Designing and Implementing 

an Effective Tobacco 

Counter-Marketing Campaign 
Designing and Implementing


an Effective Tobacco


Counter-Marketing Campaign

Suggested Citation 

Centers for Disease Control and Prevention. Designing and Implementing an Effective Tobacco


Counter-Marketing Campaign. Atlanta, Georgia: U.S. Department of Health and Human


Services, Centers for Disease Control and Prevention, National Center for Chronic Disease


Prevention and Health Promotion, Office on Smoking and Health, First Edition October 2003.


Ordering Information 

To order a copy of this publication, contact:


Office on Smoking and Health


Media Campaign Resource Center


Mail Stop K-50


4770 Buford Highway, NE


Atlanta, GA 30341-3717


770-488-5705; press 2


e-mail: mcrc@cdc.gov


www.cdc.gov/tobacco/mcrc

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table of Contents


Acknowledgments ..........................................................................................................................................................5


Introduction: How to Use this Manual ........................................................................................................................9


Chapter 1: Overview of Counter-Marketing Programs ............................................................................................13


Chapter 2: Planning Your Counter-Marketing Program ..........................................................................................21


Chapter 3: Gaining and Using Target Audience Insights ........................................................................................51


Chapter 4: Reaching Specific Populations ................................................................................................................87


Chapter 5: Evaluating the Success of Your Counter-Marketing Program ............................................................109


Chapter 6: Managing and Implementing Your Counter-Marketing Program ....................................................143


Chapter 7: Advertising ................................................................................................................................................163


Chapter 8: Public Relations........................................................................................................................................201


Chapter 9: Media Advocacy ......................................................................................................................................245


Chapter 10: Grassroots Marketing ............................................................................................................................267


Chapter 11: Media Literacy........................................................................................................................................281


Resources and Tools....................................................................................................................................................297


Glossary ........................................................................................................................................................................331


Appendices ..................................................................................................................................................................343


Appendix 2.1: Counter-Marketing Planning Worksheet....................................................................................343


Appendix 3.1: Sample Recruitment Screener for Intercept Interviews on Smoking Cessation ..................349


Appendix 3.2: Sample Recruitment Screener for Individual Interviews To Test


Advertisements and Ad Concepts ..................................................................................................................351


Appendix 3.3: Moderator’s Guide for Focus Groups With Smokers ................................................................354


Appendix 3.4: Sample Moderator’s Guide for Focus Groups To Test 


Advertisements With Youth..............................................................................................................................360


Appendix 3.5: Sample Self-Administered Form To Test Fact Sheets ................................................................363


Appendix 3.6 : Sample Intercept Interview Questionnaire ..............................................................................366


Appendix 5.1: Examples of Inputs, Activities, Outputs, and Outcomes 


for Counter-Marketing Programs ..................................................................................................................374

Appendix 5.2: Key Data Collection Tools and Methods ....................................................................................378


Appendix 5.3: Key Variables and Sample Items to Consider Including in Survey 


of Target Population ........................................................................................................................................381


Appendix 6.1: Key Elements of a Request for Proposals (RFP) for a Media Campaign ................................386


Appendix 6.2: Questions and Answers on RFPs ................................................................................................394


Appendix 6.3: Elements of a Creative Brief ........................................................................................................409


Appendix 6.4: Creative Brief, Florida

Appendix 6.5: Creative Brief, Centers for Disease Control and Prevention 


....................................................................................................................413


and World Health Organization ......................................................................................................................415


Appendix 6.6: Creative Brief, Centers for Disease Control and Prevention ....................................................418


Appendix 7.1: Sample Advertising Comment Organizer ..................................................................................419


Appendix 7.2: Sample Storyboard—“Carnival” ..................................................................................................421


Appendix 7.3: Sample Storyboard—“Drive” ......................................................................................................422


Appendix 8.1: Sample Printed Campaign Newsletter........................................................................................423


Appendix 8.2: Sample Online Newsletter............................................................................................................427


Appendix 8.3: Sample Editorial ............................................................................................................................431


Appendix 8.4: Sample Letter to the Editor ..........................................................................................................432


Appendix 8.5: Sample Op-Ed ................................................................................................................................433


Appendix 8.6: Sample Spokesperson Profile Sheet ............................................................................................435


Appendix 8.7: Sample Pitch Letter ......................................................................................................................437


Appendix 8.8: Sample News Release....................................................................................................................438


Appendix 8.9: Sample Fact Sheet..........................................................................................................................440


Appendix 8.10: Media Contact Record ................................................................................................................445


Appendix 10.1: Georgia Burden of Tobacco Brochure ......................................................................................446


Feedback Form ............................................................................................................................................................456

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Acknowledgments


The following individuals served as the managing editors for this publication: 

Linda Block, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and 


Health Promotion, Centers for Disease Control and Prevention 


Karen Gutierrez, Office on Smoking and Health, National Center for Chronic Disease Prevention and 


Health Promotion, Centers for Disease Control and Prevention


The following individuals are the primary authors of this publication: 

Elaine Arkin, Health Communications Consultant


Joan Clayton-Davis, MA, Academy for Educational Development


Susan Middlestadt, Ph.D., Academy for Educational Development


Peter Mitchell, Academy for Educational Development


Anne Marie O'Keefe, Ph.D., JD, Academy for Educational Development 


Todd Phillips, MS, Academy for Educational Development


Rose Mary Romano, MA, Academy for Educational Development


Phil Wilbur, MA, Northrop Grumman IT Health and Science Solutions


We thank the following individuals from the Centers for Disease Control and Prevention, for assistance in 

reviewing and contributing to this document: 

Cheri Ahern, Office on Smoking and Health


Stephen Babb, MPH, Office on Smoking and Health


Diane Beistle, Office on Smoking and Health


Galen Cole, Ph.D., Office of Communication


Alyssa Easton, Ph.D., MPH, Office on Smoking and Health


Monica Eischen, Office on Smoking and Health


Reba Griffith, MPH, Office on Smoking and Health


May Kennedy, MPH, Office of Communication


Sharon Kohout, MA, Office on Smoking and Health


Dianne May, MA, MPH, Office on Smoking and Health


Jeff McKenna, MS, Office on Smoking and Health


Acknowledgments 5 
Patty McLean, M.Ed., Office on Smoking and Health


Rebecca Murphy, Ph.D., Office on Smoking and Health


Claudia Parvanta, Ph.D., Office of Communication


Alpa Patel-Larson, Office on Smoking and Health


Linda Pederson, Ph.D., Office on Smoking and Health


Lisa Petersen, MS, Office on Smoking and Health


Oona Powell, MA, Office on Smoking and Health


Chris Prue, MSPH, Ph.D., Office of Communication


Robert Robinson, Dr.P.H., Office on Smoking and Health


Michael Schooley, MPH, Office on Smoking and Health


Karen Siener, MPH, Office on Smoking and Health


The Office on Smoking and Health thanks the following individuals for their careful review of drafts 

of this manual: 

Debra Bodenstine, Florida Department of Health


Deborah E. Boldt, MPA, Missouri Partnership on Smoking or Health 


Nicole Boyd, JD, The Partnership for a Healthy Mississippi


Greg Connolly, DMD, MPH, Massachusetts Department of Public Health 


Larry Davis, Global Lead Management Consulting 


Peter DeBenedittis, Ph.D., New Mexico Media Literacy Project


Robert Denniston, MA, Office of National Drug Control Policy


Mark Dinneen, Alaska Department of Health


Susan Giarratano Russell, EdD, MSPH, CHES, Health Education and Media Consultant


Sandi Hammond, Massachusetts Department of Public Health


Ann Houston, CHES, North Carolina Department of Health


Lucy Huang, IW Group, Inc.


Mary Jane Mahan, MA, DeKalb County Board of Health


Danny McGoldrick, MA, Campaign for Tobacco-Free Kids


Barbara A. Moeykens, MS, Vermont Department of Health


Mike Pertschuk, JD, Advocacy Institute


Monica Pribil, MA, Nebraska Department of Health and Human Services


6 Acknowledgments 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Amelie Ramirez, Dr.P.H., Baylor College of Medicine


Janet Reid, Ph.D., Global Lead Management Consulting


Schaelene Rollins, California Department of Health Services


Russell Sciandra, MA, Center for a Tobacco Free New York


David Sly, MS, Ph.D., Florida State University


William D. Snook, MS Ed., Missouri Health Department


Colleen Stevens, MSW, California Department of Health Services


Makani Themba-Nixon, The Praxis Project


Chuck Wolfe, Wolfe Strategies


David Zucker, Porter Novelli


The Office on Smoking and Health thanks the following individuals for support in producing this manual: 

Daria Bessom, Northrop Grumman IT Health and Science Solutions 

Adjoa Burrowes, Northrop Grumman IT Health and Science Solutions 

Sheila E. Coble, Northrop Grumman IT Health and Science Solutions 

Vivian Doidge, MA, Northrop Grumman IT Health and Science Solutions 

Dee Ellison, MS, Academy for Educational Development 

Maxine Forrest, Northrop Grumman IT Health and Science Solutions 

Catherine Macapugay, Northrop Grumman IT Health and Science Solutions 

Anne Mattison, MA, Northrop Grumman IT Health and Science Solutions 

Jennifer Mike, Northrop Grumman IT Health and Science Solutions 

Eloisa Montes, MA, Northrop Grumman IT Health and Science Solutions 

Don Mullins, MPH, Northrop Grumman IT Health and Science Solutions 

Melissa Ratherdale, MA, Academy for Educational Development 

Susan Rogers, Ph.D., Academy for Educational Development 

Rebecca Rosenthal, Academy for Educational Development 

Jeff Roussel, Northrop Grumman IT Health and Science Solutions 

Laura Simon, Northrop Grumman IT Health and Science Solutions 

Pam Sutton, Academy for Educational Development 

Carol Winner, MPH, Northrop Grumman IT Health and Science Solutions 

Acknowledgments 7 
8 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Introduction 

How To Use This Manual


This manual is designed to be a comprehensive resource for state health 

departments and other agencies and organizations in developing and 

implementing tobacco counter-marketing campaigns. It is designed to help 

readers who have different levels of experience and are managing programs 

at different stages of development. 

This manual contains a wealth of information on a range of countermarketing topics. Some of the topics and information may be new to you, 

while you may already have a good command of other topic areas. This 

resource is meant to help with activities you’re working on currently, as well 

as projects you undertake in the future. Different chapters will be more 

helpful at different times. 

Don’t feel that you have to read the manual from cover to cover. This introduction should give you a sense of the manual’s content and organization. We 

suggest that you begin by reading Chapter 1: Overview of Counter-Marketing 

Programs. Then feel free to skip some chapters, read other chapters more 

thoroughly, or move directly to the subjects that are most pertinent to 

your needs. 

What You Will Find in This Manual 

The first half of the manual focuses on planning and preparation, and the 

second half addresses specific counter-marketing techniques. The manual 

also includes a list of resource organizations, appendices relevant to topics 

found in individual chapters, and a glossary. 

Introduction: How To Use This Manual 9 
Here’s a quick look at each chapter: 

■	

■	

■	

■	

■	

■	

■	

■	

■	

Chapter 1 provides an overview of tobacco counter-marketing and the key characteristics of 

a successful tobacco counter-marketing program. 

Chapter 2 focuses on planning the tobacco counter-marketing program. It describes seven 

planning steps, from defining the problem through developing the program. 

Chapter 3 discusses the use of market research to gain insights into your target audience. To 

create effective messages, it’s important to understand the cultures, behaviors, motivations, 

interests, and needs of the target audiences. This chapter compares and discusses three types 

of market research methods: qualitative, quasi-quantitative, and quantitative. 

Chapter 4 focuses on specific populations, which are defined by demographic characteristics 

such as age, race/ethnicity, income, educational level, and sexual orientation and by 

epidemiologic data related to health disparities. The chapter discusses cultural context, 

diversity within and among specific populations, appropriate language, potential audience 

barriers and how to overcome them, the role of formative research in working with specific 

populations, and cultural competency. 

Chapter 5 addresses program evaluation, a critical component in tobacco countermarketing campaigns. Program evaluation is the systematic collection of data about a 

program’s activities and outcomes, so the program’s delivery, efficiency, and effectiveness 

can be analyzed, better understood, and improved. 

Chapter 6 explores the key steps in implementing a successful program. It addresses how to 

manage personnel issues, choose contractors, develop marketing and communication 

plans, and involve stakeholder organizations. 

Chapter 7 examines advertising and takes the reader through the four key elements of an 

advertising campaign: logistics, strategy, creative, and exposure. 

Chapter 8 focuses on public relations (PR). The first half of the chapter outlines the process 

for using PR to reach your target audience(s) and key influencers. The second half explains 

how to implement PR activities, such as managing a PR agency, handling press relations, 

developing press materials, pitching stories, and responding to media inquiries. 

Chapter 9 discusses media advocacy. Defined as the strategic use of media and community 

advocacy to create social or policy change, media advocacy helps communities create longlasting environmental change. 

10 Introduction: How To Use This Manual 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Chapter 10 focuses on grassroots marketing, which includes involving new people in 

tobacco counter-marketing campaigns, increasing the involvement of those already 

reached, and using those already engaged to increase an audience’s exposure to key 

messages. Events, community organizing, and partnerships are forms of grassroots 

marketing, and they are united by their goal to create and use target audience participation. 

■	 Chapter 11 explains how media literacy relates to and reinforces tobacco counter-marketing 

campaigns. This chapter highlights the key concepts of media literacy and provides 

resources for identifying and implementing media literacy programs. 

An effective tobacco counter-marketing campaign can make a vital contribution to a comprehensive tobacco control and prevention program. Although the components of counter-marketing are 

presented separately in this manual, they work synergistically to strengthen the impact of the 

overall campaign; one or two successful components will not be enough to achieve your program 

goals. The art of tobacco counter-marketing is in blending and balancing the various components 

into a coherent, effective whole. We hope the chapters in this manual will help you develop a 

comprehensive tobacco counter-marketing program that progresses toward achieving your goals. 

Introduction: How To Use This Manual 11 
12 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 1 

Overview of Counter-


Marketing Programs


Counter-Marketing: An Art and a Science 

With the success of programs in Arizona, California, Florida, Massachusetts, 

Minnesota, Mississippi, Oregon, and other states in the past decade, it’s 

clear that comprehensive tobacco control programs are a powerful tool for 

reducing tobacco use. As many studies have shown, an important piece of 

a comprehensive tobacco control program is a strong counter-marketing 

program (Centers for Disease Control and Prevention [CDC] 1999; Hopkins 

et al. 2001). Tobacco counter-marketing is defined as the use of commercial 

marketing tactics to reduce the prevalence of tobacco use. “Countermarketing attempts to counter protobacco influences and increase prohealth 

messages and influences throughout a state, region, or community” (U.S. 

Department of Health and Human Services [USDHHS] 2000). 

Counter-marketing activities can play a role in increasing smoking cessation, 

reducing smokeless tobacco use, decreasing the likelihood that people will 

begin smoking cigarettes, and reducing nonsmokers’ exposure to secondhand tobacco smoke. Counter-marketing messages can also substantially 

influence public support for tobacco control interventions and increase 

support for school and community efforts (USDHHS 2000). Countermarketing messages work best when they are tied to the activities of local 

programs throughout a state. 

In This Chapter


• Counter-Marketing: 

An Art and a Science 

• What We Are 

Countering 

• Qualities of a Good 

Counter-Marketing 

Program 

• The Power of 

Counter-Marketing 

Chapter 1: Overview of Counter-Marketing Programs 13 
What We Are Countering 

Tobacco counter-marketing programs play 

a vital role in countering the influential 

promotional activities of the tobacco industry, 

which spends billions of dollars a year on 

advertising and promotions. The following 

statistics underscore the importance and 

necessity of tobacco counter-marketing: 

■	

■	

■	

■	

■	

Total annual spending on cigarette 

marketing by the six major U.S. cigarette 

makers rose 16.2 percent from 1999 to 

2000, an increase from $8.24 billion to 

$9.57 billion, the highest figure ever 

reported to the Federal Trade 

Commission (FTC 2002). 

In 1999, the five major smokeless 

tobacco companies in the United States 

spent $170.2 million on advertising and 

promotions, an all-time high (FTC 2001). 

The six major U.S. cigarette companies 

spent more than $949,000 on Internet 

advertising in 2000, according to the 

Federal Trade Commission (FTC 2002). 

In 2000, more than 80 percent of young 

people in the United States were 

reached an average of 17 times per 

person by magazine ads for “youth” 

brands of cigarettes (King and Siegel 

2001). (The study defined cigarette 

brands as “youth” brands if they were 

smoked by more than 5 percent of the 

smokers in the 8th, 10th, and 12th 

grades in 1998.) 

school students in the United States saw 

tobacco ads on the Internet (CDC 2001b). 

In 2000, about one-third of middle 

school students and one-fourth of high 

Qualities of a Good CounterMarketing Program 

Best Practices for Comprehensive Tobacco 

Control Programs (CDC 1999) identifies a 

number of elements crucial to a comprehensive tobacco control program; one of these 

elements is counter-marketing. Seven key 

characteristics apply to all successful countermarketing campaigns: 

1. 	 A counter-marketing program must be 

long term. The tobacco industry took 

decades to establish brand identity for its 

products and to normalize tobacco use as 

a part of our culture. Likewise, tobacco 

control efforts should be considered longterm commitments to addressing the 

problems associated with tobacco use, 

rather than short-term or episodic 

activities. If a state is developing a branded 

campaign, it should choose a brand that 

can stand the test of time and be refreshed 

as needed with brand extensions. Effective 

counter-marketing initiatives are intended 

to make important contributions today 

toward short-term goals, while also laying 

the groundwork for meeting long-term 

goals. 

