1. Small Dollar, Big Results: Online Advertising for Tobacco Control Advocacy in Senegal and Vietnam
Tahir Turk PhD (for Stephen Hamill)
Senior Technical Advisor – Public Communication
I will be talking on behalf of WLFs resident social media expert Steve Hamill and given the 10 mintes l will only be presenting case studies on 2 countries Senegal and Vietnam

2. WLF - What We Do
Work with country partners to develop comprehensive ‘high- impact’ tobacco control communication campaigns in LMICs.
Since 2007 WLF have supported more than 100 population level tobacco control communication campaigns in 26 LMICs to support cessation, prevention and policy initiatives.
We look for campaigns to have both behavioral impact (quit smoking) and policy impact (aid support of new legislation) and increasingly social media plays an important role
Briefly what World Lung Foundation does is work in around 26 LMICs on population level communication programs and we have supported more than 100 tobacco control campaigns in the last 5-6 years that focus on cessation, smoke free policy development and increasingly include social media components to the programs.

3. Media influences Behavior, Social Norms and Policy Uptake
NCI Monograph
cancercontrol.cancer.gov/tcrb/monographs/19/m19_complete.pdf
To date the evidence on mass media to influence cessation, and smoke free and policy initiatives is quite strong in HICs and the evidence is now also building in LMICs.

4. The Rapidly Changing Media Landscape
New Populations
New Channels
New Behaviors
So why Social Media? Clearly there have been massive changes in the way people access information and communicate and this is no more evident than in the developing world.

5. Top Social Networks by Country (2012)#
Country
Users
Penetration 1
United States
166,029,240
52.9% 2
India
62,713,680
5.2% 3
Brazil
58,565,700
30.2% 4
Indonesia
51,096,860
20.5% 5
Mexico
38,463,860
33.5% 6
United Kingdom
32,950,400
52.3% 7
Turkey
32,131,260
40.3% 8
Philippines
29,890,900
28.8%
Sina Weibo
Users
Penetration
China
503,000,000+
30%+
When we look at social media penetration by the top 10 countries we find that LMICs take up 8 of the 10 spots with only the US and UK making the grade in the developed world but fading fast in comparison to China which at 30% penetration already has over 500 million users and India in the last 2 years reaching over 100 million.

6. How Does Social Media Fit? Emerging findings on new media
Scant evidence that social media changes behavior as a stand alone vehicle, especially as social media messages may be opt-in and not incidental.
Social media marketing:
Less expensive/ impression
Micro-targeting
Rapid deployment
Rapid assessment / data collection
Actionable
Excellent “prompt”*
Just briefly a caveat on social media. The evidence to date is not strong on opportunities for social media on its own to affect behaviour change. What we do know however is that it can be very costs effective in terms of reach micro targeting of specific populations, rapid tactical deployment of ads and content as well as simple actionable prompts.
*Strong evidence around SMS and web-based tobacco cessation support

7. Case Study 1 – Senegal Rapid deployment: Same day launch
Social media designed to support health harms TV and Radio campaign.
“It is here at Goree in these steps, in this square where it all began… These men, chained like animals, were deported to the land of tobacco production…If you believe the time has come to end this second slavery I invite you to break the chains of slavery tobacco companies in Africa.”
Our first case study in Senegal identifies how you can rapidly adjust online ads to support topical issues with the Doctor you see here giving a very empowering speech at the launch of the program and we creating an online ad on the same day reflecting the ‘break the chains’ of slavery theme.

8. Micro-targeting: Ads by gender
“Will your son be a smoker?
Protect youth and sign the
petition today.”
Click through rate
Per 1,000 impressions
Total clicks
.078% 231,519 impressions
78 clicks (+13%)
2,675
.069%
84,332 impressions
69 clicks
641
The other value of online ads vs traditional ads is that you can micro target people online and get instant insights into your online audience, so we developed ads that targeted both men and women – this one targets women but we found it actually outperformed among men – as they were more likely to click through with 2600 plus clicks on this ad focusing on the protection of children.

9. Actionable, Affordable, Measurable
Social media budget of US $5000:
8100+ signers to the online petition, each with an , most with mobile number
8,583 members: “likes” (453 via mobile; 8,291 from Senegal)
73% men, 27% women, 71% age yrs
7,344 “Talking about this” (past 28 days) The number of people sharing stories about SenegalSansTabac. (unique users)
Content had a reach of 547,000 (past 28 days) The number of people who saw any content of SenegalSansTabac. (unique users)
Online ads and other social media content can also be very actionable when you provide a very simple action like signing a petition. For this Senegal campaign budget of around $5K we got over 8000 signatures to the online petition with many likes and over half a million impressions during the campaign period, and we could monitor the impact on a daily basis from the metrics provided on the site.

10. Survey of Online Activists
High
Middle
Engagement level
Low
When we look at engagement levels of these online communities it does confirm the general slacktivist or clickivist mentality prevalent with most people signing the petition and lesser levels of engagement on posting comments, sending s or ultimately getting involved in the issue in the real world. We are ultimately aiming with social media to move people to the middle and high areas of engagement with these programs.

