Most young people haven’t heard of the American Legacy Foundation (ALF), but they have seen their ads.

The truth® campaign, which was developed by the Foundation, aired widely on youth-oriented TV stations like MTV. The truth campaign sought to develop a new type of anti-tobacco message, geared especially toward young people. By using edgy, humorous, and expository commercials, billboards, and other media avenues, it has been one of the most effective anti-tobacco media campaigns to date.

In addition to media campaigns, the foundation also develops programs that address the health effects of tobacco use, especially among vulnerable populations disproportionately affected by the toll of tobacco, like low-income populations, minorities, and youth. They fund grants, partnerships, culturally appropriate cessation programs, youth activism, and counter-marketing campaigns.

I was lucky enough to attend one of the Foundation’s tobacco control conferences last year while I was in the process of writing my master’s thesis on tobacco marketing. In addition to hearing from advocates, scientists, and public health officials, I also learned a bit more about the foundation itself.

The American Legacy Foundation was created as a result of the Master Settlement Agreement (MSA). This agreement, signed in November 1998, was the outcome of lawsuits filed by the attorneys general in forty-six states and five U.S. territories against the tobacco industry. It provided funds to the states to compensate them for taxpayer money spent on people with tobacco-related diseases. In addition to the creation of the ALF, the agreement required the end of tobacco billboard adverting, that tobacco companies stop using cartoon characters in their ads, and that tobacco companies make many of their internal documents available to the public. These documents have been invaluable in understanding what the companies knew about their products and for how long, and for understanding how they market their products.

Based on this information, public health officials could develop messages to combat those used by the tobacco industry. Rather than using traditional social marketing methods, which generally put the onus on the individual to change their behavior (wear a condom; don’t drink and drive), the truth® campaign exposes the tobacco industry and its deceitful marketing tactics. The commercials tell us that urea is found in both urine and cigarettes and that Polonium-210, a radioactive compound used to recently kill a Russian spy, is also in cigarette smoke. The ads tell us how in 1995, a major tobacco company decided to boost its sales by targeting homeless people; they titled their project SCUM, short for Sub Culture Urban Marketing. By highlighting the appalling and often times underhanded practices of the tobacco industry, the truth® campaign’s mission “allows teens to make informed choices about tobacco use. It doesn’t preach. It doesn’t judge. It just works.”

The truth campaign has had more success and has generated more attention than prior anti-smoking campaigns. It has won more than 300 awards for advertising efficacy: the Clios, Webbys, two Emmys, and three Effie awards, including the Grand Effie in 2003. A 2005 study published in the American Journal of Public Health found that the ads contributed to the overall decline in youth smoking during 2000–2002.

The important work being done by the Foundation may be threatened due to a stipulation in the MSA, which ensures funding only as long as the participating tobacco manufacturers maintain at least 99.05 percent of the U.S. tobacco market. While the industry continues to spend millions a day to market to susceptible audiences, we can only hope that the truth, and the American Legacy Foundation, will prevail.