Moving beyond the mainstream: Taking the National Graphic Health Warnings Campaign to priority populations Hi, my name is Alissa Guy and I am the Marketing Coordinator at Quit Victoria. Today in my presentation I am going to be discussing the strategies we used to take the National Graphic Health Warnings to priority populations Alissa Guy – Quit Victoria Edwina Pearse – Quit Victoria Anita Dessaix – Cancer Institute NSW

Background – National Health Warnings Campaign New legislation introduced in March 2006 Unprecedented opportunity for a lasting cessation campaign effort across Australia National collaboration was formed to develop a campaign highlighting the new warnings In March 2006 new legislation was introduced requiring all tobacco products manufactured in or imported into Australia to have graphic health warnings The introduction of these warnings represented an unprecedented opportunity to capitalise on and to build the momentum for a lasting cessation campaign across Australia. With this in mind a collaboration was formed by eight organisations, representing 90 per cent of Australia’s population, and six of eight Australian States and Territories and the health warnings campaign was developed

Collaborative group Quit Victoria (Project Sponsor) Cancer Institute NSW (Project Sponsor) National Heart Foundation Cancer Council SA Quit SA Quit Tasmania Queensland Health The Cancer Council Victoria Northern Territory Government These are the key organisations involved in the collaboration

Set A warnings 1 March – 31 October 2006 Smoking Causes Peripheral Vascular Disease Smoking Causes Emphysema Smoking Causes Mouth And Throat Cancer Smoking Clogs Your Arteries Don’t Let Children Breathe Your Smoke Smoking – A Leading Cause Of Death Quitting Will Improve your Health Two sets of seven warnings introduced. For my discussion today Set A are the focus, in particular the warnings on Gangrene and Mouth Cancer. Although Set A ran from 1 March – 31 October 2006, they didn’t start appearing on packs until around May. The same time as our campaign commenced.

Aims & objectives Target audience: Aim: Adult smokers aged 18–40 (lower blue collar) Aim: To increase the likelihood of smokers making a successful quit attempt by: Adding depth, meaning and personal relevance b) Maintaining the impact of the warnings c) Encouraging them to call the Quitline or visit the Quit website (www.quit.org.au) The national campaign which consisted of TV, internet and outdoor advertisements, as well as public relations and cessation resources was aimed at adult smokers aged 18 – 40 and skewed within this audience to those who were of a lower blue collar socio economic status. The aim of the campaign was to increase the likelihood of smokers making a successful quit attempt by: a) Adding depth, meaning and personal relevance to the new pictorial health warnings b) Maintaining the impact of the warnings far beyond the anticipated newsworthiness of their initial introduction c) Encouraging them to call the Quitline or visit the Quit website

Communications strategy Aim: Co-ordinate and maximise the amount of dollars spent in advertising through a comprehensive public relations (unpaid media) strategy Objectives: Co-ordinate publicity of the campaign Organise a simultaneous launch of the campaign to give prominence in each state and territory Create, identify and co-ordinate a national pool of media talent, and resources to support unpaid media activities As part of the project 4 working groups were established to focus on the key areas of the campaign and it’s implementation. One of which was was a Communications sub group. The Aim of this group was to - Co-ordinate and maximise the amount of dollars spent in advertising by supporting the paid media strategy with a comprehensive publicity (unpaid media) strategy To achieve this the group were to - Co-ordinate publicity of the National Health Warnings Campaign pre and post launch with national, state and local media Organise a simultaneous launch of the advertising campaign to give prominence in each state and territory To create, identify and co-ordinate a national pool of media talent, and resources to support unpaid media activities around the campaign

Priority populations communications strategy Aim To ensure priority populations received relevant and tailored information about the National Health Warnings Campaign Two key priority populations were selected Multicultural population Indigenous population Within this overarching communication strategy for mainstream media was a strategy aimed at taking the graphic health warnings message to priority areas. The Aim of this strategy was - To ensure priority populations received relevant and tailored information about the health warnings campaign Two key priority populations were selected Multicultural population Indigenous population Each were targeted with a slightly different strategy. For efficiency most of the work for the multicultural strategy was done out of NSW and the work for the Indigenous strategy was done out of Victoria.

Multicultural communications strategy Language groups Arabic, Chinese (Mandarin & Cantonese), Greek, Italian, Korean, Spanish and Vietnamese State television media buys on culturally appealing stations such as SBS and Channel 31 State radio media buys on culturally appealing radio stations such as SBS radio in language specific programs Adapted version of the Gangrene print advertisement The starting point for the multicultural strategy was the selection of language groups to target. The languages outlined in the slide were identified and selected because of the high rates of smoking and low rates of English language proficiency in these communities. Following this was the decision by each state and territory involved in the campaign to support the mainstream media buy with paid media on culturally appealing TV and radio stations. For the television media buys specific stations were selected and the mainstream advertisement aired. However, to cater for the radio adaptions of a 60 second radio advertisement were done in the languages mentioned above. In addition to this, an adapted print advertisement that complimented the Gangrene television advertisement was produced and run in select publications nationally.

Adapted print advertisements These are the examples of the print advertisement that was designed for mainstream media and adapted for the multicultural strategy.