2. 	 A comprehensive tobacco countermarketing program should consist of 

integrated, not isolated, components. 

Although they are explained separately in 

this manual, these components are most 

effective when they complement and 

14 Chapter 1: Overview of Counter-Marketing Programs 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

support one another. A comprehensive 

counter-marketing program must use a 

variety of available techniques and 

components at different times and in 

different combinations. 

3. 	 The counter-marketing program must be 

integrated into the larger tobacco control 

program. Just as counter-marketing 

components should be integrated, the 

counter-marketing program should 

complement the other elements of the 

tobacco control program, such as 

educational efforts, cessation initiatives, 

enforcement campaigns, and policy 

campaigns (including those related to 

secondhand tobacco smoke and price 

increases for tobacco products). 

Coordinating your counter-marketing 

efforts with local programs is a powerful 

way to extend their effect. In short, you 

need to tie the counter-marketing goals to 

the overall strategic goal for your tobacco 

control program. 

4. 	 A counter-marketing program must be 

culturally competent. No single countermarketing program will be effective for 

every segment of the population because 

tobacco use affects socioeconomic groups, 

age groups, racial/ethnic groups, and other 

specific populations in varying ways. 

Messages and strategies should be tailored 

as needed to be most effective among the 

campaign’s different target audiences. 

marketing program involves making


decisions about the overall direction of the 


program, its target audiences, creative


products, implementation, and evaluation.


Strategic planning is about setting priorities


and making sometimes difficult choices


about how program funding will be allo­


cated and how staffing will be organized.


These decisions should be based on how


these factors will contribute to the program’s


overall goals.


5.	 A counter-marketing program should be 

strategic. Successfully managing a counter6.	 A counter-marketing program should be 

evaluated. This process should begin with 

two questions: “What information do you 

or other key stakeholders want to know?” 

and “How do you obtain and use that 

information?” Evaluation isn’t merely a 

report that’s completed after all the work is 

finished. Evaluation provides a tobacco 

control program with continuous updates 

and insights on what is working, what is 

not, and what changes might need to be 

made to ensure that the program is progressing toward achieving its goals and objectives. 

7. 	 A counter-marketing program should be 

adequately funded. Tobacco advertising 

and promotion activities appear to both 

stimulate adult tobacco consumption and 

increase risk of youth initiation of tobacco 

use. Today’s average 14-year-old has been 

exposed to more than $20 billion in imagery, 

advertising, and promotions since age 6, 

creating a familiarity with tobacco products 

and an environment in which smoking is 

seen as glamorous, social, and normal 

(CDC 1999). In light of these ubiquitous 

Chapter 1: Overview of Counter-Marketing Programs 15 
and sustained messages promoting tobacco 

use, counter-marketing efforts of comparable intensity are needed. The Centers 

for Disease Control and Prevention 

recommends that, at a mini-mum, states 

should allocate $1 to $3 per capita annually 

for a counter-marketing campaign that 

addresses all program goals in all major 

media markets in the state (CDC 1999). 

The Power of Counter-Marketing 

The California Tobacco Education Media 

Campaign, which began in the late 1980s, is 

one example of a successful countermarketing campaign (Independent Evaluation 

Consortium of The Gallup Organization et al. 

2001; Pierce et al. 1998). It uses hard-hitting 

earned media, grassroots marketing, and paid 

advertising (television, radio, billboards, 

transit, and print) to communicate the dangers 

of tobacco use and secondhand smoke and to 

counter protobacco messages throughout the 

state’s ethnically diverse communities. 

California’s campaign has demonstrated a 

strong correlation between its Tobacco 

Education Media Campaign program and 

decreased smoking prevalence rates even 

accounting for all other factors (e.g., increased 

excise tax): 

■	 A study found that the California 

antitobacco media campaign reduced 

sales of cigarettes by 232 million packs 

between the third quarter of 1990 and 

the fourth quarter of 1992. This 

reduction was independent of the 

decreases in consumption brought 

about by a tax increase (Hu et al. 1995). 

■	 A report from the University of 

California, San Diego, covering 1989 to 

1993 showed that the proportion of 

Californians who tried to quit smoking 

for more than one day rose significantly 

whenever the media campaign was in 

effect (Pierce et al. 1994). 

Another example of an effective countermarketing campaign is the Florida Pilot 

Program on Tobacco Control, which began in 

1998 (Bauer and Johnson 2001). Florida’s 

program is a comprehensive, youth-focused 

campaign that includes a youth-directed 

media campaign marketing the “truth” brand 

and slogan, youth and community activities 

organized as Students Working Against 

Tobacco (SWAT), school-based education and 

training, and retailer education and enforcement. From 1998 to 2000, youth tobacco use 

declined 40 percent among middle school 

students and 18 percent among high school 

students, and attitudes among students 

changed regarding deglamorizing tobacco use 

and tobacco industry manipulation, which 

were key campaign themes. Overall program 

results demonstrated that a comprehensive 

statewide program can be effective in 

preventing and reducing youth tobacco use 

(Bauer and Johnson 2001): 

■	 Current cigarette use dropped among 

Florida students, from 18.5 percent to 

11.1 percent of middle school students 

and from 27.4 percent to 22.6 percent 

of high school students. The primary 

campaign objective, to change attitudes 

about tobacco, was achieved. The 

16 Chapter 1: Overview of Counter-Marketing Programs 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

percentage of students committed to 

never smoking increased from 56.4 

percent to 69.3 percent of middle school 

students and from 31.9 percent to 43.1 

percent of high school students. The 

percentage of students currently 

experimenting with cigarettes declined 

from 21.4 percent to 16.2 percent of 

middle school students and from 32.8 

percent to 28.2 percent of high school 

students. The percentage of students 

experimenting with tobacco use who 

indicated they would not smoke again 

increased from 30.4 percent to 42.0 

percent of middle school students and 

44.4 percent to 51.0 percent of high 

school students (Bauer and Johnson 

2000). 

■	 Participants surveyed in October 1998 

and October 2000 were contacted again 

in February 2001 to determine their 

ability to recall specific antitobacco ads 

and to determine actual changes in 

smoking behavior. The results showed a 

strong correlation between confirmed 

awareness of the “truth” advertising 

campaign and reduced likelihood of 

beginning to use cigarettes and increased 

likelihood of quitting (Sly et al. 2001). 

Along with the California and Florida 

campaigns, successful counter-marketing 

programs have been implemented in several 

other states, including Arizona, Massachusetts, 

Minnesota, Mississippi, and Oregon. In all 

these states, reductions in smoking consumption or prevalence or both have been attributed to a combination of tobacco control 

elements, including strong tobacco countermarketing campaign (CDC 1999; CDC 2003). 

The statistics from various state efforts indicate that it is possible to make a significant 

impact with counter-marketing efforts, but it 

requires hard work and ongoing commitment 

to the program. In addition, although many 

parts of a campaign can be measured and 

tested, successful counter-marketing remains 

an art as much as a science. Making the right 

choices in developing an effective countermarketing program is often complicated and 

requires constant strategic focus, coupled with 

flexibility when needed. This manual presents 

many of the lessons, subtleties, insights, and 

experiences of those who have learned firsthand how to create a successful campaign. 

Chapter 1: Overview of Counter-Marketing Programs 17 
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Bauer UE, Johnson TM. Changes in youth cigarette use and intentions: following implementation of a tobacco 

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Chapter 1: Overview of Counter-Marketing Programs 19 
20 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 2 

Planning Your CounterMarketing Program 

Planning is the foundation of your counter-marketing 

program. Although sound planning alone can’t guarantee 

success, it is a very important first step. 

Effective planning helps you clarify exactly which aspects of the problem of 

tobacco use your counter-marketing program can affect and how you can use 

resources most efficiently to make the greatest impact. Planning helps you set 

clear objectives that will enable you to select and prioritize activities. Not only 

does it guide program development, but it also helps you assess progress and 

make choices that will enhance your program’s chances for future success. 

Seven Steps for Planning 

This chapter describes the steps for planning your program (National Cancer 

Institute [NCI] 2002; Centers for Disease Control and Prevention [CDC] 2003). 

Although these steps are described here in sequence, planning is an integrated, not a sequential, process. Become familiar with each of these steps before 

you start. Planning is also an iterative process; much of the planning you do 

will incorporate multiple steps at once or require making changes to steps on 

which you have already worked. 

In This Chapter


Seven Steps for 

Planning Your 

Counter-Marketing 

Program 

1. Describe the 

Problem 

2. Identify Target 

Audiences 

3. Draft Objectives 

4. Determine 

Approaches, 

Channels, and 

Program Strategies 

5. Consider 

Collaboration 

6. Plan for Process 

and Outcome 

Evaluation 

7. Begin Program 

Development 

Chapter 2: Planning Your Counter-Marketing Program 21 
Here are the seven essential 

steps for planning a countermarketing program: 

1. Describe the problem and identify 

how counter-marketing 

approaches can address it. 

2. Identify and learn about target


audiences.


3. Draft counter-marketing


objectives.


4. Determine counter-marketing 

approaches, channels (pathways), 

and program strategies. 

5. Consider collaboration. 

6. Plan for process and outcome


evaluation.


7. Begin counter-marketing program 

development. 

With so many demands on your time, you may 

be tempted to skip some steps, but thorough 

planning will be worth the time invested. A 

written plan will help you enlist the support of 

your organization’s management, partners, 

stakeholders, and funding sources, and to 

respond to critics by defending the choices you 

have made. 

The sample Counter-Marketing Strategic 

Planning Worksheet (Appendix 2.1) can help 

you begin. You also may want to review 

CDCynergy for Tobacco Prevention and Control, 

CDC’s CD-ROM-based planning tool that 

includes several tobacco-related case studies 

(CDC 2003). 

Step 1: Describe the problem and 

identify how counter-marketing 

approaches can address it. 

Before you start, review the tobacco control 

goal(s) your program will support. For example, if the overall tobacco control program will 

focus on adult smoking cessation, then your 

counter-marketing program shouldn’t address 

smoking cessation in youth. If the overall 

program goals are to increase adult smoking 

cessation and to decrease exposure to secondhand smoke, then you’ll need to develop 

counter-marketing plans to address each of 

these goals. 

1a. Describe the problem. 

Once you have verified the program’s overall 

goal(s), you can identify the specific problem 

or issue to address. Make sure that everyone 

agrees on what the problem is and that you 

have sufficient information to understand it 

and describe it. The amount of information 

needed to develop a description of the problem depends on factors such as the following: 

■	 How much experience your


organization has with the issue


■	 How much information is available on 

the issue in your area or in a similar locale 

■ How much research is needed to justify 

your decision to your organization and 

to potential critics of your program 

Be specific in describing the problem. The 

problem description should include: 

22 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

What Works? 

Counter-marketing programs with the following characteristics are more likely to succeed (Backer et al. 

1992; NCI 2002): 

■	

■	

■	

■	

■	

■	

■	

■	

■ Commitment over time. Successful programs commit to the long term, recognizing that changes in 

behavior take time. Initial indicators of progress don’t always mean that changes will be maintained. 

■ A focus on changing social norms. Over the long term, changes in social norms that demonstrate 

acceptance of the desired outcomes are true indicators of the program’s success. 

Specific outcomes. Program objectives should be clear and specific. General descriptions don’t 

provide enough direction for program design or evaluation. (See Step 3 for tips on developing 

objectives that are specific, measurable, achievable, relevant, and time-bound [SMART].) 

Multiple target audiences. Many outcomes involve multiple target audiences. For example, if 

prevention of smoking by adolescents is the goal, you may want to reach teens in different social 

or age groups, parents, and teen “influencers” (e.g., sports coaches or older siblings) with your 

program’s messages and interventions, assuming the budget is adequate to address all of them. 

Multiple tactics. Integrating multiple tactics (e.g., combining advertising with advocacy and media 

literacy) into a unified counter-marketing campaign can help a program address a problem in 

different ways and thus enhance its effectiveness. 

Multiple types of change. Many outcomes call for changes in individual behavior as well as other 

types of change (e.g., a shift in policy or environmental norms) that will support or contribute to 

behavior change. 

Messages that directly support intended changes. General awareness or prevention messages (e.g., 

“don’t smoke” or “smoking is harmful”) rarely are enough. Messages should be specific and should 

directly contribute to achieving the intended changes (e.g., encouraging people to call a quitline). 

Tailored messages and activities. Appropriate messages and activities are likely to differ for 

different target audiences and at different times in the program, depending on the perceptions, 

needs, interests, and behaviors of the audience. 

Formative research. Research to glean key insights about target audiences is essential to guide you 

in program design and to help you determine the most effective strategies, messages, and activities. 

Research is equally important for programs that target teens, adult smokers, policy makers, or any 

other targeted group. 

Consistency. Although the program’s messages and activities are tailored for each audience, they all 

must support strategies designed to reach the tobacco control program’s overall goals. 

Chapter 2: Planning Your Counter-Marketing Program 23 
■	

■	

■	

Who is affected and how 

The severity of the problem, along with 

data used to measure the severity 

Who can positively influence the


situation or the affected group


1b. Describe who is affected. 

If possible, describe subgroups that may be 

affected disproportionately by the problem. 

These subgroups should be sufficiently large 

and sufficiently different from one another and 

the general population to justify distinction. 

Subgroup descriptions can include: 

■	

■	

■	

Demographic information (e.g., age, 

gender, race/ethnicity, education, and 

family income) 

Geographic information (e.g., location 

of residence, school, and work) 

Psychographic information (e.g., 

attitudes, opinions, intentions, beliefs, 

and values) 

You should become familiar with sources of 

available data that can help describe the 

population, the severity of the problem, and 

the ways to measure change. (See Chapter 5: 

Evaluating the Success of Your CounterMarketing Program and the Resources section 

of this manual for more information.) Individuals in your state programs for chronic disease 

or health statistics or others with epidemiologic 

training or experience can help you find 

relevant data sources. Here are some examples: 

■	 Surgeon General’s reports 

■	 Behavioral surveys such as the national 

Youth Risk Behavior Survey, the Youth 

Tobacco Survey, and the Behavioral Risk 

Factor Surveillance System survey 

■	 Consensus statements and recommendations by national organizations, such 

as the tobacco cessation guidelines 

published by the Agency for Healthcare 

Research and Quality 

■	 Web sites that list sources of U.S. government information on tobacco control 

issues (e.g., http://www.healthfinder.gov 

and http://www.cdc.gov/tobacco) 

■	 Relevant qualitative and quantitative 

research that other states or organizations conducted in developing their 

programs 

■	 Database searches for journal articles and 

scientific reports (e.g., CDC/OSH’s 

Smoking and Health Database 

(http://www.cdc.gov/tobacco/search/) 

and MEDLINE (http://medline.cos.com/) 

1c. Refine the problem statement. 

As additional information becomes available, 

refine your problem statement by adding more 

detailed descriptions of the subgroups affected. For example, if the original problem statement identified a higher rate of adolescent 

smokers in a certain city, further investigation 

may reveal that the smokers were 11th and 12th 

graders in inner-city schools. A review of the 

scientific literature and of successful tobacco 

control programs elsewhere may also reveal 

that their intentions to smoke were influenced 

by parents, athletic coaches, and peers. 

24 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

1d. Assess factors that can affect the 

campaign: strengths, weaknesses, 

opportunities, and threats (SWOTs). 

Before you progress too far in your planning, 

do a reality check. Assess strengths, weaknesses, opportunities, and threats (SWOTs). 

First, ask yourself the following questions to 

determine whether your organization is ready 

to address the problem: 

■	 Does your organization have the


necessary authority or mandate? 


■	 Do you have or can you acquire the 

necessary expertise and resources? 

■	 Will you be duplicating the efforts 


of others?


■	 How much time do you have to address 

this issue? 

■	 What can you accomplish in that time? 

Then identify your assets and your barriers. 

Consider the following factors: 

■	

■	

■	

■	

Available resources, including funds, 

time, and personnel and their skills 

The level of your organization’s 

commitment to addressing the issue 

The roles of other concerned or involved 

groups and whether there is a gap, an 

opportunity for partnering, or potential 

overlap in areas being addressed 

Whether sound guidance is available to 

address the problem 

■ Political support for, resistance to, or 

potential criticism of efforts to address 

the problem 

■	

■	

Policies or lack of policies that can help 

or hinder your efforts 

Barriers to behavioral or environmental change or both, including 

activities of adversaries 

Also, ask what other states or organizations are 

doing to address the problem: 

■	

■	

■ From their perspective, what gaps 

exist in media coverage/advertising, 

community activities, materials, and 

target audiences? 

■	

What have they learned? 

Do they have information or advice to 

help you plan (e.g., advice about targeting, budgeting, and evaluating)? 

Are there opportunities for collaborative 

ventures, especially if key goals and 

target audiences are the same? 

Experienced colleagues and contacts at other 

state health departments can offer suggestions 

or advice as you conduct this assessment. In 

addition, CDC’s Web-based State Information 

Forum (http://ntcp.forum.cdc.gov) contains a 

large collection of state tobacco control documents that you might find useful. Keep all 

the information gained through this assessment in mind as you develop the countermarketing program. 

Chapter 2: Planning Your Counter-Marketing Program 25 
1e. Review relevant theories and 

models. 

