14.3 Tobacco-control campaigns in Australia: experience

Show / hide chapter menu

Contributors: Tom Carroll, PhD August 2007, updated by Trish Cotter September 2011 with assistance from Kate Purcell, August 2011

As early as 1971, Dr Nigel Gray, then Director of the Anti-Cancer Council of Victoria, encouraged production of anti-smoking television advertisements. A series of about 26 low-budget black and white advertisements were created, mostly humorous and featuring English actors Warren Mitchell, Fred Parslowe and Miriam Karlin. Also during these early years of tobacco control, Sir MacFarlane Burnett appeared in two television advertisements about lung cancer and teenage smoking.1

Following the initial 'Quit. For Life' campaign community trial in the late 1970s as part of the New South Wales North Coast Healthy Lifestyle Program,2 statewide tobacco-control campaigns were developed in Australia by some states in the early 1980s. These commenced in New South Wales, Victoria, Western Australia and South Australia, and were funded by government and non-government organisations. In Queensland, Tasmania, the Australian Capital Territory and the Northern Territory, tobacco-control activities were initiated by a range of organisations.3 Since then, campaigns have been developed and implemented nationally (see Section 14.3.1) and across states and territories (see Section 14.3.2) as part of increasingly comprehensive tobacco-control programs.

14.3.1 Programs initiated by the Australian Government

The first national campaign on smoking was the National Warning Against Smoking campaign conducted between 1972 and 1975 at a cost of $500,000 per annum.4 The campaign used posters and slogans with anti-smoking messages. As part of the campaign, the Commonwealth Department of Health printed cardboard signs requesting smokers not to smoke nearby; these were made freely available to the public. Because the campaign was not formally evaluated no information is available about its impact.

14.3.1.1 The National Campaign Against Drug Abuse

The Ministerial Council on Drug Strategy (MCDS) was formed in 1985, comprising all Australian state and territory Health Ministers, Commonwealth Ministers for Health and Customs, and the Attorney-General.5 An early initiative of the MCDS was the launch of the National Campaign Against Drug Abuse, which aimed to reduce drug use in the community through education, rehabilitation and law enforcement. This program was later renamed the National Drug Strategy. Importantly, the National Campaign Against Drug Abuse acknowledged tobacco smoking as the major contributor to drug-related deaths in Australia.5 This ensured that tobacco issues maintained a high profile among health professionals and the media.

As part of the social marketing arm of the National Campaign Against Drug Abuse, a $2 million national television, cinema and print advertising campaign asking 'Smoking – who needs it?' was launched in 1990 and continued through 1991. It targeted teenage girls and young adult women6 and was designed to complement existing state-based programs. Campaign evaluation surveys showed significant increases in negative perceptions of smoking among the target audience, and an elevation in the percentage of young girls intending to reduce their rate of smoking.7 A low-key cinema campaign aimed at teenage smoking was conducted in 1995.

14.3.1.2 The National Tobacco Campaign

Through the 1990s Quit organisations working across Australia cooperated extensively with materials being shared or adapted where possible. However it was not until 1997 that a truly national campaign, galvanising the collective expertise and resources of all Australian Quit campaigns and the Commonwealth, was launched.

The National Tobacco Campaign was developed as steady reductions in smoking prevalence observed through the 1980s and early 1990s were stalling.8 In 1995, the Australian Government allocated research funds towards regaining the tobacco control momentum. In 1996, a commitment was made to pool the extensive tobacco control expertise and resources in Australia to develop a collaborative national anti-smoking campaign.9 Managed by the Commonwealth Department of Health and Aged Care with advice from a Ministerial Tobacco Advisory Group chaired by Professor David Hill, the National Tobacco Campaign was launched in June 1997 with funding of more than $7 million across two years. The added support from state-based organisations meant the total investment in the first six-month phase of the National Tobacco Campaign was approximately $9 million.10 With the advent of the National Tobacco Campaign, funding for tobacco-control programs in Australia increased from 26 cents per adult in 1996 to 55 cents per adult in 1998 and continued at 49 cents per adult in 2001.11

The Australian Government contributed 75% of the $4.5 million spent on advertising in the initial phase of campaign activity (June–October 1997). In subsequent phases of the campaign, states and territories contributed more: by 2000 the Australian Government contribution was estimated at $2.18 million compared with $3.29 million from state and territory Quit organisations.12

The National Tobacco Campaign targeted smokers aged 18–40 years. It is Australia's most intense and enduring mass media tobacco-control campaign. One of its great strengths was the collaboration in its development and operation between the national, state and territory governments and non-government organisations.

