Tobacco use is responsible for 20% of all Indigenous deaths [4], and two of every three deaths within the Indigenous population before the age of 65 years can be attributed to heart, stroke and vascular diseases compared with 1 in 10 for the non-Indigenous population [5]. Bold figures highlight those ads that were not rated significantly lower than the highest rated ad for each outcome at P < 0.05. Available from: 2. Following this, groups completed three activities. The highest rated ad for each outcome (columns) is indicated by * and bold; the lowest rated ad for each outcome is indicated by ∧. Therefore, all repeated measures analyses used robust standard errors to control for individuals having rated a total of 10 advertisements each. 4722.0.55.004, Canberra, Australia: Australian Bureau of Statistics,. It may be that the ads depicted in the third person are less salient among Indigenous people who all too frequently experience loss of family. Of all outcome variables, New information was consistently rated higher among Indigenous smokers. … This New Truth Initiative Study Shows the Effectiveness of Antismoking Ads Nonprofit and AOR 72andSunny estimate they prevented over 300,000 teens … Eight of the ads represented a diverse range of the types of anti-smoking ads typically aired in Australia, including strong graphic ads about the health effects of smoking (strong graphic), ads featuring real people's stories about health effects (narrative), and those showing graphic simulations of health effects (simulations). WASHINGTON, D.C. (Dec. 7, 2017) – With research showing that almost 99 percent of adult smokers start by age 26, Truth Initiative ® – the national nonprofit dedicated to making tobacco a thing of the past – reveals today in new research published in the International Journal of Environmental Research and Public Health that brand equity of the organization’s award-winning truth campaign … Few studies have examined the memory recall and subsequent evaluation of anti-tobacco TV advertisements by the urban community population. Averaged predicted probabilities of positive ad ratings for Indigenous smokers (95% confidence intervals). 2018 May 4;23(5):445–61. If you are using ad-blocking software, please disable it and reload the page. Graphic, negative advertisements have long benefited from the captive viewing environment created by free-to-air television. Ronaldo—Otolaryngologist: Strong graphic and narrative health effects, Source: New York City Department of Health and Mental Hygiene, http://www.geovisiononline.com/socialmarketing/antismoking/ronaldo. With a year-round campaign we could save even more lives and money.” Canberra, Australia: Australian Bureau of Statistics. Indigenous participants were more likely to rate the Indigenous-targeted ad (Billy) higher than non-Indigenous participants on all measures, further confirmed by the qualitative feedback. … The current sample was large enough to detect a 13% difference in proportions with 80% power at p < 0.05. These findings indicate that when Indigenous smokers are exposed to mainstream anti-smoking messages, they have the potential to motivate them to quit. I am always afraid of bad news. Responses to Leave behind were similar across all the groups. Some participants mentioned that the ad did nothing to encourage them to quit smoking. Melbourne: Roy Morgan; 2020 [cited 2020 Mar]. Ratings of 4 or 5 (slightly agree and strongly agree) were classified as positive responses, and ratings of 1–3 were classified as neutral or negative responses. Family time: Narrative of positives of quitting, http://www.quit.org.nz/file/vids/TQG_VideoDiaries_RoseanneAndIeremia_07_FamilyTime.mpg. Durkin S, Brennan E, Wakefield M. Mass media campaigns to promote smoking cessation among adults: an integrative review. These advertisements are designed to generate an increased sense of perceived personal threat of the health harms of smoking. AB and MM were responsible for drafting, reviewing and contributing to the design of the manuscript. Another strategy to continue to generate discomfort about smoking may be the use of more non-skippable advertisements where possible to increase the likelihood of securing a captive audience. This includes exposing the profit-oriented tactics that are used by the tobacco industry in the design and manufacture of cigarettes to manipulate and keep smokers addicted, such as use of flavours and filters and their marketing and promotion1. The authors would like to thank Michael Murphy from the Social Research Centre for preparation and management of the reference groups and Scott Wilson and Byron Wright from the Aboriginal Drug and Alcohol Council for their assistance with the groups and recruitment. In particular, the ad affected young males who played for their local football team, who disliked the thought of never being able to play again. Take a look at what has happened over the past decade. Finally, we see a young man in a pub buying a pack of cigarettes from a vending machine bearing the sign: Smoking kills Call the Quitline 137 848. Modern antismoking messaging must find a way to communicate with smokers that empowers them as the agents of their health decision making and provides them with the tools to make the best choices. In Australia, there has been a strong tendency