Smoking cessation through social marketing strategies

Social Marketing: Anti-Smoking

Smoking - Social Marketing

Social marketing: 'Unfriending' smoking through a Facebook campaign

Conduct a situational analysis 'If your friend jumped off of a bridge, would you do it?' Perhaps the sobering answer to that question is not simply 'yes,' but that 'if my friend, or my friend's friend did so, I just might take the leap.' In the article "Are your friends making you fat," the authors of the book Connected: The surprising power of our social networks and how they shape our lives reported to the New York Times that social networks have a profound effect on the personal decisions human beings make, spanning everything from when they get married to how much they eat at a buffet-style restaurant (Thompson, 2009, p.1). One clear, measurable impact of social networks is the normalization of certain habits and social behaviors that affect human health, including smoking.

While smoking is a physical addiction, the delights of smoking have many salient features that transcend the biologically compelling nature of nicotine. The allure of striking the match, the satisfying smack of the pack on the smoker's wrist, the seductive blue rings of smoke that escape from a person's lips -- all of these demonstrate that smoking is compelling as a habit in ways that cannot always be easily quelled with a pill and which, to some degree, require a certain level of social normalization (Kessler, 2009, p.199). Smoking must be tolerated by the person's family and friends to be truly pleasurable. If the smoker can no longer share a puff with others, and the answer to the question 'can I smoke' relegates him or her outside in the cold, the delights of smoking began to be outweighed by the difficulties incurred by smoking, and the level of explicit or implicit social disapproval felt by the smoker.

A person must want to quit, and often the reasons for a person quitting smoking are very personal in origin. But smoking, like all addictive behaviors, is at least partially a social phenomenon. And it could be argued that the decision to begin smoking is an entirely social phenomenon, as without the support of friends as well as the encouragement of advertising, few would think to put tobacco in a piece of paper, light a match and inhale. However, up until now, anti-smoking campaigns have treated smoking as an individual physical compulsion and a disease. They have targeted the individual, rather than social communities. The negative health benefits of smoking are stressed, and smoker's cravings are treated with nicotine patches. "4,000 toxic chemicals leave a stench no perfume can mask... just ask the people around you. Please stop smoking, You'll smell better instantly. Call [HIDDEN] " read the text of one recent campaign (Gilford 2008)

The media has had an undeniable contributing factor to smoking. In the 1940s, a popular film "Now, voyager" depicted the hero seducing the heroine by lighting two cigarettes against his lips, and giving her one of the lit cigarettes. Sexy women and bad-boy males smoked in the 1950s. Smoking was seen as a sign of female liberation as early as the era of the flapper in the 20s, as 'nice' girls were not supposed to smoke. During the 1960s and 1970s, Virginia Slims capitalized upon the women's liberation movement by proclaiming 'you've come a long way baby' -- a long way, an anti-smoking advocate might say, to getting cancer at the same rates as males. (Toll & Ling 2009). In fact, evidence suggests that women may be more susceptible to the negative effects of nicotine than males despite the fact that fewer women smoke than men, although the disparity between the genders is shrinking (Smoking and women fact sheet, 2009, ALA). Yet the Virginia Slims cigarette brand was seen as so iconic and integral to feminism, it even sponsored the popular women's tennis tour, lead by pioneering tennis star Billie Jean King (Favorito 2009). This further normalized smoking, associating it with health as well as modern attitudes.

Awareness about the risks of smoking has also come a long way. Social shaping can often have a more powerful and immediate impact than traditional media-driven campaigns. In the Framingham Heart Study, chronicled in Connected, people slowly, even unwillingly quit smoking as their friends did, partially due to logistical difficulties. "I would take myself to Friendly's with a book, and I would sit there and have two cups of coffee and two cigarettes," said one woman. "At the time, her cigarette habit didn't seem like a problem; most of her friends also smoked socially. But in the late 1980s, a few of them began to quit, and pretty soon Eileen felt awkward holding a cigarette off to one side when out at a restaurant. She quit, too, and within a few years nobody she knew smoked anymore" (Thomas 2009, p.1).

