Promoting corporate image or preventing underage use? Analysis of the advertising strategy and expenditures of the JUUL parent education for youth vaping prevention campaign.

OBJECTIVE: In April 2018, JUUL Labs announced a $30 million investment in efforts to combat underage use of its products through 'independent research, youth and parent education and community engagement'. Prior evidence demonstrates that tobacco industry-funded prevention programmes are ineffective and may work against tobacco control efforts; they do not discourage novices and youth from tobacco use but often improve the tobacco industry's public image. We describe the nature, timing of and expenditures related to the JUUL underage use prevention advertisements across media channels. METHODS: Expenditures for newspaper, magazine, television, and radio marketing and promotional efforts were collected through Kantar Media's 'Stradegy' dashboard, an online platform which provides counts of advertisement occurrences and expenditures on various media channels. JUUL public relations and corporate social responsibility ads were identified in the Kantar Database. All ad expenditures were extracted and aggregated by date. Analysis of the expenditure data was triangulated with newspaper and industry advertisement archives. RESULTS: Advertisements aired nationally and in over half of all US-designated market areas (n=130) across media platforms including newspapers, magazines, radio, and online in mobile web and internet displays. In 2018, JUUL Labs spent $30 million, predominantly for print advertising. The 'What Parents Need to Know about JUUL' ads primarily advertised JUUL's smoking reduction 'mission' and promoted the product. By 2019, advertising increased to $36.2 million. JUUL's message strategy transitioned to 'Cracking Down on Underage Sales in Retail Stores' and featured adult smoker testimonies, linking JUUL to smoking cessation. DISCUSSION: Marketing expenditures promoting JUUL's corporate social responsibility mission exceeded their $30 million investment in the underage use prevention efforts. The expenditures were focused on the media market areas where health organisation and legislative officials were launching investigations into JUUL social media and other promotional strategies.

Twitter analysis of California's failed campaign to raise the state's tobacco tax by popular vote in 2012.

BACKGROUND: The rapid diffusion of social media in the past decade has allowed community members to sway the discourse on elections. We use analyses of social media to provide insight into why the strong public support 1 year prior to the election did not result in an increased tobacco tax from the 2012 California Proposition 29 vote. METHODS: Using the Twitter historical Firehose, we chose all tweets on Proposition 29 posted between 1 January and 5 June 2012 differentiating between early and late campaign periods. Tweets were coded for valence, theme and source. We analysed metadata to characterise accounts. Television ratings data in 9 major California media markets were used to show the strength of the 2 campaigns. RESULTS: 'No on 29' launched television advertising earlier and with much higher household gross rating points (GRPs) than the 'Yes on 29' campaign. Among 17 099 relevant tweets from 8769 unique accounts, 53% supported Proposition 29, 27% opposed and 20% were neutral. Just under half (43%) were from accounts affiliated with the campaigns. Two-thirds of campaign messages originated outside California. The 'Yes' campaign focused on simple health messages, which were equally represented in both campaign periods. However, anti-tax tweets increased at relative to pro-tax tweets in the second period. CONCLUSIONS: Although the Prop 29 campaigns did not effectively engage the Californian twitter communities, analysis of tweets provided an earlier indication than public polls of the loss of public supporting this election. Prospective Twitter analysis should be added to campaign evaluation strategies.

Televised obesity-prevention advertising across US media markets: exposure and content, 2010-2011.

