Dr. Jocelyn Mullins
Health Promotion Program
October 6th, 2017
The truth campaign otherwise known as Truth initiative is a program dedicated to informing all youths and young adults regarding the truth about tobacco. Before it was renamed Truth Initiative it was known as the American Legacy Foundation. The American Legacy Foundation was the outcome of a successful settlement of civil cases in November 1998, between the tobacco companies and a coalition of 46 state attorneys general.1The participating tobacco manufacturers and settling states came to a split settlement agreement; the Master Settlement Agreement (MSA) and the Smokeless Tobacco Settlement Agreement (STMSA). These two settlement agreements provided for the establishment and initial funding of a Section 501(c)(3) organization to reduce tobacco usage in the United States.1 As a result of this, the Master Settlement Agreement foundation (MSA Foundation) was formed in March 1999 and was later renamed the American Legacy Foundation.1
In effects to reflect their objective to align all programs more closely and consistent with its mission, and to achieve a culture where all youths and young adults are inclusive; the American Legacy Foundation legally changed its name to Truth Initiative on August 27th, 2015.1 Even after the change of the company's name, they have kept the same mission which is to inspire tobacco-free lives. Today, the Truth Initiative is America's largest non-profit public health organization that has been widely credited with contributing to the significant drop in teen smoking. It is important to address this youth smoking issue because 99% of daily smokers try their first cigarette before the age of 27 and of all the children and young adults, 5.6 million of them will die prematurely due to tobacco-related illness.1 To improve this, the truth campaign's mission and program is designed to influence knowledge, beliefs, social norms, and attitudes that are statistically associated with the behavior the campaign seeks to change.2
Setting and Population
The targeted population for the truth initiative program are young adults and youths in every community. Initially the Truth initiative campaign focused on youths between ages 12 - 17 years old. 1 However, after collecting data from one of their surveys, the concluded that the age of initiation is increasing therefore the program expanded their campaign by focusing on youths and young adults between ages 15 - 25 years old. 1 The campaign has always been designed to reach out and send a powerful message to impact the youth and young adults who are smokers or nonsmokers. 1
The program focuses on engagement with the community and most of their work are on ground. Truth Initiative's campaign and message are executed in the community, high schools and on colleges, universities, and community college campuses across the United States. 1 For example, in April, Truth Initiative partnered with the CVS Health Foundation to help historically black colleges and universities and community colleges implement comprehensive smoke- or tobacco-free company. 1
It is explained briefly that the Truth Initiative campaign is designed to target the young adults and because of their targeted audience, they decided to partner with schools and communities because the young adults are in school to learn and gain knowledge. Therefore, by seeing posters by the campaign plastered around within the school, they will learn about the statistics of the impact tobacco has and how they can prevent themselves from things such as engaging in peer pressure, and why it is important to quit smoking if they are already doing so. With the community, colleges, universities and community colleges, connections are built and it is more informative by handing out pamphlets and having one on one conversations.
The campaign shows the importance of a smoke free environment and community to the youths and young adults because those age group are at the highest risk of engaging in using and smoking tobacco. Additionally, the environment around the youth and young adults, influence their choices therefore, by involving the community and the schools, colleges etc., the Truth Initiative campaign is covering multiple grounds while being informative.
Theory and Application
Figure 1; Statistic on flavored tobacco use amongst Hispanic middle and high school students
Taken from Truth Initiative's twitter Account. 3
After reviewing the Truth Initiative campaign, it can be categorized into the social cognitive theory and social process theory.
Social Process Theory
Truth Initiative have many advertisements on television that fall under the social process theory (diffusion of innovation). These ads usually appear on t.v. stations that young adults watch such as MTV, VH1, ABC, PBS, BET just to mention a few. With social media being influential and because it has a huge impact on their targeted audience, the campaign has changed their framework and tone for communicating through social media. Their twitter and Facebook accounts post daily messages and sometimes tips on how to make the first steps to quit smoking. As seen in figure 1 above, they also post statistics, reports from their collected data and ask questions on these accounts to see what their audience would like to improve and also their opinion on topics that tie in with the theme of the program.3 Their use of social media and t.v. ads gave them a new-found platform to speak out to the youths for 30 seconds in between their shows and reach out and connect to them with one hundred and forty characters or less. The viewers can follow the website mentioned in the t.v. ad in order to contact them for more information or by tweeting their official account, they can ask any questions to one of the members of the Truth campaign. The information they receive from these interactions are then taken back to the table of the office and shared with the campaign, whether there are positive reviews, critiques or improvement suggestions. There is still a gap within the adoption phase because its not clearly measure how many people watch the t.v. ads or come across the tweet and actually make a change.
