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Designing an effective counteradvertising campaign-oregon

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Robert Wood Johnson Foundation and Boston University
School of Medicine Working Group: Creating Statewide
Tobacco Control Programs after Passage of a Tobacco Tax
Supplement to Cancer
Designing an Effective Counteradvertising
Anne Miller
Arnold Communications, Boston, Massachusetts.
OVERVIEW. In this report, the author reviews the major lessons from the Massachusetts tobacco counteradvertising efforts. Ms. Miller ties in the Massachusetts
three-pronged campaign of youth prevention, adult cessation, and public support
with focus group-tested counteradvertising strategies. Cancer 1998;83:2742–5.
© 1998 American Cancer Society.
he Massachusetts Tobacco Control Program (MTCP) was created by
a voter’s ballot initiative (Question 1) in 1992. A 25-cent-per-pack
cigarette tax funded this comprehensive tobacco control program aimed
at reducing tobacco use in Massachusetts. Massachusetts’ campaign, the
second in the country, was launched in 1993. Arnold Communications
looked to California’s experience to help guide a successful effort for
Massachusetts. The lessons learned were invaluable.
Campaign Overview
The Massachusetts campaign is comprised of three communications
objectives, each intended to play an integral role in the overall reduction of tobacco use. These are: 1) convince youth not to start smoking;
2) prompt smokers to quit; and 3) create a supportive environment for
a smoke free future.
To achieve each of these three objectives, the media targets a
different, distinct audience (Table 1).
The Role of the Media Campaign
Presented at the Robert Wood Johnson Foundation
and Boston University School of Medicine Working
Group: Creating Statewide Tobacco Control Programs after Passage of a Tobacco Tax, Waltham,
Massachusetts, October 3– 4, 1997.
Ms. Miller is an employee of Arnold Communications, which has a client relationship with the
Massachusetts Department of Public Health.
Address for reprints: Anne Miller, Arnold Communications, 101 Huntington Avenue, Boston, MA
Received September 17, 1998; accepted September 22, 1998.
© 1998 American Cancer Society
Each campaign differs not only by objective and target but in other
ways as well. The youth campaign itself is an intervention. It engages
children in a dialogue and advances the psychologic and social reasons to be smoke free. It directly counters the methods used by the
tobacco industry to deliver prosmoking messages. The campaign
complements the efforts of local youth programs that engage youngsters individually with messages regarding the benefits of being
smoke free.
By contrast, the media-driven cessation campaign serves a specific function within the general cessation program by reaching out
and beginning a dialogue with smokers. The campaign targets smokers who have long and short range plans to quit. The media’s role is
to accelerate smokers through these stages to create demand for
cessation and thus cessation services. These services then are provided by educational programs, the statewide Quitline, and health
care providers.
Effective Counteradvertising Campaign: Massachusetts/Miller
Media Targets for MTCP
Convince youth not to smoke
Youths ages 9–17 years
Prompt smokers to quit
Smokers ages 18–49 years
Create a supportive environment for a smoke free future
General public ages 25–54 years
MTCP: Massachusetts Tobacco Control Program.
Finally, in the public opinion campaign, media
plays yet another role by providing “cover” for policy
and local level initiatives. The campaign is a tool to
frame the debate. It can introduce an issue and create
“noise.” This not only sparks dialogue but can itself
become the environment. Through planning, the
MTCP can orchestrate media coverage to support individual community actions for maximum success.
The Process
The Massachusetts process for developing media messages is rooted in research.
Formative research
The process begins with a review of existing research
and interviews with experts in related fields to serve as
an “information dump.” The media team analyzes this
information and arrives at a variety of different marketing hypotheses.
A “voice of the consumer” plan is implemented to
elicit “consumer” responses and input on general tobacco issues as well as on specific hypotheses.
Whether the plan calls for a quantitative study, a series
of focus groups, or both, this process is dynamic. As it
unfolds, it becomes a guide to refining what is asked of
the “consumer.” In this way, hypotheses are confirmed, denied, or evolved into the most promising
communications strategies.
