Tobacco in the news: an analysis of newspaper coverage of tobacco issues in Australia, 2001

Commercial tobacco endgame themes in the Australian media from 2000 to 2021

BACKGROUND

Conventional tobacco control is dominated by demand-reduction measures, whereas commercial tobacco endgame (endgame) policies address the key drivers that maintain the tobacco epidemic, such as Tobacco Industry interference in policymaking, the addictiveness of commercial tobacco products and their widespread availability via retail outlets. While Australia has been a pioneer in tobacco control, Australian Governments are yet to commit to endgame policies. The media play an important role reflecting and influencing public opinion and policymaker positions, and can help set the agenda for policy innovation.

METHOD

Media articles mentioning tobacco endgame goals and policies published between 2000 and 2021 were identified by searching Factiva and Google (News). We used reflexive thematic analysis (RTA) to identify themes in the articles, supported by content analysis, to describe elements of the data and sentiment analysis to categorise the article sentiment. A deductive-inductive approach was applied in the RTA, coding text from the articles against predefined codes, while also generating new codes where novel themes were identified. Codes were then grouped and summarised.

RESULTS

One hundred and ninety-three articles were included for analysis. The media discourse focused on three policies: tobacco-free generation; banning or phasing out retail supply of tobacco; and mandating a very low nicotine content standard for cigarettes. A broad range of themes in the articles supported endgame policies, including the large health toll from tobacco, government responsibility to act and the total social costs far outweighing any economic benefit from the tobacco market. Opposing themes included the purported failures of 'prohibition', illicit trade, 'nanny statism' and impact on retail trade. Equity themes were scarce. The benefits of a smoke-free society were described at a societal level, rather than the personal benefits for individuals.

CONCLUSION

Media articles on the tobacco endgame in Australia generally contained positive sentiment about endgame policies. When engaging with the media, endgame advocates should be aware of, and ready to counter, opposing themes such as the purported failures of 'prohibition', 'nanny state' rhetoric or a growth in illicit tobacco trade.

Rating the Valence of Media Content about Electronic Cigarettes Using Crowdsourcing: Testing Rater Instructions and Estimating the Optimal Number of Raters

Electronic cigarettes (e-cigarettes) are a controversial public health topic due to their increasing popularity among youth and the uncertainty about their risks and benefits. Researchers have started to assess the valence of media content about e-cigarette use, mostly using expert coding. The current study aims to offer a methodological framework and guideline when using crowdsourcing to rate the valence of e-cigarette media content. Specifically, we present (1) an experiment to determine rating instructions that would result in reliable valence ratings and (2) an analysis to identify the optimal number of raters needed to replicate these ratings. Specifically, we compared ratings produced by crowdsourced raters instructed to rate from several different perspectives (e.g., objective vs. subjective) and determined the instructions that led to reliable ratings. We then used bootstrapping methods and a set of criteria to identify the minimum number of raters needed to replicate these ratings. Results suggested that when rating e-cigarette valence, instructing raters to rate from their own subjective perspective produced reliable results, and nine raters were deemed the optimal number of raters. We expect these findings to inform future content analyses of e-cigarette valence. The study procedures can be applied to crowdsourced content analyses of other health-related media content to determine appropriate rating instructions and the number of raters.

News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland

OBJECTIVE

Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated.

METHOD

We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis.

RESULTS

Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43).

CONCLUSIONS

News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.

Setting the policy agenda for graphic health warning labels: An analysis of online news media coverage in South Korea, 2016

INTRODUCTION

In South Korea, a bill requesting the implementation of graphic health warning labels (GHWLs) on tobacco products was adopted at the Assembly Plenary Session on 29 May 2015, and the law was implemented on 23 December 2016. During the period, a plan of the technical details of GHWLs, such as the making of graphic warnings, was examined by the Regulatory Reform Committee (RRC). This study aims to investigate what the media reported over that period and whether the RRC's policy decisions changed.

METHODS

We conducted a content analysis of online media reports from the first legislative examination (22 April 2016) to the re-examination (13 May 2016). We coded 150 news reports according to two types (news and opinions) and three slants in terms of being in favor of or opposed to the initially government's implementation plan of GHWLs: positive, negative, and neutral.

RESULTS

At the first legislative examination, some committee members recommended placing pictorial warnings at the bottom of a cigarette pack as opposed to the plan. Initially, the media reported the results of the committee decisions neutrally. However, over time, positive news and opinions on tobacco control policy and support for positioning the GHWLs at the top of packages increased before the committee carried out the re-examination. Only 15 (10.0%) news reports adopted a negative slant, while the reports with positive (n=101; 67.3%) and neutral slants (n=34; 22.7%) comprised the majority. At the re-examination, the committee withdrew their earlier recommendation to position the GHWLs at the bottom of cigarette packs, finally deciding that the pictorial warnings should be located at the top of the packs, as per the original government's plan.

CONCLUSIONS

The friendly media coverage of the tobacco control policy suggests that the media would be a major factor in the policymakers' decision. Because the media play an important role in defining social issues in the policy-decision process, garnering support from the media is important in the tobacco control legislative process.

30+ years of media analysis of relevance to chronic disease: a scoping review

BACKGROUND

Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area.

METHODS

We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies.

RESULTS

Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work.

CONCLUSIONS

The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.

News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland

OBJECTIVE

Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated.

METHOD

We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis.

RESULTS

Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43).

CONCLUSIONS

News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.

News media coverage of shisha in Nigeria from 2014 to 2018

INTRODUCTION

Shisha which was formally popular mostly in the Eastern Mediterranean region is now gaining popularity globally and has become a trending tobacco product in Nigeria. The increasing popularity of shisha is possibly driven by the attractive flavours and the misperception that it is safer than traditional cigarettes. Since the media plays a significant influence on public awareness, perception and understanding of various issues, this study sought to explore the coverage of shisha use by five national newspapers in Nigeria.

METHODS

Five newspapers were selected based on their website traffic (online readership). The software NVIVO 12 was used to organise the content of the articles into themes.

RESULTS

Between 2014 and 2018, we found 30 relevant publications about shisha. Some newspaper articles reported that shisha smoking was gaining popularity among youths, especially in tertiary institutions across the country. Similarly, some misconceptions about the safety of smoking shisha among shisha users was reported. Addiction to shisha was also reported as being so common that many shisha users were no longer satisfied with just visiting nightclubs and shisha cafes but now own the shisha paraphernalia. There were also reports that the tobacco in shisha was in some instances being replaced or mixed with other hard drugs like marijuana. Subtle advertisement of shisha lounges, which is a violation of the Nigeria National Tobacco Control Act, was also observed.

CONCLUSIONS

There is a need for increased sensitization of the public through the media on the dangers of shisha smoking and other tobacco product use. There is also a need for a national survey to determine the prevalence of shisha use in Nigeria.