The social cognitive theory
The Truth Initiative has a few programs within the entire campaign (The National Summit on Youth Activism, The Youth Activism Fellowship and Youth Engagement Alliance for Tobacco Control) that are aimed at engaging the youth to help develop the next generation of youth and young adult tobacco-control leaders.1 In April, there was a rally outside of a Walgreen's shareholder meeting in New York.4 This was organized to pressure the pharmacy's board of directors to stop selling tobacco in their stores. 4 Because this was earlier this year there has not been any feedback or outcome from the rally yet. However, with persistence, Truth organized a petition and collected over 5,300 youth signatures and partnered with DoSomething.org on an effort that engaged more than 67,000 young people to encourage pharmacies to remove tobacco products from their stores around their communities. 1, 4 The program was tailored to young adults but there were many older people outside of the age range the campaign targets. This showed them programs that there are older aged people who support and stand behind their brand in promoting and spreading Truth Initiative's message. Parents have noticed that it sometimes begins with them and the example they are setting their children, so they joined the movement and committed to changing their behaviors and for a better and healthier future. Also, by them protesting outside of the store in their Walgreens it is bring attention to not only the owner of the store but the locals walking, riding, and driving by during their commute. Nevertheless, teen smoking in the United States have fallen to a record low 5.9% which is a full percentage point drop within one year and a huge decline from 23% in 2000. This is due to the success of the Truth Campaign, programs from the Centers for Disease Control and Prevention (CDC), U.S. Food and Drug Administration (FDA) and their public and educational programs. 1
Another example of social cognitive theory was a two-telephone survey that involved 12- to 17-year-olds with multivariate logistic regressions: a baseline survey conducted before the launch of “truth” and a second survey 10 months into the “truth” campaign. 5 They analyzed the changes in the young adults' attitudes, beliefs and intentions.5 The telephone survey of youths in Florida and nationwide demonstrated that attitudes toward tobacco changed dramatically among Florida youths compared with youths in the rest of the United States after the first year (1998) of Florida's “truth” campaign, compared with a national sample of youths whose attitudes remained relatively constant. 5
One of the strengths in the telephone survey was the fact that they targeted youths in Florida because it was noted that young adults in Florida demonstrated attitudes towards tobacco changed drastically. 5 The weakness in this survey was that this only showed a small sample of results from one state, compared to the rest of the United States, it's difficult to measure if the Truth Initiative campaign had a huge impact on the youths across the U.S. Another possible limitation may be the difficulty in separating the independent effects of each campaign if there is insufficient variation in exposure to both campaigns. This possibility could explain why we find that “Think. Don't Smoke.” appears to move youths' attitudes in a pro-tobacco direction. 5 The examination of this question through changing model specifications suggested that multicollinearity across the 2 campaign exposures was not present.5 To determine whether or not this multicollinearity is a concern, they dropped the “truth” exposure variable from the logistic regression models and examined whether the odds ratios were influenced. Results showed that all of the odds ratios remained stable. 5 Also, an aggressive national tobacco counter marketing campaign can have a dramatic influence within a short period of time on attitudes toward tobacco and the tobacco industry. 5 These attitudinal changes were also associated with reduced intentions to smoke among those at risk.
The strengths of the overall campaign are the campaign is designed around the youth and young adults. They did a great job at making their website easy to access and their message simple yet powerful. Most young children do not want to read when they see long paragraphs etc. but the website point out the import key interests as to what they are aiming to accomplish, how they are progressing as a campaign, staying up to date with data and also numerous ways the young adults can get involved either on campus, in their community or online promotion which involves spreading of the campaign's message and informing their friends and families. Many companies often rely on just their company to make a change but Truth initiative goes beyond measures by involving the people of the different communities. The only weakness I have noticed is that their audience is not met as often as I would expect. For example, the t.v. ads will come on once during the entire show, what about people that missed the commercial? Also, it should be shown on many other stations to reach a bigger audience. Another thing the campaign can improve on is their social media appearance. As previously mentioned social media has a big impact on society especially the young generation, today so they need to implement more things to gain more attention. They have almost 10,000 followers but those followers are not interactive and receiving the things they are putting out there. I would suggest using other social media platforms such as Instagram to reach a new audience through bright and straight to the point pictures, and not just words.
Results and Implications
According to the Scholarly article; results from the 2 nationally representative surveys demonstrate that 10 months into the “truth” campaign, tobacco was more prominent in the minds of youths. 5 Unaided awareness of tobacco counter marketing campaigns has nearly doubled. The “truth” campaign resonates more with youths than “Think. Don't Smoke,” even though the “Think. Don't Smoke.” campaign began in 1998 and aired for more than 12 months before the initial 10-month run of the “truth” campaign reported here. 5 Youths rated advertisements that graphically, dramatically, and emotionally portrayed the serious consequences of smoking highest in terms of making them “stop and think about not using tobacco. The attitudes that changed most dramatically were “taking a stand against smoking is important,” “not smoking is a way to express independence,” and “cigarette companies deny that cigarettes cause cancer and other harmful diseases.” 5 Analyses indicate that although the level of confirmed awareness for both campaigns is roughly equal, “truth” has had a more consistent impact on attitudes toward smoking. 5 Even though it can use some small improvements, it is without a doubt that the Truth Initiative campaign is most effective and has been influential when it comes to reducing young adults and youth engagement with tobacco smoking.
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