14.2 The role of mass media campaigns within a comprehensive smoking control program

Contributors: Tom Carroll PhD, August 2007, updated by Trish Cotter, September 2011

The strength of evidence for mass media campaigns within the context of a comprehensive tobacco-control program continues to grow. The role of the media has been recognised almost as long as our knowledge of tobacco as the cause of lung cancer. Almost 50 years ago (1962) the Royal College of Physicians of London, in its report on smoking and health,1 called on governments to:

  • provide more education to the public and especially children concerning the hazards of smoking
  • more effectively restrict the sale of tobacco to children
  • restrict tobacco advertising
  • more widely restrict smoking in public places
  • increase tax on cigarettes, perhaps by adjusting the tax on pipe and cigar tobaccos
  • inform purchasers of the tar and nicotine content of the smoke of cigarettes
  • investigate the value of anti-smoking clinics to help those who find difficulty in giving up smoking.

Three decades ago the World Health Organization and the International Union Against Cancer (UICC) advocated that a reduction in tobacco consumption could be achieved through a number of interrelated measures.2 They gave the objectives of a comprehensive smoking control program as:

  • achieving lower smoking rates in all age groups by applying all practical downward pressures on smoking rates, including health warnings on tobacco packets, increased taxation, restrictions on smoking opportunities, support for the rights of non-smokers, and information and education programs
  • encouraging non-smokers to remain non-smokers
  • ceasing all forms of tobacco advertising and promotion
  • encouraging those who had not yet stopped smoking, and therefore remained at high risk, to reduce, as far as possible, their exposure to the harmful components of tobacco smoke
  • liaising with other health organisations and authorities to ensure maximum effectiveness and to avoid conflict of activities.

This recommended tobacco-control program recognised that synergies are created when all components of a program are implemented, rather than simply individual strategies. As more evidence has emerged from tobacco-control programs internationally, the importance of social marketing and public education campaigns within a comprehensive program of strategies and activities has continued to be emphasised.3

14.2.1 The Framework Convention on Tobacco Control

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) was adopted at the Fifty-sixth World Health Assembly in 2003 and entered into force on 27 February 2005.4 The Australian Government formally ratified the WHO FCTC on 27 October 2004.5 See Chapter 18 for a detailed description. Article 12 of the Convention (Education, communication, training and public awareness) calls for the use of all available communication tools to promote and strengthen public awareness of tobacco-control issues. Guidance on education, communication and training measures concerning tobacco dependence and cessation is outlined in Article 14 (Demand reduction measures concerning tobacco dependence and cessation).

Since the ratification of the treaty, parties to the WHO FCTC have developed, refined and adopted guidelinesi to assist signatories to draft legislation and administer programs that will embody its provisions. These guidelines recognise that awareness of tobacco-control issues is essential for public acceptance of policy changes. This includes bans on advertising and promoting tobacco products.ii Public awareness can help to bring about change in the behavioural norms around tobacco consumption and exposure to tobacco smoke.iii It is recognised that health warnings will be more effective when part of a broader public education campaign.iv

In the recommended actions for demand reduction approaches concerning dependence and promotion, mass communication and education programs are seen as essential both for encouraging tobacco cessation (Section 44) and encouraging tobacco users to draw on this support (Section 60).v These programs can include unpaid and paid media placements. The guidelines for population approaches also recommend brief advice by healthcare workers, establishing quitlines and monitoring and evaluating programs to measure progress and impact. Guidelines for Article 12vi spell out how countries might go about developing, implementing and evaluating effective tobacco-control education campaigns. Australians with expertise in tobacco-control policy have had considerable input into these and other WHO FCTC Guidelines.

14.2.2 The National Tobacco Strategy 2004–09

The key role played by tobacco-control campaigns has been recognised in Australia's National Drug Strategic Framework. As part of this framework, the National Tobacco Strategy 2004–09 had the goal of significantly improving health and reducing the social costs caused by, and the inequity exacerbated by, tobacco in all its forms.6

The objectives of the strategy among all social groups are:

  • to prevent uptake of smoking
  • to encourage and assist as many smokers as possible to quit as soon as possible
  • to eliminate harmful exposure to tobacco smoke among non-smokers
  • where feasible, to reduce harm associated with continuing use of, and dependence on, tobacco and nicotine.

