1. An Overview of Australia’s National Tobacco Campaign
The Role of Social Marketing in Tobacco Control:
An Overview of Australia’s
National Tobacco Campaign
Presentation to Policy & SSMU on 16/03/2004
8th wave - including benchmark
Results not approved for release
Jenny Taylor
Jodie Grieve

2. Introduction Role of Social Marketing
Context of National Tobacco Strategy
Background to the National Tobacco Campaign
Campaign Strategy, Implementation & Evaluation
International Use of the Campaign

3. Principles of social marketing
Social marketing is the adaptation of commercial marketing technologies to the analysis, planning, execution and evaluation of programs designed to influence the behaviour of target audiences in order to improve their physical and mental well-being and that of the society of which they are a part.”
(Andreasen, 1995)

4. Social marketing differs from commercial marketing in a number of ways:
the products are more complex
the demand is varied
target audiences are more challenging to reach
consumer involvement is more intense
competition is more subtle and varied

5. Social Marketing….particularly appropriate:
- when new information and practices need to be disseminated;
- when activation is needed; and
- when counter-marketing is needed.
(Fox and Kotler, 1980)

6. Social Marketing and Health Promotion Approaches Were Developed In Response To:
The limited reach of individual and small group programs;
2. Low penetration of programs to some segments of the population; and
3. The desire to develop programs to achieve change in populations.
(Le Febvre and Flora, 1988)

7. Mass Communication Approaches Can:
reach a large proportion of the population;
reach groups who are not currently being reached;
reach target audiences cost effectively;
develop effective messages; and
potentially create support for behaviour change by reaching many people at the same time.
(Redman et al., 1990)

8. Literature, data review
The Marketing Process and Corresponding Research Stages
Literature, data review
& segmentation
Developmental
research
1 Analysis 1
Analysis 2
Planning
Implications 6
Concept development
& pre-testing 3
Feedback to
stage 1
Develop
test
refine
elements 5
Outcome
evaluation 4
Assess in-market
effectiveness
Implement-
ation
Benchmark
Process
evaluation

9. Key Principles of Social Marketing and Public Health
1. A Consumer Orientation
The importance of viewing the issue to be addressed through the eyes of the target audience.

10. The application of exchange theory
Recognising that people will only accept what we are promoting if they perceive the benefits justify or outweigh the costs.

11. Assessments of Internal and External Environments
Assessing the nature and scope of the problem to be addressed, the environment within which it will be addressed and the resources available to address it.

12. Channel Analysis
Analysing the most effective ways of reaching and communicating with the target audience.
Efficiency
Environment

13. Market Segmentation and Audience Analysis
Identifying target audience segments
Analysing target audience segments.

14. Use of Marketing Research and the Role of Formative Research
Applications of marketing research
Formative research for communication campaigns
- Pre-production research
- Pre-testing research

15. Formative Research Pre-production Research Audience analysis
Segmentation
Identification within target audience of:
- knowledge of lexicon
- beliefs and perceptions
- attitudes and values
- salience priorities
- efficacy and skills

16. Pre-testing Research Concept development Testing message executions
- assess the attention value of the message execution
- measure its comprehensibility
- determine its relevance to the target audience
- identify strengths and weaknesses
- gauge any sensitive, or controversial elements

17. Use of the Marketing Mix
Considerations of:-
Product
Price
Place
Promotion

18. Process Tracking and Outcome Evaluation
Assessing the effectiveness of campaign implementation
Assessing the achievement of campaign goals

19. A Profit Orientation
Recognising the need for cost-effectiveness .

20. An Integrated Planning and Management System
Recognising the need for all elements of the social marketing campaign to be managed effectively and to be considered in a cyclical approach
Importance of a strategic planning process:
setting goals
setting objectives
delineation of strategies and tactics
management and feedback systems

21. Television advertsing

22. Television advertising

24. National Tobacco Strategy (NTS)
“A framework for action”, with commitment from all governments in Australia to take action on tobacco control across a range of key strategy areas;
Endorsed by the Ministerial Council on Drug Strategy;
The goal is “to improve the health of all Australians by eliminating or reducing their exposure to tobacco in all its forms”

25. NTS represents a national collaborative approach to tobacco control issues, nominating a range of government, non-government and community partnerships and linkages, under six key strategy areas:
Strengthening community action
Promoting cessation of tobacco use
Reducing availability and supply of tobacco
Reducing tobacco promotion
Regulating tobacco; and
Reducing exposure to environmental tobacco smoke

26. National Tobacco Campaign addresses key strategy area of “Promoting cessation of tobacco use”
Social marketing strategies can achieve optimum outcomes when operating within a comprehensive strategy (ie NTS) and evidence based approach employed

27. Social Marketing in Tobacco Control
Social Marketing can achieve:
Agenda Setting
Increasing the salience of tobacco control issues
Facilitating acceptance of tobacco control policy initiatives to achieve structural change
Behaviour change
Increased preparedness to quit
Prompting quit action
Prompting supportive action for quitters
Providing reinforcement for ex-smokers and never smokers.