to air these types of highly emotionally evocative graphic and narrative style messages highlighting the health effects of smoking. Results: An anti-smoking advertising campaign initiated by Vermont researchers was found to be the most cost effective in that it significantly reduced adolescent smoking prevalence at a low per capita cost. amount spent on advertising). For permissions, please email: journals.permissions@oup.com, Adherence to COVID-19 mitigation measures among American adults: the need for consistent and unified messaging, Identifying knowledge, self-efficacy and response efficacy of alternative discipline strategies among low-income Black, Latino and White parents, Testing risk and protective factor assumptions in the Icelandic model of adolescent substance use prevention, Lessons learnt from the field: a qualitative evaluation of adolescent experiences of a universal mental health education program, Effectiveness of pictographs in improving patient education outcomes: a systematic review, Appendix A: Anti-smoking advertisement descriptions, http://www.nhmrc.gov.au/_files_nhmrc/file/health_ethics/human/conduct /guidelines/e52.pdf, http://abs.gov.au/AUSSTATS/abs@.nsf/mf/4714.0/, http://www.abs.gov.au/ausstats/abs@.nsf/mf/4722.0.55.004/, Receive exclusive offers and updates from Oxford Academic, The role of social norms in the relationship between anti-smoking advertising campaigns and smoking cessation: a scoping review, Using graphic warning labels to counter effects of social cues and brand imagery in cigarette advertising, Advertisement of electronic cigarettes in Italy: characteristics of online videos and the most popular promotional messages, ‘You could get sick, disgusting’: an analysis of alcohol counter-advertisements created by children. Some platforms provide media buyers (those who are buying advertising space) with the option of using skippable and non-skippable advertising spots. Her torso arches convulsively as she grips the hand of one of his assistants. The challenge is to understand the strengths and weaknesses of each platform and use them effectively to maximise reach and frequency of campaign exposure. Whetton S, Tait RJ, Scollo M, Banks E, Chapman J, Dey T, et al. We cut to an operating theatre, where the doctor feeds a large tube into the mouth of a woman lying on her back. This is an important item to consider including in future research. The first federally funded anti-smoking ad campaign hit the airwaves in the spring of 2012, followed by a second round this past spring. The reactions to Bubblewrap were mixed. Participants rated advertisements on a five-point Likert scale assessing factors including message acceptance and personalized effectiveness. Stevens W(1), Thorogood M, Kayikki S. Author information: (1)Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK. (AnIF18-25). | sbeasley@cancerwa.asn.au. The final category involves non-reality executions based on credible analogies showing the mechanism of health effects. The Butthead anti-smoking campaigns first started in 1998 to unpopularize cigarettes humorously and creatively. In: Alcohol warning label survey report. Even when those expenses are added to the cost of the Tips campaign, the total is still 15 times less than the $50,000 cost-effectiveness threshold, the CDC said. Indigenous groups commonly reported that Alive made them think about the damage that their smoking was doing to their bodies, especially the external damage caused by mouth cancer. Quit now!’, many believed that the ad focussed on not smoking around children rather than quitting. We also thank Damien Shen and Della Rowley from Drug and Alcohol Services South Australia for advice on sampling, Molly McCarthy for input into research design and Cultural Partners of Australia for their assistance in this research. It was regarded as bland and lacking urgency. http://www.youtube.com/watch?v=Kpl6YkRdREc. Significant difference between groups *P < 0.05; **P < 0.01; ***P < 0.001. Averaged predicted probabilities of positive ad ratings for non-Indigenous smokers (95% confidence intervals). Overall, ‘Bubblewrap’ received mixed ratings across the six measures. The rate of smoking in the nation increased faster even than in neighboring France, where the anti-tobacco movement was … A doctor stands before it and says: ‘Sometimes you can hear lung cancer in smokers before you can see it’. Findings indicated that, based on the number of people estimated to have quit smoking for good (about 100,000), the campaign will also prevent at le… He never got to see his daughter’. Evidence-based creative approaches must continue to generate discomfort about smoking while enticing and engaging the smoker audience to listen to the message. Canberra: ABS; 2019 [cited 2020 Aug 10]. People within low SES segments (segments D, E and FG, which are defined by Roy Morgan as the three lowest SES quintiles) have higher rates of smoking than those in more advantaged SES segments (AB and C, which are defined as the two highest SES quintiles).11 This is an important consideration when planning and buying media. Developing campaigns collaboratively, using the skills and expertise of people from across behaviour change communications, research and creative fields, will help to ensure that antismoking advertising carries