Comparative study of young people's response to anti-smoking messages

Abstract

Smoking prevalence increases rapidly with age, with the majority of people taking it up during their teenage years (Walker et al. 2001). Research conducted into young teenagers and smoking in 1998 indicated that less than 1% of 11-year-olds were regular smokers compared with over one-fifth (21%) of 15-year-olds (Higgins 1998). This evidence indicates that if young people do not begin smoking before the age of 20 they are unlikely ever to start. Targeting young people before smoking initiation in their early teens may therefore be critical to reducing smoking rates. Mass-media campaigns can play an important role in reaching large numbers of young people directly with prevention messages and are a powerful influence on individuals' awareness, knowledge and understanding of health and social issues (Pierce et al. 1991; Backer et al. 1992; Bandura 1994; Reid 1996; Mudde & De Vries 1999). When used as part of a comprehensive tobacco control programme, they have been successful in several countries in reducing the uptake of smoking by young people and encouraging cessation (Flynn et al. 1992, 1994; Sly & Heald 1999; Sly et al. 2001a, 2001b, 2002; Andrews et al. 2004). There is considerable debate, however, as to which is the most suitable message theme for reducing smoking among young people. This paper examines the rationale for, and the potential impact of, three appeals: 'fear appeals', 'social norms' and 'industry manipulation'. Evidence exists suggesting that both social norms and industry manipulation messages have worked well in influencing young people's smoking attitudes and behaviour in the United States (Sly & Heald 1999; Sly et al. 2001a, 2001b, 2002) and that fear appeals have worked with Australian adults (Donovan et al. 1999; Tan et al. 2000). There is a lack of research, however, pertaining to how young people in England may respond to anti-smoking message themes and the transferability of these appeals to different cultural contexts. Also, little is known about whether different message types have a differential impact among young people; for example, are particular types of young people more receptive to particular messages? This paper therefore first considers the existing evidence base and relevant theoretical principles before focusing on qualitative research conducted with young people in England to explore their response to different types of message themes.