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Lessons from a social media stoush

Many thanks to  Wendy Oakes, Senior Policy and Advocacy Manager, Heart Foundation NSW for this insight into using social media for public health advocacy.

Wendy writes:

Mentioning e-cigarettes on any public platform  can be a daunting experience. While social media is a potential tool for public health advocacy  the reality is that in the area of e-cigarettes, noisy, strident ‘vapers’ often  monopolise the discourse forcing many supporters of e-cigarette regulation into silence.

This article is a reflection on the Heart Foundation’s current experience with a YouTube video clip calling for regulation of e-cigarettes in NSW.

First some background. The Heart Foundation in NSW is currently implementing an advocacy strategy to persuade the NSW Government to regulate e-cigarettes under our existing State tobacco control legislation. With the recent State election on 28 March 2015, it has been an ideal time to drive our advocacy campaign calling for an amendment to NSW legislation to effect:

A ban on sales and marketing of e-cigarettes to children and

A ban on the use of e-cigarettes in public places where smoking is already banned.

We are not calling for a ban on the sale of e-cigarettes to adults in NSW nor would the amendments stop adult smokers from continuing to buy or use e-cigarettes as a replacement for tobacco products.

But what we have found is that the most vocal and frequent social media responders actually pay little attention to the particulars of our ask, framing most of their responses around 3 major themes:

  • the Heart Foundation wants people to keep smoking because it is taking money from Big Pharma and the tobacco industry
  • the Heart Foundation is letting people die by opposing e-cigarettes
  • the Heart Foundation hasn’t done its research because the ‘evidence is clear’ that e-cigarettes are safe.

For a charity, such a public attack on the good name of the organisation is always a concern. It was important before we started this campaign that we carefully considered all potential consequences and put in place risk minimisation strategies. This included ensuring that internal and external stakeholders – professional colleagues, donors and other supporters – were fully briefed about our position and were kept informed as the campaign progressed.

This meant that when the criticism first hit it was recognised for what it was by senior management and was efficiently dealt with by the Heart Foundation’s media team. Social media pages were consistently monitored and anything which was defamatory or irrelevant was removed. Further to this, anything that was incorrect was replied to with factual information and people were directed to our website for further information.

What is interesting is that there is a predictable pattern to most of these responses.

Amongst the most vocal and persistent negative responders there is little interest in the arguments underpinning our position and little effort is made to look at any of our supporting material. As other people have noted, most appeared to be located overseas and are fired by a ‘no regulation at any costs ‘agenda.

Disappointingly, while we have received many positive comments about the video from individuals via email, few are willing to make their views public. It’s understandable that people don’t want to subject themselves to the scorn dished out by some of the worst e-cig/vaping offenders but there is a risk that the vocal opposition run the playing ground if, through their collective power, they bully others to remain silent.

As health advocates we need to recognise that social media platforms can be an effective way to spread our public health messages to the increasing number of people who don’t read newspapers, rarely watch the TV news and almost certainly never read a peer-reviewed public health journal. It’s a challenge but one which we need to find a way to address.

Overall, the NSW Heart Foundation is pleased with the response. At the time I’m writing this (about 2 days after the video went live) we have had over 1,300 views with only 179 dislikes (13%). That’s roughly in line with a Newspoll survey we commissioned earlier this year which showed only 12% of respondents opposed a ban on sales of e-cigarettes to children. Conversely 80% supported a ban on sales to minors and 70% supported restricting the use of e-cigarettes in smoke-free public places.

So what is a way forward that allows us to use the reach of social media successfully without being swamped by the negative minority?

A skilled media team and strong leadership at the top are both essential components.

Our advocacy strategy on e-cigarettes has been 12 months in the making. It was based on careful consideration of available evidence, reference to colleagues and academics, and development of a range of tools, resources and key messages that was approved by a tight oversight group representing members of the NSW  Board, senior management and the media team.

Our team understands that to give our messages cut through we needed to use a vehicle that could convey our arguments in a clear concise way.  Using YouTube was a calculated risk because of the known danger of a deluge of criticism from vapers, but it is one we were prepared to make and would make again. You can watch the full video here.

Related Posts

Comments 10

  1. Scott says:

    Better argument would be to say that this is what the World Health Organisation recommends until better evidence is obtained regarding the health effects of e-cigarettes.

  2. Norman Hanscombe says:

    In a society where rational analysis has become an ever-increasingly rare event since the late 1960s, can we expect ANY socio-political issue to be discussed rationally? Just look at the Crikey site.

  3. Kevin McElligott says:

    So this is a forum for debate and discussion about health issues and policy? Would be great to have an intelligent discussion on public policy re vaping in Australia.

    I guess I’m one of those strident noisy vapers that bully others to remain silent. Maybe next time the Heart Foundation wants to issue some “information” on vaping, they should have it reviewed by an actual vaper beforehand. Or would it be wrong to include vapers as one of the many stakeholders to be consulted?