OBJECTIVE: To examine levels of exposure and content characteristics for recent televised obesity-prevention campaigns sponsored by state and community health departments, federal agencies, non-profit organizations and television stations in the USA. DESIGN: Nielsen television ratings for obesity-prevention advertising were collected for the top seventy-five US media markets and were used to calculate household exposure levels for 2010 and 2011. Governmental advertisements were coded for content. SETTING: United States. RESULTS: Average household exposure to obesity-prevention campaigns was 2·6 advertisements per month. Exposure increased by 31 % between 2010 and 2011, largely driven by increases in federal advertisements. In 2011, the federal government accounted for 62 % of obesity-prevention exposure, non-profit organizations for 9 %, community departments for 8 %, state departments for 3 %, and television station-sponsored public-service announcements for 17 %. The greatest percentage increase between 2010 and 2011 was in community advertising, reflecting efforts funded by the Communities Putting Prevention to Work (CPPW) programme. Among thirty-four state and community campaigns, the majority advocated both healthy eating and physical activity (53 %). Campaigns typically had positive or neutral emotional valence (94 %). Obesity or overweight was mentioned in 47 % of campaigns, but only 9 % specifically advocated weight loss. CONCLUSIONS: Exposure to televised obesity-prevention advertising increased from 2010 to 2011 and was higher than previously found in 1999-2003, apart from in 2003 during the federal VERB campaign. Nevertheless, exposure remains low relative to advertising for unhealthy foods. New federal campaigns have increased exposure to obesity-prevention advertising nationally, while CPPW grants have increased exposure for targeted areas.

Wanna know about vaping? Patterns of message exposure, seeking and sharing information about e-cigarettes across media platforms.

BACKGROUND: Awareness and use of electronic cigarettes has rapidly grown in the USA recently, in step with increased product marketing. Using responses to a population survey of US adults, we analysed demographic patterns of exposure to, searching for and sharing of e-cigarette-related information across media platforms. METHODS: An online survey of 17,522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Fixed effects logit models were applied to analyse relationships between exposure to, searching for and sharing of e-cigarette-related information and demographic characteristics, e-cigarette and tobacco use, and media behaviours. RESULTS: High levels of awareness about e-cigarettes were indicated (86% aware; 47% heard through media channels). Exposure to e-cigarette-related information was associated with tobacco use, age, gender, more education, social media use and time spent online. Although relatively small proportions of the sample had searched for (∼5%) or shared (∼2%) e-cigarette information, our analyses indicated demographic patterns to those behaviours. Gender, high income and using social media were associated with searching for e-cigarette information; lesbian, gay and bisexual and less education were associated with sharing. Current tobacco use, age, being Hispanic and time spent online were associated with both searching and sharing. CONCLUSIONS: US adults are widely exposed to e-cigarette marketing through the media; such marketing may differentially target specific demographic groups. Further research should longitudinally examine how exposure to, searching for and sharing of e-cigarette information relate to subsequent use of e-cigarettes and/or combustible tobacco.

The effects of smoking-related television advertising on smoking and intentions to quit among adults in the United States: 1999-2007.

OBJECTIVES: We investigated whether state-sponsored antitobacco advertisements are associated with reduced adult smoking, and interactions between smoking-related advertising types. METHODS: We measured mean exposure to smoking-related advertisements with television ratings for the top-75 US media markets from 1999 to 2007. We combined these data with individual-level Current Population Surveys Tobacco Use Supplement data and state tobacco control policy data. RESULTS: Higher exposure to state-sponsored, Legacy, and pharmaceutical advertisements was associated with less smoking; higher exposure to tobacco industry advertisements was associated with more smoking. Higher exposure to state- and Legacy-sponsored advertisements was positively associated with intentions to quit and having made a past-year quit attempt; higher exposure to ads for pharmaceutical cessation aids was negatively associated with having made a quit attempt. There was a significant negative interaction between state- and Legacy-sponsored advertisements. CONCLUSIONS: Exposure to state-sponsored advertisements was far below Centers for Disease Control and Prevention-recommended best practices. The significant negative relationships between antismoking advertising and adult smoking provide strong evidence that tobacco-control media campaigns help reduce adult smoking. The significant negative interaction between state- and Legacy-sponsored advertising suggests that the campaigns reinforce one another.

Public health obesity-related TV advertising: lessons learned from tobacco.