Your program planning may be helped significantly by a review of theories and models that 

offer perspective on the target audiences and 

the steps that might influence them (NCI 

1995). Theories can help to explain why problems exist, what you need to know about the 

target audience, and what you need to do to 

influence change. Theories and models also 

can help guide you in choosing realistic 

objectives, determining effective strategies 

and messages, and designing an appropriate 

evaluation. No single theory dominates the 

design of a counter-marketing program, 

because issues, populations, cultures, contexts, 

and intended outcomes vary. Many programs 

are based on several theories. Best practices in 

counter-marketing are discussed in this 

manual. Table 2.1, from the National Cancer 

Institute’s Theory at a Glance: A Guide for 

Health Promotion Practice (NCI 1995), 

summarizes some key theories. 

Step 2: Identify and learn about 

target audiences. 

Understanding the target audience(s) before 

you plan and develop your program is essential. To be successful in influencing them, you 

will need to understand the problem and 

potential changes from the point of view of the 

target audience(s). Before you start to plan the 

program, define the audience you want to 

reach and the results you want to achieve and 

determine how to measure those results. (See 

Step 3 for information on defining objectives.) 

Also, find out about the target audience (e.g., 

lifestyle, attitudes, environment, culture, 

knowledge, beliefs, and behaviors), so you can 

plan appropriate activities while keeping an 

eye on your program objectives. 

In Step 1, you identified who was affected by 

the problem, but the people affected may 

constitute a broad population. One or several 

target audience(s) should be selected on the 

basis of shared characteristics. For example, if 

the problem you’re addressing is that more 

middle school students are starting to smoke 

cigarettes, you may want to target middle 

school students who are at risk of starting to 

smoke. 

If reliable data on a certain group are not available, you may need to conduct qualitative or 

quantitative research or both to learn enough 

to make sound planning decisions. For 

example, in Massachusetts, the prevalence of 

cigarette smoking was significantly higher 

among physically disabled individuals than 

among other groups, but other descriptive 

data were lacking, so the state conducted 

research to further understand this audience. 

(See Chapter 3: Gaining and Using Target 

Audience Insights for more information on 

conducting research.) 

In some cases, the target audience(s) may not 

be the affected population. Let’s say you want 

to decrease illegal tobacco sales to students. 

Your target audiences might be decision 

makers, such as school officials, who can set 

policies about tobacco use on or near school 

property; community opinion leaders, who 

can increase community interest in taking 

action to decrease illegal sales; and merchants, 

who control access to and availability of 

tobacco products. If you want to affect 

26 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 2.1: Summary of Theories: Focus and Key Concepts 

Theory Focus Key Concepts 

Individual Level 

Stages of Change 

Model 

Individuals’ readiness to change or attempt 

to change toward healthy behaviors 

• Precontemplation 

• Contemplation 

• Decision/determination 

• Action 

• Maintenance 

Health Belief Model Individuals’ perception of the threat of a 

health problem and the appraisal of recommended behavior(s) for preventing or 

managing the problem 

• Perceived susceptibility 

• Perceived severity 

• Perceived benefits of action 

• Perceived barriers to action 

• Cues to action 

• Self-efficacy 

Consumer 

Information 

Processing Model 

Process by which consumers acquire and 

use information in making decisions 

• Information processing 

• Information search 

• Decision rules/heuristics 

• Consumption and learning 

• Information environment 

Interpersonal Level 

Social Learning 

Theory 

Behavior explained via a three-way, dynamic 

reciprocal theory in which personal factors, 

environmental influences, and behavior 

continually interact 

• Behavioral capability 

• Reciprocal determinism 

• Expectations 

• Self-efficacy 

• Observational learning 

• Reinforcement 

Continues 

Chapter 2: Planning Your Counter-Marketing Program 27 
Table 2.1: Summary of Theories: Focus and Key Concepts (cont.) 

Theory Focus Key Concepts 

Community Level 

Community 

Organization 

Theories 

Emphasis of active community participation 

and development of communities that can 

better evaluate and solve health and social 

problems 

• Empowerment 

• Community competence 

• Participation and relevance 

• Issue selection 

• Critical consciousness 

Organizational 

Change Theory 

Processes and strategies for increasing the 

chances that healthy policies and programs 

will be adopted and maintained in formal 

organizations 

• Problem definition 

(awareness stage) 

• Initiation of action 

(adoption stage) 

• Implementation of change 

• Institutionalization of change 

Diffusion of 

Innovations Theory 

How new ideas, products, and social 

practices spread within a society or from 

one society to another 

• Relative advantage 

• Compatibility 

• Complexity 

• Trialability 

• Observability 

Source: NCI 1995 

pregnant women who smoke, you might target 

spouses or partners. Changing the behavior of 

their partners supports the pregnant women’s 

attempts to quit smoking and reduces their 

exposure to secondhand smoke. 

The more specifically you can target an 

audience, the more likely you are to develop 

approaches that will be appropriate to the 

audience’s interests and needs. For example, 

you wouldn’t target all middle school students 

in three counties if you could more specifically 

and appropriately target those most likely to 

smoke cigarettes, such as seventh and eighth 

graders whose parents smoke, who are less 

likely to be honor roll students, and who are 

more likely to be on their own in the afternoons. 

One exception to this rule may be the targeting 

of smokers for cessation. A recent global 

review of smoking cessation campaigns indicated that smokers who are targeted narrowly 

(e.g., those most ready to stop smoking) may 

mentally exclude themselves from the category and deny that the message is meant for 

them, because they know how difficult it can 

be to stop smoking. Programs found greater 

success in prompting smokers to call quitlines 

28 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

when all smokers were included in the 

message’s target. Also helpful were messages 

targeting smokers by undeniable characteristics, such as pregnancy or ethnic background (Schar and Gutierrez 2001). 

2a. Clearly define the audience you 

want to reach and the result to be 

achieved. 

Two steps that will help to set the parameters 

of your program are defining subgroups of an 

affected population sharing common 

characteristics (audience segmentation) and 

selecting one or more subgroups—your target 

audience(s). Because no one program can do 

everything for everyone, choosing a target 

audience provides a focus for the rest of your 

planning decisions. 

To select your target audience, review the 

following questions: 

■	

■	

■	

■	

■	

What is the problem? 

What is the solution or desired outcome? 

Who is most likely to be able to make 

the desired changes happen? 

How specifically can you describe this 

group or groups—the target 

audience(s)? 

How large is each group? (Each group 

should be large enough to make a 

difference in the problem but should not 

include so many types of people that you 

can’t tailor your efforts with enough 

specificity.) 

This review may leave you with many options. 

Answering the following questions will help 

you to prioritize the audience(s) for the 

campaign (CDC 2003): 

■	 Which audiences represent the highest 

priorities for reaching the key tobacco 

control goals? 

■	 Which audiences can be most easily 

reached and influenced? 

■	 Which audiences are affected disproportionately by the health problems 

associated with tobacco use? 

■	 Which audiences are large enough to 

justify intervention? 

■	 Which audiences are most unique 

and identifiable? 

■	 Which audiences are most vulnerable 

to the health problems? 

■	 In which audiences would countermarketing efforts duplicate the efforts 

of an existing program or campaign? 

■	 Which audiences, if any, have higher 

or lower priority because of political 

considerations? 

2b. Find out more about the 

target audiences. 

What “drives” the actions and behaviors of 

audience members, what interests and 

appeals to them, and where you can reach 

them are essential pieces of information for 

program design. Also, take the time to 

understand, not simply make assumptions 

Chapter 2: Planning Your Counter-Marketing Program 29 
about, cultural contexts that influence how 

target audiences live, perceive their environment, and make decisions. (See Chapter 4: 

Reaching Specific Populations for more 

information on these groups.) 

Chapter 3: Gaining and Using Target Audience 

Insights discusses a variety of methods for 

conducting market research to learn more 

about your audience(s). You’ll need to answer 

the following questions about the target 

audiences to plan an effective program: 

■	 What are the attitudes and beliefs of the 

target audience about problems and 

behavior associated with the tobacco 

control problem? Are there misconceptions that need to be corrected? 

■	 What other attitudes and beliefs could 

influence behavior related to tobacco 

use (e.g., perceptions of “cool” that 

include tobacco use, openness to 

seeking professional help for medical 

problems, and feelings about the importance of individual rights over group 

rights)? If tobacco use is perceived as 

beneficial, what barriers to change must 

be addressed? 

■	 Are there social, cultural, and economic 

factors to consider? For example, does a 

high percentage of the target audience 

report that it is difficult to turn down a 

cigarette offered at a party? Do some 

individuals use cigarettes as a positive 

symbol because of cultural beliefs and 

practices? Does the price of cigarettes 

influence the number of cigarettes 

smoked? Do some smokers find ways 

around pricing changes, such as stealing, getting cigarettes from friends and 

family, or buying “loosies” (single 

cigarettes typically sold at small 

convenience stores or on the street)? 

30 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Where can audience members be 

reached? In the community? In school? 

At home? Through television? Radio? 

Print? Interactive media? (It helps to 

know about a typical day in the life of 

an audience member.) 

■	 What are the audience’s preferences in 

terms of learning styles, appeals, language, and tone of messages? Some 

people learn through reading and 

contemplation; others prefer discussion. 

Some may be motivated by positive 

appeals; while others may be more 

influenced by fear and other negative 

emotions. For example, the promise of a 

healthy baby might motivate a pregnant 

woman to quit smoking, while the 

threat of serious heart disease might 

move a middle-aged man with 

borderline hypertension to quit. 

■	 What are the audience’s preferences 

in terms of activities, vehicles, and 

involvement in the issue of tobacco? 

Some smokers may prefer to quit on 

their own; others may welcome access 

to a quitline counselor. 

Your counter-marketing plan should include 

the following information about each of your 

target audiences: 

■	 Demographics (e.g., gender, age, 

educational attainment, occupation, 

income, family situation, and location 

of residence, work, and school) 

■	 Community norms and cultural and 

lifestyle characteristics (e.g., language 

preferences and proficiencies, religion, 

ethnicity, generational status, family 

structure, degree of acculturation, and 

lifestyle factors such as food and activity 

preferences) 

■	 Preferences, including places where they 

might be receptive to activities; media 

use; and types of messages, sources, or 

sponsors perceived as credible 

■	 Behaviors, knowledge, attitudes, values, 

and feelings that indicate the audience’s 

willingness to accept and act on the 

information provided (i.e., their 

readiness to change) 

Step 3: Draft counter-marketing 

objectives. 

Defining your counter-marketing objectives 

will help you to determine the messages you’ll 

use and to set priorities among possible strategies and activities. Your objectives serve as a 

kind of contract or agreement about your 

program’s purpose, and they establish the 

outcomes that should be measured. 

Objectives should reflect the results expected 

from the counter-marketing program within 

the given time frame and within the context of 

a comprehensive tobacco control program. In 

general, counter-marketing programs can: 

■	 Raise awareness about the problem of 

tobacco use and about the tobacco 

counter-marketing campaign 

■	 Build knowledge about the specifics of 

the issues associated with tobacco use 

and prevention 

Chapter 2: Planning Your Counter-Marketing Program 31 
■	 Shape or shift individual attitudes or 

values, contributing to behavior change 

■	 Change community norms 

■	 Result in simple actions (e.g., asking for 

help or information) 

■	 Win broad public support for tobacco 

control issues 

More specifically, counter-marketing activities 

designed to support health policy or enforcement of health-related laws, such as a ban on 

tobacco sales to minors, might be expected to: 

■	 Frame a health policy issue to make it 

relevant to more people 

■	 Reward retailers who refrain from 

selling tobacco products to minors 

■	 Increase support for a tobacco 


control policy 


Counter-marketing activities designed to 

support tobacco cessation or other tobaccorelated health services might be expected to: 

■	 Communicate the benefits of cessation 

or the risks of continuing to use tobacco 

■	 Increase support for coverage of 

smoking cessation programs under 

private and public insurance 

■	 Prompt use of population-based 

counseling services, such as quitlines 

Your objectives also should specify the impact 

you want the program to have on the tobaccorelated problem and should support your 

organization’s broader goals for tobacco 

control. You should write objective(s) that 

answer these questions: 

■	 What specific effect do you hope to 

have related to the tobacco problem, 

and among which affected or influential 

populations? 

■	 How much change do you expect? By 

when? (Include intermediate milestones 

that will help you identify progress.) 

Setting achievable objectives is important. 

Many efforts fail because of unreasonable 

objectives. For example, achieving anywhere 

near 100 percent change is generally impossible. If you plan to specify a numerical goal for 

a particular objective, an epidemiologist, 

statistician, or advertising or marketing expert 

can offer guidance on reasonable rates of 

change. (For example, commercial marketers 

often consider a 2- to 3-percent increase in 

sales to be a great success.) Also, you should 

bring your evaluator into the process when 

you are ready to draft objectives for the 

counter-marketing program. 

Don’t let fear of failure keep you from setting 

measurable or achievable objectives. Without 

them, you have no way of showing that you 

have succeeded or are making progress, which 

could reduce support for your program. 

Chapter 5 offers more information on 

developing objectives, but here are some 

SMART tips: 

■	 Specific. Be as specific as possible. For 

example, state that the program will 

“increase by 10 percent the number of 

health care providers who counsel 

pregnant women to quit smoking,” rather 

than stating that it will “increase smoking 

cessation among pregnant women.” Use 

specific verbs such as “improve,” “increase,” 

32 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

“promote,” “protect,” “minimize,” “prevent,” 

and “reduce” to describe objectives. 

■	 Measurable. Clear objectives (“increase 

by 25 percent”) will guide evaluation 

design and allow you to track progress. 

Also, determine how you’ll measure 

results. Will the measurement rely on 

existing data or will new sources of data 

be needed? 

■	 Achievable. Objectives should be 

realistic. Explore what degree of change 

is reasonable to expect within your 

program budget and your timeline for 

program implementation. 

■	 Relevant. Objectives should be related to 

your program’s overall goals and should 

be logical, based on what you plan to do. 

■	 Time-bound. Determine the time frame 

during which you expect certain 

changes to take place. 

An example of a SMART objective might be to 

increase by 20 percent the number of smokers 

who call the state quitline and attempt to stop 

smoking by the end of 2003. In addition to 

counter-marketing, other strategies and 

tobacco control activities conducted over a 

period of time are likely to be needed to 

change behaviors, policies, and social norms. 

Step 4: Determine countermarketing approaches, channels, 

and program strategies. 

Now you can begin to develop a detailed plan. 

Select which counter-marketing approaches 

and channels you’ll use; then define program 

strategies. Although these decisions are described here in sequence, they are interrelated. 

In most cases, these decisions will be made 

together, not sequentially. 

4a. Review and select the countermarketing approaches to use. 

Five counter-marketing approaches are 

described here: advertising, public relations, 

media advocacy, grassroots marketing, and 

media literacy. Most of this manual is devoted 

Chapter 2: Planning Your Counter-Marketing Program 33 
to helping you to plan and implement these 

specific counter-marketing tactics, and each 

one is discussed in detail in a separate chapter. 

Instead of jumping to conclusions about the 

approaches to use, consider which are most 

likely to help you reach your objectives. Here’s 

a quick look at these approaches, along with 

examples of what they can and can’t contribute 

to your counter-marketing program: 

■	 Advertising is a communication tactic in 

which messages are repeatedly delivered 

directly to a mass audience. Advertising 

permits control over the message’s tone, 

content, and amount of exposure. 

– 	

– 	

Advertising can communicate a 

single, simple message to many 

people, change attitudes, create an 

image for the campaign, and expose 

the practices of adversaries or 

competitors. 

Advertising can’t provide complex 

information, feedback, or services. 

■ Public relations is used to reach target 

audiences through “earned” media 

coverage—coverage of the program and 

issue generated through activities and 

relationships with reporters and other 

media gatekeepers. 

– 	Public relations can establish ongoing 

relationships with media, stakeholders, opinion leaders, and others; 

reach audiences with information and 

messages often seen as more credible 

than advertising; gain public support 

and create a positive environment for 

the program; expose the practices of 

adversaries or competitors; and 

provide a quick response to issues 

and events as they arise. 

– 	Public relations can’t guarantee a 

story’s placement, exposure, focus, 

slant, content, or accuracy. 

■	

–

–

■	

–

–

■	

Media advocacy is the strategic use of 

media and community advocacy to 

create social or policy change. 

 	Media advocacy can help communities create lasting environmental 

change. 

 M	 edia advocacy can’t guarantee individual behavior change based on new 

information. 

Grassroots marketing is used to involve 

people in the community as participants 

in a counter-marketing program. 

 	Grassroots marketing can get people 

in the community involved in the 

issue or program, create interpersonal 

exposure to the message, channel 

feed-back, and build community 

support. 

 	Grassroots marketing can’t be tightly 

controlled or expose a broad audience 

to a very specific message. 

Media literacy helps people ask questions about what they watch, see, and 

read. It helps them critically assess how 

the mass media normalize, glamorize, 

and create role models for unhealthy 

lifestyles and behavior. Also, it includes an 

examination of techniques, technologies, 

34 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

and institutions involved in media 

production. 

– 	Media literacy can help change 

attitudes, teach people to recognize 

how messages are used to influence 

them, and show them how to 

counteract those messages by 

developing their own messages. 

– 	Media literacy can’t change industry 

marketing practices or replace 

classes or programs that explain 

tobacco’s impact on health. 

Combining several approaches is usually 

better than using just one. Any approach you 

choose must fit into your broader strategy. The 

best advertising or public relations work won’t 

make up for a lack of strategy. The following 

questions can help you decide which 

approaches to use: 

■	 Which approach or combination of 

approaches best addresses the problem 

and your program objectives? 

■	 Which options are most appropriate for 

your target audience(s)? 

■	 Which approach(es) can your organization afford and successfully implement, 

taking into account the available skills, 

budget, and experience? 

■	 Could any of the approaches cause 

undesirable or unintended effects, such 

as public or political criticism? 

