Post B: The Ingredients for a Successful Design Initiative for Tobacco Control

Tobacco use is the leading preventable cause of death in the United States, and cigarette smoking causes about one in five deaths each year, accounting for more than 480,000 deaths annually (Centers for Disease Control and Prevention n.d.). While cigarette smoking was first linked to lung cancer in 1950, the health hazards of passive smoke exposure was later established in the 1990s, and has been proven to cause death from lung cancer and heart disease (Brownson et al. 1992, p.99). In addition, the children of parents who smoke, and are therefore exposed to secondhand smoke, have a higher frequency of respiratory infections and decreased lung function as the lungs mature (Brownson et al. 1992, p.99).

Although public knowledge and beliefs about the harmful effects of smoking and secondhand smoke has increased substantially over the last century, tobacco control is still a severe global problem. In Chile, more than 55,000 children, aged between 10-14 years old, and 3,927,000 adults, aged 15 and above, continue to use tobacco each day (The Tobacco Atlas n.d.). In response to these alarming statistics, the Chilean Corporation Against Cancer (CONAC) launched a series of two provocative posters aimed to raise awareness of the adverse effects of secondhand smoke and urge citizens, and parents in particular, to quit smoking.

(Caffarena 2008)
(Caffarena 2008)

CONAC is a private non-profit entity dedicated to serve their community through education, prevention, early diagnosis, cancer research and treatment (Corporacion Nacional del Cancer n.d.). The posters designed by Foote, Cone & Belding (FCB), one of the largest global advertising agency networks, depict two distressed and crying boys, each shrouded in a cloud of smoke resembling a plastic bag (Ads of the World 2008). The posters are shockingly realistic as the smoke looks like a real plastic bag choking the boys – a provocative and therefore impactful image effective in capturing attention and evoking shock and empathy. Visually, the contrast of the boys and the white smoke against a black background emphasises their distraught faces and illustrates the consequence of secondhand smoke on children. Although there is no explicit call to action after the caption, “Smoking isn’t just suicide. It’s murder”, the implied message is smoking cessation.

There is evidence that comprehensive tobacco control programmes featuring mass media campaigns, like the posters above, can be effective in changing smoking behaviour in adults (Bala, Strzeszynski & Cahill 2009, p.2). Although the posters faced criticisms of being controversial for using images of distressed children and being too graphic and hyperrealistic, they are memorable, impactful and speak to both logic and emotion – which is essential for a successful design initiative among the masses of mundane and repetitive material warning against tobacco use.


References:

Ads of the World 2008, CONAC, viewed 10 January 2019, <https://www.adsoftheworld.com/media/print/conac_brown&gt;.

Bala, M., Strzeszynski, L. & Cahill, K. 2009, ‘Mass media interventions for smoking cessation in adults’, Cochrane Database of Systematic Reviews 2008, no. 1, pp. 1-66.

Brownson, R.C., Jackson-Thompson, J., Wilkerson, J.C., Davis, J.R., Owens, N.W. & Fisher, E.B. 1992, ‘Demographic and Socioeconomic Differences in Beliefs about the Health Effects of Smoking’, American Journal of Public Health, vol. 82, no. 1, pp 99-103.

Caffarena, P. 2008, Smoking isn’t just suicide. It’s murder., Ads of the World, viewed 10 January 2019, <https://www.adsoftheworld.com/media/print/conac_blonde&gt;.

Caffarena, P. 2008, Smoking isn’t just suicide. It’s murder., Ads of the World, viewed 10 January 2019, <https://www.adsoftheworld.com/media/print/conac_brown&gt;.

Centers for Disease Control and Prevention n.d., Tobacco-Related Mortality, viewed 11 January 2019, <https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/index.htm&gt;.

Corporacion Nacional del Cancer n.d., About us, Chile, viewed 10 January 2019, <http://www.conac.cl/quienes_somos.php&gt;.

The Tobacco Atlas n.d., Chile, viewed 11 January 2019, <https://tobaccoatlas.org/country/chile/&gt;.

Post B- The Design Influence, Australia’s Plain Packaged Cigarettes

As designers, we commonly are interested in gaining the attention of consumers, tempting them to buy products or become interested in services. It is this same notion that makes the introduction of the ‘Tobacco Plain Packaging Act 2011’ so interesting, as here the designers had the intention to do the opposite of what their job usually entails, to make a product so unappealing that nobody wants to use it.

There is no doubt Tobacco is one of the largest health issues the world faces, with more than 900 million plus people in Australia alone dying a tobacco-related premature death (NSW Health 2012, p.4). This epidemic has caused a mass change in how governments, like Australia’s, attempt to take the tobacco challenge. On the 1st of December 2012, the Plain Packaged Cigarette packs (figure 1) were rolled out with a clear objective to improve public health through a top-down initiative that was designed to be unappealing as possible. Gone were the “logos and distinctive coloured cigarette packaging” (ABC 2018), instead of a “drab olive packets that look more like military or prison issue” (ABC 2018), with the name printed in standardised, small print.