the right message, communicates the message clearly and delivers it effectively to the target audience. Available from: 9. Eventhough anti smoking campaign has been implemented, yet the effectiveness is still in question.This study will explore how customers perception toward smoking and anti smoking campaign may exhibit different impact on effectiveness of anti smoking campaign. Left ventricular and atrial global strain evaluation within subtypes of ventricular remodeling. In addition, only one Indigenous-targeted advertisement was available at the time of this research and it was of relatively poor quality compared with the other advertisements tested. His mother nods as the health worker speaks. I will have to do this for the rest of my life’. This ad begins with a repetitive whistling and whooshing sound. South Australian Government and Quit Victoria. MM has conducted research for antismoking campaign development, paid for by government and not-for-profit health agencies. They have disrupted regular television viewing without giving viewers the chance to avoid at least initial exposure. The mouth, teeth and throat. This study does not, however, provide information on whether there are differences between Indigenous and non-Indigenous groups in terms of meaningful exposure to mainstream anti-smoking messages or in ‘opportunity to sustain long-term cessation’ motivated by exposure to these messages—the other main factors thought to determine differences between campaign effectiveness in advantaged compared with disadvantaged groups [15]. Mass media advertising has always played an integral role within Australia’s comprehensive approach to tobacco control.4 Television has been the preferred media channel for antismoking campaigns for decades, with state-level campaigns starting in the 1970s1 and national campaigns in the 1990s.5 Antismoking messaging has been researched extensively and the findings continue to indicate that graphic and negative depictions of health harms and testimonial approaches are the most effective at prompting quitting behaviours.4,6,7 However, the media landscape today has created new practical challenges for antismoking campaigns including the need to develop effective creative content for different media channels and to achieve adequate audience exposure. Moving awkwardly, he looks at the camera and speaks in short bursts with a raspy breathless voice, with words in sub-text: ‘They call it throat cancer. Smoking rates have been decreasing for decades but they are not decreasing equally across the Australian population.1 People from lower SES groups, Aboriginal and Torres Strait Islander people, people experiencing homelessness and people with mental health issues all experience much higher rates of smoking than the general population.1 These population groups constitute a growing proportion of current smokers so it is critical to consider how campaign messaging and decisions on where to place advertisements ensure campaigns reach and resonate with these audiences. Potential effectiveness of specific anti-smoking mass media advertisements among Australian Indigenous smokers. The groups understood that emphysema was irreversible and that all smokers were likely to have it, while others were unfamiliar with emphysema, impeding comprehension. 3. Some participants felt that Anthony was speaking directly to them: ‘I like how at the end he looks back at the camera. Participants described Amputation as disgusting. So future plans right now: Alexandra, my oldest is coming over here for a holiday—December the 13th. Lessons learnt: Although it is known that hard-hitting, emotional and/or testimonial anti-smoking advertisements can be effective in prompting quit attempts, optimal media channel selection and media mix for reaching and engaging audience segments is dynamic in an ever-changing media landscape. The mother, Roseanne, says: ‘We didn’t notice the time that we don’t spend with our kids until we stopped smoking. Evidence from New Zealand indicates that advertisements designed for the general population were also effective in generating calls to the national Quitline by Maori people [16]. One focus group study indicated that awareness of a widely broadcast national mainstream campaign was high and that it affected knowledge of the health effects of smoking among Indigenous people [18]. An almost equal number believe that ‘Campaigns should use logic, rather than being preachy’ (25%), and that fear works best with ‘pictures of diseased lungs etc.’ being effective (23%). Some limitations should be taken into consideration. Further multivariate logistic regression analyses were conducted on the combined sample of all participants, in order to examine any differences in Indigenous and non-Indigenous participants’ ad ratings for the six outcomes, separately for each of the 10 ads. Percentages are adjusted for ad order, location, age, gender, parental status, highest level of educational attainment, average number of cigarettes smoked each day, quitting intentions, previous quit attempts, all ads and individual-level clustering. Furthermore, the ads were not rated in the context of an overall campaign but were instead assessed in the controlled environment of a reference group. pp. This video is unavailable because we were unable to