4b. Review and select the channels 

to use. 

Channels are pathways used to deliver program messages, materials, and activities to 

your target audience. Channels can be categorized into four broad groups: interpersonal, 

Chapter 2: Planning Your Counter-Marketing Program 35 
community and organizational, mass media, 

and interactive media channels. 

Interpersonal channels put health messages 

in a familiar context. Examples of interpersonal channels to reach intended audiences 

are physicians, friends and family members, 

counselors, parents, clergy, educators, and 

coaches. These channels are more likely to be 

trusted and influential than are mass media 

sources. Developing relationships with and 

creating messages and materials for interpersonal channels may take some time, but 

these channels are among the most effective, 

especially for affecting individual attitudes, 

skills, and behavior/behavioral intent. 

Influence through interpersonal contacts may 

work best when the person is already familiar 

with the message, for example, from hearing it 

through the mass media. Similarly, mass 

media approaches are most effective at 

changing behavior when they’re supplemented with interpersonal channels. 

Community and organizational channels can 

reinforce and expand on other media messages and add credibility and legitimacy. 

Community groups and organizations can 

disseminate your materials, hold events, and 

offer instruction related to your message. 

Establishing links with these groups can be a 

shortcut to developing interpersonal channels 

to your audience(s). Community and organizational channels, like interpersonal channels, 

can offer support for action and can function 

in two directions. They allow discussion and 

clarification, encouraging motivation, and 

reinforcing action. Community leaders can be 

effective channels, because they influence 

other people and can influence policy. They 

may include physicians and other health care 

professionals; religious, political, and social 

leaders; business and union leaders; and “rule 

makers,” who control the audience’s environment (e.g., teachers, parents, policy makers, 

and law enforcement personnel). Community 

leaders can disseminate messages broadly to 

groups or become part of an interpersonal 

channel. Also, garnering the support of many 

organizations that work together toward a 

common goal can create a “critical mass” 

resulting in a bandwagon effect for your efforts. 

Mass media channels offer many opportunities for dissemination of a message. Examples 

of mass media channels are radio, broadcast 

and cable TV, magazines, direct mail, billboards, and newspapers. The opportunities 

provided include mentions in news programs; 

entertainment programming (“entertainment 

education”); public affairs, “magazine,” and 

interview shows (e.g., radio call-in programs); 

live remote broadcasts; editorials on TV and 

radio and in newspapers and magazines; 

health and political columns in newspapers 

and magazines; posters; brochures; advertising; 

and public service campaigns. You may decide 

to use a variety of formats and media channels, 

but you should choose the ones that are most 

likely to effectively reach your audience(s). 

Mass media campaigns are a tried and true 

approach. They’ve been conducted on topics 

ranging from general health to specific diseases, from prevention to treatment. Overall, 

research has demonstrated that mass media 

approaches are effective in raising awareness, 

stimulating an audience to seek information 

36 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

and services, increasing knowledge, changing 

attitudes, and even achieving some change in 

behavioral intentions and behaviors (Snyder 

and Hamilton 2002). However, behavior 

change is usually associated with long-term, 

multiple-intervention campaigns, rather than 

with one-time, communication-only programs 

(Smith 2002). Mass media campaigns also can 

contribute to changes in social norms and to 

other collective changes (e.g., policy and 

environmental changes) (Hornik 2002). 

Interactive media channels are useful now 

and may have even greater reach in the future. 

Examples include Web sites, Internet bulletin 

boards, newsgroups, chat rooms, CD-ROMs, 

and kiosks). These media channels allow 

delivery of highly targeted messages to and 

feedback from the audience. Your program can 

use these media to send individual messages 

via e-mail (electronic mail) and post-program 

messages, such as information about healthrelated campaigns on popular Web sites, to 

create and display ads, to survey and gather 

information from computer users, to exchange 

ideas and ready-to-use materials with peers 

and partners, and to rally or demonstrate 

support for a policy or issue. Before choosing 

an interactive channel, you’ll need to determine whether it’s accessible and whether your 

audience is comfortable with it. 

To identify possible channels for reaching 

your audience, find answers to the following 

questions: 

■	 Where can you reach audience 

members (e.g., at home, at school or 

work, in the car, on the bus or train, or 

at a community event)? 

■	 When are they most likely to be 

attentive and open to your efforts? 

■	 Where can they act on your message? 

■	 In which places or situations will they 

find your messages most credible and 

influential? 

■	 Which places or situations are most 

appropriate for the counter-marketing 

approaches you are considering? 

Chapter 2: Planning Your Counter-Marketing Program 37 
The use of several channels has been 

most effective in producing desired 

results, including behavior change 

(NCI 2002). Using a combination of 

channels not only improves your 

chances of reaching more members 

of your audience(s), it also can 

increase the repetition of your 

message, which in turn increases the 

chance that the audience will be 

exposed to it often enough to internalize and act on it. Finally, some 

messages may seem more legitimate 

when they come from several sources or 

channels. 

Here are some tips for selecting channels to 

include in your program: 

■	 Choose channels that suit your objectives, and decide how the approaches 

described in this manual can be used 

with those channels. 

■	 Select channels and activities that fit 

your budget, time constraints, and 

resources. 

■	

physicians’ recommendations; and print 

ads may deliver a complex message 

better than TV can but may not be as 

engaging, because they lack action and 

sound. For these reasons, the best approach often is to use multiple channels 

to take advantage of the strengths of 

each channel. Table 2.2 lists some of the 

pros and cons of different channels. 

Consider the attributes and limitations 

of each type of channel. For example, 

electronic media can reach many people 

quickly to inform and create awareness, 

but they may not be as suitable as other 

channels for more complicated messages and purposes. The recommendations of physicians may be persuasive 

to smokers but may not reach many 

people; TV ads may reach many people 

but may not be as credible as 

4c. Draft program strategies. 

A strategy is the approach you plan to take with 

a specific audience. Although you may develop 

many different materials and use a variety of 

activities, your strategies are guiding principles 

for all your products and activities. 

The strategy includes everything you need to 

know to work with your audience. It defines the 

audience, states the action audience members 

should take, tells how they will benefit (from 

their perspective, not necessarily from a public 

health perspective), and explains how you can 

reach them. The strategy is based on knowledge 

38 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 2.2: Counter-Marketing Channels and Activities: Pros and Cons 

Channel Activities Pros Cons 

Interpersonal 

• Influential adults 

• Health care 

providers 

• Family members 

• Friends 

• Hotline counseling 

• Patient counseling 

• Instruction 

• Prompted, informal 

discussion 

• Can be credible 

• Permit two-way 

discussion 

• Can be motivational, 

influential, supportive 

• Most effective for 

teaching and helping/ 

caring 

• Can be expensive 

• Can be time consuming 

• Can have limited reach of 

intended audience 

• Can be difficult to develop; 

sources need to be convinced and taught about 

the message themselves 

Organizational and Community 

• Schools 

• Employers 

• Community 

groups 

• Town hall and other 

events 

• Organizational 

meetings and 

conferences 

• Workplace 

campaigns 

• Media literacy 

• May be familiar, 

trusted, and influential 

• May provide more 

motivation or support 

than media alone 

• Can sometimes be 

inexpensive 

• Can offer shared 

experiences 

• Can reach larger 

audience in one place 

• Can be time consuming to 

establish 

• May not provide personalized attention 

• Organizational constraints 

may require message 

approval 

• Control of messages may be 

lost if they are adapted to fit 

organizational needs 

Mass Media 

• Newspaper • Ads (paid or public 

service) 

• News 

• Feature stories 

• Letters to the editor 

• Op-ed pieces 

• Can reach broad 

audiences rapidly 

• Can convey health 

news/breakthroughs 

more thoroughly than 

TV or radio and faster 

than magazines 

• Audience has chance to 

clip, reread, contemplate, 

and pass along material 

• Small papers may take 

print public service 

announcements (PSAs) 

• Coverage demands a 

newsworthy item 

• PSA placement virtually 

nonexistent 

• Exposure usually limited 

to one day 

Continues 

Chapter 2: Planning Your Counter-Marketing Program 39 
Table 2.2: Counter-Marketing Channels and Activities: Pros and Cons (cont.) 

Channel Activities Pros Cons 

Mass Media (cont.) 

• Radio • Ads (paid or public 

service) 

• News 

• Public affairs/ 

interview shows 

• Dramatic programming (entertainment 

education) 

• Range of formats 

available to intended 

audiences with known 

listening preferences 

• Opportunity for direct 

audience involvement 

(through call-in shows 

and remotes) 

• Can use ad scripts 

(called “live-copy ads”), 

which are flexible and 

inexpensive 

• Paid ads or specific 

programming can reach 

intended audience 

when they are most 

receptive 

• Paid ads are relatively 

inexpensive 

• Ad production costs are 

low relative to TV 

• Ads’ message and 

execution can be 

controlled 

• Reaches fewer people than 

TV 

• Although cheaper than TV 

ads, paid ads still may be too 

expensive 

• PSA placement runs 

infrequently and at low 

listening times 

• Feature placement requires 

contacts and may be time 

consuming 

• Many stations have limited 

formats that may not be 

conducive to health 

messages 

• Difficult for audiences to 

retain or pass on material 

• Stations consolidating; fewer 

local choices 

• Televison • Ads (paid or public 

service) 

• News 

• Public affairs/interview 

shows 

• Dramatic programming (entertainment 

education) 

• Potentially the largest 

and widest range of 

audiences 

• Visual combined with 

audio good for emotional appeals and 

demonstrating 

behaviors 

• Can reach low-income 

audiences 

• Ads are typically expensive 

to produce 

• Paid advertising may be too 

expensive 

• PSA placement may run 

infrequently and at low 

viewing times 

• Feature placement requires 

contacts and may be time 

consuming 

40 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 2.2: Counter-Marketing Channels and Activities: Pros and Cons (cont.) 

Channel Activities Pros Cons 

Mass Media (cont.) 

• Paid ads or specific 

programming can reach 

intended audience when 

they are most receptive 

• Ads’ message and execution can be controlled 

• Opportunity for direct 

audience involvement 

(through call-in shows) 

• Message may be obscured 

by commercial clutter 

• Increased channel options 

have fragmented audiences 

(some channels reach very 

small audiences) 

• Promotion can result in 

huge demand 

• Can be difficult for audiences to retain or pass on 

material 

Interactive Media 

• Internet • Web sites 

• E-mail lists 

• Chat rooms 

• News groups 

• Ads (paid or public 

service) 

• Can reach large numbers 

of people rapidly 

• Information can be 

instantaneously updated 

and disseminated 

• Information can be 

controlled 

• Can reach specific 

audiences and provide 

personalized information 

• Can be interactive and 

engaging 

• Can provide health information in a graphically 

appealing way 

• Can combine the audio 

and/or visual benefits of 

TV or radio with the selfpacing benefits of print 

media 

• Can use banner ads to 

direct audience to your 

Web site 

• Can be expensive 

• Many audiences may not 

have access to the Internet 

or skills to use it 

• Audience must be proactive; 

they must search or sign up 

for information 

• News groups and chat 

rooms may require 

monitoring 

• Can require maintenance 

over time 

• Thousands of healthoriented Web sites and 

listservs exist, so size of 

audience may be small 

• Users typically scan Web 

sites quickly and may not 

attend to health messages 

This table was adapted from NCI 2002. 

Chapter 2: Planning Your Counter-Marketing Program 41 
of the audience, guided by market research and 

theories and models of behavior, and tempered 

by the realities of organization roles, resources, 

and deadlines. 

You’ll need to develop a strategy statement 

that translates this information into a cohesive 

document articulating what you’ll do, and 

you’ll need to ensure that all key decision 

makers agree with it. You may be tempted to 

skip this step. Don’t skip it. Having an 

approved strategy statement will save you time 

and effort later. Developing the statement 

provides a good test of whether there’s enough 

information to begin developing messages. It 

offers an opportunity to convince your 

organization and partners to buy into your 

program. The statement also can serve as the 

guideline for all your materials and activities. 

At this stage in the planning process, you 

should involve experts in advertising, media 

advocacy, marketing, or related fields, depending on the approaches you’ve selected. If you’re 

working with partners, they might be a part of 

this program design team. Evaluation experts, 

if they aren’t already involved, also should join 

the team at this point. 

This stage also is a good time to do another 

reality check. As you develop your strategy, 

make sure you have the budget and other 

resources to include all the approaches and 

channels you have identified. It’s better to limit 

your activities and do fewer things well than to 

stretch modest resources across many strategies and targets. Think for the long term: you 

may want to start with one target audience and 

one approach and add program components 

in future years. After several years, you can 

have a comprehensive program in place. 

For each of your target audiences, write a 

strategy statement that includes the following 

elements: 

■	 Target audience profile. The description 

will be most useful if you describe one 

person in the audience, rather than 

describing the group. The information 

you gathered in Step 2 should be used 

here. 

■	 Action you want the audience to take as 

a result of exposure to your program. 

The action should be based on the 

objectives you drafted in Step 3. 

■	 Obstacles to taking action. Common 

obstacles include audience beliefs, 

social norms, time or peer pressures, 

costs, ingrained habits, misinformation, 

and lack of access to products, services, 

or program activities. The additional 

information you gathered about the 

audience in Step 2 should help you 

identify obstacles. 

■	 Benefit the audience will perceive as 

sufficiently valuable to motivate them 

to take action. Many theories and 

models of behavior change suggest that 

people take action or change their behavior because they expect to receive some 

benefit (e.g., have more energy, save 

money, live longer, or gain acceptance 

from peers) that outweighs the cost (e.g., 

time, money, or potential loss of stature 

among peers). 

42 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Reason(s) the benefit and the audience’s ability to attain the benefit 

should be credible and important to 

the audience (sometimes called the 

“reason to believe”). Support can be 

provided through hard data, peer 

testimonials about success or satisfaction, demonstrations of how to 

perform the action (if audience 

members doubt their ability), or 

statements from people or organizations the audience finds credible. 

Support should be tailored to the 

concerns of audience members about 

the action. For example, if they are 

worried that they can’t act as recommended, a demonstration of the 

behavior may give them the confidence 

to act. If they question why they should 

take the action or whether it will have 

the promised health benefit, hard data 

or statements from credible people or 

organizations may be effective. If they 

don’t believe they need to take the 

action, a peer testimonial may make 

them reconsider. 

■	 Channels and activities that will reach 

audience members. 

■	 The image you plan to convey through 

the tone, look, and feel of messages and 

materials. You should convey an image 

that convinces audience members that 

the communication is directed at them 

and that it’s culturally appropriate. 

Image is conveyed largely through 

creative details. For example, printed 

materials convey image through typeface, layout, visuals, color, language, and 

paper stock. Audio materials convey 

image through voices, language, and 

music. In addition, video materials 

convey image through visuals, the 

actors’ characteristics (e.g., clothing and 

accessories), camera angles, and editing. 

Developing a strategy is usually an iterative 

process; as you learn more about one element, 

other elements may need to be adjusted. 

4d. Develop a logic model. 

A logic model describes the sequence of events 

that will occur to bring about the change 

(objective) you have identified. This model is 

often designed as a flowchart (see Figure 2.1). 

A logic model is valuable because it accomplishes several purposes: 

■	 Summarizes program components and 

outcomes at a glance 

■	 Can display the infrastructure needed to 

support the program 

Chapter 2: Planning Your Counter-Marketing Program 43 
Figure 2.1: Example of Logic Model for One 

Component of Youth Tobacco Use Prevention 

Advertising Campaign 

Input 

Funds for paid media 

Activity 

Design industry manipulation ad 

Output 

Industry manipulation ad is aired on the 

stations and at the time to reach youth; 

youth potentially exposed 

Short-Term Outcome 

Youth report awareness of the specific ad 

and react positively to it 

Intermediate Outcome 

Youth are more likely to believe that 

tobacco companies try to get people to smoke 

and less likely to believe smoking is cool 

Long-Term Outcome 

Fewer youth report trying 

cigarette smoking 

■	 Forces you to describe what you’re


planning in a simple way


■	 Reveals any gaps in the logic behind 

your plans 

■	 Describes what will happen over the 

course of your program, which will be 

useful for working with stakeholders, 

partners, and evaluators 

If you’ve identified several objectives and 

target audiences, you may need to develop 

several logic models. Chapter 5: Evaluating the 

Success of Your Counter-Marketing Program 

offers a more detailed look at logic models, but 

basically, your logic model(s) should include: 

■	 Inputs—what is necessary to conduct 

the program (e.g., trained staff and 

materials) 

■	 Activities—what you will do (e.g., 

provide media-literacy training or hold 

press conferences) 

■	 Outputs—what will happen as a result 

of activities (e.g., messages in the media 

as a result of public relations initiatives) 

■	 Outcomes—short-term results (e.g., 

changes in teens’ attitudes about tobacco 

advertising) and long-term results (e.g., 

lower youth smoking initiation rates) 

Step 5: Consider collaboration. 

Working with other organizations can be a costeffective way to enhance your program’s credibility and reach. Many public health agencies seek 

partner organizations to serve as gatekeepers to 

reach target audiences. Think about partnerships 

with businesses, other government agencies, 

volunteer and professional organizations, 

44 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

schools and community groups, the mass 

media, or health-related institutions. These 

organizations can help you by providing: 

■	 Access to a target audience 

■	 Enhanced credibility for your message 

or program, because the audience 

considers the organizations to be a 

trusted source 

■	 Additional resources, either financial 

or in-kind resources (e.g., volunteers, 

meeting space, and airtime) 

■	 Added expertise (e.g., training


capabilities)


■	 Cosponsorship of events 

First, you’ll need to weigh the pros and cons to 

decide whether you want to collaborate. If you 

decide to find partners, you’ll need to consider 

what types of partners you want. 