 

Did it work?

14 individual studies in the British Medical Journal found after the release of the Plain Packaging, there was a 7% increase to 27% of smokers considering attempting to quit smoking (Wakefield 2015), a 78% increase in calls to Quitline within NSW (Department of Health 2016, p.30), and from a design perspective, the new unappealing packaging was changing smokers outlook on cigarettes. No longer did smoking seem as ‘cool’ as it had in the past, with the enlarged, graphic images resulting in people being more likely to conceal their packs from view (Wakefield 2015). The dark olive colour as it was “seen to be the least appealing, had lower quality cigarettes and the highest perceived harm to health” (GfK bluemoon 2011, p.142) and the reduction in brand appeal and brand imagery also caused younger people to reconsider smoking due to the obvious health implications and social perspective on smoking.

Overall, this not only reflects a brilliant strategy that helped combat tobacco usage through helping bring the negative health affects to the user’s eyes, but also showed the influence of design on the mindset and decisions of consumers. The Plain Packaging Act is now something that’s followed across the world, with Hungary, Ireland, France, New Zealand, Norway and Britain implementing similar constraints. In 2018, the World Trade Organisation declared Australia’s Plain Packaging law “contributed to improving public health by reducing use of and exposure to tobacco products” and “rejected claims that alternative measures would be equally effective” (ABC 2018). This ruling will hopefully now lead to a role out of a similar approach to Tobacco packaging around the world, particularly in places like Indonesia who said they’d “examine its options” (ABC 2018) after originally opposing this ruling.

australian-plain-cigarette-packs (1)

Figure 1: showing the change from regular cigarette packs to Plain Packaging (Hammond 2016).

References:

ABC 2018, Australia wins landmark World Trade Organisation ruling on tobacco plain packaging laws, Sydney, viewed January 9th 2019, < https://www.abc.net.au/news/2018-06-29/australia-wins-landmark-wto-ruling-on-tobacco-plain-packaging/9921972>

Cancer Council Victoria 2016, Further initiatives to reduce tobacco-related disparities in Australia, Victoria, viewed January 8th 2019, < http://www.tobaccoinaustralia.org.au/chapter-9-disadvantage/9-10-further-initiatives-to-reduce-tobacco-related>

GfK bluemoon 2011, Market Research to Determine Effective Plain Packaging of Tobacco Products, viewed January 9th 2019, < http://www.health.gov.au/internet/main/publishing.nsf/Content/C5E90158113E0DC6CA257D120011725C/$File/Market%20Research%20-%20Plain%20Packaging%20of%20Tobacco%20Products.pdf>

Hammond, D 2016, Nothing Plain about Plain Packaging, LASLC News, viewed January 9th 2019, <http://www.lungcancernews.org/2017/02/01/nothing-plain-about-plain-packaging/&gt;

New South Wales Health 2012, NSW Tobacco Strategy 2012-2017, Canberra, viewed January 9th 2019, < https://www.health.nsw.gov.au/tobacco/Publications/nsw-tobacco-strategy-2012.pdf&gt;

The Department of Health 2016, Post-Implementation ReviewTobacco Plain Packaging, Canberra, viewed January 9th 2019, <http://ris.pmc.gov.au/sites/default/files/posts/2016/02/Tobacco-Plain-Packaging-PIR.pdf&gt;

The Department of Health 2018, Introduction of tobacco plain packaging in Australia, Canberra, viewed January 8th 2019, < http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-plain>

The Department of Health 2018, Evaluation of tobacco plain packaging in Australia, Canberra, viewed January 8th 2019, < http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-plain-packaging-evaluation>

Wakefield, Melanie 2015, Australia’s plain packaging laws successful, studies show, ABC News, Sydney, viewed January 9th 2019, < https://www.abc.net.au/news/2015-03-19/australias-plain-packaging-laws-are-a-success,-studies-show/6331736>

Post B: Smoking Cessation Applications

In 2013, the Australian National Preventive Health Agency, a government organisation, created my QuitBuddy; a free personalised app designed to help users quit smoking (Department of Health | National Tobacco Campaign, 2019). The top-down approach is government funded and was created by a large interdisciplinary team composed of innovators, communication directors, strategists, managers, account managers and producers (My QuitBuddy, 2013). They saw an opportunity to create a support tool that would be with the user 24/7. The app targets rational, emotional and social functionality and has even created a gamification aspect (Campaign Brief, 2012).

 

Apps including and similar to my QuitBuddy are limited to simple communication; working on text-based programs. However, it offers many advantages which includes goal setting, daily reminders, progress tracking and self-monitoring. Particularly my QuitBuddy features reasons for quitting, recorded messages and photos from loved ones. It is a platform that shares success stories, distraction tips and celebrates milestones (quitnow, 2015). By presenting the risk factors of health and financial costs and benefits, the app succeeds to accommodate to most users as evidence shows younger smokers are concerned with monetary rewards of quitting whilst older populations care for the health factor (Paay, Kjeldskov, Skov, Lichon, & Rasmussen, 2015).

