Research so far has shown that legal e-cigarettes are less harmful than tobacco cigarettes and they can help people stop smoking. This study evaluated a regional educational advertising campaign developed by Cancer Research UK to improve understanding of the relative harms of e-cigarettes compared with smoking and encourage smokers to consider quitting.
The campaign ran for four weeks in Greater Manchester in early 2018 and targeted smokers aged 25 to 55 years, particularly those from more disadvantaged socioeconomic groups. Researchers compared survey responses collected before and after the campaign in the intervention region and in matched control regions. The evaluation examined campaign reach, perceptions of e-cigarettes and awareness of their relative harm to tobacco, e-cigarette use, motivation to quit smoking, and quit attempts.
The campaign achieved substantial reach, with more than one-third of adults in the intervention region (36.7%) recognising at least one campaign element after it had run. Recognition was similar among the target audience and the wider population, suggesting the campaign reached beyond its intended audience.
Smokers exposed to the campaign showed increased motivation to quit smoking. Motivation to quit increased from 44.0% to 48.0% in the intervention region, while it declined in the control region over the same period. This was the clearest positive campaign effect identified in the study.
The campaign did not demonstrate a measurable improvement in perceptions of the relative harms of e-cigarettes compared with smoking, despite this being one of its primary objectives. Evidence for effects on this outcome was inconclusive.
Perceptions of e-cigarettes as an effective quitting aid increased in both regions, but the increase was smaller in the intervention region than the control region.
There was insufficient evidence to conclude that the campaign increased e-cigarette use, boosted quit attempts, increased recommendations of e-cigarettes to others, or changed daily vaping behaviour. Most non-significant findings were judged to be inconclusive rather than evidence of no effect.
This study provides evidence that educational mass media campaigns focused on e-cigarettes can reach large audiences and may help increase smokers’ motivation to quit. Given that motivation to quit is a strong predictor of future quit attempts, these findings suggest that campaigns communicating evidence-based information about e-cigarettes could play a role in supporting smoking cessation. However, the relatively short campaign duration and limited sample size may have reduced the ability to detect meaningful changes in behaviours and attitudes.
The findings also highlight the challenges of changing public perceptions about tobacco harm reduction. Although the campaign was specifically designed to address misconceptions about e-cigarettes, the evaluation was unable to show clear improvements in harm perceptions or behaviour change over the short follow-up period. This may reflect differences between the intervention and control regions, the complexity of the information being communicated, competing messages in the wider media environment, or limitations of a short-duration campaign.
Importantly, the study demonstrates that population-level communications about the relative harms of e-cigarettes can be implemented at scale and achieve substantial reach, including among groups with higher smoking prevalence. However, further research is needed to understand whether longer or more intensive campaigns can produce sustained changes in harm perceptions, increase use of effective quitting aids, and ultimately improve smoking cessation outcomes.
E-cigarettes can be a tool to support people who smoke to stop; however, e-cigarettes are not risk-free, and we don't yet know their long-term effects, therefore, children and people who have never smoked should not use them. It is important that any future evaluations measure for unintended consequences.
Read in full on the Oxford Academic websiteHarry Tattan-Birch, Sarah E Jackson, Charlotte Ide, Linda Bauld, Lion Shahab.
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