Tobacco control mass media campaigns involve communication which aims to encourage smokers to stop smoking or avoid smoking in front of others, particularly children. The campaigns may be communicated via television, radio, newspapers and/or billboards. It is likely that they contribute to changes in smokers' behaviour and reductions in smoking, and this in turn helps to reduce the number of people suffering the diseases caused by smoking. There is almost no evidence on how effective mass media campaigns in the UK have been, nor on whether this has been money well spent. The lack of UK evidence enabled the government to stop funding mass media campaigns in April 2010. Very recently, however, the government indicated that it might begin such campaigns again. Research on this topic is therefore very timely and would help ascertain how best to do this. This project will measure the effectiveness of individual mass media campaigns, and of different types of campaign, in England and Wales over recent years. We will initially identify the characteristics of individual campaigns, such as whether the campaign aimed to encourage smokers to stop or to protect their children from smoke, its emotional and informational content and style, and how it was delivered (eg whether via television, radio or print media and the balance between the three). Then we will consider how much impact each campaign and campaign type has had by looking at a range of indicators of smoking behaviour in the adult population, such as the proportion of people who smoke, the numbers of smokers trying to stop and the proportion who smoke in the home. We will also measure whether the impact of mass media campaigns reduce the health problems caused by smoking. We will do this by measuring, for example, the number of people admitted to hospital with heart attacks or strokes, and the number of children consulting the GP for respiratory infections. We will use statistical methods that enable us to examine how any changes in these indicators relate to the timing of mass media campaigns. These methods will also allow us to examine whether it is the mass media campaign that is important, or other factors, such as changes in other tobacco policies at the same time, that are responsible. We will look at these changes in smoking behaviour and health in datasets representative of England and Wales as a whole and where available, in data from specific sectors of the population, such as the more socio-economically deprived, to see whether the impact of mass media campaigns is the same in these groups. We will look at the effects of specific regional campaigns by comparing changes in smoking behaviour between regions. We will also look at what changes occurred in smokers behaviour and health at the point when government spend on advertising ceased prior to the election in 2010. This work will provide essential information to guide future decisions on anti-tobacco mass media spend at national and regional levels.