 

 

my Quit Buddy, Campaign Brief, 2012

 

Findings towards the effectiveness of this particular app is limited however US National Institute of Health undertook a systematic review of smartphone applications for smoking cessation. It is understood that applications such as my QuitBuddy has created a health intervention treatment that is more accessible than ever before (Haskins et al., 2017). Previously, face-to-face communication was the ideal way for treatment, but its scalability is not as wide reached as mobile access (Raw & McNeil, 1994). Through text-based support it alleviates problems such as fees, portability, connectivity, scheduling and time issues (Keoleian, Polcin and Galloway, 2015).

 

Weerakone’s thesis discovered hundreds of apps, in which 82 qualified for review; the few high performing apps were ones like my QuitBuddy who partnered with health or government agencies when critiqued against the Clinical Practice Guidelines (Weerakone, 2016). The most effective apps combined a calendar with a calculator in a colourful format making self-monitoring easy to digest; my QuitBuddy succeeded in this area by using infographics (Weerakone, 2016).

 

screen shot 2019-01-11 at 4.33.47 pm

Flow chart of the review process, Weerakone, 2016

 

In 2013, it was calculated that there were 200,000 downloads on iOS and Android devices which amounts to approximately 7% of all Australian smokers but more importantly; it was recorded 39% of smokers who have used my QuitBuddy managed to remain abstinent after six months (My QuitBuddy, 2013). Therefore, it is evident that this particular design intervention has been successful and fulfilled their project brief intention. It is also important to be aware of all the other applications that are available and are not made to the correct standard to achieve a positive outcome for users and communities.

 

Reference List

Department of Health | National Tobacco Campaign 2019, Health.gov.au. viewed 10 January 2019, <http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-educat&gt;.

Haskins, B. L., Lesperance, D., Gibbons, P., & Boudreaux, E. D., 2017, A systematic review of smartphone applications for smoking cessation. Translational behavioural medicine7(2), 292-299.

Keoleian, V., Polcin, D. and Galloway, G. 2015, Text Messaging for Addiction: A Review, Journal of Psychoactive Drugs, vol 47, no 2, pp.158-176.

My QuitBuddy aims to help people quit smoking 2012, Campaign Brief Australia. viewed 11 January 2019, <http://www.campaignbrief.com/2012/06/anpha-um-develop-and-launch-my.html&gt;.

My QuitBuddy 2013, DRIVENxDESIGN. viewed 11 January 2019, <https://drivenxdesign.com/MA2013/project.asp?ID=11754&gt;.

Paay, J., Kjeldskov, J., Skov., M.B., Lichon, L., & Rasmussen, S. 2015, Understanding individual differences for tailored smoking cessation apps. Retrieved from http://people.cs.aau.dk/~jeni/jeni_homepage/publications_files/CHI2015.pdf

quitnow – My QuitBuddy 2015, Quitnow.gov.au. viewed 11 January 2019, <http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/quit-buddy&gt;.

Raw, M. and McNeillL, A. 1994, The prevention of tobacco-related disease, Addiction, vol 89, no 11, pp.1505-1509.

Weerakone, S. 2016, Examining the effects of an online intervention promoting isometric exercise in smokers, University of London, vol. 1, p47-56.

POST B: Stoptober (England) Case Study

(Glenday 2017)

Stoptober is a national campaign that launched in England in 2012 based on behavioural change theory that uses both traditional and new media to create a positive mass quitting trigger. It is designed to encourage smokers to quit smoking for 28 days during the month of October based on the insight that you can achieve this, you are five times more likely to quit for good (Bennett 2017). Stoptober is estimated to have generated an extra 350,000 attempts to quit smoking, saving around 10,400 years of life. The campaign is considered to be highly cost-effective, coming in at less than £415 (740 AUD) per discounted life year. With fifty percent more people attempting to quit smoking compared to other months in the same year (‘Stoptober success’ 2014), it is considered a successful campaign in both effectiveness and cost-effectiveness.

Between 2008 and 2016, a study of mass media expenditure towards smoke-free campaigns such as Stoptober found that there was an association between higher expenditure on tobacco control campaigns in England and an increase in quit success rates (Kuipers et al. 2018). Funded by Public Health England, Stoptober reaches out to the public through TV, radio, traditional and digital press, media partnerships, and local and regional organisations such as the national Stop Smoking Services.

4b1104ae94c4a2f8914f9c7ef7253bce

(Devon County Council n.d.)

