advertising, researchers have proposed that a federal tax be levied on tobacco advertising and promotion (Bayer et al., 2002). The impact of a 10-cent tax would generate about $2.1 billion a year, which would substantially increase the funds currently available for antitobacco advertising. The U.S. Supreme Court has not yet tested the constitutionality of a content-based tax on commercial speech. More discussion and research are needed to identify and develop support for strategies that can improve the balance between advertising that promotes health and advertising for products that harm the health of the public.

Entertainment Media: Television

Television is one of society’s most common and constant learning environments. Television entertainment programs and commercials, with potential positive and negative health messages embedded in them, reach tens of millions of viewers each day. Often, these messages reach viewers who may not otherwise expose themselves to such information and do not fully realize that these messages may influence their thoughts and actions (Signorielli, 1990). However, concerted efforts to develop strong partnerships between the entertainment media and health communicators are increasingly contributing to more accurate and timely health information in entertainment programming.

American television producers have a history of working with health promotion experts to address public health issues. A few examples are alcoholism on Hill Street Blues and Cagney and Lacey; AIDS on St. Elsewhere, Designing Women, and LA Law; birth control on Valerie (Wallack, 1990); and the Jeanie Boulet storyline on AIDS on ER.

A more concerted effort to partner with entertainment media to disseminate health messages was undertaken by researchers at the Harvard School of Public Health Center for Health Communication. In 1988, the Harvard Alcohol Project partnered with the three largest television networks—ABC, CBS, and NBC—to demonstrate that a new social concept, the “designated driver” for avoiding driving after drinking, could be diffused rapidly through American society via mass communication techniques. As part of the project, television writers agreed to insert drunk driving prevention messages and references to designated drivers into the scripts of top-rated television programs. The networks also aired frequent PSAs during prime time that encouraged the use of designated drivers (www.hsph.harvard.edu/chc/alcohol). Evaluations of the campaign’s impact documented a rapid, widespread acceptance and the strong popularity of the designated driver concept. Before the campaign, 62 percent of Gallup poll respondents said that they and their families used a designated driver all or most of the time. By mid-1989, the percentage had risen to 72 percent, a



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