Quantitative Campaign Effectiveness: Research - Executive Summary October 2011

Introduction

Background

The Australian Government Department of Health launched the Indigenous Anti-Smoking Campaign - ‘Break the Chain’ on 28 March 2011. This campaign aims to contribute to halving the smoking rate for Indigenous Australians by 2018. Reports indicate that the current Indigenous smoking rate is as high as 47.7% (AIHW: Substance Abuse amongst Aboriginal and Torres Strait Islander people: Feb 2011: page 2) and that 1 in 5 will die from smoking related diseases.

The campaign is specifically aimed at smokers and recent quitters aged 16 to 40 years to contribute to a reduction in the prevalence of daily smoking by:
  • generating a higher level of salience and personal relevance of the health impacts of smoking; and
  • promoting and supporting quit attempts amongst smokers and promoting strategies to avoid relapse among quitters.

The campaign depicts a young Aboriginal woman reflecting on her own experiences of smoking, and how smoking has impacted on her life and the lives of those close to her. The call to action is her encouraging others to quit smoking as she has, to break the chain in the high prevalence of smoking across generations. The media campaign ran across television (mainstream and Indigenous), radio (regional and Indigenous) and print (mainstream and Indigenous advertising).

The campaign was a national first, not just in having an anti-smoking television commercial specifically targeted to Aboriginal and Torres Strait audience, but also airing a targeted campaign on mainstream media.

Two bursts of media activity occurred between 28 March and 26 June 2011. The initial burst of activity lasted for a total of 4 weeks from launch date and the second burst lasted from 22 May for a further 6 weeks. Both bursts of media activity included 40 TARPS, reducing to 30 TARPS in the final two weeks, with the media buy covering metropolitan and regional Australia, targeting areas with a high Indigenous population.

The Department commissioned independent research agency, ORIMA Research, to undertake tracking research to evaluate the effectiveness of the campaign amongst Aboriginal and Torres Strait Islander people.

The objectives of the research were to assess, among the target audience:
  • knowledge and awareness of the benefits (to self and others) of quitting smoking;
  • attitudes towards smoking and quitting;
  • smoking and quitting behaviours;
  • intentions to quit smoking or stay quit; and
  • campaign awareness, including advertising cut-through, message takeout and other diagnostic measures amongst smokers and recent quitters.

Methodology

This evaluation comprised of a tracking survey of n=350 Aboriginal and Torres Strait Islander smokers and recent quitters aged 16-40 years. The research approach consisted of initial recruitment of respondents (via a combination of telephone and face-to-face screening) followed by a face-to-face survey. The sample was stratified geographically in proportion to the Indigenous population in metropolitan and regional locations in each state or territory from the relevant age cohort (based on 2006 Census data). Interviewing was not undertaken in Tasmania or the ACT on fieldwork efficiency grounds (because of the very small share of the Indigenous population they each account for). All interviewing was face-to-face and was conducted by Indigenous interviewers trained and briefed by ORIMA Research and their fieldwork partner, Australian Fieldwork Solutions (AFS).

The data has been weighted by age and gender to represent the national Indigenous population aged 16-40 years.

A. Behaviours and Experiences

The majority of Indigenous smokers interviewed smoked regularly (at least weekly) with most smoking daily. Despite this, they were generally eager to quit smoking with a large proportion having at least thought about quitting in the past month. The fact that the majority had tried to quit smoking in the past, typically more than once, provided further evidence of their aspiration for a smoke-free lifestyle.

Although financial/money reasons were also important, the leading reasons behind Indigenous smokers’ most recent attempts to quit were health/fitness related. Those that tried to quit mostly attempted to do so on their own, without help of any pharmaceutical products or professional advice/ guidance.

Intentions to quit smoking in the future were relatively prominent, although those planning to quit were typically non-committal about the timing. The majority of Indigenous smokers had some confidence in their ability to quit for good and only a quarter explicitly doubted that they would be able to do so.

Indigenous recent quitters had mostly stopped smoking in the last six months, with the majority being confident that they had done so for good. Most reported giving up on their own, with fitness and cost being the leading reasons for their quitting.

In line with the above, respondents were generally well aware of the harm that their smoking has caused to their health and quality of life. However, they were less likely to recognise the impact that their smoking has had/ is having on others.

B. Attitudes and Awareness

Indigenous smokers generally displayed eagerness to quit and a degree of confidence in their ability to do so if they wanted to. Furthermore, the majority believed that they would benefit both financially and health-wise if they quit smoking.

The leading benefits (unprompted) of quitting smoking were saving money and improvement in fitness and general health. Indigenous recent quitters were more likely to cite specific benefits such as decreased risk of various diseases (lung cancer, heart disease, etc).