The relationship between press release and newspaper coverage of tobacco-related issues in South Korea

This study investigates an association between press release and news media response on tobacco-related issues in South Korea. We retrieved 231 tobacco-related newspaper articles from all major dailies throughout the year 2005. In total, 37 press releases on tobacco-related issues and policies published by the Korea Ministry of Health and Welfare were obtained from the Ministry website. Content analysis and appropriate statistical tests were performed. Results from our content analysis suggest that producing more press releases on tobacco-related issues may result in a greater volume of newspaper articles, and that a press release on a new topical issue may effect more intense media coverage. Findings also show that when Korean newspaper articles overall held less favorable views of tobacco-related policies and programs in 2005, taxation was the most frequent theme with a non-positive opinion. Findings from our multivariate logistic regression models imply that a newspaper article with a source press release-especially about a new topical issue-is more likely than an article without a source press release to discuss tobacco-related issues more positively. Our findings suggest that a press release may serve as an effective media strategy for reaching out to the public by disseminating tobacco-control efforts and policies.

Presenting a strong and united front to tobacco industry interference : a content analysis of Australian newspaper coverage of tobacco plain packaging 2008-2014

OBJECTIVES

In 2012, Australia was the first country in the world to introduce plain or standardised tobacco packaging, coupled with larger graphic health warnings. This policy was fiercely opposed by industry. Media coverage can be an influential contributor to public debate, and both public health advocates and industry sought media coverage for their positions. The aim of this study was to measure the print media coverage of Australian's plain packaging laws, from inception to roll-out, in major Australian newspapers.

METHODS

This study monitored mainstream Australian print media (17 newspapers) coverage of the plain packaging policy debate and implementation, over a 7-year period from January 2008 to December 2014. Articles (n=701) were coded for article type, opinion slant and topic(s).

DESIGN

Content analysis.

RESULTS

Coverage of plain packaging was low during preimplementation phase (2008-2009), increasing sharply in the lead into legislative processes and diminished substantially after implementation. Articles covered policy rationale, policy progress and industry arguments. Of the news articles, 96% were neutrally framed. Of the editorials, 55% were supportive, 28% were opposing, 12% were neutral and 5% were mixed.

CONCLUSIONS

Protracted political debate, reflected in the media, led to an implementation delay of plain packaging. While Australian media provided comprehensive coverage of industry arguments, news coverage was largely neutral, whereas editorials were mostly supportive or neutral of the policy. Countries seeking to implement plain packaging of tobacco should not be deterred by the volume of news coverage, but should actively promote the evidence for plain packaging in the media to counteract the arguments of the tobacco industry.

Media Portrayal of the Nursing Homes Sector: A Longitudinal Analysis of 51 U.S. Newspapers

Purpose

Most Americans' low opinion of the nursing home (NH) sector could derive, in part, from the way in which it is portrayed in the media. This study furthers understanding of media portrayal of the NH sector by identifying how NHs were depicted in 51U.S. newspapers from 1999 to 2008.

Design and methods

Keyword searches of the LexisNexis database were performed to identify 16,280 NH-related articles. Article content was analyzed, and tone, themes, prominence, and central actor were assessed. Basic frequencies and descriptive statistics were used to examine article content across regions, market type, and over time.

Results

Findings reveal considerably less NH coverage in the Western United States and a steady decline in NH coverage nationally over time. Most articles were news stories; more than one third were located on the front page of the newspaper or section. Most articles focused on NH industry and government interests, very few on residents/family and community concerns. Most articles were neutral or negative in tone; very few were positive or mixed. Common themes included quality, financing, and legal concerns. Tone, themes, and other article attributes varied across region, market type, and over time.

Implications

Overall, findings reveal changes in how newspapers framed NH coverage, not only with respect to tone but also with respect to what dimensions of this complex issue have been emphasized during the time period analyzed. Variation in media coverage may contribute to differences in government and public views toward the NH sector across regions and over time.

A comparative content analysis of media reporting of sports betting in Australia: lessons for public health media advocacy approaches

Background

Harmful gambling is a significant public health issue. There has been widespread discussion in the Australian media about the extent and impact of sports betting on the Australian community, particularly relating to young men and children. Given the role that the media plays in influencing policy change and political agendas, and the acknowledgement that media based advocacy is a fundamental component of successful advocacy campaigns, this research aimed to investigate how different stakeholder groups discuss sports betting within the Australian print media. The study uses this information to provide recommendations to guide public health media advocacy approaches.

Methods

A quantitative content analysis of print media articles was conducted during two significant Parliamentary Inquiries about sports betting - (1) The Joint Select Committee Inquiry into the Advertising and Promotion of Gambling Services in Sport (2012/2013), and (2) 'The Review of Illegal Offshore Wagering (2015/2016). A total of 241 articles from 12 daily Australian newspapers were analysed. Statistical analysis was used to compare frequency of, and changes in, themes, voices and perspectives over time.

Results

Discussions about the marketing and communication of sports betting was a main theme in media reporting (n = 165, 68.5%), while discussions about gambling reform decreased significantly across the two time periods (p < 0.0001). The presence of sports betting industry (p < 0.0001), sporting code (p < 0.0001) and public health expert (p = 0.001) voices all increased significantly across the two time periods. There were very few (n = 11, 4.6%) voices from those who had experienced gambling harm. Finally, while there were significantly fewer articles taking the perspective that regulation changes were needed to protect vulnerable sub-populations (p < 0.0001), articles that had a neutral perspective about the need for regulation change increased significantly across the two time periods (p < 0.0001).

Discussion and conclusions

Mapping the media reporting of sports betting is important in developing effective public health advocacy approaches. This study indicates that discussions about the marketing strategies utilised by the sports betting industry was still a main theme in media articles. However, discussions relating to sports betting reforms, in particular to protect individuals who may be vulnerable to the harm associated with these products and their promotional strategies (for example children and young men) decreased during the time periods. Public health advocates may seek to address the decrease in media reports about reform by developing clear evidence-based messages about why regulatory reform is needed, as well as the potential consequences of not implementing reforms. Working with organisations to build capacity for people who have experienced gambling harm may help ensure that individuals with a lived experience of harm have an increased voice in the media.

"It is merely a paper tiger." Battle for increased tobacco advertising regulation in Indonesia: content analysis of news articles

OBJECTIVE

At the end of 2012, the Indonesian government enacted tobacco control regulation (PP 109/2012) that included stricter tobacco advertising, promotion and sponsorship (TAPS) controls. The PP did not ban all forms of TAPS and generated a great deal of media interest from both supporters and detractors. This study aims to analyse stakeholder arguments regarding the adoption and implementation of the regulation as presented through news media converge.

DESIGN

Content analysis of 213 news articles reporting on TAPS and the PP that were available from the Factiva database and the Google News search engine.

SETTING

Indonesia, 24 December 2012-29 February 2016.

METHODS

Arguments presented in the news article about the adoption and implementation of the PP were coded into 10 supportive and 9 opposed categories. The news actors presenting the arguments were also recorded. Kappa statistic were calculated for intercoder reliability.

