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anti smoking

By Andrea-Zhao Xiwen May 23, 2015 4281 Words
A Social Intervention – Anti-smoking
Smoking is a habit, which is widely observed throughout the world. This phenomenon is noticeable in every country, region, culture and religious orientation and social classes. Both genders smoke so as almost every age. When we speak about smoking, we are actually talking about smoking a particular herb known as “tobacco”. Usage of tobacco is so widely spread that it impossible to think that humans were ever free from its use. This perception is contrary to reality. The old world as we know it were free from tobacco before 15th century. (World health organization, n.d.). Tobacco is the product of a plant known belonging to Solanaceae (nightshade) family. The genus is nicotiana. This plant is native to North and South America and has been growing there for thousands of years. The plant was not known in the old world until Columbus discovered America and brought the “strange leaves” to the old world. The Native Americans used tobacco is various religious and social activities. It was used in religious ceremonies of human sacrifice and priests and laymen both used it. This use was almost universal throughout the Americas. The tobacco plant was used in various forms, either smoked in pipes, or chewed or snuffed. Warriors and royalty used it alike. Sometimes tobacco was used in conjunction with other psychotropic plants especially during religious ceremonies. The so-called narcotic properties of tobacco were responsible for this use. Apart from the religious and social use of tobacco the most important use of tobacco was medicinal use. The plant was used universally in the Americas for its medicinal properties, especially against “rheumatism” and skin and respiratory problems. When the Europeans encountered the tobacco use of the natives, they accepted the myths about its benefits and brought these to Europe and old world. The tobacco fashion took the world like a storm and within 150 years, its use was widely spread throughout the world. (Young, n.d.) With the spread of tobacco, its commercial cultivation was started. The slave trade was at the heart of tobacco cultivation and large fields were cultivated with tobacco. During the 18th century the most import, use of tobacco was as a snuff. Cigars were more fashionable in the 19th century and 20th century saw the rise of mechanized cigarette making industry and it resulted in wide spread availability of cigarettes along with aggressive marketing leading to a phenomenal increase in number of smokers. By the start of 21st century, about one third of the adults used tobacco and more and more women were using cigarettes. During all this, many attempts were made by kings and the governments in various parts of the world to discourage people from smoking but these were not successful. (World health organization, n.d.) With increasing use of tobacco throughout the world, the awareness about its adverse effects was increasing gradually. In 1964 Luther L. Terry, M.D., Surgeon General of the U.S. Public Health Service, released the first report of the Surgeon General's Advisory Committee on Smoking and Health. The report stated that cigarette smoking cased lung and laryngeal cancer in men and most probably was a cause of lung cancer in women. He further concluded that smoking was the most important cause of chronic bronchitis. With this report, efforts were started at the government level in the United States of America to control the tobacco use in public. Laws were passed in United States, which required health warnings to be published on cigarette packs. Campaigns and public awareness messages were started in mass media to inform the public about the harmful effects of the smoking. Similar efforts were started in Europe and rest of world as well. Despite these continuous efforts, which have increased chronologically, more than 45 million adult Americans still, smoke. It is estimated that, around 438,000 Americans will die before time due to smoking and around 8 million are suffering a serious disease caused by smoking. (Center for Disease Control USA, 2009) Tobacco is the leading cause of death, which could be prevented, and the worse affected countries are the low and middle-income countries of the world. These countries are the targets of the big tobacco industry and their aggressive marketing campaign. It has been estimated that tobacco and its various products have resulted in deaths of 100 million people in the 20th century and it is feared that 1 billion people will die from tobacco use in 21st century. One in 10 adult deaths are due to tobacco use and around 5 million people die each year due to tobacco. It is further projected that most deaths around 80% will happen in the low and middle income countries. (Campaign for Tobacco Free Kids, 2014) (World Health Organization, 2008). Due to the deceptive and unethical commercial campaigns by the big tobacco companies, kids and young adults are falling victims to the tobacco. Approximately, there is around 80,000 to 100,000 young people become tobacco addict. Many of them will die due to tobacco related illnesses. 250 million children and young people alive today mostly in developing countries will die due to tobacco diseases. (world health organization, 2014). The smoking is unique in the sense that not only it causes death and disease in people who smoke but also in those who do not smoke themselves. These are the victims are of secondary smoking. It has been estimated that 165,000 children die each year due to second hand smoke. Total number of 600,000 people dies due to it. (Mattias Ö, 2011) To counter the smoking epidemic different strategies have been put in place at different levels. Different countries have come together to control the supply and demand of tobacco under World Health Organization Framework convention on Tobacco Control. This is an effective tool, which set legally binding obligations to countries. WHO keeps on monitoring the progress and guiding the member states in effective strategies to control tobacco and smoking (World Health Organization, 2014). Countries need to come together because tobacco related diseases are causing a great burden on the health care and financial systems. It has been estimated that 500 billion dollars was spent each year on different tobacco related costs including health care expenditures and productivity losses etc. (Shafey O, 2009). United States spends 96 billion USD on tobacco related health care costs. (Campaign for Tobacco‐free Kids., 2014). Tobacco companies have used aggressive marketing campaigns to attract people especially youth. Data proves that these