Make Smoking History
Our campaign to reduce tobacco smoking in Western Australia (WA), Make Smoking History, was established in 2000 and has made a significant impact on smoking rates in WA. But there is still work to be done.
Tobacco smoking is the leading preventable risk factor for disease and death in Australia, and increases the risk of cancer, coronary heart disease, stroke, peripheral vascular disease, and various other life-threatening diseases and debilitating conditions. Exposure to second-hand smoke can also cause lung cancer, stroke and heart disease in adults, and can cause sudden infant death syndrome and a range of other serious health outcomes in children. In addition, the social costs of smoking in Australia are enormous and were estimated to exceed $136 billion in 2015/2016.
Fortunately, there have been significant declines in smoking rates in WA since 2000, with smoking among WA adults aged 18 years and above halving from 22.5 per cent in 2002 to 11.5 per cent in 20181. However, further gains must be made as smoking rates among people in priority groups, including people of Aboriginal and Torres Strait Islander descent, are much higher than that of the general population.
Latest Make Smoking History TV commercial (‘Voice Box')
The Make Smoking History campaign was established in 2000 with the goal of reducing the prevalence of tobacco smoking among adults in WA. The campaign is an initiative of Cancer Council WA and is jointly funded by the WA Department of Health, Healthway and Cancer Council WA.
Make Smoking History aims to:
- Assist smokers to quit by providing them with information and resources to help plan their quit attempt.
- Influence public opinion and policy on key smoking and health issues.
- Raise awareness of the harms of smoking and the benefits of quitting.
Make Smoking History takes a comprehensive approach that includes state-wide, television-led public education campaigns. These campaigns urge people who smoke to quit, and also play an important role in preventing people from starting smoking in the first place, and helping people stay smoke-free. Other key strategy areas of Make Smoking History include:
- support and advocacy for evidence-based tobacco control policy and legislation,
- support and implementation of tailored cessation services, particularly for those groups with high smoking rates,
- resource development, and
- dissemination and ongoing research and evaluation.
Make Smoking History has delivered 55 waves of campaign activity since 2000. These include 15 campaigns created and developed in WA, as well as 13 campaigns licensed from other states in Australia and overseas. The campaigns feature a variety of themes and creative executions, including health effects and graphic imagery, emotive narratives, testimonials, social costs and tobacco industry or policy-related messages . Recent campaigns have featured emotional testimonials from ex-smokers (‘Terrie's Tips', ‘Meet Mick'), graphic imagery of the health consequences of smoking (‘Voice Box', ‘Sponge'), motivational messages to quit (‘You Quit You Win', ‘From Every Quitter'), and depictions of tobacco industry tactics (‘Corrective Statements').
Still image from ‘Terrie's Tips' commercial
Still image from ‘Meet Mick' commercial
Still image from ‘Sponge' commercial
Television has always been the primary media channel for Make Smoking History and will likely continue to be in the immediate future. However, as new media channels are created, audiences are becoming increasingly dispersed. Early Make Smoking History media schedules would typically include television, press, radio and out-of-home advertisements (e.g. on billboards, in cinemas, on public transport and in shopping centres). However, for some time now market research has indicated that the top media channels consumed by people who smoke in WA are internet, radio, television and out-of-home.
To maintain visibility when television-led campaigns are off-air, Make Smoking History also creates and promotes messaging specifically for Facebook and Twitter. In recent years, this has included a focus on topics such as smoking and alcohol, smoking and cardiovascular disease, and tobacco industry deception.
Make Smoking History Twitter activity. Follow the campaign onTwitter @msh_wa
‘From Every Quitter' digital creative
Smoking and alcohol Facebook campaign image
‘Voice Box' out-of-home advertisement
Make Smoking History conducts a post-campaign evaluation immediately after every campaign that aims to measure awareness of and attitudes towards the campaign, as well as behavioural intentions and outcomes resulting from the campaign. For each evaluation, the sample comprises around 200 WA adults who smoke regularly or who quit smoking within the campaign period. The evaluation is also used to measure smokers' attitudes towards current and emerging tobacco control policy issues, such as support for expanding smoke-free places.
Since conception, Make Smoking History post campaign evaluation results have demonstrated consistently high levels across five key impact areas:
- Campaign awareness (ranging from 46-93 per cent)
- Intended message take-out (71-97 per cent)
- Convincingness (53-89 per cent)
- Personal relevance (42-79 per cent)
- Total quitting action (46-82 per cent).
One of the most successful WA campaigns is ‘Zita's Story'. This testimonial campaign uses interview footage of Zita Roberts talking about her terminal lung cancer and the effect on her family. ‘Zita's Story' launched in 2006 and achieved the highest level of awareness of any Make Smoking History campaign at 93 per cent. The campaign also scored highly in convincingness (83 per cent) and relevance (71 per cent). In 2014, Make Smoking History filmed additional television advertisements with testimonials from Zita's children (‘Zita's Kids').