    The overwhelming negative response to the youtube clip was entirely predictable and deserved. It’s typical of health orgs that have a clear bias, which leads them to overstate the risks and dangers of vaping, while ignoring or understating the relative benefits.

    The internal counter-reaction is also typical. After so many years taking free-kicks at smokers they have gotten very thin-skinned themselves. Vapers kick back. Hard. It’s not enough for you to fall back on your good intentions as a justification for your behaviour. You have to look at the end result. Vaping is less harmful than smoking. More vaping equals less smoking. When a public health org lobbies against vaping, it is harmful to public health.

    I know you don’t like that math. But that’s because of your gut reaction to something that looks suspiciously like smoking. It’s okay to be suspicious, or cautious. It’s not okay to be misleading. Vapers are also suspicious. Maybe this is too good to be true. Maybe in the long run it will turn out to be worse than smoking. Maybe maybe maybe if if if. In the here and now, results to date are good, and very promising for the foreseeable future.

    I have been to the Heart Association website and looked the info on ecigs and vaping. It’s 100% negative, and as a result it is misleading, harmful, and unethical (yes it’s a hard word to throw at you and your organisation, but you deserve it). A balanced look at the issue of vaping as a substitute for smoking would conclude with a positive but cautious recommendation encouraging smokers to make the switch (and telling non-smokers to stay away from ecigs). Kind of like your sister-organisation in the US did a few months ago. So as long as the Heart Association (or any other public health organisation) continues with its stubborn and wrong-headed policy against vaping, then expect a hostile response from vapers to any propaganda material that you produce.

    I’m not one of those foreign vapertarians. I live in WA, where a bunch of well-meaning dumb people have decided to prohibit the sale of vaping products, while allowing the sale of (much more harmful) cigarettes in every corner shop. The day that vaping products are more widely sold and used than cigarettes will be the day to lobby for more restrictions on vaping. Until then you should focus your attention on the real enemy, and see vaping as an ally in the fight.

  4. Jenny Stone says:

    Really well said Kevin McElligott.

    I would just like to reiterate a couple of things in defence of vapers. There is a vast difference in power between a well funded public health body and the ordinary people who are the ‘public’ in Public Health. There is a kind of ivory tower feel to the Heart Foundation’s complaints about criticism received from those they purport to serve.

    Do they believe they have no obligation whatsoever to consider feedback from the ‘stakeholders’ they completely left off their list? The list included; professional colleagues, donors and other supporters, but not those directly affected (the definition of ‘stakeholder’!) by the extremely negative tone of the HF’s advocacy campaign and website position statement. What other voice or platform do ex-smokers and future ex-smokers who’ve benefited from vaping have for counteracting the negative, one sided opinions promulgated by such a powerful organisation with such a vast reach?

    Do the Heart Foundation, The Cancer Council and similar organisations feel they are so above reproach and beyond question that they have no accountability to those who are directly impacted by their actions? Are we, the smokers, the vapers, the disadvantaged and comparatively uneducated, supposed to just shut up and do as we are told? Is it too far down for those in public health to stoop so as to actually ask us for our experience and opinions on this matter, as legitimate stakeholders?

    This article is a form of bullying using lopsided power relations, and I strongly object to it.

    Jenny Stone – Support Worker, mental health & homelessness.

  5. Martin Joseph says:

    I think the major problem with the Heart Foundation’s message is that it falsely conflates the e-cigarette industry with the tobacco industry. Big tobacco companies are selling the e-cigarettes which look, feel, and in a way functions (through it’s ‘sucking on the device’ activation) like a real cigarette.

    The reason why the tobacco industry has invested solely in these kind of devices is most likely for the reasons that tobacco control advocates have suggested – to keep smokers in the habit of smoking.

    However, a much more significant majority of the industry sell devices that require the user to click a button to activate the device. These devices also look and feel very different to real cigarettes. These features are terrifying thing to the tobacco industry because it de-familiarises the user from smoking. Tobacco companies, particularly Altria and RJ Reynolds, have explicitly asked the US government to ban non-cigarette-lookalike devices.

    As Simon Chapman wrote – “if the Tobacco industry screams, you know you’re doing the right thing”. Two major tobacco companies calling for a ban on an entire product category needs to be acknowledged as a “scream”.

    If you want to get a good idea about the people who criticise the Heart Foundation (and other charity’s) stance on e-cigarettes, you should ask these people what kind of devices they use. I’m certain you’ll find that they use devices that the tobacco industry don’t sell. These people tend to be very sensitive to, and deeply offended when it is implied that they are associating with, or supporting the tobacco industry – which is exactly what the Heart Foundation has done in it’s latest public video.

    The Heart Foundation needs to acknowledge the differences between what Big Tobacco are selling and what >95% of the e-cigarette industry are selling, and, most importantly, what their critics (i.e Vapers) have used to successfully and completely stop smoking.

  6. Scott says:

    World Health Organisation report on e-cigarettes if anyone is interested.

    http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf?ua=1

  7. Kevin McElligott says:

    Scott,
    Thanks for the link, but the WHO report is old news. Much debated elsewhere. Bottom line is vapers were really disappointed by the stance taken by WHO.

