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The Content of Cigarette Counter-Advertising: ArePerceived Functions of Smoking Addressed?

NANCY RHODES

Indiana University-Purdue University at Indianapolis, Indianapolis,Indiana, USA

DAVID ROSKOS-EWOLDSEN

The Ohio State University, Columbus, Ohio, USA

CASSIE A. ENO

University of Alabama, Tuscaloosa, Alabama, USA

JENNIFER L. MONAHAN

University of Georgia, Athens, Georgia, USA

Media campaigns can be an effective tool in reducing adolescent smoking. To betterunderstand the types of ads that have been used in campaigns in the United States, acontent analysis was conducted of ads available at the U.S. Centers for DiseaseControl and Prevention (CDC) Media Campaign Resource Center (MCRC;Waves 1 through 7). A total of 487 ads were coded. Ads were coded for target audi-ence, primary theme present in the ad, and sensation value—production techniquesthat have been demonstrated to attract attention and increase arousal. Primarythemes extended earlier studies by focusing on the perceived functions of smoking(weight lose, stress management, controlling negative affect) as well as the tradi-tional themes of industry attack, the health consequences of smoking, secondhandsmoke, quitting, and the social image of smokers. A majority of ads were rated ashaving moderate sensation value, and ads targeted at teens and children were, onthe average, higher in sensation value than those targeting general audiences.Changes across time suggest that campaigns are focusing more on adolescent smok-ing and relying more on attacking the tobacco industry. Research indicates that thefunctions of stress relief, mood regulation, and weight loss are strong reasons forinitiating and continuing to smoke cigarettes; however, none of the 487 adsaddressed these functional themes. Implications for developing campaigns that moreclosely relate to the functions of smoking are discussed.

Antismoking advertising campaigns can be effective in reducing smoking rates.Findings from research on teen smoking demonstrate clearly that media campaignscan work (Flynn et al., 1992, 1994; Hopkins et al., 2001; Jacobson et al., 2001;

The authors gratefully acknowledge the support of grant number CD000242-01 to the South-ern Center for Communication, Health and Poverty. We thank Linda Pederson at the Office ofSmoking and Health at the Centers for Disease Control for her helpful comments on this project.

Address correspondence to David Roskos-Ewoldsen, Psychology, Box 870348, Tusca-loosa, AL 35487-0348, USA. E-mail: d.ewoldsen@gmail.com

Journal of Health Communication, 14:658–673, 2009Copyright # Taylor & Francis Group, LLCISSN: 1081-0730 print=1087-0415 onlineDOI: 10.1080/10810730903204262

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Pechmann, 1997) as part of a larger campaign that involves a variety of elementsincluding school programs, community efforts, policy changes, and taxes on tobaccoproducts (Jacobson et al., 2001). Such programs, when supplemented by publicservice announcements (PSAs), can reduce smoking rates and smoking initiationby youth (Friend & Levy, 2002; Lantz et al., 2000; Wakefield & Chaloupka, 2000;Wakefield, Flay, Nichter, & Giovino, 2003). For example, the American LegacyFoundation’s TRUTH campaign is a national media campaign targeting high-riskadolescents. Teens who report greater exposure to the campaign have more negativeattitudes toward the tobacco industry and may be less likely to begin smoking(Farrelly et al., 2002, Farrelly, Davis, Haviland, Messeri, & Healton, 2005; Herseyet al., 2005; cf., Roskos-Ewoldsen, 2007).

The effectiveness of individual ads, however, is less well established. Experimen-tal studies find that antismoking messages can reverse the negative effects of tobaccoads on nonsmoking youths’ attitudes and intentions to smoke (Pechmann &Ratneshwar, 1994; Pechmann & Shih, 1999). Studies also are exploring what typeof antismoking message themes that youth self-report as most effective; however,evidence often is conflicting (Balch & Rudman, 1998; Biener, McCallum-Keeler, &Nyman, 2000; Biener, Ming, Gilpin, & Albers, 2004; Biener & Seigel, 2000; Goldman& Glantz, 1998; Hill, Chapman, & Donovan, 1998; Pechmann & Reibling, 2006;Pechmann, Zhao, Goldberg, & Reibling, 2003; Perrachio & Luna, 1998; Wakefield,Durant et al., 2003; Worden, Flynn, & Secker-Walker, 1998). Indeed, the effective-ness of ads depend on the characteristics of the target audience (Rhodes, Roskos-Ewoldsen, Edison, & Bradford, 2008; Wakefield, Flay, Nichter, & Giovino, 2003)and may require a match of the message to the individual’s reasons or motivationsfor engaging in the behavior (Clary et al., 1998; Sanderson & Cantor, 1995; Snyder &Cantor, 1998).