The primary objective was to elevate quitting on smokers' personal agendas. The campaign recognised that to potentiate the intention to quit smoking, an individual needed to gain fresh insights. Smokers needed to see material as personally relevant and gain confidence in their own ability to quit smoking (self-efficacy) as well as see they would gain more than they lost by giving up smoking. The task of the creative strategy was to instil the message and remind smokers of it often so that it remained on their personal agenda.13

The creative development process called for close collaboration between the advertising agency's creative team and medical experts in the cardiovascular, neurology and respiratory fields. Between 1997 and 2000, six health effects advertisements were produced (known as 'Artery', 'Lung', 'Tumour', 'Brain', 'Eye' and 'Tar') and one 'Call for help' advertisement showing a caller to the Quitline.

A lower socio-economic bias was adopted in media placement, which reflected the social class gradient of smoking in Australia.14 In support of the primary campaign advertising medium of television, secondary media included print advertising, radio, outdoor (billboards, bus and tram sides) and a campaign website: www.quitnow.info.au.

Read more about the National Tobacco Campaign development and implementation.

Evaluating the National Tobacco Campaign

Three evaluation volumes15,17 and a dedicated supplement to the Tobacco Control journal18 have published extensive research and evaluation on the campaign.

There was a significant reduction in smoking prevalence among Australian adults observed over the period of the National Tobacco Campaign.19 Campaign surveys indicated a decline from 23.5% in May 1997 to 20.4% in November 2000.12 It is difficult to know how much of this decline can be attributed to the National Tobacco Campaign,11 as opposed to other tobacco-control policy initiatives such as increased taxes on cigarettes20 or other trends. Nevertheless, campaign survey findings regarding advertising recall, recognition, appraisal, new learning and changes in health beliefs and attitudes are consistent with predicting these changes in smoking prevalence.21

Overall, the results of campaign surveys indicated that the campaign advertising was seen and recalled by the majority of the target audience, with levels of prompted recognition of campaign advertising at approximately 90%. Approximately half of the smokers who recognised the campaign advertising reported that this had made them more likely to quit.

In addition to the annual cross-sectional surveys conducted each November from 1997 to 2000, a continuous tracking study explored the relationship between campaign advertising and measures such as awareness and response to the advertising and indicators of interest in quitting. It assessed 'cut-through' of campaign advertising, response to this advertising and considered levels of response generated at different levels of campaign advertising weight.22 Unprompted recall and recognition (prompted recall) were related to advertising weight (measured in Target Audience Rating Points (TARPs). The greater the advertising weight for a particular advertisement, the greater the levels of recall and recognition.23 However, it was also found that cut-through for a particular advertisement was clearly mediated by its message and creative execution. 'Artery', 'Brain' and 'Tar' achieved the highest cut-through per TARP of the health effects advertisements.

Further studies have since been undertaken that provide valuable information on program placement, relationship between advertising and call generation, and optimal TARP weights to inform campaign media planning—see Section 14.4.3.

Two cost-effectiveness studies10, 24 were conducted on the initial phase of the campaign. Using the baseline survey (May 1997) and the first evaluation survey (November 1997), estimates were made regarding the reduction in number of smokers that could be attributed to the National Tobacco Campaign. From this calculation it was estimated that in its first six months of operation the National Tobacco Campaign achieved a reduction of 1.4% in the smoking prevalence, avoided 32,000 cases of chronic obstructive pulmonary disease, 11,000 cases of acute myocardial infarction, 10,000 cases of lung cancer and 2500 cases of stroke. In addition, Hurly and Matthews estimate that the National Tobacco Campaign prevented about 55,000 deaths and achieved gains of 323,000 life-years and 407,000 Quality Adjusted Life Years (QALYs) with potential healthcare savings of $740.6 million.24 The National Tobacco Campaign was therefore both cost saving and effective.

14.3.1.3 Australian Competition and Consumer Commission campaign

During 2006 tobacco campaign activity increased nationally and among the state Quit organisations. In December 2005, the Australian Competition and Consumer Commission (ACCC) launched a $9 million campaign to advise smokers that 'light' and 'mild' cigarettes are not a healthier option than smoking other cigarettes. The campaign was funded by Philip Morris, British American Tobacco Australia and Imperial Tobacco Australia as part of court-enforceable undertaking obtained by the ACCC after finding that these tobacco companies had represented that cigarettes marketed and packaged as 'light', 'mild' or similar descriptors had certain health benefits in comparison to those marketed as regular or higher yield cigarettes.25 This campaign featured prominent television and outdoor advertising over the early months of 2006.

