In 2012 the English Department of Health designed a campaign called ‘Stoptober’, which focuses on the psychological principles underpinning tobacco use…
Studies reveal the effectiveness of mass media anti-smoking campaigns (Bala et al., 2008, 2012) and studies that compare different message types find that harm focused messages have a higher impact than those with an ‘anti-industry or how-to-quit-themes’ (Durkin et al., 2012). In 2012 the English Department of Health designed a campaign called ‘Stoptober’, which focuses on the psychological principles underpinning tobacco use, aiming to create a positive mass quitting trigger, an area which Durkin et al. (2012) shows there has been little research done on the effectiveness. The name itself, ‘Stoptober’, was designed to build engagement with the public through the association with other popular national events such as ‘Movember’ and to increase awareness on social media. The campaign was seen in a combination of traditional media such as TV, print, radio, online advertising and digital platforms such as Facebook and Twitter with the aim to create a social movement around a specific activity, stopping smoking for 28 days.
The main psychological principles which the campaign underpinned its components included:
- Social contagion theory: behavioural changes within societies are reinforced through messages spread through social networks, thus amplifying the message.
- SMART goals: specific intermediary goals, that are seemingly attainable, provide individuals with a tool to help achieve more difficult behavioural goals. This is promoted through the challenge set by the campaign, of being smoke-free for 28 days starting on October 1st 2012.
- PRIME theory: our motivational system is inherently unstable which therefore needs an external force to help maintain a pattern of behaviour. It is essential that interventions address a whole motivational system, rather than some elements, with an aim to create new sources of desire and control. Stoptober provides the opportunity for smokers to stop through frequent positive messages and a support network by undertaking the challenge at the same time as others. The campaign also offered a postal pack, a motivational text messaging programme and an app to provide online encouragement and self-monitoring tools.
The campaign used both top-down strategies, with advertising and public relations as well as bottom-up strategies, with its peer networking and support services. The results of the campaign show that more than 300,000 people took part in the campaign in 2012 and the overall estimate of past-month quitting was calculated to be 4.15%, being most cost-effective for the modal 35-44 year-old group, with an ICER (incremental cost-effectiveness ratio) of £414.26 (Brown et al., 2014). As a public health campaign, the cost-effectiveness of Stoptober compared favourably with other estimates concerning UK anti-tobacco campaigns. The effectiveness of the campaign is shown through its continuation since 2012 (Brown et al., 2014).
Some interesting strategies such as the motivational text messaging programme is a particularly effective strategy with teens, as revealed in the Swiss study ‘Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults’ (Haug et al., 2012). Unique to this study is the use of personalised messages that changes depending on the users’ personal traits over an extended period of 24 months.
The Stoptober campaign reveals the effectiveness of national campaigns based on psychological motivations through positive messages and social behavioural movements over the common fear strategies utilised in anti-smoking campaigns.
Bala M., Strzeszynski L., Cahill K. Can tobacco control programmes that include a mass media campaign help to reduce levels of smoking among adults. Cochrane Database Syst. Rev. 2012;(6) Art. No.: CD004704.
Brown, J., Kotz, D., Michie, S., Stapleton, J., Walmsley, M. & West, R. 2014, “How effective and cost-effective was the national mass media smoking cessation campaign ‘Stoptober’?”, Drug and alcohol dependence, vol. 135, pp. 52-58, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929003/>.
Haug, S., Meyer, C., Dymalski, A., Lippke, S. & John, U. 2012, “Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults: Study protocol of a cluster randomised controlled trial”, BMC Public Health, vol. 12, pp. 51, <https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-51>.
Durkin S., Brennan E., Wakefield M. Mass media campaigns to promote smoking cessation among adults: an integrative review. Tob. Control. 2012;21:127–138, <https://www.ncbi.nlm.nih.gov/pubmed/22345235>.