|
Article Excerpt
Despite the success of antismoking campaigns that aim to prevent young teens from smoking, this qualitative study provides strong evidence that different initiatives are needed for college students, particularly those who already smoke. When asked for responses to current antismoking messages, nonsmokers generally championed the cause; however, smokers often responded with anger, defiance, denial, and other negative responses. Consumers who respond in this manner are not well served by existing strategies, and money used for such campaigns could be better spent. New strategies are offered in hopes that antismoking campaigns can communicate more effectively with one high-risk group--college student smokers.
**********
All the "truth" campaign does is convince me that I should go outside and light up another cigarette. (Participant #24)
... All smokers hate anti-smoking ads, whether they're good or not. They hate them because they love to smoke and hate being told not to do something. Every smoker I know has a no-smoking sign in their house to make a mockery of anti-smoking messages. (Participant #67)
I am going to have to die from something someday, and I like smoking, so why shouldn't this be my cause of death? (Participant #43)
These are the comments of college student smokers in response to the wide range of antismoking messages found in the media. Their anger and defiance make it imperative that researchers investigate whether these responses are isolated incidents or a widespread response. If anger and defiance are the rule rather than the exception, many of the antismoking messages that may successfully prevent young teens from starting to smoke may nevertheless be ineffective with college students who already smoke, or worse, undermine smokers' efforts to quit.
Despite the optimism that counteradvertising campaigns can be effective, comments from college students wave a warning flag that special initiatives may be needed for different audiences. Specifically, researchers must investigate whether the types of prevention efforts that can be successful with nonsmokers are either ineffective or change attitudes in the wrong direction among smokers. Using a qualitative approach to understand the realities of college student smoking, this study attempts to evaluate the effect of various sources of antismoking messages on college student smokers and nonsmokers, and to probe for insights into effective communication. It first considers the nature of the problem, social marketing campaigns, and responses predicted by risk models and psychological theories. It then organizes the data around a set of research questions and makes recommendations for the creators of antismoking messages so that their efforts achieve the greatest possible success and better serve consumers.
THE NATURE OF THE PROBLEM
The Centers for Disease Control and Prevention (CDC) estimates that more than 46.2 million Americans smoke, despite the fact that smoking results in the death or disability of half of all regular users, with more than 440,000 deaths attributed to cigarette smoking each year (Targeting Tobacco Use: The Nation's Leading Cause of Death, USDHHS 2004). The onset for tobacco use typically occurs during adolescence, which accounts for the majority of prevention efforts being directed at preadolescents and young teens; however, some research suggests that the onset is later for some population groups including African American women whose smoking rates continue to increase through the twenties (Moon-Howard 2003).
Smoking is a concern for all individuals, but among college students it is especially problematic. With the transition to college comes the freedom to make self-initiated choices including the decision whether or not to smoke (Emmons et al. 1998; Patterson et al. 2004). Some college students experiment with cigarettes for the first time, and many who were occasional smokers in high school become heavier smokers as they enter college (Christie-Smith 1999; Patterson et al. 2004; Schorling et al. 1994). More than 60% of college students have tried a tobacco product, 46% have done so in the past year, and 33% are current tobacco users (Rigotti, Lee, and Wechsler 2000). Because young adults represent the youngest legal targets of tobacco industry marketing, Rigotti, Lee, and Wechsler suggest that they may need special countermarketing efforts.
Forty-four percent of young adults aged 18-25 use tobacco in the form of cigarettes, smokeless tobacco, cigars, or pipes, compared to 29% for those aged 26 and older, and 15% for those aged 12-17 (National Household Survey on Drug Abuse, USDHHS 2001). Although the prevalence of cigarette smoking decreases with increasing levels of education, usage among college students remains a concern. Thirty-three percent of full-time college students aged 18-22 have smoked cigarettes in the past month (National Household Survey on Drug Abuse, USDHHS 2001).
Though many college students believe that they can quit smoking any time and therefore are not at risk, a longitudinal study at one university reported that over the course of four years almost 90% of daily smokers and 50% of occasional smokers continued to smoke (Wetter et al. 2004). Furthermore, 14% of occasional smokers became daily smokers and 11% of nonsmokers took up smoking. Sixty-eight percent of college students have tried to quit smoking at some time (Youth Risk Behavior Surveillance Report, USDHHS 1997). Given the tendency of college student smokers to underestimate the difficulty in quitting, special initiatives may be needed to effectively promote smoking cessation. Greater success in curbing smoking would not only benefit smokers but other members of society as well, many of whom suffer the toll of secondhand smoke and rising health care costs.