14.3.1.4 Introduction of graphic health warnings

In mid-February 2006 the Australian Government launched the first stage of its new National Tobacco Campaign to address youth smoking rates, committing $25 million over four years.26 This initial stage focused public attention on the release of a new system of graphic health warnings on tobacco product packaging. From 1 March 2006 tobacco products manufactured or imported into Australia were required to be printed with the new health warnings images (see Chapter 12A.1).27 This campaign was staged from February to April 2006 including the national broadcast of a television advertisement featuring a mouth and throat cancer graphic health warning.

14.3.1.5 The National Tobacco Youth Campaign

The second stage of the Australian Government's new National Tobacco Campaign targeting smoking rates among young adults and teenagers was launched at the end of December 2006 and the initial phase continued until March 2007. The new campaign, featuring television, cinema, magazines, radio and outdoor advertising, graphically depicted the range of toxic chemicals in cigarette smoke, as well as linking to graphic health warnings.26 Campaign advertisements can be viewed at www.quitnow.info.au.

14.3.2 State and territory campaigns

14.3.2.1 State-based Quit campaigns

Early state- and territory-based smoking-control activity was often undertaken by the state Cancer Councils and the Heart Foundation (formerly the National Heart Foundation). The combined finances and expertise of these groups resulted in a high standard of education campaigns and tobacco policy development in Australia.

These campaigns typically focused on a 'Quit week' of activities, but varied their activities throughout the year. Information on smoking, advice on quitting and the opportunity to attend cessation courses encouraged smokers to quit. Young people were targeted through schools, where class resources were designed for specific age groups. The Quit organisations also provided support and resources for health professionals, including medical practitioners, to assist with counselling and to support community-based activities. In some states a 'Quitline' (telephone information service) was available, delivering a recorded message that advised on quitting and directed callers to trained staff for individual counselling and self-help resources.

Informed by campaign research and evaluation studies, specific population groups were identified and targeted, including children, young women, Aboriginal and Torres Strait Islander smokers, smokers from non-English speaking backgrounds, and older smokers. Quit groups developed and delivered programs for workplaces that required general information or guidance on becoming smokefree and programs aimed at restaurants and other public places.

Mass media campaigns and sports sponsorships were the most visible means used to promote messages about smoking and health. The Quit message was also promoted through community events such as no-smoking days or education campaigns run in schools, hospitals, worksites, health centres and other community-based venues and through press and media coverage generated by these events.

The significant investment by and cooperation between state and territory Quit organisations (which include both government and non-government agencies) has continued since the National Tobacco Campaign. Many new campaigns have been created, focusing on a range of themes and primarily targeting adults; campaign organisations have frequently shared these advertisements.

Details of campaigns, including links to campaign advertising materials, are available on the websites of Quit organisations and other government and non-government organisations listed in Appendix 1. Advertisements produced since 2005 are listed and described in Table 14.3.1.

14.3.2.2 Health promotion foundations

During the late 1980s and the 1990s health promotion foundations were established by legislation in Victoria, South Australia, the Australian Capital Territory and Western Australia. These foundations were financed by an increased levy on state or territory tobacco license fees, and shared the objectives of:

  • sponsoring activities related to the promotion of health or to the prevention and early detection of disease
  • increasing awareness of programs promoting good health through sponsorship of sports, the arts and popular culture
  • funding research and developing activities in support of these aims.

In 1993, the Queensland Health Promotion Council was also established to fund health promotion (though promotion via funding of sports was excluded). The Tasmanian Health Promotion Council was established along similar lines in the same year.

These foundations gave rise to new opportunities, especially in their capacity to provide an alternative source of funding from tobacco companies for sponsorships of sport and the arts. They were also able to purchase advertising space (particularly on billboards and in cinemas) previously used by tobacco companies, thereby assisting the advertising industry during the transition period when tobacco advertising bans were being introduced.

