attitude changes were significantly associated with greater support for an antitobacco social movement (e.g., agreement to the item "I would be part of a movement to end smoking"). Greater social movement support predicted a slower rate of progression on smoking intensity after two years of the campaign.

CONCLUSIONS:

Findings suggest that engaging youth and young adults in a cause-based social movement for promoting health can be a powerful strategy to drive positive behavior change. Messages targeting attitudes that resonate with values important to this age group, including independence and connectedness, are particularly effective. Investments in national antitobacco public education campaigns are key policy interventions which continue to help prevent tobacco use among youth and young adults.

KEYWORDS:

Intervention; Mass media campaign; Prevention; Youth tobacco use

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