Recall of Tobacco Corrective-statements advertisements and Effects on Health Information-seeking Behavior
Abstract Background: In the 2006, landmark ruling, US District Judge Gladys Kessler instructed tobacco companies to disseminate corrective-statements (CSs) against their products through media advertisements. This study objectives were to (1) examine the proportion of adults who were exposed to each of the five CS messages ; and to (2) describe the association between exposure to CSs and health-information seeking behavior among the US adult population.Methods: Data, settings, participants, outcomes, and statistical approach.We analyzed the most recent nationally representative data from the population-based cross-sectional survey of US adults, the Health Information National Trends Survey (HINTS5-Cycle2,2018). Data collection began in January 2018 and concluded in May 2018, and analysis took place from May 2019 to October 2019. Statistical significance was defined as a P-value less than 0.05, and all tests were 2-tailed. All data were weighted to be nationally representative.Results: Key findings.Exposure to CS was not independently associated with health-information seeking behavior. Among exposed, those with less than high school education sought out health information significantly less (70.2%, 95%CI=53.8-86.5) compared to college graduates (93.3%, 95%CI=90.8 - 95.7) (p<0.0002); exposed females reported higher prevalence of seeking healthinformation 88.4% (95%CI= 85.9– 90.96) compared to males at 75.4% (95%CI =67.3– 83.6) (p<0.0001). Assessing the impact of CS language and advertisement framing on message recall, we found that majority reported exposure to (Message 1) “health effects of smoking.” estimated at 85.8% (95%CI= 82.9 – 88.6). Followed by 65.8% (95%CI= 61.1 – 70.5) recalling (Message 2) “health effects of secondhand smoke”.Our logistic regression analysis revealed that the odds of health information seeking were two times higher in females (Adjusted Odds Ratio [AOR], 2.07; 95%CI=1.59- 2.69); while odds were 2.55 folds higher among those who had at least college education (95% CI= 1.26 - 5.21), compared with less than high school. Compared to white adults, odds of seeking health information were lower among Blacks (AOR=0.46; 95%CI=0.29 - 0.74) and Hispanics (AOR=0.51; 95%CI= 0.33 - 0.79).Conclusions: Key message and implications.This study found that the court ordered national antismoking advertising campaign had different exposure and recall patterns in subgroups depending on the message category. While some messages were easier to recall others, perhaps more technical ones, were less likely to make an impact on participants’ memory and prompt change to health behavior.