ICCN 17

Tobacco control and prevention through social media

Joan Bottorff – University of British Columbia, Kelowna, Canada



Tell us about your research.

My research focusses on the area of tobacco control and why that’s particularly important is that increasingly there’s a lot of attention being payed to the prevention of cancer and tobacco is one of the leading causes of cancer, not the only cause, obviously, but it’s one of the ones we know the most about. So reducing tobacco use and helping people not to start smoking or using tobacco in any way could make a really major difference in the number of cancer cases we have. Although in Canada we’ve been really good at reducing our smoking rates, there are still groups where the smoking rates are higher than they need to be and so much of our research has been focusing on some of those groups. One of the groups that we focus on is youth because we would like to prevent their uptake of smoking. One of the interesting projects that we’re doing is in relation to the use of social media; what we’re finding is that because of tobacco control regulations, tobacco companies have begun to advertise their products on social media like Facebook and other places. This is because there are no regulations there and so they will blatantly put up ads on Facebook, for example, advertising cigarettes. Of course, the most common users, or a group that commonly uses Facebook and other social media, are youth. So they’re really targeting youth to draw more people into smoking and it’s very clear.

So it’s interesting that tobacco control advocates haven’t really taken up this medium very much so one of the students that I’m working with, Laura Struik at the University of British Columbia, conducted a study. As a preliminary project we interviewed young women about the kind of tobacco control ads that they thought would work on Facebook because we showed them the current tobacco control ads that you might see in a magazine or on a poster encouraging people not to smoke, or young women in particular not to smoke. So we showed them those as a beginning and got their feedback on those and then we asked them, ‘If we were to put a message like this on Facebook, how would it need to change?’ They gave us some ideas about that, suggesting, for example, the messages needed to be interactive; they also need to be catchy because you just glance at things on Facebook and you’re not going to press on it and look at it unless it’s interesting and catchy or it’s something to interact with. So we need to design messages with those kinds of attributes to them. The advantage is if we could develop some effective messages for Facebook, particularly for young women, that was our target audience for this particular study, through social media the message could get spread very quickly because as soon… We found that girls in our groups often had 300 and 400 friends so if they like something then all of their friends are notified of that like, so immediately the message gets spread and it’s even better if it becomes viral or something like that. So there’s huge potential in using social media for tobacco control messages, particularly targeting youth, we think, and we haven’t done a lot of work in that area. So this was a beginning study to give us some ideas about how to design those messages so they’d be interesting and attractive to young women and encourage them to read them and interact with them.

Can you tell us about your presentation?

I’m presenting on a couple of our tobacco projects and in our programme of research we’re looking at various groups. For each group that we’re looking at, we’re trying to understand how best to support tobacco reduction in that particular group. We’re taking a gendered perspective in most of our studies so one of the studies that we’ve been doing for a number of years, we call it the FACET study, we’re looking at new families, so pregnant and postpartum women and expectant new fathers. We started the study because we were interested in trying to find better ways to support women’s tobacco reduction during pregnancy and postpartum because it’s such a critical thing for the health of the baby but also for the health of women as well. If we could prevent or encourage women to stop smoking at an early age like that, their chances of getting cancer down the road would also be decreased. As part of that study we began to interview partners as well, trying to figure out how they might be able to support women’s tobacco reduction. As we did those interviews with partners, we realised that we were talking with mostly men who smoked. We thought this was kind of interesting because when one person stops smoking in a household, in this case related to pregnancy, you would think it would be a cue to action for the other person in the household or that they might co-quit. We did find a couple of co-quitters but they were very hard to find; we found that most men continued to smoke during their partner’s pregnancy and that often made it very difficult for women to reduce themselves smoking, as you can imagine.

So we started talking to men because we thought why is it that they would continue to smoke? They justified their smoking in a whole number of ways but at the same time they talked then, as they became fathers and that baby was born and they became engaged in fathering, it weakened their resolve around smoking, they began to wonder if they should be smoking. Many of these men wanted to be ideal dads and they really talked about actually how important fathering was and how important being a dad was for them; it was actually really heart-warming. They didn’t want their children to know them as smoking men so they went to great pains to separate their smoking from their infants but they didn’t like that either. They thought that would be OK but they didn’t like it because it put them outside of the house smoking, away from their baby at a time they wanted to be with their babies. At the same time they told us there was no-one there that really helped them stop smoking. So we decided to talk to men a bit more, share some of our findings and begin to develop some resources that were specific for men. One of the resources we developed is a booklet that’s called The right times, the right reasons: Dads talk about reducing and quitting smoking. It’s got a very masculine look and feel to it; it includes the words and stories of the fathers that we interviewed; it’s there and that’s why it’s Dads talk about smoking. It’s not the expert voice, it’s the voice of fathers that comes through because men wanted to help each other and they really valued the experience of other men. So we thought rather than an expert talking that it may motivate men more to begin to reduce and stop smoking if it were other men talking about their experiences. In fact that kind of has proved true, we’ve had some very good response from both men and healthcare providers for this booklet because there’s nothing really like it out there. If we could figure out ways to support and reduce, help men support and reduce their smoking at this particular time, it would help women reduce their smoking, it would provide more smoke-free homes for children and it would prevent men’s cancer down the road and heart disease and all those other tobacco related diseases because you’re stopping smoking at an early time.

We’ve gone on to then develop a group programme for men that we call DIG – Dads in Gear. It’s an eight week programme, it’s very masculine oriented, it includes three thing: it includes, of course, a bit of tobacco reduction but there’s no set schedule for reducing and stopping smoking, we try to let men make their own decisions, they want to be autonomous in deciding how and when they want to quit smoking and so we encourage that. It includes fathering because we think one of the main motivators for reducing and stopping smoking is engagement in fathering and being a good father. So in every session we talk about things that will strengthen and support them in fathering. Then the last part is exercise because they told us that it’s really stressful being a new father and that was one of the reasons they needed to continue to smoke, to manage their stress. So we decided to include an exercise component as a stress management strategy but also as a way to help reduce smoking as well; we know that exercise can also support smoking cessation. So it’s an integrated programme with a masculine theme each week and we’ve done a pilot study of that and now we’re beginning to develop the resources that we used in that pilot so that we can begin to launch this programme in several communities and evaluate its effectiveness.