This suggests that social forces have a tremendous impact on behavior as much as generic slogans -- although awareness campaigns may impact some individuals, those individuals must sow the seeds of healthy behaviors in their friends for campaigns truly have a widespread positive impact. "By analyzing the Framingham data, Christakis and Fowler say, they have for the first time found some solid basis for a potentially powerful theory in epidemiology: that good behaviors -- like quitting smoking or staying slender or being happy -- pass from friend to friend almost as if they were contagious viruses. The Framingham participants, the data suggested, influenced one another's health just by socializing. And the same was true of bad behaviors -- clusters of friends appeared to 'infect' each other with obesity, unhappiness and smoking" (Thomas 2009, p.2). Normalization of everything from child-bearing to eating too much -- to smoking, was passed along through social modeling.

Step 2: Select target audiences

The Framingham study began long before the Internet was accessible to consumers, and residents of the small, rural Massachusetts community are not 'hyper-connected,' by and large, because of their age. But the influence of social networks in real life suggests the potential to use social networks for good in the virtual world. This is, in a way, even more exciting, as more people can be reached with a point and click, rather than slowly and steadily through the more limited connections of the real world.

Teens are still smoking in record numbers -- but they are also using Internet social media in equally record numbers. It is time for anti-smoking to be 'invited' onto Facebook, in other words. Creating a Facebook-driven campaign to eliminate smoking upon teens is one way to use technology in a positive way, to truly make smoking 'uncool.' 'Unfriending smoking' can have a dual focus -- on teens who use Facebook, and upon parents as well, since older adults are the fastest-growing population of Facebook users. A Twitter campaign focused on adults, as adults are the most dedicated consumers of this 'micro-blogging' technology, would be another cost-effective way to foster non-smoking behavior in a positive fashion (Miller 2009). Every day, a 'tweet' could be issued that would contain a tip to keep teens away from smoking, a positive or negative statistic related to teen smoking, or positive messages about parents' need to quit themselves. The growing numbers of community members would create a state of social reinforcement on Facebook, amongst teens, to quit smoking and amongst adults on Twitter to quit or to more closely monitor their teens' behavior.

This social media strategy would deploy the current location of many Internet users on the relatively concentrated sources of social media. The time is now to create the campaign, before Facebook and Twitter have more competition. More competition means that communities online are likely to grow more diffuse, although currently Facebook and Twitter are dominant. This current domination would enable organizations committed to anti-smoking campaigns, like the American Lung Association and the federal government, to reach the maximum amount of people. It would also take advantage of the recession, given that many people want to quit smoking -- and are feeling forced to quit smoking -- due to the cost of cigarettes.

There is also added incentive to quit smoking now, because of the popularity of laws mandating restaurants and bars to ban smoking from indoor accommodations, These can leave smokers alone, miserable, cold and/or wet on long winter nights, while their friends have fun inside. The Facebook/Twitter campaign must make 'friends' want to come inside from the cold by 'unfriending' smoking. Targeting teens is ideal, because it focuses on the upcoming wave of addicted smokers before the habit has become a hardened part of these young persons' daily lives. It also tries to mitigate the health effects of smoking by encouraging teens not to start, or to quit as soon as possible, minimize potentially catastrophic damage to their developing bodies.

This campaign is important because quite often the dangers of smoking amongst teens are forgotten, because of concerns about other public health issues, such as teen pregnancy and violence. But "every day approximately 3,600 children between 12 and 17 years of age smoke their first cigarette, and an estimated 1,100 of them will become regular smokers. Half of them will ultimately die from their habit" (Smoking and teens fact sheet, 2009, ALA). Teens continue to smoke in record numbers -- particularly girls, who often report that they use smoking as a method of weight control (Smoking and women fact sheet, 2009, ALA). Demographic groups of teens that report the highest levels of weight consciousness also report the highest increases in rates of smoking: "Between 1992 and 1998, smoking prevalence increased significantly among white girls (from 31.2% to 41.0%) but only slightly among black girls (from 7.0% to 12.0%" (Smoking and teens fact sheet, 2009, ALA). Also, it is difficult for teens to quit when they see the behavior normalized at home in their parent's behavior.