load a message from our sponsors. Roderick T. 5-year cost modelling for a national anti-tobacco campaign. The effectiveness of national television advertising campaigns on generating calls to a national Quitline by Maori, Aboriginal users of Canadian quitlines: an exploratory analysis, The impact of the National Tobacco Campaign in Indigenous communities: a study in Victoria, Television and delivery of health promotion programs to remote Aboriginal communities, Awareness and impact of the ‘Bubblewrap’ advertising campaign among Aboriginal smokers in Western Australia, Adults' response to Massachusetts anti-tobacco television advertisements: impact of viewer and advertisement characteristics, Anti-tobacco advertisements by Massachusetts and Philip Morris: what teenagers think, Appraisal of anti-smoking advertising by youth at risk for regular smoking: a comparative study in the United States, Australia and Britain, Exploring differences in smokers’ perceptions of the effectiveness of cessation media messages, The effects of emotional arousal and valence on television viewers’ cognitive capacity and memory, The impact of emotional tone, message, and broadcast parameters in youth anti-smoking advertisements, Pre-Testing Anti-Smoking Commercials: Process for the Conduct of Market Research, Cancer Institute NSW for the Bloomberg Global Initiative to Reduce Tobacco Use, A prospective study of degree and type of mass media campaign exposure on smoking cessation among socioeconomic subgroups, Does perceived message effectiveness cause persuasion or vice versa? A collaborative approach between health professionals, researchers, creative directors and media buyers is required to ensure advertising materials are communicating the right message for the audience, and that it is being delivered effectively. In the general population, there is clear evidence to suggest that advertisements that arouse strong negative emotions (depicting the serious harm of smoking) outperform those that do not [21–24]. Some rural Indigenous groups believed that it was important to produce ads with Indigenous people in them as they found them more relatable. Available from: 10. The ad shows a doctor sitting in front of Ronaldo—a middle-aged man of Hispanic appearance—and approaching him with a medical scope. His chest wheezes under the stethoscope. Furthermore, while the ad clearly stated at the end, ‘Do it for your family! Facebook. The ads ‘Which disease and Family time’ received the lowest ratings overall, and these ads were consistently rated significantly lower than the top performing ads (i.e. This ad opens with the image of an x-ray of an upper torso with two lung-shaped pieces of plastic bubblewrap superimposed over the chest. Available at: A review of tobacco interventions for Indigenous Australians, An evidence-based approach to planning tobacco interventions for Aboriginal people, Evaluation of multi-component community tobacco intervention in three Australian Aboriginal remote communities, Where there’s smoke there’s fire: high prevalence of smoking among some sub-populations and recommendations for intervention. Recent Australian statistics indicate that in 2008, almost half (47%) of Aboriginal and Torres Strait Islander Australians (Indigenous Australians) aged 15 years and over smoked regularly, which is more than twice the smoking rate of non-Indigenous Australians [1]. Indigenous smokers were more likely than the non-Indigenous to report that the ads contained ‘New information’, and so it is possible that these ads were less likely to have been previously seen among Indigenous people. Search for other works by this author on: National Aboriginal and Torres Strait Islander Social Survey, WHO Framework Convention On Tobacco Control, Experimental Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 1991-2021, Cat. Oxford University Press is a department of the University of Oxford. However, the impact of mass media campaigns on the Indigenous community is not well understood. Participants were paid an incentive according to market rates (AUD 80 for metropolitan and AUD 70 for rural groups). (AIM18-25). A Caucasian man, approximately 30 years old, begins by addressing the camera from his lounge room: ‘Smoking-related lung cancer is a long, painful way to die’ he says, ‘There’s no other way to describe it—it was absolutely hellish’. While these approaches have been effective in prompting people to make a quit attempt, the challenge today is finding new ways to effectively engage current smokers and provide new information to maintain their interest. Download this citation in one of the formats below: Sarah Jane Beasley | Cancer Council Western Australia, Perth, Adam Barker | Gatecrasher Advertising, Perth, WA, Australia, Michael Murphy | MMResearch, Melbourne, VIC, Australia, Toby Roderick | Customedia, Sydney, NSW, Australia, Tom Carroll | Carroll Communications, Sydney, NSW, Australia; School of Public Health, University of Sydney, NSW, Australia, Sarah Jane Beasley Available from: 13. Scollo M, Winstanley M. Tobacco in Australia: facts and issues. Percentages are adjusted for ad order, location, age, gender, parental status, highest level of educational attainment, average number of cigarettes smoked each day, quitting intentions, previous quit attempts, all ads and