The multi-faceted public health campaign provides support for staying smoke-free through motivational text-messaging, and an app for self-monitoring progress. Psychological principles such as the use of SMART (Specific, Measurable, Attainable, Realistic and Time-sensitive) goals means that a difficult behavioural goal seems more attainable through starting with very specific intermediary goals (Brown et al. 2014). PRIME theory is also considered in the use of motivational text-messaging and peer support via Facebook, the theory being that behaviour is determined on a moment-to-moment basis due to a variety of inputs, impulses and emotional states (Brown et al. 2014). Frequent messages provide a trigger for smoking cessation and Stoptober provides an opportunity for people to do the challenge at the same time as others.

stoptober-9

(Smail 2016)

stoptober-1

(Smail 2016)

Overall, the mass media campaign Stoptober has provided good value for money as a tool for digital support for quitters and life-saving public health intervention. The campaign’s use of key psychological principles with a clear behavioural target has made a substantial impact on public health in triggering serious quit attempts and significant behavioural change.

_____

Bennett, V. 2017, ‘Stoptober: helping to achieve a smoke-free generation’, Practice Nursing, vol. 28, no. 10, pp. 440-442.

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, viewed 10 January 2019, <https://www.sciencedirect.com/science/article/pii/S0376871613004705?via%3Dihub>

Devon County Council n.d., Pinterest, viewed 10 January 2019, <https://www.pinterest.co.uk/pin/232709505723256924/?lp=true>

Glenday, J. 2017, Stoptober 2017 TV Advert, video recording, Youtube, viewed 10 January 2019, <https://www.youtube.com/watch?v=28aIsV4ya5A>

Kuipers, M. A. G., Beard, E., West, R. & Brown, J. 2018, ‘Associations between tobacco control mass media campaign expenditure and smoking prevalence and quitting in England: a time series analysis’, Tobacco Control, vol. 27, viewed 10 January 2019, <https://tobaccocontrol.bmj.com/content/27/4/455>

Smail, P. 2016, Stoptober: The Marketers Smoking Gun?, Eight Million Stories, viewed 10 January 2019, <https://8ms.com/2016/10/25/stoptober-marketers-smoking-gun>

‘Stoptober success’ 2014, British Dental Journal, vol. 216, no. 3, p. 100.

Post B: Tobacco in India

Where does this leave our youth?

India is the second largest consumer of tobacco in the world, The use of tobacco among adults (15 years and above) is 35% (Rani et al., 2003). Among males it is 48%, and that among females is 20%. Close to 38% of adults in rural areas and 25% of adults in urban areas will use tobacco in some form (Kaur and Jain, 2011).

India was among the first few countries to join WHO the Framework Convention on Tobacco Control (WHO FCTC) in 2004 (Kaur and Jain, 2011). However despite India’s WHO FCTC early involvement, the effectiveness of tobacco control initiatives are staggered at different rates across its states due to non prioritisation of this issue (Tobacco Free Initiative, 2015).

Since their involvement different government based initiatives have been implemented such as in 1975, a statutory warning “cigarette smoking is injurious to health” became a mandatory requirement to be displayed on all cigarette packaging (Kaur and Jain, 2011). 

A public space ban Memorandum issued by the Cabinet Secretariat in 1990, prohibiting the sale of tobacco products to and by minors (persons below 18 years). As well as, not allowing tobacco products to be sold within 100 yards of all educational institutions. Specifically protecting the youth of India along with a number of other prohibitions including no smoking in public spaces and a ban on tobacco advertising.

(Mobilising Youth for Tobacco Related Initiatives in India)

A challenge however that’s being faced, and requires serious attention is the taxation of tobacco related products. At the moment an average pack of ‘bidis’ (thin tobacco cigarettes) costs only Rs 4 with the tax averaging around 9% of the retail price. This ultimately means the products remain quite inexpensive and affordable even for school children (John et al., 2008). This poses a serious threat to the youth of India as if this were to continue on, over 38 million bidi smokers will die prematurely from diseases caused by tobacco use (John et al., 2008). 

(Mobilising Youth for Tobacco Related Initiatives in India)

According to the World Health Organisation, nearly 80 percent of all adult smokers begin before 18, and in just India alone 5500 youth begin smoking a day. So to combat this the Bloomberg Initiative began a HRIDAY’s school-based tobacco use prevention program Project MYTRI (Mobilising Youth for Tobacco Related Initiatives in India). A two-year school intervention, based on social cognitive theory, involving four primary components (MH et al., 2007);

  1. Classroom curriculum
  2. School posters
  3. Parent postcards
  4. Peer-led health activism
(Mobilising Youth for Tobacco Related Initiatives in India)

These School intervention activities enhanced awareness and advocacy skills of adolescents through campaigns, such as the submission of a signature campaign to the Prime Minister of India appealing for a ban on tobacco advertisements in India. The results of the outcome evaluation revealed that over the two-year intervention period, students were less likely to show an increase in cigarette and bidi smoking, and they were also significantly less likely to express intentions to smoke or chew tobacco in the future.

References:

Kaur, J. and Jain, D. (2011). Tobacco Control Policies in India: Implementation and Challenges, Indian Journal of Public Health, viewed 9 January 2019. 