Sponsorship agreements brought about major opportunities for health promotion.28 Target groups now included participants in and spectators of sports or cultural events, who may not have been reached by previous health promotion strategies. Not only were messages about smoking prevention and smoking cessation seen more often, but the messages could also be tailored for specific audiences and adjusted to maintain a fresh and contemporary image. Importantly, the relationships that developed as a result of sponsorship contracts could also be used to encourage the adoption of changes such as policies on smokefree areas at venues, the provision of low alcohol drinks, healthy food choices and sun protection.29

14.3.2.3 State-based graphic health warnings campaign collaboration

In 2005 the Cancer Institute NSW and Quit Victoria spearheaded a major collaborative effort between eight state and territory anti-tobacco organisations, to capitalise on the introduction graphic health warnings. The initiative aimed to extend the impact of pack warnings beyond their initial newsworthiness. The basic premise of the advertising campaign was that if graphic health warnings served to remind smokers of the health consequences of smoking every time they had a cigarette30 then exposure to the health warnings advertisements might serve to increase the salience of these consequences.

Responding to consumer insights31, the most salient health effects depicted in the graphic health warnings were those that were visible outside the body. The first advertisement, 'Amputation', was launched in May 2006 and dramatised the graphic health warning 'smoking causes peripheral vascular disease'. It featured a surgeon about to amputate a man's gangrenous foot. This advertisement was followed by 'Mouth cancer' in July 2006. The advertisement dramatised 'smoking causes mouth and throat cancer' and depicted a woman with mouth cancer. Three further advertisements were launched in 2007 to capitalise on the introduction of the second set of graphic warnings and focused on a smoker's choice of packets with different health warnings ('Which disease?'), the graphic depiction of an operation to remove plaque from a woman's carotid artery ('Carotid') and a chilling portrayal of a man's thoughts about the consequences of his smoking after experiencing a stroke ('Voice within'). These powerful advertisements have been broadcast by most states as components of their tobacco-control programs, with heaviest exposure being bought in the most populous states of New South Wales and Victoria. These advertisements can be viewed on smoking and health program websites listed in Appendix 1.

Evaluation studies showed high levels of awareness and engagement with these advertisements, and prompting of significant discussion and quitting attempts.32 Brennan and colleagues demonstrated a complementary effect of the advertising campaign and the graphic warnings introduction. Importantly, this research provides some of the first evidence in support of a multi-faceted approach to the introduction of new tobacco-control policies with the use of media campaigns to facilitate and extend understanding and impact.33

14.3.3 International use of Australian tobacco campaign materials

Adapting or re-using mass media material from other countries is becoming an increasingly accepted practice in Australia and overseas. Many Australian states have used materials that originated in other countries such as the US and the UK. Examples include the 'Echo' campaign adapted and re-shot based on a successful Californian advertisement, the 'What's worse' ad featuring a woman telling her children she has lung cancer, the 'Anthony' testimonial ad from the UK, the 'Ronoldo' ad from Massachusetts and the 'Cigarettes are eating you alive' ad from New York.

Adapting materials saves on production costs and time, enabling resources to be concentrated into broadcasting.34 Some advertisements are more suitable for adaption than others. Those with good potential are those that have performed well in their country of origin. Ads are also more suitable for adaption if they have no people in them (e.g. using graphics, simulation or body parts) or have people who do not speak directly to the camera (so that a voiceover can be recorded in any language).34

Adapting advertisements reduces reliance on medical knowledge and marketing expertise, which may be hard to find or 'upskill' in short timeframes. This approach has now been used in many low and middle income countries by the World Lung Foundation using funds from the Bloomberg Initiative.

Some examples of successful Australian campaign exports:

  • Perhaps on Australia's greatest campaign export has been the National Tobacco Campaign and specifically the 'Artery' advertisement. National Tobacco Campaign advertisements have been used and adapted in numerous countries around the world including Cambodia, Canada, Iceland, Mongolia, New Zealand, Norway, Poland, Singapore, the US (various states) and Vietnam.
  • The 'Sponge' campaign (Cancer Institute NSW) has been aired in the world's most populous nations—in India (two national campaigns, for World No Tobacco Day 2009 and 2010), Russia and China, as well as in Turkey, the Philippines and Mauritius.
  • The 'Carotid' advertisement (Quit Victoria), made in 2007 in support of the new graphic health warnings, has been used by New South Wales, the Northern Territory and the state of New York and New York City.
  • The 'Bubblewrap' campaign (Quit Victoria), produced in 2005 and aiming to educate smokers on emphysema, has been used by New South Wales, South Australia, Western Australia, Queensland and Tasmania as well as in Greece, New York City, Egypt, Poland, Russia, Turkey and China.
  • The 'Separation' campaign (Quit Victoria), produced in 2008, which aimed to educate smokers on the impact their smoking has on others, has been used by Tasmania and in New York City, New York State, Virginia and Rhode Island in the US.