‘16 Cancers' is another very successful WA campaign. The primary television advertisement includes five graphic scenes depicting different types of cancer and the way those cancers can affect people's lives. ‘16 Cancers' is associated with the highest total quitting action during a campaign period (82 per cent). The campaign also performed strongly on intended message take-out (91 per cent), convincingness (81 per cent) and relevance (70 per cent).
Still shot from ‘16 Cancers' commercial
These results are not surprising considering the large body of research which indicates that emotive anti-smoking advertisements which include graphic health effects and testimonials are the most effective at prompting quitting behaviours.
Still shot from ‘Voice Box' commercial
While there is significant evidence to support strong action and a comprehensive approach to tobacco control, there are ongoing challenges for Make Smoking History (and other tobacco control programs) that can prevent progress.
Tobacco industry strategising
The tobacco industry is in the unique position of selling a highly addictive product, which, when used as intended, kills its own customer base, making the industry highly motivated to source new customers. In the face of tobacco control initiatives in Australia, the tobacco industry has embarked upon aggressive global and national campaigns to remain in business. Most recently, the industry has invested heavily in the production of novel products, such as e-cigarettes, and heat-not-burn tobacco products. The tobacco industry uses these strategies, which are designed to oppose and undermine evidence-based tobacco control measures, while they continue to sell and promote traditional combustible tobacco products.
Still from Make Smoking History ‘We Lied' commercial - developed to call out the tobacco industry on tactics they use to attract and keep people smoking.
Complacency about the need for tobacco control poses a risk to further driving down smoking rates and reducing the burden of tobacco-related disease and death. Although Australia currently collects around $12 billion in tobacco excise, national investment in areas such as mass media anti-smoking campaigns is at its lowest point in 20 years. Fortunately for WA, funding for Make Smoking History has been sustained, thanks to ongoing support from the Department of Health, Healthway and Cancer Council WA. However, as long as tobacco smoking continues to be the leading cause of death and disease in Australia, tobacco control agencies must ensure tobacco control programs are well-funded.
Groups with high smoking prevalence
Compared with the overall population, smoking prevalence is higher among certain groups, including;
- people of Aboriginal or Torres Strait Islander descent
- people living with mental illness
- people in prison
- people with alcohol and other drug issues
- people experiencing homelessness
- people in the LGBTQI+ community
- people experiencing socioeconomic disadvantage.
While Make Smoking History campaigns are primarily created for population-level consumption, strategic placement helps to ensure advertisements are seen and heard by people in certain groups.
Fragmentation of media
With the increase in digital technology, people now have more options and control over the media they consume, which has led to a decrease in the portion of audience reachable via television alone. The profusion of media channels and new technology, combined with a need to maintain investment in television, means that greater overall investment is required to secure more varied media. Research has found that the likelihood of a person making a quit attempt increases with every additional media channel in which they are exposed to anti-smoking messaging.
Now more than ever, we need evidence-based action to continue the decline in smoking in WA. We need action that we know works, including television-led public education campaigns and expansion of smoke-free environments. It is also critical to ensure that evidence-based support is provided to all smokers to help them quit, particularly for priority groups with higher smoking rates.
For Make Smoking History, this will mean that television-led public education campaigns will remain a crucial element, as free-to-air television has proven to be an effective media channel in priority populations. However, using multiple media channels in combination with free-to-air television is critical for extending campaign reach to those who are not frequent consumers of television. Make Smoking History must continually advocate for increased investment in anti-smoking advertising to intensify frequency and reach on traditional channels as well as expand into new and varied media channels.
New media channels bring their own challenges - such as strict restrictions on digital content - which can be a major roadblock for the graphic campaigns that are so effective in anti-tobacco advertising. At the same time, new media channels also provide opportunities for smoking advertisements to bypass regulation that applies to traditional media.
For Make Smoking History, the future also includes an ongoing commitment to reach groups with high smoking prevalence. We will continue to work extensively with health and community services to embed a systematic approach to smoking cessation as well as developing and implementing tailored, evidence-based interventions to address smoking within these services.
Make Smoking History will also remain committed to supporting and advocating for evidence-based tobacco control policy and legislation. To truly make smoking history, we should be aiming for the end of the commercial sale of traditional combustible tobacco products, and strive for record-lows of smoking prevalence among all Western Australians to eradicate the enormous health and social burden caused by tobacco smoking once and for all.
Behind the scenes of filming for ‘Voice Box' commercial
- Epidemiology Branch. Prevalence of Smokers and E-cigarette Users, 18 years and over, 2002-2018, HWSS. Perth: WA Department of Health; 2020
- Visit the Make Smoking History website
- View all of Make Smoking History's past campaigns
- Follow Make Smoking History on Twitter
- Like Make Smoking History on Facebook
- Follow Make Smoking History on Instagram