A review of the effectiveness of mass media interventions which both encourage quit attempts and reinforce current and recent attempts to quit smoking (Report)

BACKGROUND: The aim of this review was to synthesise evidence evaluating the effectiveness of mass media interventions on helping people to quit smoking/tobacco use and/or to prevent relapse. These interventions were considered for both the effectiveness of the channel of communication and also for the effectiveness of message content, and this is reported under six research questions. Particular emphasis was placed on evaluating relevance to the UK setting and effectiveness within population groups such as young people, pregnant smokers and hard to reach communities.
METHODOLOGY: This review follows the processes recommended in the NHS National Institute for Health and Clinical Excellence methods manual ‘Methods for the development of NICE public health guidance’ (March, 2006). This manual also prescribes a reporting structure that is followed here.
LITERATURE SEARCH Nineteen databases/internet sources were searched for systematic reviews and other studies, which identified 8226 references. A further 11 references were identified from other sources (e.g. bibliographies). 80 records were selected for full text retrieval, and after assessment, a final total of 44 studies/reviews met the inclusion criteria.
INCLUSION/EXCLUSION CRITERIA: The included papers focus on mass media interventions that both encourage quit attempts and reinforce current and recent attempts to quit smoking among all population groups. These interventions include mass media events and community interventions (limited to community interventions which have a mass media component). This review excluded studies with a prevention focus, studies set in developing countries, papers in a language other than English, and mass media campaigns whose impact has been assessed only in terms of intermediate outcomes (e.g. intentions to quit, motivation to quit and confidence, attitudes to smoking, and knowledge about smoking).
QUALITY APPRAISAL: Potentially relevant papers were assessed for quality using a checklist adapted from Appendix A.1 of the NICE ‘Manual’. Papers were graded both for the quality of the review or study (e.g. likelihood of bias; methodological rigour) and for the type of evidence it was reviewing (e.g. RCTs or non-RCTs). Reviews were graded for the likelihood of bias as ++ (high quality, lowest level of bias), + (good quality, low level of bias) or – (variable quality with greater degree of bias). Systematic reviews were categorised according to the study types which they included as follows: RCTs only (1), other study types (2), or a mixture of both (1&2). Following the NICE guidance, studies categorised as ‘level 3’ were not given a quality score, although we indicate where the study limitations or quality may affect the reliability of results.