Multicultural communications strategy Adapted resources Bilingual spokespeople available for media and kits sent to radio stations Promotion of campaign and distribution of material to relevant organisations in the community State and territory based interpreter services (Quitline) Language specific Quitlines set up in NSW providing advice and information A large emphasis was also placed on reaching this audience through unpaid media and making the resources we had for the mainstream media relevant for this audience. This was done by - Adapting the media release and fact sheets for the campaign and distributing them to 44 ethnic newspapers. Inviting Community health promotion staff from the Arabic, Chinese, Italian and Vietnamese communities were to the launch. This provided good photo opportunities for material to accompany the distribution of press releases. It also resulted in CTVB (Chinese cable television) covered the event. Sending information packs with adapted media releases to relevant radio stations across Australia. Sending packages with all the campaign information and adapted resources to 586 relevant organisations in NSW as well as their interstate counterparts. Sending the same packages to 300 community organisations and health organisations covering these languages selected. This included Government and non- Government institutions and individual health professionals throughout NSW. In addition to this, to ensure the barriers to calling Quitline were reduced each state offered an interpreter service with NSW offering specific Quitlines for the selected languages.

Results - Multicultural calls to NSW, 2006 Month/ Language June July August Sept Total Arabic 4 6 2 1 13 Mandarin 11 38 Cantonese 7 14 5 - 26 Italian 8 22 Vietnamese 31 25 34 91 Korean Spanish Greek 64 65 199 Although generating calls from this priority group wasn’t the main aim, it is positive to see that during the campaign calls from members of the target audience increased. This is particularly true in NSW where the majority of the activities took place. Note: NSW were airing two different campaigns at the time, the health warnings and the Quitline campaign. There was also an increase in calls requesting translators in Victoria, South Australia and Queensland.

Indigenous communications strategy A targeted media buy with the Imparja network to reach Australia’s Indigenous communities Imparja audience of 430,000 people Indigenous and locally produced programs, Imparja purchases much of its programming from the Nine and Ten Networks The second priority group selected was the Indigenous community. The aim for the Indigenous strategy was much the same as the Multicultural strategy and aimed to ensure that the messages from the health warnings campaign were communicated directly to the Indigenous community in the most relevant and appropriate way possible. This was done primarily through a paid national media buy on the Indigenous network Imparja. For those who aren’t familiar with Imparja – Imparja is a private, fully commercial television company registered in the Northern Territory. Audience of 430,000 people Airs Indigenous and locally produced programs, purchasing much of its programming from the Nine and Ten Networks

The Imparja network Reaching remote communities in the Northern Territory and the majority of remote areas in South Australia, Queensland and New South Wales with select coverage in both Victoria and Tasmania Although the satellite technically covers the whole of Australia, Imparja is only licensed to deliver its TV signal to Central and Eastern Australia. Imparja reaches remote communities in the Northern Territory and the majority of remote areas in South Australia, Queensland and New South Wales with select coverage in both Victoria and Tasmania

Indigenous communications strategy Customised media kits distributed amongst Indigenous media outlets News story on the launch of the campaign featured on the Imparja television network Interviews with various Indigenous radio programs to discuss the campaign Imparja News Coverage – Mouth Cancer To coincide with the mainstream media launch of the campaign customised media kits were distributed amongst Indigenous media outlets A news story on the launch of the campaign was arranged to feature on the Imparja television network on the night of the launch Interviews with various Indigenous radio programs to discuss the campaign were also organised

Local Indigenous activity Regular contact with key Indigenous health professionals and stakeholders prior to the campaign Victorian Aboriginal Community Controlled Health Organisation (VACCHO) Centre for Excellence in Indigenous Tobacco Control (CEITC) Koori Health Unit (DHS) Letter to Indigenous health professionals and organisations leveraging off the WNTD 2006 theme including order form for WNTD resources Information sheets on the PVD warning In conjunction with the strategies discussed on the previous slide, an important part of the Indigenous strategy was making a connection at a local level. This included - Regular contact with key Indigenous health professionals and stakeholders prior to the campaign Letter sent to Indigenous health professionals and organisations leveraging off the WNTD 2006 theme This letter was accompanied by an order form for resources for WNTD and included information sheets on the Gangrene warning.

Indigenous resources To ensure the material being sent at a local level was culturally appealing to this audience, the resources were developed using Indigenous friendly colours and visual images.

Conclusion What made the strategy successful? Resources made culturally appealing through changes to layout, format, wording and colours Adapted resources and media material where appropriate Creating links with community groups and organisations Paid media specific to the priority groups Culturally relevant spokespeople for media So in conclusion, what made the strategy a success? Resources made culturally appealing through changes to layout, format wording and colours Adapted resources and media material where appropriate increased the likelihood of getting coverage Creating links with community groups and organisations who have direct and daily contact with priority groups ensured the issue was raised and discussed Paid media specific to the priority groups to further enhance the unpaid communications Culturally relevant spokespeople for media encouraged coverage in tailored publications

Acknowledgements Cancer Institute NSW (Project Sponsor with Quit Victoria) NSW Health Department NSW Multicultural Health Communications Cancer Council Victoria Quit South Australia Cancer Council South Australia Queensland Cancer Council Queensland Health Department Quit Tasmania NT Department of Health and Community Services