Functional Approaches to Persuasion

A fruitful approach to the study of social behavior involves a focus on the functionsthat the behavior serves for the individual (Maio & Olson, 2000; Snyder & Cantor,1998). From this perspective, it is important to understand the goal that a behaviorserves for an individual. People may perceive smoking as serving many differentfunctions, so they are motivated to smoke for different reasons. For example, a per-son may smoke because smoking is perceived as helping relieve stress or is thought toaid in weight control. The matching hypothesis grew out of the work on attitude func-tions (Maio & Olson, 2000; Sanderson & Cantor, 1995). The matching hypothesisstates that persuasive appeals that address the function a behavior or object servesfor a person are more effective at changing a person’s attitudes and behavior thanpersuasive appeals that do not address the function served by the behavior or object.

Research on persuasion consistently has found support for the matchinghypothesis—when persuasive appeals focus on the function that a behavior servesfor an individual, the persuasive appeal is substantially more effective than if theappeal is not focused on the function of the behavior (Clary et al., 1998; Lavine &Snyder, 2000; Sanderson & Cantor, 1995). The matching hypothesis has beendemonstrated in diverse domains such as consumer products (DeBono, 1987;Shavitt, 1990), volunteer work, including long-term work with AIDS victims(Snyder, Clary, & Stukas, 2000), and adolescent sexual behaviors and safe sexbehaviors (Sanderson & Cantor, 1995). The work on the matching hypothesis

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suggests that it is important to consider why adolescents smoke cigarettes to moreeffectively persuade them not to.

The extant literature suggests that adolescents perceive that cigarettes serve severalfunctions. Adolescents believe that smoking cigarettes can help them to control nega-tive affect, including stress (Kassel, Stroud, & Paronis, 2003; Wills, Sandy, Yaeger, &Shinar, 2001; Wills, Sandy, & Yaeger, 2002), depression (Lloyd-Richardson,Papandonatos, Kazura, Stanton, & Niaura, 2002; Windle & Windle, 2001), and anger(Kassel et al., 2003). Cigarettes also are perceived to serve a social lubricant functionthat helps them fit in (Lewis-Esquerre, Rodrigue, & Kahler, 2005) and are believed,especially by White teen girls, to assist with weight control (Baker et al., 2004; Myers,McCarthy, MacPherson, & Brown, 2003). The research on the matching hypothesissuggests that messages addressing these functions would be an effective approach toaddress smoking initiation. The extent to which existing tobacco counteradvertisingaddresses functional themes was investigated in the present research.

Sensation Value and Persuasion

Recent work also has pointed to the features of PSAs that make them likely to drawthe attention of viewers, particularly high sensation seeking children and teens.Sensation seeking refers to a person’s need for stimulation, arousal, and novelty.High sensation seekers are more likely to pay attention to advertisements that appealto their need for arousal. Ads containing high intensity elements (i.e., high sensationvalue ads) such as visceral images, background noise, and rapid camera cuts or edits(either related or unrelated1), may be well suited to attract the attention of highsensation seeking teenagers and preteens (Lang, Chung, Lee, Schwartz, & Shin,2005; Lang, Dhillon, & Dong, 1995; Morgan, Palmgreen, Stephenson, Hoyle, &Lorch, 2003). It should be noted, however, that high sensation value ads actuallymay distract these adolescents from processing antismoking messages (Kang,Cappella, & Fishbein, 2006). Being able to describe ads in terms of sensation valuemay help direct research attention to the motivation and ability of differentaudiences—such as high or low sensation seekers—to effectively process ad content.

