Association Between National Smoking Prevention Campaigns and Perceived Smoking Prevalence Among Youth in the United States

Abstract Purpose To understand the potential effects of anti-smoking media campaigns on perceived peer smoking prevalence, a noted predictor of smoking initiation and prevalence among youth. Methods We used cross-sectional time series data from the Legacy Media Tracking Surveys (LMTS), a nationally representative telephone survey of approximately 35,000 12- to 17-year-olds in the United States. Exposure to the truth campaign and the “Think. Don’t Smoke” (TDS) campaign was measured with a series of questions on self-reported recall of the campaigns in general and of specific ads from each campaign. Perceived smoking prevalence was the primary outcome variable, measured using the LMTS question: “Out of every 10 people your age, how many do you think smoke?” We estimated a series of multivariable models to assess the association between perceived smoking prevalence and exposure to the truth and TDS campaigns in the United States. Results Findings indicate that exposure to the truth campaign was negatively and significantly associated with perceived smoking prevalence, whereas the TDS campaign was not associated with perceived smoking prevalence. These findings were consistent across several different measures of exposure to the campaigns. Conclusions This study highlights the potential impact of anti-smoking media campaigns on precursors to smoking and suggests that the truth campaign may have an impact on youth’s perceptions of smoking prevalence. Given the documented relationship between perceived smoking prevalence and smoking initiation, the findings highlight the need for further examination of perceived smoking prevalence as a mediating factor through which media campaigns may affect smoking behaviors.