In 1992, Massachusetts approved a ballot initiative that increased the tax on cigarettes and devoted the funds to an antismoking intervention. The intervention included a media campaign that was initiated in October 1993. The media campaign was conducted primarily through advertisements on television, radio, newspapers, and billboards. The portion of the media campaign aimed at youth was almost exclusively on the television and radio.

A total of $735,000 USD was spent on advertisements targeting youth during the first 6 months of the media campaign: 80% was allocated for television advertisements; 14% for radio spots; 5% for billboards; 1% for newspaper advertisements. The goal of this phase of the intervention was to expose a broad cross-section of the population, rather than to specifically target youth at high-risk for smoking initiation.

To reduce the number of older adolescents who progress to established smoking.

The television component of the Massachusetts antismoking media campaign may have reduced the rate of progression to established smoking among young adolescents.

A follow-up study was conducted 4 years after the initiation of the media campaign. 592 youths were who aged 12 to 15 during the first phase of the antismoking intervention were asked to participate in a telephone survey in 1997 and were asked about their current smoking habits and progression to established smoking. Participants were asked if they recalled having seen an antismoking advertisement on television or on billboards or if they heard on the radio in order to ascertain exposure to the major channels of the media campaign. The rates of progression to established smoking between groups on the basis of their reported baseline exposure to television, radio, and outdoor antismoking advertisements, was assessed using multiple logistic regression (the model controlled for age, race, sex, baseline smoking status, base line susceptibility to smoking, smoking by parents, friends, and siblings, hours of television viewing, and baseline exposure to antismoking messages not related to the media campaign).

Among younger adolescents (aged 12 to 13 years at baseline), those reporting baseline exposure to television antismoking advertisements were significantly less likely to progress to established smoking (odds ratio = 0.49, 95% confidence interval = 0.26 to 0.93). Exposure to television antismoking advertisements had no effect among older adolescents (aged 14 to 15 years at baseline), and there were no effects of exposure to outdoor or radio advertisements. The results are not explained by baseline differences in the educational status of the adolescent’s parent or guardian; after adding this variable to the model, the effect of television antismoking advertisements on progression to established smoking among young adolescents was unchanged.

This is the first longitudinal study to examine the effect of a statewide antismoking advertising campaign on smoking initiation among youths.