Digital media and tobacco control: Building the evidence base Rhiannon Newcombe, Iain Potter

1. Digital media and tobacco control: Building the evidence base Rhiannon Newcombe, Iain Potter Health Sponsorship Council Karen Gutierrez Global Dialogue

2. Global Dialogue • Global Dialogue for effective stop-smoking campaigns • Since 2005 • Work internationally to improve campaigns • US-based • Numerous initiative partners

3. Why are communication strategies important? • Part of a broad, comprehensive tobacco control programme • Evidence of benefit • Decrease youth uptake • Increase cessation • Reduced prevalence • Traditional channels: • TV, radio, print, outdoor, billboard

4. Traditional channels

5. How are digital media defined? For purposes of this presentation: Computerised, or networked information and communication technologies. Examples: Websites Blogs Text messaging Cell phone communications

6. Why are digital media important? • Embraced by business sector • Tobacco industry using extensively • Ad bans don’t usually including digital vehicles • Facebook “fan” pages have been created for brands such as Marlboro, Peter Stuyvesant and Lucky Strike • Camel brand engaged online community to help design a new cigarette packet - 5 million adult smokers had been invited to give their input • Our audience use in everyday lives • Calls that we should be using in public health

7. Use by audience 1 Smith, P., Smith, N., Sherman, K., Goodwin, I., Crothers, C., Billot, J., Bell, A. (2010). The Internet in New Zealand 2009. Auckland: Institute of Culture, Discourse and Communication, AUT University. 2 Research New Zealand (2009). New Zealanders’ Use of Broadcasting and Related Media. Wellington. 3 Stats NZ

8. What do we know about impact of digital media campaigns? • Not enough • Many countries are using some form of digital media in their campaigns, however, too few are measuring outcomes • “process” measures easy to find (i.e., # visitors to site, # text message responses, time spent on site) • “outcome” measures more difficult (i.e., increases in knowledge, changes in attitudes, changes in behaviors)

9. International Review of Lessons Learned from Digital Campaigns • Not a comprehensive literature review • Used international networks • Gathered lessons learned • Reflect 8 lessons learned to date • Work in progress

10. International Review of Lessons Learned from Digital Campaigns Country Case Studies: • Australia (2) • Canada (4) • China • Denmark (2) • England (5) • European Union (2) • Germany • Israel • Netherlands • New Zealand (2) • Norway • Singapore • United Kingdom • United States (6)

11. #1: Digital media can reach diverse audiences Examples: • New Zealand: Maori • England: Routine and Manual workers (“blue collar”) • Singapore: Parents of young children • Many countries: teenagers, young adult smokers, all smokers

12. Singapore “Kids Watch. Kids Learn.” http://www.oureverydaythings.com/2009/08/smoking-kids-watch-kids-learn/ http://www.babyandpapa.com/forums/forum113/thread1470.html Influential Blogger Engagement

13. #2: People want to be engaged

14. Concept only

15. #3: Participants like digital interacting because it’s anonymous and personal • Denmark • Personal weight calculations • Personal online advice (based on individual’s input) • Discussion forum • Diary

16. Switzerland “Feelok” home page

17. New Zealand web banners

18. #4: Variety of digital vehicles can increase participants’ involvement United Kingdom: Viral seeding and video sharing

19. US (Minnesota) “QuitCash”Recruitment Email Blast

20. Quitcash.com Sign Up for Text Messages Mobile Welcome Text Message is sent immediately after user provides cell phone number and hits submit.

21. Mobile Sign Up Same entry fields as online signup page. Intro Text Includes: “click to call” to the QUITPLAN Services Scroll Choice of weekly tips sent to email or mobile phone. Click to call QUITPLAN & link to website. WAP Signup Page

22. Quit Tips Email and Videos

23. #5: Digital campaigns inexpensive, but reach limited and measurement critical • UKYouth Anti-Smoking Video Competition: 108,000 views of winning videos across video sharing sites and seeding network ($1.63 per view) • England: Yahoo Forum • 300,000+ visitors (39,000+ visits of 5+ minutes) • Almost 4000 smokers pledged to quit smoking (each cost NHS 1/3 of what normal TV campaign costs to achieve) • England: MSN partnership • 160,000 unique visitors over 6 weeks • Cost per active response of approx. $7.50 (the lowest of all media responses, including TV)

24. “Smoke-free Ride” Results Canada: Campaign for a Smoke-free Ride • Campaign to influence parents not to smoke in cars and increase support for legislation • Measured awareness, main message communication, attitudes & claimed behaviors Findings • 86% awareness among parents • ‘Smoking in cars with children is illegal’ most commonly recalled message • Those who recalled Campaign in greater disagreement with statement ‘Smoking in cars with children won’t harm them as long as you leave the windows open’ than those who didn’t recall campaign • Those who recalled Campaign messages less likely to report smoking in cars with children.

25. Xhale Results • Smoking cessation support • 12-month follow-up study • Intervention > control to be Smokefree at 1 year follow-up • Positive feedback on content and form • Attracted target audience (15- to 25-year-olds)

26. #6: Digital campaigns can benefit from saliency of traditional media • Nielsen (2010) • TV has far greater reach • Web advertising helps TV campaigns work ‘harder’

27. England

28. Canada “Smoke-Free Ride” Materials

29. #7: Needs to be part of a broader strategy • One-off approaches less successful • Needs to be integrated • Strategy important

30. #8: Internet opens your program to everyone in the world • Benefits: inexpensive way to publicise your program and key messages • Also a way to help target a global problem • Drawbacks: difficult to determine whom you are reaching and whether they are in the scope of your target audience(s) • Your cost per participant or per visitor may include people who you aren’t interested in reaching

31. New Zealand • Example – viral games developed in New Zealand Kiss Off Kanvas

32. Smoking Not Our Future Example 1: Kiss Off • Application on FB, Bebo, and seeded into global viral gaming sites • 450,000 visits, including 22,000 from NZ • NZ visits ranked 6th Example 2: Kanvas • Linked to NZ campaign website • 26,500 visits, including 25,000 from NZ • NZ visits ranked 1st

33. Summary of Lessons Learned • Digital media provide excellent means to reach diverse audiences, not just youth and high-income • People want to be engaged—want to be heard and give advice (e.g., stories and experiences), to build relationships • Participants like interacting digitally because it feels both anonymous and personal/tailored • A variety of digital vehicles and relationships (Internet, mobile messaging, IVR, etc.) can increase the participants’ involvement in the program • Digital campaigns can reach many people quickly and inexpensively, however numbers typically in thousands not millions, and outcomes are critical to measure • Digital campaigns can benefit from the saliency of traditional vehicles • Digital campaigns need to be part of a broader strategy • The Internet opens your program to everyone in the world—has benefits and drawbacks

34. Contact Information Karen Gutierrez Global Dialogue for Effective Stop-Smoking Campaigns global@stopsmokingcampaigns.org For campaign development resources and summaries of lessons learned, visit: www.stopsmokingcampaigns.org Rhiannon Newcombe Health Sponsorship Council rhiannon@hsc.org.nz

36. US time spent on internet Source: http://blog.nielsen.com

37. Use of digital media is changing • 40% of time by US online users spent doing three things: • Social networks • Online games • E-mail • Increase in time spent on social networking sites and online games; email decreasing