RESULTS

Of the 213 relevant news articles, 202 included stakeholder arguments, with a total of 436 arguments coded across the articles. More than two-thirds, 69% (301) of arguments were in support of the regulation, and of those, 32.6% (98) agreed that the implementation should be enhanced. Of 135 opposed arguments, the three most common were the potential decrease in government revenue at 26.7% (36), disadvantage to the tobacco industry at 18.5% (25) and concern for tobacco farmers and workers welfare at 11.1% (15). The majority of the in support arguments were made by national government, tobacco control advocates and journalists, while the tobacco industry made most opposing arguments.

CONCLUSIONS

Analysing the arguments and news actors provides a mapping of support and opposition to an essential tobacco control policy instrument. Advocates, especially in a fragmented and expansive geographic area like Indonesia, can use these findings to enhance local tobacco control efforts.

Death and Taxes: The framing of the causes and policy responses to the illicit tobacco trade in Canadian newspapers

The illicit tobacco trade accounts for 10% of the global cigarette market and results in US$31 billion in lost tax revenues annually. Despite legal prosecution of tobacco companies, and the introduction of new policy responses, the trade has reached an all-time high. Previous research documents how transnational tobacco companies have sought to influence government responses to the illicit trade in various countries through multiple means, including influencing of news media framing. This paper extends this analysis to Canada where the illicit trade is particularly problematic in scale and political complexity. Articles in Canadian newspapers, published from 2010-2015, were systematically searched (n=177) and analyzed to identify dominant frames, frame sponsors and policy positions related to the illicit tobacco trade. The results show that the most common frames present the issue in ways favourable to the industry. The most common non-governmental sponsors of these frames frequently have links to the tobacco industry, which are rarely disclosed. Findings indicate the need for Canadian media to be critical in its use of data sources amid industry efforts to shape public policy, and the importance of reframing policy discussions in public health terms based on independent evidence.

Setting the agenda for a healthy retail environment: content analysis of US newspaper coverage of tobacco control policies affecting the point of sale, 2007-2014

BACKGROUND

Tobacco control policies affecting the point of sale (POS) are an emerging intervention, yet POS-related news media content has not been studied.

PURPOSE

We describe news coverage of POS tobacco control efforts and assess relationships between article characteristics, including policy domains, frames, sources, localisation and evidence present, and slant towards tobacco control efforts.

METHODS

High circulation state (n=268) and national (n=5) newspapers comprised the sampling frame. We retrieved 917 relevant POS-focused articles in newspapers from 1 January 2007 to 31 December 2014. 5 raters screened and coded articles, 10% of articles were double coded, and mean inter-rater reliability (IRR) was 0.74.

RESULTS

POS coverage emphasised tobacco retailer licensing (49.1% of articles) and the most common frame present was regulation (71.3%). Government officials (52.3%), followed by tobacco retailers (39.6%), were the most frequent sources. Half of articles (51.3%) had a mixed, neutral or antitobacco control slant. Articles presenting a health frame, a greater number of protobacco control sources, and statistical evidence were significantly more likely to also have a protobacco control slant. Articles presenting a political/rights or regulation frame, a greater number of antitobacco control sources, or government, tobacco industry, tobacco retailers, or tobacco users as sources were significantly less likely to also have a protobacco control slant.

CONCLUSIONS

Stories that feature procontrol sources, research evidence and a health frame also tend to support tobacco control objectives. Future research should investigate how to use data, stories and localisation to encourage a protobacco control slant, and should test relationships between content characteristics and policy progression.

Characteristics of Community Newspaper Coverage of Tobacco Control and Its Relationship to the Passage of Tobacco Ordinances

To answer the call for more systematic surveillance, analysis and evaluation of tobacco news coverage, a 6-year content analysis of newspaper stories from Missouri was conducted to evaluate the presence of public health facts and characteristics of stories framed for or against tobacco control. The method was a content analysis of all Missouri newspapers (N = 381) from September 2006 to November 2011 for a total sample of 4711. Results were connected to the larger, societal context within which newspaper stories reside, i.e., towns that passed or did not pass a smoke-free ordinance during the project intervention. Results showed the majority of news stories were about tobacco control, which were mostly written at the local level, were episodic, and carried a positive slant toward tobacco control. However, there were more negative than positive headlines, and more negative editorials than non-editorials. Tobacco control stories used fewer public health facts than non-tobacco control stories. Towns with existing smoke-free ordinances had more tobacco control stories, and towns without smoke-free ordinances had fewer tobacco control stories and more non-tobacco control stories, suggesting a connection between news media coverage and the passage of smoke-free policies. We conclude that the tobacco industry may have had success in impacting news stories in no-ordinance cities by diverting attention from tobacco control to secondary topics, such as youth smoking, which meant stories had fewer public health facts and fewer positive health benefits in towns that may have needed these details most.

African media coverage of tobacco industry corporate social responsibility initiatives

Guidelines for implementing the World Health Organization's Framework Convention on Tobacco Control (FCTC) recommend prohibiting tobacco industry corporate social responsibility (CSR) initiatives, but few African countries have done so. We examined African media coverage of tobacco industry CSR initiatives to understand whether and how such initiatives were presented to the public and policymakers. We searched two online media databases (Lexis Nexis and Access World News) for all news items published from 1998 to 2013, coding retrieved items through a collaborative, iterative process. We analysed the volume, type, provenance, slant and content of coverage, including the presence of tobacco control or tobacco interest themes. We found 288 news items; most were news stories published in print newspapers. The majority of news stories relied solely on tobacco industry representatives as news sources, and portrayed tobacco industry CSR positively. When public health voices and tobacco control themes were included, news items were less likely to have a positive slant. This suggests that there is a foundation on which to build media advocacy efforts. Drawing links between implementing the FCTC and prohibiting or curtailing tobacco industry CSR programmes may result in more public dialogue in the media about the negative impacts of tobacco company CSR initiatives.

Newspaper coverage of maternal health in Bangladesh, Rwanda and South Africa: a quantitative and qualitative content analysis

OBJECTIVE

To examine newspaper coverage of maternal health in three countries that have made varying progress towards Millennium Development Goal 5 (MDG 5): Bangladesh (on track), Rwanda (making progress, but not on track) and South Africa (no progress).

DESIGN

We analysed each country's leading national English-language newspaper: Bangladesh's The Daily Star, Rwanda's The New Times/The Sunday Times, and South Africa's Sunday Times/The Times. We quantified the number of maternal health articles published from 1 January 2008 to 31 March 2013. We conducted a content analysis of subset of 190 articles published from 1 October 2010 to 31 March 2013.

RESULTS

Bangladesh's The Daily Star published 579 articles related to maternal health from 1 January 2008 to 31 March 2013, compared to 342 in Rwanda's The New Times/The Sunday Times and 253 in South Africa's Sunday Times/The Times over the same time period. The Daily Star had the highest proportion of stories advocating for or raising awareness of maternal health. Most maternal health articles in The Daily Star (83%) and The New Times/The Sunday Times (69%) used a 'human-rights' or 'policy-based' frame compared to 41% of articles from Sunday Times/The Times.

CONCLUSIONS

In the three countries included in this study, which are on different trajectories towards MDG 5, there were differences in the frequency, tone and content of their newspaper coverage of maternal health. However, no causal conclusions can be drawn about this association between progress on MDG 5 and the amount and type of media coverage of maternal health.

