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Anti-smoking campaigns should focus on how big companies are using young people

Cancer Council WA has launched an anti-smoking campaign, called “how you’re seen”, that emphasises the marginalisation of smokers, showing people smoking outside alone, in the rain and other grey conditions.

You can see the clip at Mumbrella and the WA advertising blog CampaignBrief.

In the article below, a nurse blogger, Rick Turner, argues the case for campaigns to specifically focus on young peoples’ cultural norms around smoking.

He suggests that a campaign showing young people “how they are seen” by big tobacco companies, rather than by their peers or family, may be the greatest weapon we have in preventing teens from starting smoking.

***

We need a campaign that speaks to young people

Rick Turner writes

An interesting article  in The Age caught my eye last month.

Entitled “What do we think of smoking now?”, the article posed the problem of how to counteract decades of art, movies, advertising and popular culture that have all implicitly or explicitly promoted the idea of smoking as being “cool”.

As we all know everybody from Madonna to cowboys to fashionistas and movie stars have all promoted smoking (whether they like it or not); and public health campaigns are unfortunately far from being the epitome of the most rebellious kind of media.

“I can’t help wondering,” ponders health reporter Amy Corderoy, “how that cool-factor can be overcome. As much fun as public health people are …, how can a PhD or an advocacy body overcome years of art, culture and ideas?”

This got me thinking. You see I have a 15 year old who is cool and also dabbling with cigarettes.

Given all the public funds that have been thrown at cessation campaigns in this country; all the interventions, such as bans on smoking in clubs, pubs and workplaces; and perhaps the highest tobacco tax in the western world; why is it that my son is still tempted to smoke?

Lord knows, his mother is a doctor and his father is a nurse; you would think that we of all people, would somehow have got the message across that smoking is not such a good idea!

Even the marketing director of British American Tobacco Australia, has described Australia as one of  “the darkest markets in the world ” – an allusion to how successful our anti-smoking campaigns have been.

So is it that the message is simply not getting through to young people? Or is it somehow not formulated quite appropriately for teens?

Take for example the National Tobacco Campaign of 1997-2000 (NTC). It was the anti-smoking campaign through which my son grew up, but vestiges of it still remain today.

Just last week, my son and I watched a re-run of one of its major screen commercials at the movies. “Every cigarette is doing you damage” says the ominous voice, as a cigarette burns its way through bubble wrap: a simple reference to the damaging effects of cigarette smoke on the alveoli of the lungs.

Now for someone like me, who is interested in cultural studies, the importance of such campaigns is that they acknowledge the role of social media in the desirability of smoking as a cultural past time.

They understand that smoking connotes something, that it has meaning, and that to encourage people to quit, or not take up the habit means effectively changing this meaning.

Yes, you must give people strategies to quit, supply advice and emotional support, but at some point you are also going to have to treat fire with fire and force consumers to (re)view their habit in different ways.

For the NTC the key points guiding the creative strategy for the campaign’s communication were (and I quote):

  • show the health damage from smoking in new insightful ways that were both enlightening and chilling,
  • develop a conditioned association between the images of harm to the body and the act of smoking,
  • translate the scientific knowledge about smoking into ‘felt’ experience, rather than a cognitive appreciation of risk, and
  • describe the certain consequences of smoking to diminish self-exemption.

The problem is, however, not all consumers are created equal, and what works for one segment of the tobacco market might not work for another.

Might a campaign that proves “enlightening” and “chilling” only fuel risk-taking behaviour amongst young people? Does not a campaign that prioritises ‘felt experience” over “scientific knowledge” only encourage a group of people who clearly already value the former (as “lived experience”), and reject the later as another form of authority to which to disavow?

To be fair, the NTC was a cessation campaign primarily aimed at 18–40 year old smokers and was not necessarily designed for the teen market.

But there was, however, also “a desire and intention that this adult focus and broad exposure of the campaign advertising would be effective in reducing the appeal of smoking to children and adolescents”, which does suggest that the policy makers were hoping that young people were at least listening. (Indeed two cross sectional surveys were subsequently carried out at a national and state (Victorian) level to see how young people responded to the campaign).

What I am trying to suggest is that even if was not aimed at them, the NTC still fed (and continues to feed) young people with an  implicit message that smoking was cool and rebellious, precisely because it is unhealthy, dirty, risky and socially no longer acceptable.

We can do better. We need to shift the parameters and move away from this very limited view of public health advertising.

We need a campaign that speaks to young people and clearly articulates that young people are getting ripped off or exploited, by large multinational corporations.

Our message to young people (be it movies, television, facebook or advertising) should have a little to do with health per se, and more to do with power.

For if there is one thing that is NOT cool to young people, is knowing that they are the pawns in the game of a higher or larger power.

• Rick Turner is a haematology nurse working in one of Melbourne’s leading tertiary hospitals. A keen follower of cultural studies, he has an enormous interest in the politics of representation and how they intersect with health, health care and nursing.

This post first appeared at his blog, Reflections of a Critical Care Nurse


Comments 3

  1. Steve777 says:

    I agree. Virtually every smoker, at least in the First World, was a teenager who wanted to look cool or defiant. Most of the anti smoking campaigns that I have seen seem to be aimed at adults who have seen the light and want to stop. We need these campaigns, but we also need to open another front to dissuade teenagers from starting in the first place.

    The decision to take up decades or a lifetime of smoking is nearly always made by children. Tobacco companies know this and have been intentionally marketing addictive poison to minors for decades.

    Telling a 15 year old that something bad might happen to them when they are very old (35 or 50 perhaps) probably won’t cut it. We need to make smoking appear as unappealing as acne, something that will be bad for them now – a sort of mirror opposite of the old tobacco advertising. While they weren’t allowed to show anyone under 25 in the ads, no one looked older than 25.