<http://www.ijph.in/article.asp?issn=0019-557X;year=2011;volume=55;issue=3;spage=220;epage=227;aulast=Kaur>.

Tobacco Free Initiative. (2015). Tobacco control in India, World Health Organisation, viewed 10 January 2019.

<https://www.who.int/tobacco/about/partners/bloomberg/ind/en/>.

Chatterjee, M. (2012). Engaging the Youth in Tobacco Control: The Real Investment, Youth Ki Awaaz, viewed 9 January 2019

<https://www.youthkiawaaz.com/2012/05/engaging-youth-tobacco-control-real-investment/>.

John, R., Kavita Rao, R., Govinda Rao, M., Moore, J., Deshpande, R., Sengupta, J., Selvaraj, S., Chaloupka, F. and Jha, P. (2008). Tobacco Taxes in India. Tobacco Economics, India: Bloomberg Philanthropies and the Bill and Melinda Gates Foundation, viewed 9 January 2019

<https://www.tobaccofreekids.org/assets/global/pdfs/en/India_tobacco_taxes_summary_en.pdf>.

MH, S., CL, P., M, A., R, S., C, M. and KS, R. (2007). Intermediate outcomes from Project MYTRI: mobilizing youth for tobacco-related initiatives in India, NCBI, viewed on 10 January 2019

<https://www.ncbi.nlm.nih.gov/pubmed/17548662>.

Rani, M., Bonu, S., Jha, P., Nguyen, S. and Jamjoum, L. (2003). Tobacco Control. 12th ed. [ebook] Baltimore, p.4, viewed on 10 January 2019,

<https://tobaccocontrol.bmj.com/content/12/4/e4.short>.


Post B: One of the many guides to breaking up with tobacco.

Telling someone to quit smoking, is synonymous to telling your best friend that the guy she likes; is just not that into her. She probably knows it, and you and your friends definitely know it, but at the end of the day, it’s her choice to keep sending desperate messages, and a smoker’s choice to keep smoking tobacco.

Tobacco control campaigns around the globe work very similarly to how you would approach your lovesick friend. There is already an established knowledge of the harmful effects of smoking, and smokers are exposed to the graphic warnings of their actions, making them even more so aware of the risks, and yet they still continue to smoke tobacco willingly. (Keane, 2018) Previous initiatives were symbolically either the nurturing empowering friend, or the brutal, truthful one. But what is usually missing, is the empathetic one; one that understood that often people giving up an addiction isn’t a choice – it’s just impossible to stop.

So how can initiatives work successfully in controlling the use of tobacco?

Florida’s ‘Tobacco Free Florida’ campaign focuses on understanding ‘the reasons’ behind why people smoke, and furthermore why they can’t stop. It utilises an empathetic lens to drive its initiative to both inspire, and helps others experiencing the same difficulty to also make a change. Instead of using aggressive advertisements, they use positive mindset goals and testimonials, to inspire people to seek help and help others in quitting tobacco use.

The slightly different approach allows the campaign to create a relatable framework that simplifies quitting, and shows an understanding that smokers already realise the risks and responsibilities that come with smoking tobacco, they just need a push towards why they should quit. Listening to things that resonate with a dominant amount of the smoking population like “It takes energy from me, it slows me down, it’s costly. I spend a little over $6 for a pack of cigarettes, if you calculated what I spent in a week, it’s terrible, I could probably pay for my family’s bills. It’s embarrassing.” [Video below] , shows the smoking population that they are not in this alone.

Christy Lanier’s testimonial for the Tobacco Free Florida campaign.

This initiative saw positive results within the first two years, where Florida’s adult cigarette smoking rate had decreased from 19.3 percent in 2011 to 16.8 percent in 2013. (CDC, 2013) Their progress continued to grow, showing encouraging signs in their ‘3 ways to quit’ platform, where in only one year, over 93,000 Floridians used this platform that utilises web coaches and in-person classes in collaboration with the Florida Area Health Education Centres to assist people in their journey to quit smoking. (CDC, 2013)

This isn’t saying that the friend who tells you ‘he’s just not interested’, isn’t effective in changing one’s choices – because for smokers; strong evidence proves that alarming graphic advertisements are effective in reducing youth participating or beginning to smoke (CDC, 2015).

However, for those that are already in too deep; well, sometimes they just need an understanding friend.

References

 

POST: B The Plain Tobacco Packaging Design Initiative of Australia

The Tobacco Plain Packaging act 2011 was a top-down initiative which was funded and created by the Australian government to minimise the tobacco usage in Australia. I chose to talk about this design imitative because in my opinion is the best design related initiative to tobacco control to this date, other than some very graphic and intensely emotional TV commercials tied in with the plain packaging initiative. Another reason why I believe it was so successful and interesting to me is because it goes against basic design ethics, this is a product they have redesigned to make consumers NOT want to buy the product, which to me as a product designer is very interesting and creative to say the least.