"Tired of watching customers walk out the door because of the smoke": a content analysis of media coverage of voluntarily smokefree restaurants and bars

Background

News media are key sources of information regarding tobacco issues, and help set the tobacco control policy agenda. We examined US news coverage of voluntarily smokefree restaurants and bars in locales without mandatory policies to understand how such initiatives are perceived.

Methods

We searched three online media databases (Access World News, Lexis Nexis, and Proquest) for all news items, including opinion pieces, published from 1995 to 2011. We coded retrieved items quantitatively, analyzing the volume, type, provenance, prominence, and content of news coverage.

Results

We found 986 news items, most published in local newspapers. News items conveyed unambiguous support for voluntarily smokefree establishments, regardless of venue. Mandatory policies were also frequently mentioned, and portrayed positively or neutrally. Restaurant items were more likely to mention health-related benefits of going smokefree, with bar items more likely to mention business-related benefits.

Conclusion

Voluntary smokefree rules in bars and restaurants are regarded by news media as reasonable responses to health and business-based concerns about worker and customer exposure to secondhand smoke. As efforts continue to enact comprehensive smokefree policies to protect all in such venues, the media are likely to be supportive partners in the advocacy process, helping to generate public and policymaker support.

A Descriptive Study of Television News Coverage of Tobacco in the United States: Frequency of Topics, Frames, Exemplars, and Efficacy

There is a positive correlation between recall of tobacco-related television news and perceived risks of smoking and thoughts about quitting. The authors used Cision US, Inc., to create a sampling frame (N = 61,027) of local and national television news coverage of tobacco from October 1, 2008, to September 30, 2009, and to draw a nationally representative sample (N = 730) for content analysis. The authors conducted a descriptive study to determine the frequency and proportion of stories containing specified tobacco topics, frames, sources, and action messages, and the valence of the coverage. Valence was generally neutral; 68% of stories took a balanced stance, with 26% having a tenor supportive of tobacco control and 6% opposing tobacco control. The most frequently covered topics included smoking bans (n = 195) and cessation (n = 156). The least covered topics included hookah (n = 1) and menthol (n = 0). The majority of coverage lacked quoting any source (n = 345); government officials (n = 144) were the most quoted sources. Coverage lacked action messages or resources; 29 stories (<4%) included a message about cessation or advocacy, and 8 stories (1%) contained a resource such as a quitline. Television news can be leveraged by health communication professionals to increase awareness of underrepresented topics in tobacco control.

Health in the news: an analysis of magazines coverage of health issues in veterans and military service organizations

The purpose of this study was to conduct a content analysis of Veterans and Military Service Organizations (VMSOs) magazines to determine what health-related topics VMSOs target and how they inform their constituencies about health issues. Health-related topics in 288 VMSOs' magazines from 21 VMSOs published in 2011 and 2012 were coded by trained raters using a standardized manual. The top three most addressed health topics were Health Services (Health care, Insurance), Disability and Disability benefits, and post-traumatic stress disorder. Topics least frequently covered were Tobacco and Smoking cessation, Illegal drugs, Alcohol, Gulf War Syndrome, and Weight and Body composition. VMSOs are concerned about the health and well-being of their members given the considerable amount of content devoted to certain health topics such as health insurance concerns, disability, and post-traumatic stress disorder. However, other health concerns that affect a considerable number of both current military personnel and veterans and cost both the Department of Veterans Affairs and the Department of Defense millions annually, such as drug and alcohol problems, and tobacco use and smoking cessation, are infrequently covered. The results of this study improve our understanding of the health-related information that reaches the military and veteran populations through this important media outlet.

A Content Analysis of Electronic Cigarette Portrayal in Newspapers

OBJECTIVE

To determine how electronic cigarettes (e-cigarettes) are portrayed in newspaper informative articles and opinion pieces.

METHODS

A content analysis was conducted on 450 articles published in the United States from 1997 to mid-2014 and obtained by a Newsbank search. The articles were reliably coded for overall frame, type of article, first topic and main topics addressed.

RESULTS

The article topics have changed over time and suggest significant differences between news articles and opinion pieces. Informative articles focused on e-cigarette regulation, while opinion pieces highlighted their increasing popularity and perceived health benefits.

CONCLUSIONS

This content analysis uncovered significant interest in e-cigarettes, particularly in their regulation. The FDA should consider public perceptions of e-cigarettes when developing regulations.

Implications for alcohol minimum unit pricing advocacy: what can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable tactic both within the UK and internationally.

•

This study offers the first insights into how key claim-makers have presented arguments about MUP in the media.

•

Minimum unit pricing is an intervention that raises the price of the cheapest alcohol to reduce related harms.

•

There is a growing literature on the alcohol industry's influence on policy development.

•

There is a need to shift focus away from heavy drinkers, towards population-level over-consumption.

•

Greater focus should be placed on getting across the message that MUP is part of a wider package of alcohol policies.

Newspaper coverage of implementation of the Michigan smoke-free law: lessons learned

OBJECTIVE

To examine whether newspaper coverage of the Michigan smoke-free law was favorable or hostile, contained positive messages that had been disseminated by public health groups, contained negative messages, and differed across regions.

METHOD

Articles about the smoke-free law in print or online editions of Michigan newspapers the month immediately before and after the law took effect were identified and were coded for tone, positive messages contained in media outreach materials, and negative messages commonly disseminated by smoke-free law opponents.

RESULTS

A total of 303 print and online articles were identified; the majority were coded as "both positive and negative" (34%) or "mainly positive" in tone (32%). Of 303 articles, 75% contained at least one pro-law message and 56% contained at least one anti-law message. The most common pro-law messages were information about enforcement of the law (52%) and the benefits of smoke-free air (48%); the most common anti-law messages were about potential negative economic impact (36%), government intrusion/overreach (31%), and difficulties with enforcement (28%).

CONCLUSIONS

Public health departments and partners play an important role in implementation of smoke-free laws by providing the public, businesses, and other stakeholders with clear and accurate rationale, provisions, and impacts of these policies.

National newspaper portrayal of nursing homes: tone of coverage and its correlates

OBJECTIVES

The mass media can exert considerable influence over the relative saliency of different public policy concerns. Because emotional resonance can have a strong impact on how the general public and policy makers perceive specific issues, the purpose of this study is to characterize the tone of nursing home coverage in the national media.

METHODS

Keyword searches of LexisNexis were used to identify 1562 articles published in 4 national newspapers from 1999 to 2008. The content of each article was analyzed and tone, themes, prominence, focal entity, and geographic focus assessed. Multinomial logit was used to examine the correlates of tone.

RESULTS

Most articles were negative (49.2%) or neutral (40.3%); few were positive (10.5%). Both positive and negative articles were considerably more likely than neutral articles (>10 times) to be an opinion piece. Negative articles were three quarters more likely to be on the front page and two thirds more likely to focus on industry actors. Positive articles were 10 times more likely to be about community actors and two and three quarters more likely to be about local issues. Positive articles were considerably more likely to be about quality; negative articles about negligence/fraud and natural disasters.

