Looking at the case study: ;Under the skin': campaign aimed at hardened smokers

What techniques were used for message framing?

The case study

(Gold winner 2004 IPA Effectiveness Award) The campaign was part of ongoing activity which had used a range of messages and message frames, as shown by the illustrations overleaf.

The strategy chosen reflected the constant and multifaceted challenge to reduce the number of UK smokers and drew on the combined forces of the government, the British Heart Foundation and all other related charities working constantly towards minimising the number of people who start and maximising the number of people who successfully stop.

The British Heart Foundation's part in this was the now infamous 'fatty cigarette' campaign which dramatically bought to life the arterial damage caused by smoking. This case documents how the efforts of multiple advertisers produced a powerful combined effect, helping to reduce the number of smokers by over a million. Iconic imagery of the fat dripping from the cigarette created a powerful visceral response of revulsion in the smoker, and successfully pushed many of its target over the tipping point to quitting.

Given its enormous success, the British Heart Foundation could easily have opted to run 'fatty cigarette' again and again. But instead they chose to try to create the same impact, but with a new tactic. Those who resisted the 'fatty cigarette' message were now sufficiently desensitised to suggest its impact was abating. The law of diminishing returns had kicked in. A new and unexpected way to increase the determination of the hardened smoker to successfully quit was needed, one that positioned BHF as a friend of the smoker, a place to seek the help and support so vitally needed.

returns had kicked in. A new and unexpected way to increase the determination of the hardened smoker to successfully quit was needed, one that positioned BHF as a friend of the smoker, a place to seek the help and support so vitally needed.

A secondary target was identified as influencers and medical professionals and, beyond that, the rest of the smoking population.

In order to put together the strategic battle plan, we needed an understanding of the mindset of our core target, what they were expecting and how they could be 'caught' unawares. Research had identified the following characteristics:

• Expecting to be lectured and made to feel like socially unacceptable outcasts.
• Expecting huge scary statistics, most of which they know already and can repeat back to you word for word.
• Expecting to be made to feel like pariahs, when in fact the cigarette is the real enemy.
• An amazing capacity to defer the effects of smoking into the future on the basis that they'll stop 'tomorrow' or convince themselves that the worst-case scenario won't happen to them.

The strategy was to take a feel-good, popular song about love and longing, and cruelly twist it to refer to heart damage. However, this realisation would hit people only after they had begun humming along.

I've got you under my skin. I've got you deep in the heart of me. So deep in my heart, that you're really a part of me. I've got you under my skin . . . I'd sacrifice anything come what might. For the sake of having you near. In spite of a warning voice that comes in the night. And repeats, repeats in my ear: Don't you know you fool, you never can win? Use your mentality, wake up to reality. But each time I do, just the thought of you. Makes me stop before I begin. 'Cause I've got you under my skin.

The campaign did not portray someone on their deathbed, but instead just regular people, seemingly healthy (beautiful even), in regular everyday smoking scenarios that every smoker can relate to. It is the cigarette that is vilified, as the smoker is seen to be unaware of the clot that moves under their skin, moving ever nearer to the heart . . . and a heart attack.

The creative focused on communicating the ever-present danger of breakaway blood clots that can cause a heart attack any time, anywhere. The statistic 'A blood clot kills another smoker every 35 minutes' was a perfect fit to purpose. The statistic wasn't the biggest heart-stopping fact when researched, but was the one that best elicited a reaction of sufficiently alarm, without being so dramatic as to permanently remove all hope (and therefore reason to stop). Through making the cigarette the enemy, not the smoker, and by adopting a tone of helpful ally rather than disdainful judge, the BHF aimed to give people hope.

The creative focused on communicating the ever-present danger of breakaway blood clots that can cause a heart attack any time, anywhere. The statistic 'A blood clot kills another smoker every 35 minutes' was a perfect fit to purpose. The statistic wasn't the biggest heart-stopping fact when researched, but was the one that best elicited a reaction of sufficiently alarm, without being so dramatic as to permanently remove all hope (and therefore reason to stop). Through making the cigarette the enemy, not the smoker, and by adopting a tone of helpful ally rather than disdainful judge, the BHF aimed to give people hope.

Media placement targeted people when they had smoking front of mind - just coming out of the station ready to light up or having just put one out on their way into the station. Getting on and off the tube in Zone 1 is stressful in anyone's estimation . . .

Having beer mats in pubs was too good an opportunity to miss, catching people who had a pint in one hand and a fag in the other. An online strategy reached smokers at work. Here they could look in more detail at what they had heard or seen in other media the same day, while the initial message was still fresh.

Results

Sixty-three per cent of the core target strongly engaged with the TV, with a third 'completely drawn into it'. A large proportion of these people would have switched off instantly to traditional shock-based anti-smoking communications. We reached people previous campaigns couldn't.

The campaign was reported in detail, and at length, in most of the major national daily and weekly newspapers. More than four out of five of the core targets saw some element of the campaign. The campaign achieved very high cross-over, with over half the target seeing three or more parts of it. This compares to one in ten for the 'fatty cigarette' campaign.

People who saw three or more channels were 70% more likely to set a date to quit. Setting a date is recognised by the experts to be a serious step towards quitting. Over and above this, 18% of the target that saw three or more channels actually gave up versus 16% that saw just a single channel.

Seventeen per cent of the core target who saw the campaign stopped smoking. Of the core target that missed the campaign, only 11% stopped smoking. The difference is large enough to assert that the campaign didn't just make people more determined to quit, it nudged them over the quit line. The figure rose to 20% for people who strongly agreed that the ad told them 'smoking causes blood clots'.

These people could lapse; they had in the past. However, the average smoker takes six attempts at quitting before they finally make it. At the very least this was one more towards the final, successful, attempt. For many, it was that attempt.

The campaign's grand purpose was ultimately to improve the health, and therefore life expectancy, of the people we targeted. If the campaign is measured against the value of a life, it needs to save nine lives to warrant its 3 million investment. In these terms the campaign massively over-exceeded its objectives by contributing towards saving over 5,400 lives. For every 1 invested, 600 of value was retained within the economy.

The property of the song will live on beyond the campaign. People who saw the campaign will hear it again and again, and it will continue to remind these people not of falling in love, but of blood clots heading to the heart. Betty McBride, Policy and Communications Director at the BHF, summed it up: 'Thanks to Sinatra, every time they hear that song the smoker will bring to mind the unseen damage.'