Introduction

Background

The Australian Department of Health and Ageing launched the National Tobacco Campaign (NTC) - More Targeted Approach-Culturally and Linguistically Diverse (CALD) Component in January 2011. This included print, radio and online advertising aimed at CALD audience groups. Campaign advertising concluded in June 2011.

The campaign was aimed at people aged 18-40 from cultural groups who are known to have a high prevalence of tobacco use, including people from Arabic, Chinese, Korean, Pacific Islander, Spanish, Vietnamese, Greek and Italian backgrounds.
The communication objectives of the campaign are to:
  • increase and reinforce awareness of the range of health harms associated with smoking; and
  • generate and reinforce intentions among current smokers to quit now.

The CALD ‘Health Benefits’ campaign was designed to work in conjunction with the mainstream campaign, building on and reinforcing its impact.

The CALD ‘Health Benefits’ campaign included the following elements:
  • radio advertising conducted in seven languages
  • print advertising was conducted in eight languages
  • online advertising was conducted in two languages

Additionally, this evaluation also obtained key effectiveness measures on the mainstream ‘Cough’ TVC.

Methodology

The CALD evaluation component comprised a face-to-face survey of n=50 interviews with individuals from each of seven different cultural/linguistic backgrounds aged 18-40 years, for a total of 350 interviews. The seven cultural/linguistic groups were Arabic, Cantonese, Korean, Mandarin, Pacific Islanders, Spanish and Vietnamese speakers. The sample was allocated across Sydney, Melbourne and Brisbane based on the relative proportion of each cultural/linguistic group residing in each of these three states, according to the 2006 Census of Population and Housing. To prevent the fieldwork becoming very inefficient, resulting quotas of fewer than five interviews were reallocated proportionately across the other cities.

The research approach consisted of initial recruitment of respondents from a variety of sources, including Migrant Resource Centres, ethno-specific community organisations, community service announcements on SBS radio, and street intercept interviewing in areas with high known concentrations of the groups in question. Potential respondents were pre-screened for eligibility based on smoking status and having a preference for communicating or consuming media in one of the relevant non-English languages. As the Pacific Islander campaign material was in English (and therefore screening by language was not appropriate), eligibility for this group was instead based on self-identification with the Pacific Islander community. After being screened, eligible individuals were interviewed face-to-face. When necessary, interpreting services were provided by either the community organisation where the interviews were held, by a trusted friend or family member accompanying the respondent or by bilingual interviewers.

This evaluation did not include the Greek and Italian communities as it was felt that most 18-40 year olds from these communities would be proficient in English.

Recruitment and pre-screening of respondents took place throughout late July 2011 and August 2011 with survey fieldwork being undertaken between 27 August 2011 and 13 October 2011. The time lag between the end of the media buy and the start of survey fieldwork, was largely attributable to the difficulty of recruiting eligible survey respondents.

A. Behaviours, Attitudes and Awareness

The majority (79%) of smokers intended to quit smoking, many in the near future. The leading motivations for quitting or attempting to quit were health factors, together with financial cost and family-related reasons.

Most respondents acknowledged that smoking had lowered their quality of life and health. They also tended to perceive the damage from their own smoking was greater to themselves than to other people. The vast majority of respondents, particularly smokers, recognised the possibility of becoming ill from smoking and were worried about this.

Respondents generally held anti-smoking and pro-quitting attitudes, recognising the harms of smoking and the benefits of quitting. However, there was some ambivalence regarding the perceived social acceptance of smoking in Australia. Most respondents recognised the difficulty of quitting smoking, with smokers identifying more difficulty in quitting than recent quitters.

Respondents widely recognised that quitting smoking would result in improved health and fitness, and financial savings. Respondents’ awareness of the health effects of smoking was high, although awareness of respiratory health effects was higher than that of cardiovascular or other health risks.

B. Campaign Awareness and Impact

Recall of Campaign Advertisements

Although the vast majority of the target audience reported exposure to smoking-related advertisements, spontaneous recall of any of the CALD ‘Health Benefits’ advertisements was low (3% overall). This may have been impacted by the time lag between the end of the media buy and the start of survey fieldwork, which resulted from the complexity of setting up this challenging research program.

