Factsheet 5. Mass media campaigns

Key Facts

• Mass media campaigns are an essential part of a comprehensive tobacco control programme.
• Campaigns to promote smoking cessation can encourage more people to attempt quitting smoking.
• Good mass media campaigns are cost effective.
• Campaigns should make clear why smokers should quit and be supported by information on how they can quit

The need for mass media campaigns
An essential component of any tobacco control programme is mass media campaigns.⁽¹⁾ The aims of mass media campaign are to:

• Build awareness of the adverse health effects of tobacco use
• Motivate smokers to try to quit
• Build awareness of the dangers of secondhand smoke
• Change the attitudes and beliefs of smokers about smoking and quitting
• Contribute to changes in tobacco-related behaviour, leading to reduced tobacco consumption and reduced exposure to secondhand smoke among non-smokers

This factsheet will focus on smoking cessation campaigns as they are the most thoroughly evaluated campaigns to date.

Effectiveness of mass media campaigns for smoking cessation
Evidence from developed countries shows that mass media campaigns to promote smoking cessation are effective in achieving their aims.^{(2) (3)} Their function is to encourage larger numbers of smokers to make a quit attempt.

Mass media campaigns can also be very cost effective compared with other healthcare interventions.⁽⁴⁾ This is largely because, by motivating smokers to quit, they contribute to reductions in prevalence and smoking-related illness, as well as in their associated treatment costs.

Key elements of an effective mass media campaigns
Comprehensiveness
Campaigns are most effective when part of a comprehensive tobacco control programme. Smoking cessation messages are most effective in an environment that aims to make smoking less socially acceptable.⁽⁵⁾
As mass media smoking cessation campaigns are conducted in a crowded media environment, it is important that each campaign is comprehensive.⁽⁶⁾ Multiple audiences, communications methods, messages and tactics should be used to reach smokers. Campaigns use television, radio, print, billboards, online and outdoor advertising to reach very large groups of people.

Targeting
tobacco control campaign managers have found that targeting very specifically (e.g. smokers ready to quit) does not always work. Some campaigns have been more successful when they targeted smokers more broadly or in ways that make the messages unavoidable.
A good example of targeting broadly is the Australian ‘Every cigarette is doing you damage’ campaign. This approach was effective in several countries. Campaigns like this may appeal to smokers and non-smokers, to young people and adults. A study in Australia found that young people thought the campaign adverts, originally designed for adults, were relevant to them.⁽⁷⁾

Messages - why quit?
Effects on the smoker’s health - It is important to use messages that present the health risks or negative emotional consequences in a new way. Messages evoking negative emotions, such as fear, disgust and loss, are more likely to prompt smokers to attempt quitting immediately than messages eliciting positive emotions.⁽⁸⁾

Effects of secondhand smoke - Most smokers respond well to messages about the health effects of secondhand smoke on their loved ones. Although they may not be willing to quit for themselves, they may be willing to attempt quitting or smoke less to protect their friends and family.⁽⁵⁾ The tone of campaign messages should be sensitive, non-judgemental and respectful.

Messages - how to quit?
Providing information on how to quit gives smokers hope that they can quit once they are motivated to do so. It also provides an avenue for support for those already attempting to quit. A telephone quit line allows the smoker to access information and resources to help them quit.⁽⁸⁾

Delivery of messages
Mass media campaigns should deliver a strong message to quit through a variety of different channels. The messages should be frequent enough to build awareness, and change beliefs, attitudes and behaviour among smokers. The range of media used, the number of times the messages are aired or placed, and the length of a campaign are crucial to their success.

Sustained smoking cessation campaigns continually remind people to quit smoking, not to start smoking, or to remain a non-smoker.

Other marketing interventions
Other non-mass marketing interventions can be used to support mass media campaigns to improve smoking cessation. These include ‘earned’ media or news coverage (not paid for), public relations, communication with health professionals, posters, brochures and other interventions.

Well managed publicity supporting media campaigns can have a large impact on the number of people aware of and responding to a campaign.

