Many nations desire that their citizens live in harmony and attain the highest possible standards of living. As such, they set key developmental targets in the most crucial sectors to be achieved within certain time frames. The government of the United States through the Department of Health and Human Services has set such an objective in the field of healthcare. Through the framework called Healthy People 2020, the government identified key concerns in the sector that it targets to remedy or at least alleviate by the year 2020. The blueprint has set about 1200 targets organized into 42 topical areas of concern (CDC, 2015). One of the guidelines aimed at promoting the quality of life and concurrently reduce premature deaths is controlling tobacco use. Increased attention to the health effects of cigarette smoking is among the strategies that have been proposed to achieve this goal. Vickerman et al. (2015) examined the efficacy of a national tobacco education campaign on the cessation outcomes of smokers. This paper will provide a critical appraisal of this study to evaluate its strengths and weaknesses as well as its validity.
The study by Vickerman et al. (2015) evaluated whether anti-smoking mass media campaigns have an effect on tobacco users. Specifically, they carried out a study on whether a TV campaign containing Prevention Tips from Former Smokers (Tips) have an impact on the number of smokers who resort to tobacco quitlines. The study is carried out in the states of Nebraska, North Carolina, and Texas analyzing the results of 715 smokers. It led to the conclusion that such campaigns increase the number of users who engage in tobacco quitlines thus enhancing their chances of quitting the stick. However, the study does not reveal whether the campaigns have a direct impact on tobacco abstinence.
The study question of this research was “To determine whether quit outcomes seven months after enrollment were related to the Tips campaign exposure among tobacco users seeking help from quitlines?” (Vickerman et al., 2015). This question is relevant to the study since it states in a nutshell what the researchers seek to achieve. The ultimate aim of the research is to determine whether the mass media campaign has an effect on the habit of smokers. Although it is limited in the scope, the study adds something that can be used by policy makers. The authors note that there have been studies that investigated the effect of the mass media campaigns against smoking on the behavior of smokers, but only few have considered the long-term impact. This study investigates the effect on tobacco users seven months after cessation of the campaigns. The type of research question asked in the study is causal since it seeks to unravel whether there is a long-term relationship between anti-smoking media campaigns and the behavior of tobacco users. This investigation has a cross-sectional study design. It is an observational study, and it is not possible to obtain data from all smokers exposed to the Tips advert in the states where the study took place (Vickerman et al., 2015). The study design is, therefore, less expensive and can give more accurate results hence being appropriate for the study question used in this investigation.
The most potent source of bias for the study was the differential exposure to the Tips anti-smoking campaign advertisement. The campaign focused on areas deemed to have a high prevalence rate among smokers which incidentally may have made less progress in tobacco control strategies. To reduce this bias, the investigators weighted the data collected for non-response based on various metrics such as age, race, and sex among others (Vickerman et al., 2015). The study method was, therefore, sufficient to deal with this source of bias. From the findings of the study, everything seems to have worked according to the planned protocol. There was no need to alter the study design or the methodology of the study. The study has two stated hypotheses. The first one is “Greater exposure to Tips messaging may have increased the likelihood that quitline enrollees successfully quit” (Vickerman et al., 2015). The alternative one is derived from Nonnemaker et al. study (as cited by Vickerman et al., 2015) and claims that “Greater exposure may have prompted callers who were less ready to quit to engage in the treatment program” (Vickerman et al., 2015). The findings which were got from the analysis of 715 participants who participated in the study noted that during the survey period, 27.7% of them abstained from cigarette smoking for seven or more days. It further found that 24.5% abstained for 30 days or more. The conclusion was that the duration of the Tips campaign did not have an impact on the habit of a smoker. The conclusion was, therefore, justified in light of the findings since there is no significant difference between the 7-day and 30-day rates of quitting. The authors acknowledged the financiers of the study as well as those who assisted in its facilitation. They do not have any affiliation to these individuals; hence, there is no apparent conflict of interests.
As already outlined above, the work under appraisal is a cross-sectional study. The key methodological points to consider are: whether the subjects were recruited in an acceptable manner; whether the kind of measures used were effective in reducing bias; whether the data were collected in a manner that supported the research question; and whether the study had sufficient participants to minimize the likelihood of chance (Munn et al., 2014).
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This paper presents a critical appraisal of the study by Vickerman et al. (2015) that seeks to identify whether there is a relationship between long-term exposure to anti-smoking adverts and cessation outcomes among smokers. It identifies the research as well as several methodological aspects that are crucial to a study of this nature. The conclusion logically follows the findings of the study. Therefore, it can assist health policy makers in deciding whether they should change tact regarding the implementation of the strategies employed in fighting tobacco use in the country.
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