    Martin,
    I think your point is very important. Here’s a link to news report on a recent study:

    http://www.independent.co.uk/life-style/health-and-families/health-news/realisticlooking-ecigarettes-less-likely-to-help-smokers-quit-study-claims-10190877.html

    The key takeaway:
    11% quit rate for cigalikes (mainly sold by tobacco companies)
    28% quit rate for tank devices (extremely high)
    13% quit rate for non-ecig uses (seems a bit high)

    Overall, the claimed quit rates all seem a bit high, but the relative numbers are really the story.

    The vapophobes immediately focused on the low relative quit rate for cigalikes. And that is important. But it’s wrong to ignore the big positive number on tank devices. You should look at Simon Chapman’s story in The Conversation site as a typical example.

  8. Judith Walters says:

    I’m an Australian, I read peer reviewed science and medical journals but certainly don’t read newspapers and I sometimes post in defence of smoking. After 50 years of heavy smoking I had tried everything to quit and had given up giving up when along came vaping to save my life. I have been tobacco free for nearly seven months and I still can’t believe it’s true that I can breathe again.

    The thing about vaping is that people who have stopped smoking thanks to e-cigarettes are quite evangelical about it. Whenever there is strong feeling there is bound to be passion which in some cases comes out in an abusive manner. I know I have to work hard to control my anger when I see ignorance about vaping being touted as expertise on vaping and the resultant misinformation that is being spread. The situation now is that the vaping community sees people in Public Health as knowingly or unknowingly supporting tobacco sales and the vaping community feel as if they have ended up with the job of getting people off tobacco. The tobacco companies see vaping as a threat because people can actually escape long term with the right equipment. E-cigarettes are the greatest threat to the tobacco companies that have ever existed and they must be having a good laugh as people in Tobacco Control try to limit this threat for them. Don’t be deceived by tobacco companies, have an open-minded look at vaping and you might be surprised as it has the potential to eliminate smoking as long as it is not over-regulated. If you speak to some vapers you might find it enlightening and that is one of the reasons there is so much anger as we are never consulted. WE ARE STAKEHOLDERS but are consistently ignored.

    By trying to ban vaping in all indoor areas the Heart Foundation are opposing an element of vaping which would encourage the switch from tobacco. There is NO solid research which says that vaping is harmful to other people but there is solid research which says the opposite. http://www.biomedcentral.com/1471-2458/14/18 As an ex-smoker I strongly object to being forced to spend time inhaling second hand smoke if we are forced into smoking areas.

    The vaping community agree that selling to children is not acceptable and vendors have as many safeguards in place as is possible but it is not possible to stop young people getting hold of anything they want and e-cigarettes are no exception. The government can bring in any laws they wish and it will make no difference except to make e-cigarettes more desirable to the young. An important difference between e-cigarettes and tobacco which seems to be overlooked is that young people can vape without using nicotine which is not possible with smoking so they need to be kept away from tobacco which has other addictive elements besides nicotine. This is an important point because they can stop vaping anytime they like without consequences which is a bit different to tobacco experimentation.

  9. Judith Walters says:

    CORRECTION: “I’m an Australian, I read peer reviewed science and medical journals but certainly don’t read newspapers and I sometimes post in defence of smoking.” I would never post in defence of SMOKING and I did of course mean VAPING.

  10. Deb Downes says:

    Mentioning e-cigarettes on a public platform in Australia is ONLY daunting if you choose to consistently misrepresent the facts. Unlike the UK, we in Australia, are yet to have the pleasure of reading a fact based positive report on vaping.

    Vapers in the UK have the rather pleasant experience of Smoking Cessation professionals working with the Vaping Community to assist people in QUITTING. I would have thought this should be the primary objective of organisations like the Heart Foundation and The Cancer Council.

    If Australian Public Health professionals (and I use that term loosely) insist on sticking their collective heads in the sand and abrogating their responsibility to free thinking, then I’m at a loss to understand why they’d be upset at being taken to task. Particularly since they consistently refuse to actually consult with the “Stakeholders” (don’t you love that term) that they choose to denigrate.

    Public Health Professionals are consistently misrepresenting the facts, and when they are questioned, they get all precious and start shouting ‘bullying’.

    Well, I consider they are the ‘bullies’. They refuse to engage with vapers, they consistently misrepresent vaping as smoking. They have their own agenda and also refuse to admit their COMMERCIAL funding sources.

    Why doesn’t Crikey subscribe to a balanced point of view? Where’s the other half of this story which interviews the Vapers that responded to the Heart Foundation’s YouTube ad?

    A message to the Heart Foundation and the Cancer Council:

    Whilst the number of vapers in Australia is small by global measures, they are growing. They also have family and friends who want to see them tobacco free. If every vaper, such as I, says I’m no longer donating to your organisation, and my family and friends support my position, then you are in a lose/lose situation – think about that.

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