Anti-tobacco advertisements in India: insights from content analysis and young adults’ perceptions

With over a billion impressions annually, the Anti-tobacco advertisements (ATAs) are a major means of tobacco control messaging in India. This multi-phase study was conducted to assess the characteristics of ATAs, identify the core messages, and explore young adults’ views on ATAs in India. A preliminary content analysis of 15 ATAs hosted on the National Tobacco Control Programme (NTCP) website was conducted using descriptive and inductive thematic analysis. Subsequently, the ATAs were presented to 20 purposively sampled young adults, and qualitative in-depth interviews were conducted. These in-depth interview data were analysed using the thematic analysis method, incorporating both inductive and deductive coding approaches. Most ATAs targeted smoking products, and were enactments or advisories. The prominent messages of ATAs include (i) tobacco kills at a young age; (ii) smoking is dangerous; (iii) tobacco destroys homes; and (iv) stop tobacco. The young adults’ views towards ATAs include (i) impactful and enduring; (ii) trust, accessibility, and efficiency; (iii) paradox of intense imagery; (iv) audience representation; and (v) message fatigue and limited actionable guidance. The findings highlight the need to strengthen ATAs by improving demographic and cultural representation, reducing message repetition, and incorporating clearer guidance on accessing cessation support like quitlines and tobacco cessation centres.