Oklahoma "Tobacco Stops with Me"Media Campaign Effects on Attitudes toward Secondhand Smoke.

Importance: Public education campaigns in tobacco control play an important role in changing tobacco-related knowledge, attitudes and behaviors. The Oklahoma Tobacco Stops with Me campaign has been effective in changing attitudes overall and across subpopulations towards secondhand smoke risks.

Objective: Investigate campaign impact on secondhand smoke policy and risk attitudes.

Design: Serial cross-sectional data analyzed with univariate and multivariable models.

Setting: Random-digit dialing surveys conducted in 2007 and 2015.

Participants: Oklahomans 18-65 years old.

Main Outcomes And Measures: 1) Support for smokefree bars; 2) risk assessment of secondhand smoke (very harmful, causes heart disease, causes sudden infant death); and 3) likelihood of protecting yourself from secondhand smoke.

Results: With Tobacco Stops with Me exposure, from 2007 to 2015, Oklahomans demonstrated significant increases in: 1) supporting smokefree bars (23.7% to 55%); 2) reporting beliefs that SHS causes heart disease (58.5% to 72.6%), is very harmful (63.8% to 70.6%) and causes sudden infant death (24% to 34%); and 3) reporting they are very likely to ask someone not to smoke nearby (45% to 52%). Controlling for demographics, smokers and males showed reduced attitude change. In uncontrolled comparisons, high-school graduates faired better than non-diploma individuals, who lacked significant attitude changes.

Conclusions And Relevance: Tobacco Stops with Me achieved its mission to more closely align public perception of SHS with well-documented secondhand smoke risks. Efforts to target women were particularly successful. Smokers may be resistant to messaging; closing taglines that reinstate individual choice may help to reduce resistance/reactance (e.g., adding Oklahoma Helpline contact information).