403 Mass media interventions effective for smoking cessation in adults

November 01, 2013

PEARLS 403, September 2013, written by Brian R McAvoy

Clinical question

How effective are mass media interventions in reducing smoking among adults?

Bottom line

Five large studies out of the nine studies which reported smoking prevalence found some positive changes in smoking behaviour with mass media interventions. Three large studies out of seven that measured the quantity of tobacco smoked found reductions. Four of the seven studies which measured quit rates reported significant increases in abstinence, but this finding was difficult to interpret because studies used different definitions of smoking, smokers and quit attempts. The intensity and duration of mass media campaigns may influence effectiveness, but length of follow-up and concurrent events in the community can make this difficult to verify. No consistent relationship was observed between campaign effectiveness and age, education, ethnicity or gender of those taking part.


Studies differed in design, settings, duration, content and intensity of intervention, length of follow-up, methods of evaluation and also in definitions and measures of smoking behaviour used. All the studies used some kind of control group, but did not randomise communities to intervention and control conditions. Most of the studies with positive findings had problems with participant drop-out and missing data. Response rates ranged from 43% to 99%, with retention rates between 52% and 76%.


Mass media interventions involve communication through television, radio, newspapers, billboards, posters, leaflets or booklets, with the intention of encouraging smokers to stop, and of maintaining abstinence in non-smokers. It is likely they contribute to a reduction in smoking when used as part of a complex set of interventions, but it is difficult to establish their independent role and value in this process.

Cochrane Systematic Review

Bala MM et al. Mass media interventions for smoking cessation in adults. Cochrane Reviews, 2013, Issue 6. Art. No.: CD004704.DOI: 10.1002/14651858. CD004704.pub3. This review contains 11 studies involving over 41 million participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.