Perceived impact of mass media campaign messages on smoking and mental health: an online survey

BACKGROUND: A common reason for smoking is perceived mental health benefits but systematic reviews have shown that stopping smoking is associated with mental health benefits such as a reduction in symptoms of anxiety and depression. This message is rarely included in mass media campaigns (MMC) for stopping smoking which largely focus on physical health. We developed animatics (early versions of videos) about the relationship between smoking cessation and mental health and evaluated several perceived impact outcomes. METHODS: Two short MMC animatics (one informational, one testimonial) were co-developed using a multi-stage process, with experts by experience and profession. In an online survey, n=1504 participants watched these two alongside an existing animatic (stress-cycle) in a randomised order. All participants currently or previously smoked or currently vaped; those with mental health conditions were oversampled (73% ≥1 mental health diagnosis, 70% past-month psychological distress). PRIMARY OUTCOME: perceived effectiveness (six items rated from strongly disagree (1) to strongly agree (5)). Secondary outcomes included preferred animatic, relatability, and feeling a) more motivated to stop smoking, b) encouraged to seek professional support, c) more positive about the mental health benefits of stopping smoking. RESULTS: All three animatics scored > 3.5 on perceived effectiveness with no difference by mental health measures. The informational animatic scored higher on some outcomes, with all effects being small or very small. There were no significant effects for ever diagnosis for any secondary outcome. People with psychological distress rated the informational and stress-cycle animatics higher than those with no or low distress. Each animatic was a favourite for about one-third of respondents, regardless of mental health status. CONCLUSIONS: Smoking cessation campaign messages highlighting mental health benefits were well-received across people with and without mental health conditions, suggesting potential to reduce smoking prevalence.