Message development
As a result of the formative process, the campaign
commits to key directions. Important questions must
be answered before we develop concepts: 1) to whom
is the message aimed; 2) what helpful information
regarding these messages is available; 3) what is the
single message to communicate; 4) what tone and
manner should be used; and 5) what justifies the
claims that are made? Once identified, specific ideas
for advertisements are checked with the “voice of the
consumer.” Putting the ideas in front of the target
audience tests whether the message is communicated,
relevant, understandable, and interesting. It also de-
termines whether there are any unintended negative
If the concepts check out on paper, they move into
production. Television spots are filmed and edited.
Media buys are made. The spots air.
Finally, once the campaign has aired, quantitative
evaluative research is conducted to assess the campaign on key measures. It is standard to appraise the
campaign on measures of awareness and attitudinal
change. The results of this research are diagnostic and
contribute to the formative process of new initiatives
within the campaign.
Lessons Learned
Lesson 1: youth–there is no one silver bullet
Youth are a very diverse target. It is not surprising that
9-year-olds are very different from 17-year-olds, but
there are even profound differences between ages 11
and 13 years. Age is only one of many factors that
affect the way children view and approach the use of
tobacco, and their responses to different motivational
stimuli regarding tobacco. Hence, it is necessary to
employ a variety of messages. The campaign must
identify those “motivators” that have the broadest impact on the population. The following types proved to
be most motivational.
Universal truths. Although youth are different, there
are a number of aspirations that are universal among
adolescents. The majority of teenagers aspire to having money to do what they want, looking good, being
attractive to the opposite sex, being a good athlete,
and being a good role model for younger brothers and
Smoking can be a barrier to achieving these goals,
and messages demonstrating how smoking hinders
these universal aspirations resonate with broad segments of young people. Specific message platforms
are: most teens don’t want to date smokers; smoking
causes shortness of breath; smoking causes wrinkles;
smoking costs $1000 a year; and smoking leads
younger siblings to smoke.
Industry manipulation. Having grown up in a world in
which the media constantly exposes individuals’ and
companies’ immoral acts, children are extremely cynical. This generation’s reaction has been to live and let
live. They are quick to excuse the tobacco executives
as simply doing their jobs. When we can expose the
tobacco industry as different from other industries
CANCER Supplement December 15, 1998 / Volume 83 / Number 12
because they manipulate the public, this crosses a line
for youngsters, putting the tobacco industry in a category apart from all other big business. Specifically,
the tobacco industry is positioned as dishonest, manipulative, and trading lives for profits.
Young people will reject any implication that they
personally have been manipulated by advertising or
imagery. This outright rejection of being manipulated
breaks down the credibility of any positioning that
supports this personal manipulation. By generalizing
the manipulation, youngsters can accept the argument. They are more apt to agree that younger children or their friends are manipulated than they are to
agree that they are to agree that they are personally
sure); the lack of control; and the indiscriminate nature of addiction (it can happen to anyone who
smokes a cigarette, anytime).
Addiction. The universal aspirations noted earlier and
industry manipulation are the basis for broad stroke
messages that resonate across many youth segments.
It also is important to discern which messages effectively reach the most at-risk sector of this population.
In identifying those groups with both the greatest
intentions to smoke and the highest uptake, the campaign found (consistent with other studies) that the
key age of cigarette uptake is between 11 and 14 years.
In addition, an examination of psychographic and attitudinal characteristics of the high propensity groups
showed them to have the following profile: more likely
to get in fights; do not like school; enjoy risky behaviors; come from families that smoke; and have friends
who smoke.
Universal aspiration messages resonated with
“high risk” youngsters and the general youth population. We also found that high risk youngsters often
were surrounded by cigarettes and cigarette smokers.
Even as nonsmokers, they believed they had an intimate knowledge of cigarettes and purported to understand addiction. In their opinion, addiction was real
and was a commonly heard reason not to smoke.
However, nonsmokers in the high risk group tended to
minimize the strength of the addiction claim. They
equated addiction to what they could relate to “It’s
like wanting a piece of chocolate really bad. . .” Only
addicted smokers demonstrated a realistic knowledge
of the properties of addiction.