11. Case Study 2: Viet Nam 2013
Smoking prevalence 47.4% male, 1.4% female.
High SHS exposures among adult non-smokers
91.5M population, 31M internet users, 10.6M Facebook users, 134M mobile subscriptions!
Smoke-free legislation was being considered by National Assembly
Integrated communication approach with mass media designed to build risk perceptions and social media to build support for the passage of tobacco control legislation.
The second case study is in Vietnam where there is quite high prevalence with mend and about 30% of the country are internet users with more than 10 million on facebook. Mobile phone use is also very high which provides indicators on the types of channels for social media we could consider.

12. Viet Nam Social Media Goals
Build on awareness of tobacco harms
Build support and awareness of SF legislation
Empower people to demonstrate their support for a strong tobacco law through new media
Use SM to generate earned media to demonstrate widespread public support to legislators
You can see generally our social media programs tend to focus on building support for legislative efforts rather than directing people to quit options given the resource limitations for cessation support in developing countries. We also use the results of the online petitions for further earned media advocacy.

13. Synergized Activities to Raise Awareness and Build Momentum for Behavior Change
Public Relations TV
You can see the range of synergistic components to the communication campaign here with TV PR or earned media activities, outdoor posters and community events conducted.
Video Outdoor
Events
Posters

14. Engaging Advocates Through New Media
Microsite and
Mobile short code “6069”
Approaches to get 5000 Supporters
The social media component aimed to get 5000 supporters for the petition but also had a social harms message on the microsite emotive facebook ads mobile phone SMS campaign with shortcode messages which were also included on a component of the TV campaign to drive people to support the legislation.
Broadcast SMS with short code
TV with short code
Facebook ads

15. 6226 Signups: 3269 Online 2842 Mobile
You can see that we exceeded the campaign goal and achieved over 6 thousand signups with the red line on this chart showing the number of signups per day via the web and the blue line, showing the number of signups a day from mobiles. You can see when we achieved the first spike (1) when all the activities lined up together with signups generally flattening off when only one activity such as Facebook ads or PR activities occurred without other significant support. You can also see the 3rd and 4th spikes occurred when the TV spots with the shortcode were running which indicates the generally broader reach of main media and how simple it can be include these shortcode messages to channel people through to new media.

16. Viet Nam 2012 – Spot Survey Results
advocacy
Paid media
Unpaid media
The survey results showed that people did predominantly hear about the legislation through online activities despite the relatively small budget of under $10K for the online and SMS component. (Survey monkey)

17. Facebook Ads: 6,743 clicks, US$1.012
Reach
Frequency
Click Rate
Cost Per Click
$59.83
6.1
.031%
$0.12
$130.22
5.4
.044%
$0.11
$230.10
6.3
.059%
$0.09
And when we look at the number of Impressions or Reach of the facebook ads we can see the ad version at the bottom had the best response rate with over 678 thousand impressions at a cost of only $230 with a cost per click of only .09c.

18. Cost Effectiveness for Recruiting Advocates
Channel
Signups Attributed
Budget
Cost per Sign-up
All channels
6111
$37,617
$6.16
TV with short code
1979
(online +sms)
$28,500
$14.40
Broadcast SMS
2316
$8,105
$3.49
Facebook ads
3483
(online)
$1,012
$.29
TV with short code was the most costly way of recruiting advocates, but played a crucial double role by helping to put the legislation on the public agenda and growing knowledge. Facebook was more than 10 times more efficient than broadcast SMS.
So if we are looking specifically at the objective of sign-ups we can see that the facebook ads are by far the least expensive option at only .29c per signup with the mobile phones which showed so much promise in terms of their coverage being a lot more expensive at nearly $4 per sign-up. And TV being the most expensive although the shortcode was only a value added component of the TV campaign which was about building risk perceptions and generating discussion in the broader community.

19. Takeaways
Social media offers great new potential, but also a number of challenges.
Social media on it own is unlikely to prompt significant behavioral change for tobacco control but synergizes well with traditional mass media channels to prompt higher levels of engagement by advocates and ‘opinion leaders’.
Social/ New media can create actionable moments, mobilize supporters and create communities.
Online ads can be cost effective when linked to integrated campaigns which direct viewers to specific and actionable advocacy behaviors.
Social media campaigns need constant tending (daily) and should be evaluated using “real-world” metrics and outcomes.
In closing, the key takeaways from our work to date in social media indicate that it does offer lots of potential but also a few challenges in the developing world. Its unlikely to prompt significant behavioural change due to its opt in approach but it does synergise well within a comprehensive communication program incorporating traditional media channels. It can create simple actionable moments to engender support for an issue or create online communities. Online ads can be particularly cost effective when linked to the broader campaign themes. Its important to note that although social media approaches are relatively cost effective sites do need tending daily and can provide real world metrics at short notice for nuancing campaigns. Thank-you.

20. Thank you! www.worldlungfoundation.org shamill@worldlungfoundation.org
And you can more information about our campaigns from our website at worldlungfoundation.org