Anti-Smoking Campaigns

Trends in Cigarette Smoking in the United States

The prevalence of cigarette smoking in the United States varied dramatically over the past century. Cigarette smoking gained popularity in the late 19th century following the mass manufacturing and marketing of machine-rolled cigarettes. Although several organizations voiced concerns about the health effects of smoking, cigarette consumption increased dramatically between 1900 and the early 1960s. A sharp acceleration in cigarette smoking rates occurred during the 1940s, aided by cigarette companies' successful efforts to link smoking with patriotism and U.S. military efforts in World War II. By the mid-20th century, cigarette smoking was seen as a socially acceptable and normative behavior.

The late 1950s and early 1960s brought increased concerns about the health effects of smoking, culminating in the 1964 publication of the first Surgeon General's Report on the health effects of smoking. U.S. smoking rates have declined since the late 1960s, with accelerated reductions following the 1986 Surgeon General's Report on the health effects of secondhand smoke and the 1998 Master Settlement Agreement punishing cigarette companies for denying the harmful effects of their product. Today, approximately 20% of U.S. adults smoke.

Anti-Smoking Campaigns Since 1960

The first nationally coordinated anti-smoking media campaign in the United States occurred between 1967 and early 1971. Anti-smoking activists successfully lobbied the Federal Communications Commission to apply the Fairness Doctrine [Page 54]to cigarette advertising, which required that broadcasters donate one free anti-smoking ad for every three cigarette commercials. This legal move resulted in widespread public broadcasting of anti-smoking ads, most of which focused on the health effects of cigarette smoking. Scholars estimate that over $200 million worth of donated time was used for anti-smoking campaign messages. The campaign stopped in 1971, when cigarette companies agreed to halt all broadcast advertising for their products.

The next two decades witnessed the development and evaluation of several controlled community intervention trials related to cigarette smoking. These trials assessed the impact of anti-smoking media campaigns alongside broader community efforts (school-based tobacco education, community education, and other events) in small sets of matched communities. Notable examples include the North Karelia Project in Finland, the Stanford Three-City and Five-City Projects in California, the Minnesota Heart Health Program, the Quit for Life Programs in Australia, and the Community Intervention Trial for Smoking Cessation (COMMIT) in the United States. These trials often combined anti-smoking messages with broader efforts (for example, messages to improve diet) to reduce cardiovascular disease risk.

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