CONCLUSIONS

Findings suggest that negative reporting predominates and its impact on public perceptions and government decision making may be reinforced by its prominence and focus on industry interests/behavior. The adverse impact of media coverage on the industry's reputation has likely influenced consumer care choices, particularly in light of growing competition from the home-based and community-based and assisted living sectors.

Protecting the world from secondhand tobacco smoke exposure: where do we stand and where do we go from here?

INTRODUCTION

Article 8 of the Framework Convention on Tobacco Control mandates all signatory countries to "protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places." Even though there has been great progress in the implementation of Article 8, still most of the world population remains exposed to secondhand smoke (SHS). In this article, we sought to summarize the research that supports Article 8, where do we stand, and current research gaps and future directions.

DISCUSSION

Secondhand smoke is an established cause of heart disease and several types of cancer. Additional research is needed to reach final conclusions for diseases where evidence is only suggestive of causality. The only solution to SHS exposure in public places is banning smoking indoors. Research on the gaming industry and nightclubs, particularly in developing countries, needs to be disseminated to support their inclusion in smoke-free laws. Aside from indoor bans, additional research is needed for outdoor and multiunit housing bans and in support of measures that protect children and other vulnerable populations. The impact of smoke-free laws on other health outcomes, besides heart disease and respiratory outcomes, is another area where further research is needed. Thirdhand smoke assessment and health effects are also likely to be a topic of further research. As new tobacco products emerge, evaluating SHS exposure and effects will be vital.

CONCLUSIONS

Furthering research in support of Article 8 can contribute to reach the final goal of protecting everyone from SHS exposure.

News Media Outreach and Newspaper Coverage of Tobacco Control

Introduction.

Little is known about the impact of media outreach on news media coverage of tobacco control.

Methods.

Media outreach data were obtained from the Centers for Disease Control and Prevention’s Office on Smoking and Health (CDC/OSH) from 2003 to 2006; one to six types of outreach activities for 50 scientific publications were performed during 35 discrete time periods. The authors analyzed quantitatively and qualitatively 205 newspaper articles generated based on the CDC/OSH scientific publications.

Results.

Media coverage of specific CDC/OSH-related tobacco themes was highest for disparities (100%) and tobacco statistics (98%). More outreach activities increased the likelihood of moderate pickup of the number of themes in newspaper articles (odds ratio = 2.0, 95% confidence interval = 1.5-2.8), but there appeared to be a ceiling effect. Certain types of outreach were more strongly associated with front page and headline coverage.

Conclusions.

The extent and type of outreach were associated with increased newspaper coverage but the relationship is not necessarily straightforward. Additional research is needed to better understand relationships between scientific findings, outreach, and news media coverage of tobacco.

The growth in newspaper coverage of tobacco control in China, 2000-2010

Background

Media coverage of tobacco-related issues can potentially shape individual beliefs, attitudes and behaviors about tobacco use. This study aims to describe news coverage of tobacco control related issues in Chinese newspapers from 2000 to 2010.

Methods

All 1149 articles related to tobacco control were extracted from the Database of Chinese Important Newspapers and content analyzed for the period Jan 1, 2000 to Dec 31, 2010. The changing pattern of tobacco control topic, article type, viewpoint, and article origin, and their relationship were analysed.

Results

News coverage of tobacco control related issues increased significantly (p < 0.01) from 2000 to 2010, with news coverage being relatively intensive in May and June (p < 0.01), around World No Tobacco Day. 24.9% (n = 286) of all articles focused on secondhand smoke, 25.3% (n = 291) warned about the dangers of active smoking, and 10.0% (n = 115) focused on prevention and cessation programs and campaigns. Tobacco control topics varied significantly between national vs city/regional newspapers (χ² = 24.09, p = 0.002) and article types (χ² = 193.35, p < 0.001). Articles in national newspapers had more coverage of the dangers of tobacco and on enforcing bans on tobacco-advertising. News stories centered around monitoring tobacco use and smoke free activity, while editorials focused on enforcing bans on tobacco-advertising, youth access and programs and campaigns. Letters to editors focused on the dangers of smoking, raising tax, and smoking cessation. More articles (50.4%) took an anti-tobacco position (compared with 10.5% which were pro-smoking), with the amount of negative coverage growing significantly across the decade. National articles tended to lean toward anti-tobacco, however, local articles tended mix of pro-tobacco and neutral/balance positions. Editorials seemed to be more anti-tobacco oriented, but letters to the editor tended to show a mix of anti-tobacco and pro-tobacco positions.

Conclusion

Chinese newspapers are giving increasing attention to tobacco control, but coverage remains lower than in the USA and Australia. Health workers need to give higher priority to efforts to increase news coverage beyond the present concentration around World No Tobacco Day and to develop strategies for making tobacco control issues more newsworthy to both national and local news outlets.

Making News: The Appearance of Tobacco Control Organizations in Newspaper Coverage of Tobacco Control Issues

Purpose.

To characterize the presence of advocacy groups in media coverage about tobacco issues.

Design.

A content analysis of tobacco-related newspaper articles.

Setting.

Australia.

Sample.

All 12 national and state capital daily newspapers published in Australia between 2004 and 2007.

Measures.

We coded each article for explicit mentions of any of 16 major national or state tobacco control advocacy groups; for the article type, prominence, and topic; for the tone of the event; and for the author's opinion.

Analysis.

A series of 2 × 2 χ2 analyses assessed the extent to which advocacy groups were more or less likely to be mentioned in articles of each type, prominence, topic, event impact, and opinion orientation.

Results.

Of the 4387 tobacco-related articles published over this period, 22% mentioned an advocacy group. There was a greater-than-expected proportion of advocacy groups mentioned in news articles with very high prominence (44%; χ2 [1, N = 3118] = 27.4, p < .001), high prominence (34%; χ2 [1, N = 3118] = 10.9, p < .001), and medium prominence (30%; χ2 [1, N = 3118] = 7.3, p = .007), and in articles covering events with mixed (30%; χ2 [1, N = 4387] = 10.0, p = .002) or positive (24%; χ2 [1, N = 4387] = 26.1, p < .001) implications for tobacco control.

Conclusions.

Australian tobacco control advocacy groups have a reasonable presence within the news discourse on tobacco control issues and so are likely to contribute to generating and shaping this discourse, particularly in relation to evolving and controversial issues.

Supporting Tobacco Control

A large and growing literature confirms that well-designed web-based programs can be effective in preventing or treating several chronic diseases. This study examined how the Internet can deliver information and train community activists and specifically tested the effects of web-based technical assistance on local tobacco control coalitions’ efforts to use media advocacy to advance their agendas. The authors compared a highly interactive, Enhanced website (intervention) to a noninteractive, Basic text-based website (comparison) in Colorado communities. A total of 24 tobacco control coalitions led by local county health departments and nursing services were enrolled in the project and randomly assigned to use either the intervention or comparison website. A total of 73 local daily and weekly newspapers were identified in the service areas of 23 of the 24 coalitions. A posttest assessment of newspaper coverage was conducted to locate all newspaper articles with tobacco control information published between January 1 and April 9, 2004, the last 3 months of the intervention. Although there was no evidence of a treatment effect on the frequency of newspaper articles on tobacco-related issues, there was, however, evidence that newspapers in counties where the coalition had access to the Enhanced website printed more stories focused on local/regional issues and more anti-tobacco local/regional stories than in the counties where coalitions had access to the Basic website. Coalitions can improve their influence on local media for community tobacco control when high-quality online technical assistance, training, and resources are available to them.