Overview to the Present Study

The content of antismoking messages has received scant attention. Although charac-teristics of antismoking ads have been examined to determine their effectiveness(Niederdeppe, 2005), only a small set of ads in use in an active campaign were codedin that study. There are two recent content analyses of the antismoking ads availableat the COC (MCRC). The CDC’s collection contains ads developed by various statehealth departments and other agencies that have been made available to the CDC toshare with state and local campaigns.

Beaudoin’s (2002) analysis focused on the target audience for the ads andspecific themes of the antismoking ads. The analysis included 197 antismokingads from the years 1998 to 1999 of the CDC’s PSAs. The four most common

1Related cuts are edits that involving the same scene or actors. For example, in a scene withtwo people talking, a related edit that involves switching from looking over the shoulder of onecharacter to over the shoulder of the other character. An unrelated cut involves switching to anew scene. Therefore, an unrelated cut would be an edit that switches from the two characterstalking to some unrelated scene such as a tobacco executive sitting at a table laughing.

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themes of antismoking ads involved attacking the tobacco industry (24% of the ads),secondhand smoke (27%), cessation (23%), and addiction (14%).

Cohen, Shumate, and Gold (2007) analyzed whether the ads in the CDC’s setutilized theories of health campaigns. Cohen and colleagues analyzed 399 ads thatwere available from the CDC through the last week of March, 2004. They concludethat the antismoking media campaigns largely are atheoretical and that the majorityof ads focus on changing attitudes rather than social norms or attempting to providenonsmoking models for teens to emulate.

The present research examined a broad sample of antismoking messages fromthe CDC (Waves 1 to 7; N! 487) in an attempt to characterize the array of specificmessage strategies and ad characteristics that have been used in past antismokingmedia campaigns and how they have evolved across time. There were three goalsin the present content analysis. First, the study will extend Cohen and colleagues’(2007) study by exploring another theoretical orientation to persuasion to determineif antismoking media campaigns address the perceived functions served by cigarettes.Of interest is the extent to which available antismoking PSAs focus on the perceivedfunctions served by cigarette smoking: stress and mood management, weight control,and a social lubricant. The first research question follows:

1. Do antismoking PSAs address the functions smoking is perceived to serve foradolescents? If so, which functions are targeted?

Second, given the potential importance of the sensation value of a a PSA onattention, the present analysis looked at the sensation value of the ads. Ofparticular interest is whether PSAs targeting youth differ in sensation value fromthose targeting adults.

2. Do antismoking PSAs that target adolescents have higher sensation values thanantismoking PSAs addressing different audiences?

Third, the present research extended the early content analyses by covering theyears 1998 to 2003. In this way, we could explore changes in the themes, target audi-ences, and sensation value of ads across time. The campaigns are fluid, and it isimportant to understand how they have changed if the effectiveness of antismokingcampaigns is to be fully understood.

3. Were there changes in the themes found in antismoking PSAs from Wave 1–3 adsof the CDC’s MCRC (1998 to 1999) and the Wave 4 to 7 ads (1999 to 2003)?

Method

Sample of Ads

The sample consisted of television tobacco control antismoking advertisements madeavailable through the (MCRC). The MCRC is a clearinghouse of antismoking adsfrom 25 state campaigns, nonprofit organizations, and federal agencies that aremade available for antismoking campaigns to use. All of the television antismokingadvertisements released from 1998 to 2003 (N! 487) were used in this content ana-lysis (Waves 1 to 7). There were 204 ads in the years 1998 to 1999 (Waves 1–3a) and283 ads in the years 2000 to 2003 (Waves 3b to 7). Unfortunately, the CDC’s MCRCstopped making antismoking advertisements available free of charge to researchersafter 2003 (CDC, 2008).

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Reliability

Two coders were trained to code the ads according the coding scheme listed below.Intercoder reliability was calculated using percent agreement for 113 antismokingadvertisements. Disagreements were settled by discussions between the coders andthe authors. One coder completed the remaining 374 antismoking advertisementsafter intercoder reliability was established.

Unit of Analysis and Coding Scheme

The standard unit of analysis was a single antismoking advertisement.