BACKGROUND: Over the past 25 years, the percent of overweight and obese adults and children in the United States has increased dramatically. The magnitude and scope of the public health threat from obesity have resulted in calls for a national comprehensive obesity prevention strategy, akin to tobacco use prevention strategies undertaken over the past two decades. The purpose of this paper is to describe and compare population exposure to paid media campaigns for tobacco and obesity prevention, draw lessons from tobacco advertising, and compare tobacco and obesity behaviors/influences to identify priorities and pitfalls for further research on obesity adverting. METHODS: This is a descriptive study. Ratings data for the years 1999-2003, for the top 75 designated market areas in the U.S. were used to quantify exposure levels to anti-obesity and anti-smoking advertising in the U.S. RESULTS: Anti-tobacco campaigns preceded anti-obesity campaigns by several years, and in each year exposure levels--both total and average--for anti-tobacco media campaigns far outweighed those of anti-obesity campaigns. CONCLUSIONS: It is important to compare both similarities and differences between smoking- and obesity-related behaviors, which might affect the potential impact of anti-obesity media campaigns. Given the scope of the public health risks attributable to obesity, and the amount of federal, state, and other resources devoted to anti-obesity media campaigns, there is a clear need to evaluate the potential impact of such campaigns efforts. Nonetheless, the challenges are significant in both motivating and monitoring such complex behavior change, and in attributing changes to a given media campaign.

State anti-tobacco advertising and smoking outcomes by gender and race/ethnicity.

OBJECTIVE: This paper examines overall and gender- and racial/ethnic-specific relationships between exposure to state-sponsored anti-tobacco televised advertising and smoking-related outcomes among US middle and high school students using five years of cross-sectional nationally representative data. DESIGN: Nationally representative 8th, 10th, and 12th grade student sample data for 1999-2003 were merged with commercial ratings data on mean potential audience exposure to network and cable television anti-tobacco advertising across the 74 largest US designated market areas, resulting in a final sample size for analysis of 122,340. Associations between state-sponsored anti-tobacco televised advertising exposure and youth smoking-related beliefs and behaviours were modelled while controlling for relevant individual and environmental factors as well as other televised tobacco-related advertising. RESULTS: Higher potential for exposure to state anti-tobacco advertising within the previous four months was generally associated with decreasing odds of current smoking across groups. In addition, such exposure was related, to varying degrees, with decreased perceptions that most/all friends smoked, stronger five-year intentions not to smoke, and increased perceived harm of smoking. These relationships appeared possibly to be weaker for Asian students. CONCLUSIONS: The results from these analyses indicate that state anti-tobacco advertising significantly relates to beneficial outcomes -- especially regarding current smoking behaviour -- among US youth as a whole.

Impact of smoking cessation aids and mass media among recent quitters.

BACKGROUND: Although studies have addressed the effectiveness of conventional smoking aids such as quit-smoking programs and pharmaceutical therapy, few studies have assessed their likely impact on cessation at the population level relative to the impact of mass media anti-tobacco advertisements. METHODS: A random digit dial telephone survey of 6739 Massachusetts residents conducted in 2001-2002 yielded a subsample of 787 individuals who had quit-smoking within the past 2 years. Measures included the types of cessation aids used and perceptions of their helpfulness. Rates of population impact were estimated. Multinomial logistic regression determined the predictors of being helped by conventional aids, by TV advertisements only, or having no help. RESULTS: Analyses conducted in 2004-2005 showed that advertisements were the most frequently mentioned source of help among recent quitters. Older more dependent smokers were most likely to find conventional aids helpful. Younger respondents and those who had remained abstinent for more than 6 months were most likely to report being helped by TV ads. The most helpful ads were those that depicted illness due to smoking or provided inspirational quit tips. CONCLUSIONS: Anti-tobacco media campaigns are a vital component of the National Action Plan for Tobacco Cessation. It is essential that such a campaign be implemented, both to support the National Quit Line and to provide assistance to those smokers who find no other form of aid helpful.

Mixed messages on tobacco: comparative exposure to public health, tobacco company- and pharmaceutical company-sponsored tobacco-related television campaigns in the United States, 1999-2003.

