Smoking cessation is a global priority, with the WHO recommending that HCPs (healthcare providers) offer patients a comprehensive set of interventions to support individuals. This includes behavioural support, digital tools and pharmacological treatments, and often a combination of all three.
With 750 million tobacco users worldwide, clearly effective mass comms with patientsmust also be a priority; we can’t rely on 1-2-1 interactions with primary care to promote support, we need smart smoking cessation communication using mass media, as well as owned channels.
Our interest is in helping commissioners to understand the complex audience of smokers, to create compelling smoking cessation campaigns that promote available interventions and drive long-term behaviour change. That includes insight-driven campaigns and behavioural science-led campaign structure.
Using insight to drive effective smoking cessation campaigns
Typical approaches to smoking cessation focus on top-down health messaging, using varying tactics including Fear Appeal and more nurturing messages to encourage quitting. You’ll have seen the type: clogged arteries at one end of the spectrum, through to Better Health campaign’s ‘And Breathe’ messaging at the other.
Both tactics have their place but only as part of a strategy. Assuming a one-and-done campaign approach is the solution simply will not deliver the long-term behaviour change that is needed around smoking cessation. A heavily nuanced, insight-driven campaign strategy is needed.
In any campaign, building creative from audience insights supports emotional connection, helping brands and communications lodge in the System 1/limbic brain. We usually recommend local primary research to build detailed personas, and to provide a robust, defensible backdrop to all activity to aid decision-making. It will also be useful to benchmark understanding of local services and pathways, and show behaviour change over time.
However based on our own primary and secondary research, we know the following to be true:
- Smokers have personal relationships with their habit. Many realise at least some negative impact that their smoking habit has – whether on their own health, their families, finances, etc – but have barriers and objections to quitting, which need to be carefully dismantled.
- Barriers and objections to quitting will change over time. It can take c.30 attempts to quit smoking, showing real dedication, especially in those who succeed, and also highlighting again the need for sticky communications so the campaign/offer is easily recalled as people progress along the path towards quitting.
- Co-morbidities often occur with smoking, including mental illness, which can have an adverse impact on quit attempts. Communicating about smoking in a vacuum is insensitive and likely ineffective.
- People from minoritised communities are more likely to smoke.** These groups are, however, just as motivated to quit as other smokers, but they tend to be more addicted, and to face greater barriers in quitting, and,
- Social pressures, especially in minoritised communities, can perpetuate smoking, as can reduced social support for quit attempts and reluctance to engage in ‘top-down’ or authority-led support and schemes.
To tackle health inequalities we must focus on greater understanding of these communities (see below), and upweight our efforts to reach these groups.
Structuring smoking cessation campaigns using behavioural theory
The Transtheoretical Model of Change is particularly usefulin smoking cessation asit’s focussed on changing health behaviours, recognising that this isn’t linear, as well-evidenced in smokers’ 30+ attempts at quitting. In particular ourStrategist Em Blalock, a trained Health Coach, is expert in adapting this model to apply to a range of issues/challenges.
These frameworks lead our content approach and our marketing strategy; by using a model such as this as a structure for messaging over multiple touchpoints – above-the-line campaign, community care, HCP/primary care, etc – we can create multi-pronged strategies that meet people where they are, and create deep, nuanced messaging frameworks that guide behaviour change over time, even as motivations change.
Co-creation challenges
A final note on co-creation. We believe that co-creation processes are important in ensuring creative and messaging resonates with a diverse range of individuals, addressing their unique challenges. This is particularly necessary in smoking cessation, given the over-indexing of minoritised audiences who smoke. That said, the very nature of our audiences adds complexity to co-creation processes that it is our responsibility to overcome. For example, we know first-hand (and it is evidenced) that people in poverty are less likely to engage with co-creation sessions. Ethnic minoritised groups are also less likely to want to engage with government and perceived top-down institutions, so it can be harder to fairly represent their voice in the process.
These are all challenges that should be discussed early and mitigations sought (exactly what our process does so well), so that a smoking cessation campaign, and any other health behaviour change campaign, can really and truly represent the voices of the people it needs to serve.
Summary
To conclude, when it comes to smoking cessation, only deep audience insight can drive the nuanced campaign approach that is needed to guide our audiences towards long-term behaviour change. Whether working solo, in-house or with an agency such as ourselves, we’d urge you to really understand the many, varied factors that drive smoking and keep people smoking, and speak to them over a sustained period of time. That’s how real behaviour change will happen.
For more information on how we deliver campaigns that promote long-term behaviour change, contact Rachel: Rachel@threetenseven.co
*We refer to smokers but include all tobacco users, including smokeless tobacco products, heated tobacco products (HTPs), cigars, etc.
**We use the term ‘minoritised’ because itactively emphasises the fact that individuals have been minoritised through systemic processes/oppression, i.e. this is something that is/has been done by other people. The Law Society explains this well.
