Get ready for a barrage of ads that will come at you with a singularly mind-blowing message: Smoking is bad for you. Not just bad for you. Really bad for you.
It's a fact that should be obvious to any sentient being, yet within the next year or so, not one but two federal agencies, the Centers for Disease Control and the Food and Drug Administration, will be newly pounding the nation's airwaves with anti-smoking ads -- as if it were a sure thing that you needed them. To be a smoker in 2012 is not only to ignore the biological reality that the habit will knock years off your life but also shrug off the cultural stigmas -- the dwindling number of smoke-friendly public places, the dirty looks -- and the fact that heavily-taxed smokes are priced at a point only a one-per center could easily afford.
If we've seen a "demoralization of smoking," as the CDC describes it, do we need to drop hundreds of millions of dollars on a familiar message during cash-strapped times? If all those appeals to the brain, wallet and pride don't work, how will a bunch of ads?
As it turns out, anti-smoking ads actually do work. There's plenty of academic research proving it. And there's circumstantial, but no less compelling, evidence that in the absence of advertisements, smoking rates don't go down as quickly as they would without the nagging. And that entails its own costs.
Smoking's steady decline, which began in the 1960s after the Surgeon General's initial warning, has leveled off in recent years. Between 1998 and 2005, the adult smoking rate dropped 13%, but since 2005, any changes have been minimal. For the better part of six years, it has been at the 20% mark or just below. All-important youth-smoking rates declined 40% between 1997 and 2003, but between 2003 and 2009, that decline slowed to 21%.
Meanwhile, during those years funding decreased dramatically for the main national anti-tobacco advertising player, Legacy, the foundation funded by the 1998 settlement between tobacco companies and the attorneys general of 46 states. According to Kantar, Legacy's media budget between 2007 and 2010 totaled about $100 million. That's the amount Legacy would spend in a single year in its early days. And, at the state level, average household exposure to anti-smoking ads peaked in 2006 and 2007 and has been coming down since, according to a study of Nielsen data by the University of Illinois-Chicago.
"There's no consistency at the state level," said Eric Asche, chief marketing officer at Legacy. "And the general trend has been to spend less, not more."
Connecting the slowing decline in smoking with the steeper drop in anti-tobacco ad spending is to draw a broad correlation. It's a mug's game to chart smoking-rate changes directly to the rise and fall of advertising budgets. Media spending is not the only factor in smoking prevention, and probably not even the most important. That distinction goes to taxes. There are other factors, especially smoke-free-air laws that effect bans in workplaces and other public places. With all the activity, it's difficult to isolate the effects of advertising.
But there's no doubt that the leveling off of the smoking rate has occurred at a time when many states, amid deep cuts to tobacco-prevention budgets, are spending next to nothing on ads and have been getting little air cover from the national level. This is bad news when you consider how effective those ads have been.
Research scientists have been studying the impact of anti-smoking ad campaigns for decades, even before the "Truth" campaign launched in 2000, when the job was mainly the province of individual states.
Many have found what Sherry Emery, a health economist who has studied the impact of media campaigns at the state level, has. Ms. Emery said that analyses of youth and adult reaction "showed that higher levels of exposure to the state media campaigns were associated with less smoking and more anti-smoking attitudes and beliefs."
The Truth campaign, currently handled by Arnold, is the most important national anti-tobacco ad effort in recent years and has yielded positive results. A 2005 study in the American Journal of Public Health reported that about 22% of the decline in youth smoking between 1999 and 2002 was attributable to the Legacy foundation ads -- not bad when you consider that the ads weren't even running through the entire period. Since 2003, Legacy's funding has been just a fraction of what it started with, a function of the master-settlement agreement.
That's because the agreement required the Big Four tobacco companies that signed it to fund Legacy only through 2003 if their collective market share fell below 99.05%. (By 2001, that share was already below the threshold, at 96 %.) Settlement payments to states continue, but it's a sore spot with some that a small percentage of that revenue -- just under 2% of $25 billion in 2011 by the Campaign for Tobacco-Free Kids' count -- goes to fight tobacco use. As for the states, the dire economic conditions of recent years have led many to cut back their tobacco programs. The group estimates that total state spending has dropped 36% over the past four years.
Kentucky, a tobacco-growing state tied for the highest smoking rate, and with a tiny budget to fight it, is as particular as it can be about what ads it will run. Rather than use off-the-shelf ads for its just-launched $370,000 secondhand-smoke campaign, the state developed creative via Doe Anderson, Louisville. It's a big investment, as average expenditure on media campaigns is in the neighborhood of $100,000 (but can be much less).
"I think it's very hard at the national level for a government agency to make ads that both can stand out and be acceptable to everyone," said Gwenda Bond, assistant communications director at Kentucky's Cabinet for Health and Family Services. "It's sort of a Catch-22 in some ways. I think the states have a little more freedom and flexibility to go a little bit further field with their concept."
The good news is that there's evidence that various styles of advertising work, from the industry-as-manipulator ads of Truth to campaigns focusing on the nasty health effects of smoking.
Ms. Emery is currently analyzing what kinds of ads work best. Preliminary results show that the answer is not what you might expect, and seem to have little to do with state-smoking laws or whether the state is a tobacco grower. Ms. Emery's hunch is that in "media markets that are dominated by one primary message, like a health-effects ad or secondhand-smoke ad, their overall campaign is a little less effective than media markets that have a diverse portfolio of messages."
OK, so you're not swayed by science. Then what about money? Do anti-smoking ads pay for themselves?
Return on investment is a knottier problem than whether the ads work with audiences on an emotional level, and it hasn't been studied as much. But there is one informative study.
Three years ago, the American Journal of Preventive Medicine published a cost-utility analysis of the Truth campaign between the years 2000 and 2002. The researchers found that campaign efforts costing $324 million averted about $1.9 billion in medical costs. That's a return of about 6 to 1 for one of the most intense -- in terms of reach and cost -- anti-smoking ad campaigns ever done.
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