Objectives: This study sought to identify the pathways through which state-funded counterindustry media campaigns influence beliefs and attitudes regarding tobacco industry practices and smoking status.
Methods: A national random-digit-dial telephone survey of 6875 youths 12 to 24 years old was conducted in Winter 1999-2000. Exploratory and confirmatory factor analysis investigated the structure underlying beliefs and attitudes toward the tobacco industry. Structural equation modeling tested whether the data were consistent with a theoretically based causal model of campaign effects from exposure to an aggressive counterindustry campaign, mediated by beliefs about tobacco industry practices and attitudes toward the tobacco industry, to smoking status.
Results: Exploratory and confirmatory factor analysis indicated that two dimensions underlie perceptions of the tobacco industry: beliefs about tobacco industry practices and attitudes toward the industry. Structural equation models provided strong support for the hypothesized model: youth living in states with aggressive counterindustry media campaigns had more negative beliefs about tobacco industry practices, which led to negative attitudes toward the industry and less progression along a continuum of smoking intentions and behavior.
Conclusions: Media campaigns using counterindustry messages show promise in reducing smoking behavior among teens and young adults by changing beliefs about industry practices.