Assessing the impact of the national 'truth' antismoking campaign on beliefs, attitudes, and intent to smoke by race/ethnicity

Objective. To examine racial/ethnic differences in the association between exposure to the 'truth' antismoking campaign and youth's beliefs and attitudes about cigarette companies and their intent to smoke. Design. The data are for 31,758 youth aged 12-17 from seven waves of the Legacy Media Tracking Survey (LMTS), conducted in the USA between December 1999 and July 2003. LMTS was designed to include sufficient proportions of African Americans (n=4631), Hispanics (n=6311), and Asians (n=2469) to assess tobacco countermarketing campaign associations in individual racial/ethnic groups. Separate belief and attitude indices were created. An indicator for the respondent not intending to smoke during the next year was created for non-smokers only, and models were estimated separately by ever-/never-smoking status. Results. Exposure to the truth campaign was positively associated with increased antitobacco beliefs and attitudes among youth overall. When analyzed by race/ethnicity, this association was statistically significant for white and African American youth. An examination of the individual belief and attitude items that composed the measurement indices suggests that different messages appealed to youth based on their race/ethnicity. Among never smokers, those exposed to the truth campaign had significantly higher odds of not intending to smoke. When analyzed separately by race/ethnicity, the estimates for African American youth were statistically significant and the estimates for white and Hispanic youth approached significance. Among ever smokers and across all racial/ethnic groups, those exposed to the truth campaign had significantly higher odds of not intending to smoke, and every racial/ethnic group had an odds ratio greater than one that was also statistically significant. Conclusions. The findings suggest that the individual items comprising the indices may be less meaningful for some non-white groups of youth. Analyses of intention to smoke indicated that, among those who had never smoked, there were greater odds of not intending to smoke when examining all youth together without stratifying by race/ethnicity; however, a statistically significant effect was found only for the African American group when examining the effect by race/ethnicity. Among those who had ever smoked, a statistically significant effect was found for most racial/ethnic groups. This is a rich area for further research and is potentially critical to the success of future efforts to reach youth through behavior change messages.