Media Literacy Tops Traditional Education In School Smoking-Prevention Efforts

A school-based smoking prevention program centered on media literacy performed better than traditional anti-smoking educational programming, according to a study by Pitt’s School of Medicine.

Traditional anti-smoking education focuses on the health effects of smoking and resisting peer and other social influences. In contrast, a focus on media literacy empowers participants to analyze and evaluate portrayals of tobacco use in the media—in film, magazines, and other outlets—and to question their appeal when compared with health statistics and the reality of smoking’s known effects on health.

In the study, published recently in the Journal of School Health, the researchers randomly assigned 796 ninth-grade students in three Pittsburgh high schools to receive either an anti-smoking media literacy program or a rigorous traditional anti-smoking program.

Among high-risk students who originally said they planned to smoke in the future, more students in the media literacy program changed their minds at the conclusion of the program compared with those in the traditional program. Students who received media literacy programming also perceived smoking as less popular, which has been closely linked with better behavioral smoking outcomes in the past.

The students in the media literacy group also gave higher evaluation scores for their enjoyment of and attention to the program. They were more likely to indicate that they would look at smoking and advertising differently in the future, compared with the traditional group.

In other areas, such as attitudes toward smoking, the two programs performed similarly, but the traditional program did not surpass the media-literacy program in any category.

“Because traditional programs have not been as successful as we would like in preventing smoking among youth, it is very important that we innovate in this area,” said lead author Brian A. Primack, a professor of medicine and pediatrics in Pitt’s School of Medicine, and director of Pitt’s Program for Research on Media and Health. “The results of this study suggest that media literacy has potential, which we should continue to investigate.”

Primack and his colleagues suggest that one reason media literacy may be effective is that youth aged eight to 18 continue to be exposed to more than 10 hours of media content each day, including multiple positive images of smoking, which previous research has clearly linked to initiation of smoking. Additionally, media literacy inherently may be more effective for sensation-seeking, rebellious individuals who are more at risk for using tobacco.

“We were particularly interested in the group of 236 students who reported at the start of the program that they intended to smoke in the future. Among these individuals, 24 percent of those assigned to the media literacy group reverted to not intending to smoke after the intervention, compared with only 16 percent of those assigned to the traditional program,” said Primack. “Although our study was relatively small, if changes of this magnitude are borne out in other studies, this would translate into clinically meaningful differences. Another challenge for the future will be to examine longer-term smoking outcomes.”