Lancet study: Affordable Care Act-sponsored stop-smoking media campaign was valuable, may help bring down smoking rates

by Brian Wolfman

We've blogged here about the difficulty of altering unhealthy or economically destructive behavior through public-education campaigns or mandated disclosures.

Bringing down smoking rates took a lot of work. In 1964, the U.S. government said for the first time that smoking causes cancer. The next year, cigarette packages were required by law to have cancer warnings. TV ads for tobacco products were banned in 1969 (effective in 1970). The campaign to curb smoking has been large and sustained, with funding from public and private sources. It drove down U.S. adult smoking rates from more than 42% in 1965 to about 19% today.

In the Affordable Care Act, Congress wanted to do something to further drive down smoking rates. With funding provided by the Act, the U.S. Centers for Disease Control (CDC) ran a hard-hitting, three-month media blitz stressing the health hazards of smoking.

The medical journal The Lancet has just published an analysis of the penetration and effectiveness of the CDC campaign (with the catchy title "Effect of the first federally funded US antismoking national media campaign"). Here's the article's description of the CDC's campaign:

In the USA, the Patient Protection and Affordable Care Act 2010 (ACA)
provides opportunities to accelerate national progress in tackling
tobacco use,
including enhanced reimbursements for cessation services and mass-media
support. In 2012, through the ACA, the US Centers for Disease Control
and Prevention launched the first, federally funded, national,
antismoking, mass-media education campaign—Tips From Former Smokers
(Tips). This $54 million initiative featured emotional true stories told
by former smokers to increase awareness of the human suffering caused
by smoking, encourage quitting, and motivate non-smokers to communicate
with family and friends about the dangers of smoking. We aimed to
measure changes in quit attempts by smokers, quit status at follow-up,
and non-smokers' cessation support behaviour in nationally
representative cohorts of smokers and non-smokers and to estimate the
effect of the campaign nationally by applying cohort rates to US census

Here is the authors' brief and wonky "Intepretation" of the study:

The high-exposure Tips media campaign was effective at increasing
population-level quit attempts. The growth in smokers who quit and
became sustained quitters could have added from a third to almost half a
million quality-adjusted life-years to the US population. Expanded
implementation of similar campaigns globally could accelerate progress
on the WHO Framework Convention on Tobacco Control and reduce smoking
prevalence globally.

The full article provides much more detail.

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