NHS Health Scotland
Outcome Indicators

2.3. Activity: Mass Media

Impact on outcomes


Impact on short term and intermediate outcomes

There is review level evidence supporting:

  • the general benefits of media campaigns on smoking cessation (albeit these are not clear whether directly through cessation or through SHS) / the effectiveness of mass media campaigns – although whether this is of SHS or cessation or prevention campaigns and its specific outcomes (e.g. whether it changes smoking behaviour - where smoking takes place, results in cessation or prevention/delayed onset of smoking) is unclear
  • media campaigns as part of a wider tobacco control strategy; mass media and point-of-sales measures combined with other prevention activity; multi-channel mass media campaigns (combined with other interventions)
  • national, anti-tobacco mass media campaigns, supported by local activities (in playing an important role in changing society’s attitudes towards tobacco use)
  • mass media campaigns (in preventing the uptake of smoking and also influencing knowledge, attitudes and intentions of children and young people; in being effective in reducing cigarette use prevalence in adolescents when combined with other interventions although the contribution of individual components to the overall effectiveness of these interventions cannot be attributed; in being effective in preventing the uptake of smoking in young people either on their own or when combined with a school-based programme)
  • campaigns when long in duration and greater in intensity of exposure (being most effective in this way)

There are policy and review level evidence documents collectively reporting/supporting:

  • sustained media campaigns as part of a wider smoking control strategy (strong evidence for this reducing youth smoking when intensive and long-lasting, and with strong, carefully-designed messages on TV supported by other media)
  • anti-smoking adverts on Scottish TV (achieving high viewer awareness and accurate recognition of the message)
  • graphic picture warnings (highly effective in encouraging people to quit smoking);
  • posters or printed media (effective for increasing awareness of campaigns)
  • TV recall
  • advertisements evoking strong negative emotions such as fear (clear evidence of their effectiveness) 

…and recommending:

  • an on-going, multi-stranded media campaign, building on the previous national campaigns, with a strand focusing on girls in more disadvantaged communities and another on older teens
  • the integration of both with other anti-smoking measures and with other media-based health information for young people (raising awareness is not sufficient to change behaviour– media campaigns and other measures need to be supported by wider measures)


Scottish Executive (2006). Towards A Future Without Tobacco.Scottish Executive, Edinburgh.

Thomas RE, Baker PRA, Lorenzetti D. Family-based programmes for preventing smoking by children and adolescents. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD004493. DOI: 10.1002/14651858.CD004493.pub2

NICE (2008). Public Health Guidance 14 – Preventing the uptake of smoking by children and young people: mass-media and point-of-sales measures to prevent the uptake of smoking by children and young people. NICE, London.

NICE (2008). Public Health Guidance 10 – Smoking cessation services in primary care, pharmacies, local authorities and workplaces, particularly for manual working groups, pregnant women and hard-to-reach communities.  NICE, London.

Sowden, A.J. (1998). Mass media interventions for preventing smoking in young people. Cochrane Database of Systematic Reviews, 4, Art. No: CD001006; doi:10.1002/14651858.CD001006

Scottish Government (2008). Scotland’s Future is Smoke Free: A Smoking Prevention Action Plan. Scottish Government, Edinburgh.

Naidoo B et al. (2004) Smoking and public health: A review of reviews of interventions to increase smoking cessation, reduce smoking initiation, and prevent further uptake of smoking.   London: H.D.A.  

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