individual-level clustering. J Health Commun. The wheezing sound was attention grabbing across a range of the groups with some commenting that they also made the same sound when breathing: ‘Very relatable, makes you feel like quitting’. The man lights up a cigarette and breathes in smoke that swirls around in his lungs. campaign program done by Malacca Health Department on Anti-Smoking Clinic, campaign effectiveness towards Malacca citizens and public perceptions and also to find out the strategies in improving communication skills while dealing with the public’s especially the group of smokers. The surgeon then draws a black line just below the knee indicating where an amputation is going to take place, saying: ‘I want you to think about what’s happening here every time you look at your cigarette pack. Experimental research also supports the hypothesis that advertisements that evoke high arousal will receive greater viewer attention and will be remembered more readily [25]. Figure 1 shows that of the five ads, most frequently selected by Indigenous and non-Indigenous participants as most likely to make participants feel like trying to quit smoking, four of these were the same for both groups: Anthony, Ronaldo, Bronchoscopy and Alive. To counterbalance any potential effects of ad viewing order on ratings, two different ad presentation orders were used, one being the reverse of the other. Nicotine Tob Res. Published by Oxford University Press. Perth: National Drug Research Institute; 2019 [cited 2020 Aug 10]. I will be alive for that’. Type of program or service: Anti-smoking mass media advertising campaigns. It begins with a woman returning a pack of cigarettes to a shopkeeper, saying, ‘Oh, I’d rather not have mouth cancer, can you give me something else?’ The scene cuts to a supermarket with a mother and two kids at the checkout. In the case of Ronaldo, Indigenous participants commented on his striking voice, the confronting imagery of the hole in his throat and the fact that this was a real person, all as factors that appeared to have made it an effective ad. At the beginning of each group testing session, participants completed a demographic questionnaire, were shown a test advertisement for shampoo and completed four practice ad rating items. A total of 10 anti-smoking advertisements were tested ( Appendix 1). Indigenous smokers also reported being more likely to discuss Billy, Amputation and Family time compared with non-Indigenous smokers. Feedback regarding the strong graphic advertisement Amputation has some important implications for practice. 2003;12(suppl 2):ii9–14. The challenge remains for adequate financial investment to be committed to ensure mass media campaigns can productively reach and engage these audiences with an effective media channel mix and personally relevant, meaningful communication that can prompt them to quit. Available from: 12. (RIM18-25). Research has shown that national mass media communication campaign is one of the most effective means of raising awareness of the real health harms of tobacco and second-hand smoke, deterring youth from initiating tobacco use, urging smokers to comply with smoke-free laws and encouraging smokers to stop smoking. Principal component analysis was performed using the 11 ad rating items averaged across the 10 ads. Indonesia’s anti-smoking campaign still focuses on the severe harm that smoking causes. A key to achieving this engagement is to continue to present smokers with new information about how smoking creates harms, as identified in medical research. Durkin S, Bayly M, Brennan E, Biener L, Wakefield M. Fear, sadness and hope: which emotions maximize impact of anti-tobacco mass media advertisements among lower and higher SES groups? Billy: Indigenous-targeted: Second-hand smoke health effec, Source: Department of Health and Families, Northern Territory Government. Funding anti-smoking advertising at the levels required to effectively prompt and maintain smoking cessation remains a high priority considering the extensive social and economic costs of smoking. As he smokes, Billy tries to wave the smoke from his face. Analysis of key themes was then undertaken and a brief summary of the results is presented. It was common for participants to react to ‘Family time’ by describing this ad as ineffective, especially among the men and those without children. The discussions from Part 3 were recorded and transcribed. Four ads had previously been aired in SA or were being aired at the time of the study: Alive, Bubblewrap, Amputation and Which disease. Give up for the people who care about you’. A maximum was set of two participants with a university degree or higher per group. A blackened section appears across the bottom third of the screen displaying the Northern Territory Health Services logo and the words ‘Talk to Your Health Centre Now’. Available from: 14. Maximising campaign effectiveness in a new media environment There are several factors which impact the successful use of non-television platforms for antismoking campaigns. A total of 143 Indigenous and a comparison group of 156 non-Indigenous smokers from South Australia were shown 10 anti-smoking advertisements representing a range of advertisements typically aired in Australia. 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