To summarise how anti-tobacco mass media campaigns delivered via digital media are evaluated, including campaign characteristics, targeted populations, behavioural outcomes and exposure measurement strategies.
Six databases (PubMed, Web of Science, Scopus, PsycINFO, Embase, Communication & Mass Media) were searched using tobacco-related, digital media-related and prevention-related terms.
Articles were eligible if they were peer-reviewed, written in English, published between 2004 and 2025 and evaluated an anti-tobacco mass media campaign that used social media or web-based platforms and assessed a tobacco-related behaviour. Studies that exclusively assessed campaign awareness, knowledge or attitudes towards tobacco use were excluded.
Two independent coders screened all titles and abstracts. Full texts were coded for campaign characteristics, exposure measurement and behavioural outcomes.
The final sample included 21 studies with 236 915 participants. Most campaigns were conducted in the USA (n=16, 76.2%) and used national samples (n=17, 81.0%). Campaigns targeted adolescents (n=87 746, 45.2%) and young adults (n=83 683, 38.7%). Exposure was assessed using aided recall (n=12, 57.1%) and binary response formats (n=9, 42.9%). Across all studies, 37 statistical effects were reported; the most examined behavioural outcomes were past 30-day tobacco use (k=15, 40.5%) and quit intentions (k=12, 32.4%). Of these, 73.3% (k=11/15) and 75.0% (k=9/12) reported statistically significant improvements, respectively.
Digital anti-tobacco mass media campaigns show promise in influencing tobacco-related behaviours. However, existing exposure measures in the evolving digital environment may limit the ability to accurately link campaign exposure to behavioural outcomes. Advances in exposure measures are needed.