Spontaneous recall of the mainstream ‘Health Benefits’ advertisement was comparable with that of the CALD advertisements. It is worth noting that some respondents may not have differentiated between materials from these two campaigns.

Prompted recognition of the CALD ‘Health Benefits’ advertisements was significantly higher, with the highest audience reach achieved through radio. Recognition rates were - 43% for the radio ad, 17% for the print ad, and 13% for other materials handed out at festivals or community events.

Key Message Take-Out

The CALD ‘Health Benefits’ print and radio advertisements achieved successful cut-through for the key message that quitting smoking has many health benefits, which was recalled (unprompted) by the majority (52% – 64%) of respondents exposed to the ads.

Furthermore, at least nine tenths of respondents exposed to the CALD ‘Health Benefits’ advertisements identified the following messages (when prompted):
  • there are many short and long term health benefits to quitting smoking (96% overall);
  • the day you stop smoking, your body starts to repair itself (92%); and
  • every cigarette you don’t smoke is doing you good (90%).

Opinions of Print Campaign Advertisement

Respondents’ opinions of the CALD ‘Health Benefits’ print advertisement indicated a high level of creative execution quality. Nearly all respondents who had seen the ad felt that it was easy to understand and was believable. More than four fifths (at least 81%) felt it related to them and made them feel worried about their smoking.

Campaign Influence

The CALD ‘Health Benefits’ advertisements were effective in delivering a call to action, particularly among recent quitters, many of whom reported that they had quit smoking or encouraged their family or friends to quit as a result of seeing or hearing the advertisements.

The leading actions taken by smokers as a result of exposure to the campaign were to reduce the amount of cigarettes they smoked, to discuss smoking and health with their partner, family or friends, and to stop smoking.

The advertisements were also effective in delivering an impetus for future actions. Within the next month, two fifths (40%) of recent quitters planned to encourage their family or friends to quit, one quarter (25%) of smokers planned to reduce the amount of cigarettes they smoke, and 14% of smokers planned to quit smoking.

Mainstream Campaign

Two thirds (67%) of respondents recognised the mainstream ‘Cough’ television ad and more than one fifth (23%) recalled seeing images of this ad elsewhere, upon prompting. Furthermore, 15% of respondents spontaneously recalled the ‘Cough’ ad.

The leading message derived from the ‘Cough’ TV ad was that smoking affects others, including family, kids and the community.

Respondents generally indicated this advertisement was effective, with more than three quarters (at least 76%) agreeing that it was easy to understand, was believable, made them stop and think, and made them more likely to try to quit or to want to remain quit. Recent quitters were more likely to endorse these outcomes than smokers.

Around one third of respondents experienced wear-out from the mainstream ‘Cough’ TV ad. Recent quitters were less likely to experience wear-out than smokers.

C. Conclusions

The CALD ‘Health Benefits’ campaign achieved a moderate level of target audience reach, with recognition of the radio ad being the strongest, but with low spontaneous recall of the advertisements.

Take-out of the campaign messages among those exposed was high. The main message recalled (without prompting) for the CALD ‘Health Benefits’ print advertisement by respondents who had seen the ad was that quitting smoking has many health benefits (64%). In addition, more than one quarter of respondents who had seen the ad recalled:
  • that the day you stop smoking, your body starts repairing (31%); and
  • the slogan “stop smoking, start repairing” (29%).

Opinions of the campaign advertisements were quite positive and indicative of its effectiveness in eliciting intended sentiments among the target audience.

The campaign delivered a solid call to action among the target audience, with the impetus for action being particularly pronounced in motivating recent quitters to influence other smokers to quit. Over one quarter (28%) of recent quitters indicated that they had quit smoking as a result of exposure to these ads. Furthermore, one fifth (20%) of recent quitters had encouraged their family or friends to quit. Among smokers, 16% had reduced the amount of cigarettes they smoked, 10% had discussed smoking and health with their partner, family or friends, and 6% had stopped smoking.

The impact of the campaign on those exposed to it was found to be strong, particularly in consideration of the brief advertising period and small media buy.

The CALD campaign was generally successful in achieving its aims among those exposed to it. However, a wider campaign reach would be needed to accomplish the desired effects among a broader cross-section of the target audience.