Public education mass media campaigns are an important intervention for influencing behaviour modifications. However, evidence on the effectiveness of such campaigns to encourage the population to ...reduce sun exposure is limited. This study investigates the benefits and costs of three skin cancer campaigns implemented in New South Wales from 2006-2013. This analysis uses Australian dollars (AUD) and 2010-11 as the currency and base year, respectively. Historical data on skin cancer were used to project skin cancer rates for the period 2006-2020. The expected number of skin cancer cases is derived by combining skin cancer rates, sunburn rates and relative risk of skin cancers due to sun exposure. Counterfactual estimates are based on sunburn exposure in the absence of the campaigns. Monetary values are attached to direct (treatment) and indirect (productivity) costs saved due to fewer skin cancer cases. Monetary benefits are compared with the cost of implementing the campaigns and are presented in the form of a benefit-cost ratio. Relative to the counterfactual (i.e., no campaigns) there are an estimated 13,174 fewer skin cancers and 112 averted deaths over the period 2006-2013. The net present value of these benefits is $60.17 million and the campaign cost is $15.63 million. The benefit cost ratio is 3.85, suggesting that for every $1 invested a return of $3.85 is achieved. Skin cancer public education mass media campaigns are a good investment given the likely extent to which they reduce the morbidity, mortality and economic burden of skin cancer.
ABSTRACT
Aims To track smokers' responses to the increasing price of cigarettes after a tax increase, and assess socio‐demographic differences in responses.
Design The Cancer Institute NSW's ...Tobacco Tracking Survey (CITTS) is a continuous tracking telephone survey. Weekly data were collected between May and September 2010.
Settings New South Wales, Australia.
Participants A total of 834 smokers and 163 recent quitters (quit in last 12 months).
Measurements Responses to the price increase included smoking‐related changes (tried to quit, cut down) and product‐related changes (changed to lower priced brands, started using loose tobacco, bought in bulk). Recent quitters were asked how much the increasing price of cigarettes influenced them to quit.
Findings Overall, 47.5% of smokers made smoking‐related changes and 11.4% made product‐related changes without making smoking‐related changes. Multinomial logistic regressions showed that younger smokers (versus older) were more likely to make product‐related changes and smoking‐related changes in comparison to no changes. Low‐ or moderate‐income smokers (versus high‐income) were more likely to make smoking‐related changes compared to no changes. Highly addicted smokers (versus low addicted) were more likely to make product‐related changes and less likely to make smoking‐related changes. The proportion of smokers making only product‐related changes decreased with time, while smoking‐related changes increased. Recent quitters who quit after the tax increase (versus before) were more likely to report that price influenced them.
Conclusions The effect of increasing cigarette prices on smoking does not appear to be mitigated by using cheaper cigarette products or sources. These results support the use of higher cigarette prices to encourage smoking cessation.
Objective: To use population‐level data to monitor the impact on smoking cessation activity of the April 2010 Australian tobacco tax increase.
Design and setting: The Cancer Institute NSW New South ...Wales Tobacco Tracking Survey (CITTS) is a continuous tracking telephone survey conducting about 50 interviews per week. Data from February to September in 2009 and 2010 were analysed (ie, data on people who quit smoking in the 3 months before and 5 months after the tax increase in 2010 were compared, and quitting activity over the same period in 2009 was also analysed).
Participants: Adult smokers and smokers who had stopped smoking in the previous 12 months; 2009 (n = 1604); 2010 (n = 1699).
Main outcome measure: Recent quitting (defined as stopping smoking or trying to quit within a 1‐month period).
Results: 22% of the sample reported that they had quit smoking in May 2010, compared with 13% in April 2010 and 12% in May 2009. Respondents interviewed in the 3 months after the tax increase (May–July) were significantly more likely to report quitting than those interviewed in the 3 months before the tax increase (odds ratio, 1.84; 95% CI, 1.26–2.69; P < 0.01). This increase in quitting activity was not sustained in the subsequent months (August–September).
Conclusions: The tobacco tax increase was associated with a short‐term increase in the rate of smoking cessation among NSW adult smokers and recent quitters, suggesting that regular increases in tobacco tax may further encourage quitting activity.