28. Genesis of the Campaign
A collaborative infrastructure
Pooling of expertise and knowledge
Funding commitment
Minister
Commonwealth Dept. of Health & Aged Care
National Expert Advisory Committee on Tobacco
State/Territory Quit Coordinators
Research & Evaluation Committee
Campaign Technical Advisory Committee

29. Literature, data review
The Marketing Process and Corresponding Research Stages
Literature, data review
& segmentation
Developmental
research
1 Analysis 1
Analysis 2
Planning
Implications 6
Concept development
& pre-testing 3
Feedback to
stage 1
Develop
test
refine
elements 5
Outcome
evaluation 4
Assess in-market
effectiveness
Implement-
ation
Benchmark
Process
evaluation

30. The Competitive Marketplace: The ‘product’
“We are searching explicitly for a socially acceptable addictive product……” British American Tobacco
“The cigarette is an inexpensive, extremely effective nicotine delivery device, engineered to rapidly provide the user with nicotine, thus maximising the addicting and toxic effects of the drug.”
The American Medical Association

31. The Product Consumption Pattern
“ a pattern of repeated self-administration that usually results in tolerance, withdrawal and compulsive drug taking behaviour”
“a pattern of maladaptive use that continues despite adverse consequences….”
The American Medical Association

32. The Tobacco Industry Massive infrastructure Billion dollar budgets
Ingenious product marketing

33. The Anti-tobacco ‘Industry’
Quit campaigns
Health departments - State/Territory and Commonwealth
Cancer councils
National Heart Foundation
Action on Smoking and Health
Peak medical bodies
Quitline x 8
Pharmaceutical companies x 3
Fragmented infrastructure
Cooperative rather than coordinated approach
Limited funding
Smokers targeted through multiple approaches with varying research to support

34. Government Influences on Marketplace
Restrictions on advertising and sales
Phasing out of tobacco sponsorship
Smoke free public place legislation
Increases in excise duties

35. Theoretical model Transtheoretical stages of change model
Quitting is a process not a single action
Stages
Precontemplation: do not intend to change behaviour
Contemplation: considering quitting in the next 6 months
Preparation: making plans to quit within the next 30 days
Action: have quit (but for less than 1 year)
Maintenance: have successfully quit for more than 1 year
Cyclical process

36. Strategy Development
Review of existing literature and reports from previous anti-tobacco campaigns
Identification of target group & cessation focus
Development of an individual model of behaviour change, most smokers do want to quit but not today
Unwritten personal agenda
Long term behaviours need resources and reinforcement to remain on that agenda

37. Campaign Strategy Development
Knowledge about negative health effects is universal but basic
The campaign should:
Achieve identification with the smoker
Provide new information that is relevant and can be recalled with the behaviour of smoking
Graphically display the consequences of smoking
Provide a positive call to action
5 rounds of concept testing research showed the potential of the strategy on both an emotional and rational level
Further phases of research to develop later executions

38. Campaign Components Powerful advertising
Promotion of National Quitline number
Upgraded cessation services
Promotional events
Involvement of general practitioners, pharmacists, opthamologists, optometrists, and cardio-vascular specialists
Campaign website

39. Implementation Timetable
1997 June Campaign launch (June - November)
3 new TVCs ‘Artery’ ‘Lung’ ‘Tumour’
1998 January New Year’s Eve Campaign
February Launch of campaign targeting NESB communities
May World No Tobacco Day Campaign
2 new TVCs ‘Brain’ ‘Call for help’
1999 January New Year’s Eve Campaign
May World No Tobacco Day Campaign
September Spring Campaign
2000 January New Year’s Eve Campaign
May World No Tobacco Day Campaign
2 new TVCs ‘Tar/Lung’ ‘Eye’
2001 January New Year’s Eve Campaign
May World No Tobacco Day Campaign
2002 January New Year’s Eve Campaign
May World No Tobacco Day Campaign
2003 May World No Tobacco Day Campaign
2004 May World No Tobacco Day Campaign

