Measuring the Effectiveness of Anti-Smoking Initiatives

"Smoking rates were 1.5 percentage points lower than they would have been in the absence of the campaign"

In 2002, the Centers for Disease Control and Prevention (CDC) hired RTI to measure the effectiveness of the American Legacy Foundation's "truth" smoking-prevention campaign. The Foundation, formed as a result of the settlement of a major lawsuit between U.S. states and the tobacco industry, had been given a mandate to reduce smoking, particularly among youth, in the United States. Its $100 million mass-media campaign detailing the adverse health effects of smoking consisted primarily of television, radio, and Internet advertising; the question before the CDC was whether the campaign was effective.

At RTI, Matthew Farrelly and his colleagues scrutinized the campaign to discern its value in reducing tobacco use among young people. Initially, the team undertook surveys of teenagers in 210 media markets across the country to determine if they had seen the foundation's antismoking advertisements–75 percent, in fact, had. Subsequent surveys indicated that the campaign was achieving the desired effect.

"By 2002, the second year of the campaign, smoking rates overall were 1.5 percentage points lower than they would have been in the absence of the campaign, which translates to roughly 300,000 fewer youth smokers in the United States," said Farrelly. "That's a 22 percent total decline in youth smoking. We confirmed the result by accounting for other influences." The findings were published in The American Journal of Public Health.

Farrelly's team undertook similar studies of anti-tobacco campaigns at the state level. New York state, for example, had committed more than $250 million from 2000 to 2006 to its tobacco-control media campaign. RTI found that, as a result of this campaign, the prevalence of youth and adult smoking had declined faster in New York than in the U.S. as a whole–a reduction of more than 600,000 smokers in the state over the six-year duration of the initiative.

Continuing its efforts to improve public health, the CDC also funded a 2003 RTI study of the medical costs of obesity. The findings indicated that medical spending related to obesity accounted for a whopping 9.1 percent of the nation's total health care costs—as much as $93 billion a year–roughly half of it financed by taxpayers via Medicare and Medicaid expenditures. Subsequent studies by RTI indicated that obesity cost companies as much as $2,500 per employee, per year, in medical expenses and absenteeism.