Not all mass media campaigns have been effective. The media are, after all, merely channels through which people receive information and entertainment. It has been estimated that there are up to 1,500 persuasive messages each day aimed at any given individual in the United States. Advertisers have closely studied behavior and know where to put a message to maximize our chances of being exposed to it. We are not passive as an audience, however. We actively seek some messages, avoid others, and let the majority flow by us, paying attention to one here and there that catches our attention and interest.

The amount of money that needs to be spent to ensure that a target audience is exposed to and pays attention to a given message depends on how the message is packaged. To minimize the money needed for mass media campaigns, tobacco control programs have sought to produce television advertisements that viewers will remember forever after seeing them once. However, what is recalled is a version of the original message. One cannot predict how the media message will be processed to fit the individual's experience or how it will relate to other salient messages the person has received. Powerful messages focusing on the health consequences of smoking appear to have been very important in promoting a community atmosphere that encourages smokers to quit. In addition, many smokers think about quitting when they see such advertisements and will take an immediate action, such as picking up the telephone and asking for help in quitting. This window of willingness to change can be quite brief, and the emotional impact that demands an action response to the message is generally gone in a few days. Linking such messages with telephone counseling help lines is an effective way of extending the life of a message (Pierce et al., 1992; Zhu et al., 1996). If assistance in quitting is quickly available to these responding smokers, it becomes possible to double the rate of successful quitting.

Another mass media approach that has been used is to challenge the credibility of the tobacco industry. This approach, which has been used extensively in California, argues that the industry needs to present itself in a very positive light to sustain its influence on legislators and others in thwarting tobacco control efforts. Negative advertising on the image of the industry is seen as one means of reinforcing community norms against smoking. These norms appear to play an important role in influencing smokers' willingness to attempt to quit and in influencing nonsmokers' willingness to experiment with smoking (Pierce et al., 1993, 1994a).

The third area in which the mass media have been extensively used is in advertising to prevent the uptake of smoking. Typically, tobacco control programs have emphasized images that are salient to confirmed nonsmokers. Unfortunately, there are very few success stories in this area. The tobacco industry typically outspends these campaigns by orders of magnitude as high as 25 to 30 times. Furthermore, the industry, in conjunction with advertisers, has carefully honed its messages and their presentation so that it is virtually impossible for tobacco control programs to win the image war with adolescents. Recall that



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