Tobacco advertising and press coverage of smoking and health in 10 years of Argentinean newspapers

OBJECTIVE

To describe the extent and content of tobacco-related images, advertising and articles published in the largest Argentinean newspapers before and after a voluntary advertising ban implemented in 2001.

METHODS

Issues from four months of each year of the four main national newspapers were examined from 1995 to 2004. We recorded the number of tobacco images (advertisement or not), tobacco-focused articles, space used, and placement within the newspaper. Regression analyses evaluated time trends.

RESULTS

We identified 1800 images and articles from 4828 different issues. Non-advertisement images were the most frequent (71.2%), followed by articles (20%) and advertisement images (8.8%). Advertisements only appeared in the two best selling newspapers with a majority (57%) in the Sunday magazine and 21% in the sports sections. Non-advertisement images were published in the sports and entertainment sections (55%) and showed a public figure in 88%. Of 336 articles, 39% focused on health topics and 55% emphasized the negative effects of tobacco on health. Regression models showed that prior to 2001 there were significant time-related decreases in ad images and articles and significant increases in non-ad images. The trend of each outcome changed direction beginning in 2001 and the magnitude of the change in trend was significant for ad images and non-ad images. The number of non-ad images dropped significantly in 2001 from a model-predicted value of 178 per year to 103 non-ad images and remained constant thereafter.

CONCLUSIONS

Tobacco images exceeded information about tobacco hazards in Argentinean newspapers over this period. Advertisement increased from 2001 to 2005, following the voluntary advertisements ban. Partial advertisement bans are ineffective and a total ban is imperative.

How does the media profile of cancer compare with prevalence?

INTRODUCTION

Knowledge and understanding of disease can influence time to presentation and potentially, therefore, cancer survival rates. The media is one of the most important sources of public health information and it influences the awareness and perception of cancer. It is not known if the reportage of cancer by the media is representative to the true incidence of disease.

MATERIALS AND METHODS

The top 10 UK daily newspapers were assessed over a 1-year period for the 10 most common UK cancers via their on-line search facilities.

RESULTS

Of the 5832 articles identified, there was marked over-representation of breast, kidney and stomach cancer with ratios of prevalence to reporting of 1.4, 1.9 and 3.2 to 1, respectively. Colorectal, non-Hodgkin lymphoma, bladder and oesophageal cancers are all markedly under-represented with ratios of 0.4, 0.2, 0.6 and 0.4 to 1, respectively.

CONCLUSIONS

A policy of media advocacy by health professionals could enhance the information provided by the media and thus reflect the true extent of disease. A partnership between health professionals and journalists could result in articles that are relevant to the population, informative and in a style and format that is easily comprehendible. Targeted public health information could highlight the 'red-flag' symptoms and break down any stigma associated with cancer. This enhanced awareness could improve the health-seeking behaviour of the general population and reduce the delay from symptoms to diagnosis.

Tobacco control interest groups and their influence on parliamentary committees in Canada

OBJECTIVES

The aim of this study was to determine how tobacco control interest groups influence tobacco policy decision-making through submissions and presentations to parliamentary committees.

METHODS

A qualitative content analysis was used to examine the presentations and submissions on tobacco-related legislation made to parliamentary committees between 1996 and 2004. The sample was identified from the public list of tobacco-related bills tabled in both the House of Commons and the Senate; the Government of Canada website and LEGISinfo were used to determine which committee reviewed the relevant bill. Committee clerks were asked to send submissions and presentations related to specific bills identified through LEGISinfo. Submissions and presentations were scanned and entered into QSR N6 software for coding. The coding instrument was adapted from previous studies employing qualitative content analysis. Montini and Bero's recommendations were used to evaluate the submissions and presentations.

RESULTS

Tobacco control interest groups did present scientific evidence to support tobacco control. However, they underused credible witnesses to present information at meetings. The topics presented by tobacco control interests groups were usually relevant to the bill being discussed.

DISCUSSION

Tobacco control interest groups employed some of the strategies suggested by Montini and Bero in their attempt to influence parliamentary committees through submissions and presentations. They did include scientific evidence in their submissions; however, they could improve their strategies in the area of using credible witnesses, such as scientists and medical experts. Incorporating Montini and Bero's recommendations into lobbying efforts may increase success in influencing committees.

[Tobacco in the media: analysis of journalistic texts in the year of 2006]

Aiming at understanding the relation among health, press and public policies on Tobacco in Brazil, this article analyses the texts about Tobacco published in the Brazilian press in 2006. In the clipping process of eight newspapers and magazines, the information about Tobacco were identified and then submitted to content analysis allowing categorization and classification of the texts. The frequency of the texts in 2006 was compared to that of in 2000 and 2003. We observed a higher prevalence of factual approach among the texts (46.7%). Most of the texts mentioned the negative consequences, such as physical health problems (44.2%), death (20%) and dependence (14.2%). The analysis of the headlines and lead-ins showed control policies, anti-smoking movements and spreading of results as the main categories observed. The frequency of the articles in 2006 was similar to that of in 2003 and lower to that of in 2000. The journalistic coverage on Tobacco in 2006 was restricted predominantly to harm to health and anti-smoking movements. The high proportion of the factual approach and the stabilization in the frequency of texts (2003-2006) might suggest an impoverishment of the discussion on this issue in the country.

Tobacco coverage in print media: the use of timing and themes by tobacco control supporters and opposition before a failed tobacco tax initiative

OBJECTIVE

Tobacco control policies gained ground nationwide in 2006, with voters in nine states approving legislation to strengthen clean indoor air policies and increase tobacco excise taxes. Despite having the second lowest cigarette tax rate in the nation, Missouri was unsuccessful in passing its 2006 ballot initiative to raise the tax. An important way to encourage health-related policy change such as increasing tobacco taxes is through media coverage of tobacco issues. We examined how tobacco issues were presented in Missouri's print media leading up to the 2006 election.

METHODS

This study analysed 1263 articles with tobacco content published in 187 Missouri newspapers in the year before the election. Articles were coded for general and tobacco-related characteristics including article type (news story, editorial, letter to the editor), tobacco control position (pro, neutral, anti) and article theme (economic, health, political).

RESULTS

Most articles were news stories (73.6%) and pro-tobacco control (63.8%). The proportion of anti-tobacco control articles increased significantly (chi(2)=104.9, p<0.001) the month before the election, driven by an increase in economically themed articles. Economic articles were published more often in counties with less voter support for the tax (F=5.68, p<0.01). Finally, tobacco control position varied significantly across article types (chi(2)=148.3, p<0.01), with letters to the editor being anti-tobacco control most often.