Target Audience. The target audience was defined as the population the adwas designed to appeal to. The category scheme was based on previous studiesand a review of the PSAs in this set. The categories within the scheme were mutuallyexclusive and exhaustive. Each antismoking advertisement was coded for a targetaudience of ‘‘children,’’ ‘‘adolescents,’’ ‘‘young adults,’’ ‘‘parents,’’ ‘‘women,’’‘‘pregnant women,’’ or ‘‘adults.’’ Cues for determining the target audience includeddirect references (e.g., ‘‘if you are pregnant and smoking’’), age of the people in thead, or the stylistic features of the PSA such as music. If no specific target audiencewas apparent, the target audience was coded as ‘‘general.’’ These codes were reliablyapplied, with 79.46% agreement (see Table 1).

Message Theme. Message theme was coded if the theme represented the mostcentral message theme in the advertisement. The theme of the antismoking messagewas coded from a total of 16 categories of themes. These included the followinghealth consequence of smoking, industry attack on tobacco companies, imagesof smokers, reasons for smoking, and smoking-related death (see Table 2 for thecomplete list). These themes were drawn from previous studies (e.g., Pechmannet al., 2003) and the literature on the functions that smoking serves for adolescents.While ads could contain several themes, coders were instructed to code for theprimary theme of the ad, resulting in a scheme with mutually exclusive categories.Reliabilities were calculated separately for each message theme and ranged from92.03% to 100.00%, with an average of 97.97%.

Table 1. Changes in the target audiences for antismoking adsbetween 1998–1999 and 2000–2003

Years

Target audience 1998–1999 2000–2003

Children 4.4% (9) 7.4% (21)Adolescents 30.4% (62) 45.6% (129)Parents 11.8% (24) 7.4% (21)Women .5% (1) 0% (0)Pregnant women 3.9% (8) 0% (0)Adults 9.3% (19) 13.8% (39)General 35.8% (73) 21.9% (62)Young adults 3.9% (8) 3.9% (11)

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Table 2. Main ad themes and prevalence

Theme Description % of Ads

Industry attack Focus on the tobacco industry including lies ofthe tobacco companies or marketingtechniques of the tobacco industry. Examplesinclude quotes from tobacco companies orads that make fun of the tobacco industry fortargeting specific groups.

26

Health Describe any health consequences of smoking,long-term or short-term, and death caused bysmoking. Examples include shortness ofbreath, emphysema, cancer, etc.

20

Secondhand smoke Focus on secondhand smoke in homes,restaurants, bars, or other public places andalso about the effects of secondhand smoke—both health and death related. Examplesinclude ads that talk about the dangers ofsecondhand smoke in the home or the effectsof secondhand smoke on others.

12

Quitting Encourage quitting, promote the benefits of,strategies for, or reasons to quit. Examplesare ads that give quitline numbers or includepersonal testimony about quitting.

11

Image Include the negative social image of smokers.Examples include ads that talk about howdisgusting or uncool smoking is or presentedpositive images of not smoking.

10

Athletes Emphasize how smoking will hurt athletes anddecrease athletic performance. Ads ofteninclude professional athletes or show peopleplaying sports.

5

Cigarette smoke ispoisonous

Ads about the poisonous materials found incigarettes or cigarette smoke. Examplesinclude ads that talk about the number ofpoisons or list the specific poisons of smoke=cigarettes.

5

Nicotine is addictive Ads that talk about smoking being addictive. 4Be a role model by notsmoking

Contain advice from parents or siblings aboutbeing a role model by not smoking. Examplesinclude setting positive examples forchildren=adolescents or talking to children=adolescents about smoking.

