A Description of the Mangini Funded

San Francisco Youth Media Campaign

In the Spring of 2001 the San Francisco Tobacco Free Project designed and implemented a paid youth media campaign to discourage youth smoking. With the help of a Community Advisory Board, the group underwent an extensive process to ensure the proposed campaign would be effective and settlement monies were well spent. The group reviewed existing research about ‘what works’, reviewed existing ads, conducted focus groups to determine whether additional ads needed to be developed, and if so, what the messages of those ads should be.
REVIEW OF EXISTING RESEARCH

Initially, Tobacco Free Project staff conducted an extensive review of the current literature that described what is known about tobacco prevention media messages and their effectiveness with youth. Evaluation results from various statewide media campaigns and analyses of focus group data were also collected from various sources. The information gathered related to both media strategies and media messages. The following types of messages appeared to significantly lower youth’s intent to smoke.

A.Effective Messages:

  • Family Message – Ads that discussed the negative impact of smoking on the family were very powerful among youth. The idea of being a good role model for a younger sibling was also very effective.
  • Addiction – Messages, which conveyed the loss of control and independence. Youth are afraid of becoming addicted, but don’t believe they can become addicted.
  • Industry Manipulation – Messages that exposed the tobacco industry’s manipulation to hook new smokers and boost profits were particularly well received among California and San Francisco youth. Youth wanted to be told the truth about the industry’s manipulation on both the local and global level.
  • Empowerment – Messages that emphasize that youth can take control and make educated decisions.
  • Denormalizing smoking as the social norm – Messages which convey that most youth DON’T smoke
  • Secondhand Smoke – Messages which discuss the negative impact of secondhand smoke.
  • Short-Term Negative Health Consequences - “Messages that address “how does smoking affect me now?” or the immediate negative consequences.
  1. Ineffective Messages
  • The use of humor. Youth saw humor as trivializing the seriousness of the issue
  • Long-term health consequences such as lung cancer, heart disease, etc.
  • Short-term cosmetic effects such as, yellow teeth, smelly hair, etc.
  • Romantic rejection, which youth perceived as manipulative
  • Preachy messages that convey the “Don’t smoke” message. This type of message is currently used by the tobacco industry.
  • Messages that portray smoking as being an “adult behavior,” a forbidden fruit. This type of message is used by the tobacco industry.
  • “I choose” type of message, which is also used by the tobacco industry.
  • Use of only a single message for all youth.

C. Message Delivery

Research findings also included information on how messages could be communicated effectively to youth. Ads that were effective with youth incorporated the following characteristics:

  • Teen Culture (focus on “teens talking to teens”) - Messages that are carefully adapted to the characteristics, vocabulary, needs and perceptions of the target receiver are the most persuasive. Youths of various ethnic groups wanted to see themselves represented in ads (in a positive light, yet not singled out).
  • Ads that were fast-paced, image conscious, high quality, and hard-hitting.
  • Diversity - Both African American and white youth wanted messages to be sensitive to diversity in age, race and gender. “The message must speak to me.”
  • Peers delivering the message. “The messenger is the message”.
  • Need for multiple messages. Not all youth can be reached using the same message. Therefore, a variety of complementary messages should be used in campaigns.

ADVISORY GROUP REVIEW AND INPUT

A culturally diverse advisory committee with youth participants was formed. Members of the committee included representatives from the Latino, Chinese, African American, and South East Asian, gay and lesbian communities.

The target group for the campaign was identified as 14-17 year olds who do not smoke or have experimented with smoking, but are not yet addicted. Research has shown that over 80% of adult smokers began using tobacco before they were 18 years of age with the largest increment in smoking experimentation occurring between the ages of 14 and 15.

Criteria were developed by the advisory committee, which then reviewed 50 existing ads against the research-based criteria and selected 8 for focus group testing.

FOCUS GROUPS

Two (2) rounds of 8 focus groups were conducted to test both existing ad and the newly developed ads. The first round tested the existing ads and the second round tested the new ad messages. Both sets of focus groups included youth of different ethnic backgrounds: African American, Cantonese-speaking Chinese, English-speaking Asian, Filipino, Spanish-speaking Latino, English-speaking Latino, Caucasian English speaking, gay and lesbian.

There was tremendous congruence of responses among all of the eight youth focus groups. While some differences did exist, overall the groups were more similar than different. However, there were some differences among the groups as well:

  • Youth of color seemed more emotionally impacted with ads that focused on the family.
  • Youth who smoked were less sympathetic to those ads, which showed people with smoking related illnesses. They felt it was the smoker’s fault for not quitting and therefore, the smoker should take responsibility for his/her current situation.
  • Asian youth were less likely to believe that tobacco was addictive.

