"Help - for a life without tobacco" is one of the largest public health awareness-raising initiatives in the world and was launched in 2005 by the European Commission in the fight against smoking. It is a large media campaign aimed at encouraging young people in EU countries to resist smoking. Addressing the key issues of prevention, passive smoking and cessation, Help employs an integrated approach targeting Europeans between the age of 15 and 34 years through national media, television and web-based campaigns.

HELP Website

CTCR Staff: Gerard Hastings, Laura McDermott (left 2008), Louise Hassan (left 2007), Joanne Freeman (left 2008) and Gayle Tait (left 2009)

This study sought to obtain assessments of teenager's appraisals of different anti-smoking advertisements in the UK, US and Australia. Previously, our collaborators in the US had developed, pilot-tested, and completed full data collection for the ad rating component. Eighth, 10th and 12th grade teens viewed one of two rotations of 10 different anti-smoking ads over a one-hour period. After viewing each ad twice, they completed a one page rating form which assessed comprehension and a range of emotional and cognitive responses to the ad, and when all ads had been shown, made an assessment of the ad they liked best. At a one week phone follow-up, measures were made of ad recall and cognitive and emotional processing of ad-specific messages. During March/April 2001, approximately 300 teens completed the protocol in Chicago and Boston for a total of 50 ads. The ads included those broadcast by state and national tobacco control programs, pharmaceutical companies and tobacco companies. A full range of main messages and advertising executions were featured.

This approach was subsequently repeated and administered in the UK and Australia. The purpose of the comparison was to determine the extent to which teenagers from at least broadly similar cultural backgrounds might respond in similar ways to the ads. This pattern of findings would suggest enduring characteristics of ads that can be expected to promote similar responses among teenagers, irrespective of cultural differences and tobacco control context. If this is the case, even for only a subset of particular advertising messages or executional styles or combinations of both, it would lend support for the case for recycling anti-smoking ads, rather than pursuing the more costly option of creating new ads. Such a finding could greatly assist the tobacco control dollar to go further. In addition, our understanding of key anti-smoking messages and executional styles is significantly enhanced by the additional statistical power.

CTCR Staff: Susan Anderson (left 2005) and Gerard Hastings

Findings from the study have been published in Tobacco Control:
Wakefield M, Durrant R, McElrath YT, Ruel E, Balch G, Anderson S, Szczypka G, Emery S and Flay B (2003). Appraisal of anti-smoking advertising by youth at risk for regular smoking: A comparative study in the United States, Australia and Britain. Tobacco Control, 12(II): 82-86.

In April 2001 British American Tobacco, Philip Morris and Japan Tobacco International launched a £2.4m advertising campaign on MTV Europe. The industry claimed the campaign was targeting 12-17 year olds with the message 'you can be cool and not smoke'. In 2001, the campaign consisted of six short adverts depicting teenagers doing normal 'cool' activities while being non-smokers. Those running the campaign reported that its aim was to create an environment where adolescents can be cool and not smoke by providing them with non-smoking role models they can look up to.

Qualitative research was conducted to explore young people's response to the Youth Smoking Prevention campaign, and in particular, to explore their comprehension and appreciation of the message, style of execution, and reported impact on their smoking knowledge, attitudes and behaviour. Eight focus groups were conducted with young people age 12-17 years. Purposive sampling was used to ensure the inclusion of smokers and non-smokers and both sexes. The groups were conducted in Scotland during November and December 2001.

Analysis showed the majority of young people did not engage well with the campaign for three reasons. First, they found the message unrealistic and lacking in credibility. Second, the style and execution jarred with their lifestyles making it difficult for them to identify with, and relate to, the adverts. For example, the adverts showed scenarios that were geographically and culturally distant from young people. Third, they strongly disliked the central characters in the adverts, seeing them as 'too perfect' and 'snobby'. The net effect of these unattractive attributes was to make respondents more, rather than less, disposed towards smoking.

CTCR Staff: Lynn MacFadyen, Elinor Devlin (left 2005) and Gerard Hastings

Publications:
Devlin E, MacFadyen L, Hastings G and Anderson S (2002). Evaluation of the industry funded 'Youth Smoking Prevention' (YSP) campaign. Proceedings of the 3rd European Conference on Tobacco or Health, Warsaw, June.

This research was conducted to examine young smokers' engagement with cigarette packaging and responses to current UK cigarette warnings labels, and to identify potential improvements in the content and design of labels. The manner in which young people engaged with health warnings, the effects of this on smoking attitudes, behaviour and brand image were also explored.

Sixteen mini-focus groups were conducted with young people aged 12-17 years. The groups were purposively sampled according to: gender, socio-economic group and smoking experience. The research was conducted in two stages. The first stage examined young people's responses to packaging concepts in general and explored how they engaged with packaging and used on-pack information. Their responses to cigarette warnings labels were examined in this context. The second stage examined their responses to cigarette warnings labels in more detail, and their response to potential improvements in content and design explored.

The research found that current health warnings are not very visible, credible or influential. Furthermore, that they lack novelty and sympathy with young people's needs. However, young people do notice health warnings and have genuine concerns for the health consequences of smoking. Health warnings, when improved, can be more visible, credible and effective and encourage greater processing of the health risks, particularly when pictorial warnings are included.