CONCLUSION

The media have a critical role in promoting public health goals and presenting health issues which influences formation of health policies. Tobacco control advocates must consider public opinion, opposition pressure, timing and themes in tobacco-related media coverage when promoting policy change.

Media reporting of health interventions: signs of improvement, but major problems persist

Background

Studies have persistently shown deficiencies in medical reporting by the mainstream media. We have been monitoring the accuracy and comprehensiveness of medical news reporting in Australia since mid 2004. This analysis of more than 1200 stories in the Australian media compares different types of media outlets and examines reporting trends over time.

Methods and Findings

Between March 2004 and June 2008 1230 news stories were rated on a national medical news monitoring web site, Media Doctor Australia. These covered a variety of health interventions ranging from drugs, diagnostic tests and surgery to dietary and complementary therapies. Each story was independently assessed by two reviewers using ten criteria. Scores were expressed as percentages of total assessable items deemed satisfactory according to a coding guide. Analysis of variance was used to compare mean scores and Fishers exact test to compare proportions. Trends over time were analysed using un-weighted linear regression analysis. Broadsheet newspapers had the highest average satisfactory scores: 58% (95% CI 56–60%), compared with tabloid newspapers and online news outlets, 48% (95% CI 44–52) and 48% (95% CI 46–50) respectively. The lowest scores were assigned to stories broadcast by human interest/current affairs television programmes (average score 33% (95% CI 28–38)). While there was a non- significant increase in average scores for all outlets, a significant improvement was seen in the online news media: a rise of 5.1% (95%CI 1.32, 8.97; P 0.009). Statistically significant improvements were seen in coverage of the potential harms of interventions, the availability of treatment or diagnostic options, and accurate quantification of benefits.

Conclusion

Although the overall quality of medical reporting in the general media remains poor, this study showed modest improvements in some areas. However, the most striking finding was the continuing very poor coverage of health news by commercial current affairs television programs.

Yesterday's dinner, tomorrow's weather, today's news? US newspaper coverage of food system contributions to climate change

BACKGROUND

There is strong evidence that what we eat and how it is produced affects climate change.

OBJECTIVE

The present paper examines coverage of food system contributions to climate change in top US newspapers.

DESIGN

Using a sample of sixteen leading US newspapers from September 2005 to January 2008, two coders identified 'food and climate change' and 'climate change' articles based on specified criteria. Analyses examined variation across time and newspaper, the level of content relevant to food systems' contributions to climate change, and how such content was framed.

RESULTS

There were 4582 'climate change' articles in these newspapers during this period. Of these, 2.4% mentioned food or agriculture contributions, with 0.4% coded as substantially focused on the issue and 0.5% mentioning food animal contributions. The level of content on food contributions to climate change increased across time. Articles initially addressed the issue primarily in individual terms, expanding to address business and government responsibility more in later articles.

CONCLUSIONS

US newspaper coverage of food systems' effects on climate change during the study period increased, but still did not reflect the increasingly solid evidence of the importance of these effects. Increased coverage may lead to responses by individuals, industry and government. Based on co-benefits with nutritional public health messages and climate change's food security threats, the public health nutrition community has an important role to play in elaborating and disseminating information about food and climate change for the US media.

Impact of tobacco control policies and mass media campaigns on monthly adult smoking prevalence

OBJECTIVES

We sought to assess the impact of several tobacco control policies and televised antismoking advertising on adult smoking prevalence.

METHODS

We used a population survey in which smoking prevalence was measured each month from 1995 through 2006. Time-series analysis assessed the effect on smoking prevalence of televised antismoking advertising (with gross audience rating points [GRPs] per month), cigarette costliness, monthly sales of nicotine replacement therapy (NRT) and bupropion, and smoke-free restaurant laws.

RESULTS

Increases in cigarette costliness and exposure to tobacco control media campaigns significantly reduced smoking prevalence. We found a 0.3-percentage-point reduction in smoking prevalence by either exposing the population to televised antismoking ads an average of almost 4 times per month (390 GRPs) or by increasing the costliness of a pack of cigarettes by 0.03% of gross average weekly earnings. Monthly sales of NRT and bupropion, exposure to NRT advertising, and smoke-free restaurant laws had no detectable impact on smoking prevalence.

CONCLUSIONS

Increases in the real price of cigarettes and tobacco control mass media campaigns broadcast at sufficient exposure levels and at regular intervals are critical for reducing population smoking prevalence.

Neglected diseases in the news: a content analysis of recent international media coverage focussing on leishmaniasis and trypanosomiasis

Background

Although the pharmaceutical industry's “neglect” of neglected tropical diseases (NTDs) has been investigated, no study evaluating media coverage of NTDs has been published. Poor media coverage exacerbates the neglect. This study aimed to investigate, describe, and analyse international media coverage of “neglected diseases” in general and three specific NTDs—African trypanosomiasis, leishmaniasis, and Chagas disease—from 1 January 2003 to 1 June 2007.

Methods

Archives of 11 leading international, English-language media were searched. A content analysis was done, coding for media organisation, date, author, type of report, slant, themes, and “frames”. Semi-structured interviews with journalists and key informants were conducted for further insight.

Principal Findings

Only 113 articles in a 53-month time period met the inclusion criteria, with no strong trends or increases in coverage. Overall, the BBC had the highest coverage with 20 results, followed by the Financial Times and Agence France Presse. CNN had the least coverage with one result. The term “neglected diseases” had good media currency and “sleeping sickness” was far more widely used than trypanosomiasis. The disease most covered was leishmaniasis and the least covered was Chagas. Academic researchers were most commonly quoted as a main source, while the World Health Organization (WHO) and pharmaceutical industry were the least quoted. Journalists generally agreed NTDs had not been adequately covered, but said a lack of real news development and the need to cater to domestic audiences were major obstacles for NTD reporting. All journalists said health agencies, particularly WHO, were not communicating adequately about the burden of NTDs.

Conclusions

Public health agencies need to raise priority for NTD advocacy. Innovative strategies, such as reporting grants or creating a network of voices, may be needed.

In recent years, there has been a flurry of activity to reverse the neglect that has characterised NTDs, mostly focussed on drug development. The drug gap may be explained by market failure, yet other forces also conspire to cause the neglect of NTDs. One problem is the low visibility of these diseases. By comparison, the high-profile “big three” infectious diseases of AIDS, tuberculosis, and malaria have received increased donor attention and funding with greater visibility. Efforts to remove the “neglect” from NTDs must involve raising their profile. This study, focussing on three of the most neglected diseases, aims to provide a context of the current media situation—the what, where, and why of NTD coverage—to support future advocacy work.

Skin cancer coverage in a national newspaper: a teachable moment

BACKGROUND

The objectives of this study were to (1) identify the number of published articles related to skin cancer in The New York Times newspaper from 1980-2004; (2) assess the content of the articles related to skin cancer, and (3) examine the trends in media coverage of skin cancer over time.

METHODS

We performed a content analysis on articles related to skin cancer appearing in The New York Times during January 1, 1980, through December 31, 2004, using the ProQuest online content repository database and key words skin cancer. We conducted an advanced focus search of all "skin cancer" articles using key words "melanoma," "squamous cell carcinoma," "basal cell carcinoma," "sunscreen," "tanning," "sunbathing," and "tanning salon".

