Objectives:

• To increase knowledge of some of the major health effects of smoking.
• To increase smokers' awareness of the cumulative damage every cigarette smoked does to their health.
• To increase the number of smokers likely to seriously consider quitting or making a quit attempt.
• To encourage ex-smokers to stay stopped.
   

Background:
In December 1998 the Tobacco White Paper Smoking kills was published identifying smoking related diseases as a major threat to public health and making reducing rates of smoking a priority. Three clear objectives were identified in the Tobacco White Paper: to reduce smoking among children and young people; to help adults, especially the most disadvantaged, to give up smoking; to offer help to pregnant women who smoke.

In 2001 the Health Promotion Agency commissioned qualitative research with adult smokers to aid the development of a public information campaign targeting this group.

As well as this research the Health Promotion Agency also looked at successful anti-smoking campaigns in other countries to see if any elements could be adapted for Northern Ireland.

An issue highlighted during the qualitative research was the limited knowledge about the health effects of smoking. While there was a strong awareness of the link between smoking and lung cancer there was limited knowledge about the link between smoking and heart disease, strokes and cancers other than lung cancer.

The Australian anti-smoking campaign, which combined support services and a mass media campaign, and focused on the health effects of smoking, was identified as one that had been successful and could be adapted for the Northern Ireland campaign.

The campaign:

Phase one

Phase one of the ‘Every cigarette is doing you damage’ public information campaign ran from January to the end of March 2002. The campaign focused on the health effects of smoking and, in particular, the link between smoking and heart disease.

The main television advertisement entitled 'Artery', adapted from the successful Australian National Tobacco Campaign, used the slogan 'Every cigarette is doing you damage'. The 'Artery' advertisement shows fatty deposits being squeezed from the abdominal artery of a 32 year old smoker. This advertisement received a positive reaction when tested with an audience of smokers in Northern Ireland.

Click here to view the 'Artery' television advert

Two further television advertisements were developed to support smokers who wanted to, or were trying to, give up smoking. Both advertisements promoted nicotine replacement therapies (NRTs) as an aid to beating cigarette cravings and also promoted a freephone helpline service that operated during the television advertising campaign.

Click here to view the 'Stressed mum' television advert

Click here to view the 'Footballers' television advert

The Smokers' Helpline was an important element in the campaign providing advice and support to callers and directing them to local cessation services. All the helpline operators were trained smoking cessation advisers. Over one million beermats promoting the helpline were produced and distributed to pubs and clubs across Northern Ireland.

A booklet entitled Stopping smoking made easier was produced and distributed via the helpline. A short information leaflet focusing on the health effects of smoking was also developed and distributed to the public via GP surgeries, pharmacies, dentists and libraries.

Contact was also made with the press and broadcast media resulting in features on television, radio and in local newspapers.

Phase two

Phase two of the ‘Every cigarette is doing you damage’ campaign was launched on 7 January 2003. This continued to focus on the health effects of smoking and in particular the link between smoking and strokes.

A television advertisement developed for the Australian National Tobacco Campaign entitled ‘Brain’ is used to show the link between smoking and strokes. This advertisement shows a brain dissected in two and as the two halves of the brain are separated, a blood clot is revealed. The viewer is told the clot is the result of a minor stroke in a smoker aged 38. This advertisement finishes with the slogan ‘Every cigarette is doing you damage’. The Smokers’ Helpline number 0800 85 85 85 is promoted at the end of the advertisement.

Click here to view the 'Brain' television advert

Another television advertisement promoting the Smokers’ Helpline service was also developed for phase two. This advertisement was produced to reassure smokers that they would get friendly help and advice from this service and was also used to promote the helpline telephone number.

Click here to view the 'Helpline' television advert

The two television advertisements promoting NRTs, which were developed for phase one, were also broadcast during phase two.

Seven radio advertisements were produced and aired on local radio stations from January to March 2003. These advertisements were awarded a finalist certificate in the radio commercial category of the Global Awards (International healthcare communication awards).

A range of printed materials was produced for phase two of the campaign including another short information leaflet focusing on the health effects of smoking, cards and posters to promote the helpline number and an A3 sized information poster. These materials were distributed to GP surgeries, pharmacies, dentists and libraries. The booklet entitled Stopping smoking made easier produced for phase one was also revised and distributed to the public via GP surgeries and the helpline service.

Phase three

Phase three of the ‘Every cigarette is doing you damage’ campaign ran intermittently from June 2003 to March 2004 and focused on the link between smoking and lung cancer.

Two television advertisements adapted from the Australian National Tobacco Campaign were shown in this phase. The advertisement entitled ‘Tumour’ graphically depicts how smoking attacks a vital gene which protects lung cells from cancer and explains that one damaged cell is all it takes to trigger lung cancer.

The second advertisement called ‘Lung’ illustrates how the lungs are like sponges with millions of tiny air sacs for transferring oxygen around the body. Tobacco smoke attacks these air sacs, causing shortness of breath and respiratory problems including chronic obstructive pulmonary disease, a serious lung disease.

The campaign also featured a rerun of the television advertisement promoting the Smokers’ Helpline and the two advertisements promoting the range of NRTs available. All advertising further promotes the freephone helpline service for Northern Ireland.

The radio advertisements developed for phase two were also broadcast during this phase to highlight the help and support available to smokers trying to quit.

Click here to view the 'Lung' television advert

Click here to view the 'Tumour' television advert

Evaluation:
The evaluation of phase one was very positive, with three out of five smokers and ex-smokers saying the campaign encouraged them to stay off or quit cigarettes. Also, the yearly quit rate increased from 19% to 24% following the campaign - this means that the increase in the number of those attempting to quit rose by 20,000 smokers. A report was produced detailing the findings of the evaluation of phase one of this campaign.

Phase two of this campaign is currently being evaluated.