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NC Department of Health and Human Services
NC DPH: Chronic Disease and Injury Section

Tobacco Prevention and Control Branch

Youth Tobacco Use Prevention: Conducting Mass Media Campaigns Combined with Other Interventions

Evaluations of the potential impact of media campaigns on teen tobacco use prevention in the United States began with the 1967 Federal Communications Commission’s (FCC) Fairness Doctrine. It applied to cigarette ads and required a "balance" between anti-smoking and cigarette ads. The balance created a ratio of one free anti-smoking message on television or radio for each three cigarette commercials broadcast. The land-breaking countermarketing TV and radio messages that aired between 1967 and 1970 as part of the FCC’s Fairness Doctrine reduced smoking among adolescents. The messages in this ads focused on the health consequences of smoking, at times employing fear inducing strategies.

The Guide to Community Preventive Services Task Force found that mass media campaigns are effective in reducing tobacco use by children, adolescents and adults. Between 2004 and 2011 North Carolina funded mass media campaigns coordinated with local and statewide tobacco control interventions targeting youth and young adults. Funds for tobacco control interventions were allocated to 49 geographic and culturally diverse organizations, including community, school, college, and priority population grantees, to be spent on community and school-based interventions that affect teens.

Tobacco Reality Unfiltered, commonly known as “TRU," was based on data indicating the effectiveness of showing real people telling real stories about the devastating human consequences of tobacco use. Dr. Adam Goldstein with UNC Family Medicine, an independent evaluator of the TRU, stated that “the campaign might have led 9000 kids in the state not to experiment with cigarettes, at least 450 of whom would have gone on to become regular smokers, costing the state approximately $4 million. Thus, the state's media campaign might save $2 for every dollar it spends on its media campaign.”

To see ads from the TRU campaign, visit






Updated: February 26, 2020