PowerPoint Presentation

truth campaignMike KendallCatherine MontoyaJames MontoyaCarmelita ParrazJohn SampsonNatalie Skogerboe

1Vintage Smoking Advertisements1964 Surgeon General ReportFocus on the link between smoking and lung cancer1965 Federal Cigarette Labeling and Advertising ActRequired Surgeon General Warning label printed on cigarette packs1967 70 Fairness Doctrine ActRequired TV Networks to balance anti and pro smoking ads1984 Comprehensive Tobacco Education Act (Public Law 98-474)Interagency Committee on Smoking and Health1989 National Cancer Institute Use activists to impact public opinion on smokingCDC booklet entitled Tips for Kids stated smokers were second class citizens1994 Clinton takes on kids smoking

Post War History of Anti Smoking

3truth campaign was based on the Florida Truth campaign, which reduced youth smoking rates

In 1998 Florida Department of Health launched a tobacco prevention program that featured a mass media campaign known as truth ( Farrelly et al, 2005).Florida Truth Campaign4A telephone survey of youths demonstrated that attitudes toward tobacco changed amongst Florida youth compared with youths in the rest of the United States after the first year. Florida Youth Tobacco Survey 18% and 8% among middle-school and high-school students after year oneAfter year two 40% and 18%Florida Truth Campaign5truth campaign Launched in 2000 by the American Legacy Foundation (Legacy)1st year had a budget of more than $100 million

6Market its message as a brand, like other youth brands (e.g., Nike, Sprite)Truth TV and print commercials feature what experts call edgy youths, promotional items, street marketing, and a Web site (www.thetruth.com)(Farrelly, 2002).Deliver stark facts about tobacco and tobacco industry marketing practicesCore Strategy of the truth campaign7You wont see statistics about the toll of tobacco, Farrelly. Emphasizing the long-term consequences of smoking is not as effective as addressing the more immediate problems, said Howard Willard, senior vice president of youth smoking at Philip Morris (Grand Rapids Press, 2002).

In comparison to Philip Morris ads8Only national youth smoking prevention program in the U.S. not sponsored by the tobacco industry (Holden, D. & Zimmerman, M., 2009, p. 124)Advertising spots in major metropolitan demographic market areas (DMAs)

truth Campaign9In December 1999, Legacy Media Tracking Survey (LMTS) fielded - primary evaluation tool 2000-2003In 2000, LMTS targeted specific racial and ethnic groups, 12-17 year oldsContinuous tracking-benefited media contractors, creative directors, and other stakeholders2nd wave of LMTS 10 months after launch of Truth found 75% exposureTelephone surveys10Exposure and recallMessage reactions and receptivityBehavioral determinants (knowledge, attitudes, and beliefs)Behavioral outcomesMedia EvaluationsMeasure 4 key process and outcome dimensions(Holden, D. & Zimmerman, M., 2009, p. 125)113 critical elements for successful youth tobacco prevention mediaTeen focused counter-marketingTalk to teens on their level, i.e. do not talk down to teensHighlight tobacco industrys failure to highlight addictiveness and health effects

(Columbia Marketing Panel, 1996; McKenna, Gutierrez, & McCall, 2000)12Process evaluationsMedia EvaluationsOutcome evaluationsAssess if the teens heard the Truth CampaignDetermine effects on health behaviorDid children react favorably Were children less likely to smoke?Creates Formative Feedback13Expose youth to truth messages and promote positive reactions to these messagesChange attitudes and beliefs towards tobacco useReduce tobacco use among youthThree Main Objectives14Overall looking at marketing campaignsTo promote or change consumer behaviorHealth communicationAffect consumer health behaviorSocial MarketingIncorporating business and social objectivesInfluence social behaviorTo benefit target market & society as wholeE.g. CDC or American Cancer SocietyMedia Evaluation15For Immediate Formative Feedback to enhance the campaign effortsProcess and Outcome data must happen simultaneouslyLooking at 4 key areas:Exposure & recallMessage reactions & receptivityBehavioral determinantsBehavioral outcomesWhy Need to Evaluate?16Relationship between evaluators, advertisers, and marketersEvaluation design and measurementEnvironmental factors external to campaignDifficulty to isolate and assess effects of TruthChallenges in Evaluation17Expose youth to Truth & get positive reactionsChange attitudes & beliefs towards tobacco use & companiesReduce tobacco use among youth3 Primary Objectives of truth 18For Objectives 1 & 2 (telephone):LMTS (Legacy Media Tracking Survey)For Objective 3 (in-school survey):ELM (Elaborate Likelihood Model)NYTS (National Youth Tobacco Survey)MTF (Monitoring the Future)Types of Evaluations Used19No control or comparison market - implemented nationally rather quicklyTherefore rely on quasi experimental comparison (dose of Truth)Many states built own campaignsTobacco control in prices & taxesPhilip Morris campaign - tobacco industryEvolving campaign & multiple stakeholdersMore Challenges20Pre- truth vs. During truth

