Advocacy and Communication of Health Risks: Examples from Tobacco Control

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2 Advocacy and Communication of Health Risks: Examples from Tobacco Control Jeff Niederdeppe, Ph.D. Associate Professor, Cornell University

3 Overview of Presentation (Evidence from Tobacco Control) 1. What factors determine the success or failure of public communication campaigns targeting individual behaviors? 2. What impact can health risk messages have on support for policies to remedy those threats?

4 What factors determine the success or failure of public communication campaigns targeting individual behaviors?

5 When Do Health Risk Campaigns Work? 1. When they focus on BEHAVIORS and THEIR CONTEXT, not necessarily health risks per se Identify the intention(s) and behavior(s) you want to change, then work backward

6 Florida TRUTH Campaign Source: Niederdeppe, J., Farrelly, M.C., & Haviland, M.L. (2004). Confirming truth : More evidence of a successful tobacco countermarketing campaign in Florida. American Journal of Public Health, 94,

7 TRUTH Campaign Theory Source: Hersey, J.C., Niederdeppe, J., Evans, W.D., et al. (2005). The theory of the truth: How counter-industry media campaigns affect smoking behavior among teens. Health Psychology, 24,

8 TRUTH Campaign Effects Source: Farrelly MC, Davis KC, Haviland ML, et al. (2005). Evidence of a dose-response relationship between truth antismoking ads and youth smoking prevalence. American Journal of Public Health, 95(3),

9 When Do Health Risk Campaigns Work? 1. When they focus on BEHAVIORS and THEIR CONTEXT, not necessarily health risks per se 2. When they achieve frequent, widespread exposure for many sources over time Anti-tobacco campaigns 4 to 10+ ads/month Messages/campaign goes away so do effects Source: Durkin S, Brennan E, Wakefield M (2012). Mass media campaigns to promote smoking cessation among adults: An integrative review. Tobacco Control, 21,

10 Florida TRUTH Campaign Index of Campaign-Targeted Beliefs actual predicted, without budget cuts predicted, without budget cuts or Legacy Budget Cuts Legacy truth Apr-98 Sep-98 Feb-99 Jul-99 Dec-99 May-00 Month Source: Niederdeppe, J., Farrelly, M.C., Hersey, J.C., & Davis, K.C. (2008). Consequences of dramatic reductions in state tobacco control funds: Florida, Tobacco Control, 17,

11 Florida TRUTH Campaign Intentions to Avoid Trying Cigarettes 100% 95% 90% 85% 80% actual predicted, without budget cuts predicted, without budget cuts or Legacy Budget Cuts Legacy truth Apr-98 Sep-98 Feb-99 Jul-99 Dec-99 May-00 Month Source: Niederdeppe, J., Farrelly, M.C., Hersey, J.C., & Davis, K.C. (2008). Consequences of dramatic reductions in state tobacco control funds: Florida, Tobacco Control, 17,

12 When Do Health Risk Campaigns Work? 1. When they focus on BEHAVIORS and THEIR CONTEXT, not necessarily health risks per se 2. When they achieve frequent, widespread exposure for many sources over time 3. When the social and policy environment provides additional opportunities and motivation for change Tobacco examples: taxes, indoor smoking bans, restrictions on cigarette marketing Source: Wakefield MA, Loken B., & Hornik RC (2010). Use of mass media campaigns to change behaviour. The Lancet, 376(9748),

13 When Do Health Risk Campaigns Work? 1. When they focus on BEHAVIORS and THEIR CONTEXT, not necessarily health risks per se 2. When they achieve frequent, widespread exposure for many sources over time 3. When the social and policy environment provides additional opportunities and motivation for change 4. When they take the socio-economic context of the behavior into consideration in message design

14 WI Tobacco Cessation Ads Relationship between levels of education and recall of Wisconsin tobacco cessation ads emphasizing HOW to quit Source: Niederdeppe et al. (2008). Smoking cessation media campaigns and their effectiveness among socioeconomically advantaged and disadvantaged populations. American Journal of Public Health, 98,

15 HOW to Quit versus WHY to Quit Sources: Noar SM, Hall MG, Francis DB, Ribisl KM, Pepper JK, Brewer NT. (2015). Pictorial cigarette pack warnings: a meta-analysis of experimental studies. Tobacco Control, 25, Brewer NT, Hall MG, Noar SM. (2016). Effect of pictorial cigarette pack warnings on changes in smoking behavior: A randomized clinical trial. JAMA Internal Medicine, 176(7),

16 NY Tobacco Cessation Ads Source: Niederdeppe, et al. (2011). Socioeconomic variation in response to campaign advertisements to promote smoking cessation. Social Science and Medicine, 72,

17 What impact can health risk messages have on support for policies to remedy those threats?

18 Can Health Risk Messages Change Policy? Source: Slater, M. D. (2009). Integrating application of media effects, persuasion, and behavior change theories to communication campaigns: A stages-of-change framework. Health Communication, 11(4),

19 Can Health Risk Messages Change Policy? News media attention to health risks can promote increased legislative attention to these issues and local policy action Exposure to state tobacco cessation campaigns emphasizing secondhand smoke are associated with increased support for clean indoor air laws Sources: Niederdeppe, J., Avery, R. J., Skurka, C., & Kellogg, M. (under review). Market-level exposure to state antismoking media campaigns and public support for tobacco control policy in the United States, Niederdeppe, J., Farrelly, M. C., & Wenter, D. (2007). Media advocacy, tobacco control policy change, and teen smoking in Florida. Tobacco Control, 16,

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