3

Effects of smokingon family

Describe how smoking effects other familymembers or children. Examples includefamily member of people who have died fromsmoking or how children are affected bysmoking

3

(Continued )

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Sensation Value. The sensation value of the antismoking advertisement wasestablished through a combination of five dimensions identified in prior researchas features that attract attention to an ad (Lang et al., 1995, 2005; Niederdeppe,2005). The antismoking advertisements were coded for the presence or absence ofunrelated cuts (cuts to another scene), related edits (cuts within the same scene),background noise=saturation, negative visceral images, and second half punch.Second half punch involves a surprise or unexpected ending to the ad. FollowingNiederdeppe’s (2005) procedure for looking at the combination of features foundin high sensation value ads, the presence of unrelated and related cuts wasdichotomized. Based on Lang and colleagues’ (2005) procedures and findings, wedetermined that if there were five or more related cuts, the PSA was coded as havingrelated cuts. Likewise, Lang and colleagues (2005) found that ads containing 5 to 10unrelated cuts attracted the most attention. Consequently, if the PSA had 5 to 10unrelated cuts, the ad was coded as having unrelated cuts. The value of one wasadded to sensation value for the presence of each of the dimensions. Values onthe sensation value variable could vary from zero to five, with those advertisementsobtaining higher scores on the scale representing ads with higher sensation value.Reliabilities were calculated separately for each component of sensation value andranged from 77.00% to 100.00%, with an average of 86.17%.

Results

Target Audience. As expected with the emphasis on youth prevention in existingmedia campaigns, the most common audience targeted by the PSAs in the analysiswas adolescents, accounting for nearly 40% of all ads in the set. The next mostcommon target audiences were general audiences at 28%, adults at 12%, parentsat 9%, and children at 6%. Ads targeting audience segments such as women,

Table 2. Continued

Theme Description % of Ads

Regulation Ads aimed at regulating smoking or regulatingthe sale of cigarettes.

3

Youth access Advocate reducing youth access to cigarettes.Examples include cigarette smoking machinesor selling cigarettes to youth.

2

Social influenceto smoke

Talks about positive social influence to notsmoke. Examples include encouragingchildren not to smoke and demonstratingresistance to influence to smoke.

1

Stress Ads that address controlling stress as a functionof smoking.

0

Weight Ads that address controlling weight as afunction of smoking.

0

Mood control Ads that address controlling depressed mood asa function of smoking.

0

Note: Total number of ads! 487. Percentage exceeds 100 due to rounding error.

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pregnant women, and young adults were not common in this set of ads, at less than5% each.

There were significant changes in the target audience for the ads between theWave 1–3 ads (1998 to 1999) and the Wave 4–7 ads (1999 to 2003), X2

(7)! 33.85, p< .001. As can be seen in Table 1, there were substantial increases inthe ads targeting children (increased from 4.4% to 7.4%) and adolescents (increasedfrom 30.4% to 45.6%) and a decrease in the percentage of ads targeting parents (dropfrom 11.8% to 7.4%) and pregnant women (drop from 3.9% to 0%).

Message Themes. The most common message themes are those that present anattack on the tobacco industry or describe health consequences of smoking, includ-ing that cigarette smoking causes death (see Table 2). These two categories accountfor nearly one-half of all ads. Next in frequency were ads that emphasized the dan-gers of secondhand smoke. Somewhat less common were ads advocating quittingsmoking. Importantly, none of the ads in the current set addressed the functionsof smoking of stress relief, weight control, and mood management (e.g., controllinganger and depression). Ads addressing the social functions of smoking (image ofsmokers or nonsmokers and resisting social influence to smoke) were present inthe set, but, at 11% of coded ads, they were relatively uncommon. Further, theseads focus more on modeling for adolescents effective ways to resist social pressureto begin smoking rather than countering the idea that smoking enhances an adoles-cent’s social standing or allows one to gain membership in a desired group.

There were significant shifts in the themes of the ads found in the first 3 waves(1998–1999) of the CDC set and the later waves (2000–2003; see Table 3), X2

(13)! 49.87, p< .001. There were substantial increases in PSAs focusing on thetobacco industry (from 19.6% to 30%), the effects of smoking on health (from

Table 3. Changes in the themes of antismoking ads between 1998–1999 and2000–2003

1998–1999 2000–2003

Industry attack 19.6% (40) 30.0% (85)Health 7.8% (16) 15.5% (44)Secondhand smoke 15.2% (31) 13.8% (39)Quitting 11.3% (23) 9.9% (28)Image 13.7% (28) 12.7% (36)Athletes 10.8% (22) 1.4% (4)Cigarette smoke is poisonous 4.4% (9) 1.4% (4)Nicotine is addictive 3.9% (8) 3.5% (10)Be a role model by not smoking 3.4% (7) 3.2% (9)Effects of smoking on family 1.0% (2) 4.2% (12)Regulation 4.4% (9) 1.8% (5)Youth access 3.4% (7) .4% (1)Social influence to smoke 1.0% (2) 2.1% (6)Stress 0% (0) 0% (0)Weight 0% (0) 0% (0)Mood control 0% (0) 0% (0)

Note: v2 (13, N! 487)! 49.87, p< .001.

