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A comprehensive tobacco strategy:
The resources needed for success
Stephen Woodward
Protocol Management UK Ltd
What is a comprehensive tobacco strategy? (i)
WHO (1979), UICC (1980)
• Achievement of lower smoking rates in all age groups of the population by the application of all practical downward pressures:
– health warnings on packs– increased taxation– restrictions on smoking opportunities– support non-smokers rights– information and education programmes
What is a comprehensive tobacco strategy? (ii)
• Ban tobacco advertising and promotion
• Maintaining liaison with other health organisations and authorities to ensure maximum effectiveness and to avoid conflict of activities
How do we measure success?
• Numbers of leaflets?• Numbers of hits to website?• Pleasure of the Minister/Civil Servants?• Number of people employed?• Amount of money spent?• Level of our pay packet?• Happiness and harmony among tobacco
control workers?
Our only measureof success
• Lower smoking rates
• (Lower tobacco consumption)
The A B C for success
A
B
C
mbition
est practice
andour
Ambition
• Believe you can make a difference
• You can make a difference
• In a short time
Trends in smoking rates:Northern Ireland and California
0
5
10
15
20
25
30
35
N. Ireland California
%
19881998
Lung cancer death rates:Northern Ireland
0
5
10
15
20
25
30
35
1973 1983 1993
Age standardised
mortality rate under 65
years per 100,000 persons
Male Female
Lung cancer death rates:California…
Changes in heart attack & stroke in Northern Ireland under
White Paper v California targets
0
5
10
15
20
25
Heart attack Stroke
Year 1
Nu
mb
er o
f ad
mis
sio
ns
White Paper
California
Adapted from Naidoo, Stevens, McPherson. Tobacco Control, Dec 2000, pg 397-400
Changes in heart attack & stroke in Northern Ireland under
White Paper v California targets
0
100
200
300
400
500
Heart attack Stroke
Year 10
Nu
mb
er o
f ad
mis
sio
ns
White Paper
California
Adapted from Naidoo, Stevens, McPherson. Tobacco Control, Dec 2000, pg 397-400
Cumulative benefit of a sustained programme:
fewer cases of heart attack & stroke
0
20
40
60
80
100
1 2 3 4 5 6 7 8 9 10
Year
Ad
mis
sio
ns
What resources make a difference?
• Sustained (over 10 years),
• appropriately weighted,
• evaluated mass media programmes
Mass media costs money
• Get the money
• Keep the money
• Spend it wisely
How much money is required?
California: 30 million people
US$ 634 million over 10 years
US$ 63.4 million per year
US$ 28.6 million per year on media
US$ 2.11 per person per year
How much money is required?
Northern Ireland: 1.6 million people
US$ 2.11 per person per year
= US$ 3.38 million per year
= UK£ 2.11 million per year, with about half spent on media
Why mass media?
• It works
• It reaches the right target groups
Why mass media?
Why mass media?• It works
• It reaches the right target groups
• It passes the “Scream Test”
Smoking prevalence, Victoria 1983 - 1997
0
5
10
15
20
25
30
35
40
Health Promotion Foundation established
Quit funding
cut
Mass media costs money
• Get the money
• Keep the money
• Spend it wisely