21FIGURE 1: Aided and unaided awareness of the American Legacy Foundation's Truth campaign and Philip Morris's Think. Don't Smoke. campaign among 12- to 17-year-olds. From:Am J Public Health. 2002 June; 92(6): 901-907.Copyright American Journal of Public Health 2002% Change from Baseline to 10-Month Surveys

22Tobacco more prominent in minds of youthtruth campaign resonates more with youth than Think. Dont Smoke. even though that campaign aired more than 12 months prior to truth Findings

23Results from the 2 nationally representative surveys demonstrate that 10 months into the Truth campaign, tobacco was more prominent in the minds of youths. Unaided awareness of tobacco countermarketing campaigns has nearly doubled. The Truth campaign resonates more with youths than Think. Don't Smoke, even though the Think. Don't Smoke. campaign began in 1998 and aired for more than 12 months before the initial 10-month run of the Truth campaign reported here.

The percentage of youths who held anti-tobacco attitudes and beliefs increased by an amount that ranged from 6.6% to 26.4% during the first 10 months of the campaign, which compares favorably with the 10% average increase in Florida during the first year of the campaign

Farrelly MC, Healton CG, Davis KC, et al. Getting to the truth: evaluating national tobacco countermarketing campaigns. Am J Public Health 2002;92:901-907

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447480/Did the truth reach its Objectives?OBJECTIVE 1Expose youth to truth and get positive reactionsExposure and RecallMessage Reactions and Receptivity75% of 12-17yr old survey respondents recalled the ads YES! 24Branding was seen as a key strategy to reach the goal of reducing smoking, rather than to communicate a traditional public health message. The TRUTH appears to have done this.

25The areas with higher and lower exposure were used as natural controls. Evaluators and were able to determine that area of higher exposure and recall of truth campaigns has more significant outcomes. The target audience was exposed to the messages (process measure)

Did the truth reach its Objectives?OBJECTIVE 2Change Attitudes and Beliefs Toward tobacco use AND tobacco companies Behavioral DeterminantsSignificant changes in knowledge, attitudes and beliefs related to truth messagesYES! 26These findings show that some portion of the campaigns outcome measures were reached because youth knowledge, attitudes and beliefs were positively in proportion to the exposure to the ads. Did the truth reach its Objectives?OBJECTIVE 3Reduce tobacco use among youthBehavioral outcomesHow can these be attributed to the truth campaign?YES!? 27Some of the challenges mentioned by Catherine made this measure difficult to attribute to the TRUTH. There was already a declining trend for tobacco use among youth, there were a number of other antismoking ads and programs/initiatives occurring at the same time as TRUTHbut the evaluators were able to use the DOSE to determine the role of the TRUTH campaign in youth smoking reductions. SOURCE: Figure 6.2 in Holden & Zimmerman (2009) A Practical Guide to Program Evaluation Planning28This 22% decline in youth smoking equates to 300,000 fewer youth smokers!INSERT info from Ted Millers cost benefit ratios..Evaluators were able to survey a large number of youth because of the high levels of exposure to the campaignNo opportunity for experimental controlCampaign messages and evaluation tools changed over timeCould impact time seriesRequires decisions along the way as to which variables should stay and goEvaluators came up with creative ways to analyze dose-response relationshipsConclusions29Program developers believed it would be unethical to choose some areas that would not receive the messages since it showed such positive effects in Florida. Evaluators did a good job of keeping in touch with campaign developers and adapting their evaluation tools/questions with the campaign. This flexibility allowed for QI and rapid adjustment of campaign messages.

More discussion around what populations were of primary concern (i.e. geographic locations or ethnic groups with higher prevalence rates etc.)Also, how the messages were adapted to address those populationsCost savings resulting from the reductions in youth smoking Truth ads should expand its target groups to include: existing smokers, age groups (18-24), and youth who reside in non-urban locations. Group Reflections30Anti Smoking Ads Anti Smoking Ad Survey