1. Yvette Chang 40th Union World Conference on Lung Health Cancun – December 2009

2. Agenda The Role of Mass Media in Tobacco Control Best Practice Strategies The China Context Progressive Campaigns Key Learnings Summary

3. The Role of Mass Media in TC Mass media can be its own tobacco control intervention hard-hitting ads can motivate people to quit smoking Mass media can also support Direct: Warn people of dangers of tobacco Indirect: Protect people from SHS smoke, e.g. facilitating S/F Offer to help quit

4. Target Audiences CAMPAIGNS TARGETING ADULT SMOKERS ARE THE MOST EFFECTIVE. Adult-targeted ads reach broader population Seek to change attitudes and social norms Reach youth through adult messages Stronger response to social and emotional consequences compared to health messaging alone Broader message also applies to both women and non-smokers Source: National Cancer Institute. The Role of the Media in Promoting and Reducing Tobacco Use. Tobacco Control Monograph No. 19. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Pub. No. 07-6242, June 2008. BEST PRACTICE STRATEGIES:

5. Media Channels TV IS THE MOST POWERFUL MEDIUM. Strongest stand-alone medium Visual / Graphic messaging Twice (2x) recall rate of Radio High absolute cost Lowest per impression cost of all media channels Easily supported by other channels (i.e. billboard, print, radio, web) BEST PRACTICE STRATEGIES:

6. Key Messages ADS THAT WORK ARE INFORMATIONAL & EMOTIONAL. Successful Themes : Changing social norms Example: make smoking abnormal, unacceptable practice Includes SHS and youth smoking initiation issues Must engage entire population – not individual smokers Showing the physical damage of smoking Fear-based messaging to evoke strong response Increase urgency to quit PRE-TEST YOUR MESSAGES WITH TARGET AUDIENCE! Source: National Cancer Institute. The Role of the Media in Promoting and Reducing Tobacco Use. Tobacco Control Monograph No. 19. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Pub. No. 07-6242, June 2008. BEST PRACTICE STRATEGIES:

7. The China Context 1/3 of all smokers in the world – 350 million people 65% of all adult males >15 smoke State Tobacco Monopoly Strong policy influence Few/weak restrictions on tobacco industry sponsorship and advertising State-controlled media – very strict censorship Positive depiction of negative health consequences

8. Opportunistic Beginnings 2008 Beijing Olympics Approx. 8 ads made – promoting S/F Games No audience pretesting Soft, ‘celebratory’ tones Focus on Olympic Games and civil society messages Health warnings: very limited or none at all Use of humour, celebrity ambassadors, etc. BUT…helped to build awareness among policymakers

11. “Smoke-Free Beijing” Supported By ： Beijing Patriotic Health Campaign Committee Beijing Municipal Health Bureau Period ： February 2008 to February 2009 Coverage ： Beijing Municipality Media Delivery ： Local TV, Mobile Media, OOH, web columns, earned media 6 ads created – 3 supported by WLF Dec 2008: campaign evaluated via street intercept surveys (N = 700) NEXT…

12. “BJG Directive”

13. “Smoke-Free Beijing” Source: Smoke-free Beijing Communications Evaluation Dec 08 and Mar 08 N=700 NEXT… Post-Campaign Evaluation (3 WLF-supported ads) 1. Of respondents who saw the ad(s), nearly all (99-100%) felt the ad(s) were credible and relevant. 2. 98% of all respondents said they would support banning smoking in public places. 3. Key message takeaways: SHS is harmful to health 48% SHS causes respiratory diseases 45%

14. “Giving Cigarettes Is Giving Harm” Supported By :Chinese Center for Disease Control and Prevention + five regional government partners Campaign Date :Jan to Feb 2009 (to Apr 2009 in some cities) Reach :Beijing, Guangzhou, Shanghai, Shaoguan, Shenyang, Shenzhen, Tianjin Media Delivery :Local/National Satellite Television, Mobile Media, Outdoor LEDs, Indoor LEDs*, Posters/OOH, Web 200,000 posters in 20+ provinces TV/Mobile: >258M viewer impressions nation-wide Street intercept surveys conducted in 4 cities @ 1,000 SIGNS OF PROGRESS:

15. “Giving Cigarettes Is Giving Harm”

16. Post-Campaign Evaluation 1. Fewer people reported plans to give gifts as cigarettes Impact on gift-giving behaviour (BJG: 45% vs. 24%) 2. Increase in knowledge of risk of cardiovascular disease due to tobacco use (GZH: 25% vs 40%) 3. Respondents across all cities felt ad was credible (88-96%) and relevant to their lives (85-98%) This ad has since been adapted and aired in several other cities across China. SIGNS OF PROGRESS:

17. “Sponge” Supported By :Beijing Municipal Health Bureau Beijing Patriotic Health Campaign Committee Campaign Date :Jan to Feb 2009 / May to Jun 2009 Reach :Beijing Municipality Media Delivery :Jan-Feb ’09 – BTV, Mobile Media May-Jun ’09 – Indoor LEDs (District TV, City TV), OOH Adapted from Australian Cancer Council campaign Subsequently adapted and aired in Yunnan province, and 19 other cities across China MAJOR BREAKTHROUGH:

18. “Sponge” CASE STUDY:

19. “Sponge” AN ONGOING EFFORT:

20. “Sponge” Post Campaign Evaluation March 2009: 700 street intercept surveys, sampling based on population statistics Evaluated together with 3 other ads – had highest aided recall rate (40%) Of respondents surveyed: 95% felt ad was relevant to their lives 97% felt ad was believable 76% said might persuade others to quit smoking 63% said would consider quitting themselves AN ONGOING EFFORT:

21. Summary Mass media campaigns work! Use research to guide your campaigns Adapting existing ads saves time and money Campaigns targeting adult smokers are most effective TV is the most cost-effective method for reaching large populations Remember to evaluate!

22. Mass Media Campaigns Can: Motivate individuals to change their behaviours Contribute to changing social norms Create a positive environment for policy change Build knowledge about tobacco harms and policies Influence audience attitudes and beliefs Build awareness of tobacco control programs

23. Yvette Chang Marketing Communications Manager ychang@worldlungfoundation.org