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Aims: We aimed to explain the association between exposure to a cigarette advertisement and favorable attitudes towards the advertisement. Methods: We used data from an observational cross-sectional study with a sample of 3,415 German schoolchildren aged 10-17 years. Cigarette advertising exposure was assessed with an image of a Marlboro ad, asking for contact frequency (number of times seen the ad) and brand name. Liking of the ad was measured with two items (alpha = 0.78). Results: We found a positive linear association between exposure to the Marlboro ad and liking it. This association remained significant (standardized β = 0.09; p < 0.001) even after statistical control for smoking status, smoking of friends and parents, attitudes towards smoking in general, cigarette advertising receptivity (having a favorite cigarette ad), exposure to other advertisings, age, sex, socioeconomic status, rebelliousness and sensation seeking, self-reported school performance, and study region. Conclusions: The association between exposure to an advertisement and liking it was robust and could not be fully explained without referring to either unmeasured confounding or implicit advertising effects (e.g. mere exposure). Implicit effects have implications for prevention strategies as it may be very difficult to counteract unconscious advertising effects. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims To assess the effect of an antismoking advertisement under real-world conditions. Design Quasi-experimental study. Setting/participants Multiplex cinema in Kiel, Germany; 4073 patrons were surveyed after having viewed a movie. Some 4005 patrons were ≥10 years old (28.7% between 10 and 17 years). A total of 654 subjects (16.3%) were smokers. Intervention In the intervention condition (weeks 1 and 3), a 30-second antismoking advertisement—accentuating long-term health consequences of smoking and promoting cessation—was shown prior to all movies; in the control condition (weeks 2 and 4) no such spot was shown. Main outcome measures (i) Awareness of smoking in the movie, (ii) approval of smoking in the movie, (iii) attitude towards smoking, (iv) intention to smoke in the future and (v) desire to smoke among smokers. Findings Patrons who were exposed to the antismoking advertisement were more likely to be female, but did not differ with respect to smoking status. After controlling for gender differences, patrons exposed to the antismoking advertisement had (i) higher awareness of smoking in the movies, (ii) lower levels of approval of smoking in the movies, and (iii) a more negative attitude towards smoking in general compared with those not exposed. Among smokers, smoking in the movies increased urge to smoke, but there was no interaction between smoking in the movies and experimental condition. Conclusions Study results suggest that placing an antismoking advertisement before movies can affect attitudes towards smoking, bolstering evidence in support of such policies. [ABSTRACT FROM AUTHOR]