 

Table 14.3.1
TV commercials produced in Australia since 2005*

Theme

Campaign name

First run by

Description

Simulated negative health effects

Bubblewrap

Quit Victoria 2005

Using bubblewrap to represent human lungs, it aims to increase awareness of the dangers of smoking on the respiratory system and the inevitability of emphysema.

Sponge

Cancer Institute NSW 2007

A remake of the 1979 'Sponge' advertisement produced by John Bevins for the NSW Department of Health. The ad uses ordinary sponges to demonstrate how lungs soak up cigarette smoking and collect tar.

Stairway to emphysema

Cancer Institute NSW 2008

Aims to encourage smokers to quit by focusing on a well-established health consequence of smoking: emphysema. It links the common smoker feeling of breathlessness after climbing up a flight of stairs with symptoms of emphysema. Smokers are prompted to think about the damage smoking has already caused to their lungs and the fact that it is irreversible.

Emphysema TV

Cancer Institute NSW 2009

This 60-second television commercial, adapted from the Quit Victoria emphysema radio advertisement, emphasises the health consequences of smoking by showing a man delivering the script and breathing exercise to camera. He engages the viewer by showing what it is like to have emphysema. The apparent discomfort reinforces what breathing is like in the later stages of emphysema.

Graphic

Mouth cancer

Quit Victoria 2006

Builds on the graphic health warning 'smoking causes mouth and throat cancer' and highlights the fact that smoking is a major cause of cancer of the mouth (oral cavity) and throat (pharynx).

Amputation

Cancer Institute 2006

Builds on the graphic health warning 'smoking causes peripheral vascular disease' and highlights that smoking can cause peripheral vascular disease (gangrene). The television advertisement is a dramatisation of the warning about peripheral vascular disease.

Carotid

Quit Victoria 2007

Shows a carotid endarterectomy (surgical procedure) to remove a fatty deposit found in the main artery to the brain. The advertisement explains the link between smoking and stroke and aims to encourage people to quit.

Bronchoscopy

Cancer Institute NSW 2007

Encourages smokers to quit by revealing what smoking-caused lung cancer looks and sounds like. It also communicates how the damage starts early and poor survival from lung cancer.

Artery (health warnings)

Department of Health and Ageing 1997 revised by Cancer Institute NSW 2008

Highlights connection with graphic health warning.

Everybody knows

Cancer Institute NSW 2008

Presents memorable scenes from existing campaigns set to the music of the Leonard Cohen song of the same name. It shows the range of health consequences caused by smoking, and reinforces that smoking can lead to many diseases.

Cigarettes are eating you alive

Cancer Institute NSW, adapted from New York City Department of Health and Hygiene 2009

Portrays the negative health effects of smoking by using strong graphic images of disease and damaged tissue, which illustrate the multiple negative health effects of smoking.

Cigarettes are eating our kids alive

Cancer Institute NSW, adapted from New York City Department of Health and Hygiene 2009

Portrays the negative health effects of smoking around children by using strong graphic imagery of diseases and children affected by smoking.

Cough

Australian Government 2011

Depicts a smoker going about his everyday business while suffering from a nagging smoker's cough. Finishes with the tagline 'At any time your smoker's cough ... can become smoker-with-lung-cancer's-cough. Every cigarette brings cancer closer'.

Sugar sugar

Cancer Council WA 2010

Features a range of scenes depicting various smoking-related diseases including laryngeal cancer, chronic bronchitis, emphysema and heart disease. The advertisement is set to the well-known song by The Archies 'Sugar Sugar' and finishes with the words 'Additives such as sugar and honey can hide the bitter taste of tobacco. But the damage cigarettes do can't be hidden'.

Reflective

Which disease?

Cancer Institute NSW 2007

Produced as part of the National Health Warnings campaign; builds on multiple graphic health warnings. It focuses on the reality that you can't choose which smoking-caused disease you will actually get if you continue to smoke. It encourages smokers to reflect on their own smoking behaviour and challenges their beliefs regarding the likely health consequences of their smoking.

If smoking was a friend

Cancer Institute NSW 2007

Encourages smokers to quit by showcasing the lengths smokers go to in order to accommodate smoking in their lives. It also highlights a number of health consequences caused by smoking.

Narrative testimonial

Parents

Quit Victoria 2000

Produced by Quit Victoria and Cancer Council South Australia in 2001, it aims to increase awareness among smokers, particularly parents, of the negative effects smoking has on their health, fitness and lifestyle.

