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Issue addressed: Australia has smoking prevalence of less than 15% among adults, but there are concerns that the rates of decline have stabilised. Sustained mass media campaigns are central to decreasing prevalence, and the emotions evoked by campaigns contribute to their impact. This study investigates the association between potential exposure to campaigns that evoke different emotions on quitting salience (thinking about quitting), quitting intentions and quitting attempts. Methods: Data on quitting outcomes were obtained from weekly cross‐sectional telephone surveys with adult smokers and recent quitters between 2013 and 2018. Campaign activity data were collated, and population‐level potential campaign exposure was measured by time and dose. Results: Using multivariate analyses, a positive association between potential exposure to 'hope' campaigns and thinking about quitting and intending to quit was noted, but no association was seen with quit attempts. Potential exposure to 'sadness' evoking campaigns was positively associated with quitting salience and negatively associated with quit attempts, whereas those potentially exposed to campaigns evoking multiple negative emotions (fear, guilt and sadness) were approximately 30% more likely to make a quit attempt. Conclusions: This study suggests a relationship between the emotional content of campaigns, quitting behaviours. Campaign planners should consider campaigns that evoke negative emotions for population‐wide efforts to bring about quitting activity alongside hopeful campaigns that promote quitting salience and quitting intentions. The emotional content of campaigns provides an additional consideration for campaigns targeting smokers and influencing quitting activity. So what?: This study demonstrates the importance of balancing the emotional content of campaigns to ensure that campaign advertising is given the greatest chance to achieve its objectives. Utilising campaigns that evoke negative emotions appear to be needed to encourage quitting attempts but maintaining hopeful campaigns to promote thinking about quitting and intending to quit is also an important component of the mix of tobacco control campaigns. [ABSTRACT FROM AUTHOR]

Highlights • Quantified the number of lung cancer deaths averted in Australia through tobacco control. • Almost 2 million lung cancer deaths have already been prevented over the period 1956–2100. • Lung cancer will continue to be a significant public health concern in Australia. • Achieving zero smoking by 2025 would result in 360,000 more lung cancer deaths being averted by 2100. • Highlighted the urgent need for more effective and targeted tobacco control strategies to be implemented. Abstract Objectives To estimate the number of past and future lung cancer deaths that have already been averted by tobacco control initiatives in Australia, and to estimate the number of additional deaths averted under various smoking scenarios. Methods We predicted lung cancer mortality rates and case numbers to 2100 using a previously validated generalized linear model based on age, birth cohort and population cigarette smoking exposure. We estimated the impact of various tobacco control scenarios: 'actual tobacco control' (incorporating the aggregate effect of past and current taxation, plain packaging, mass media campaigns and other initiatives) and scenarios where 10%, 5% and 0% smoking prevalence was achieved by 2025, all of which were compared to a counterfactual scenario with the highest historical smoking consumption level continuing into the future as if no tobacco control initiatives had been implemented. Results Without tobacco control, there would have been an estimated 392,116 lung cancer deaths over the period 1956–2015; of these 20% (78,925 deaths; 75,839 males, 3086 females) have been averted due to tobacco control. However, if past and current measures continue to have the expected effect, an estimated 1.9 million deaths (1,579,515 males, 320,856 females; 67% of future lung cancer deaths) will be averted in 2016–2100. If smoking prevalence is reduced to 10%, 5% or 0% by 2025, an additional 97,432, 208,714 or 360,557 deaths could be averted from 2016 to 2100, respectively. Conclusion Tobacco control in Australia has had a dramatic impact on the number of people dying from lung cancer. Several hundred thousand more lung cancer deaths could be averted over the course of the century if close-to-zero smoking prevalence could be achieved in the next decade. [ABSTRACT FROM AUTHOR]