June 2002, Vol 92, No. 6
American Journal of Public Health
Farrelly et al.
Forum on Youth Smoking
FORUM ON YOUTH SMOKING
This study examines how the American Legacy Foundation’s “truth” cam-
paign and Philip Morris’s “Think. Don’t Smoke” campaign have influenced youths’ atti-
tudes, beliefs, and intentions toward tobacco.
We analyzed 2 telephone surveys of 12- to 17-year-olds with multivariate
logistic regressions: a baseline survey conducted before the launch of “truth” and a sec-
ond survey 10 months into the “truth” campaign.
Exposure to “truth” countermarketing advertisements was consistently as-
sociated with an increase in anti-tobacco attitudes and beliefs, whereas exposure to Philip
Morris advertisements generally was not. In addition, those exposed to Philip Morris ad-
vertisements were more likely to be open to the idea of smoking.
Whereas exposure to the “truth” campaign positively changed youths’
attitudes toward tobacco, the Philip Morris campaign had a counterproductive influ-
Am J Public Health.
casting loudly via megaphones that these rep-
resent the 1200 people killed daily by tobacco.
Empirical evidence for the potential bene-
fits of the national “truth” campaign’s ap-
proach comes from the dramatic decline in
youth tobacco use associated with the Flor-
campaigns, as well
as from other studies that have found cam-
paigns focusing on tobacco industry practices
to be effective.
Legacy’s model is that “truth” will change
youths’ attitudes toward smoking, and that
this in turn will change their smoking behav-
ior, prevent them from initiating smoking, or
Thus, attitude shifts are an intermedi-
ate outcome on the path to changing smoking
behavior. A telephone survey of youths in
Florida and nationwide demonstrated that at-
titudes toward tobacco changed dramatically
among Florida youths compared with youths
in the rest of the United States after the first
year (1998) of Florida’s “truth” campaign,
compared with a national sample of youths
whose attitudes remained relatively con-
The accompanying change in smoking
prevalence was at first statistically nonsignifi-
cant, but results from the Florida Youth To-
bacco Survey showed drops in smoking
among middle-school and high-school stu-
dents of 18% and 8%, respectively, after year
1 and of 40% and 18% after year 2.
Getting to the Truth: Evaluating National Tobacco
Matthew C. Farrelly, PhD, Cheryl G. Healton, DrPH, Kevin C. Davis, MA, Peter Messeri, PhD, James C. Hersey, PhD, and M. Lyndon Haviland, DrPH
Some assert that a portion of this decline
can be attributed to the November 1998
$0.45-per-pack price increase.