Which are the communication styles of anti-tobacco spots that most impress adolescents?

Objectives To evaluate emotions and opinions of Italian adolescents aged 13-18 years old about different anti-tobacco spots delivered by the mass media campaigns over the world. Methods A multicenter cross-sectional study was conducted. Italian students from different regions were enrolled. A video that collected 7 anti-tobacco spots from all over the world. The spots describe the tobacco dependence, the health damages and the tobacco components using different communication styles (funny, scientific, dramatic, comedians, shocking, and sad). Information on age, gender, smoking status of family and peers were gathered. Descriptive and univariate analysis of emotional and cognitive reactions to spots were performed with respect to gender, smoking status of adolescents, their peers and parents. Results 495 students were enrolled. 14% of them were current smokers. Two spots resulted to have most impressed the students: Sponge (29%) and Icons (18%). In the first spot the sponges represent human lungs, a pair of hands squeeze the tar from the sponge, revealing the cancer-producing tar that goes into the lungs of a pack-a-day smoker every year. The second one contrasts tobacco industry images such as a cowboy, a hip-hop DJ with a more accurate depiction of the repercussions of smoking: a dying man in a wheelchair who warns, ‘The reality is you can end up looking like this’. The reactions on these videos are disgust, reflection and sadness, respectively: Sponge 79%, 44% and 15%; Icons 60%, 3% and 20%. Univariate analysis showed differences by smoking status about video considered most impressive (p = 0.02) and by gender about the choice of spot in the role of the Minister of Health (p < 0.001). Conclusions The spot media campaigns that gave a clear and scientific message or that changed the “icon” of the smoker were preferred by adolescents. Further research is needed to study adolescents’ responses and smoking outcomes obtained by different anti-tobacco mass media campaigns. Key messages The study demonstrates the preference of adolescents for spot giving clear scientific messages or using strategies that fight manipulation of the tobacco industry and aimed at changing smoker’s icon. The present study underlines that it is necessary to monitor the effect of a multimedia campaign and to examine its longitudinal impact, especially its impact on smoking behavior.