Exposure to tobacco advertising and promotion increases the likelihood of smoking amongst young people. While there is a universal ban on traditional or ‘above-the-line’ advertising in Australia, the ...types and extent of exposure of young people to ‘below-the-line’ tobacco advertising and promotion is largely unknown. In this study we aim to identify levels of exposure of New South Wales (NSW) adolescents and young adults to tobacco promotion at the point-of-sale (PoS), on the internet, in entertainment media and at venues such as events or festivals and pubs, clubs, nightclubs, or bars; and to identify those most at risk of exposure.
A telephone survey of 1000 NSW adolescents and young adults aged 12 to 24 years was conducted. Self-reported exposure to tobacco promotions or advertising in the last month were measured in four areas: (1) promotions or advertising at (a) events or festivals and (b) pubs, clubs, nightclubs or bars, (2) on the internet, (3) people smoking cigarettes in (a) movies, (b) TV shows, (c) video games and (d) on the internet, and (4) displays of cigarette packs for sale at (a) large supermarkets, (b) grocery stores or small supermarkets, (c) convenience stores, and (d) service or petrol stations. Smoking status and susceptibility to smoking was also assessed.
A substantial proportion of the young people surveyed reported seeing tobacco promotion sometimes or often in the last month over most of the channels studied.The highest levels of exposure were at the PoS (approx. two-thirds) and to people smoking cigarettes in movies(77%). Lower levels of exposure to tobacco promotions and imagery were reported on the internet (20%); at events or festivals (22.5%); in pubs, clubs, nightclubs or bars (31%); and in video games (23%). However, the odds of exposure through video games increased by 8% for every additional hour spent on the internet per day.
This study shows that adolescents and young adults in NSW are exposed to tobacco advertising or promotion at the PoS, on the internet, in entertainment media and at venues such as events or festivals and pubs, clubs, nightclubs or bars, despite the restrictions on the marketing of tobacco in Australia.
Increasing rates of smoking cessation is one of the most effective measures available to improve population health. To advance the goal of increasing successful cessation at the population level, it ...is imperative that we understand more about smokers' use of cessation methods, as well as the helpfulness of those methods in real-world experiences of quitting. In this survey of recent quitters, we simultaneously examined rates of use and perceived helpfulness of various cessation methods.
Recent quitters (within 12 months; n = 1097) completed a telephone survey including questions relating to 13 cessation methods. Indices of use and perceived helpfulness for each method were plotted in a quadrant analysis. Socio-demographic differences were explored using bivariate and multivariate analyses.
From the quadrant analysis, cold turkey, NRT and gradual reduction before quitting had high use and helpfulness; GP advice had high use and lower helpfulness. Prescribed medication and online programs had low use but high helpfulness. Remaining methods had low use and helpfulness. Younger quitters were more likely to use unassisted methods such as cold turkey; older or less educated quitters were more likely to use assisted methods such as prescribed medication or advice from a general practitioner.
The majority of recent quitters quit cold turkey or cut down before quitting, and reported that these methods were helpful. Efforts to influence population smoking prevalence should attempt to provide support and motivation for smokers choosing these methods, in addition to assessing the effectiveness and accessibility of other methods for smokers who need or choose them.
Background Despite the decline in the incidence of cervical cancer in Australia as a result of population screening, a substantial proportion of women in NSW screen less regularly than the ...recommended two-yearly interval or do not screen. With higher rates of cervical cancer in unscreened and underscreened women, and despite the introduction of the human papillomavirus vaccine, there remains a need to continue to remind women to screen. The mass media has been shown to be effective at improving participation in cervical screening. A 2007 television advertising campaign to promote cervical screening in New South Wales (NSW) was examined. Methods Data from the NSW Papanicolaou (Pap) Test Register were used to compare weekly numbers of Pap tests for NSW overall and in metropolitan local government areas with low screening rates by age group and by time since the last Pap test. Time series regression analysis incorporating seasonal effects was used to estimate the strength of the association between screening and the media campaign. Results Overall during the advertising campaign, 15% more screens (16 700) occurred than expected for 2007 without the advertising campaign. Increases were evident among unscreened and underscreened women, with little overscreening occurring. Women living in low screening areas also showed a significant increase in mean weekly screens of 21% (388) over that expected in the absence of the media campaign. Conclusions Despite the ecological nature of this study, the mass media campaign appears to have been successful in increasing screening in unscreened and underscreened women in NSW.