5a. Decide whether to collaborate. 

In determining whether to recruit partners, 

consider these questions: 

■	 Which organizations have similar goals 

and might be willing to work with you? 

■	 Which types of partnerships would help 

to achieve the objectives? 

■	 How many partners would your program need? You might want to partner 

with one or a few organizations for 

specific projects, or you may need to 

rally the support of many organizations. 

■	 Will the collaboration compromise 

your message? 

Although working with other organizations 

and agencies can greatly enhance what you 

can accomplish, be realistic about the potential disadvantages of collaboration. Working 

with other organizations can: 

■	 Be time consuming. You’ll have to 

identify the organizations, persuade 

them to work with you, gain internal 

approvals, and coordinate planning, 

training, or both. 

■	 Require altering the program. Every 

organization has different priorities 

and perspectives, and partners may 

want to make minor or major program 

changes to accommodate their structure 

or needs. 

■	 Result in loss of ownership and control 

of the program. Other organizations 

may change the schedule, functions, or 

even the messages and take credit for 

the program. 

Decide in advance how much flexibility you 

can give partners without violating your program’s integrity and direction and your own 

organizational procedures. 

5b. Consider criteria for partner 

participation. 

Once you’ve decided to partner with other 

organizations, you should be selective in 

choosing partners. Consider which organizations meet the following criteria: 

■	 Would best reach your audience(s) 

■	 Are likely to have the most credibility 

and influence with your audience(s) 

Chapter 2: Planning Your Counter-Marketing Program 45 
■	 Would be easiest to persuade to work 

with you (e.g., organizations where you 

have a contact) 

■	 Would require less support or fewer 

resources from you 

Health care companies and other for-profit 

organizations may be willing to work with you 

even if their products or services aren’t related 

to your program. They may view partnering 

with your program as a way to provide a useful 

public service, improve their corporate image 

and credibility, or attract the attention of a 

particular sector of the public. You must 

consider whether a collaboration of this type 

will add value or jeopardize the credibility of 

your program. 

Step 6: Plan for process and 

outcome evaluation. 

Evaluation is crucial for showing funding 

sources, partners, supporters, and critics what 

you’ve achieved. Even though most evaluation 

occurs later, you must plan for it at an early 

stage, to ensure that you have the budget and 

infrastructure to gather and analyze the information you’ll use (CDC 1999). In addition, 

you’ll probably want to conduct a baseline 

study of the target audiences’ current awareness, knowledge, attitudes, and behaviors. 

Planning for the baseline study must be done 

early enough to implement the research before 

the campaign begins. You’ll be able to determine the progress of the campaign by comparing its results with information from the 

baseline study. 

Work with your evaluation experts on 

evaluation plans. If they have participated in 

the program planning, they will better understand what you’re trying to do. Evaluation 

experts can help to plan an appropriate 

evaluation and to make decisions about data 

collection methods and analysis. (See Chapter 

5: Evaluating the Success of Your CounterMarketing Program for more information on 

planning for process and outcome evaluation.) 

Your objectives and logic model for the countermarketing program form the basis for design 

of the evaluation. A good evaluation plan 

should include both process and outcome 

measures: 

■	 Process evaluation shows whether your 

program’s components and flow of 

activities worked the way you planned. 

Process evaluation can help to identify 

any problems with implementing the 

program as designed. 

■	 Outcome evaluation shows whether you 

met your program objectives. 

Including both types of evaluation will provide 

a comprehensive “picture” of what happened 

and why. 

As you plan for evaluation, keep these tips 

in mind: 

■	 Make sure your evaluation design is 

appropriate for the particular activity. 

Experimental designs are the gold 

standard of outcome evaluation. In 

experimental design, a treatment 

group (people exposed to the program) 

46 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

is compared with a control group 

(people who aren’t exposed). However, 

this type of design often can’t be used to 

assess counter-marketing activities, 

largely because untreated control groups 

may not exist for statewide or communitybased efforts. Even if people aren’t 

exposed to your activities, they are likely 

to be exposed to some communication or 

other intervention on the topic. Other 

options include quasi-experimental, 

cross-sectional, and case study designs. 

(See Chapter 5: Evaluating the Success of 

Your Counter-Marketing Program for 

discussion of these and other types of 

design for evaluation.) 

■	 Consider how the activities are expected 

to work and the time frame. Then make 

sure the activities are evaluated according 

to those expectations. For example, if you 

expect people to need at least five to eight 

exposures to your message before they’ll 

take action, you must allow sufficient 

implementation time to achieve that level 

of exposure. If you expect people to take 

action immediately after exposure, then 

the outcome measurement should take 

place soon after exposure. Conversely, if 

you don’t expect to see program effects 

for at least one year, outcomes shouldn’t 

be measured until then. 

■	 Include process measures and milestones. This will allow you to assess 

progress and to determine whether you 

need to make any changes in the 

program’s implementation. 

■	 Determine the kind of evidence needed 

for the outcome evaluation. One example is information for a report to your 

funding agency or partners. 

■	 Consider the baseline measures you 

have available or can collect and how 

you’ll track changes related to desired 

outcomes. Determine how you will 

collect data and how often. 

■	 Measure change against the program’s 

specific objectives. These objectives 

should be consistent with, but may not 

be identical to, your organization’s 

general tobacco control goal. 

■	 Avoid having your program deemed a 

failure because it doesn’t achieve sufficient reach, frequency, or duration. Two 

possible causes of such a failure, real or 

apparent, are that activities aren’t funded 

adequately or that they begin later than 

expected and aren’t in place long enough 

before outcomes are measured. Process 

evaluation can track the level of intensity 

and the duration of exposure to the 

message and can help you learn why 

expected outcomes did or didn’t occur. 

6a. Write questions about the program 

that you want the evaluation to answer. 

Planning for evaluation includes developing 

questions that you want the evaluation to answer 

about the implementation and outcomes of your 

program. Determine which key measures will be 

necessary to demonstrate to key decision makers, 

funding sources, other stakeholders, staff, and the 

public at large that the program is making 

Chapter 2: Planning Your Counter-Marketing Program 47 
progress toward its objectives. Questions may 

include the following: 

■	 Did your counter-marketing program 

achieve the outcomes you expected 

(e.g., increased awareness of program 

messages and changes in knowledge, 

beliefs, and attitudes)? 

■	 What did target audiences think of your 

program? Did they become involved? 

Did it affect them in some way? 

■	 Did partners contribute as expected? 

Why or why not? How might these 

partners want to work with you in the 

future? 

■	 Did you have an adequate level of 

resources? Did you schedule enough 

time for program development and 

implementation? 

6b. Design the evaluation. 

To decide on the appropriate evaluation 

design, you’ll need to consider the 

following questions: 

■	 Which evaluation questions are most 

important? (You may have to decide 

which ones you can realistically answer.) 

■	 What information will you need to 

answer each evaluation question? 

■	 How will you gather the information? 

■	 How will you analyze it? 

By now, you may be thinking that good 

evaluation is beyond your capacity. It’s true 

that evaluation can be complex and costly, but 

it also can be relatively simple and inexpensive. Look at what other states have done and 

what might be useful in supporting future 

efforts. Also, examine the evaluation designs 

others have used and borrow what you can. 

Ask others what worked for them and what 

changes they’d make in future evaluation 

designs. 

In addition to designing the program evaluation, you’ll need to plan to pretest messages 

and materials. (See Chapter 3: Gaining and 

Using Target Audience Insights for more 

information.) You also may want to consider 

conducting a pilot test for your program. In a 

pilot test, you run and evaluate your program 

in a limited area for a limited time, then make 

adjustments based on the test results, before 

expanding the program. Consider pilot testing 

if your program meets the following criteria: 

■	 Designed as a new type of program for 

your organization 

■	 Intended to become a large investment 

■	 Planned to cover many communities 

■	 Expected to continue over several years 

Step 7: Begin counter-marketing 

program development. 

Now you’re ready to start putting the pieces 

together. Program development and management are discussed more fully in Chapter 6: 

Managing and Implementing Your CounterMarketing Program, but here are some key 

points: 

■	 Develop a communication plan that 

includes all the elements of your planning. It should be used to explain your 

48 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

plans to those within your organization 

and to others; support and justify budget 

requests; provide a record of where you 

began; and show the program’s planned 

evolution. Some sections of the plan, 

such as implementation and process 

evaluation, may not be as detailed as 

others at this point. But you can always 

update the plan later. 

■	 Add a budget and a timeline that lists and 

assigns tasks and identifies deadlines. 

■	 Find out more about similar programs in 

other states and how you may be able to 

use their “lessons learned” and any 

messages and materials they’ve 

developed. 

■	 Conduct any market research needed to 

understand more about your target 

audience’s culture, motivations, interests, 

and lifestyle. 

■	 Begin to develop program activities. 

(See Chapter 7: Advertising, Chapter 8: 

Public Relations, Chapter 9: Media 

Advocacy, Chapter 10: Grassroots 

Marketing, and Chapter 11: Media 

Literacy for guidance.) 

■	 Plan for testing messages, developing 

materials, organizing activities, negotiating partner roles, and conducting a 

program review for stakeholders. 

The timeline should include every imaginable 

major task from the time you write the plan 

until the time you intend to complete the 

program. The more tasks you build into the 

timetable, the more likely you’ll be to remember 

to assign the work and stay on schedule. Also, 

detailing the tasks will make it easier to determine who’s responsible for completing tasks 

and what resources will be required. The 

timeline is a flexible management tool. You 

may want to review and update it regularly 

(e.g., once a month), so you can use it to help 

manage and track progress. Computer-based 

tools, such as project management software, 

can be especially useful for this task. 

Points To Remember 

■	 Effective planning will help you: 

– 	 Better understand the tobacco control issue you’re addressing 

– 	 Identify the most appropriate approaches to bring about or support change 

– 	 Create a counter-marketing program that supports clearly defined objectives 

■	 Your counter-marketing program plan should complement the broader tobacco 

control effort and overall plan. 

■	 Many of the planning activities in this chapter can be completed simultaneously. 

■	 A plan is a living document. As the program progresses, review the plan to clarify 

and revise it as needed. 

■	 Be prepared to evaluate what you do. 

Chapter 2: Planning Your Counter-Marketing Program 49 
Bibliography 

Backer TE, et al. Designing Health Communication Programs: What Works? Newbury Park, CA: Sage


Publications, 1992.


Centers for Disease Control and Prevention. CDCynergy for Tobacco Prevention and Control (CD-ROM).


Atlanta, GA: U.S. Department of Health and Human Services, CDC, National Center for Chronic Disease


Prevention and Health Promotion, Office on Smoking and Health, 2003.


CDC. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;


1748(RR–11):1–40.


Hornik RC, editor. Public Health Communication: Evidence for Behavior Change. Mahwah, NJ:


Lawrence Erlbaum Associates, 2002.


National Cancer Institute. Making Health Communication Programs Work: A Planner’s Guide. Bethesda,


MD: USDHHS, Public Health Service, National Institutes of Health, NCI, 2002. NIH Pub. No. T068.


NCI. Theory at a Glance: A Guide for Health Promotion Practice. Bethesda, MD: USDHHS, Public Health


Service, National Institutes of Health, NCI, 1995. NIH Pub. No. 95-3996.


Schar E, Gutierrez K. Smoking Cessation Media Campaigns From Around the World: Recommendations From


Lessons Learned. Atlanta, GA: Centers for Disease Control and Prevention; Copenhagen, Denmark: World


Health Organization, 2001.


Smith W. From prevention vaccines to community care: new ways to look at program success. 


In: Hornik RC, editor. Public Health Communication: Evidence for Behavior Change. Mahwah, NJ:


Lawrence Erlbaum Associates, 2002, pp. 327–56.


Snyder LB, Hamilton MA. A meta-analysis of U.S. health campaign effects on behavior: emphasize


enforcement, exposure, and new information and beware the secular trend. In: Hornik RC, editor.


Public Health Communication: Evidence for Behavior Change. Mahwah, NJ: Lawrence Erlbaum


Associates, 2002, pp. 327–56.


50 Chapter 2: Planning Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 3 

Gaining and Using Target 

Audience Insights 

Understanding your target audience—its culture, lifestyle, 

behaviors, interests, and needs—is vital to developing an 

effective counter-marketing program. Market research can 

help you gain those insights.1 

Once you’ve determined who your target audience is, you’ll need to 

gather relevant information about that audience. This information will 

help you tailor your counter-marketing messages and materials and 

ensure that your programs will be effective. 

One way to gain insights about your target audience is through market 

research, which can help you understand the audience’s motivations, 

interests, needs, culture, lifestyles, and behaviors and determine the best 

channel(s) for reaching the audience. Market research can help you 

explore ideas for activities and concepts for messages and identify and 

develop stronger ideas and eliminate the weaker ones. It can be used to 

pretest messages and materials in near-final stages, to fine-tune the 

process while changes can be made, and to serve as a “disaster check.” 

Market research also can be a mechanism for pilot testing new tactics 

and interventions before using them more broadly. Market research for 

development of counter-marketing efforts is often called formative 

research. Other types of research for the purposes of process and outcome evaluation are discussed in Chapter 5: Evaluating the Success of 

Your Counter-Marketing Program. 

1 This chapter has been excerpted and adapted from the National Cancer Institute’s Making Health 

Communication Programs Work: A Planner’s Guide (2002). 

In This Chapter


• The Importance of 

Market Research 

• Market Research on 

a Limited Budget 

• Qualitative and 

Quantitative 

Research Methods 

• Qualitative Research 

• Quasi-Quantitative 

Research 

• Quantitative 

Research 

• Other Market 

Research Tools 

Chapter 3: Gaining and Using Target Audience Insights 51 
This chapter describes market research tools 

commonly used to gain insights into target 

audiences.2 These tools include focus groups, 

individual in-depth interviews, central 

location intercept interviews, theater-style 

pretests, and surveys. Diaries and activity logs, 

gatekeeper reviews, and readability testing are 

also described. 

Some tools are better suited for certain purposes than others, so most programs use a 

combination of methods. For example, focus 

groups with members of your target audience 

can help you learn which approaches, messages, and channels are most likely to succeed 

with that audience. The focus groups could be 

augmented with individual in-depth interviews to probe more deeply into motivations, 

particularly if the issues are controversial or 

very personal or if the audience members are 

influenced heavily by their peers. Messages 

and materials might be tested through central 

location intercept interviews, in which 

respondents are recruited and interviewed at 

malls or other public settings, or through 

theater-style pretests, which use a simulated 

television-viewing environment to replicate a 

real-life viewing experience. Use of multiple 

tools can help confirm the validity of your 

findings. 

Regardless of the tools you use, be sure to 

apply the results. Market research can provide 

critical data at various stages of your 

program, but that information won’t do much 

good if it isn’t used. Other chapters in this 

manual explain when and how to incorporate 

your results into program planning and 

development. (In particular, see Chapter 2: 

Planning Your Counter-Marketing Program, 

Chapter 4: Reaching Specific Populations, and 

Chapter 7: Advertising.) 

Market research generally isn’t something you 

can do on your own. Your program could stray 

off course if you use the wrong method, use 

the methods incorrectly, recruit the wrong type 

or number of participants, or misinterpret 

results. Unless you have the appropriate skills 

and experience, do-it-yourself market research 

can yield the same kinds of results as do-ityourself plumbing. This chapter is designed to 

give you background on methods and techniques that will help you work with market 

research professionals. However, don’t turn 

over complete control of the research to your 

ad agency or market research firm. You need to 

be involved in every step of the process. 

The Importance of Market Research 

Sometimes program managers want to 

eliminate market research to cut costs, 

especially when the budget is tight. However, 

spending some money on market research up 

front can save your program money in the 

long run. The initial expenditure can help 

ensure that the program elements are likely to 

2 Some of the research methods described here may require Institutional Review Board (IRB) approval. Nearly all 

government agencies, academic institutions, and other organizations require an assessment of the impact on 

human subjects involved in qualitative and quantitative research, including the protection of collected data. Some 

data collection efforts are exempt from IRB approval. For each research project undertaken, it is recommended 

that you consult the IRB expert in your organization. 

52 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

be effective, rather than having no impact or, 

even worse, creating a backlash. If you air 

ineffective ads, you lose much more money in 

media placement funds than you would have 

spent on market research to determine the 

likelihood of success. Unfortunately, this is 

only one example of the many negative 

outcomes of insufficient market research. 

Market Research on a Limited 

Budget 

Few program managers have the luxury of 

conducting as much market research as they 

would like. When faced with a tight budget, 

try the following: 

■	 Contact others in tobacco control to find 

out what research they’ve done. Can you 

use their findings in developing your 

own program? Do they have research 

designs and instruments you can use as 

models? Can you solicit advice from 

experienced managers on making the 

most of your tight budget? Can they give 

you advice or referrals to resources from 

other experts, such as those in your 

community with expertise in commercial marketing and advertising or in 

market research? Have you contacted a 

project officer or health communication 

staff member from the Centers for 

Disease Control and Prevention (CDC) 

for advice, referrals, or both? 

■	 Be sure your program plan fully explains 

the need for market research and spells 

out a thorough market research plan. If 

you can’t secure the funds you need this 

year, try to convince decision makers 

now that investing in research next year 

will pay off. Point out that market 

research is a core component of effective 

counter-marketing programs. 

■	 Beware of too many shortcuts. You need 

to conduct enough market research to 

feel confident that the findings provide 

clear direction. For example, if you’ve 

tested message concepts in a few focus 

groups and the results are inconclusive, 

you probably need to conduct a few 

more focus groups. 

