Exposure to a single pro-smoking media message increases college-aged students' risk of using tobacco for seven days, providing new clues about the influence of media on smoking, according to a new RAND Corporation study.
The novel project is the first to attempt to quantify the persistence that cigarette advertising and other pro-smoking media messages have on consumers. The study is published online by the Journal of Adolescent Health.
Researchers say the findings have important implications for policies that limit tobacco advertising and other efforts aimed at curbing youth tobacco use.
"We were surprised how long the influence of pro-smoking messages lasted," said Steven Martino, a study co-author and a psychologist at RAND, a nonprofit research organization. "The results suggest that positive media messages about smoking are likely to influence behavior even if opportunities to smoke occur infrequently."
The study involved 134 college students in Pittsburgh aged 18 to 24 who were given hand-held devices that allowed them to document their exposure to pro-smoking media messages during their normal routine over a three-week period. Participants included both nonsmokers and those who smoke either regularly or occasionally.
After viewing a pro-smoking advertisement or message, participants reported their smoking intentions and ability to refuse tobacco by answering a series of questions such as, "Do you think you will try a cigarette anytime soon?" The hand-held devices also prompted participants to answer these questions at other times during the day when they were not exposed to pro-smoking messages.
This study design allowed the researchers to see how long the effects of exposure to a pro-smoking message could be detected in participants' responses to the survey questions.
Researchers found that after exposure to a single pro-smoking media message, smoking intentions immediately increased by an average of 22 percent. Although smoking intentions decreased with each passing day, they remained elevated for a full 7 days.
While the study focused on the effects of single pro-smoking media messages, all of the study participants reported being exposed to multiple pro-smoking media messages during the three-week data collection period. In total, participants reported 1,112 exposures to pro-smoking media messages during the study.
"Our findings suggest that exposures that occur before the influence of a prior message 'wears off' could cause the risk of smoking to accumulate over the long term," Martino said. "This might explain why exposure to these media messages can have an enduring effect on people's attitudes and behaviors toward smoking."
Young adults ages 18 to 25 are the group that has the highest level of tobacco use, reporting rates of smoking that are nearly 50 percent higher than either high school seniors or adults over age 26.
Previous studies have documented that about two-thirds of exposures to pro-smoking media messages occurs at places where tobacco is sold, such as convenience stores, gas stations or grocery stores.
Although the advertising of smoking has been banned from television and radio outlets, such ads are still running at places where tobacco is sold, in newspapers and magazines, and on the Internet. Pro-smoking media messages also occur through positive depictions of tobacco use in movies.
"Prior research has shown that greater exposure to pro-smoking media messages, whether in advertising or entertainment media, is associated with an increased risk for beginning or progressing toward regular tobacco use among young adults," said Claude M. Setodji, the lead author of the study and a senior statistician at RAND. "Our study provides evidence about how that happens."
Support for the RAND study was provided by the National Cancer Institute. Other authors of the study are Deborah M. Scharf and William G. Shadel.
RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.
Journal of Adolescent Health