Teen's brains are not fully developed, and they often have difficulty appreciating the consequences of their behavior -- they feel immortal, even if they might be highly intelligent (Inside the teenage brain, 2002, PBS). Teens might intellectually appreciate the consequences of smoking, but the emotional resonance of dying from smoking, or suffering in a gruesome fashion has less resonance than socially rewarding activities with peers. These social rewards might take the form of losing weight or sharing a cigarette with friends -- or the social and psychological reward might take the form of not conforming to parental demands and expectations.

Step 3: Set objectives and goals

Specifically, the desired objective of the Facebook/Twitter campaign is to get teens to stop smoking that have begun to smoke, and to stop teens from starting to smoke who do smoke by increasing teen awareness about the consequences of smoking in a way that makes them want to influence their friends to do the same. On a more specific level, the campaign also strives to make smoking 'uncool' and encourage teens to 'unfriend' and 'unlike' smoking, including social smoking.

Many teens ages 14 to 17 may not yet have the freedom or financial resources to be hard-core smokers, but they can adopt social smoking behavior, imitating older teens and parents, as well as media figures. Social smoking can spiral into actual addiction. Teens need to come to believe that smoking is uncool. One advertiser notes, in support of Internet-driven antismoking campaigns: "Small closely connected groups will result in [more effective] behavioral changes," than messages targeted at larger audiences, because small groups working together on a media site feel a personal investment in one another's success and behavior (Quit smoking with social networks, 2009, Social media trader). Only then do they strive to influence family members and friends in the real world to change.

Step 4: Analyze target audiences and the competition

In contrast to teens growing up in previous decades, teens today, thanks to school and television educational programs are at least intellectually or theoretically aware that smoking is bad (Smoking and teens fact sheet, 2009, ALA). They may not fully appreciate the health risks of smoking, which include heart disease as well as lung cancer and emphysema. They may also not understand that smoking can exacerbate current health conditions, like diabetes. They may be vaguely aware of the fact that smoking is unaesthetic, and also harms the teeth and gums. They may or may not know the extent of the risks of second hand smoke (Smoking and teens fact sheet, 2009, ALA). This is critical as even teens who do not smoke may be unwilling to tell their friends to 'quit it' when they light up in a car, or go to a smoky club.

Teens may be less apt to perceive the health benefits of quitting, especially if they suffer no immediate negative health consequences, although some teens might experience coughing, retching in the morning, and shortness of breath. However, some girls may fear gaining weight and perceive weight gain as a barrier. They may fear gaining weight in the short run more than the health benefits (including increased endurance during exercise, which promotes weight loss) in the long run because of the nature of teen risk perception (Inside the teenage brain, 2002, PBS).

Some teens who are contemplating quitting may fear alienating their friends, and losing a self-affirming social network. The usefulness of a teen-friendly medium like Facebook is that it has fewer associations with parental obedience than a traditional public health message by the government. While the costs of smoking themselves weigh on teen's minds, the perceived 'costs' of being alone or seeming to please one's parents must be taken into consideration when constructing the campaign. This would be one advantage to having a separate, Twitter-based campaign for teen parents, to separate the 'Unfriend' smoking campaign targeting teens.

Step 5: Develop marketing strategies

The core product will be a Facebook campaign in favor of smoking cessation. There will a persona on Facebook that teens can become a 'friend' of, and teens can also become a part of an 'Against Smoking' network of friends. Friends can also pledge to stop smoking and become a 'fan' of the site 'Against Smoking: Unfriend Smoking.' Teens trying to quit will be able to post how long they have quit on their 'walls' through the use of applications they 'allow.' Friends and fans will pledge not to 'favorite' any pro-tobacco products or logos. This will create a socially rewarding network of individuals wishing to abandon a negative behavior.