Since legislation prohibiting tobacco advertising in traditional media, online communication platforms and social media have become one of the few avenues for the tobacco industry to promote its ...products to Australians. Little is currently known about the exposure of young people to these new media promotions.
To measure exposure to Internet-based tobacco advertising and branding among Australian youth, identify common formats of branding encountered, and examine the association between exposure and smoking susceptibility.
The Tobacco Promotion Impact Study is a repeat cross-sectional telephone survey of young people (12-24 years) in 2 Australian states, conducted yearly from 2010 to 2013 (total n=8820). The survey included questions about past-month exposure to Internet-based tobacco advertising and tobacco company branding. Changes in levels of exposure, characteristics of exposed youth, and the association between exposure and smoking susceptibility were explored.
Past-month exposure to Internet-based tobacco advertising and branding among young people increased over the years of the survey (advertising: 21% in 2010 to 29% in 2013; branding: 20% in 2010 to 26% in 2013). The participants who were younger, female, from lower socioeconomic status, and never-smokers were more likely to report exposure. Facebook was the most commonly cited platform for encountering tobacco branding in 2013 (22% of all branding). Compared with young people interviewed in 2013, participants in 2010 were significantly less likely to report exposure to tobacco branding on social media (odds ratio OR 0.26, 95% CI 0.20-0.33, P<.001) or 2011 (OR 0.46, 95% CI 0.37-0.57, P<.001). Among never-smokers aged 12-17 years, exposure to online advertising and branding (OR 1.32, 95% CI 1.11-1.57, P=.002) or branding alone (OR 1.39, 95% CI 1.10-1.77, P=.007) were significant predictors of smoking susceptibility.
Ensuring tobacco advertising bans are inclusive of Internet-based media is essential. Given the global nature of Internet-based content, cooperation among signatory nations to the World Health Organization Framework Convention Alliance on Tobacco Control will be necessary.
We assessed the effects of levels and duration of exposure to televised antismoking advertising on cognitive and behavioral changes.
We used data from a serial cross-sectional telephone survey with ...weekly interviews of adult smokers and recent quitters in New South Wales, Australia (n = 13,301), between April 2005 and December 2010. We merged survey data with commercial TV ratings data to estimate individuals' exposure to antismoking advertising.
Logistic regression analyses indicated that after adjustment for a wide range of potential confounders, exposure to antismoking advertising at levels between 100 and 200 gross rating points per week on average over 6 to 9 weeks was associated with an increased likelihood of having (1) salient quitting thoughts and (2) recent quit attempts. Associations between exposure for shorter periods and these outcomes were not significant.
Broadcasting schedules may affect the success of antismoking ads. Campaign planners should ensure advertising exposure at adequate frequency over relatively sustained periods to maximize impact.
The authors investigated the potential for antismoking advertising to generate interpersonal pressure on smokers to quit using the Cancer Institute NSW's Tobacco Tracking Survey, a telephone tracking ...survey of adult smokers conducted throughout the year with approximately 50 interviews per week (N = 5,448). The survey includes questions relating to recently broadcast antismoking advertisements, including whether smokers have received pressure from family and friends as a result of their seeing the advertisements. The authors conducted multivariate logistic regression analyses to predict: (a) receiving ad-stimulated interpersonal pressure; and (b) quitting outcomes. All analyses controlled for smoker characteristics and potential exposure to the advertisements. Compared with ads coded as having a low level of emotion (by independent coders), ads coded as highly emotional were more likely to have generated interpersonal pressure. Ad-stimulated interpersonal pressure was associated with an increased likelihood of recent quit attempts and with salient quitting thoughts, with a greater effect on quitting thoughts for interpersonal pressure generated by highly and moderately emotional ads. These results support previous research suggesting that highly emotional antismoking ads with personal stories or graphic imagery are effective in promoting smoking cessation, and these results help to identify communication processes that contribute to the ads' success.
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