Based on the focus group data collected, it was determined that new ads would be needed in order to fill the gaps identified. The message gaps identified by the advisory committee included:

  • Messages that addressed “addiction”
  • Messages that exposed the tobacco industry’s manipulation including marketing tactics and targeting of youth.
  • Messages that addressed the tobacco industry’s global impact on various environmental and global issues that affect the youth’s own environment
  • Ads that depict the diversity of San Francisco youth through their ethnicity, neighborhoods, language, style and culture.
  • Multiple and complementary messages must be used as not all youth can be reached using the same channels or messages.

This campaign used a variety of media and a variety of perspectives on messages. Based on focus group data, three existing adswere selected for use in the media campaign by the advisory committee.

The advisory group also recommended that at least 4 new ads be developed to fill a variety of gaps identified in focus groups and in the research literature. The gaps identified by the advisory committee included:

  • Messages that address “addiction”
  • Messages that expose the tobacco industry’s manipulation including marketing tactics and targeting of youth.
  • Messages that address the tobacco industry’s global impact on various environmental and global issues that affect the youth’s own environment

NEW ADS DEVELOPED

Five new television and 2 new radio ads were developed based on the recommendations above and from extensive information gathered from a second round of 8 focus groups representing the same ethnic, cultural and gender identity youth groups..

1. “Animated Brain” – This new ad addresses the message of “addiction and loss of control”, a concept that youth identified as important to them in youth focus groups. Youth of all ethnicities wanted to see ads that provided new information about nicotine addiction and how it affects them now.

2. “Innocent Death” – This new ad addresses the message of the “global impact of tobacco”. According to information from the first set of focus groups, San Francisco youth of all ethnic groups are aware and concerned about how their environment is being damaged and polluted at an alarming rate. This ad is intended to show youth how the action of smoking in the United States impacts people in other countries.

3.“Father and Son” – This new Cantonese language ad addresses the message of the “Family and loss of family due to tobacco related illnesses”. Messages, which convey the negative impact of smoking on the family, resonate with youth of color and in particular with Asian and Cantonese speaking youth. Youth mentioned that these types of ads are effective in deterring them from smoking.

4. “Hooked Too Quick”– This ad addresses the message of “addiction” and how difficult it can be to stop smoking if one starts. During the first round of focus groups, youth mentioned that they wanted to see all ethnic groups represented in an ad because they felt addiction could happen to anyone and not just one ethnic group.

5. “I Don’t Want to Die” – In this ad, the message of addiction and family loss is conveyed through an interview with a San Francisco young person of color. “Tre”, as his friends call him, is a young Latino man who depicts San Francisco youth culture through his clothes and language style. According to our youth focus groups, youth want ads that depict the diversity of San Francisco youth through their neighborhoods, language style and culture.

Two radio ads were also developed for this campaign: Industry Manipulation and Health effects of Tobacco.

Media preferences:

Data on media preferences was collected, including favorite channels and programs. Favorite TV channels were MTV, Channel 26 (Chinese language programming) Black Entertainment Tonight (BET), and Channels 12, 2, 34 and 44.

Language preferences:

Youth were also asked to identify the language spoken with friends. English was spoken with friends among 64.2% of respondents while, Cantonese was spoken by 27.9% and Spanish by 1.8%.

Ethnic Representation:

A stratification of a youth sample was developed to reflect the ethnic makeup of San Francisco youth. Of the 742 participants, 41.8% were Chinese, 16.8% White, 11.6% Latino and 9.5% African Americans. Interviews were conducted in English, Spanish and Cantonese.

Media campaign targeting and placement:

In order to ensure that the targeted San Francisco youth population was reached, a detailed media placement plan was developed based on demographic media research information as well as from the pre- youth survey described above in section A.

The youth survey provided information on the media habits of San Francisco youth. Data collected included specific programs and channels watched. Latino and Chinese youth also provided information on language preference and media channels watched. Additionally, data on radio listening habits was gathered such as station, time and type of music preferred. The data was broken by ethnicity to assure that media placement would target groups on the appropriate channels and programs. Demographic media research data was also utilized for placement planning.

To ensure maximum exposure of the new ads, placements were made on following networks:

  • Cable Television (San Francisco only): Shows and stations chosen for this network include:

-Black Entertainment Television (BET), which has high African American and Latino audience,

-MTV, music station which appeals to all youth in our target age group

-(English and limited English speaking)

-VHI, music station which appeals to all youth in our target age group

-(English and limited English speaking)

-Comedy Central, Discover, FX, Lifetime, Nickelodeon, USA, TBS (All of these stations where mentioned as most watched by San Francisco youth according to demographic media research information)

  • KTVU-TV (ch. 2, Bay Area Wide). Shows chosen for this network include:

Malcolm in the Middle, X-Files, Normal Ohio, Boston Public, Sheena, Titus, Futurama, King of the Hill. (Based on demographic media research information,

these shows had high youth viewership in all ethnic groups.)