The new re-design of the packaging is very basic but also very powerful. Some key features of the new redesign in 2012 are:

  • Bright yellow and black health warning sign.
  • Very unappealing dark green colour.
  • No brand logo.
  • Large white descriptive text (slogans).
  • Graphic images of health risks related to tobacco usage.
Australia’s Plan Tobacco Package Design (2012)

It was hard to find some legitimate evidence to the effectiveness of this initiative other then some statistics dated up to 2016 from the Department of health ‘Smoking prevalence rates’ page. But with some primary research and observations over the years I have discovered that the packaging has stopped people from starting up smoking because of the intense imagery when looking at the package. I have also seen it stop a number of people from smoking because of the social impact caring the disgusting packaging everywhere has on them.

Some issues and challenges the Australian Government encountered in 2012 during the implementation of this act was a lawsuit from the tobacco companies which the Australian Government won. This was actually great lawsuit for the world because other countries continued in Australia’s footsteps because of the fact that Australia won, in which I do hope the Indonesian government does also follow. Other initiatives not design related (seen in the Tobacco Control Timeline) that were tied in with this act that also really helped Australia become less inclined to use tobacco are, increased tobacco taxes, and a lot of non-smoking areas and making it illegal to smoke within 4 to 10 meters from a restaurant. All of these Australian initiatives design related or not are all very important and should be followed or beaten by all other counties of the world.

References

The Department of health, Tobacco Control Timeline, viewed 10 January 2019,

<http://www.health.gov.au/internet/publications/publishing.nsf/Content/tobacco-control-toc~timeline&gt;.

Liberty works, WTO plain packaging verdict is an assault on liberty, viewed 10 January 2019,

<https://libertyworks.org.au/wto-plain-packaging-verdict-is-an-assault-on-liberty/&gt;.

University of Melbourne 2018, Big Tobacco vs Australia’s Plain Packing, viewed 11 January 2019

<https://pursuit.unimelb.edu.au/articles/big-tobacco-vs-australia-s-plain-packaging&gt;.

The Department of health, Tobacco Plain Packaging Evaluation, Viewed 11January 2019,

<http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-plain-packaging-evaluation&gt;.

The Department of health, Smoking Prevalence Rates, Viewed 11January 2019,

<http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-plain-packaging-evaluation&gt;

POST B: Canada’s Plain Packaging

Tobacco control is a significant issue worldwide. In effects to tackle this issue, the Canadian government introduced new national regulations, implementing a plain and standardised appearance for all tobacco packaging and certain tobacco products (Government of Canada 2018). Under these regulations, all tobacco packaging must have a consistent overall appearance in terms of font and colour as well as standardised size and shape (Government of Canada 2018). Furthermore, brand colours, logos and other images are also no longer permitted (Government of Canada 2018). These new designs are expected to be seen on store shelves from 2019 (Cunningham 2018).

cigarette-packaging.jpg
Plain Packaging: proposed cigarette packaging by the World Health Organisation (Directo 2011)

This transdisciplinary initiative imposes a variety of costs on the tobacco industry and government of Canada, estimated to range from $138-$195 million in total (Government of Canada 2018). However, the warning labels proves to be an extremely cost-effective educational intervention when compared to other measures such as mass media campaigns (Thrasher et al. 2007).

Under the public health treaty, the Framework Convention on Tobacco Control (FCTC) adopted by World Health Organisation, it is insisted that warning information in the form of image, text or both must consist of at least 30% of the front and back of cigarette packaging (Kees et al. 2006). As a party of FCTC, Canada already includes both visual warnings of graphic disease and text warnings (Hammond et al. 2007), proving to be extremely effective as the visual messages can reach the illiterate population (Thrasher et al. 2007) whilst provoking negative emotions such as fear and anxiety (Kees et al. 2006). Furthermore, research showed that the health warning is effective as Canadian smokers reported higher levels of awareness when compared to the United States, which only include text warnings on packages (Hammond et al. 2007).

20-years-after-settlement-billions-in-anti-tobacco-funds-spent-elsewhere.jpg
Branded tobacco packaging (Angelillo 2018)

The visual text warnings coupled with the new plain packaging regulations are expected to be a success, proving to be the world’s “best and most comprehensive” plain packaging requirements (Cunningham 2018). Furthermore, research projects funded by Ontario Tobacco Research Unit suggests that ‘plain’ packaging may reduce brand appeal and thus susceptibility to smoking among young women (Doxey & Hammond 2011). Findings also suggest that standardised cigarette packaging may decrease demand and reduce misleading insights about product harm among the young (Kotnowski et al. 2016). Although the full results from this initiative is yet to be seen, the Canadian Cancer Society is already commending the new tobacco plain packaging as the most effective worldwide (Cunningham 2018).