RESULTS

We identified 874 published articles relating to skin cancer. Melanoma was the primary subject of the 874 articles, with 29% of the articles focusing on some aspect of melanoma. Coverage of other major subjects included sunscreen (11%), tanning (9%), basal cell carcinoma (7%), squamous cell carcinoma (3%), sunbathing (2%), and tanning salon (2%). The remaining 37% of articles contained some mention of skin cancer, but skin cancer was not the main topic nor were any of the focus terms. Over the 25-year period we examined, there was a slight upward trend in the number of skin-cancer-related articles, although we observed year-to-year variation.

CONCLUSIONS

Understanding how the print media portrays skin cancer issues provides valuable feedback for federal agencies and cancer organizations and may ultimately help promote skin cancer prevention and education.

US news media coverage of tobacco control issues

OBJECTIVE

To characterise the relative amount and type of daily newspaper, local and national TV newscast, and national news magazine coverage of tobacco control issues in the United States in 2002 and 2003.

DESIGN

Content analysis of daily newspapers, news magazines, and TV newscasts.

SUBJECTS

Items about tobacco in daily newspapers, local and national TV newscasts, and three national news magazines in a nationally representative sample of 56 days of news stratified by day of week and season of the year, from 2002 and 2003.

MAIN OUTCOME MEASURES

Story theme, tobacco topics, sources, story prominence, story valence (orientation), and story type.

RESULTS

Tobacco coverage was modest over the two-year period as estimated in our sample. Only 21 TV stories, 17 news magazine stories, and 335 daily newspaper stories were found during the two-year sampling period. Noteworthy results for the newspaper data set include the following: (1) government topics predominated coverage; (2) government action and negative health effects topics tended not to occur together in stories; (3) tobacco stories were fairly prominently placed in newspapers; (4) opinion news items tended to favour tobacco control policies, while news and feature stories were evenly split between positive and negative stories; and (5) tobacco coverage in the southeast, which is the country's major tobacco producing region, did not differ from the rest of the country.

CONCLUSION

Results suggest mixed support in news coverage for tobacco control efforts in the United States. The modest amount of news coverage of tobacco is troubling, particularly because so few news stories were found on TV, which is a more important news source for Americans than newspapers. When tobacco was covered, government themed stories, which often did not include mentions of negative health effects, were typical, suggesting that media coverage does not reinforce the reason for tobacco control efforts. However, some results were encouraging. For example, when newspapers did cover tobacco, they accorded the stories relatively high prominence, thus increasing the chance that readers would see tobacco stories when they were published.

Pictures worth a thousand words: noncommercial tobacco content in the lesbian, gay, and bisexual press

Smoking prevalence in the lesbian, gay, and bisexual (LGB) community is higher than in the mainstream population. The reason is undetermined; however, normalization of tobacco use in the media has been shown to affect smoking rates. To explore whether this might be a factor in the LGB community, we examined noncommercial imagery and text relating to tobacco and smoking in LGB magazines and newspapers. Tobacco-related images were frequent and overwhelmingly positive or neutral about tobacco use. Images frequently associated smoking with celebrities. Text items unrelated to tobacco were often illustrated with smoking imagery. Text items about tobacco were likely to be critical of tobacco use; however, there were three times as many images as text items. The number of image items was not accounted for by the number of text items: nearly three quarters of all tobacco-related images (73.8%) were unassociated with relevant text. Tobacco imagery is pervasive in LGB publications. The predominant message about tobacco use in the LGB press is positive or neutral; tobacco is often glamorized. Noncommercial print images of smoking may normalize it, as movie product placement does. Media advocacy approaches could counter normalization of smoking in LGB-specific media.

Reducing the gap between the economic costs of tobacco and funds for tobacco training in schools of public health

Tobacco use costs approximately dollar 167 billion annually in the U.S., but few tobacco education opportunities are available in schools of public health. Reasons for the discrepancy between the costs of tobacco use and the creation of tobacco training opportunities have not been well explored. Based on the Behavioral Ecological Model, we present 10 recommendations for increasing tobacco training in schools of public health. Six recommendations focus on policy changes within the educational, legislative, and health care systems that influence funds for tobacco training, and four recommendations focus on strategies to mobilize key social groups that can advocate for change in tobacco control education and related policies. In addition, we present a model tobacco control curriculum to equip public health students with the skills needed to advocate for these recommended policy changes. Through concurrent changes in the ecological systems affecting tobacco control training, and through the collaborative action of legislators, the public, the media, and health professionals, tobacco control training can be moved to a higher priority in educational settings.

Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia

BACKGROUND

The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS) presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS.

METHODS

In-depth interviews with 21 key stakeholders in the state of New South Wales (NSW), including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation.

RESULTS

SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans.

CONCLUSION

Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to finish the job. Publicity to the growing number of state and national governments that have successfully implemented total bans over the past decade is likely to make incrementalism an increasingly unattractive political option.

Motivation of chemical industry social responsibility through Responsible Care

Advocates of corporate social responsibility argue corporations should not only meet the needs of shareholders, but other key stakeholders including the community, customers, suppliers, and employees. Since 1988, the chemical industry has engaged in a major self-regulatory "Responsible Care" industry-wide social responsibility campaign to ensure environmental, public health, safety, and security performance among member companies. Contrary to the arguments of advocates of corporate social responsibility that such efforts meet the needs of stakeholders other than shareholders such as the community, the primary goal of the Responsible Care effort has been to change public concerns and opinion about chemical industry environmental and public health practices while also opposing support for stronger and more expensive public health and environmental legislation and regulation of chemical products, even if warranted.

Pediatric medication safety and the media: what does the public see?

BACKGROUND

In the safety community, it is widely thought that a culture of safety is required to achieve high levels of safety. However, the press tends to report accidents, which are negative by their nature. Pediatric cases are often especially tragic. Relatively few data have been available on the role that the media play in forming opinions about patient safety and the subsequent impact on the culture of safety.

METHODS

To address these issues, we analyzed newspaper coverage of pediatric medication errors and adverse drug events. We searched Lexis Nexis for newspaper articles on pediatric medication safety from the United States, Canada, United Kingdom, Australia, and Ireland, during a 10-year period (1994-2004), by using specific keywords. Main outcome measures were the number of articles (adjusted for population), the type of events covered, and article slant. We also examined qualitatively the overall themes and the extent to which these articles portrayed a culture of safety to the public.

RESULTS

Throughout the world, there was a steady increase in articles on pediatric medication safety, peaking in 2003, with the highest per-capita rate in Canada. Approximately 65% of articles were about patient incidents, 20% mentioned policy, and 25% discussed research. Of the reported events judged to be negative for patient safety, 75% were covered in a neutral manner and 19% were covered in an unduly negative manner.

CONCLUSIONS

Media coverage of pediatric medication safety has increased in the past 10 years. Reporting of patient safety failures was generally fair, and reports were generally framed in light of a culture of safety.