How Effective Are Anti-Smoking Ads?
Joel Keller recently ranted about ‘inefficient’ anti-smoking ad campaigns. Here’s what he gets wrong about the bottom line.
We came across this article by Joel Keller in Slate, criticizing some “extreme” anti-smoking ads that he considers “maddeningly manipulative.”
Advertising that’s manipulative? We’re shocked. Not.
The CDC keeps promoting these ads despite evidence that they don’t really work, at least not for people who are trying to quit. The agency’s own study showed that after its first national ads aired in 2012, compared to before the campaign, 1.6 million more people sought help to quit. Yet, after three months, only 200,000 were smoke-free, and the agency admitted that half those people have relapsed. It’s a tough addiction to quit, and manipulating the emotions and scaring the crap out of millions just to get 100,000 people to quit is an annoyingly inefficient use of resources.
Getting 100,000 smokers to quit, that sounds pretty awesome. Let’s make a cost-benefit calculation. To start, we need to know how many quality-adjusted-life-years (QUALYs) is that? We assume 100,000 additional quitters, not 100,000 people who would have quit even without the ads.
We put the question to Google: “How many years of life do you save by quitting smoking?” The search engine came up with this: Quitting Smoking Can Add 10 Years to Life. “Could” add 10 years, huh? Let’s split the difference and say five life-years per quitter, or just call it five qalys.
And how much is a qaly worth? One way to find out: Google “how much is a qaly worth,” and we are sent to a New York Times article that says, “a year of life is worth at least $100,000.”
Now let’s get back to Keller’s question. Is it really “an annoyingly inefficient use of resources” to “manipulate the emotions and scare the crap out of millions just to get 100,000 people to quit"?
The manipulating emotions and scaring the crap out of people don’t bother us so much—this all seems pretty trivial compared to getting a hundred thousand people to quit smoking—so let’s go to the “inefficient use of resources.”
The estimated dollar benefit of the ads is (100,000 quitters) x (5 qalys per person) x (100,000 dollars per qaly) = 50 billion dollars.
Maybe you don’t buy the $50 billion number. Maybe you don’t really think the ad campaign caused 100,000 people to quit. Maybe you think quitting smoking doesn’t really save you on average five years of life—maybe Kenneth Ludmerer (PDF) is correct that smoking doesn’t even cause lung cancer—or maybe you think that $100,000 is too much to pay for a year of life.
The point is, though, if you want to argue against the CDC’s ad campaign, you have to make at least one of these arguments. And then you’ll have to deal with the fact that the campaign didn’t cost anything close to 50 billion bucks.
We can Google that too: “Cost of CDC anti-smoking campaign.” We found a press release from the CDC:
The 2012 Tips From Former Smokers campaign spent only $480 per smoker who quit and $393 per year of life saved, according to an analysis by the Centers for Disease Control and Prevention. The results of the study were published today in the American Journal of Preventive Medicine.
Interesting. The CDC’s cost-benefit calculation is a bit more conservative than our crude guesses above. They estimate that quitting saves, on average, only a bit more than one year of life, and they value a year of life at only $50,000.
That said, it’s possible the CDC is wrong—they certainly have an incentive to prove their program is effective. And we think the American Journal of Preventive Medicine has published its share of mistakes.
But… if you want to argue the CDC is wrong, you have to make the case on the numbers, not on a bizarre, bizarre statement that getting 100,000 people to quit smoking is no big deal.
If you don’t bring the numbers, then, what can we say? By default, we’ll trust the CDC and the American Journal of Preventive Medicine more than someone who “writes about TV, food, tech, and pop culture for The New York Times, A.V. Club, Vulture, and others.” This is not to say that a pop culture and tech writer can’t have useful opinions about what makes effective advertising—but if you want to call something an “inefficient use of resources,” we’d prefer you bring some numbers to the table.