Hard-hitting anti-smoking media campaigns are very effective. They raise awareness about the serious toll that tobacco use takes on one’s health and the many lives it affects.

In the United States, tobacco use is responsible for about 480,000 deaths each year.¹ For every person that dies, about 30 more people suffer from at least one serious illness caused by smoking.¹ Smoking also affects the numerous nonsmokers exposed to hundreds of toxic chemicals in secondhand smoke. Since 1964, 2.5 million nonsmokers have died from exposure to secondhand smoke.¹

Can a graphic and emotional ad on TV really make a difference? The Florida Department of Health’s (FDOH) Tobacco Free Florida (TFF) campaign uses aggressive ads that show the human impact of smoking as part of a comprehensive program. FDOH and the Bureau of Tobacco Free Florida (BTFF) select ads that have run in other states and countries that have demonstrated a positive effect on inspiring people to seek help in quitting smoking.

Strong evidence proves that graphic hard-hitting anti-tobacco ads work, and those that arouse strong negative emotions perform better than those that do not. Hard-hitting media campaigns are not only effective at promoting quit attempts, they also reduce youth initiation.²

The Evidence

• According to a report published in The Lancet medical journal in September 2013, the Centers for Disease Control and Prevention’s (CDC) 2012 Tips From Former Smokers® (Tips®) campaign motivated 1.6 million smokers to make a quit attempt. More than 100,000 U.S. smokers have quit for good as a result of the 2012 campaign.
• In the first two years of the Tips® campaign, an estimated 6 million nonsmokers talked with friends and family about the dangers of smoking.³
• Studies show that emotionally evocative media campaigns featuring graphic images of smoking-related diseases are effective in motivating smokers to quit.^4,5,6,7
• According to a study, ads that utilize a why-to-quit strategy with graphic images of the physical consequences of smoking, and ads that use testimonials of personal loss from smoking, were perceived as more effective among smokers than other ad categories.⁸
• Campaigns that show the serious health consequences linked to smoking to motivate adults to quit have also been associated with prevention of smoking uptake among youth.⁹
• Studies indicate that sad or frightening ads that are highly emotional and feature the serious health consequences of tobacco use, score significantly higher among adults on perceived effectiveness compared to ads that are funny or neutral.¹⁰
• In one study, smokers who reported being exposed to more highly emotional and personal testimonial ads were more likely to quit smoking at follow-up.¹¹
• Meta-analyses on the use of fear appeals in health campaigns conclude that fear appeals are most effective when accompanied by equally strong efficacy messages, such as information to call a Quitline for help and support to quit.¹²
• Australia’s National Tobacco Campaign, which featured graphic hard-hitting ads depicting the negative health consequences of smoking, found that the campaign achieved high rates of recall and recognition, was appraised favorably by smokers, contributed to new learnings about smoking and health, and increased agreement with campaign-related attitudes.^13,14 Furthermore, even though the campaign was not targeted at teenagers, the vast majority of adolescents were aware of the campaign and thought it was relevant to them.¹⁵ These ads, Artery and Sponge, were chosen by FDOH and BTFF to run in Florida.

An example of a hard-hitting ad is Terrie’s Ad. As a teen, Terrie started smoking. As she grew older, smoking was linked to more and more diseases. At age 40, Terrie got cancer. In this TV ad, photos of Terrie put a human face on the millions killed by smoking.