Excuses/echo 1, 11 and 111

Cancer Institute 2005

A remake of a successful Californian television commercial. Tackles smokers' self-exempting beliefs by balancing their excuses with the certain consequences of continued smoking.

Narrative testimonial (continued)

Voice within

Cancer Institute NSW 2007

Aims to build on the graphic health warning 'smoking doubles your risk of stroke' to reinforce the fact that smoking can cause stroke and to motivate and remind smokers to quit.

Zita

Cancer Council WA

Uses edited footage from a Channel Seven Today Tonight story. It tells the story of Zita Roberts, a 36-year-old Perth mother of three. She had terminal lung cancer caused by smoking,

Anthony

Cancer Institute NSW, adapted from UK 2008

Based on the personal testimony of a man diagnosed with throat and lung cancer. It was developed in the UK to motivate smokers to quit smoking.

Separation

Quit Victoria 2008

Set at a train station, it powerfully depicts the personal and emotional impact that smoking-caused illnesses have on the lives of smokers' families, particularly their children. The tagline 'If this is how your child feels after losing you for a minute, imagine if they lost you for life' aims to convince smokers to
quit now.

Best intentions

Cancer Institute NSW 2008

Research with smokers revealed the specific milestones in their life when they had promised themselves they would quit smoking e.g. New Year. Many expressed a sense of regret at missing these key milestones. The advertisement was developed in consultation with cancer care experts and patient case studies.

What's worse?

Cancer Institute NSW, adapted from UK 2009

Developed by the Department of Health UK, it depicts the real-life health consequences of smoking. It evokes an emotional response by focusing on the difficult situation of a mother communicating the realities of her illness to her young children.

Who will you leave behind?

Cancer Council WA

Focuses on the experiences, thoughts and emotions of family members left behind by those who die from smoking-related diseases. The advertisements feature Luke and Ben, as well as Luke's son James, talking about their father, Neil, who died from a smoking-related illness. Family photos and footage of Neil set the scene in the background.

Ronoldo

Quit Victoria 2009

Adapted from the Massachusetts Department of Public Health, this ad features Ronaldo Martinez, who at 39 years of age lost his voicebox due to smoking-induced cancer and now breathes through a permanent hole in his throat. Ronaldo talks about how his life will never be the same now he has a tracheotomy.

Adrian's regret

Cancer Council WA, adapted from New Zealand 2010

The story of New Zealand man Adrian Pilkington, who, at the time of filming, was dying from smoking-related mouth cancer. Highlights the debilitating impact head and neck cancers have on day-to-day quality of life for patients, and the impact on their families.

Break the chain

Australian Government 2011

Testimonial-style ad from an Aboriginal mother talking about her family's history with smoking disease. The points she makes are punctuated, where appropriate, with cutaways to old photographs, sick relatives or other memorabilia. The advertisement finishes with her stating 'If I can do it, I reckon we all can'. Encourages smokers to break the chain.

Supportive

Quitline services

Cancer Institute NSW 2006

In six advertisements Quitline advisors talk to camera about cravings, nicotine replacement therapy, planning quit attempts, call-back service, the best ways to quit and previous quit attempts.

Get off cigarettes

Cancer Institute NSW, adapted from UK 2009

Was developed in the UK to support and encourage smokers to quit by increasing awareness of the range of support services available.

I can quit/willpower

Cancer Institute NSW 2010

Conveys the message that willpower is like a muscle: the more you use it the stronger it gets. The shows a woman in the process of quitting and how this helps her resist the urge to smoke.

Never give up

Quit Victoria 2010

Follows a smoker caught up in the cycle of quitting and relapsing. At first he quits for three days, then six weeks and then one year. The advertisement concludes with him successfully quitting after three years. The campaign is designed to build smokers' confidence to quit for good rather than focus on the negative effects of smoking.

Smoke-free

Pubs and clubs

Cancer Institute NSW 2006

Announces changes to state legislation regarding smoking in pubs and clubs.

Smokefree car and home

Quit Victoria 2007

Focuses on the interaction between a smoker and his daughter, and aims to prompt smokers to think about not smoking around others, especially children. It also encourages non-smokers to ensure that others do not smoke around them and their children.

Youth

Feeling good

Queensland Government 2007

Targets young women 18 to 24 years who smoke, particularly those classified through research as 'trapped' smokers. The campaign theme is 'Discover life without smoking'. Three advertisements feature young women in three different 'high-risk' situations and illustrate how they manage to stay quit, given the pressures of these situations. The advertisements culminate with the resulting feelings of success the women experience.

