The Real Cost: A Tobacco Prevention and Control Educational Campaign That Steers Away From Health Effects Messaging In Search Of Results

Background:  Alaska is one of few states yet to pass a statewide smokefree workplace policy. With some of the highest rates of smoking prevalence and tobacco use, per capita, in the nation, the State of Alaska’s Tobacco Prevention and Control (SOATPC) program aims to combat prevalence with a comprehensive program offering education, the provision of resources and a stronger than ever media component. “The Real Cost” is an overarching campaign encompassing a series of “mini campaigns” that focus on the economic impact and health effects of tobacco use to Alaskans. Because influencers, super-voters aged 25-54, predominantly live and work in population centers with existing smokefree policies, The Real Cost aims to reach beyond health effects messaging to a topic affecting each and every one of them: money. The cost of other people’s smoking on their pocketbook. The campaign is comprised of three mini campaigns: “Dream Scene,” an introduction to the issue concerning medical expenditures and lost productivity; “Oil Change,” an education specifically on lost productivity due to life lost from tobacco-related deaths; and “Young Girl,” a spot that closes the loop on the issue by way of health effects and introduces policy as a solution. 

Program background:  The SOATPC Program is organized and prioritized to reflect the CDC’s program goals for best practices. The program continues to be strengthened by full funding, statewide community collaboration, and ongoing training, research and evaluation. Alaska has achieved success over time with a sustained and strategic program.

Evaluation Methods and Results:  Campaign development included both quantitative and qualitative research and evaluation methods. Concepts underwent rigorous pre- and post-testing that included messaging, concept mock-ups, scripts and finished products. Additionally, a baseline survey was fielded prior to campaign kick-off and included a core set of questions that were regularly tested after each phase of the campaign. Three ad recall surveys also followed each phase and were cross-examined with a formal post-buy analysis for each quarter of the campaign to determine overall effectiveness.

Conclusions:  The campaign tested well in all key areas. Knowledge and understanding of the issue increased over time, as did positive feelings toward messaging. The ad recall survey performed well and an initial spike in increased understanding and awareness gave way to small upticks at each testing phase. The complicated topic of economic impact to smokers and non- is possible with a targeted, phased approach to education and awareness.

Implications for research and/or practice:  There is room for innovation, even when using CDC best practices as a guide. Public health does not need to be limited to health effects messaging to successfully educate on health topics. A fresh approach that reaches beyond creative execution, that actually changes the message, can garner the attention an issue needs and place it in a new light. People know smoking is bad for them. People know secondhand smoke is bad. Changing the variable and result can make an issue new and allow a campaign to more deeply resonate with the right audience.