AIMS: To describe and compare the extent of exposure among youth and adults to antitobacco advertising funded by tobacco control agencies, and to smoking-related advertising from tobacco and pharmaceutical companies. DESIGN: Archival records of television advertising exposures from Nielsen Media Research for the largest 75 media markets in the United States from 1999 to 2003. MEASUREMENTS: Mean monthly advertising exposures for households with televisions and adolescents aged 12-17 years for: state tobacco control programs; the national American Legacy Foundation (Legacy) program; tobacco company advertising for youth smoking prevention, parent advertising and corporate image; pharmaceutical company advertising for nicotine replacement therapy and Zyban; and other miscellaneous tobacco-related advertising. FINDINGS: Combined tobacco company youth/parent advertising exposures matched those for combined State/Legacy campaigns (4.56 advertisements/month versus 4.97 advertisements/month among households; 3.05 advertisements/month versus 3.38 advertisements/month among adolescents). Tobacco company corporate image advertising averaged 3.25 advertisements/month among households and 0.73 advertisements/month among adolescents. Tobacco company advertising exceeded public health-sponsored advertising by a factor of 1.57-1, and among youth by 1.11-1. Pharmaceutical companies were the largest sponsor of tobacco-related advertising for households (10.37 advertisements/month) and provided significant exposure among adolescents (2.61 advertisements/month). CONCLUSIONS: This is the first study to demonstrate systematically that public health-sponsored antitobacco campaigns in the United States are matched or exceeded by tobacco company advertising, as well as pharmaceutical cessation product advertising. Research is needed to determine whether such advertising may dilute or undermine the established benefits of tobacco control-sponsored campaigns.

Televised state-sponsored antitobacco advertising and youth smoking beliefs and behavior in the United States, 1999-2000.

BACKGROUND: Recent state budget crises have dramatically reduced funding for state-sponsored antitobacco media campaigns. If campaigns are associated with reduced smoking, such cuts could result in long-term increases in state health care costs. METHODS: Commercial ratings data on mean audience exposure to antitobacco advertising that appeared on network and cable television across the largest 75 media markets in the United States for 1999 through 2000 were combined with nationally representative survey data from school-based samples of youth in the contiguous 48 states. Multivariate regression models were used to analyze associations between mean exposure to state antitobacco advertising and youth smoking-related beliefs and behaviors, controlling for individual and environmental factors usually associated with youth smoking and other televised tobacco-related advertising. RESULTS: Mean exposure to at least 1 state-sponsored antitobacco advertisement in the past 4 months was associated with lower perceived rates of friends' smoking (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.58-0.88), greater perceived harm of smoking (OR, 1.25; 95% CI, 1.11-1.42), stronger intentions not to smoke in the future (OR, 1.43; 95% CI, 1.17-1.74), and lower odds of being a smoker (OR, 0.74; 95% CI, 0.63-0.88). CONCLUSIONS: To our knowledge, this study is the first to explore the potential impact of state-sponsored antitobacco media campaigns while controlling for other tobacco-related advertising and other tobacco control policies. State-sponsored antitobacco advertising is associated with desired outcomes of greater antitobacco sentiment and reduced smoking among youth. Recent cuts in these campaigns may have future negative health and budgetary consequences.

The effect of antismoking advertisement executional characteristics on youth comprehension, appraisal, recall, and engagement.

This article examines how two executional characteristics of antismoking advertising may interact with other relevant advertising features to affect youth comprehension, appraisal, recall of, and engagement with antismoking ads. Fifty antismoking ads made by tobacco control agencies, tobacco companies, and pharmaceutical companies were appraised by 268 youth using an audience response methodology with a follow-up component. Analyses show that thematic and executional characteristics varied both across and within ad sponsor, and that executional characteristics of "personal testimonial" and "visceral negative" clearly had the strongest and most consistent effect on appraisal, recall, and level of engagement. Antismoking advertisements are not alike in their ability to engage youth. Advocates attempting to develop increasingly successful antismoking campaigns should consider the executional characteristics of proposed ads.