SOCIAL MARKETING CAMPAIGNS
Given the seriousness of the health problems, a number of studies have attempted to isolate the factors that lead to smoking in hopes of creating more effective social marketing campaigns. Advertising has been singled out as a potentially powerful agent of influence, with calls for various restrictions on tobacco advertising and increased antismoking efforts (DeLorme, Kreshel, and Reid 2003). However, most studies have demonstrated only weak effects from advertising or have provided seemingly contradictory evidence.
Peer pressure, family smoking behavior, and prior beliefs have consistently been identified as more important factors in predicting smoking level among adolescents than product advertising and antismoking campaigns (DeLorme, Kreshel, and Reid 2003; Smith and Stutts 1999). Researchers for econometric studies add further support to the weak effects perspective by concluding that aggregate advertising does not stimulate consumption (Andrews and Franke 1991; Duffy 1996).
Social marketing campaigns typically attempt to discourage harmful behavior or encourage positive behavior (Andreasen 1994). Past efforts have been directed not only toward smoking prevention and cessation (Farrelly et al. 2002) but also toward a multitude of other issues including drinking (Agostinelli, Brown, and Miller 1995), drugs (Kelder et al. 2000), obesity (Vranica 2003), AIDS (Witte 1991), use of seat belts (Calkins and Zlatoper 2001), sunscreen for skin cancer prevention (Huncharek and Kupelnick 2002), and medical screening tests (Keller, Lipkus, and Rimer 2002). However, the effectiveness of social marketing campaigns is sometimes less positive than hoped for. Rotfeld (2001) notes that social marketing campaigns have the very difficult task of persuading large numbers of people to change their behavior despite the fact that they are fully aware of the consequences of their behavior and have already decided to ignore the risks. Furthermore, Rotfeld notes that the basic question of whether advertising can bring about behavior change often goes unasked, resulting in marketing that is "misplaced." Some campaigns are not only ineffective but also have triggered adverse effects, such as increased drinking by college students in response to antidrinking campaigns on college campuses (Wechsler et al. 2003). These adverse effects are what Pechmann and Slater (2005) call the "dark side" of social marketing campaigns.
Several recent studies have reviewed the vast literature on the effectiveness of antismoking efforts (see Agostinelli and Grube 2003, and Wakefield et al. 2003 for comprehensive evaluations). Wakefield et al. (2003) note that an already intense debate about the efficacy of antismoking themes was fueled after several states received funding from the 1998 Master Settlement Agreement (MSA) between tobacco manufacturers and attorneys general and also after several tobacco companies began to use advertising strategies to target youths via antismoking campaigns. Wakefield and her colleagues conclude that antismoking ads appear to have the most reliable, positive effects for those in preadolescence and early adolescence by preventing smoking initiation; that interactions with family and peers can reinforce, deny, or neutralize potential effects of antismoking messages; and that various types of message strategies have proven inconsistent, leaving no single "recipe" for antismoking advertising.
A number of different strategies have been used in antismoking messages aimed at adolescents including a focus on long-term health effects, short-term cosmetic effects, tobacco marketing practices, marketers as "murderers," secondhand smoke, negative social consequences, and attractiveness of nonsmokers (Pechmann and Goldberg 1998; Stutts, Smith, and Zank 2003). In their review of the research, Agostinelli and Grube (2003) evaluated studies that addressed counteradvertising message content and the psychological mediators involved, and prior smoking experience, among other factors. Regarding message content, Agostinelli and Grube concluded that certain outcome expectancies, such as beliefs about the potential gains and losses from smoking such as the likelihood of developing lung cancer, effectively predict smoking behavior but are ineffective messages for counteradvertising content regardless of whether the messages target short-term or long-term health effects (Goldman and Glantz 1998) and regardless of the type of negative consequences, such as unattractiveness, death, and disease (Pechmann and Goldberg 1998). Similarly, normative beliefs--perceived approval or disapproval from others and beliefs about the behavior of others--effectively predicted smoking behavior but failed as counteradvertising messages (Morgan and Grube 1994). The normative approach generated executions such as "kissing a smoker is like licking an ashtray" (Goldman and Glantz 1998) but was deemed ineffective because, among other things, it did not consider the smoking status of the message recipient.
The theme of manipulation by tobacco companies held much hope as a persuasive message; however, it too received mixed results--effective in some studies (Goldman and Glantz 1998) and ineffective in others (Pechmann and Goldberg 1998). Message strategies that were the most effective in preventing smoking among 7th- and...
|