campaigns, which glamourize cigarette smoking for young people, are highly successful. (U.S. Department of Healthand Human Services, 2010)Looking at the success of these techniques the anti-smoking experts have thought of using the “marketing strategies” to counter smoking. Application of marketing straggles to promote health care and wellbeing of humans by modifying behavior is called social marketing. (Centre for excellence in indeginous tobacco control, 2012). Social marketing is an invaluable technique to induce behavioral change in the target audience for health and social wellbeing. It is being used as part of national tobacco control straggles of many nations. Social marketing is part of the “Creating a Tobacco Free Generation: A Tobacco Control Strategy for Scotland. (Government of Scottland, Edinburgh, 2013). United Kingdom’s NHS has developed a smoke free marketing Campaign strategy for 2012 to 2015 recognizing its huge potential as an effective anti-smoking tool. (National Health Servies UK, 2012) Let us look at one of the most celebrated and successful social marketing exercise, which was taken in state of Florida in the United States of America. It was the first counter marketing exercise, which was done by using money from the big tobacco industry. This money was generated by the settlement between the state of Florida and Tobacco Industry. (Schum C, 2007) The Florida campaign was the first use of horizontal influencing. It used peer-to-peer influencing which was very successful. The Florida campaign was able to create a brand and effectively sell it to the youth, which was its target audience. The campaign used a counter marketing strategy. It focused the tobacco industry marketing campaign, which was presented as being manipulative to influence young people to start smoking. The manipulation theme was the one, which was focused and spread in the youth, and teens through youth networking and creating peer groups. The purpose was to give the young people a reason to stay away from the highly glamorized campaign by the tobacco industry to attract them. The campaign was not simply run on the media i.e. TV and radio although a very effective media campaign was part of it. The youth were asked to identify the adults who were being manipulative in order to make youth smoke. The youth than confronted tobacco, industry directly by engaging in activism this gave them a sense of purpose. In every county network of peers were created which followed these activities. Teen conferences were held where the youth were asked to tell what they think about the manipulative practices of industry and certain adults who want children and youth to smoke. Teens told what they liked and what they do not. In this way, the messages were kept relevant to the target audience who felt involved and in control. All of this converted the “truth” message into an effective brand as opposed to the manipulation of the tobacco Industry. A tabloid style “truth” magazine was launched. In addition, truth trains and truth trucks were launched. These were parked at concerts and sports venues where the youth comes to spread the message. On side of the media, steps were taken to make the campaign as effective as possible. Instead of running the adds after midnight to get the less cost or free time slot adds were run on MTV shows which were popular with kids and also during sports programs which we known that youth don’t miss. All these behavioral and attitudinal information was taken by different surveys, which were conducted throughout the campaign. Doing telephonic and other surveys to continuously monitor the level of awareness also checked the progress. The results of the truth campaign were significant. A large number of youth stayed away from smoking and the smoking rates were down in high schools and target audiences. Awareness level reached 92%. One year after the campaign, the smoking decreased in middle school students by 19.4% and in high school by 8%. This success can be attributed to a combination of factors. The significant amount of money was at disposal of the campaign made things easier for organizers. The model of using settlement money taken from the tobacco industry being used to run anti-smoking campaign is an effective model, which should be replicated in other states and regions of the world. The effective use of peer to peer influencing, the youth networking and youth activism all made the brand extremely successful in the target audience. (Vargyas, 2008) (Schum C, 2007) (Jeff Niederdeppe, 2004.) (Social Marketing Institute, 2014) The success of the social marketing depends on how much we know about the target audience. It is extremely important that we know what are the behaviors and attitudes of the target audience. These can be known through demographic and behavioral surveys. Models, which get information through knowledge, attitude and behavior surveys are very important in these regards. Once we have all these information, we can start an effective branding and promotion exercise to sell of social brand to our audience. Florida exercise was done a decade ago. Now we have gone a long way forward. We now know that the youth is not a monolithic group. There are different sub cultures in youth and not all of these may identify with a single message or strategy. This was the main weakness in the Florida campaign. The minority groups like Hispanics and Blacks were not targeted separately. The message lagged behind in the Hispanic community. It is very important to target the subcultures and minority groups using their cultural symbols and sensitivity. This approach is holistic and it results in social integration and brings different groups together. In addition, this results in higher success rates because the offensive behavior does not remain entrenched in a sub culture of society. If this happen it could result in that group becoming a sort of stimulator for the other groups. In addition, the Florida campaign did not targeted the gay, lesbian and bisexual youth groups where we know there is a higher smoking rate (U.S. Department of Healthand Human Services, 2010). Moreover, the primary objective of the Florida campaign was preventive and it focused on the objective of youth not starting smoking. A large number of young people smoke and these should be part of the strategy. The programme should include mechanisms to target these people and help them quit. A large curative aspect should be part of such campaigns. Based on the study of the Florida campaign and other similar campaign we propose a plan of social marketing, which we think will be based on the success of these but will add features, which we think, were missing in the previous campaigns. Target Population:

Our target audience is youth and young adults, which we think is a group, which should be targeted because they are ones, which are the focus of the tobacco industry. The incidence of smoking in the youth and young adults is higher than in general population. Many studies have shown this fact. In Canada, for example we know that 21.5% of the young people between the age of 20 to 24 y and 23.7% of those aged 25 to 34 were smokers. The national average for Canada on the other hand is 17.3% (Hayward, 2012) (Health Canada, 2011) (D, 2005;) (Abroms LC, 2008). It is also important to note that this age group has very interesting smoking style. One hand these are more likely to become regular smokers and smoke more cigarettes than the rest but on the other hand, these are also more like to quit (D, 2005;) (Abroms LC, 2008). Since this group is the main group being targeted by the industry it is paramount that we target this because the industry is also focusing on the quitters of these groups to regain them. For this target population we need to learn more about their attitudes, behavior, and lifestyles. For this we will do an extensive literature review of the existing studies. Secondly, before starting the program we will do our own survey not only to understand the behavior and attitudes but also to monitor the progress Secondly, we will focus on the different sub groups of this population. We need to know the different subgroups and target similar subgroups. Anderson for example notes that it is important to tailor strategy for each specific sub group or sub culture Specific and tailor made strategies will be made for minority groups, gay, lesbian and bisexual youth. Methodology: Prevention plus cure