■	 Whenever possible, consult with market 

research experts during planning and 

implementation, even if you have to cut 

corners elsewhere. For example, you 

may be able to save money by recruiting 

research participants through community organizations instead of paying a 

contractor to handle recruiting. 

■	 Always ask prospective contractors and 

vendors for nonprofit rates. 

■	 Ask professionals with market research 

experience if they’d be willing to donate 

their time. 

■	 Use a market researcher you can trust 

to be objective and to not “color” results 

to match a program or advertising 

agency bias. 

Qualitative and Quantitative 

Research Methods 

Two main categories of market research can be 

conducted with target audiences: qualitative 

and quantitative research. Qualitative research 

Chapter 3: Gaining and Using Target Audience Insights 53 
seeks to gain in-depth knowledge about 

perceptions, motivations, and behaviors. It can 

answer the questions “why,” “when,” and 

“how”—questions that are critical to developing effective media campaigns. Common 

methods of qualitative research include focus 

groups and individual in-depth interviews. 

Quantitative research seeks to provide estimates of knowledge, beliefs, attitudes, and 

behaviors in a population of interest. It can 

answer the questions “How many?” “How 

much?” and “How often?” Common methods 

of quantitative research include surveys using 

random sampling and convenience sampling. 

Because each approach provides a different 

kind of information, it’s often best to use both. 

Qualitative research methods should be used 

for the following purposes: 

■	 To develop materials and to determine 

reactions to concepts or draft materials 

■	 To explore a topic or idea 

■	 To gain insights into a target audience’s 

lifestyle, culture, motivations, behaviors, 

and preferences 

■	 To understand the reasons behind the 

results from quantitative research 

Qualitative research should be conducted by 

using the following methods: 

■	 Select a small group of people on the 

basis of certain common characteristics. 

■	 Convene a discussion through focus 

groups or in-depth interviews or 

observe individuals’ behaviors in their 

homes, schools, malls, supermarkets, or 

other settings. 

■	 Keep the discussion somewhat 

unstructured, so participants are free to 

give any response, rather than choosing 

from a list of possible responses. 

Use a discussion or interview guide to make 

sure you ask questions relevant to your 

research purpose, but be prepared to revise the 

sequence of questions on the basis of participants’ responses, rather than having to stick to 

a set order. (See Step 5 in the section on 

Designing and Conducting Focus Groups or 

Individual In-Depth Interviews, later in this 

chapter, for discussion of how to develop a 

moderator’s guide.) 

Qualitative research results aren’t quantifiable 

and can’t be subjected to statistical analysis or 

projected to the population from which 

respondents were drawn. The participants 

don’t constitute a representative sample, the 

samples are relatively small, and not all 

participants are asked precisely the same 

questions. Even though you can collect very 

valuable information from qualitative 

research, and even if you conduct a great deal 

of it, you won’t get findings that you can 

project to the target audience as a whole. For 

that, you need quantitative research. 

Quantitative research methods should be 

used for the following purposes: 

■	 To determine “how many,” “how much,” 

and “how often” 

54 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 To profile a target audience for communication planning, such as measuring which proportion of the audience 

thinks or behaves in certain ways 

■	 To measure how well your program is 

doing (See Chapter 5: Evaluating the 

Success of Your Counter-Marketing 

Program for a more complete discussion 

of surveys and program evaluation.) 

Quantitative research should be conducted by 

using the following methods: 

■	 Select a large group of people. 

■	 Use a structured questionnaire containing predominantly closed-ended or 

forced-choice questions. 

Quantitative research results can be analyzed by 

using statistical techniques that can provide 

estimates of behavior or beliefs of interest for 

the target population. These results can be 

representative of the population from which 

respondents were drawn if they were randomly 

selected. In some cases, oversampling of 

specific population groups is necessary to 

provide data on those groups. In addition, the 

results can help in segmenting broad target 

populations (e.g., high school students) into 

more specific groups with similar 

characteristics. 

Quasi-quantitative market research tools 

(e.g., central location intercept interviews 

and theater-style pretests) are usually used 

to pretest messages and materials. Although 

these tools are used for measurement and 

typically involve questionnaires with mostly 

forced-choice questions, the results can’t be 

projected to the audience as a whole, because 

participants aren’t chosen in a way that 

produces a representative sample. 

Here’s a closer look at the different research 

methods and tools, along with a discussion of 

how to conduct the research and use the 

results to inform your project. 

Qualitative Research 

Use qualitative research to: 

■	 Learn what drives the audience’s behav­


iors and understand what is needed to


influence their awareness, knowledge,


attitudes, intentions, and behaviors 


■	 Determine whether your materials


communicate the intended messages


effectively and persuasively


■	 Understand why your program is or 


isn’t working as expected


■	 Gain insights into findings on the effec­


tiveness of the program’s implementation


The most common tools used in qualitative 

market research are focus groups and individual in-depth interviews. Many innovative 

methods may also be appropriate: 

■	 Friendship pairs, in which best friends


(commonly teens or preteens) are


recruited to discuss sensitive subjects


■	 In-home observations, in which you


gain permission to spend one or two


hours in someone’s home to learn about


their habits and practices


Chapter 3: Gaining and Using Target Audience Insights 55 
■	 Video logs, in which individuals are 

given video cameras or still cameras 

to record their environment and 

daily activities 

Because the methods for focus groups and indepth individual interviews are similar, they 

will be discussed together in this section, using 

instructions for focus groups as a guide. 

Focus Groups 

In a focus group, a skilled moderator uses a 

discussion guide to facilitate a one- to twohour discussion among five to 10 participants. Typically the session is conducted in 

person. If that isn’t possible because of 

distance or other factors, another option is to 

conduct the session by telephone or computer. The moderator keeps the session on 

track while participants talk freely. As new 

topics related to the material emerge, the 

moderator asks additional questions. 

Focus groups are commonly used to 

accomplish the following purposes: 

■ Develop a communication strategy by: 

– 	 Learning about feelings, motivators, and experiences related to a 

health topic 

–	 Exploring the feasibility of potential 

actions from the audience’s viewpoint 

– 	 Identifying barriers to those actions 

– 	 Exploring which benefits the 

audience finds most compelling and 

believes can result from taking a 

particular action 

– 	 Learning about the audience’s use of 

settings, channels, and activities 

– 	 Capturing the language the audience 

uses to discuss a health issue 

– 	 Identifying cultural differences that 

may affect message delivery 

■	 Explore reactions to message concepts 

(concept testing) by: 

– 	 Identifying concepts that do or don’t 

resonate and learning why 

– 	 Triggering the creative thinking of 

communication professionals 

– 	 Showing others what audience 

members think and how they talk 

about a health issue 

■	 Develop hypotheses (broad questions) 

for quantitative research, and identify 

the range of responses that should be 

included in closed-ended questionnaires 

■	 Provide insights into the results of 

quantitative research by obtaining indepth information from audience 

members 

■	 Brainstorm for possible program


improvements


Pros: 

■	 Group interaction can elicit in-depth 

thought and discussion. 

■	 Group interaction can encourage 

brainstorming, because respondents 

can build on each other’s ideas. 

56 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■ Moderators have considerable 

opportunities to probe responses. 

■ 

■ 

Each person is limited to about 10 to 15 

minutes of talk time. 

■	 Focus groups provide richer data about 

the complexities of the audience’s 

thoughts and behaviors than surveys do. 

The moderator might ask leading 

questions of the group or might neglect 

to probe for critical insights. 

■	 Groups provide feedback from a 

number of individuals in a relatively 

short time. 

Individual In-Depth Interviews 

The process, uses, benefits, and drawbacks of 

individual in-depth interviews are similar to 

those of focus groups, except that the 

interviewer speaks with one person at a time. 

In-person interviews can take place at a 

central facility or at the participant’s home or 

place of business. As with focus groups, when 

individual interviews can’t be conducted in 

person, they can be conducted by phone or 

computer. Although the interviews take more 

total time, responses usually are less biased, 

because each participant is interviewed alone 

and isn’t influenced by others’ responses. 


Cons: 

■	

■	

■	

Findings can’t be projected to the target 

audience as a whole. 

Focus groups can be labor intensive and 

expensive, especially when they’re 

conducted in multiple locations. 

Group responses don’t necessarily 

reflect individuals’ opinions, because 

some individuals might dominate the


discussion, influence others’ opinions, 

or both. In addition, the facilitator might 


not be able to get everyone’s reactions to


every question.


Insights From Focus Groups 

In a series of 24 focus groups conducted in four U.S. cities by CDC and three state tobacco 

control programs, youth were exposed to 10 antitobacco ads developed for youth audiences. 

Participants were asked to rate the ads on the basis of how likely the ads were to make them 

“stop and think about not using tobacco.” The four ads consistently rated highest had a 

strong message about the negative health consequences of tobacco. Three of the four ads 

used real stories in a testimonial format to share the risks of using tobacco. 

An important insight gleaned from the research was that youth seemed to be more affected 

by the thought of living with the negative consequences of tobacco use than dying from 

them (Teenage Research Unlimited 1999). 

Chapter 3: Gaining and Using Target Audience Insights 57 
An Experience With One-on-One 

Interviews 

A television and movie actor who had lost 

several family members to tobacco offered his 

time for a tobacco control ad. An advertising 

concept and script were developed to encourage smokers to consider quitting by having 

them think about how their own death from 

tobacco use would affect their loved ones. 

Before producing the ads, the sponsoring 

organization conducted one-on-one interviews with adult smokers to ensure that the 

script and visual presentations would clearly 

and persuasively communicate the intended 

message. The smokers were shown the ad 

concept and asked their reactions to it 

through a variety of questions. Individual 

interviews were used instead of focus groups, 

because it was important for the smokers to 

be honest and vulnerable. The sponsoring 

organization was concerned that if smokers 

were in a focus group together, they might 

become defensive about the ad’s message that 

their tobacco use could ultimately hurt their 

loved ones. 

The approach worked. The one-on-one 

interviews elicited honest, heartfelt responses 

from the smokers. The interviews also revealed that many respondents didn’t recognize 

the actor. As a result, the decision was made 

to identify him on screen at the beginning of 

the ad. In addition, the original script included a line noting how the actor’s grandfather 

couldn’t stop smoking even though he knew it 

was making him sick. Respondents didn’t find 

that line credible. They believed the grandfather should have—and would have—quit if 

he knew smoking was making him sick. These 

respondents said they would stop as soon as 

they found out their smoking was causing 

them serious harm. Whether or not that perception was realistic, the script was changed 

to focus on the grandfather’s suffering, which 

research respondents sympathized with, 

rather than focusing on his failure in quitting. 

Designing and Conducting Focus 

Groups or Individual In-Depth 

Interviews 

Here are seven major steps for conducting 

focus groups and individual in-depth 

interviews: 

1. 	 Plan the research. 

2. 	 Choose the location and format for 

focus groups or interviews. 

3. 	 Draft a recruitment screener. 

4. Recruit participants. 

5. 	 Develop a moderator’s guide. 

6. 	 Conduct the focus groups or interviews. 

7. 	 Analyze and use results. 

Step 1: Plan the research. 

Determine the following information: 

■	 What you want to learn. Decide how 

you’ll use the results from the focus 

group discussion or individual interview 

before you conduct the research. Prepare 

the questions you want answered, then 

make sure the moderator and interviewer guide will provide the answers. 

(See Step 5 for more information on 

developing a moderator’s guide.) You’ll 

use these questions to analyze the 

results of the discussions and to 

organize the report on the focus group 

discussion or individual interview. 

■	 When you need to have that 

information. Your timing needs will 

58 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

determine the way you’ll need to recruit and, 

to some extent, your costs. 

■	 How you’ll apply what you learn. Make 

sure the information you’ll gain will be 

actionable. 

■	 Your budget. The size of your budget will 

dictate how many groups or interviews 

you can conduct, in how many locations, 

and how much of the work you will be 

able to delegate to contractors. 

■	 Your criteria for participants. Use the 

following suggestions to help you select 

participants. 

– 	 Choose people who are typical of your 

audience. Participants should have the 

same behavioral, demographic, and 

psychographic characteristics as your 

audience. (Psychographics are a set of 

variables that describes an individual 

in terms of overall approach to life, 

including personality traits, values, 

beliefs, preferences, habits, and 

behaviors.) You may want to conduct 

separate groups with “doers,” who 

already engage in the desired behavior, 

and “nondoers,” who don’t engage in 

the desired behavior. This strategy will 

help to identify what actions the doers 

take and why. Those actions then can 

be explored with the nondoers. 

– 	 Do not select experts. Exclude market 

researchers and advertising professionals, because of their familiarity 

with the methods, and exclude those 

who have, or might be perceived by 

other group members as having,


expertise in the subject matter. For


example, exclude health professionals


from focus groups when the topic is


related to health. In addition, anyone


involved in the production, distri­


bution, or marketing of tobacco


products should be excluded from


focus groups related to tobacco


control. 


– 	 Match participants by gender, race, 

age, level of formal education, or 

other characteristic(s) within each 

group. Participants with matched 

characteristics are more likely to 

express themselves freely. If your 

target audience includes people with 

different demographic traits, consider 

whether you need to conduct separate 

sessions for each audience segment to 

determine whether differences 

between the groups are significant. 

– 	 Select people who are relatively 

inexperienced with interviews. Participants’ reactions should be spontaneous. This consideration will help you 

to avoid questioning “professional” 

respondents who have participated in 

many focus groups or individual 

interviews and thus may lead or 

monopolize the discussion. Recruitment screeners typically exclude 

people who have participated in 

qualitative research in the past six 

months. (See Step 3 later in this 

section, for further discussion of 

recruitment screeners.) 

Chapter 3: Gaining and Using Target Audience Insights 59 
■	 The number of focus group discussions 

or interviews you’ll conduct. If you’re 

using focus groups, conduct at least two 

groups with each audience segment. For 

example, if you’re conducting separate 

groups with men and women, you’ll 

need at least four groups: two with men 

and two with women. If you’re using 

individual interviews, conduct about 10 

interviews per audience segment. 

If audience perceptions vary or the audience 

feedback is unclear, you may want to conduct 

additional groups or interviews, especially if 

you revise the moderator/interviewer guide to 

further explore unresolved issues. 

Step 2: Choose the location and format 

for focus groups or interviews. 

You can conduct focus groups or interviews in 

several ways: 

■	 Commercial focus group facilities can 

recruit participants. These facilities offer 

audio recording equipment, video 

recording equipment, or both and oneway mirrors with observation rooms. 

However, commercial facilities are often 

expensive and may not be available in 

small towns. 

■	 Teleconference services can set up 

telephone focus groups. Most 

teleconference services allow observers 

to listen without being heard. Some 

have the capability to allow the 

moderator to see a list of participants 

(with a symbol next to the one currently 

speaking) or to see notes sent by a 

technician from observers listening to 

the call. Some teleconference services 

also can recruit participants. 

■	 You can conduct focus groups or 

interviews in meeting rooms at office 

buildings, schools, places of worship, 

homes, or other locations. If an 

observation room with a one-way 

mirror isn’t available, allow staff to listen 

by hooking up speakers or closed-circuit 

TV in a nearby room or by audio 

recording the session, video recording 

the session, or both. In some cases, you 

may have one or two quiet observers 

taking notes in the room. 

Step 3: Draft a recruitment screener. 

A recruitment screener is a short questionnaire 

that is administered to potential participants, 

typically by telephone, to ensure that they meet 

the criteria you developed in Step 1. Your 

contractor, if you have one, will administer this 

questionnaire. The screener should help you 

to exclude people who know one another or 

have expertise in the subject of the sessions. 

Potential participants can be told the general 

subject area (e.g., “a health topic”), but they 

shouldn’t be told the specific subject. If 

participants know the subject in advance, they 

may formulate ideas or study to become more 

knowledgeable about the subject. Furthermore, if 

participants know one another, they may speak 

less freely. For similar reasons, they also shouldn’t 

be told who the sponsor is. 

60 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 3.1: Pros and Cons of Formats for Focus Groups and Individual Interviews 

Format Pros Cons 

Face to Face 

Moderator/interviewer 

and participants are in 

one room, usually around 

a table; observers (members of the research team) 

are behind a one-way 

mirror. 

• Body language can be assessed. 

• Observers can be present without distracting participants. 

• If the session is videotaped, it 

can be shared with others who 

couldn’t attend. 

• Participants give undivided 

attention. 

• Responders lose anonymity. 

• The session has higher travel 

expenses because of multiple 

locales. 

• The session may be a logistical 

challenge in rural areas or small 

towns. 

Telephone 

Moderator/interviewer 

and participants are on a 

conference call; observers 

listen. 

• The session is more convenient 

for participants and observers. 

• Participants can easily include 

people in rural areas or small 

towns, as well as the homebound. 

• Relative anonymity may result 

in more frank discussion of 

sensitive issues. 

• Nonverbal reactions can’t be 

assessed. 

• It’s more difficult to get reactions 

to visuals. (They can be sent 

ahead of time, but you still have 

less control over exposure.) 

• Participants can be distracted by 

their surroundings. 

• There may be noise interference 

from callers’ environments. 

Internet Chat Sessions 

Moderator and participants “chat” while 

observers read. 

• A complete record of session is 

instantly available. 

• Relative anonymity may result 

in more frank discussion of 

sensitive issues. 

• The session is useful only for 

participants comfortable with 

this mode of communication. 

• The relatively slow pace limits 

topics that can be covered. 

• There’s no way to assess whether participants meet recruitment criteria. 

• Body language or tone of voice 

can’t be assessed. 

• It’s more difficult to get reactions to 

visual presentations. (They can be 

sent ahead of time, but you still 

have less control over exposure.) 