  • KRON-TV (ch. 4, Bay Area Wide) Shows chosen for this network include:

XFL, NBA, Saturday Night Live, Conan O’Brien, Entertainment This Weekend, Friends, Will & Grace, ER. (Based on demographic media research information, these shows had high youth viewership in all ethnic groups.)

  • KBWB-TV (ch. 20/WB20, Bay Area Wide): Shows chosen for this network include:

(Based on demographic media research information, these shows had high youth viewership in all ethnic groups.)

  • KTSF-TV (ch. 26, Chinese programming, Bay Area Wide): All programming on this station is in a Chinese language.

In addition to the television spots, the media campaign extended into radio with a large promo event planned for its premiere. Details are still being worked out as to the frequency of the spots and stations on which the ads will air.

Evaluation of the Mangini Campaign

Evaluation of the youth media campaign sought to answer four basic questions:

1)Did respondents see the media ads?

2)Did youth think the ads were effective at discouraging youth smoking?

3)Were youth that were non-smokers at follow-up still non-smokers following the campaign?

4)Did youth that were smoking at pre: 1)quit, 2) try to quit, 3) contemplated quitting

Did respondents see the media ads?

Overall data indicate that the percentage of youth that saw any single ad varied from 13.4% (animated brain ad) to 47.5% (lung ad).

No. and percentage of all youth that saw each ad.

  • Marlboro man’s brother16939.3%
  • Lung20547.6%
  • Artery15936.8%
  • Hooked Too Quick15535.8%
  • I Don’t Want To Die12929.9%
  • Father and Son 11426.4%
  • Innocent Death 10725.1%
  • Animated brain 5813.4%

The “dosage” or number of ads seen by youth is described below. Data indicate that more than four out of five youth (91.7%) saw at least one of the eight campaign ads.

Dosage of ads seen by youth

0 ads 8.3%

1 ad18.8%

2 ads26.9%

3 ads22.3%

4 ads12.9%

5 ads 6.0%

6 ads 3.4%

7 ads .7%

8 ads .7%

The majority of youth saw fewer than 4 ads (76.3%), while 23.7% saw 4 or more campaign ads.

Did the ads make smokers want to quit smoking or non-smokers remain smokefree?

All of the ads were deemed effective by the youth that reported seeing them, with the artery ad being judged as the most effective at making youth want to quit or remain smokefree, and the innocent death ad the least effective (at discouraging smoking.). It is also interesting to note that a number of TV stations would not play the artery ad because of the graphic nature of the ad although the youth themselves believed it to be the most effective.

  • Marlboro man’s brother13178.9%
  • Lung18590.2%
  • Artery13791.3%
  • Innocent Death 9186.7%
  • I Don’t Want to Die11188.1%
  • Father and Son10089.3%
  • Animated brain 4787.0%
  • Hooked Too Quick12583.3%

The Ads Were Most Effective With Infrequent Smokers

When we looked at the response to the ads by smoking status, data suggest the ads were generally seen as more effective by non-smokers or infrequent smokers (smoked in the last 12 months but not the past 30 days) than by current smokers or daily smokers, which is really who the campaign was targeting).

Changes in Pro-smoking attitudes

Pro smoking attitudes were higher among youth that smoked or started to smoke than those that didn’t.

Pro smoking attitudes both improved and declined depending upon the question. For example there was a significant decrease in youth that believe 1) it safe to smoke for only a year or two, 2) that smoking can help people with weight control, 3) if you smoke you can stop any time you want to, and 4) smoking can help people when they are stressed. Similarly, there was a significant increase in youth that believe there is harm in smoking an occasional cigarette.

The only pro-smoking attitude that changed for the worse between baseline and follow-up among respondents was a significant increase in youth that believed smoking could make you more comfortable at parties.

Youth with low pro-smoking attitudes were significantly more likely to say ads made them want to quit or to not start smoking than those with high pro-smoking attitudes.

Changes Anti-smoking attitudes

There was a lot of positive movement with regard to anti-smoking attitudes among youth from pre to post. For example there was a significant increase in youth that believed the following were good reasons not to smoke: 1) can’t play sports well, 2) friends don’t like it, 3) boyfriend or girlfriend doesn’t like it, 4) it’s bad for your health, 5) once you start you can’t stop, and 6) there are too many places you can’t smoke.

Conversely, there were three instances where anti-smoking attitudes seemed to worsen between pre and post, and those included a decrease in youth that thought the following were good reasons not to smoke: 1) too hard or too much of a hassle to get them, 2) causes bad breath, and 3) makes your clothes smell.