My smoking

Queensland Government 2011

Focuses on the importance to young people of making their own choices, as well as the influence of opinions, experiences and voices of their peers. 'Real people – real stories' is the main tagline, with real Queenslanders discussing daily smoking-related issues: looks, money, relationships and short-term
health implications.

* Thank you to Kate Purcell for research and compilation of information for this table.

References

1. Cancer Council Victoria. Our history, the 1970s. Melbourne, Australia: Cancer Council Victoria, 2005 [viewed November 2011]. Available from: http://www.cancervic.org.au/about/70-years/history-1970s

2. Egger G, Fitzgerald W, Frape G, Monaem A, Rubinstein P, Tyler C, et al. Results of a large scale media anti-smoking campaign in Australia: the North Coast Healthy Lifestyle Program. British Medical Journal 1983;287:1125-8.

3. Winstanley M, Woodward S and Walker N. Tobacco in Australia: facts and issues, 1995. 2nd edn. Carlton South: Victorian Smoking and Health Program, 1995. Available from: http://www.quit.org.au/quit/FandI/welcome.htm

4. Senate Standing Committee on Social Welfare. Drug problems in Australia: an intoxicated society? Canberra: Australian Government Publishing Service, 1977. 

5. National Campaign Against Drug Abuse. Campaign document issued following the Special Premiers' Conference April 2, 1985. Canberra: Australian Government Publishing Service, 1985. 

6. Blewett N. Australia's achievements and ongoing strategy in the fight against tobacco consumption. In Durston B and Jamrozik K, eds. Tobacco and health 1990: the global war. Proceedings of the Seventh World Conference on Tobacco and Health, 1-5 April 1990. Perth: Health Department of Western Australia, 1990;6-8. 

7. Research and Marketing Group. Tracking research for the Drug Offensive 'Smoking. Who needs it?' campaign and evaluation of campaign sponsorship of surfing events and clinics. Drug offensive research report. Sydney: The Department of Health, Housing, Local Government and Community Services, 1983. 

8. Hill DJ, White VM and Scollo MM. Smoking behaviours of Australian adults in 1995: trends and concerns. Medical Journal of Australia 1998;168(5):209–13. Available from: http://www.mja.com.au/public/issues/mar2/hill/hill.html

9. Wooldridge M. Preface. In Hassard, K, ed. Australia's National Tobacco Campaign: evaluation report vol. 1. Every cigarette is doing you damage. Canberra: Commonwealth Department of Health and Aged Care, 1999;Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

10. Carter R and Scollo M. Chapter 7: Economic evaluation of the National Tobacco Campaign. In Hassard K, ed. Australia's National Tobacco Campaign: evaluation report vol. 2 Every cigarette is doing you damage. Canberra: Commonwealth Department of Health and Aged Care, 2000;201–38. Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

11. White V, Hill D, Siahpush M and Bobevski I. How has the prevalence of cigarette smoking changed among Australian adults? Trends in smoking prevalence between 1980 and 2001. Tobacco Control 2003;12 (suppl. 2):ii67-74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12878776

12. Wakefield M, Freeman J and Inglis G. Chapter 5: Changes associated with the National Tobacco Campaign: results of the third and fourth follow-up surveys. In Hassard K, ed. Australia's National Tobacco Campaign: evaluation report vol. 3 Every cigarette is doing you damage. Canberra: Department of Health and Ageing, 2004;Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

13. Hill D and Carroll T. Australia's National Tobacco Campaign. Tobacco Control 2003;12(suppl. 2):ii9–14. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/12/suppl_2/ii9

14. National Public Health Partnership. Preventing Chronic Disease: A Strategic Framework. Melbourne, Australia: National Public Health Partnership, 2001. Available from: http://www.nphp.gov.au/publications/strategies/chrondis-bgpaper.pdf

15. National Tobacco Campaign Research and Evaluation Committee. Australia's National Tobacco Campaign: evaluation report vol. 1 Every cigarette is doing you damage. Canberra, ACT: Ministerial Council on Drug Strategy, 1999. Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

16. National Tobacco Campaign Research and Evaluation Committee. Australia's National Tobacco Campaign: evaluation report vol. 2. Every cigarette is doing you damage, ed. Hassard, K. Vol. Two. Canberra: Commonwealth Department of Health and Ageing, 2000. Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

