Impact of the Tips from Former Smokers 2012 Campaign on Awareness and Use of Cessation Resources Kevin Davis, MA, 1 Robert Alexander, PhD, MPH 2 Paul Shafer, MA, 1 Nathan Mann, B.A., 1 Lei Zhang, PhD, 2 Ann Malarcher, PhD 2 1 RTI International, Public Health and Policy Research Program 2 Centers for Disease Control and Prevention, Office on Smoking and Health RTI International is a trade name of Research Triangle Institute. www.rti.org
Tips from Former Smokers Campaign In 2012, CDC launched the first federally funded national tobacco prevention media campaign Tips from Former Smokers (Tips) Aired nationally from March 19 to June 10, 2012 National and local television, radio, and in other channels including online, print, and outdoor media Graphic and emotional true stories about the devastating health consequence of smoking, told by former smokers Focus on daily challenges of living with smoking-attributable disabilities and conditions Ads promoted the 1-800-QUIT-NOW telephone quitline portal and Smokefree.gov
Tips Advertisements Tips ads focus on disabilities and severe health conditions caused by smoking Tracheotomy, heart attack, Buergers disease (amputations) Additional ads focus on cessation and asthma in children
Cessation Resources Promoted by Tips 1-800-QUIT-NOW National telephone portal to state quitlines State quitlines offer phone counseling, self-help materials, free or reduced priced NRT (most), and/or referrals to other cessation resources Smokefree.gov Free online resource for quitting smoking Offers guides to quitting, links to quit aids such as a craving journal, information about smoking triggers, and smoking facts Offers information for friends and family on how to support someone while they are quitting Offers information on 1-800-QUIT-NOW
Tips Campaign Strategy for Promoting 1-800-QUIT-NOW and Smokefree.gov Approximately 2/3 of all television ads were tagged with Smokefree.gov Remaining 1/3 of television ads were tagged with 1-800- QUIT-NOW Allocation of ad tagging primarily driven by sensitivity to state quitline capacity Ads tagged with 1-800-QUIT-NOW aired primarily during weekday business hours Airings generally corresponded with operating hours of most state quitlines
Objectives Evaluate the impact of the Tips campaign on smokers awareness and use of cessation resources by examining: Pre-post campaign changes in smokers awareness of 1-800- QUIT-NOW and Smokefree.gov Pre-post campaign changes in overall call volume to 1-800- QUIT-NOW and visitors to Smokefree.gov Relationship between measures of advertising delivery and trends in call volume and Smokefree.gov visitation during Tips Effectiveness of ad tagging strategies for managing call volume
Overview of Data Sources Campaign Advertising Delivery Weekly gross ratings points (GRPs) National pre-post cohort of smokers interviewed before and after Tips campaign Assesses awareness of 1-800-QUIT-NOW and Smokefree.gov in a national population of smokers Provides national estimates of Tips campaign exposure 1-800-QUIT-NOW call volume Weekly call volume, by media market Smokefree.gov visits Weekly unique visitors to Smokefree.gov
Campaign Advertising Data Measured at market level with Gross Ratings Points (GRPs) Measures relative dose of advertising in a given media market during a given period of time Defined as the product of population exposure (i.e., audience reach) and number of times exposure occurred (i.e., frequency). Example: If 75% of a media market is exposed to Tips ads 2 times in a week, the resulting GRP is 150 (75 x 2) for that week. Compiled from Nielsen television ratings data for programs on which ads aired Measured for each ad, permitting separate analysis of ads tagged with either 1-800-QUIT-NOW or Smokefree.gov
Tips Advertising GRPs by Media Market, March 4 June 10, 2012
Awareness of 1-800-QUIT-NOW and Smokefree.gov National evaluation cohort of smokers, surveyed before and after Tips campaign implementation Online survey of smokers from GfK KnowledgePanel (n=3,051) Sample augmented with additional smokers from Survey Sampling International (n=2,190) Total smoker n=5,241 Smokers were asked to report whether they were aware of 1-800-QUIT-NOW and Smokefree.gov resources Descriptive and multivariate analyses were used to assess pre-post change in these outcomes as a result of the Tips campaign.
Unique Visits to Smokefree.gov Weekly unique visitors to Smokefree.gov provided by NCI Data originates from Google Analytics platform National-level totals, by week beginning with 2 weeks prior to campaign through end of campaign Represents unique visits within each week, not page views or total visits Correlation between weekly website visits at national level and weekly variation in campaign GRPs was analyzed
1-800-QUIT-NOW Call Volume Weekly area code-level calls to 1-800-QUIT-NOW provided by NCI Includes two weeks prior to and following the campaign plus 12 campaign weeks Represents attempted calls, not unique callers Relationship between weekly area code-level calls and weekly market-level GRPs was analyzed Linear regression used to estimate calls as a function of Weekly market-level GRPs for ads tagged with 1-800-QUIT-NOW Weekly market-level GRPs for ads tagged with Smokefree.gov Covariates for secular time trend, area code population size, proportion of market population that is African American, proportion of media market population that has college degree, median income in market, and state fixed effects
Awareness of Tips Campaign By Media Channel
Change in Awareness of 1-800-QUIT-NOW and Smokefree.gov a Statistically significant difference between pre-campaign and post-campaign (p<0.05)
Trend in Weekly Unique Visitors to Smokefree.gov
Trends in Weekly Call Volume
Trend Summary Average number of unique visitors to Smokefree.gov increased from 15,083 per week before the campaign to an average of 52,492 per week during the campaign Weekly visits to Smokefree.gov were highly correlated with weekly total Tips campaign GRPs and weekly GRPs for television ads that were tagged with the Smokefree.gov URL During the Tips campaign, an average of 30,176 calls per week were placed compared to average of 16,133 per week during the two weeks before and after Tips Weekly calls were correlated strongly with weekly variation in advertising GRPs
Regression of Weekly Area Code-Level 1-800-QUIT-NOW Calls on Market-Level Tips GRPs Independent Variable 1-800-QUIT-NOW TV GRP (in 100s) Smokefree.gov TV GRP (in 100s) β (p-value) [95% CI] 52.17 (0.000) [44.44, 59.89] 22.48 (0.000) [18.68, 26.29] Elasticity Mean Market-Level Weekly GRP 0.381 31.2 0.164 69.7 Incremental call volume increases: 100 GRP increase per week (1-800-QUIT-NOW ads) => Increase of 52.2 calls/week in a given area code 100 GRP increase per week (Smokefree.com) => Increase of 22.5 calls/week in a given area code
Predicted Calls Attributable to Tips Campaign
Discussion We find strong evidence that the Tips campaign was effective in generating significant increases in awareness and use of 1-800- QUIT-NOW and Smokefree.gov during its 12-week implementation in 2012 Call volume results are consistent with previous evidence from multiple state-based campaigns Our study is first to demonstrate a dose-response effect on these outcomes in a national setting Tips GRPs for ads tagged with Smokefree.gov were also associated with call volume Smaller effect size (as expected) compared to GRPs for 1-800-QUIT-NOW ads Suggests significant number of callers retrieved 1-800-QUIT-NOW number from Smokefree.gov Quitline capacity can be effectively managed via ad tagging without compromising overall exposure to campaign ads through reduced media buys
Contact Information: Kevin Davis, MA Public Health Policy Research RTI International (919) 541-5801 kcdavis@rti.org RTI International is a trade name of Research Triangle Institute. www.rti.org