40. Evaluation Issues What would equal success?
Methodology developed to enable reliable detection of a change in prevalence of 1%
Series of surveys
Evaluation surveys - prevalence and process measures
Continuous tracking surveys - measures of campaign ‘cut-through’, response to campaign communication and impact of specific strategies
Monitoring calls to the Quitline

41. Relationship Between Calls to the Quitline and TARPs

42. Process Measures (Wakefield and Miller, 2000)
Call volume during the Campaign increased by 500%
1 in 25 smokers called the Quitline in first year of national promotion
Improvement in accessibility, quality and promotion of the services through a national number
Strong link to campaign advertising
Almost 80% of callers to the Quitline were in the Campaign’s target age group (18-40)
A follow up study found 29% of smokers who contacted the Quitline were not smoking at the 12 month point

43. Evaluation Findings*
The Campaign remains highly memorable with high levels of advertising recognition by the target group
Prompted recall of the Campaign among smokers and those who quit within the past 12 months was 95%. In the first follow-up in November 1997, prompted recall was 87%.
The Campaign continues to have a positive impact on quitting behaviour.
Campaign-attributed encouragement to quit was reported by one in two smokers (48%). This has been maintained across the years. At benchmark, 37% reported anti-smoking advertising had made them more likely to quit.
Smokers and recent quitters indicated they believed the health effects demonstrated through the Campaign to be true
Highest for ‘smoking causes a build up of tar on the lungs’ (99%).
*Source: 2004 survey

44. Smoking Prevalence in Australia 1997 – 2004*
Benchmark (May 1997) %
Follow-up 1 (Nov 1997) %
Follow-up 2 (Nov 1998) %
Follow-up 3 (Nov 1999) %
Follow-up 4 (Nov 2000) %
Follow-up 5 (Nov 2001) %
Follow-up 6 (Nov 2002) %
Follow-up 7 (Nov 2003) %
Follow-up 8 (Nov 2004) %
*Source: Smoking prevalence & consumption,

45. Impact / Outcome measures (Carter and Scollo, 2000)
CESSATION as a result of the first six months campaign* activity is estimated at 190,000 fewer smokers
DECREASE IN PREVALENCE of smoking
is estimated at 1.4%
DECREASE IN INCIDENCE OF DISEASE associated with smoking eg. lung cancer (1.76%), COPD (0.93%) and various cardio-vascular diseases (3.64%)
920 FEWER PREMATURE DEATHS
REDUCED HEALTH CARE COSTS ($24.2 M)
*Australian Govt. expenditure $7.1 million in 1997

46. Success of Campaign Based on:
Strong Ministerial commitment
Unprecedented coalition of government and non-government organisations
Pooling of expertise, resources and funding from Commonwealth, State and Territory governments and key non-government organisations
Powerful creative strategy/advertising grounded in theory and research
Supporting high quality cessation services ie QUIT lines

47. International Use of NTC
Earned national and international awards and recognition for excellence in advertising
Campaign’s partnership base has grown to an international level with in excess of 40 countries using/applying to use the campaign
Enables countries to access a campaign rich in research and proven outcomes for minimal investment

48. International Use of NTC
Countries that have used/applied to use NTC TVCs:
Singapore, Philippines, New Zealand, Cambodia, Tonga, USA, Canada, Norway, Poland, Iceland, Northern Ireland, Germany, Armenia, Bosnia & Herzegovina, Croatia, Greece, Kazakhstan, Kyrgyzstan, Malta, Republic of Srpska, Russian Federation, Tajikistan, Belgium, Costa Rica, East Timor, India, Indonesia, Italy, Japan, Malaysia, Mongolia, Netherlands, Republic of Ireland, Thailand, Sweden, Philippines, UK
Use of TVCs in documentary/current affairs programs:
Holland, USA (including Oprah Show), UK, India, Japan, Germany
Educational Use of TVCs (schools, universities)
Canada, Venezuela, Japan, Costa Rica , Brazil , Italy, Republic Of Ireland

49. Conclusion
The National Tobacco Campaign has been the most collaborative and sustained anti-tobacco campaign in Australia’s history
Approximately $24 million of Australian Government funding was spent on the Campaign from 1997 to 2004
$25 million over 4 years has been committed by the Australian Government in 2005 to a new tobacco campaign targeting youth smoking

50. THE NATIONAL TOBACCO CAMPAIGN
A federal, state and territory health initiative