Evaluating anti-tobacco mass media campaigns in the digital age: scoping review

OBJECTIVE: To summarise how anti-tobacco mass media campaigns delivered via digital media are evaluated, including campaign characteristics, targeted populations, behavioural outcomes and exposure measurement strategies. DATA SOURCES: Six databases (PubMed, Web of Science, Scopus, PsycINFO, Embase, Communication & Mass Media) were searched using tobacco-related, digital media-related and prevention-related terms. STUDY SELECTION: Articles were eligible if they were peer-reviewed, written in English, published between 2004 and 2025 and evaluated an anti-tobacco mass media campaign that used social media or web-based platforms and assessed a tobacco-related behaviour. Studies that exclusively assessed campaign awareness, knowledge or attitudes towards tobacco use were excluded. DATA EXTRACTION: Two independent coders screened all titles and abstracts. Full texts were coded for campaign characteristics, exposure measurement and behavioural outcomes. DATA SYNTHESIS: The final sample included 21 studies with 236 915 participants. Most campaigns were conducted in the USA (n=16, 76.2%) and used national samples (n=17, 81.0%). Campaigns targeted adolescents (n=87 746, 45.2%) and young adults (n=83 683, 38.7%). Exposure was assessed using aided recall (n=12, 57.1%) and binary response formats (n=9, 42.9%). Across all studies, 37 statistical effects were reported; the most examined behavioural outcomes were past 30-day tobacco use (k=15, 40.5%) and quit intentions (k=12, 32.4%). Of these, 73.3% (k=11/15) and 75.0% (k=9/12) reported statistically significant improvements, respectively. CONCLUSIONS: Digital anti-tobacco mass media campaigns show promise in influencing tobacco-related behaviours. However, existing exposure measures in the evolving digital environment may limit the ability to accurately link campaign exposure to behavioural outcomes. Advances in exposure measures are needed.