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7.8% to 15.5%), and the effects of smoking on the family (from 1% to 4.2%). Con-versely, there were declines in ads focusing on the effects of smoking on athletes(from 10.8% to 1.4%), youth access to cigarettes (from 3.4% to .4%), and the poiso-nous materials found in cigarettes (from 4.4% to 1.4%). Although relatively infre-quent appeals, there also were declines in the two categories of ads focusing onthe regulation of smoking: regulating secondhand smoke (declined from 2.9% to1.1%) and general regulation of smoking (declined from 1.5% to .7%).

Further analyses were conducted to investigate whether different themes weremore likely to be presented to different audiences. For this analysis, target audiencewas recoded into two categories, one representing ‘‘youth,’’ for those ads targetingchildren, adolescents, and young adults, and one representing the ads targetinggeneral and adult audiences. A significant chi square was obtained, v(13)! 131.81,p< .001, indicating that message themes vary significantly by audience. As seen inTable 4, ad themes targeting youth are those concerned with the social image ofsmokers, smoking hurting athletes, and industry attack. In contrast, ad themes thatare more likely to target adults or general audiences emphasize quitting, the effect ofsmoking on the family, that cigarettes contain poisons, secondhand smoke, and theneed to regulate secondhand smoke.

Message Sensation Value. The sensation value for each ad was determined bythe presence of the five characteristics of high sensation value ads (five or more unre-lated cuts, five or more related cuts, background noise=saturation, negative visceralimages, and second half punch) were present in each ad. Ads could have a score from0 (none of characteristics present) to 5 (all characteristics present). On the average,antismoking ads have a moderate sensation value. The mean sensation value across

Table 4. Ad theme by intended audience

Target audience

Theme Youth % (n! 240) Adults=general % (n! 193)

Industry attack 33 24Health 13 12Secondhand smoke 6 18Quitting 3 20Image 25 2Athletes 10 1Cigarette smoke is poisonous 1 5Nicotine is addictive 5 3Be a role model by not smoking 1 1Effects of smoking on family 0 6Regulation 1.3 5.1Youth access <1 3Social influence to smoke 3 1Stress 0 0Weight 0 0Mood control 0 0

Note: Themes differed significantly by audience type (p< .05 as determined by chi square).

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the ads was 1.36 (SD! 1.02), indicating that the average ad has between one and twofeatures present that represent a high sensation value.

An additional analysis focused on whether ads differed in their sensation valuedepending on whether they were aimed at children and adolescents versus olderaudiences or general audiences. In addition, the research on sensation value is recent,so we were interested in whether there were increases in the sensation value of adsacross time. To answer these two questions, sensation value was examined using a2 (target audience: children and adolescents vs. other) X2 (when the ads wereproduced: 1998 to 1999 vs. 2000 to 2003) ANOVA. There was a main effect of targetaudience such that ads targeting younger audiences had higher sensation value scores(M! 1.54, SD! 1.13) than ads targeting the remaining audiences (M! 1.21,SD! .90), F(1, 483)! 7.08, p< .001. But there was an interaction between targetaudience and when the ads were produced such that the higher levels of sensationvalue found in the PSAs for younger audiences only during the later producedantismoking ads, F(1, 483)! 9.48, p< .001. As Figure 1 demonstrates, the sensationvalue for ads aimed at adolescents was substantially higher in the 2000 to 2003timeframe than ads from 1998 to 1999 or ads aimed at other audiences.

