Rendez-Vous 170 July 10, 2007
Philippe Boucher: Hello Denise. Nice to have you back for a rendez-vous since our previous cyber-interview took place on March 31, 1999. You are still very much involved in tobacco control. Can you update the professional information about yourself?
Denise Sullivan: Thank you
Philippe. I am pleased to say I am still very involved in tobacco
control, although now working in the non-government sector. In
August 2000, I took up the inaugural position of Director of The Cancer
Council Western Australia’s Tobacco Program (known then as ‘Target
15’).
I am really enjoying working in the non-government sector compared to previous roles in government. While I liked my time in government and worked with dedicated people doing some very important work on the legislation and policy fronts, the capacity to get things done, the flexibility, and ability to get more involved in issues both nationally and internationally that working within an NGO allows has been refreshing and very rewarding professionally.
Q1. You started with the Target 15 program in 2000. At that time the prevalence of smoking among adults was 25% and the goal of your program was to help reduce it to 15% by 2010. Can you tell us what happened and where you are now?
Denise Sullivan: There has been tremendous progress in Western Australia since establishment of the Target 15 program almost 8 years ago, so much so we have had to rename our media campaign Make Smoking History! The prevalence of smoking among adults is now down to 17%, and, assuming we are able to maintain momentum and investment in tobacco control, we are well on track to achieving our goal of 15% or less by 2010. In fact, advocates are now talking about the endgame for tobacco and how that might be achieved.
Q2. I have looked on your site at your previous TV campaigns. The ads are available since the year 2000 and are basically one per year. The most frequent theme seems to be raising the awareness of the dire health consequences. I found especially touching the testimonies of Jenny and Zita, both young women with terminal lung cancer. This year you focus on some-free homes and cars. Can you tell us how you choose the theme of your annual media campaign? Is the once a year for 4/6 weeks cycle a budget constraint and can you tell us how your budget has evolved along the years?
Denise Sullivan: The Cancer Council WA’s Tobacco Program uses a range of strategies that include public education (the Make Smoking History campaign), advocacy, and input into the development of state and national public health policies, smoking cessation support, and research. The strength of the program lies in the fact that it is an integrated package. Media advertising, while important, is but one component. It plays a key role in helping set an agenda and in maintaining a high public profile for tobacco control issues, but it does not stand alone.
The media primarily used in the Make Smoking History campaign is television and press because they provide best reach and value at this time.
The television and press advertising serve distinct purposes. The television advertising is largely used to promote smoking cessation messages, and the press advertising to support advocacy activity on topical smoking and health issues. An over-riding consideration in the development of all advertising is that it be strategic, in populations and issues that it targets, and high impact.
The television advertising developed for the campaign targets adult smokers. It is direct and hard-hitting, and aims to convey the grim realities of smoking, providing fresh insights into the impact of smoking on the lives of smokers and pressing home the urgency of quitting. This approach is based on our own research, as well as that of other state and national campaigns.
Choosing subjects for our annual campaigns is partly determined through our research (i.e. what are misconceptions about smoking, new news about the harms of smoking that we need to address and lend themselves to a media campaign), happenstance (i.e. Zita, the young woman with lung cancer, who featured in our 2006 campaigns, came to us asking if sharing her story might help discourage others to quit) and political imperative (i.e. driving or supporting changes in public health policy or legislation on tobacco). Our campaigning is generally planned 3-years in advance with some flexibility to accommodate changes in the environment, size of budgets and conflicting activities.
The total budget for the entire program was about AUD 500,000 p.a. when I started with a staff of one – me. The budget is now about AUD 2.2 million p.a. with 7.2 staff (including me). Funding comes from three sources – The Cancer Council WA (AUD 300,000), the Department of Health WA (AUD 1.5 million) and the Health Promotion Foundation of WA (AUD 400,000). As you can see most of the funds come through other agencies, so a big part of our time is taken up with writing and reporting on grants – if we are successful!
The biggest increase in budget has occurred over the last 2 years meaning we have been able to produce a greater number and range of new advertising materials and have a more consistent presence in the media over the year. About 70% of the budget goes into the production and placement of our media advertising as well as the research and publications needed to support the campaign and its development.