C. Campaign Recall and Recognition

Recall of Campaign Advertisements

Around nine in ten (92%) respondents reported hearing or seeing smoking-related advertisements in the past six months. When asked to describe the first two advertisements that come to mind, ‘Break the Chain’ campaign was top of mind for one in five (19%) respondents and just over one in ten (12%) specifically described the ‘Break the Chain’ TV ad. This is reflective of the relatively low media buy for the ‘Break the Chain’ campaign (in comparison with other mainstream anti-smoking campaigns). Unprompted recall was uniform across Indigenous current smokers and recent quitters.

The ‘Break the Chain’ campaign (channel unspecified) was more likely to be top of mind for those aged 30 years and over (24%), with household income of $60,000 p.a. and over (29%) and those from non-professional households (24%).

Specific mentions of the TV advertisement were higher among households with higher income (20% of those with income of $60,000 or more) and those where the main income earner was in non-professional employment (17%).

Prompted recall was highest for the TV advertisement (77%), which is a strong result particularly in light of the relatively low media buy. The ‘Health Benefits’ radio ad with ‘Break the Chain’ tagline had the next highest prompted recognition at 53%. The ‘Break the Chain’ radio and print ads had lower cut-through, but were still recognised by over a third of respondents (44% - radio and 37% - print ad).

Although not statistically significant, recognition of the TV advertisement was higher among Indigenous current smokers (78%) than recent quitters (69%). The ‘Health Benefits’ radio ad was more salient among males (58%) than females (49%), whilst the ‘Break the Chain’ radio ad had stronger cut-through in non-metropolitan areas (49%, relative to 35% of metropolitan respondents).

Key Message Take-Out

For the majority of respondents, the leading message in the TV ad centred on how others (family, children and community) are affected by their smoking. This message was more dominant for Indigenous current smokers than recent quitters. Respondents also commonly used the ‘Break the Chain’ phrase to describe the key take-out, endorsing the appropriateness and relevance of the tagline for this audience.

The radio and print advertisements were mostly associated with a generic “quit smoking” message, although the tagline ‘Break the Chain’ and the impact of smoking on others also featured prominently in the top three take-out messages.

Upon prompting, the advertisements were seen to effectively communicate all the main campaign messages with the strongest being “your smoking affects others”.

Opinions of the Campaign

The TV advertisement was seen as easy to understand, believable and thought provoking. Respondents also indicated a high level of self-identification with the advertisement – four fifths (81%) stated that the advertisement related to them. Slightly less than a quarter (23%) experienced campaign wear out, saying that they were getting tired of seeing the ad.

Campaign Influence

The ‘Break the Chain’ campaign was reasonably effective in eliciting action from the target audience. The actions taken most commonly centred on reducing the amount smoked and discussing smoking and health with family and friends.

Unsurprisingly, actions taken differed considerably between Indigenous smokers and recent quitters, with the latter most commonly reporting that they had quit smoking as a result of the campaign.

Over half of respondents (57%) indicated they were planning to take action in the next month, mostly to reduce the amount they smoke or quit altogether. Intentions were also different for Indigenous smokers and Indigenous recent quitters. Among Indigenous smokers, planned actions typically related to reducing or quitting smoking, whilst Indigenous recent quitters were more focused on advocating quitting smoking to their family and friends.

Mainstream Campaign

Prompted recall of the mainstream ‘Cough’ television ad was high with nearly nine in ten (87%) respondents reporting that they had seen the ad. Higher recognition of the ‘Cough’ TV ad is in line with the much higher media buy of the mainstream campaign.

The key message derived from the campaign was “quit smoking” although over a third of respondents felt that the campaign was conveying that smoking causes specific health issues (lung cancer, heart disease, stroke, breathing difficulties) and affects others (family, children, community).

Whilst the mainstream campaign was also seen as easy to understand, believable and thought provoking, as expected it did not elicit the same level of self-identification from the Indigenous target audience as the ‘Break the Chain’ campaign.

Wear out was also more pronounced for the mainstream campaign – just under two fifths (37%) of respondents agreed that they are getting tired of seeing it.

D. Conclusions

The ‘Break the Chain’ campaign resonated well with the Indigenous target audience. The main messages in the campaign regarding the effect of smoking on others and ‘Breaking the Chain’ were conveyed effectively, particularly through the TV advertisement. Furthermore, the campaign was found to elicit a stronger sense of self-identification from the target audience than the mainstream campaign.

The ad delivered a solid call to action by way of encouraging Indigenous smokers to cut down or quit smoking and encouraging Indigenous recent quitters to continue not to smoke and put pressure on others to quit.

Considering the strong resonance of the ‘Break the Chain’ campaign with the target audience and its solid call-to-action, the research suggests that achieving greater reach via further expenditure on the ‘Break the Chain’ campaign has significant potential to further impact the behaviour of the target audience.