Discussion

The content analysis of these 487 tobacco counteradvertisements demonstrated thata sizeable portion of antismoking PSAs are targeted at youth, but this trend largelystarted since 2000. While more ads are targeting youth in recent campaigns, there hasbeen a marked decrease in ads aimed at parents, and ads for pregnant women havedisappeared from the later waves of the CDC’s collection. Furthermore, ads target-ing young audiences are likely to focus on the social functions of smoking and thedeception and manipulation of the tobacco industry. The focus on the tobaccoindustry has dominated campaigns aimed at youth, particularly since the adventof Florida’s and American Legacy’s Truth campaigns. Another shift in the themesfound in campaigns is a marked decrease in ads aimed at increasing the regulation

Figure 1. Sensation value by ad cohort by intended audience.

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of smoking such as ads focusing on youth access to cigarettes and the regulation ofsecondhand smoke. While regulation ads were never common, the decrease is unfor-tunate because regulating smoking is an effective technique for decreasing adolescentsmoking (Jacobson et al., 2001).

A recent trend is that PSAs targeting youth (children, adolescents, and youngadults) are higher in sensation value than are ads that target adults or the generalpopulation. High sensation values have been linked to greater attention to ads,although this finding is somewhat controversial (Kang et al., 2006; Lang et al.,1995, 2005; Niederdeppe, 2005). Future research can build on the current findingsby directly testing the effects of ads that vary in sensation value on message proces-sing by individuals from different target audiences.

Public service announcements (PSAs) that target general audiences frequentlyaddressed health effects. These ads likely serve an important health education function.Importantly, however, recent work demonstrated that teenagers perceived themselvesto be uninformed with respect to the health consequences of smoking (Scales,Monahan, Rhodes, Roskos-Ewoldsen, & Turbes-Johnson, 2009). Thus, it is usefulfor campaigns to continue focusing on health consequences, and perhaps makinghealth consequences the focus of more ads targeting young audiences would be helpful.

Using industry attack as a theme is a trend in ads targeting teens. These adsinvoke anger toward the tobacco industry and are thought to undermine industryefforts to hook young people by making these motives on the part of the tobaccoindustry accessible to teenagers. Such appeals appear to be effective at changingattitudes toward the tobacco industry, but their long-term value at keeping youngpeople from smoking is not well established (Farrelly et al., 2005). Future researchshould be directed at more fully understanding the implications of changing attitudestoward the tobacco industry on smoking behavior.

Prior research in persuasion has demonstrated that appeals that match the func-tional value of a behavior are more effective than other types of appeals (Lavine &Snyer, 2000; Maio & Olson, 2000; Snyder & Cantor, 1998). This functional matchinghypothesis makes sense: if the reason a person smokes is to help manage stress, buthe or she views an ad that focuses on the evils of the tobacco industry, the appeal is irre-levant to the person’s reasons for smoking. Consequently, the smoking behavior is unli-kely to change, because the underlying function of the behavior has not been addressed.

The existing literature suggests that adolescents perceive four functions ofcigarette smoking: a social lubricant, stress management, weight loss, and moodmanagement. The content analysis suggests that antismoking campaigns havefocused only on the social lubricant function of smoking. If one broadly includesthe categories of image PSAs (focus on positive images of nonsmokers or negativeimages of smokers) and the social influence to smoke PSAs as addressing the socialfunctions of smoking, 11% of all PSAs address this function, but fully 28% of thePSAs aimed at adolescents address this function to varying degrees.

Ads that attack the social functions of smoking represent a promising approach,because one of the functions of cigarette smoking among young people is to act as asocial lubricant, allowing the adolescent to fit in with a particular group of peers.Findings from Ohio’s Stand campaign suggest that campaigns influence norms,which in turn reduced adolescent smoking to a limited degree (Evans et al., 2007).These messages, however, may not always be effective. In particular, it appears thatnorm messages that invoke a remote norm, such as ‘‘kids at my school’’ or ‘‘kids myage’’ are ineffective if the teen’s own peer group, or the group with which the teen

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would like to associate, has a different norm than that portrayed in the message.Media messages indicating that it is not cool to smoke may help define the behavioras undesirable to the majority of teens, but to the extent that a particular teen isattracted to a peer group in which smoking is acceptable, the norms message willbe ineffective. Indeed, recent research indicates that to the extent smokers are ableto quickly bring to mind a proximal, prosmoking norm, they will not process anantismoking message (Rhodes et al., 2008). Further research is needed to more fullyunderstand how, and for whom, social norms messages can be effective.