    Perhaps talk about bad breath, nicotine stains and smoker’s cough, emphasising how unappealing these are to the opposite s_x. Perhaps we could emphasis the cost ($100 a week for a pack a day smoker – what else could you do with the money). Perhaps we could emphasise impotence – albeit a longer term impact but we could help form a mental connection between this very unappealing consequence and smoking in young men’s minds. I also remember some graphic ads some years back showing fish hooks springing out of filter tips (emphasising how quickly they would be hooked).

    And finally, has anyone heard of a non-smoker who felt like they missed out on one of life’s great pleasures by never taking up the habit?

  2. Margo says:

    Yes, the most effective advertising taps into, and even appropriates, personal values and ‘felt experience’. Coca-Cola sells ‘happiness’ (and who doesn’t want that?), and feel-good ads for oil companies don’t talk about oil, but about parents’ aspirations for their children and the kind of world they will live in. Public health social marketing needs to be much more like commercial marketing in terms of its research base and its sophistication. Adolescents may be a tricky market, but they are not an impossible one.

    There have been promising efforts, but these are largely isolated, uncoordinated and short-term. Twenty years ago, the ACT Division of the Heart Foundation used a few thousand dollars of left-over funding to run a series of PSAs targeting youth smoking. Based on the theme of, ‘Smoking – it can take you right out of the picture’, and with the support of both the Heart Foundation and the Cancer Council, the ads were written and acted by members of Canberra Youth Theatre and filmed ‘on location’ around Canberra. The ads featured practical issues which mattered to high school students, such as smoking and weight control and a boy’s response to an otherwise attractive girl who smokes. (As usual, no money for an evaluation.) In the 1980s, ASH UK worked with a financial institution to give young people a simple, face-saving way to say ‘no’ when offered a cigarette: they developed an endowment savings product which allowed a teen to truthfully assert that, ‘My parents are giving me £1000 when I’m 21 if I don’t smoke, and I really need that money!’

    Health promotion (including Australian health promotion) provides numerous examples of earnest but failed attempts at persuasion and behaviour change. Unfortunately, the analyses of these failures frequently confuse two quite distinct aspects of an initiative: the ‘what’ and the ‘how’. Blaming the wrong aspect means that we might stop doing something when it was the right thing to do but just the wrong approach (usually because it’s not based on good research), and that we continue to do things for which there is no effective approach.

    Anti-smoking social marketing aimed at young people is a case in point. There are varied opinions about this, and public health advocates who wanted to see a top-quality ‘campaign that speaks to young people’ lost that battle long ago to those who argued that such marketing doesn’t work, and given that teens want to be like adults, messages aimed at adults will have a dual impact on teens by changing adult behaviour and changing the image of what it means to be an adult. However, it could be argued that good qualitative research tells us, first, that the problem isn’t that social marketing to teens doesn’t work – it’s just that we don’t tend to do it very well; and, second, that teens don’t want to be like adults, they want to be like the next age group up (eg, 16 yr olds want to be like 18-22 year olds). Failures such as the 1995 cinema campaign which sought to convey the message to teens that smoking was ‘boring’ have served to warn governments and health advocates away from trying to talk directly to teens. But was it the wrong thing to do, or just the right thing done badly? (See http://www.tobaccoinaustralia.org.au/chapter-14-social-marketing/14-3-tobacco-control-campaigns-in-australia-experi for a history of Australian tobacco control campaigns.)

    It’s not easy, and there are certainly complications. These include limited resources, which result in advocates having to argue with Ministers’ offices and health departments about what constitutes the biggest bang for the buck; as a consequence, we often get ads that are widely, rather than specifically, targeted. There are also cultural differences between Australian teens and those in other countries which will influence what works. For example, an effective US anti-smoking youth campaign which highlights the tobacco industry’s manipulation of young people and encourages young people to lobby their elected representatives won’t be as effective where the industry hasn’t been demonised, where teens are more cynical about corporate manipulation, and where there is less of a tradition of direct political action by young people.

    Finally, there is the strong argument that you change behaviour and social norms by changing the environment, such as through smoke-free public places and workplaces and the elimination of tobacco advertising. Certainly I don’t think anyone would argue against the importance of social venues becoming non-smoking, even if this presents opportunities for some sort of ‘solidarity’ among smokers. Smoking in films remains a divisive issue, with some leading tobacco control advocates resistant to tackling the issue head-on, while others argue that failing to address this significant influence on young people’s attitudes and perceptions constitutes a major gap in efforts to discourage youth smoking.

    Turner has raised a number of important questions, but the basic one is still this: should we be trying to directly address youth smoking through campaigns that target youth and, if so, will we have the resources to do it well? There was excellent qualitative research done in the 1990s by researchers such as Tom Carroll and Bev Carroll, and the team which produced Finding the strength to kill your best friend – smokers talk about smoking and quitting (Carter S, Borland R, Chapman S.. Australian Smoking Cessation Consortium and GlaxoSmithKline Consumer Healthcare; Sydney: 2001). We know even more now about psycho-social influences on health-related behaviour, as well as the ‘behavioural economics’ of decision-making. If Turner’s point is that we need to be smart, be savvy, and think like commercial marketers rather than like health professionals in order to successfully market our ‘product’ to young people, then I couldn’t agree more.

  3. destroythejoint says:

    The other possibility of course is to adopt Professor Jon Berricks proposal and prohibit the sale of tobacco products to anyone born this century. This would phase out smoking in about 60 years. these children are now aged twelve but would never be able to buy cigarettes. As most research shows that children get cigarettes from their peers, then it would not take many years before each age cohort could not buy cigarettes. They would not be penalised, this is not prohibition. We could save an entire generation of people from tobacco smoke.

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