 

REFERENCE LIST

Cunningham, R. 2018, ‘Canada to have the world’s best tobacco plain packaging requirements’, Canada Cancer Society, viewed 10 January 2019, <http://www.cancer.ca/en/about-us/for-media/media-releases/national/2018/canadian-plain-packaging-requirements/?region=on&gt;.

Doxey, J. & Hammond, D. 2011, ‘Deadly in pink: the impact of cigarette packaging among young women’, Tobacco Control, vol. 20, no. 5, pp. 353-360.

Government of Canada 2018, Canada Gazette, Part I, Volume 153, Number 25: Tobacco Products Regulations (Plain and Standarized Appearance), Canada, viewed 9 January 2019, <http://gazette.gc.ca/rp-pr/p1/2018/2018-06-23/html/reg9-eng.html&gt;.

Hammond, D., Fong, G., Borland, R., Cummings, M., McNeill, A., Driezen, P. 2007, ‘Text and graphic warnings on cigarette packages: findings from the international tobacco control four country study’, American Journal of Preventive Medicine, vol. 32, no. 3, pp. 202-209.

Kees, J., Burton, S., Andrews, C. & Kozup, J. 2006, ‘Tests of graphic visuals and cigarette package warning combinations: implications for the framework convention on tobacco control’, Journal of Public Policy & Marketing, vol. 25, no. 2, pp. 212-223.

Kotnowski, K., Fong, G., Gallopel-Morvan, K., Islam, T., Hammond, D. 2016, ‘The impact of cigarette packaging design among young females in Canada: findings from a discrete choice experiment’, Nicotine & Tobacco Research, vol. 18, no. 5, pp. 1348-1356.

Thrasher, J., Hammond, D., Fong, G., Arillo-Santillan, E. 2007, ‘Smokers’ reaction to cigarette package warnings with graphic imagery and with only text: a comparison between Mexico and Canada’, Salud Publica de Mexico, vol. 29, no. 2.

 

IMAGES

Angelillo, J. 2018, File Photo, UPI, viewed 10 Jan 2019, <https://www.upi.com/20-years-after-settlement-billions-in-anti-tobacco-funds-spent-elsewhere/8971543517818/&gt;.

Directo, J. 2011, Cigarette Packaging, Sault Online, viewed 10 Jan 2019, <https://saultonline.com/2016/05/canada-moves-forward-on-plain-tobacco-packs/&gt;.

 

 

Post B: The Shock Factor – Chilean Tabacco Control

The message of all anti-smoking campaigns at their core remain the same, however there is a delicate interplay of visual choices and messaging that work to make a piece of visual communication successful in delivering a powerful message. Often the health consequences of long-term smoking are grim and the reality of this can be a powerful way to leave a lasting impression on an audience. In 2001, a study in Massachusetts found that youths between the ages of 14 and 19 felt advertisements that evoked strong negative emotional were more believable and impactful about the long-term health consequences of smoking. This was compared to advertisements which positive in tone, whether humorous or entertaining (Biener, L. & Ji, M. & A Gilpin, E. & Albers, A. 2004).

In South America smoking continues to be a widespread health epidemic, with Santiago in Chile and Buenos Aires in Argentina having the highest smoking prevalence (Champagne, BM., Sebrié, EM., Schargrodsky, H et al. 2010). In 2008 CONAC or the Chilean Chilean Corporation against Cancer funded and featured a controversial campaign in which the message was ‘Smoking isn’t just suicide, it’s murder’. The campaign aimed to bring attention to effects of second hand smoke, specifically targeting parents who smoke around their young children. The result is a series of disturbing and deeply powerful imagery which through the emotional tone and production quality are quite successful. The campaign did receive criticism raising the issue of using children in advertising, particularly as these images convey deep distress and can be difficult to view. There is a level of political incorrectness and a question of the audience potentially being offended by such content, however it may be this shock factor that is the only effective way to get an audience to be genuinely engaged. Whether disgusted or moved, it certainly leaves a lasting impression on anyone who comes across it.

Images: Caffarena 2008

It is interesting to note that the specificity of the audience of this campaign may also be a contributing factor to its success rather than a generalised “smoking is bad” message. The audience of this campaign is fairly specific to parents who smoke around their young children which is perhaps easier to target than smokers as a whole. In 2014, The Cancer Association of South Africa featured a campaign in which the message was ‘did you know tobacco kills’ (see below), which as it is a broad and impersonal statement, lacks the emotional impact and engagement which CONAC’s advertisement certainly had. The imagery of cigarettes themselves with a skull aims to evoke that same fear and disgust, however what CONAC does well is by giving the message a face, particularly the one of a child, the audience has something to invest in and empathise with.

Image: CANSA 2014

References

Biener, L. (2002). Anti-tobacco advertisements by Massachusetts and Philip Morris: What teenagers think. Tobacco Control, pp. 43–46.

Biener, L. & Ji, M. & A Gilpin, E. & Albers, A. (2004). The Impact of Emotional Tone, Message, and Broadcast Parameters in Youth Anti-Smoking Advertisements, Journal of health communication, pp. 259-74.

