Anti-tobacco mass media campaigns Media are important to the WHO FCTC(Education,communication, or to reveal tobacco industry tactics tobacco control efforts training and public awareness)to assist that the public might find objectionable. Parties in meeting their treaty obligations Such campaigns contribute to changes The media,which encompass journalistic (see the previous chapter for more details on in attitudes and beliefs of smokers that reporting and commentary,entertainment Artide 12 guidelines)(4). lead to changes in their smoking-related programming and paid advertising and behaviour,specifically by reducing tobacco promotion,play a key role in shaping consumption and increasing motivation tobacco-related knowledge,opinions, Anti-tobacco mass media to make cessation attempts,as well as attitudes and behaviours,and can be campaigns can reduce reducing exposure to second-hand smoke extremely powerful in influencing both tobacco use among non-smokers (16). individuals and policy-makers regarding tobacco use and tobacco control issues (16, Anti-tobacco mass media campaigns are Anti-tobacco advertising sustains messaging 63,64).As a result,mass media advertising used to increase awareness of the harms about the dangers of tobacco.Advertising campaigns have become a key component of tobacco use and of second-hand smoke campaigns can be run in all types of media of tobacco control programmes (16,65,66). exposure,and in particular the harmful (television,radio,print,billboards and effects on health(67).Anti-tobacco other outdoor display advertising,and In November 2010,the COP adopted advertising can also be used to explain online)(16),as well as on other items (e.g. guidelines for implementation of Article 12 of the benefits of a tobacco-free society. matchbook covers)that are likely to be seen 28 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011
28 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 Media are important to tobacco control efforts The media, which encompass journalistic reporting and commentary, entertainment programming and paid advertising and promotion, play a key role in shaping tobacco-related knowledge, opinions, attitudes and behaviours, and can be extremely powerful in influencing both individuals and policy-makers regarding tobacco use and tobacco control issues (16, 63, 64). As a result, mass media advertising campaigns have become a key component of tobacco control programmes (16, 65, 66). In November 2010, the COP adopted guidelines for implementation of Article 12 of Anti-tobacco mass media campaigns the WHO FCTC (Education, communication, training and public awareness) to assist Parties in meeting their treaty obligations (see the previous chapter for more details on Article 12 guidelines) (4). Anti-tobacco mass media campaigns can reduce tobacco use Anti-tobacco mass media campaigns are used to increase awareness of the harms of tobacco use and of second-hand smoke exposure, and in particular the harmful effects on health (67). Anti-tobacco advertising can also be used to explain the benefits of a tobacco-free society, or to reveal tobacco industry tactics that the public might find objectionable. Such campaigns contribute to changes in attitudes and beliefs of smokers that lead to changes in their smoking-related behaviour, specifically by reducing tobacco consumption and increasing motivation to make cessation attempts, as well as reducing exposure to second-hand smoke among non-smokers (16). Anti-tobacco advertising sustains messaging about the dangers of tobacco. Advertising campaigns can be run in all types of media (television, radio, print, billboards and other outdoor display advertising, and online) (16), as well as on other items (e.g. matchbook covers) that are likely to be seen
by smokers(68).Anti-tobacco mass media part of an ongoing,multi-faceted tobacco Television is the most campaigns can be cost effective compared control programme,in part because synergies effective advertising medium with other interventions despite the expense created by multiple interventions are capable required(69),and can have a greater of producing greater reductions in smoking Television is generally considered to be the impact because they reach large populations than might be expected by merely adding most powerful communications medium, quickly and efficiently(16) together expected impacts of individual and television advertising is especially interventions(16,71,72).However,even effective (16).Anti-tobacco television Advertising can also help to counteract in the absence of other tobacco control advertising has higher recall than do positive images of tobacco use portrayed by interventions,mass media campaigns have advertisements in radio or print media tobacco industry marketing and reverse the been shown to be effective on their own. (76,77)because television facilitates erroneous perception that tobacco use is a the use of graphic imagery,which helps low-risk habit (67).Changing social norms As is the case with health warning labels, reinforce the association of tobacco about tobacco use in this way also increases most current evidence has examined the with dangerous health consequences. support for other initiatives to reduce impact of mass media campaigns on These images more accurately depict tobacco consumption(70). cigarette smoking in high-income countries. the human impact of tobacco use by However,evidence from low-and middle- graphically showing suffering and illness, A well-funded and intensive anti-tobacco income countries and for other types of and can clearly portray tobacco use as mass media campaign is most effective as tobacco use is growing (73-75). socially undesirable and negative.In Anti-tobacco mass media campaigns can be cost effective compared with other interventions despite the expense required, and can have a greater impact because they reach large populations quickly and efficiently. WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011 29
WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 29 by smokers (68). Anti-tobacco mass media campaigns can be cost effective compared with other interventions despite the expense required (69), and can have a greater impact because they reach large populations quickly and efficiently (16). Advertising can also help to counteract positive images of tobacco use portrayed by tobacco industry marketing and reverse the erroneous perception that tobacco use is a low-risk habit (67). Changing social norms about tobacco use in this way also increases support for other initiatives to reduce tobacco consumption (70). A well-funded and intensive anti-tobacco mass media campaign is most effective as part of an ongoing, multi-faceted tobacco control programme, in part because synergies created by multiple interventions are capable of producing greater reductions in smoking than might be expected by merely adding together expected impacts of individual interventions (16, 71, 72). However, even in the absence of other tobacco control interventions, mass media campaigns have been shown to be effective on their own. As is the case with health warning labels, most current evidence has examined the impact of mass media campaigns on cigarette smoking in high-income countries. However, evidence from low- and middleincome countries and for other types of tobacco use is growing (73–75). Television is the most effective advertising medium Television is generally considered to be the most powerful communications medium, and television advertising is especially effective (16). Anti-tobacco television advertising has higher recall than do advertisements in radio or print media (76, 77) because television facilitates the use of graphic imagery, which helps reinforce the association of tobacco with dangerous health consequences. These images more accurately depict the human impact of tobacco use by graphically showing suffering and illness, and can clearly portray tobacco use as socially undesirable and negative. In Anti-tobacco mass media campaigns can be cost effective compared with other interventions despite the expense required, and can have a greater impact because they reach large populations quickly and efficiently
countries where funding for anti-tobacco 84);increase the numbers of smokers well as to differences in television and radio advertising campaigns is limited,use of seeking cessation service from telephone access. less-expensive radio advertising may be quit lines(85)and increase adult cessation an effective supplementary or alternative rates(86);result in steady positive changes communications medium,especially in in attitudes,beliefs and intentions to smoke Social media is increasing in places where radio broadcasts reach a among youth(87);and increase youth importance larger population than does television abstinence rates (88).Even limited exposure programming (78). to anti-tobacco television advertising can Although traditional media continue increase intentions among youth not to to have the widest population reach, Exposure to effective anti-tobacco mass smoke and reduce the likelihood of their use of the Internet and other emerging media campaigns has similar effects on becoming smokers in the future(89). social media is expanding rapidly.These adults and youth,with adult smokers newer communications methods are more likely to quit(79)and youth less Results from GATS show that anti-tobacco becoming increasingly more effective in likely to become established smokers advertisements on television and radio reaching youth,who in some cases are (80).Advertising campaigns broadcast at reach large segments of the population being exposed to them to a far greater sufficient exposure levels and at frequent (90).Differences between countries may extent than they are to other media.New intervals reduce adult smoking prevalence be related to the frequency and duration of media forms can be used to disseminate (81,82)and decrease youth smoking (83, existing anti-tobacco media campaigns,as anti-smoking messages that prevent 30 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011
30 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 countries where funding for anti-tobacco advertising campaigns is limited, use of less-expensive radio advertising may be an effective supplementary or alternative communications medium, especially in places where radio broadcasts reach a larger population than does television programming (78). Exposure to effective anti-tobacco mass media campaigns has similar effects on adults and youth, with adult smokers more likely to quit (79) and youth less likely to become established smokers (80). Advertising campaigns broadcast at sufficient exposure levels and at frequent intervals reduce adult smoking prevalence (81, 82) and decrease youth smoking (83, 84); increase the numbers of smokers seeking cessation service from telephone quit lines (85) and increase adult cessation rates (86); result in steady positive changes in attitudes, beliefs and intentions to smoke among youth (87); and increase youth abstinence rates (88). Even limited exposure to anti-tobacco television advertising can increase intentions among youth not to smoke and reduce the likelihood of their becoming smokers in the future (89). Results from GATS show that anti-tobacco advertisements on television and radio reach large segments of the population (90). Differences between countries may be related to the frequency and duration of existing anti-tobacco media campaigns, as well as to differences in television and radio access. Social media is increasing in importance Although traditional media continue to have the widest population reach, use of the Internet and other emerging social media is expanding rapidly. These newer communications methods are becoming increasingly more effective in reaching youth, who in some cases are being exposed to them to a far greater extent than they are to other media. New media forms can be used to disseminate anti-smoking messages that prevent
