INTRODUCTION: There is substantial evidence that mass media campaigns increase calls to quitlines and smoking cessation. In 2012, the Centers for Disease Control and Prevention launched the first federally funded national tobacco education campaign, Tips From Former Smokers® (i.e. Tips), which has since aired television advertisements annually. To date, no studies have examined the long-term effect of a national smoking cessation campaign on quitline calls. This study examined the long-term impact of Tips television ads on calls to 1-800-QUIT-NOW from 2012 through 2023. METHODS: Exposure to the Tips campaign was measured using weekly television gross rating points (GRPs) in each U.S. designated market area. We obtained data on calls to 1-800-QUIT-NOW from the National Cancer Institute and used linear regression to model calls to 1-800-QUIT-NOW, from 2012 through 2023, as a function of weekly media market-level GRPs for Tips television ads. Using the regression model results, we calculated predicted values of calls to 1-800-QUIT-NOW across observed GRP values to determine the total additional calls to 1-800-QUIT-NOW that were attributable to the Tips campaign during 2012-2023. RESULTS: Tips GRPs were positively and significantly associated with calls to 1-800-QUIT-NOW across all years (b = 39.94, p < 0.001). Based on this association, we estimate the Tips campaign generated nearly 2.1 million additional calls to 1-800-QUIT-NOW during 2012-2023. CONCLUSIONS: Exposure to the Tips campaign has consistently and significantly increased calls to tobacco quitlines. IMPLICATIONS: Quitlines provide evidence-based support to help people quit smoking. They have been shown to increase the likelihood of successfully quitting. Mass media campaigns have promoted quitline services, and quitline calls have increased significantly with media promotion. The long-term effect of campaigns - like the Centers for Disease Control and Prevention's Tips From Former Smokers® (i.e. Tips) - on quitline calls has not been determined. From 2012 through 2023, exposure to the Tips campaign is estimated to have generated nearly 2.1 million additional calls to 1-800-QUIT-NOW. This study supports continued use of mass media to promote quitlines.

In a recent study by Ayers et al.,1 the authors analyzed Google search patterns associated with health conditions depicted in CDC’s national tobacco education campaign, Tips From Former Smokers (Tips). Although examining search trends to inform the effectiveness of health campaigns holds promise, the authors make a number of statements that we, as the principal scientists and campaign managers, disagree with. | First, the authors state that “Tips is the nation’s most costly tobacco control initiative.” To put the cost of Tips (approximately $50 million annually) into perspective, this amount represents less than 2 days of what the tobacco industry spends in a year ($8 billion) on tobacco promotion. States also spend approximately $500 million yearly on integrated tobacco control. A recent study2 demonstrated that the Tips campaign was a highly cost-effective initiative, based on often-used benchmarks for public health interventions. | Second, the authors state that “little is known about [the Tips campaign’s] effectiveness,” citing a 2013 study published in Lancet.3 However, this study was a rigorous evaluation of campaign effectiveness, based on a large, nationally representative, longitudinal cohort of smokers and nonsmokers in the U.S. The campaign was responsible for approximately 1.6 million new quit attempts, with an estimated 100,000 of these sustained for at least 6 months. In addition, the 2012 Tips campaign was associated with increased knowledge of the health conditions featured in Tips ads, increased motivation to quit, and increased smoking-related concerns about health.4 | Third, the authors posit that Tips was no longer effective in 2013. CDC has closely tracked calls to the 1-800-QUIT-NOW quitline, which showed increases directly associated with campaign tags in 2012 and 2013.5 In 2013, there were marked increases in calls in the alternating weeks the campaign was on the air (Figure 1). In addition, an independent prospective cohort study of smokers found that 71% saw at least one 2013 Tips ad and the campaign increased awareness of health risks and cessation resources.6

CONTEXT: Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. EVIDENCE ACQUISITION: Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. EVIDENCE SYNTHESIS: Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. CONCLUSIONS: Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.