Tobacco use has always been a major health issue in Australia, being the cause of around 15,000 cancer cases per year. Since the 1970s, the Australian government has been using media campaigns and legal restrictions in order to reduce smoking rates, encourage smokers to quit, and increase their awareness of the dangers of the habit. For two decades, they have been having an effect, and the country witnessed a steady reduction of the number of smokers in the 1980s and the beginning of the 1990s, followed by a stagnation in the middle of the decade (Hill & Carroll, 2003). Although the number of smokers dropped from 37% in 1977 to 24% in 1995 (Australian Bureau of Statistics, 2000), millions of Australians continued to smoke cigarettes and use other tobacco products. It encouraged the government to put forward an initiative to develop a national anti-smoking campaign.
The National Tobacco Campaign was launched in 1997 and was the longest and most prominent public health campaign in Australia. In order to develop an effective advertising strategy, the initiative group undertook an extensive review of scientific data based on 40 years of health studies and market research reports prepared by various Australian state Quit campaigns (Australia’s National Tobacco Campaign, Evaluation Report Volume One, p. 11, 1999). The campaign was a collaboration between advertising agencies, media companies, non-government organizations, national and state governments and set the tone for all future Australian public health campaigns.
The campaign was aimed at adult smokers aged 18–40 years, and its primary task was to encourage people to put quitting higher on their personal agenda. It established that in order to quit, smokers need to gain fresh insights on the dangers of smoking, build confidence in their ability to quit, and see the benefits of cessation. The main task of the campaign’s creative strategy was to come up with the message that smokers would find personally relevant, to instill this message, and remind people of it so often that it remained on their agenda.
The National Tobacco Campaign featured TV ads, radio advertisements, and print advertising materials encouraging smokers to quit and depicting the harms of cigarettes and other tobacco products. Television advertisements created by Brown, Melhuish, and Fishlock agency constituted the core campaign materials designed to have the most impact (The History of the National Tobacco Campaign, 2018). Starting from the launch of the campaign in 1997 and up to 2000, six advertisements were produced: ‘Artery’, ‘Lung’, ‘Timor’, ‘Brain’, ‘Eye’, and ‘Tar’. Each had four distinctive components designed to achieve a certain purpose:
- A depiction of a typical smoking situation meant to show that the advertisement is aimed at helping smokers, not intimidating them.
- A sequence of images linking the act of lighting and inhaling a cigarette with the harm the smoke does when it enters the body.
- Information about the harm of smoking, with each advertisement focused on a particular problem.
- A slogan “Every cigarette is doing you damage” intended to stress the immediate and ongoing effect of smoking instead of the long-term consequences (Hill & Carroll, 2003).
The idea was to show the harm cigarettes do in a new way that was both frightening, enlightening, and thought-provoking, and to develop a direct association between the scary images of damaged organs and body parts, and smoking. The ‘Lung’ advertisement depicted emphysema damage, the ‘Brain’ outlined the mechanism of a smoking-related stroke, while ‘Artery’ showed a human aorta filled with fatty deposits (Quitline New Zealand). The vital part of the development process was the collaboration between the advertising agency behind the campaign and medical experts specializing in the neurology, respiratory, and cardiovascular fields. It ensured that the health damage mechanisms depicted in the advertisements were accurate.
The campaign focused on ‘scare tactics’ to stimulate the response in the viewers. Associating smoking with fear for one’s health was intended to encourage quitting behavior, emphasizing that in order to get rid of fear, one needs to quit. The slogan “Every cigarette is doing you damage” accentuated the relatively certain rather than less possible effects. In order to aid those who want to quit, each advertisement featured the Quit hotline number.
The National Tobacco Campaign results have been extensively researched and examined, with several articles in the Tobacco Control journal and three volumes of evaluation reports published in the following years. The research showed a noticeable reduction of smokers over the period of the campaign with a decline from 23,5% of tobacco users in May 1997 to 20,4% in November 2000 (Cancer Council, p. 16, 2012). However, the researchers were faced with a problem evaluating the impact of the campaign itself, as together with the campaign, several other initiatives were introduced, including a significant increase in the taxes and tobacco products prices.
Nevertheless, the survey results showed that the advertisements were recognized by around 90% of viewers. Almost half of the smokers who saw and remembered the campaign messages said that they made them more willing to quit and provoked constant reflections about the harm they are doing to themselves (Australia’s National Tobacco Campaign, Evaluation Report Volumes One & Two). Essentially, the campaign greatly contributed to the steady reduction of smoking prevalence in Australia.
The National Tobacco Campaign proved to be effective and provided an approach that was adopted by many future health campaigns both in Australia and abroad. The evaluation reports showed that anti-smoking advertisements cause a number of positive effects, including the development of a negative attitude towards smoking, and an increase in the awareness of health risks (Australian Government Department of Health, 2019). Despite some criticism, the results and methods of the campaign have been extensively used in advertising and government anti-tobacco strategies.
The campaign’s design concept was based on a combination of two principles: expert knowledge and fear factor, which was successful but also caused some criticism. The first feature of the campaign was that it relied on expert knowledge to channel the messages to the audience. The images of damaged organs and body parts used in the advertisements required an expert commentary and explanation in order for them to be understood by the general public. Without a descriptive narrative, the visual portrayal of a blocked aorta may be less able to provoke an emotional response from viewers (Hill, Chapman, & Donovan, 1998). This method proved to be successful and was used in many later campaigns.
The second feature was the implementation of ‘scare tactics’ and images that provoked a shock response. The campaign has been seen by many as “the mother of all scare campaigns” based on the belief that ‘scary’ health consequences are the primary motivation for smoking cessation (Hill, Chapman, & Donovan, 1998). However, although successful, the messages emphasized the medical dichotomy between healthy non-smokers and unhealthy smokers, resulting in the stigmatization of smokers (Thompson, Pearce, & Barnett, 2009). The more rational solution would be to use messages that included the fear elements without arousing a state of emotional distress in people who continue to smoke.
The National Tobacco Campaign demonstrated that effective health campaigns require medical, behavioral, marketing, and psychological expertise to provide scientifically accurate content and ensure that the presentation is effective yet not too severe. The methods used in the National Tobacco Campaign, including messages providing new information about the dangers of smoking and encouraging smokers to put quitting high on their personal agenda, are continued to be used in other anti-smoking campaigns. However, the fear-based approach is increasingly changing to a more positive one, designed to motivate rather than frighten viewers.
Australian Bureau of Statistics. (2000). Health Risk Factors: Trends in Smoking. Web.
Australian Government Department of Health. (2019). National Tobacco Campaign. Web.
Australia’s National Tobacco Campaign, Evaluation Report Volume One. (1999). Web.
Cancer Council. (2012). Tobacco in Australia: Facts & Issues (4th ed.). Chapter 14. Social marketing and public education campaigns. Web.
Hill, D., & Carroll T. (2003). “Australia’s National Tobacco Campaign.” Tobacco Control, 12 (Suppl. II), ii9–ii14. Web.
Hill D., Chapman S., & Donovan R. (1998). “The return of scare tactics.” Tobacco Control, 7, pp. 5–8. Web.
The History of the National Tobacco Campaign. (2018). Web.
Thompson L., Pearce J., & Barnett J. (2009). “Scared straight? Fear-appeal anti-smoking campaigns, risk, self-efficacy and addiction.” Health Risk & Society, 11(2), pp. 181–196. Web.
Quitline New Zealand. (2016). Every Cigarette Is Doing You Damage – Aorta. YouTube. Web.