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UCSF study shows attitudes toward tobacco industry linked to smoking behavior


A new study by UCSF researchers concludes that media campaigns that portray the tobacco industry in a negative light and that appeal to young adults may be a powerful intervention to decrease young adult smoking.

The study sheds light on the relationship between attitudes toward the tobacco industry and smoking behaviors of young adults aged 18 to 25 years, the age group with the highest smoking rate among any in the United States.

The study is the first to link attitudes about the tobacco industry to smoking attitudes and behavior among a national sample of young adults, according to the research team. To determine attitudes, the researchers asked respondents how strongly they agreed or disagreed with three statements: Taking a stand against smoking is important to me; I want to be involved with efforts to get rid of cigarette smoking; and I would like to see cigarette companies go out of business.

The researchers found that those who agreed with those statements and supported action against the tobacco industry were one-third as likely to be smokers as those who did not support action against the tobacco industry. Among current smokers, those who had a negative attitude towards the tobacco industry were over four times more likely to plan to quit smoking than smokers who did not support action against the tobacco industry.

The results show a national impact of the “tobacco industry denormalization” approach, which educates the public about deceptive practices of the tobacco industry in order to influence individuals’ decisions about smoking, according to the research team.

The study is reported in the “American Journal of Preventive Medicine,” published online at and in the May 2009 print edition.

“Running anti-tobacco ads to expose the fact that the tobacco industry kills five million people worldwide annually turns out to be hugely successful in preventing and promoting cessation,” said Stanton Glantz, PhD, a study co-author and professor of medicine and director of UCSF’s Center for Tobacco Control Research and Education. Other anti-smoking advertising campaigns have focused more on health hazards of smoking, rather than those including tobacco-industry denormalization messages, he added.

“This is the first study to examine attitudes toward the tobacco industry itself as motivating smoking behavior in young adults,” said Pamela Ling, MD, MPH, lead author of the study and assistant professor of general internal medicine at UCSF. “The results show a huge effect of attitudes linked to advertising campaigns that focus on portraying the tobacco industry in a negative light. The tobacco industry cares a lot about public opinion and hates those ads, because the ads make the industry look bad,” said Ling.

The UCSF study measured attitudes of 1,528 people in the 18-25 age range through questions covering attitudes toward the tobacco industry, support of action against the industry, social groups, receptivity to advertising, depression, alcohol use, and other factors associated with smoking.

Ling attributes negative attitudes toward tobacco companies to the success of the advertising campaigns that slant against the industry. The study breaks new ground in examining attitudes in a national young adult sample that had previously been evaluated only in California, she noted.

Smoking prevention efforts have been heavily concentrated on adolescents under the age of 18, and results of denormalization campaigns on adolescent smoking have been studied elsewhere. The tobacco industry focuses much of its advertising efforts on young adults in the 18 to 25 year old range, because it is the youngest legal market for tobacco. The target group in the UCSF study therefore mirrors the demographic group that has been the major target of the tobacco industry’s advertising efforts.

“Young adults are ground zero in tobacco battles right now,” said Ling. “They are sensitive to the tobacco industry lying about its products, and to the fact that the industry has been manipulating the public for so long.”

Added Glantz, “Young adulthood is an important period of transition, when some people who have tried smoking stop, and others go on to develop into smokers. So it is important to look at what motivates behavior change among this group.”

The other author on the study is Torsten B. Neilands, PhD, associate professor, Department of Medicine, and director of the research methods core at the UCSF Center for AIDS Prevention Studies.

The study was supported by grants from the Flight Attendant Medical Research Institute and the National Cancer Institute.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical and public health research, graduate-level education in the life sciences and health professions, and excellence in patient care. For further information, visit


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