Anti-cigarette messaging works, study shows

David Heitz

(Mathew Macquarrie/Unsplash)

Messages aimed at people who smoke informing them of the dangers of the habit cause them to consider quitting, a study published online today in Journal of the American Medical Association shows.

The U.S. Food and Drug Administration has a civic duty to inform Americans of the hazards of smoking, a public health problem. But officials at the FDA wondered how to best go about informing Americans of smoking dangers. Would anybody even listen?

They commissioned some research to find out. Lead author Dr. Adam O. Goldstein of the University of North Carolina at Chapel Hill and colleagues conducted a clinical trial of almost 800 daily smokers.

Some received emails warning of the dangerous of smoking; others did not. Those who received the emails demonstrated they were three times more likely to consider quitting smoking than before the information campaign.

Participants in the study received daily e-mails for 15 days. Some said cigarette smoke contains arsenic and causes heart damage. The messages were sourced by the FDA to show where the science comes from.

Others received messages like, “Within 3 months of quitting, your heart and lungs work better. Ready to be tobacco free? You can quit. For free nicotine replacement, call 1-800-QUIT-NOW.” A control group only received messages about littering cigarette butts.

The smokers kept track of their daily cigarette habits to show how the messaging may have affected them.

“These findings indicate that messages about cigarette smoke constituents increased smokers’ intentions to quit, which can inform national efforts to communicate harmful constituents in cigarette smoke among adults who smoke,” the authors concluded.

“To our knowledge, this is the first longitudinal test of cigarette constituent campaign messages in a national sample of adults who currently smoke.”

Mass media campaigns effective

Fewer Americans smoke today than ever before. But cigarette smoking still is a pervasive habit in American culture.

“While smoking rates have reached the lowest level ever recorded among US adults, 34.2 million adults still smoke cigarettes,” the researchers reported. “Smoking is higher among socioeconomically disadvantaged populations, and these populations experience disproportionately higher smoking-related health effects. Smoking results in a large annual loss in U.S. economic productivity ($170 billion) and higher medical care expenditures ($133 billion), accentuating the need for stronger public health solutions.”

Organizations like the FDA have various weapons in their arsenal for attacking the habit of cigarette smoking. “Tobacco control strategies include increasing tobacco prices, implementing smoke-free laws, improving access to evidence-based cessation treatment, and deploying hard-hitting media campaigns,” the authors reported. “Research shows that mass media campaigns have a wide population reach and can change smoking behaviors and be cost-effective.

“The duration, intensity, message design, and targeting of the media campaign to a specific population play an important role in the success and effectiveness of the campaign.”

‘Arsenic, formaldehyde’ catch smokers’ attention

“Research examining cigarette smoke constituent messages suggests that there is a substantial misunderstanding of the source of harmful constituents, and awareness that certain chemicals are contained in tobacco smoke is low,” the authors noted after examining previous research.

Another study found that certain key words could most effectively discourage cigarette smoking. Those are words like "arsenic" and "formaldehyde.”

The research helps inform future messaging by the FDA. “Prior research has shown the importance of source credibility (i.e., presenting the FDA logo) on attitudes and behavioral intentions. Engagement text about quitting, including information on the benefits of quitting, with an interrogative cue, a self-efficacy cue, and quit line information can all enhance the impact of messages.”

Opioid therapy benefits those who abuse alcohol

In other research published online Wednesday in the Journal of the American Medical Association, a clinical trial showed that medications used to wean people off opioids have an added benefit.

People given methadone or other opioid replacements had fewer adverse alcohol-related events, such as falls.

Unfortunately, people who abuse opioids often abuse alcohol, too. The two drugs together, both nervous system depressants, can prove deadly.

“Alcohol is the most commonly misused substance, both as a standalone drug and in the context of polysubstance use,” the authors of the research reported. “More than 25 percent of patients with opioid use disorder exhibit problematic alcohol use, and, therefore, mitigation of risk for incident or recurrent alcohol use disorder presents a salient problem in the treatment of opioid use disorder.

“As central nervous system depressants alcohol and opioids can be lethal in combination, leading to increased overdoses and mortality among patients with opioid use disorder in addition to increased health care utilization.

"Because problematic alcohol and opioid use are traditionally studied as independent conditions, limited evidence-based strategies exist for mitigation of alcohol-related risk among patients with opioid use disorder.”

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I've been in the news business 35 years, spending much of my career in editing roles at local newspapers in Los Angeles, Detroit, and the Quad-Cities of Illinois and Iowa. Upon moving to Denver in 2018, I began experiencing severe mental illness due to several traumatic experiences. I became homeless on the street for about a year before spending time in the state mental hospital. I am living proof that people can rebound from mental illness with proper treatment, even after experiencing homelessness. I consider myself a lucky guy to live in a great place like Denver. I hope my writing reflects the passion I have for living here. You can email me news releases and story ideas at

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