Factors Affecting Youth Awareness of Anti-Tobacco Media Messages

1. Factors Affecting Youth Awareness of Anti-Tobacco Media Messages Komal Kochhar, M.B.B.S., M.H.A. Terrell W. Zollinger, Dr.P.H. Robert M. Saywell, Jr., Ph.D., M.P.H.

2. Background & Rationale • Mass media anti-smoking campaigns are a promising and costly tool for health promotion. • Their design has been guided primarily by focus groups. • Scientific research is limited regarding what factors impact awareness and effectiveness of media campaigns.

3. The Indiana Anti-tobacco Media Campaign • Indiana Tobacco Prevention and Cessation Agency began a media campaign in 2002. • $8 million budgeted for the first 2 years • Television, radio, print and billboard media venues • Baseline data used for this study.

4. Venue TV Mediating Factors Confounding Factors Aware Duration Intensity Radio • Message • Theme • -Emotion Print Billboards Not Aware

5. Research Aims • To identify mediating and confounding factors that are associated with youths’ awareness of anti-smoking messages in the mass media. • To evaluate whether such factors vary by media venue. - Television - Print Media - Radio - Billboards

6. Methods • Telephone survey was conducted in 2001. • Representative sample of Indiana youths (n=610) • Stratified by age, gender, race, and geographical region. • Weighted to allow valid and reliable inferences to be made to the state’s youth population.

7. Methods (Continued) • Analysis was conducted using SPSS 11.5. • To measure the association between media awareness for each media venue and numerous variables (knowledge, belief, smoking behavior, and demographic characteristics). • Using the chi-square test of independence.

8. Methods (Continued) • Instrument measured various tobacco related aspects (developed with a media expert): • Anti-smoking media awareness • Demographics • Tobacco-related knowledge • Tobacco-related attitudes / beliefs • Smoking behavior / susceptibility

9. Survey Approach • Conducted by the IU Public Opinion Laboratory. • Telephone numbers selected with high probability of having youth living at home. • Interviewers first obtained permission from a parent/guardian before interviewing the adolescent. • Standard instructions given to both the parent/guardian and the targeted youth.

10. Outcome Variable: Awareness • During the past 30 days, how many commercials have you seen / heard about NOT smoking cigarettes? • Asked separately for each media venue: • TV • radio, • print media • billboards • Responses dichotomized to none or some.

11. Results: Awareness

12. Ad Think? • Did this advertising make you think about whether or not you should smoke? Almost three-fourths of the respondents agreed that the messages did make them think about whether or not to smoke.

13. Results: Demographics • Awareness of anti-smoking messages among the youth: • Differed significantly by: • Age group: 15-17 years, • race and, • parental education • No significant association seen in the • Age group :12-14 years • gender

14. Results: Demographics • Youth in the 15-17 years age group were less aware of the messages on billboards. • White, non-Hispanic youth were more aware of messages on the print media and on billboards. • Youth with one or both parents who have higher education were more aware of messages on the radio.

15. Results: Knowledge • 14 items: • 11 items were agree or disagree • 9 showed no significant association • Range of correct responses: 80.6%-100.0% • 2 differed significantly • 3 items were factual statements with no significant association • Range of correct responses: 15.6%-40.6%

16. Results: Knowledge • Those aware of messages on the TV and radiomore often agreed that people are affected by thecosts of tobacco-related problems. • Respondents aware of messages on the TVmore often agreed that tobacco is as addictive as other drugs, such as heroin and cocaine.

17. Results: Attitudes / Beliefs • 18 items under 4 broad categories: • Industry manipulation • Autonomy • Social norms • General exposure • 10 items showed no significant association • Range of correct responses: 77.1 % - 100.0% • 8 items differed significantly

18. Results: Attitudes / Beliefs • Industry Manipulation: • Youth who were aware of messages on the TVmore often believed that tobacco ads influenced youth to smoke. • Youth who were aware of messages on the radio were less likely to attend events, like concerts and sporting events, even if they were sponsored by tobacco companies.

19. Results: Attitudes / Beliefs • Autonomy: • Youth who were aware of messages on the radio were more likely to say they could easily refuse cigarettes, if offered. • Youth who were aware of messages on the radio were more likely to participate in community activities against tobacco use.

20. Results: Attitudes / Beliefs • General Exposure: • Youth who were aware of radio messages more often agreed that exposure to second-hand smoke is a serious problem. • Youth who were aware of radio messages more often agreed that tobacco use by young people is a serious problem.

21. Results: Attitudes / Beliefs • Youth who were aware of messages on TV were less likely to agree that smoking makes young people look cool. • Youth who were aware of messages on TV were less likely to agree that smoking makes young people more popular.

22. Results: Smoking Behavior • 8 items: • 5 items showed no significant association • 3 items differed significantly • Non-users were more aware of anti-tobacco messages.

23. Results: Smoking Behavior • Youth who had NEVER tried cigarette smoking were more aware of the anti-smoking messages on billboards. • Youth who had NOT smoked cigars during the past 30 days, indicated they were more aware of the anti-smoking messages on billboards than those who had used tobacco products.

24. Results: Smoking Behavior • Youth who had NOT smoked chewing tobacco in the past 30 days, indicated they were more aware of the anti-smoking messages on TV than those who had used tobacco products.

25. Interpretation Cautions • Recalled exposure vs. actual exposure. • Awareness does not always equal effectiveness.

26. Summary • Most youth were aware of the TV media messages and two-thirds were aware of messages in other media venues. • Most youth agreed that the media messages did make them think about whether or not they should smoke. • Non-users were more aware of anti-smoking messages.

27. Summary • Only a few demographic characteristics and beliefs were significantly related to the level of message awareness, depending on the media venue. • The youth were generally quite knowledgeable and held strong anti-smoking / anti-tobacco beliefs.

28. Conclusions • Media messages did not seem to have a great effect on knowledge or beliefs of youth, although the messages did make them think about whether or not they should smoke. • Additional success from media campaigns to prevent tobacco use in youth may require a targeted approach towards specific sub-population groups (like race and education status of parents).