Caffarena, P (2008). Smoking isn’t just suicide. It’s murder. Available at: http://adsoftheworld.com/media/print/conac_chilean_corporation_against_cancer_blonde %5B, Accessed 10 January 2019.

Champagne, BM., Sebrié, EM., Schargrodsky, H et al. (2010). Tobacco smoking in seven Latin American cities: the CARMELA study Tobacco Control 2010, vol. 19, pp. 457-462.

The Cancer Association of South Africa CANSA (2014). Youth Targeted by Tobacco Industry On World No Tobacco Day 31 May 2014, Available at: https://www.slideshare.net/CancerAssociationSA/cansa-no-tobacco-campaign-2014, Accessed 10 January 2019.

Post B: Trepidation to Cessation: The Persuasion of Fear

The Centers of Disease Control and Prevention (CDC) Tips From Former Smokers Campaign was downright scary.

For the twelve weeks in 2012 that the multi-media initiative ran in the US, it was difficult to escape the horrifying reality of smoking.

From social media badges to television advertisements, the campaign’s wide reach was possible due to the $54 million of federal government funding (CDC 2018) (Rigotti & Wakefield 2012, p. 907).

The campaign’s goals aligned with the WHO Framework Convention on Tobacco Control’s suggested measures for reducing tobacco demand via public awareness and encouraging cessation (WHO 2003, pp. 10-13). The CDC’s goal to ‘Encourage smokers to quit, and make free help available’, by informing people of the adverse health effects proved successful for the three-month duration (CDC 2018, para 7). 207, 519 more calls were made to the provided quit line, compared with the same period of 2011 (Rigotti & Wakefield 2012, p. 907). The success of the public awareness goal was also seen on Twitter, as 87% of Tips-related tweets displayed message acceptance, and sparked further conversations online (Emeryl et al 2015, p. 286) (Emeryl et al 2015, p. 290).

The strategy? Fear.

Across all media formats used, the campaign featured faces and bodies with smoking-induced disfigurations performing their everyday tasks. Text conveyed haunting ‘advice’ from the former smokers, and the quit line number included a free and immediate resource to act on those fears.

Image result for brandon's tip CDC

Fear has proven to be the most effective method for tobacco consumers to take steps towards smoking cessation across a wide demographic (Andrews et al 2014) (Emeryl et al 2014, p. 278). The CDC’s scare tactics were particularly successful due to the underlying theme of ‘Real People, Real Stories’. The damages presented were clearly severe and abnormal, yet they were normalised through everyday routines, rather than dramatized. Communicating the risks via inescapably real stories emphasised the health implications as something that could happen to anyone. It thus reduced common reactions of distance and denial towards cigarette warnings (Rigotti & Wakefield 2012, p. 907).

Overall, the campaign was highly successful in the period that it ran for. But what about after?

After the designated advertising period ended, the number of quit line calls dropped (Rigotti & Wakefield 2012, p. 908). A substantial hindering factor to this campaign, and ones like it, was the high saturation of commercial tobacco marketing and long-term addiction that outlasts the prevalence of warning messages (Durkin, Brennan & Wakefield 2012, p. 133).

Whilst the campaign seized short-term successes, a truly successful initiative works simultaneously along supply and demand chains in a long-term effort to sustain the terror of tobacco (WHO 2003).

Reference List:

Andrews, J. C., Netemeyer, R. G., Kees, J. & Burton, S. 2014, ‘How graphic visual health warnings affect young smokers’ thoughts of quitting’, Journal of Marketing Research, vol. 51, no. 2, pp. 165-183.

Centers of Disease Control and Prevention 2018, Tips From Former Smokers – About the Campaign, Atlanta, viewed 9 January 2019, <https://www.cdc.gov/tobacco/campaign/tips/about/index.html&gt;.

Durkin, S., Brennan, E. & Wakefield, M. 2012, ‘Mass media campaigns to promote smoking cessation among adults: an integrative review’, Tobacco Control, vol. 21, no. 2, pp. 127-138.

Emeryl, S. L., Szczypkal, G., Abril, E. P., Kim, Y. & Vera, L. 2014, ‘Are you scared yet? Evaluating fear appeal messages in tweets about the Tips campaign’, Journal of Communication, vol. 64, no. 2, pp. 278-295.

Rigotti, N. A. & Wakefield, M. 2012, ‘Real people, real stories: A new mass media campaign that could help smokers quit’, Annals of Internal Medicine, vol. 157, no. 12, pp. 907-909.

World Health Organisation 2003, Who Framework Convention on Tobacco Control, World Health Organisation, Geneva, viewed 10 January 2019, <https://www.who.int/fctc/text_download/en/&gt;.

Image:

Centers of Disease Control and Prevention 2012, Brandon’s Tip, CDC, viewed 9 January 2019, <https://www.cdc.gov/tobacco/campaign/tips/resources/social/index.html&gt;.