The other functions of smoking are notably absent in the content of antismokingads. The set of ads coded for this study completely ignored one of the most prevalentreasons teenagers give for smoking: stress relief. Other functions of smoking thatwere not represented in the coded ads are weight control and mood management.In spite of consistent findings in the literature that smokers and nonsmokers alikehold the belief that smoking a cigarette can help one relax in a stressful situation,messages that counter this belief are nonexistent in the CDC set of PSAs. In contrastto this set of antismoking PSAs, however, pharmaceutical companies have begunusing functional messages in ads marketing nicotine replacement products such aspatches and lozenges. A recent campaign for lozenges portrays a mother of youngchildren resisting the urge to smoke a cigarette even when the children clearly arecausing her to feel stressed. Likewise, an ad for a nicotine patch portrays a youngwoman standing in front of a mirror attempting to zip up her jeans. The voiceoverfor the ad describes a program offered by the pharmaceutical company to help withweight control while quitting smoking. Cigarette ads have emphasized functions ofsmoking; for example, social belongingness has been featured in ads targeting youngwomen (Anderson, Glantz, & Ling, 2005). It is significant that pharmaceutical andtobacco companies have determined that addressing the functions of smoking maybe an effective way to market their products, but the producers of PSAs have notyet incorporated such themes into antismoking media campaigns designed to preventthe uptake of cigarette smoking. Undermining needs-based messages by the tobaccoindustry and identifying alternate means to fulfill needs is a promising direction fornew antismoking campaigns (Anderson et al., 2005).

In their recent commentary, Polland and colleagues (Polland et al., 2006)emphasized the importance of combining approaches to tobacco control acrossdisciplines. They noted the value of moving beyond the public health emphasis onindividual addiction and beyond the social psychological view of peer and groupinfluences to more fully and deeply understand the meaning of smoking withinthe social context. They urge researchers to take into account the perspectives ofsmokers, and emphasize that ‘‘we cannot afford to be out of step with what smokersthink, feel, and need’’ (p. 61). The findings of the current content analysis ofantismoking PSAs suggest that extant antismoking messages are indeed out of stepwith susceptible teens—extant messages largely ignored teens’ perceptions of themeaning and function of smoking for them. We propose that future researchaddress this gap by studying the effects of functionally themed messages on messageprocessing and subsequent smoking behavior.

There are limitations to the current research. First, the set of ads that was avail-able at the time of the coding was somewhat dated, in that it included only adsreleased by the CDC up to 2003. Although we are not currently aware of any cam-paigns that address functional themes, some of these themes (e.g., stress and weightcontrol) are beginning to emerge in ads for pharmaceutical nicotine replacement

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products. A second limitation is that the present research was a content analysisonly, and it did not directly address the effectiveness of any of the ads coded. Thus,we cannot assume the effectiveness of any of the ads used in this analysis. The needfor controlled experimental research to investigate the effectiveness of different typesof antismoking PSAs is clear.

Conclusions

While Cohen and colleagues’ (2007) content analysis involved a substantially moreabstract coding scheme than the current content analysis, the results are complemen-tary. Cohen and colleagues found that antismoking PSAs were atheoretical becausethey ignored the practical implications of the theory of reasoned action, the healthbelief model, and social cognitive theory. The current content analysis furtherstrengthened the criticism that antismoking PSAs are generally atheoretical. The cur-rent campaigns ignore an extensive literature on attitude functions and the matchinghypothesis by not addressing perceived functions of cigarette smoking. Current anti-smoking campaigns ignore the functional value that people perceive that smokingoffers them. We are not arguing that cigarettes actually serve positive functions.Even if cigarettes did help people control their stress, maintain their weight, fit inwith others, or delay the onset of depression, there clearly are better ways to achievethese goals. But to the extent that people perceive cigarettes as functioning inthese ways, antismoking messages that attack these functions may be successful inreducing smoking behavior.

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