There were 38 groups of participants—20 groups of Indigenous smokers (either Aboriginal or Torres Strait Islander) and 18 groups of non-Indigenous smokers, included to provide context for the responses of Indigenous smokers. An end tag with the words: ‘No smoker can breathe easily’ and ‘Quitline 137848’, appear on the screen across the image of the doctor. Quit smoking today’. The campaign centred on the play ‘ Tiryaki Kukla ’ (Puppet the Addict), and the rest of the campaign was designed to increase awareness of the play and hence awareness of issues of smoking and health. People aged ≥18 years who smoke factory-made cigarettes, by socio-economic quintile, Hard-hitting and emotional campaigns, particularly testimonials, have been found to be effective in prompting quit attempts among Aboriginal and Torres Strait Islander people and people from lower SES groups who smoke.6,19 In terms of advertisement placement, people with mental health issues have high levels of internet and television consumption, and people experiencing homelessness can also be reached effectively online.20,21, Finally, there has also been a reduction in the frequency of exposure to antismoking mass media advertising in recent years due to reduced government investment.1 Sustained investment in high intensity antismoking mass media campaigns is crucial to maintaining an effective, comprehensive approach to tobacco control.4 For instance, smoking prevalence rose in South Australia when funding for the state-wide mass media campaign temporarily ceased.22 It is of concern that there has been no population-wide, national antismoking advertising campaign since 2012, although the Australian Government has recently committed to a degree of reinvestment.23 Best practice would indicate that a national quit campaign using an integrated mix of traditional and digital media channels and adopting targeted media buying techniques should be conducted with an adequate media buy (i.e. 18. Some platforms provide media buyers (those who are buying advertising space) with the option of using skippable and non-skippable advertising spots. These were among the top rated ads for at least three of the six outcome measures. Targeting media channels popular with lower socio-economic status (SES) smokers can efficiently achieve wide population exposure as well as effectively reaching population groups with higher smoking prevalence. In the family car, Billy sits coughing between his parents who are both smoking. Five-year reach potential trends – smokers 18–49. Ronaldo continues: ‘Every twelve weeks I have to see the otolaryngologist to make sure the cancer hasn’t come back. New shock tactics have helped quadruple the effectiveness of the government's anti-smoking campaign Anti-smoking advertising has become so effective that it is … Results: An anti-smoking advertising campaign initiated by Vermont researchers was found to be the most cost effective in that it significantly reduced adolescent smoking prevalence at a low per capita cost. Durkin S, Bayly M, Brennan E, Biener L, Wakefield M. Fear, sadness and hope: which emotions maximize impact of anti-tobacco mass media advertisements among lower and higher SES groups? With limited Indigenous-specific messages available and given the finite resources of most public health campaigns, exposure to mainstream strong graphic and emotive first-person narratives about the health effects of smoking are likely to be highly motivating for Indigenous smokers. Indigenous participants tended to give higher ratings to all the mainstream advertisements overall in comparison to non-Indigenous people. Overall, non-Indigenous smokers reported smoking significantly more cigarettes per day than Indigenous smokers (t(276) = 2.85, P = 0.005). pp. Melbourne: Roy Morgan; 2020 [cited 2020 Mar]. Even the brain. That said, the changing profile of current smokers places even more importance on understanding audience segments and designing messaging in line with consumer insights. Further analyses examined clustering at the individual and location level (Adelaide, Port Lincoln, Port Augusta and Ceduna) but found all clustering was due to individual-level effects. Even if you only smoke low tar cigarettes, chances are, you have emphysema in its early stages. Three studies have been published evaluating the effect of specific anti-smoking mass media campaigns on Indigenous people in Australia [18–20]. 23. In particular, the ad affected young males who played for their local football team, who disliked the thought of never being able to play again. All multivariate analyses controlled for ad order, location (metro or rural), gender, age, parental status, highest level of educational attainment, average number of cigarettes smoked daily, quitting intentions, previous quit attempts and all 10 ads. In Part 2, participants were presented with screenshots of all 10 ads simultaneously and asked to indicate which one ad ‘most’ made them feel like trying to quit smoking. However, there is a dearth of research and evaluation of tobacco interventions in Indigenous populations in Australia [11–14], and so it is not possible to determine whether the apparent null effects of these campaigns for Indigenous smokers (as compared with the general population) might be due to differences in ‘meaningful exposure’ to these campaigns, differences in ‘opportunities and support to sustain long-term quitting’ and/or differences in the these mainstream campaigns’ ability to ‘motivate smokers to quit’ [15]. no. Advertisements with strong graphic imagery depicting the health effects of smoking were rated highest by Indigenous smokers. Potential effectiveness of specific anti-smoking mass media advertisements among Australian Indigenous smokers. Qualitative discussions remarked upon the fact that Anthony was speaking directly to them, reportedly making the ad more powerful. Alive was described by participants (particularly Indigenous groups and rural groups) as horrible and disgusting: ‘Makes me want to throw up’. Budgets for producing anti-smoking campaigns and purchasing mass media air time are often limited and cannot usually be tailored specifically for Indigenous people, so a balance between what will be effective in the population as a whole and Indigenous people needs to be struck. This supports the possibility that differences between the effects of these campaigns in the general population compared with the Indigenous population may be, at least in part, due to different levels of ‘meaningful exposure’ to these messages [15]. Significantly more Indigenous than non-Indigenous participants selected Billy (χ2 = 6.10, P = 0.014) and Amputation (χ2 = 4.25, P = 0.039) as most likely to make them feel like trying to quit. Facebook, for example, places restrictions on advertisements containing excessive visible skin, close-up images of some body parts and administrators can ban advertising if it is deemed to contain scary or disturbing scenes of any nature.15. 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