Effect of a Statewide Media Campaign on Smoking Cessation Among Florida Adults

Abstract

Introduction: Since December 2010, Florida's Bureau of Tobacco Free Florida has aired a statewide tobacco education campaign to encourage smoking cessation. The Tobacco Free Florida campaign consists of evidence-based advertisements primarily characterized by strong emotional content and graphic imagery designed to increase awareness of the health risks of tobacco use. We evaluated the effect of the media campaign on population-level quit attempts by using a statewide representative sample of Florida adults aged 18 or older.

Methods: We examined data from 5,418 Florida adult cigarette smokers and recent quitters aged 18 or older from the Florida Adult Tobacco Survey, an annual, cross-sectional survey conducted from 2011 through 2018. The primary outcome was incidence of quit attempts in the previous 12 months. We used multivariable logistic regression models to estimate the odds of making a quit attempt as a function of advertising levels across state media markets. Rates of quit attempts in Florida were also estimated.

Results: Approximately 66% of smokers in the study made at least 1 quit attempt. Exposure to the campaign was associated with increased odds of a quit attempt in the previous 12 months (odds ratio = 1.25; P = .02) among smokers and recent quitters. The Tobacco Free Florida campaign was associated with an estimated 332,604 additional smokers making quit attempts per year during the study period.

Conclusion: The Tobacco Free Florida campaign affected cessation-related behaviors in Florida over an 8-year period. Evidence-based state tobacco education campaigns can accelerate progress toward the goal of reducing adult smoking.

Figure 1

Quit attempt probability as a function of past year Tobacco Free Florida target rating points, Florida 2011–2018. Quit attempt probabilities were predicted by using estimates from a logistic regression model that controlled for age, sex, race/ethnicity, nicotine dependence, children younger than 18 years of age residing in the home, educational attainment, employment status, potential exposure to the Centers for Disease Control and Prevention's Tips From Former Smokers campaign, time spent watching television, media market, and year. Error bars show 95% confidence intervals. The average number of target rating points (TRPs) was 4,190.

Figure 2

Estimated number of smokers with past year quit attempts attributable to the Tobacco Free Florida (TFF) campaign. These estimates were calculated by taking the annual overall difference between the actual quit attempt percentage for the sample and the predicted quit attempt percentage in a hypothetical scenario where no exposure to the campaign occurred (ie, target rating points = 0), and then applying that difference to the state population of adult smokers in Florida.