• Participants can be distracted by 

their surroundings. 

Chapter 3: Gaining and Using Target Audience Insights 61 
Contracting With Commercial Facilities 

One way to conduct face-to-face focus groups or individual interviews is to contract with a company that 

specializes in this service. Before you contract with a commercial facility, prepare a specification sheet 

detailing all the services you need, and if you will be asking the facility to recruit participants, prepare a 

profile of your audience. Vendors will use this information to estimate the project’s cost and to develop bids. 

Use this checklist to decide which vendors to consider. Each vendor should provide these items: 

❑	 Descriptions of past projects 

❑	 Descriptions of or a list of clients (If you are unfamiliar with the vendor, check the company’s


references.) 


❑	 Location of the facility (Is it conveniently located? Accessible by public transportation? If not, does 

the vendor provide transportation assistance, such as taxi money or van service? What does this 

add to the cost?) 

❑	 Size of the interview room(s) 

❑	 Diagram of the table/seating arrangements (What shape is the table? How big is the table? 


Where does the moderator sit?)


❑	 Size and features of the observation room(s) 

❑	 Details about audio recording and video recording arrangements and costs 

❑	 Details about food arrangements for participants and observers, including staff from your


organization and ad agency


❑	 Description of the vendor’s moderator services 

❑	 Description of the vendor’s method of recruitment, including the database used and the


geographic area the company covers


❑	 Recommendations for participant incentives 

❑	 Reasonable rates for vendor services (Ask for nonprofit rates.) 

❑	 Examples of focus group summaries/reports, moderator notes, screeners (short questionnaires 

used to recruit potential participants), and other documents produced by the vendor for other 

clients if you’re going to ask the vendor to provide these services 

62 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

The screener should guarantee the approximate 

mix of respondents for a group that isn’t separated by certain characteristics, such as a balance of 

men and women in a mixed-gender group. (See 

Appendices 3.1 and 3.2 for sample screeners.) 

Step 4: Recruit participants. 

Choose appropriate participants for the focus 

groups or interviews, so your research is more 

reliable. Even if a contractor does the recruiting, make sure the screener is followed carefully so that only those who qualify will be 

included in the research. 

Participants should be recruited by telephone 

one to three weeks before the sessions. How 

you identify potential participants depends on 

the type of people they are and the resources 

you have. Focus group facilities typically 

identify members of the audience through 

their own databases. If you do the recruiting, 

you might need to run an ad in a local publication, work with community organizations, 

purchase lists of phone numbers of individuals 

with certain characteristics, or identify professionals through a relevant association or 

mailing list service. Here are some ways 

to recruit: 

■	 Hire a focus group facility or independent 

recruiter. Two directories of facilities are 

the American Marketing Association’s 

GreenBook: Worldwide Directory of Focus 

Group Companies and Services (2003) 

and the Marketing Research 

Association’s Blue Book (2003). 

■	 If you have many facilities and recruiters 

to choose from, consider getting recommendations from local companies or 

organizations that conduct qualitative 

research. 

■	 Enlist help from students in a university 

marketing research or advertising class 

if they are knowledgeable and 

experienced in focus group research. 

■	 Work through gatekeepers such as 

teachers (for students); instructors for 

courses of English as a second language 

(for recent immigrants); health care 

systems (for patients, physicians, or 

nurses); and religious institutions or 

community organizations whose 

members meet your audience criteria. 

(A small donation may encourage an 

organization to recruit for you.) 

Getting People to Show Up 

To ensure that enough people show up, offer an 

incentive (usually money) and recruit more 

people than you need. If everyone shows up, 

select those who best fit your screening criteria, 

thank the extra participants, give them the 

agreed-on incentive, and ask them to leave. You 

also can make sure you have enough people by: 

■	 Scheduling sessions at times convenient 

for your potential participants (e.g., 

during lunchtime or after work) 

■	 Choosing a safe and convenient site 

Chapter 3: Gaining and Using Target Audience Insights 63 
■	 Providing transportation or reimbursing 

participants for agreed-on transportation costs 

■	 Arranging for child care 

■	 Letting participants know you’ll provide 

snacks or refreshments 

Recruiting for Telephone Interviews 

If you’re recruiting for telephone interviews, 

create a spreadsheet with spaces for the 

following information about each potential 

participant: the time zone in which the person 

is located; the date, time, and number at which 

they should be called; and the result of each 

call (e.g., scheduled an interview, no answer, 

busy, or refused). This type of spreadsheet also 

can be helpful in planning in-person interviews and using other research methods. 

Step 5: Develop a moderator’s guide. 

The quality of the moderator’s guide is critical 

to the success of focus groups. The guide tells 

the moderator or interviewer what information you want from the sessions and helps him 

or her keep the discussion on track and on 

time. Your contractor will draft the guide for 

you if you need this service. Before it is drafted, 

you’ll need to determine the following 

information: 

■	 What you want to learn from the focus 

group or interview 

■	 How to apply what you learn 

■	 What tools (e.g., descriptive information, message concepts, or other draft 

creative work) you’ll need to provide for 

the sessions 

You should write questions for the guide that 

relate to the purposes you’ve identified. Most 

questions should be open-ended, so participants can provide more in-depth responses 

than just “yes” or “no.” Also, make sure the 

questions aren’t worded in a way that will 

prompt a particular response. For example, 

don’t ask, “What problems are you having with 

quitting smoking?” Instead, you could phrase 

the question more neutrally by asking, “What 

problems do smokers have with quitting?” 

Participants will then be more likely to offer 

honest responses, rather than the answers they 

think you want. The time and depth of exploration given to each issue should reflect the 

issue’s importance to your purposes. (See 

Appendices 3.3 and 3.4 for examples of 

moderator’s guides.) 

In the focus groups, don’t include questions 

for group discussion if you need individual 

responses. However, you can have the 

moderator give each participant a selfadministered questionnaire to complete before 

the session. Participants also can be asked to 

individually rank certain items (e.g., potential 

actions, benefits, or message concepts) on 

paper during a session to combine individual 

and group reactions. 

Step 6: Conduct the focus groups 

or interviews. 

Focus groups and interviews typically begin 

with the moderator welcoming participants 

and briefing them on the process (e.g., that 

64 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Working With Community Organizations (Partners) To Conduct Focus Groups 

You’ll need a formal or informal agreement to conduct focus groups with your partner. Working with your 

contact at the partner organization, develop an agreement that includes the following elements: 

■	 A description of your organization 

■	 A description of the material/topic to be discussed and its purpose 

■	 Details about participants to be recruited 

■	 An outline of activities involved 

■	 The incentives you are offering the partner organization and/or the participants 

■	 A detailed explanation of why the partner should not reveal details about the topic to participants 

in advance 

■	 How you will protect participants’ confidentiality 

■	 If and how you will share the information learned 

Once you have an agreement, decide how you will recruit participants. One idea is to conduct your 

research as part of one of the partner organization’s regular meetings. Here are the pros and cons of 

this approach: 

Pros: 

■	 Little extra effort is required to recruit participants. 

■	 Minimal or no incentives may be involved. 

■	 Your partner’s regular, convenient, and familiar meeting place can be used. 

Cons: 

■	 You have little control over the number of people who will come or the composition of the focus 

group. Respondents are likely to know one another, which will affect the focus group’s dynamics 

and make results less reliable. 

■	 Because a focus group may last one or two hours, it is difficult to place it on the agenda of a


regular meeting.


■	 Scheduling the focus group for the near future may be difficult, because many organizations set


their calendars months in advance.


Continues 

Chapter 3: Gaining and Using Target Audience Insights 65 
Working With Community Organizations (Partners) To Conduct Focus Groups 

(cont.) 

An alternative is to recruit your partner’s members/constituents to come to a special meeting. This 

approach offers the ability to screen participants. In addition, participants may be less distracted in a 

meeting solely devoted to your research than in a focus group conducted as part of a regular meeting. 

Scheduling the focus group immediately before or after the regular meeting may make it more convenient for participants. A person with the organization—or you, on behalf of the organization—can ask 

members/constituents to participate. Also, if you’re providing refreshments or incentives, let participants 

know in advance to encourage them to attend and to stay through the entire meeting. 

If you do the recruiting, you’ll have more control over what people are told about the focus group and 

you’ll be able to screen potential participants. However, recruiting takes a significant amount of time, 

and organization members/constituents may be more likely to participate if they are asked by someone 

they know. 

If the member organization recruits participants, you need to provide the recruiter with detailed instructions. These instructions must include (1) a written description of the general (not specific) topic, which 

should be read to potential participants verbatim, and (2) a questionnaire to screen participants. 

there are no right or wrong answers, that it’s 

important to speak one at a time and maintain 

confidentiality, that observers will be present, 

and that the session will be recorded).3 In focus 

groups, participants introduce themselves to 

the group, noting information relevant to the 

discussion (e.g., number of attempts to quit 

smoking and number of cigarettes smoked each 

day). Next, the moderator asks a few simple 

“icebreaker” questions to help participants get 

used to the process and reduce their anxiety. 

This step also helps the moderator develop a 

rapport with the participants. Again, to reduce 

the risk of introducing bias, the sponsor of the 

research should not be revealed. 

The session then shifts to an in-depth investigation of participants’ perspectives and issues. 

Following the moderator’s guide, the moderator manages the session and ensures that all 

topics are covered without overtly directing the 

discussion. Participants are encouraged to 

express their views and even disagree with one 

another. The moderator doesn’t simply accept 

what participants say but probes to learn 

about thoughts and attitudes. The moderator 

also seeks opinions from all participants, so 

everyone has a chance to speak, rather than 

letting a vocal few dominate the discussion. 

3 If the group is conducted in a language that observers don’t understand, provide a translator in the 

observation room. 

66 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

The Moderator’s Role 

The moderator or interviewer doesn’t need to be an expert on your topic, but he or she should be briefed


well enough to ask appropriate questions and must have experience in facilitating group discussions.


Rehearse with the moderator any topics or concerns you want emphasized or discussed in depth. The


moderator’s guide is just that, a guide. Experienced moderators flow with the conversation, ask questions


that are not leading or closed ended, and sequence to the next topic when appropriate or deviate from it


to avoid awkward transitions or unnecessary banter between topics.


A good moderator has the following characteristics: 

■	 The moderator understands what information you’re seeking, how you need to use it, and how to


probe and guide the discussion to get the information. He or she makes sure all agreed-on topics


are covered sufficiently.


■	 The moderator builds rapport and trust, and probes without reacting to or influencing participants’


opinions. He or she emphasizes to participants that there are no right or wrong answers.


■	 The moderator understands the process of eliciting comments, keeps the discussion on track, and


finds other ways to approach a topic if necessary.


■	 He or she leads the discussion and isn’t led by the group. 

Use local advertising agencies, the American Marketing Association’s GreenBook: Worldwide Directory of


Focus Group Companies and Services (2003), or the Qualitative Research Consultants Association to find


a good moderator. If your organization plans to conduct focus groups regularly by using your internal


staff, consider hiring a skilled, experienced moderator to train your staff to moderate focus groups. 


Near the end of a focus group, the moderator 

may give participants an activity or simply 

check with the observers to find out if they 

have additional questions. Notes can be discreetly given to the moderator throughout the 

session if the observers want other questions 

asked or changes made. 

Step 7: Analyze and use results. 

In many analyses of focus groups or interviews, 

the goal is to look for general trends and agreement on issues while noting differing opinions. 

In some instances, the goal is to capture a 

range of opinions. Keep an eye out for individual comments that raise interesting ideas or 

important concerns, such as lack of cultural 

sensitivity or difficulty in comprehension. 

One advantage of the focus group/interview 

method is that the moderator’s guide and 

any materials presented can be revised 

between sessions. 

Reviewing transcripts is the easiest and most 

thorough way to analyze the sessions, 

Chapter 3: Gaining and Using Target Audience Insights 67 
although the sessions can be analyzed less 

thoroughly by reviewing notes taken during 

the discussion. Avoid counting or quantifying 

types of responses (e.g., “75 percent of 

participants preferred concept A”). Because 

this is qualitative research, you can’t quantify 

the results or suggest that they represent the 

opinions of the audience as a whole. 

Results are worthless if they aren’t used. Use 

them to answer the questions you drafted to 

guide the research design—to shape the campaign strategy, message, and materials design. 

Also, your results help you “sell” your program 

as “researched and tested.” Share your findings 

with partners and others who might benefit. 

Estimated Costs of Focus Groups 

and Interviews 

The cost estimates in Table 3.2 can help you 

budget for pretesting if you’re using commercial research firms. Your actual costs will vary 

depending on your location, the target 

audience being recruited, and the amount of 

time contributed by staff, contractors, and 

participants. For example, if your staff includes 

a focus group expert who can analyze the 

results, you won’t have to pay a contractor for 

that task. However, don’t jeopardize the quality 

of your results with a budget that’s too small. 

The estimates for focus groups assume that 

you conduct two groups, each with 10 memTable 3.2: Estimated Costs of Two Focus Groups and 10 Individual In-Depth Interviews Conducted With 

Participants From the General Population 

Item Costs of Two Focus 

Groups 

Costs of 10 Individual 

In-Depth Interviews 

Develop screener* $800–$1,000 $800–$1,200 

Develop discussion guide* $800–$1,200 $800–$1,600 

Recruit participants $1,500–$2,000 $750–$1,500 

Rent facility $700–$1,000 $1,000–$2,000 

Provide respondent incentives/refreshments $600–$1,500 $0–$500 

Hire moderator or interviewer $1,500–$2,100 $500–$1,000 

Audiotape and videotape sessions 

Transcribe audiotapes $500–$800 $300–$400 

Analyze research findings and write report* $1,600–$2,400 $1,600–$2,400 

Total $8,000–$12,000 $5,750–$10,600 

68 

*One-time costs that will not be incurred for each group. 

Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

bers of the general population. This size is for 

cost estimates only. Most program managers 

prefer groups of five to eight, because doing so 

more easily engages all group members in 

conversation, but others prefer groups of eight 

to 12. In either case, larger numbers frequently 

are recruited to allow for some “no-shows.” 

However, if more people show up than you 

need, you must still give them any promised 

incentive. Also, recruiting specific, hard-to-find 

target audiences may be more expensive than 

selecting a group from the general population. 

The cost estimates also assume that each 

session is two hours long, conducted in 

English, and audiotaped. Staff travel, food for 

participants, and videotaping, which is useful 

when some of your program team can’t 

directly observe the session, are not included. 

The interview estimate shown in Table 3.2 

assumes 10 half-hour interviews that are 

conducted in English and audiotaped. 

Quasi-Quantitative Research 

Quasi-quantitative tools are used most often to 

pretest messages and materials, as noted 

earlier. These tools include central location 

intercept interviews and theater-style pretests. 

If you pretest many ads using the same 

methodology and the same questions, you can 

develop a database of results that allows you to 

assess the relative strengths of various ads. 

Central Location Intercept Interviews 

In central location intercept interviews, 

interviewers go to a place frequented by 

members of the target audience and ask them 

to participate in a study. If they agree, they’re 

asked specific screening questions to determine whether they fit the recruitment criteria. 

If they do, the interviewers take them to the 

interviewing station (a quiet spot at a 

shopping mall or other site), show them the 

pretest materials, and then administer the 

pretest questionnaire. The interview should 

last no longer than 15 to 20 minutes. 

For intercept interviews to be effective, you 

must obtain results from at least 100 of each 

type of respondent or more if you want to 

break out specific subgroups (e.g., males vs. 

females or age groups) (NCI 2002). 

Pros: 

■	 You increase your chances of finding the 

right participants if you choose the right 

location. 

■	 You can connect with harder-to-reach 

respondents and present them with a 

stimulus (an ad, graphics, messages, or 

a brochure). 

■	 The interviews can be conducted quickly. 

■	 The interviews are a cost-effective way 

to gather data in a relatively short time. 

Cons: 

■	 You must train interviewers. 

■	 Your results aren’t representative and 

can’t be generalized. 

■	 Intercept interviews aren’t appropriate 

for sensitive issues or potentially threatening questions. 

■	 Intercept interviews aren’t appropriate 

for in-depth questions, and they don’t 

Chapter 3: Gaining and Using Target Audience Insights 69 
allow you to probe for additional information easily. 

■	 Respondents might not want to be interviewed on the spot. Although setting up 

prearranged appointments is time consuming and more expensive, ultimately 

it may save time if respondents won’t 

cooperate in a central location. 

Developing the Questionnaire 

Unlike focus groups or individual interviews, 

the questionnaire used in central location 

intercept interviews is highly structured and 

contains primarily multiple-choice or closedended questions to permit quick responses. 

Open-ended questions, which allow freeflowing answers, should be kept to a minimum, because they take too much time for the 

respondent to answer and for the interviewer 

to record. Questions that assess the audience’s 

comprehension and perceptions of the pretest 

materials form the core of the questionnaire. 

The interview may also include a few questions tailored to the specific item(s) being 

pretested (e.g., “Do you prefer this picture or 

this one?”). As with any research instrument, 

the questionnaire should be pilot tested before 

it’s used in the field. (See Appendix 3.6 for a 

Sample Intercept Interview Questionnaire.) 

Setting Up Interviews 

A number of market research companies 

throughout the country conduct central 

location intercept interviews in shopping 

malls. You can also conduct these interviews in 

clinic waiting rooms, religious institutions, 

Table 3.3: Estimated Costs for Central Location 

Intercept Interviews Conducted With 100 

Participants From the General Population 

Item Costs 

Develop questionnaire 

Print questionnaire 

Schedule facility and phones 

Screen and conduct interviews 

Provide respondent incentives 

Code, enter data, and tabulate 

Analyze research findings and 

write report 

$750–$3,500 

$400–$600 

$2,000–$3,500 

$600–$750 

$850–$1,300 

$1,500–$3,500 

Total $6,100–$13,150 

Social Security offices, schools, work sites, 

train stations, and other locations frequented 

by audience members. You must obtain 

permission from the site well before you want 

to set up interviewing stations. 

