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The effectiveness of television advertising campaigns on generating calls to a national Quitline by Māori
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1. N Wilson1,
2. M Grigg2,
3. L Graham3,
4. G Cameron2
1. 1Wellington School of Medicine & Health Sciences, Wellington, New Zealand
2. 2The Quit Group, Wellington, New Zealand
3. 3Graham Strategic, Wellington, New Zealand
1. Correspondence to:  Dr Nick Wilson  Wellington School of Medicine & Health Sciences, PO Box 7343, Wellington, New Zealand; nwilsonactrix.gen.nz

## Abstract

Objective: To examine the effectiveness of four mass media campaigns on calls to a national Quitline by Māori (the indigenous people of New Zealand).

Methods: Monthly Quitline call data and calls within one hour of a television commercial (TVC) being shown were analysed for the 2002–2003 period. Data on target audience rating points (TARPs) and expenditure on TVCs were also used (n  =  2319 TVC placements).

## DISCUSSION

### Main findings

This study found that television advertising campaigns are successful in generating calls to a national Quitline from indigenous New Zealanders. Effectiveness was highest for those campaigns in which the Quitline number was included in the TVCs, and for the particular campaign that had both “threat appeal” and “calling for help” components (the EC campaign). Two of the four TVCs in this campaign were modified to include Māori specific aspects, and so these may have contributed to its effectiveness for Māori. Although the more Māori orientated campaign (IAW) was less effective in generating calls than the EC campaign, it is not strictly comparable as it covered a much broader scope of health issues (including smoking in pregnancy and SHS). It also had the broader theme of affirming Māori cultural identity, which has potentially both social and health benefits.

These findings are consistent with other data indicating that the IAW campaign was regarded favourably by a Māori audience,9,10 and with data on Quitline usage for the non-Māori and Pacific peoples in New Zealand.7

The cost effectiveness data suggests that expenditure on television advertising smoking cessation campaigns is a good use of public health sector expenditure. Even so, this effectiveness could be greatly enhanced if tobacco control in New Zealand was further strengthened (for example, by raising tobacco taxes).

### Study limitations

This study compared campaigns which had somewhat different objectives. Two campaigns consistently used the Quitline number in all TVCs while the two SHS campaigns did not include the number and did not have Quitline calls as an objective at all. Another difference between the campaigns was that the EC campaign had been running for over two years longer than the IAW campaign (albeit with some variation in the TVCs used).

During some of the year 2003, both the EC and IAW campaign TVCs were placed in time slots outside of Quitline opening hours as part of “general awareness raising” rather than to generate Quitline calls. This was to reduce the risk of the Quitline capacity being overloaded, to support and remind people undertaking quit attempts, and to support those who may choose to quit without the Quitline assistance. However, the probable outcome of this approach is that the results for calls per TARPs reported here are likely to be underestimates, relative to the use of other TVC placement strategies focused entirely on attracting Quitline calls. Even so, some of these calls to the Quitline may also be motivated by factors additional to the content of the TVCs—for example, access to the vouchers for heavily subsidised nicotine replacement therapy that are provided by the Quitline. Other more minor limitations with this study are detailed more fully elsewhere.7

### What this paper adds

This study examined the impact of four television advertising campaigns on calls to a national Quitline service by Māori (New Zealand’s indigenous population). The two campaigns with a Quitline telephone number were effective and cost effective in generating calls (particularly the one with the threat appeal messages). Health authorities should continue to support and further develop such campaigns and Quitline services to protect the health of indigenous peoples and reduce health inequalities.

### Implications for policymakers

Given this evidence for effectiveness and cost effectiveness, health authorities should continue to invest in such television campaigns and national quitline services. TVCs that are borrowed from other countries (as per the EC campaign) can be cost effectively utilised for different populations (at least for certain threat appeal messages). Nevertheless, local adaptation of these TVCs to maximise appropriateness for an indigenous audience is desirable so as to ensure a reduction in health inequalities attributable to smoking. Complete local development of TVCs by indigenous health workers for their own population may be more expensive, but it has the potential benefit of maximising authenticity and cultural appropriateness of the TVCs. As television channels multiply (for example, the new Māori television channel) there will be even greater scope for expanding reach to indigenous peoples and therefore maximising the benefits to health and the reduction of health inequalities.

## Acknowledgments

The authors wish to thank the Quitline callers who provided information about their ethnicity. They also thank Ramzan Afzal, Helen Glasgow, and Dr George Thomson who provided useful comments on the draft. This study was funded by The Quit Group which runs the Quitline on contract to the New Zealand Ministry of Health.

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## Footnotes

• Competing interests: none declared

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