BACKGROUND: While television advertisements (ads) that communicate the serious harms of smoking are effective in prompting quitting-related thoughts and actions, little research has been conducted among smokers in low- to middle-income countries to guide public education efforts. METHOD: 2399 smokers aged 18-34 years in 10 low- to middle-income countries (Bangladesh, China, Egypt, India, Indonesia, Mexico, Philippines, Russia, Turkey and Vietnam) viewed and individually rated the same five anti-smoking ads on a standard questionnaire and then engaged in a structured group discussion about each ad. Multivariate logistic regression analysis, with robust SEs to account for the same individual rating multiple ads, was performed to compare outcomes (message acceptance, perceived personalised effectiveness, feel uncomfortable, likelihood of discussing the ad) across ads and countries, adjusting for covariates. Ads by country interactions were examined to assess consistency of ratings across countries. RESULTS: Three ads with graphic imagery performed consistently highly across all countries. Two of these ads showed diseased human tissue or body parts, and a third used a disgust-provoking metaphor to demonstrate tar accumulation in smokers' lungs. A personal testimonial ad performed more variably, as many smokers did not appreciate that the featured woman's lung cancer was due to smoking or that her altered physical appearance was due to chemotherapy. An ad using a visual metaphor for lung disease was also more variable, mostly due to lack of understanding of the term 'emphysema'. CONCLUSION: Television ads that graphically communicate the serious harms of tobacco use are likely to be effective with smokers in low- to middle-income countries and can be readily translated and adapted for local use. Ads with complex medical terms or metaphors, or those that feature personal testimonials, are more variable and at least require more careful pre-testing and adaptation to maximise their potential.
BACKGROUND: While television advertisements (ads) that communicate the serious harms of smoking are effective in prompting quitting-related thoughts and actions, little research has been conducted among smokers in low- to middle-income countries to guide public education efforts. METHOD: 2399 smokers aged 18-34 years in 10 low- to middle-income countries (Bangladesh, China, Egypt, India, Indonesia, Mexico, Philippines, Russia, Turkey and Vietnam) viewed and individually rated the same five anti-smoking ads on a standard questionnaire and then engaged in a structured group discussion about each ad. Multivariate logistic regression analysis, with robust SEs to account for the same individual rating multiple ads, was performed to compare outcomes (message acceptance, perceived personalised effectiveness, feel uncomfortable, likelihood of discussing the ad) across ads and countries, adjusting for covariates. Ads by country interactions were examined to assess consistency of ratings across countries. RESULTS: Three ads with graphic imagery performed consistently highly across all countries. Two of these ads showed diseased human tissue or body parts, and a third used a disgust-provoking metaphor to demonstrate tar accumulation in smokers' lungs. A personal testimonial ad performed more variably, as many smokers did not appreciate that the featured woman's lung cancer was due to smoking or that her altered physical appearance was due to chemotherapy. An ad using a visual metaphor for lung disease was also more variable, mostly due to lack of understanding of the term 'emphysema'. CONCLUSION: Television ads that graphically communicate the serious harms of tobacco use are likely to be effective with smokers in low- to middle-income countries and can be readily translated and adapted for local use. Ads with complex medical terms or metaphors, or those that feature personal testimonials, are more variable and at least require more careful pre-testing and adaptation to maximise their potential.
Authors: Eric C Leas; Mark G Myers; David R Strong; C Richard Hofstetter; Wael K Al-Delaimy Journal: Am J Public Health Date: 2015-02 Impact factor: 9.308
Authors: Melanie A Wakefield; Kerri Coomber; Sarah J Durkin; Michelle Scollo; Megan Bayly; Matthew J Spittal; Julie A Simpson; David Hill Journal: Bull World Health Organ Date: 2014-03-18 Impact factor: 9.408
Authors: Elizabeth A Kilgore; Jenna Mandel-Ricci; Michael Johns; Micaela H Coady; Sarah B Perl; Andrew Goodman; Susan M Kansagra Journal: Am J Public Health Date: 2014-04-17 Impact factor: 9.308
Authors: Amy McQueen; Erika A Waters; Kimberly A Kaphingst; Charlene A Caburnay; Vetta L Sanders Thompson; Sonia Boyum; Matthew W Kreuter Journal: J Health Commun Date: 2016-07-13
Authors: Li-Ling Huang; James F Thrasher; Erika Nayeli Abad; K Michael Cummings; Maansi Bansal-Travers; Abraham Brown; Gera E Nagelhout Journal: Health Educ Behav Date: 2015-01-14
Authors: Sarah Parvanta; Laura Gibson; Heather Forquer; Dina Shapiro-Luft; Lorraine Dean; Derek Freres; Caryn Lerman; Giridhar Mallya; Mihaela Moldovan-Johnson; Andy Tan; Joseph Cappella; Robert Hornik Journal: Soc Mar Q Date: 2013-12
Authors: Li-Ling Huang; James F Thrasher; Yuan Jiang; Qiang Li; Geoffrey T Fong; Yvette Chang; Katrina M Walsemann; Daniela B Friedman Journal: Tob Control Date: 2014-05-09 Impact factor: 7.552