Quit and Smokefree messages were central to the National Tobacco Strategy 2004–09. The strategy noted that '[discouraging] initiation to smoking and [promoting] quitting, as well as not smoking around children, requires sustained and commercially realistic funding for campaigns'. This is necessary:

  • to keep quitting on people's agendas and to reach people as they cycle in and out of 'readiness to quit' at many times each year
  • to reach people at times in their life when they are vulnerable to messages about smoking, and times when they are more likely than usual to be responsive to encouragement to change.

The National Tobacco Strategy encouraged the promotion of hard-hitting, well-researched campaigns to:

  • encourage smokers to personalise the health risks of smoking
  • keep quitting on smokers' 'agenda'
  • increase understanding of the quitting process
  • promote treatments and services.7

The National Tobacco Strategy also encouraged promoting the advantages of not starting and of stopping before quitting becomes more difficult, as well as the advantages of parents quitting while their children are still young.

Increasing the promotion of Quit and Smokefree messages nationally supported other components of the National Tobacco Strategy, such as:

  • generating greater support for further regulation
  • promoting greater use of services and treatment for smokers
  • providing support for parents, carers and educators helping children develop a healthy lifestyle
  • supporting policies that reduce smoking as a means of addressing disadvantage
  • targeting communication messages and services to ensure access by disadvantaged groups
  • fostering collaboration in program policy and development.


i For copies of the WHO FCTC guidelines that have been adopted to date, go to: http://www.who.int/fctc/protocol/guidelines/adopted/en/

ii Refer to Sections 3f, 69 and 70 of the WHO FCTC guidelines for Article 13: Guidelines on tobacco advertising, promotion and sponsorship. Available from: http://www.who.int/fctc/protocol/guidelines/adopted/article_13/en/index.html

iii Refer to sections 29 and 30 of the WHO FCTC guidelines for Article 8: Protection from exposure to tobacco smoke. Available from: http://www.who.int/fctc/protocol/guidelines/adopted/article_8/en/index.html

iv Refer to Section 42 of the WHO FCTC guidelines for Article 11: Packaging and labelling of tobacco products. Available from: http://www.who.int/fctc/protocol/guidelines/adopted/article_11/en/index.html

v Refer to Sections 10, 44 and 60 of the WHO FCTC guidelines for Article 14: Demand reduction measures concerning tobacco dependence and cessation. Available from: http://www.who.int/fctc/protocol/guidelines/adopted/article_14/en/index.html

vi Refer to WHO FCTC guidelines for Article 12: Guidelines on education, communication, training and public awareness. Available from: http://www.who.int/fctc/protocol/guidelines/adopted/article_12/en/index.html

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1. Royal College of Physicians. Smoking and health: report of the Royal College of Physicians on smoking in relation to cancer of the lung and other diseases. London: Pitman Medical Publishing Co Ltd., 1962.

2. Gray N and Daube M. Guidelines for smoking control. UICC technical report series no. 52. Geneva: International Union Against Cancer, 1980.

3. Centers for Disease Control and Prevention. Ch. 1 Overview of counter-marketing programs. Designing and Implementing an Effective Tobacco Counter-marketing Campaign. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2003;Available from: http://www.cdc.gov/tobacco/stateandcommunity/counter_marketing/manual/index.htm

4. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization, 2003. Available from: http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf

5. Australian Government Department of Health and Ageing. Framework Convention on Tobacco Control. Canberra: Government of Australia, 2004 [viewed 14 October 2011]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-conv

6. Ministerial Council on Drug Strategy. Australian National Tobacco Strategy 2004-2009. Canberra: Department of Health and Ageing, 2005. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-strat

7. Ministerial Council on Drug Strategy. Meeting the challenges of the next five years-2: Ideas and resources for increasing promotion of Quit and Smokefree messages. National Tobacco Strategy, supporting documents. Canberra: Department of Health and Ageing, 2005. Available from: http://www.health.gov.au/internet/wcms/publishing.nsf/Content/phd-pub-tobacco-tobccstrat2-cnt.htm/

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