The campaign identified this gap between their
perception versus the reality of addiction as an opportunity. Given that high risk youth believed addiction
existed and was a reason not to smoke, demonstrating
the power and control of a nicotine addiction gave
meaning to their belief that such addiction was a
reason not to smoke. Addicted youngsters perceive
three different characteristics of addiction that the
campaign has addressed: the physical nature (pres-
Rewards. The final message category is a direct response to the tobacco industry’s promotional tactics.
The campaign turns their proposition around and offers children prizes for choosing a smoke free lifestyle.
Emotional benefits. All of the above motivators are
rational reasons not to smoke. Successful advertisements persuade consumers with a rational argument
and seduce consumers with an emotional benefit.
Adolescent smoking has its roots in the emotional
gratification that smoking behavior offers. Young people want to be “cool” and this is the image that they
associate with cigarettes. To counter this strong emotional “promise,” antismoking media campaigns must
create an alternative emotional promise for a smoke
free life-style.
Lesson 2: adult smokers–acknowledge readiness to quit
In exploring the role of advertising in encouraging
adults to quit smoking, the campaign learned that
smokers vary by mindset and can be categorized along
a quit continuum. Smokers are located somewhere
along a continuum based on their readiness to quit.
“Pre-Contemplators” are smokers with no intention or
plans to quit smoking. At the other end of the continuum are “Active Quitters.” In the middle are “Contemplators,” those who have long term plans to quit, and
“Ready-to-Quits,” those who have short term plans to
Rather than targeting all smokers with the goal
of convincing them to quit, the campaign addressed specific smokers with the goal of moving
them one step closer to cessation. Behavioral theory suggested that those who are closer to quitting (“Contemplators and Ready-to-Quits”) were
most receptive to “helping relations.” The campaign attempted to establish such relations by creating a personal trust, a message of encouragement,
and an empathic tone. Messages regarding the benefits of quitting were most motivating to “Contemplators.”
Conversely, “Pre-Contemplators” were most motivated by negative environmental and social pressure.
To inspire movement among this group, the campaign
focused on the negative consequences of smoking. To
achieve maximum impact from these messages, the
media effort orchestrated their exposure in a way that
alternated the positive benefits of quitting with the
Effective Counteradvertising Campaign: Massachusetts/Miller
negative consequences of smoking, “pushing” and
“pulling” the smoker along the continuum.
Lesson 3: public opinion–activate the middle
To create an environment for a smoke free future, it is
important to have the backing of the majority. In this
way, advertising tobacco is like issue marketing rather
than product marketing. There are staunch supporters
on both sides of the tobacco issue. To win, tobacco
control programs must capture the large group that
currently is in the uncommitted middle. To capture
the middle, we need to succeed on two fronts: numbers of supporters and conviction of supporters.
Number of supporters
In convincing this uncommitted middle that tobacco
is an important issue, the most compelling message
may be secondhand smoke. Secondhand smoke repositions the tobacco issue from its current standing as a
persons’ right to smoke, to a new place, a persons’
right to breathe.
A corollary to the secondhand smoke message is
acknowledging that the middle group are not zealots
and will defend their smoking friends. Messages must
be absolutely clear that the smoker is not the enemy
and the issue does not pit smokers against nonsmokers. Rather, it is an issue of society against the tobacco
Although changing the attitudes of the middle is important, it is not enough. Victory cannot be claimed
until there is conviction. Attitude changes must give
way to beliefs. To accomplish this transition, there
must be an emotional reason to care. The research
conducted during the ballot initiative identified the
emotional platform for this issue as protecting children. Even smokers agreed that protecting youth was
a good reason to tax cigarettes.
The campaign returns to the theme of protecting
youth periodically to serve as a reminder of this underlying goal and rallying cry. Protecting youth from
access, marketing, and exposure to secondhand
smoke all strike an emotional chord and serve to inspire conviction. The combination of conviction and
numbers will produce the support necessary for action
at the community level.
Massachusetts was one of the first states to embrace a
multifaceted approach toward the overall goal of reducing tobacco use. These three initiatives (youth prevention, adult cessation, and public support) have all
contributed toward the overall success of the program
to date.
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