FCTC requirements
Under Article 12 of The WHO Framework Convention on Tobacco Control, parties must promote and strengthen public awareness of tobacco control issues, using all available communication tools, as appropriate. This includes promoting the benefits of smoking cessation.⁽⁹⁾

Best practice
A recent World Health Organization report outlined the following key steps for mass media campaigns⁽¹⁰⁾ :

• Explain the economic impact on families of personal spending on tobacco and the early death of a parent.
• Highlight the successes of tobacco cessation, while aiming to prevent smoking initiation among young people.
• Ensure advertising is professionally produced, and subjected to screening among focus groups.
• Governments should spend US$2-4 per person per year on anti-tobacco health communication and counter advertising (15-20% of total tobacco control expenditure), according to recommendations from the US Centers for Disease Control and Prevention.⁽¹¹⁾

Successful campaigns have five key elements. Campaigns must: (1) be part of a comprehensive approach to reduce tobacco use; (2) be sustained for long enough to have impact; (3) be grounded in research and properly evaluated; (4) understand the target audience; and (5) be creative and professional.

Outlook
Much of what is known about mass media campaigns for smoking cessation has come from research and evaluation in developed countries. Data from developing countries and many non-English-speaking countries is not widely available. The more that mass media campaigns are conducted and thoroughly evaluated, the more that can be learned about what works and what does not.

For more information on smoking cessation visit http://www.stopsmokingcampaigns.org and
http://www.iuatld.org http://www.tobaccofreeunion.org tobaccofreeunion@iuatld.org

⁽¹⁾ Gutierrez K. Mass media interventions to stimulate and promote smoking cessation. Expert opinion paper. London: National Institute for Health and Clinical Excellence, 2007
⁽²⁾ Reducing tobacco use: a report of the Surgeon General. Atlanta, GA: Dept of Health and Human Services, Centers for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health
Promotion, Office of Smoking and Health; Washington, DC: 2000. http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2000/sgr_tobacco_chap.htm
⁽³⁾ Best practices for comprehensive tobacco control. Centers for Disease Control and Prevention. US Department of Health and Human Sciences, Atlanta, GA 1999. http://www.cdc.gov/tobacco/tobacco_control_programs/stateandcommunity/best_practices/index.htm
⁽⁴⁾ Ratcliffe J, Cairns J, Platt S. Cost effectiveness of a mass media-led anti-smoking campaign in Scotland. Tob Control 1997;6:104-10
⁽⁵⁾ Schar E, Gutierrez K. Smoking cessation media campaigns from around the world. Recommendations from lessons learned. Centers for Disease Control and Prevention. US Department of Health and Human Sciences,
Atlanta, GA 2001
⁽⁶⁾ Randolph W, Viswanath K. Lessons learned from public health mass media campaigns: marketing health in a crowded media world. Annu Rev Public Health 2004;25:419-37.
⁽⁷⁾ White V, Tan N, Wakefield M, Hill D. Do adult focused anti-smoking campaigns have an impact on adolescents? The case of the Australian National Tobacco Campaign. Tob Control 2003 Sep;12 Suppl 2:ii23-9
⁽⁸⁾ Overview of evidence-based recommendations. Based on lessons learned from international literature review and unpublished campaign results. 2006. Global Dialogue for Effective Stop Smoking Campaigns.
http://www.stopsmokingcampaigns.org
⁽⁹⁾ The Framework Convention Alliance for Tobacco Control. http://www.fctc.org
⁽¹⁰⁾ WHO report on the global tobacco epidemic, 2008. The MPOWER packgage. Geneva, World Health Organization, 2008. http://www.who.int/tobacco/mpower/en/index.html
⁽¹¹⁾ US Department of Health and Human Services, Centers for Disease Control. Best practices for comprehensive tobacco control programs 2007. Atlanta, USA 2007. http://www.cdc.gov/tobacco/tobacco_control_programs/stateandcommunity/best_practices/