title: Impact of The Real Cost Campaign on Adolescents' Recall, Attitudes, and Risk Perceptions about Tobacco Use: A National Study.
abstract: The Food and Drug Administration's (FDA)The Real Costcampaign advertisements (ads) have targeted U.S. youth with messages designed to prevent and reduce tobacco use. This study examined exposure toThe Real Costcampaign, including ad and slogan recall, and associations with attitudes and risk perceptions among U.S. adolescents. We analyzed data from a nationally representative sample of adolescents aged 13 to 17 years (n= 1125) surveyed by phone from October 2014 to June 2015. We assessed aided recall of and attitudes toward four campaign ads and the one slogan. Logistic regression models assessed whether aided recall ofThe Real Costads or slogan was associated with perceived likelihood of serious health consequences of cigarette smoking. Most (88%) adolescents reported seeing or hearing at least one of four ads forThe Real Cost, and 54% recalledThe Real Costslogan. The majority of adolescents reported more negative attitudes toward tobacco products after seeing or hearing the ads. Recall of anyThe Real Costad was significantly associated with greater perceptions of serious health consequences of cigarette smoking (Adjusted Odd Ratios (AOR) = 5.58, 95% Confidence Interval (CI) = 1.20-25.90). The FDA'sThe Real Costcampaign has achieved very high reach and is associated with more negative attitudes toward tobacco products and greater risk perceptions of cigarette smoking among U.S. adolescents.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA. huangl@email.unc.edu.
authors.forename: Li-Ling
authors.initials: LL
authors.lastname: Huang
authors.affiliation: School of Media and Journalism, University of North Carolina, Chapel Hill, NC 27599, USA. lazard@unc.edu.
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Lazard
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA. jpepper@rti.org.|RTI International, Research Triangle Park, NC 27709, USA. jpepper@rti.org.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Pepper
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA. noar@email.unc.edu.|School of Media and Journalism, University of North Carolina, Chapel Hill, NC 27599, USA. noar@email.unc.edu.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Noar
authors.affiliation: Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. leah_ranney@unc.edu.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Ranney
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA. adam_goldstein@med.unc.edu.|Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. adam_goldstein@med.unc.edu.
authors.forename: Adam O
authors.initials: AO
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011939:Mental Recall; D018570:Risk Assessment; D000074606:Smoking Prevention; D064424:Tobacco Use / Q000523:psychology*
keywords: health communication; health promotion; media; outcome evaluation; smoking and tobacco use