truth® Research Summary

International Journal of Environmental Research and Public Health (IJERPH) – February 2009

A study published in the online issue considered the differences between the approaches of the truth® campaign and a Philip Morris campaign - “Think. Don’t Smoke” (TDS) - studying the two campaigns’ effects on antismoking beliefs, intent to smoke and smoking initiation among youth. Researchers found that recall of the truth® campaign increased antismoking beliefs among teens, decreased their intent to smoke, and lowered the rates of teens starting to smoke. In contrast, Philip Morris’ “Think. Don’t Smoke” campaign had virtually no effect on changing teens’ beliefs about tobacco or on smoking initiation. In fact, it actually increased teens’ intentions to smoke soon.

[Davis KC, Farrelly MC, Messeri P, Duke J. The Impact of National Smoking Prevention Campaigns on Tobacco-Related Beliefs, Intentions to Smoke and Smoking Initiation: Results from a Longitudinal Survey of Youth in the United States. International Journal of Environmental Research and Public Health, 2009; 6(2): 722-740.]

American Journal of Preventive Medicine (AJPM) – February 2009

A study in the April 2009 issue (appearing online in February 2009) found a direct association between the level of truth® advertising exposure and a decreased risk of beginning to smoke among teens. The study, titled “The Influence of the National truth® Campaign on Smoking Initiation” was conducted by researchers at RTI International. According to the study, “approximately 450,000 fewer adolescents and young adults initiated smoking as a result of the truth® campaign from 2000 to 2004.”

[Farrelly MC, Nonnemaker J, Davis KC, Hussin A. The Influence of the National truth Campaign on Smoking Initiation. American Journal of Preventive Medicine, 2009; 36(5): 379-384.]

A second study appearing online in February 2009 examined whether the economic investment in the truth® campaign was justifiable given its effect on public health outcomes. The study, called “Cost-utility Analysis of the “truth®” Social Marketing Campaign to Prevent Youth Smoking,” looked at the years 2000 to 2002. It found that “truth® not only markedly improved the public’s health but did so in an economically efficient manner by not only recouping the costs of the campaign, but also saving between $1.9 and $5.4 billion in medical care costs to society.”

[Holtgrave DR, Wunderink KA, Vallone DM, Healton CG. Cost-Utility Analysis of the National truth Campaign to Prevent Youth Smoking. American Journal of Preventive Medicine, 2009; 36(5): 385-388.]

Ethnicity and Health – February 2009

In the study, “The Impact of the 'Truth' Campaign on Beliefs, Attitudes, and Intent to Smoke by Race/Ethnicity,” researchers from RTI International set out to “examine racial/ethnic differences in the association between exposure to the 'truth' antismoking campaign and youth's beliefs and attitudes about cigarette companies and their intent to smoke.” Lead author AJ Cowell and his team wrote that the data from the research “indicates that exposure to the truth® campaign was positively associated with increased anti-tobacco beliefs and attitudes among youth overall.” The study underscores that different truth® campaign messages appealed to youth based on their race/ethnicity, an issue that should be considered when developing future campaigns to reach youth with behavior change messages.

[Cowell AJ, Farrelly MC, Chou R, Vallone DM. Assessing the impact of the national ‘truth’ antismoking campaign on beliefs, attitudes, and intent to smoke by race/ethnicity. Ethnicity and Health, 2009; 14(1):75-91.]

Monitoring the Future Study – December 2008

The annual 2008 Monitoring the Future study measuring youth tobacco use rates found monthly smoking prevalence among youth to be at historically low levels. The study found 8th grade smoking rates down by two-thirds; 10th graders by more than half; and 12th graders’ rates down by nearly half since recent peaks in the mid-90s.
Report investigators cited the Master Settlement Agreement’s changes to cigarette advertising in the U.S., and “the American Legacy Foundation, which has sponsored national antismoking ad campaigns aimed at youth in the years since,” as factors in the decline.

[National Institutes of Health U.S. Department of Health and Human Services. Monitoring the Future. National Results on Adolescent Drug Use: Overview of Key Findings, 2007]

Health Education Research Report – January 2008

According to a January 2008 study, teens who are exposed to the truth® campaign are more likely to harbor critical feelings towards the tobacco industry, and less likely to intend to smoke in the future.
In addition, the study found that teens that saw Philip Morris’ “Think Don’t Smoke” advertising campaign had more favorable beliefs and attitudes toward tobacco companies.
The study found that teens that were aware of the campaign were twice as likely to say they did not intend to smoke in the future.
The data showed that approximately 70 percent of teens were aware of the campaign over the three years studied.

[Farrelly MC, Davis KC, Duke J, Messeri P. Sustaining ‘truth’:changes in youth tobacco attitudes and smoking intentions after 3 years of a national antismoking campaign. Health Education Research, 2008, Advance Access published 17 January 2008.]

Monitoring the Future – December 2007

Sshowed youth smoking rates among 8th graders have declined significantly, but that the declines for 10th graders are statistically insignificant and the rates for 12th graders are at a standstill.
For the fourth consecutive year, the rates for 10th and 12th graders stayed flat, a trend that now threatens the historic near 30-year decline in youth smoking.

[Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. (2008). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2007 (NIH Publication No. 08-6418). Bethesda, MD: National Institute on Drug Abuse.]

Institute of Medicine – May 2007

This major, landmark report found that America must implement strategies that effectively reduce and prevent smoking and combine those efforts with a changed regulatory and policy landscape to fight the nation’s number-one cause of preventable death: tobacco-related disease.
The report, presented to Congress, specifically mentions the truth® campaign, and “concludes that a national, youth-oriented media campaign should be a permanent component of the nation’s strategy to reduce tobacco.”

[IOM (Institute of Medicine). 2007. Ending the tobacco problem: A blueprint for the nation. Washington, DC: The National Academies Press.]

RTI Prevalence Study – September 2007

Found that the truth® campaign may be changing teens' perceptions about how common smoking is among their peers.
Teens exposed to the truth® campaign have a more accurate view of the number of their peers who smoke while teens with less exposure to the campaign believed smoking was more common among people their age.
The study, “Association Between National Smoking Prevention Campaigns and Perceived Smoking Prevalence Among Youth in the United States,” appeared in the Journal of Adolescent Health.
The finding is good news for the truth® campaign because teens' perception of the prevalence of peer smoking has been shown to predict future smoking.

[Davis KC, Nonnemaker JM, Farrelly MC. Association Between National Smoking Prevention Campaigns and Perceived Smoking Prevalence Among Youth in the United States. Journal of Adolescent Health, 2007; 41: 430-436.]

AJPH – Behavioral Results – February 2005

In February 2005 the American Legacy Foundation released the results of an evaluation of the national truth® campaign that was published in the American Journal of Public Health.
The study found that 22 percent of the overall decline in youth smoking during the first two years of the campaign (2000-2002) is directly attributable to truth®.
This equates to 300,000 fewer youth smokers in 2002 as a result of the campaign.

[Farrelly MC, Davis KC, Haviland ML, Messeri P, Healton CG. Evidence of a Dose-Response Relationship Between “truth” Antismoking Ads and Youth Smoking Prevalence. American Journal of Public Health, 2005; 95(3): 425-431.]