1. Stephen Hamill Online Communications Director

2. Turkey “Smoke like a Turk”

3. Turkey: Background Population: 73,922,000 Tobacco prevalence: 35.5% (51.6 male / 19.2% female)

4. Turkey: Strategic Importance 10 th largest tobacco producer Tobacco grown on more than.25% arable land

5. Turkey: Strategic Importance An important regional influence with cultural and economic ties to many other countries developing tobacco control programs

6. Smoke-free Communications Signage & Enforcement Stakeholder Comms Public Information Web sites Business kits Paid advertising Public relations / Earned Media

7. Smoke-free Communications Stakeholder communications target policy makers, opinion leaders, journalists and business owners Signage and enforcement show which places are smoke- free and make business owners the front line of SF Public information campaigns inform the public: When legislation is happening Why smoke-free is important: health impact Counters misinformation: i.e. Smoke-free hurts business Smoke-free works and is achievable Business owners, signage, no ashtrays and visible enforcement are the key to compliance

8. Turkey: Smokefree December 2007, Turkey passes tobacco control legislation that includes 100% SF. Smoke-free enacted in 2 stages First phase, May 19, 2008: All public places including govt. buildings, malls, transport Second phase, July 19, 2009: All hospitality areas including bars, restaurants and teahouses Legislation included key opportunity: No-cost air time for tobacco control All television and radio channels required to provide 90 minutes to tobacco control per month, including 30 minutes in prime time BI Partners WHO The Union CTFK

9. Smokefree: First Phase First phase objective: Most public areas become Smoke-free May 19 th. Mass Media planning meeting April 2008 Challenge 1: No time or resources to develop new ads Challenge 2: Public confusion about which places are smoke free and which are not CTFK poll, conducted in April 2008 showed 85%+ level of public support and high levels of knowledge about dangers of secondhand smoke. The poll was very influential for policy makers, journalists

10. Smokefree: First Phase Challenge: Time and Money Best practice for developing campaigns includes message testing ad concepts to ensure they are effectively communicating key messages Answer: Adapt successful ads from other countries Irish “Office” ad was chosen due because it answered communications challenges Showed typical public places Easy to license, quick and easy to reshoot Used health messaging

11. Smokefree: Irish "Office”

12. Smokefree: Turkish “Office”

13. Smokefree: Turkish “Taxi”

14. Smokefree: First Phase Challenge: Public confusion about which places were Smoke-free 100% Smoke-free is easy to communicate, but staged approach can lead to problems in compliance Answer: Develop an informational ad Animated ad develops Very straightforward messaging unlikely to be confused Animated ad quick and inexpensive: no actors or shooting Also incorporated health messaging and message about the fine

15. Smokefree: “Locations”

16. Phase one: success!

17. Smokefree: Second Phase Second phase objective: 100% Smoke-free, including all hospitality areas such as restaurants, bars, teahouses July 19 th,2009 Challenge: Overcome misinformation about hospitality sector and “cultural affinity” towards tobacco Solution: Message test a number of different types of messages to find which best reinforce compliance National partners and WLF tested a number of concepts in two sets, some potential adaptations from successful campaigns from other countries and some new concepts developed by Turkish ad firms

18. Smokefree: Second Phase “Fade Away” Original concept SHS kills 1 million a year, 5,000 people in Turkey “Waitress” Adaptation: Originally aired in U.S. Key message: Health effects on workers

19. Smokefree: Second Phase “Café Burak” New Concept Concept: Emotional portrayal of SHS exposure on children, voice-over health effects “Cigarettes are Eating Your Baby Alive” Adaptation: Originally aired in U.S. Concept: Graphic portrayal of SHS on children, no public environments shown

20. Smokefree: Second Phase In both message tests, ads focused on SHS effects on children were rated the highest. Comparing the two message testing groups, and taking into consideration broadcasting restrictions, “Café Burak” was chosen for Smoke Free Istanbul campaign.

21. Smokefree: Café Burak

22. Smokefree: Baby Alive

23. Smokefree: Café Burak Leveraging municipal resources: billboards, health clinics, ferry terminal video screens

24. Smokefree: Evaluation Around 95 % of people (from television) remember that they have seen any ad related to anti-smoking, only 1% in other media However, they do not remember the ads specifically (around half of them remember) when they are asked to describe them. Non-smokers evaluate the ad more positively than smokers. However it should be noted that one third of smokers mention that the ad made them more likely to quit smoking. Of a random sample of 1000+ Istanbul residents before and after the “Café Burak” media campaign: Almost 1 in 5 show prompted recall of the campaign:

25. Did the ad perform as expected? Smoking around children exposes them to thousands of dangerous chemicals and poisons Smoking around children can cause them asthma Smoking around children can cause them painful ear infections Cigarette smoke is harmful to children and babies Cigarette smoke can cause severe health problems Cigarette smoke is can increase the risk of Sudden Infant Death Syndrome Passive smoking is as dangerous as active smoking Smoking around children can cause them pneumonia Cigarettes can cause asthma Smoking around children can cause them severe health problems NO RECALL OF ANY MESSAGES Message retention of those who recalled the ad: Smokers Made me MORE likely to avoid exposing others to your cigarette smoking Made me LESS likely to avoid exposing others to your cigarette smoking Made NO DIFFERENCE Do you think that it…? Made me MORE likely to quit Made me LESS likely to quit Made NO DIFFERENCE Don t know Smokers

26. Smokefree: Evaluation Of those who indicated they saw the “Café Burak” ad: 3,9 1,9 3,9 2,2 2,3 Mean (1) Recalls Ad (*A) Turkish society disapproves of smoking Smokers have the right to smoke inside public closed places It disturbs me when someone is smoking near me People who smoke are marginalized by smoke-free ordinances If someone does not want to breathe tobacco smoke, he/she can go to another place 3,7 1,8 4,0 2,0 2,1 Mean (1) Does not recall (*B) Disagree totally + DisagreeNeither..nor..Agree + Agree totally Do not know (*B) Higher ratio of people, who recall the ad, disagree that “if someone does not want to breathe tobacco smoke, he/she can go to another place” compared to those, who do not remember the ad.

27. Population Impact: Smokefree

28. Turkey: 100% Smoke-free Through Stakeholder communications to ensure business owners are making their establishments smoke-free, signage and enforcement to inform the public about which areas are smoke free and provide an incentive for business owners to comply, and public information campaigns using advertising and public relations to let the public know the law is coming, Turkey has become smoke-free.

29. Turkey: 100% Smoke-free The expression "smoke like a Turk" seems destined for the rubbish bin of history now that Turkey has introduced some of the toughest anti-smoking legislation in all of Europe. The new ban aims to curb Turkey's love affair with tobacco, which is blamed for 100,000 smoking deaths in the country each year “Smoke like a Turk?” No more. Surveys indicate around 90 percent popular support for the smoking ban, which started last year in workplaces and shopping centers. “Smoke like a Turk?” No more. Surveys indicate around 90 percent popular support for the smoking ban, which started last year in workplaces and shopping centers.

30. Stephen Hamill shamill@worldlungfoundation.org