Campaigns using graphic images of illness and showing people suffering or dying demonstrate the harm caused by tobacco use,and are especially effective in convincing users to quit. youth smoking initiation as well as assist Anti-tobacco mass media tobacco use,and are especially effective in adults with smoking cessation (16, campaigns with hard-hitting convincing tobacco users to quit (93-95). 91).However,it is important that these themes help convince people Young and middle-aged adults should emerging communications methods adhere to quit be the focus of advertisements whenever to established evidence-based smoking possible,whether they are suffering from cessation guidelines(e.g.counselling,quit Campaigns using graphic images of tobacco-related illness themselves or lines and pharmacotherapy)(92). illness and showing people suffering or are experiencing the negative effects of dying demonstrate the harm caused by someone who is ill (e.g.A parent).This HARD-HITTING ANTI-TOBACCO CAMPAIGNS ARE MORE EFFECTIVE THAN INFORMATIONAL CAMPAIGNS IN SAO PAULO,BRAZIL 100% Informational campaign Hard-hitting campaign 90% 82% 81% 80% 80% 73% 73% 70% 61% 50% 50% 40% 30% 20% 10% 0% Said something More convincing Made me want to try personally important to me than other ads to stop smoking (among smokers) All differences shown are significant at p<0.05. Source:(74). WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011 31
WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 31 youth smoking initiation as well as assist adults with smoking cessation (16, 91). However, it is important that these emerging communications methods adhere to established evidence-based smoking cessation guidelines (e.g. counselling, quit lines and pharmacotherapy) (92). Anti-tobacco mass media campaigns with hard-hitting themes help convince people to quit Campaigns using graphic images of illness and showing people suffering or dying demonstrate the harm caused by tobacco use, and are especially effective in convincing tobacco users to quit (93–95). Young and middle-aged adults should be the focus of advertisements whenever possible, whether they are suffering from tobacco-related illness themselves or are experiencing the negative effects of someone who is ill (e.g. A parent). This 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Informational campaign Hard-hitting campaign Proportion of respondents Said something personally important to me 73% 82% More convincing than other ads 73% 81% Made me want to try to stop smoking (among smokers) 61% 80% Hard-hitting anti-tobacco campaign s are more effective than informational campaigns in São Paulo, Brazil All differences shown are significant at p<0.05. Source: (74). Campaigns using graphic images of illness and showing people suffering or dying demonstrate the harm caused by tobacco use, and are especially effective in convincing users to quit
Exposure to effective anti-tobacco mass media campaigns has similar effects on adults and youth, with adult smokers more likely to quit and youth less likely to become established smokers. helps counteract widely held assumptions messages focusing on the harms of second- depict illness attributable to smoking or that only the elderly are affected by hand smoke and on tobacco industry that provide practical advice on remaining tobacco-related illness. deception are also promising strategies tobacco-free are considered most helpful for preventing youth smoking(102, (106). Campaigns developed primarily for adults 103).Advertisements that make a strong can be equally effective among youth(96, emotional appeal are likely to increase Anti-tobacco mass media campaigns are 97),whereas advertising focused on youth recall among youth (104).Among adults, generally believed to be more effective does not have a similar impact on adults advertisements eliciting strong negative when tailored to the cultural values of (98).Advertising that focuses on the emotions are rated most effective,whereas various targeted racial and ethnic groups, health impact and other negative aspects humorous advertisements were seen as although this is not necessarily the case of smoking appear to be the most effective ineffective(16,105).Among adult smokers (107).At least among youth,content and among youth(16,99-101),although who had recently quit,advertisements that other characteristics of advertisements 32 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC,2011
32 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC, 2011 helps counteract widely held assumptions that only the elderly are affected by tobacco-related illness. Campaigns developed primarily for adults can be equally effective among youth (96, 97), whereas advertising focused on youth does not have a similar impact on adults (98). Advertising that focuses on the health impact and other negative aspects of smoking appear to be the most effective among youth (16, 99–101), although depict illness attributable to smoking or that provide practical advice on remaining tobacco-free are considered most helpful (106). Anti-tobacco mass media campaigns are generally believed to be more effective when tailored to the cultural values of various targeted racial and ethnic groups, although this is not necessarily the case (107). At least among youth, content and other characteristics of advertisements messages focusing on the harms of secondhand smoke and on tobacco industry deception are also promising strategies for preventing youth smoking (102, 103). Advertisements that make a strong emotional appeal are likely to increase recall among youth (104). Among adults, advertisements eliciting strong negative emotions are rated most effective, whereas humorous advertisements were seen as ineffective (16, 105). Among adult smokers who had recently quit, advertisements that Exposure to effective anti-tobacco mass media campaigns has similar effects on adults and youth, with adult smokers more likely to quit and youth less likely to become established smokers