Skip to main content
Rural Health Information Hub

Mass-Reach Health Communication Interventions

Mass-reach health communication interventions aim to disseminate tobacco prevention and cessation messages to communities in different ways. Communication channels can include:

  • Broadcast media (for example, television and radio) print media (for example, newspapers and magazines)
  • Social and digital media (for example, internet and mobile)
  • Outdoor media (for example, billboards and advertising on public transit)

This model is recommended by The Community Guide, which reports that mass-reach health communication interventions have been effective in decreasing the prevalence and initiation of tobacco use and increasing tobacco cessation.

Mass-reach anti-tobacco communications can be especially important in reducing the initiation of tobacco products by children and teenagers. The 2012 Report of the Surgeon General on preventing tobacco use among youth and young adults notes that pro-tobacco marketing and media have a significant impact on the odds of youth holding positive views of tobacco use. Effective anti-tobacco messaging strives to elicit negative emotional responses for viewers, including anger or disgust. Communications campaigns that focus on prevention typically focus on one or more of the following themes:

  • Health and/or cosmetic effects: Illustrate long-term effects, including emphysema and cancer, or short-term effects, including negative impacts on the appearance of skin and teeth
  • Marketing practices of the tobacco industry: Focus on exposing deceptive practices of tobacco companies, particularly those targeting adolescents and youth
  • Secondhand smoke: Describe the harmful effects of tobacco smoke on other people
  • Refusal skills: Refute the social acceptability of using tobacco products
  • Addiction: Depict the harmful effects of tobacco dependence
  • Athletic performance: Describe how tobacco products can negatively impact athletic performance (for example, smoking can cause breathing issues)
  • Celebrity or athlete spokesperson: Encouragement from respected and well-known figures in society speaking against tobacco use

Examples of Mass-Reach Health Communication Interventions

  • Spit It Out: One anti-smokeless tobacco program in West Virginia, Spit It Out, engaged in mass-reach communication efforts to promote tobacco cessation and prevention. The program placed billboards across McDowell County to educate residents about the harmful effects of smokeless tobacco and aired three hundred radio ads during hunting season on the local radio station.
  • Down and Dirty: The Vermont Department of Health Tobacco Control Program developed Down and Dirty, a tailored social branding tobacco prevention program that targets high risk rural teens who identify with “Country” lifestyles. This peer group is known to have a high risk of using cigarettes and chewing tobacco. This social branding initiative appeals to the cultural interests of these teens, which include hunting, off-roading, and mudding. The campaign includes video ads, social media outreach, and sponsored events. The Vermont Department of Health and Rescue Social Change Group have collaborated with the Virginia Foundation for Healthy Youth and the Mississippi Department of Health to implement Down and Dirty campaigns in their states.
  • The Real Cost: Smokeless Doesn't Mean Harmless: The Food and Drug Administration (FDA) recently expanded their Real Cost Campaign, a mass media effort that educates consumers about the dangers of tobacco, to focus on the use of smokeless tobacco among rural teens. The FDA is targeting rural, White males between the ages of 12 and 17, a demographic that is more likely to be using smokeless tobacco than other youths. The campaign's partner, Minor League Baseball, will run television ads on stadium monitors, place print ads in stadiums, and raise awareness about smokeless tobacco prevention. The “Smokeless Doesn't Mean Harmless” television ads are available on The Real Cost's YouTube page.
  • Tips from Former Smokers: The Centers for Disease Control and Prevention (CDC)'s national tobacco education campaign is called Tips From Former Smokers (Tips). The Tips campaign features testimonies from former smokers who have incurred smoking-related conditions and disabilities. The CDC has tailored several video ads and materials for specific populations affected by tobacco, including racial and ethnic minority groups, people with HIV, the LGBTQ+ community, military service members and veterans, people with mental health conditions, and pregnant women. Some tobacco programs brand Tips ads with their own information in an effort to better reach people in their communities.
  • The North Dakota Center for Tobacco Prevention and Control Policy (BreatheND): Implemented a mass-reach communications campaign based on the CDC Best Practices for Comprehensive Tobacco Control Programs. The comprehensive media plan focused on the denormalization of tobacco, reducing secondhand smoke exposure, and helping tobacco users quit. The program developed mass media messages and tests the messages with their target market: people ages 24 to 54. The center also used the CDC Tips From Former Smokers video ads to reach populations across the state.

    BreatheND provided grants to local public health units to provide tobacco prevention work on a local level, which included a budget for implementing a local public relations campaign. The public relations campaigns were tailored to each community's needs, and included local print media, radio advertising, and news releases.

Considerations for Implementation

Mass-reach health communications efforts require formative research to identify the messages and communication channels that will most effectively reach community members. This formative research may involve surveys, focus groups or interviews where community members provide feedback on messages. One study, Creating Effective Media Messaging for Rural Smoke-Free Policy, conducted focus groups with rural adults to identify important themes for a smoke-free policy campaign. For example, participants noted that business owners in rural locations may be concerned that smoke-free policies in bars and restaurants will deter community members from patronizing their establishments. To address this issue, campaign planners could emphasize the business opportunities that smoke-free policies can create.

In addition, program planners may need to conduct a community needs assessment to determine which population (for example, children, teens, or adults) and form of tobacco use (for example, cigarettes, smokeless tobacco, or secondhand smoke) to target.

Some health communication interventions may require significant resources. Some communication channels, such as television ad placements, may be more expensive than others, such as social media platforms and local radio segments. The University of North Dakota Center for Rural Health's Communication Toolkit provides an overview of the resources associated with each communication tool. Building strong relationships with community partners can help program planners disseminate communications materials, such as posters or brochures, at a low cost. Creating partnerships with gatekeepers can also be a critical step in achieving buy-in from the targeted community members. Potential community partners could include local businesses, healthcare organizations, schools, community- and faith-based organizations, media entities, and local government representatives.

Integrating cultural considerations into the development of mass-reach health communication interventions can increase the effectiveness of the communication. It is also important to consider the language and health literacy of the intended audience when implementing these interventions.

Program Clearinghouse Examples

Resources to Learn More

Communication Toolkit
This toolkit provides rural healthcare facilities with strategies for communicating with the media.
Organization(s): University of North Dakota Center for Rural Health

Implementing a Social Marketing Effort
This toolkit is designed to help create successful social marketing initiatives, which may be used to promote healthy living.
Organization(s): Community Tool Box

Tips from Former Smokers
The Centers for Disease Control and Prevention's national tobacco education campaign is called Tips From Former Smokers (Tips). The Tips campaign features testimonies from former smokers who have incurred smoking-related conditions and disabilities. Tips provides materials that you can include as part of your anti-smoking media campaign.
Organization(s): Centers for Disease Control and Prevention