The impact of media campaigns on smoking cessation activity: a Structural Vector Autoregression analysis

ArticleinAddiction 107(11):2043-50 · May 2012with54 Reads
DOI: 10.1111/j.1360-0443.2012.03958.x · Source: PubMed
To evaluate the effect of tobacco control media campaigns and pharmaceutical company-funded advertising for nicotine replacement therapy (NRT) on smoking cessation activity. Multiple time series analysis using structural vector autoregression, January 2002-May 2010. England and Wales. Tobacco control campaign data from the Central Office of Information; commercial NRT campaign data; data on calls to the National Health Service (NHS) stop smoking helpline from the Department of Health; point-of-sale data on over-the-counter (OTC) sales of NRT; and prescribing data from The Health Improvement Network (THIN), a database of UK primary care records. Monthly calls to the NHS stop smoking helpline and monthly rates of OTC sales and prescribing of NRT. A 1% increase in tobacco control television ratings (TVRs), a standard measure of advertising exposure, was associated with a statistically significant 0.085% increase in calls in the same month (P = 0.007), and no statistically significant effect in subsequent months. Tobacco control TVRs were not associated with OTC NRT sales or prescribed NRT. NRT advertising TVRs had a significant effect on NRT sales which became non-significant in the seasonally adjusted model, and no significant effect on prescribing or calls. Tobacco control campaigns appear to be more effective at triggering quitting behaviour than pharmaceutical company NRT campaigns. Any effect of such campaigns on quitting behaviour seems to be restricted to the month of the campaign, suggesting that such campaigns need to be sustained over time.
    • "These may work via different mechanisms, with negative campaigns increasing motivation to quit and influencing risk attitudes (Wakefield et al., 2003), and positive campaigns enhancing self-efficacy among smokers with high readiness to quit (Wong and Cappella, 2009). Although most of the available evidence indicates that quitline services are effective at promoting and sustaining smoking abstinence among callers (Langley et al., 2012; Zhu et al., 2002; Rabius et al., 2004; Owen, 2000; Hollis et al., 2007; Ramon et al., 2013; Stead et al., 2013), it is estimated that only around 4.0% of smokers in England use the national quitline annually (NHS The Information Centre for Health and Social Care, n.d.). While we have previously shown similarly that both campaign types are effective in reducing smoking prevalence (Sims et al., 2014), further work is needed to relate exposure to positive and negative emotive messages to other population-level outcomes such as referrals and quit rates to determine policy effectiveness. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective To investigate the effects of different types of televised mass media campaign content on calls to the English NHS Stop Smoking helpline. Method We used UK government-funded televised tobacco control campaigns from April 2005 to April 2010, categorised as either “positive” (eliciting happiness, satisfaction or hope) or “negative” (eliciting fear, guilt or disgust). We built negative binomial generalised additive models (GAMs) with linear and smooth terms for monthly per capita exposure to each campaign type (expressed as Gross Ratings Points, or GRPs) to determine their effect on calls in the same month. We adjusted for seasonal trends, inflation-adjusted weighted average cigarette prices and other tobacco control policies. Results We found non-linear associations between exposure to positive and negative emotive campaigns and quitline calls. The rate of calls increased more than 50% as exposure to positive campaigns increased from 0 to 400 GRPs (rate ratio: 1.58, 95% CI: 1.25–2.01). An increase in calls in response to negative emotive campaigns was only apparent after monthly exposure exceeded 400 GRPs. Conclusion While positive campaigns were most effective at increasing quitline calls, those with negative emotive content were also found to impact on call rates but only at higher levels of exposure.
    Full-text · Article · Sep 2014
    • "The most common use of VAR for human data appears to be to analyze time-series data from neurophysiologic experiments (e.g., (Chen et al. 2011)). VAR has also been used to analyze time-series data from a variety of fields including ecology (Dhoray and Teelucksingh 2007), epidemiology (Hii et al. 2012), public health (Joyce and Grossman 1990; Langley et al. 2012), clinical medicine (Tschacher and Kupper 2002; Tsacher et al. 2003; Jones et al. 2008; Rosmalen et al. 2012; Bringmann et al. 2013), studies of human migration (Gorbey et al. 1999), models of gene regulatory networks (Lim et al. 2013), prediction of disease biomarkers (Rochon 2003), developing predictors of respiratory motion in robotic surgery (Ernst et al. 2013), and relating blood pressure to heart rate (Matsukawa and Wada 1997). "
    [Show abstract] [Hide abstract] ABSTRACT: Our previous finding of a fractal pattern for gastric pH and esophageal pH plus the statistical association of sequential pH values for up to 2 h led to our hypothesis that the fractal pattern encodes information regarding gastric acidity and that depending on the value of gastric acidity, the esophagus can signal the stomach to alter gastric acidity by influencing gastric secretion of acid or bicarbonate. Under our hypothesis values of gastric pH should provide information regarding values of esophageal pH and vice versa. We used vector autoregression, a theory-free set of inter-related linear regressions used to measure relationships that can change over time, to analyze data from 24-h recordings of gastric pH and esophageal pH. We found that in pH records from normal subjects, as well as from subjects with gastroesophageal reflux disease alone and after treatment with a proton pump inhibitor, gastric pH values provided important information regarding subsequent values of esophageal pH and values of esophageal pH provided important information regarding subsequent values of gastric pH. The ability of gastric pH and esophageal pH to provide information regarding subsequent values of each other was reduced in subjects with gastroesophageal reflux disease compared to normal subjects. Our findings are consistent with the hypothesis that depending on the value of gastric acidity, the esophagus can signal the stomach to alter gastric acidity, and that this ability is impaired in subjects with gastroesophageal reflux disease.
    Full-text · Article · Jul 2014
    • "Therefore, whilst our results support the hypothesis that negative campaign content is more effective in increasing recall, this does not necessarily imply that this translates into increased smoking cessation, behaviour change or improvements in other outcome measures. The length of time that campaigns were recalled contrasts with our previous findings which suggest that impacts on quitting behaviour may be limited to the immediate aftermath of the campaigns [4]. It is possible that campaigns will be recalled for a longer time after airing, but that campaign effects on quitting behaviours will be tied more closely to recent campaign exposure. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Although there is some evidence to support an association between exposure to televised tobacco control campaigns and recall among youth, little research has been conducted among adults. In addition, no previous work has directly compared the impact of different types of emotive campaign content. The present study examined the impact of increased exposure to tobacco control advertising with different types of emotive content on rates and durations of self-reported recall. Methods Data on recall of televised campaigns from 1,968 adult smokers residing in England through four waves of the International Tobacco Control (ITC) United Kingdom Survey from 2005 to 2009 were merged with estimates of per capita exposure to government-run televised tobacco control advertising (measured in GRPs, or Gross Rating Points), which were categorised as either “positive” or “negative” according to their emotional content. Results Increased overall campaign exposure was found to significantly increase probability of recall. For every additional 1,000 GRPs of per capita exposure to negative emotive campaigns in the six months prior to survey, there was a 41% increase in likelihood of recall (OR = 1.41, 95% CI: 1.24–1.61), while positive campaigns had no significant effect. Increased exposure to negative campaigns in both the 1–3 months and 4–6 month periods before survey was positively associated with recall. Conclusions Increased per capita exposure to negative emotive campaigns had a greater effect on campaign recall than positive campaigns, and was positively associated with increased recall even when the exposure had occurred more than three months previously.
    Full-text · Article · May 2014
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