Q3. Some Health Agencies (like Health Canada for instance) now post some of their TV ads on YouTube. What is your strategy toward posting (or not) your ads on YouTube and other similar services? Could you consider posting all your ads (including the ones produced before 2000) on the YouTube of the internet? I am asking because I assume there is a potentially bigger traffic on those sites than on the original site of a Health Agency.
Denise Sullivan: Currently, we don’t post our ads on YouTube or other Internet sites other than our own. Most of our ads are developed for use in mainstream media (such as free to air TV, press, radio and outdoor) as these continue to provide best reach for our target group/s. We do monitor very closely changes in media consumption, and already we are noticing some fragmentation of the media market. In addressing this, we are taking even more care than usual in our media planning so as to ensure we are reaching people of different ages, gender and geographic location.
Fragmentation of the media market will present some interesting challenges for us and other agencies running social marketing campaigns in the future, as these campaigns are modestly funded by commercial standards.
I should add we have recently funded a pilot research project on viral marketing through the Centre for Behavioural Research in Cancer Control at Curtin University of Technology. This research comprises the dissemination of unbadged ads on how disgusting is smoking.
The ads were originally developed for a teenage market by the same research team some years ago. The ads are being circulated via select university student email listings the idea being that students view and complete a short questionnaire on responses to the ads and hopefully pass on the email to their friends.
The project looks at how an older youth market responds to the advertising concepts, and how we can evaluate the utility of less controlled media – like the Internet – in getting messages out to our target markets. The latter is important for future planning and for reporting on the outcomes of investment in programs to funding bodies.
Q4. Graphic health warnings and communicating about them are also part of your strategy. Can you tell us how it works? Is the number for the quitline printed on the packs a local (Western Australia) number or is it a national number? Are the calls free?
Denise Sullivan: Graphic health warnings have been required under federal legislation since March 2006. To promote the new warnings and new information they convey, the federal government ran a media campaign in the lead up to March 2006 and for the months following.
A number of states and territories developed separately or in partnership with others additional advertising linking the health effects of smoking with the messages on the pack.
In Western Australia, The Cancer Council WA produced a set of outdoor advertising for use on billboards and bus shelters highlighting the link between blindness and peripheral vascular disease and smoking. The advertisements were simple, quirky and incorporated images from the new pack warnings. They can be viewed on our website at the foot of the following page:-
http://www.cancerwa.asn.au
And, the Quitline number which features on cigarette packs is a confidential telephone information and advice service, available throughout Australia. For the cost of a local call (except mobiles), professional telephone advisors provide encouragement and support to help smokers quit. The number is national, but diverts call to state-based quitline service providers.
Q5. What are now the main challenges for tobacco control in Western Australia? How different are they (or not) from the situation in 1999?
Denise Sullivan: There have been some great gains in tobacco control in WA, particularly in recent years. The prevalence of smoking is the lowest ever; there are strict controls on the sales, marketing and use of tobacco; most people accept smoking is bad for health; public support for measures discouraging the use and promotion of tobacco is strong; and there is better support for smokers wanting help to quit.
Investment in tobacco control has been boosted especially since establishment of the Health Promotion Foundation of WA. And tobacco control is now embedded in organisational and government policies: making tobacco control the business of many rather than a few.
Nonetheless, there are still lots of smokers; there has been little change in the high rates of smoking among Aboriginal and Torres Strait Islander peoples, people with mental illness and pregnant women; help to quit is not universal; the industry thrives; government support waxes and wanes; the activists are few; and there is a real risk of complacency.
So, for us, there is need to maintain and step up efforts.
Q6. Is there anything else you would like to add?
Denise Sullivan: The Cancer Council WA is in the process of producing a publication chronicling the achievements in tobacco control over the past two decades that also looks at the challenges ahead and endgame for tobacco. The publication comprises papers by individuals who have played a leading role in driving change and setting the agenda in tobacco control in WA and nationally. Indeed many of the authors are well-known to our international colleagues such as Mike Daube, Rob Donovan and Konrad Jamrozik. We hope to release the publication later this year, which may be of interest to the Globalink community.
Thank you Denise for having taken the time to answer our questions.
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