CTCR Staff: Lynn MacFadyen, Anne Marie Mackintosh, Elinor Devlin (left 2005) and Gerard Hastings

The South Ayrshire Schools Tobacco Awareness Project was a three-year multi-component tobacco awareness programme for young people in South Ayrshire. It aimed to raise awareness of issues surrounding tobacco use amongst young people, contributing to a positive choice not to smoke. The main objective was repeated exposure to child-focussed tobacco awareness education in Primary 6 and 7 (10 and 11 years old). This was delivered by Class Teachers, supported by the full-time Project Co-ordinator, and used a carefully piloted Tobacco Awareness Resource Pack. Implementation took place in Spring/Summer terms over two years. Our comprehensive programme of impact and process evaluation comprised: 'before/after' surveys undertaken in Primary 6 with cohort follow-up in Secondary 1; and process evaluation through qualitative interviews at the end of each delivery year, including exploring the experiences of participating children and teachers, together with the wider role of the co-ordinator. The project was supported by the South Ayrshire Department of Education, Culture and Lifelong Learning, Ayrshire and Arran NHS Board and the Roy Castle Lung Cancer Foundation. Dissemination included a poster at the second UK National Smoking Cessation Conference in 2006.

CTCR Staff: Susan MacAskill, Gerard Hastings and Laura McDermott (left 2008)

Publications:
MacAskill S and McDermott L (2003). South Ayrshire Schools Tobacco Awareness Project - Baseline Survey: Primary 6 School Children - Report. Glasgow: University of Strathclyde, Centre for Tobacco Control Research.

McDermott L and MacAskill S (2003). South Ayrshire Schools Tobacco Awareness Project - Interim Findings: Process Evaluation Research Primary 6 Stage - Report. Glasgow: University of Strathclyde, Centre for Social Marketing: November.

An expert seminar convened by HEBS and ASH Scotland to consider evidence on the effectiveness of tobacco-related interventions among young people highlighted the need to develop a comprehensive tobacco control strategy for young people (HEBS/ASH 1999). This national survey of current and planned tobacco-related work targeted at young people in Scotland was designed to act as a baseline against which to monitor the development of work in this area. The questionnaire was sent to 506 professionals, representing the experiences of: health boards, the Scottish Tobacco Control Alliance members, voluntary and statutory youth work, trading standards, local health care co-operatives, social inclusion partnerships, drugs action teams, community health projects, voluntary sector organisations and other national experts.

Health Education Board for Scotland/ASH Scotland (1999). Report of ASH/HEBS Expert Seminar on Tobacco and Young People. Health Education Board for Scotland, 23 April.

CTCR Staff: Susan MacAskill and Emma Cooke (left 2002)

Publications:
MacAskill S and Cooke E (2002). National Survey of Tobacco-related Work with Young People. Glasgow: University of Strathclyde, Centre for Tobacco Control Research.

Report available in PDF format

This study evaluates interventions targeting young people across two local authorities within Ayrshire and Arran Health Board area. Both projects, when established, incorporated aims addressing youth cessation and youth access, in addition to tobacco awareness education (see also South Ayrshire Tobacco Awareness Project). There was little consensus in the literature as to the best way to address these objectives and it was felt that an overall qualitative process evaluation would enable rich lessons to be drawn from both projects, reflecting the different approaches taken and the background context of different local authorities and associated agencies.

CTCR Staff: Susan MacAskill

Smoking prevalence increases rapidly with age. Research has indicated that while only 1% of 11 year olds smoke regularly, over a fifth (21%) of 15 year olds are regular smokers. Targeting young people before smoking initiation in their early teens is critical to reducing smoking rates. Mass media campaigns can play an important role in reaching large numbers of young people directly with prevention messages. Given the current level of debate in this area regarding whether youth prevention is worthwhile and which message theme(s) are most appropriate, this study was conducted to explore young people's views, attitudes and behaviours towards smoking and examine young people's response to different types of message appeals, including normative/denormalisation messages, industry manipulation messages, and information/fear-based messages.

A qualitative research design was employed. A total of 12 focus groups and 18 friendship pairs were conducted in England with 11-14 year olds, half of whom were smoking and half of whom were experimenting with smoking.

CTCR Staff: Elinor Devlin (left 2005), Douglas Eadie, Martine Stead and Gerard Hastings

Publications:
Devlin E, Eadie DR, Stead M and Hastings GB (2004). Applying marketing communication principles to a mass media youth smoking prevention campaign. Presentation at the European Marketing Academy Conference, Murcia, Spain, 18th-21st May.

Devlin E, Stead M, Hughes K and Eadie DR (2004). Informing a charity mass media campaign using a social marketing framework: the case of youth smoking prevention. Presentation at the 4th International Colloquium on Non-profit, Social and Arts Marketing, London, 15th September.

Devlin E, Hughes K, Eadie DR and Stead M (2004). Youth smoking prevention in the UK: the way forward. Poster presentation at the UICC World Conference for Cancer Organisations, Dublin, Ireland, 17th-19th November.

This Department of Health funded study (1999-2000) explored the nature, extent and potential influence of smoking images and messages in youth style magazines. The research, which combined quantitative and qualitative methods, found that young men's style magazines contained large amounts of pro-tobacco advertising and editorial, that pro-tobacco advertising and supportive editorial has increased during the 1990s, and that style magazines helped young people define their identity through the magazine's own brand imagery and the lifestyle alternatives they present. The research concluded that research-driven policy should aim to control smoking imagery in the advertising and editorial sections of youth style magazines (2003).

CTCR Staff: Lynn MacFadyen and Gerard Hastings

Publications:
MacFadyen L, Amos A, Hastings GB and Parkes E (2003). 'They look like my kind of people' - Perceptions of smoking images in youth magazines. Social Science and Medicine, 56(3): 491-499.