New anti-smoking campaign adopts shock tactics

BMJ 2012; 345 doi: (Published 28 December 2012) Cite this as: BMJ 2012;345:e8697
  1. Gareth Iacobucci
  1. 1BMJ

A hard hitting new government campaign warning about the “hidden dangers” of smoking may not be effective in targeting all smokers and should be used alongside other measures, say public health experts.

The campaign, launched this week by the Department of Health, includes a new TV advert featuring a tumour growing on a cigarette as it is smoked, which is designed to make the invisible damage caused by cigarettes visible. The government estimates that around 365 000 people will attempt to quit as a result of the campaign.

But public health experts said the shock tactics will benefit some more than others and called for other initiatives, such as standardised packaging of tobacco products and funding for smoking cessation schemes.

John Middleton, vice president of the Faculty of Public Health, said: “FPH welcomes this focus on the dangers of smoking as part of a broader strategy that it believes should also include the standardised packaging of tobacco products.

“However, it urges caution that the approach may benefit some more than others, and that monitoring its effectiveness may prove difficult. Positive images of non-smoking and of how to stop successfully are also needed. Many believe wrongly that the harm is already done, so there is little point in stopping, or they won’t cope without cigarettes. Work is needed to support these people and funding for smoking cessation services secured.”

The campaign, which will cost £2.7m (€3.3m; $4.4m), is described as the government’s first “shock” advert since the “fatty cigarette” campaign in 2004. It has been sparked by research showing that more than a third of smokers still believe the health risks associated with smoking are greatly exaggerated, while the number of people trying to quit has fallen.

It is supported by several charities, including Cancer Research UK, and will also encourage smokers to collect “quit kits”—practical tools and advice to help smokers quit smoking—which are available free of charge from more than 8200 pharmacies across England.

The government said the initiative would bolster the tough message already being projected through banning tobacco vending machines in licensed premises; raising the legal age of smoking from 16 to 18 years; the “stoptober” challenge to stop smoking for 28 days, and the national campaign warning against the dangers of second-hand smoke.

The advert, targeted at young people, will air pre-watershed for nine weeks from 28 December 2012 and will be supported by outdoor and online media.

England’s chief medical officer Sally Davies said: “We want smokers to understand that each packet of cigarettes increases their risk of cancer. And I want smokers to know that the NHS will help you quit.”

Davies described the campaign as “a tough message for a new generation,” many of whom will recall previous hard hitting campaigns. “It is difficult getting the message over, [but] I truly believe this campaign is going to make a difference.”

Harpal Kumar, chief executive of Cancer Research UK, said: “Hard hitting campaigns such as this illustrate the damage caused by smoking and this can encourage people to quit or may even stop them from starting in the first place.”

Martin Dockrell, director of policy at public health charity Action on Smoking and Health (ASH), said: “You need a variety of messages. There are a lot of smokers out there who have tried to quit before and just need the help to motivate themselves. For many, a campaign like this will stiffen their resolve.”

Melanie Wakefield is director of the Centre for Behavioural Research in Cancer in Melbourne and has also done research on tobacco control mass media campaigns. She said there was strong evidence that mass media campaigns are effective in adults. They work in young people because they make smoking “seem disgusting.”

“These kinds of messages work because they help adult smokers to viscerally ‘feel’ the risks of smoking—and therefore increase the sense of urgency and motivation to quit. This style of campaign is highly effective in cutting through clutter of competing media, and generates lots of discussion about the harms of smoking and the need to quit,” she said.

However, Wakefield added that the hard hitting campaign should be complemented by other tobacco control policies and additional help for people trying to quit.

England’s Department of Health launched a consultation on standardised tobacco packaging in April 2012 to which more than 200 000 members of the public responded by the 10 August deadline.1 2 The government is considering its response.


Cite this as: BMJ 2012;345:e8697