In this project, we want to use a combination of prevention and cure approaches. It is because a number of young adults are smoking and it will be counterproductive to exclude this group. These can become a negative role models for the rest other wise We will create a peer groups, social groups, and committees of young people, which will follow the whole campaign, direct it through positive and negative feedback loops. Musical gigs, sports clubs, high schools, colleges, and social networking sites like Facebook, twitter, my space will be used to create peers groups. Work places will also be targeted to get the young adults who are working. In order to do that, unions and professional associations will be approached. Role models need to be created from the same age groups, sub cultures and groups, like bright students, singers, sportsmen, and gay or lesbian or minority icons. Many school /colleges and professional associations have counselors. There are community counselors, psychologists and psychiatrists in many communities, these will be trained and used as anti-smoking counselors to help people quit These counselors will be provided with nicotine patches and aids and use of behavioral cognitive therapy will be used. Media campaign; online magazines, floats, posters and songs will be used. It is important to note that many studies note that young adult prefer to quit smoking as such without nicotine replacement (Ling PM, 2004) (Staten RR, 2007) (DeBernardo RL, 1999) (Bader P, 2011) but its better to provide these so that these be used when and if required. Social Marketing Mix: The marketing mix usually refers to traditional 4Ps (AR., 1994) (Grier S, 2005) Product:

In this situation of social marketing, the product is actually the healthy behavior, which we are trying to promote. It creates value for the target population and addresses their concerns (AR., 1994) (Grier S, 2005) Further it’s important to understand that behavior changes in league with present attitudes are more easy to implement and creating new options more feasible than changing old ones Also the population must think that change is manageable and will benefit them. (Lin CA, 2005) (Sutton SM, 1995;) In our case, our product is “smoking free cool” young person. We will continue the “Truth” message of the Florida campaign. We will focus on the manipulation theme of the tobacco industry and our brand will be based on truth and justice. Price

In case of social marketing, the price is the economic, psychological and social cost and pressure, which an individual has to endure to adopt the required behavior. In our case after quitting smoking and or not starting it what issues, will he or she face? These stresses include being “less cool” or less “rebellious” in certain in groups. This cost must be less than the benefits of stopping or non-starting. (AR., 1994) (Grier S, 2005) We will counter this by creating role models and creating a nonsmoking cool aura through our promotional campaigns and peer networking. Different studies show that young adults are more focused on short-term health gains than long-term health loss (Bader P, 2007) (JM, 2006) (Hayward, 2012) so our messages will reflect this Place:

In situation of social marketing place is the suitable environment. For example, tobacco control policies, which make cigarettes expensive, and makes it difficult for young people to smoke. (Bader P, 2011) (L., 2008;) (Minian N, 2010; ) Such policies already exist in many places and can be further augmented. Moreover, we will focus on places where young people are present like high schools colleges, sports and music clubs, pubs, where counselling and messaging will be done. Promotion:

Promotion is the main tool through which behavior is changed. This sometimes is most visible aspect of social marketing but it should work in collaboration with other 3 Ps. (Grier S, 2005) We will focus on targeted promotion based on different sub groups, cultures, gender and socioeconomic conditions. Media campaign will be done during programs which youth watches like those that music etc and networking of peers will further promote and create a positive image and role model. We think our strategy has advantages to the Florida campaigns because it addresses a number of factors, which Florida ignored. SWOT Analysis:

Strengths:
Identifying the sub groups within the young population
Tailor making strategy targeting each group like gays and lesbians, minorities, quitters and smokers Identifying gender issues and focusing on gender sub groups like women and girls Creating role models from within each group

Combining preventive and curative approach
Creating positive messages based on short term benefits and creating a cool profile for non-smokers Weaknesses
We need more resources and more capital in term of cash
Involving different stakeholders could be a problem
Opportunities
Being gender sensitive and involving minorities using their cultural symbols and role models we can play a role in social integration We can help fight sexism and prejudice during this exercise
Threats
Big money and influence of the Tobacco industry
Manipulative activities of the Industry
Minority sensitivity could be a problem if not properly understood

References
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