Evidence map›Paper›PMID 34906127›Full record

Trial reportBMC public health2021

"The Real Cost" Smokeless campaign: changes in beliefs about smokeless tobacco among rural boys, a longitudinal randomized controlled field trial.

Matthew C Farrelly, Nathaniel H Taylor, James M Nonnemaker, Alexandria A Smith, Janine C Delahanty, Xiaoquan Zhao

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Tailoring e-Cigarette Health Messages by Vaping Status: How Source and Message Presentation Type Shape Young Adults' Perceptions.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
    Trial
  3. Review
  4. Review
  5. Article
  6. The Impact of Social Media Use and Gaming on Initiation of Smokeless Tobacco Use Among Rural Male Youth.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2023
    Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Matthew C FarrellyCenter for Health Analytics, Media, and Policy, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709, USA.
Nathaniel H TaylorCenter for Health Analytics, Media, and Policy, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709, USA. NTaylor@rti.org.
James M NonnemakerCenter for Health Analytics, Media, and Policy, RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC, 27709, USA.
Alexandria A SmithCenter for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Janine C DelahantyCenter for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Xiaoquan ZhaoCenter for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA.
RTI International · USUnited States Food and Drug Administration · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prevalence of current smokeless tobacco (SLT) use in 2019 among high school students was 4.8%, and the overall rate of SLT use was higher among high school boys (7.5%) than girls (1.8%). The U.S. Food and Drug Administration (FDA) launched "The Real Cost" Smokeless media campaign in April 2016 to educate rural youth about the dangers of SLT use. In this study, we evaluate the effectiveness of "The Real Cost" Smokeless campaign.

methodsWe use a 3-year (Jan 2016 - Dec 2018) randomized controlled longitudinal field trial that consists of a baseline survey of boys and a parent/guardian and four follow-up surveys of the boys. The cohort includes 2200 boys who were 11 to 16 years old at baseline and lived in the rural segments of 30 media markets (15 treatment markets and 15 control). "The Real Cost" Smokeless campaign targets boys who are 12 to 17 years old in 35 media markets. It focuses primarily on graphic depictions of cosmetic and long-term health consequences of SLT use. The key outcome measures include beliefs and attitudes toward SLT that are targeted (explicitly or implicitly) by campaign messages.

resultsUsing multivariate difference-in-difference analysis (conducted in 2019 and 2020), we found that agreement with 4 of the 11 explicit campaign-targeted belief and attitude measures increased significantly from baseline to post-campaign launch among boys 14 to 16 years old in treatment vs. control markets. Agreement did not increase for boys 11-13 years old in treatment vs. control markets and only increased for one targeted message for the overall sample.

conclusionsThese findings suggest that "The Real Cost" Smokeless campaign influenced beliefs and attitudes among older boys in campaign markets and that a campaign focused on health consequences of tobacco use can be targeted to rural boys, influence beliefs about SLT use, and potentially prevent SLT use.

Indexed as

Tobacco, SmokelessAdolescentChildFemaleHumansMalePrevalenceSchoolsStudentsTobacco UseLongitudinalMedia campaign evaluationRandomizedRural youthSmokeless tobacco

Identifiers

PMID34906127
PMCPMC8670032
OpenAlexW4200026912

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.