17. National Tobacco Campaign Research and Evaluation Committee. Australia's National Tobacco Campaign: evaluation report vol. 3. Every cigarette is doing you damage. Canberra: Commonwealth Department of Health and Ageing, 2004. Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

18. Woodward A. Insights from Australia's National Tobacco Campaign. Tobacco Control 2003;12(suppl. 2):ii0. Available from: http://tobaccocontrol.bmj.com/content/12/suppl_2/ii0.short

19. Australian Institute of Health and Welfare. Statistics on drug use in Australia 2004. Drug statistics series no.15, cat. no. PHE 62. Canberra: AIHW, 2005. Available from: http://www.aihw.gov.au/publications/index.cfm/title/10143

20. Scollo M, Younie S, Wakefield M, Freeman J and Icasiano F. Impact of tobacco tax reforms on tobacco prices and tobacco use in Australia. Tobacco Control 2003;12(suppl. 2):ii59–66. Available from: http://tc.bmjjournals.com/cgi/content/abstract/12/suppl_2/ii59

21. Wakefield M, Freeman J and Donovan R. Recall and response of smokers and recent quitters to the Australian National Tobacco Campaign. Tobacco Control 2003;12(suppl. 2):ii15-22. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/12/suppl_2/ii15

22. Donovan R, Freeman J, Borland R and Boulter J. Chapter 4: Tracking the National Tobacco Campaign. In Hassard K, ed. Australia's National Tobacco Campaign: evaluation report vol. 1. Every cigarette is doing you damage. Canberra: Commonwealth Department of Health and Aged Care, 1999;127–87. Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

23. Donovan RJ, Boulter J, Borland R, Jalleh G and Carter O. Continuous tracking of the Australian National Tobacco Campaign: advertising effects on recall, recognition, cognitions, and behaviour. Tobacco Control 2003;12(suppl. 2):ii30–9. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/12/suppl_2/ii30

24. Hurley SF and Matthews JP. Cost-effectiveness of the Australian National Tobacco Campaign. Tobacco Control 2008;17(6):379-84. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/17/6/379

25. Low yield cigarettes 'not a healthier option': $9 million campaign. Canberra: Australian Competition and Consumer Commission, 2006. Available from: http://www.accc.gov.au/content/index.phtml/itemId/719575

26. Australian Government Department of Health and Ageing. Background on the national Tobacco Youth Campaign. National Tobacco Campaign. Canberra: Department of Health and Ageing, 2006 [viewed 8 June 2007] . Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/youth-lp

27. Australian Government Department of Health and Ageing. Graphic Health Warnings: labelling of tobacco products. Australian Government Department of Health and Ageing, 2006. Available from: http://www.quitnow.info.au/internet/quitnow/publishing.nsf/Content/warnings-lp

28. Holman C, Donovan R, Corti B, Jalleh G, Frizzell S and Carroll A. Banning tobacco sponsorship: replacing tobacco with health messages and creating health-promoting environments. Tobacco Control 1997;6(2):115–21. Available from: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1759553&blobtype=pdf

29. Holman CDJ, Donovan RJ and Corti B. Report of the evaluation of the Western Australian Health Promotion Foundation. Department of Public Health and Graduate School of Management. Perth: The University of Western Australia, 1994. Available from: http://heapro.oxfordjournals.org/content/8/3/199.abstract

30. Borland R, Yong H, Wilson N, Fong G, Hammond D, Cummings K, et al. How reactions to cigarette packet health warnings influence quitting: findings from the ITC Four-Country survey. Addiction 2009;104(4):669–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19215595

31. Murphy M. Cigarette pack warning labels. Report of exploratory qualitative research for Quit Victoria and Cancer Institute NSW. Melbourne, Australia: Market Access Consulting and Research Pty Ltd, 2005.

32. Quit Victoria and The Cancer Institute NSW. Health warnings campaigns. Sydney: Quit Victoria and The Cancer Institute NSW, 2007.

33. Brennan E, Durkin S, Cotter T, Harper T and Wakefield M. Mass media campaigns designed to support new pictorial health warnings on cigarette packets: evidence of a complementary relationship. Tobacco Control 2011;[Epub ahead of print] . Available from: http://www.ncbi.nlm.nih.gov/pubmed/21474501

34. Cotter T, Perez D, Dunlop S, Hung WT, Dessaix A and Bishop JF. The case for recycling and adapting anti-tobacco mass media campaigns. Tobacco Control 2010;19(6):514–17. Available from: http://tobaccocontrol.bmj.com/content/19/6/514.abstract

      Previous Chapter Next Chapter