If you’re using a market research company to 

conduct the interviews, provide the company 

with the screening criteria and the pretest 

materials in appropriate formats and quantities. Some companies have offices in shopping 

malls, and some offices have one-way mirrors 

that allow you to watch the interviews. 

University and college departments of marketing, communication, or health education 

might be able to provide interviewer training, 

trained student interviewers, or both. Pretesting 

is an excellent real-world project for a faculty 

member to adopt as a class project or for a 

70 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

master’s degree student to use as a thesis 

project. However, this approach may mean you 

don’t get your results as quickly, and you may 

compromise the quality of the research if the 

individuals lack the appropriate experience. 

Table 3.3 shows estimated costs for central 

location intercept interviews. These costs are 

based on questioning 100 respondents from the 

general population for 15 to 20 minutes each. 

Central location intercept interviews might not 

be feasible if your audience is geographically 

dispersed or does not have easy access to a 

central facility. In those cases, you can use 

telephone interviews and send materials to 

participants in advance. This type of pretest 

typically resembles an individual interviewing 

project in cost and number of interviews, but 

more closed-ended questions may be used 

and the question sequence may be followed 

more closely. 

Recruiting Participants 

If your organization is recruiting the participants, you’ll need to develop screening 

criteria, a script, and training for approaching 

audience members. The interviewer should be 

familiar with the screening criteria and 

approach only those people who appear to fit 

the criteria. Whenever the people approached 

don’t qualify, the interviewer should thank 

them for their time and willingness to 

participate. If they do qualify, the interviewer 

can bring them to a designated location and 

proceed with the interview. 

Theater-Style Pretests 

Theater-style pretests are most commonly 

used to assess the effectiveness of TV ads. 

Animated video storyboards are used to select 

Use of Theater-Style Pretesting To Compare Ad Formats 

Theater-style pretesting was used with youth and adults to compare the effectiveness of two Massachusetts 

ads, “Cowboy” and “Models.” This method was chosen because norms had been established over time, and 

results of the two ad pretests could be compared with those of previous pretests. In “Cowboy,” a man tells 

the story of his brother, a former actor in Marlboro ads who died from lung cancer at a young age. In 

“Models,” the U.S. women’s soccer team discusses the negative impact of smoking on sports performance. 

Both ads also include a message about how the tobacco industry manipulates and influences people. Both 

are black-and-white ads featuring people talking to the camera. 

“Cowboy” scored better than “Models” on several key measures, including recall of the main message and 

how convincing and engaging it was. “Cowboy” also scored better than most ads previously pretested with 

the same method. The respondents’ verbatim comments helped explain why. The respondents were very 

moved by the real story of the man losing his brother because he smoked cigarettes. They vividly recalled 

many more details about “Cowboy” than about “Models,” and male and female respondents alike said the 

ad was realistic and made them cry. They also frequently commented on an image in which the former 

Marlboro man is in a hospital bed attached to numerous tubes. 

Chapter 3: Gaining and Using Target Audience Insights 71 
the best concept, or a rough-cut (near-finished) 

ad is pretested as a “disaster check.” Participants are invited to a central location to watch 

a pilot for a new TV program. During the 

program, they’re exposed to several ads, 

including the pretest ad. After the show, participants complete a questionnaire. They first 

respond to questions about the show and then 

answer questions about the pretest materials, 

to determine how effectively the message was 

communicated and what their overall 

reactions were. For theater-style pretests to be 

effective, you must obtain results from at least 

100 respondents of each type (NCI 2002). 

Pros: 

■	 You can obtain responses from a large 

number of respondents at the same time. 

■	 Running the ad as part of TV programming allows you to more closely 

replicate participants’ experiences of 

watching TV at home. 

Con: 

■	 Your results aren’t representative and 

can’t be generalized. 

During theater-style pretests, participants are 

invited to a conveniently located meeting 

room or auditorium that is set up for screening 

a TV program. Participants should be told only 

that their reactions to a TV program are being 

sought, not the real purpose of the gathering. 

The program can be any entertaining, nonhealth-related video presentation that is 15 to 

30 minutes long. About halfway through the 

program, some commercials are shown, and 

your message is among them. 

Table 3.4: Estimated Costs of a Theater-Style Pretest 

Conducted With 100 Participants From the General 

Population 

Item Costs 

Develop questionnaire $400–$2,400 

Produce questionnaire $400–$600 

Recruit participants $4,500–$6,000 

Rent facility $0–$$$* 

Rent audiovisual equipment $0–$2,000 

Conduct theater-style pretest $0–$800 

Provide respondent incentives $3,000–$5,000 

Code, enter data, and tabulate $800–$3,200 

Analyze research findings 

and write report $1,600–$3,200 

Total $10,700–$23,200+ 

*The cost of large facilities (e.g., hotel ballrooms) 

varies widely by geographic region. Check with local 

facilities for approximate costs. 

After the program, participants receive a questionnaire designed to gauge their reactions to 

the program. Then they complete a section of 

questions focusing on the ad. 

In some cases, one-half of the audience is sent 

home and the rest are asked to stay. The 

remaining group watches your ad again and 

answers several additional questions. The 

participants who were sent home are called 

back two to three days later and asked 

questions about the ad, to determine how well 

they recalled the ad and its main message. 

72 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

In more sophisticated theater-style pretests, 

participants answer questions by using automated audience-response systems. They are 

given a small device with response keys that 

they push when a question is asked. The data 

are automatically tabulated, giving you instant 

access to the numbers. Questions can be 

instantly added or deleted from the questionnaire on the basis of the previous responses. 

However, an automated system is much more 

costly to use than a standard paper-and-pencil 

questionnaire. 

15-minute video on smoking cessation that 

will be shown in a clinic. You should have 

participants view a series of videos that 

includes yours. Participants evaluate the 

videos the same way they evaluate ads, but 

these sessions last longer than ad pretests. 

If you’re using print ads, try a variation of the 

theater-style pretest. In this method, several 

ads, including yours, are inserted into a 

magazine. Participants are asked to read an 

article with the ads interspersed and are given 

enough time to finish the article. Then they 

complete a questionnaire designed to gauge 

their reactions to the article and ads, as well as 

a section containing questions focusing on the 

ads. Finally, your ad is displayed alone, and 

participants respond to several more questions. 

Table 3.4 shows the estimated costs of a theaterstyle pretest conducted with 100 participants. 

Pretesting Other Media 

Theater-style pretesting also can be used to 

assess video presentations, such as a 10- to 

Using a Mix of Research Methods 

The World Health Organization and CDC worked with an agency to develop several advertising concepts 

to encourage smokers to try to quit with help. The likelihood of successful smoking cessation increases 

greatly if the smoker takes advantage of help (e.g., counseling, a “quitline,” written materials, physician’s 

advice, and pharmacological products). The concepts were shared with smokers in one-on-one 

interviews, and one ad concept was selected for production. The ad was produced, but before it was 

recommended to countries to air, it was pretested through a central location intercept method. 

This research showed that the number of respondents who preferred calling a quitline was nearly equal 

to the number who preferred visiting a Web site for help in quitting. It was decided that when possible, 

both a toll-free phone number and a Web site should be provided on the tag at the end of the ad. 

In addition, although smokers understood the message well, they didn’t believe it was forceful enough. 

Because the audio presentation was a “voiceover” and the wording could be changed inexpensively 

before finishing the ad, the agency made the wording more direct and also selected a different actor who 

had a more confident voice. 

Chapter 3: Gaining and Using Target Audience Insights 73 
Designing and Conducting a TheaterStyle Pretest 

There are six steps for designing and conducting theater-style pretests, but many ideas, particularly those in Step 2, also are useful for 

central location intercept interviews. The six 

steps are as follows: 

1.	 Plan the pretest. 

2.	 Develop the questionnaire. 

3.	 Recruit participants. 

4.	 Prepare for the pretest. 

5.	 Conduct the pretest. 

6.	 Analyze the pretest. 

Step 1: Plan the pretest. 

Determine your requirements for the following 

information: 

■	 What you want to learn 

■	 When you need the results 

■	 What your budget is 

■	 Which contractors are qualified to do 

this work 

■	 What criteria participants should be 

required to meet (Your contractor can 

help you to determine these criteria.) 

■	 Which facility you’ll use (Your 

contractor will make this decision.) 

The facility must be large enough to accommodate all your participants simultaneously. 

Several video monitors may be needed for all 

participants to see the program well. 

You can also rent space, such as a hotel ballroom, if you want to pretest materials among 

a large number of people. Hotels often have 

audiovisual equipment available for rent. You 

must reserve facilities and equipment well in 

advance of your pretest. 

Some market research companies conduct 

theater-style pretesting. They can provide 

details about the process they follow in 

conducting this pretesting. 

Step 2: Develop the questionnaire. 

Work with your contractor to carefully construct the questionnaire. At a minimum, it 

should contain three parts: 

■	 Recall and communication of the main 

idea of pretest materials 

■	 Audience reaction to pretest materials 

■	 Demographic characteristics of the 

participants 

Recall and Communication of the Main Idea 

The standard questions on recall and communication of the main idea are critical to the 

pretest. They address some of the most 

important measures of a message’s potential 

effectiveness: 

■	 Whether it attracts the audience’s


attention (recall)


■	 Whether it communicates your main 

point (main idea) 

■	 What respondents thought and how they 

felt when they viewed the ad (e.g., potential persuasiveness and believability) 

74 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

See main idea questions in Appendix 3.6: 

Sample Intercept Interview Questionnaire. 

Keep in mind that the sample questionnaire 

was designed for research in which the ad was 

shown among a group of ads, not within a 

pilot TV program. 

Audience Reaction 

Include several standard questions on 

audience reaction that address your specific 

concerns about your message. Suppose your 

message asks viewers to call a toll-free number 

for more information. You may want to ask, 

“What action, if any, does the message ask 

you to take?” or “Did the telephone number 

appear on the screen long enough for you 

to remember it?” 

If possible, develop one or more questions 

addressing each characteristic of your message. 

Use the following list of characteristics 

commonly found in messages to determine 

which ones apply to your message, and 

develop questions that focus on these 

characteristics: 

■	 Use of music (with or without lyrics) 

■	 Use of a famous spokesperson 

■	 Use of telephone numbers 

■	 Use of mailing addresses 

■	 Request for a particular action 

■	 Instructions for performing a specific 

health behavior 

■	 Presentation of technical or medical 

information 

■	 Presentation of new information 

■	 Promotion of a sponsoring organization 

or event 

■	 Representation of characters intended 

to be typical of the target audience 

■	 Use of a voiceover announcer 

■	 Presentation of controversial or


unpleasant information


Some theater-style pretests don’t ask specific 

questions about characteristics of each ad; 

instead, they rely on the respondents to 

volunteer reactions about the ads. When 

compiled, the responses often suggest patterns 

indicating perceptions about elements of the 

ad (e.g., confusing, polarizing, persuasive, or 

credible). See Appendix 3.6, Sample Intercept 

Interview Questionnaire, for examples of 

open-ended questions to gauge respondents’ 

reactions, and closed-ended questions to 

assess respondents’ perceptions about the 

pretest ad. Remember that the objective of 

pretesting is to uncover any problems with 

your ad before final production or airing. 

Demographics 

Questions about demographics record the 

participants’ characteristics (e.g., sex, age, level 

of education, and health status). This information will help you later if you need to separate 

and analyze the data by subgroups. 

Chapter 3: Gaining and Using Target Audience Insights 75 
Step 3: Recruit participants. 

Your contractor will recruit participants for a 

recruiting fee. You’ll also pay an incentive to 

participants. (See section on Focus Groups, 

earlier in this chapter, for information on 

recruiting participants.) 

Step 4: Prepare for the pretest. 

Before the pretest session, your contractor 

should make sure that all arrangements are 

made. This checklist may be helpful: 

■	 Has participant recruitment taken place 

as scheduled? Were participants 

reminded to attend? Do they have 

transportation and correct directions? 

■	 Have the moderators or interviewers 

rehearsed? 

■	 Is the meeting room or other facility 

reserved for you? Is it set up? Are enough 

chairs available? Are extra chairs 

available in case more people show up 

than you expect? Is the heating or air 

conditioning working properly? Do you 

know where the light switches are? If a 

microphone is needed, is it set up and 

functioning properly? 

■	 Is the pretesting videotape ready? Are 

the video and audio portions of the tape 

clear? 

■	 Are the videocassette recorder (VCR) 

and TV monitors working properly? 

Do you need another monitor so that 

everyone will be able to see the 

program? 

■	 Are enough copies of the pretest questionnaire on hand? Is each questionnaire complete (no pages missing)? Are 

there enough pencils for participants? 

Will they need clipboards or pads? 

Step 5: Conduct the pretest. 

The following checklist is useful for conducting 

the pretest: 

■	 Have everything organized and working 

before the session. 

■	 Conduct a dry run to check on equipment and timing. 

■	 Be friendly and courteous to participants from the moment they arrive until 

they leave. (Remember to thank them.) 

■	 Have a backup plan in case “surprises” 

occur (e.g., a large number of no-shows, 

too many participants, equipment 

failure, or a disruptive individual). 

The session should take no more than one 

hour and 15 minutes if you’re organized and 

well prepared. 

Step 6: Analyze the pretest. 

Analyze the questionnaires in two steps. First, 

tabulate or count how many participants gave 

each possible response to each question, and 

look for patterns in the responses to both 

closed-ended and open-ended questions. The 

patterns will help you to draw conclusions 

about the effectiveness of your message. 

76 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Then look at the overall results, and answer 

these questions to determine whether your 

message is both effective and appropriate or 

whether you need to revise your message 

before implementation: 

■	 What did you learn from the pretest? 

■	 Did your message receive a favorable 

audience reaction? 

■	 Did your message fulfill its 


communication objectives?


■	 What are your message’s strengths? 

Weaknesses? 

■	 Did answers to any particular 


question stand out?


■	 Should you revise your message? 


If so, how?


Quantitative Research 

Quantitative research is used to: 

■	 Determine the percentage of your target 

audience that has certain behaviors, 

behavioral intentions, attitudes, and 

knowledge of your subject 

■	 Monitor the audience’s use of materials 

and awareness of your communication 

program and its tactics 

■	 Measure progress toward the program’s 

objectives, such as changes in beliefs, 

knowledge, attitudes, and behavior (See 

Chapter 5: Evaluating the Success of 

Your Counter-Marketing Program for 

more information.) 

Surveys are a primary tool in quantitative 

research. They’re used in a program’s planning 

and assessment stages to obtain baseline and 

tracking information. They also can be useful 

in gaining insights into a target audience and 

gauging reactions to potential core messages. 

Surveys generally involve large numbers of 

respondents (300 or more) and questionnaires 

with predominantly closed-ended questions. 

Pros: 

■	 Random sampling can be used in 


surveys to obtain results that can be


generalized to the target population,


providing better direction for planning


programs and messages.


■	 Participants can be anonymous, which


is beneficial for sensitive topics.


■	 Surveys can include visual material 


and can be used to pretest items such 


as prototypes. 


Cons: 

■	 Surveys limit the ability to probe


answers. 


■	 There’s a risk that the people who are


more willing to respond may share


characteristics that don’t apply to the


audience as a whole, creating a potential


bias in the research. 


■	 Surveys can be costly and time 


consuming.


■	 Response rates are declining, especially


for telephone and Internet surveys


(Singer, et al. 2000).


Chapter 3: Gaining and Using Target Audience Insights 77 
Most surveys are customized to answer a 

specific set of research questions. Some 

surveys are omnibus studies, in which you add 

questions about your topic to an existing 

survey. A number of national and local public 

opinion polls offer this option. 

Table 3.5 displays the pros and cons of different survey formats. 

Designing and Conducting a Survey 

To design and conduct a survey, follow the 

same basic steps used for the other types of 

research outlined earlier in this chapter: 

1.	 Plan the research. 

2.	 Decide how the survey participants will 

be selected and contacted. 

3.	 Develop and pretest the questionnaire. 

4.	 Collect the data. 

5.	 Analyze the results. 

Quantitative surveys involve complex topics— 

such as sampling size and composition, questionnaire design, and analysis of quantitative 

data—that are beyond the scope of this chapter. 

(See Chapter 5: Evaluating the Success of Your 

Counter-Marketing Program for more information on planning a survey.) 

Other Market Research Tools 

Other tools can help you gain insights into 

your target audience and develop effective 

messages and materials. These tools include 

diaries and activity logs, gatekeeper reviews, 

and readability pretesting. 

Diaries and Activity Logs 

Diaries and activity logs are written records of 

what occurred each day, week, or other time 

period during a program’s planning or execution. These records are kept and updated by 

people from whom you want input and feedback about the program. They’re commonly 

used to: 

■	 Track program implementation 

■	 Assess the effectiveness of program 

implementation 

■	 Pilot test an intervention 

■	 Monitor whether planned activities are 

on schedule and within budget 

■	 Learn what questions program participants asked 

■	 Determine what technical assistance 

program staff needed 

■	 Track the audience’s exposure to


program components


■	 Gain insights about the audience’s 

relevant day-to-day experiences (e.g., 

smokers can record each time they 

smoked a cigarette, and how they felt 

before, during, and after smoking the 

cigarette, providing insights into how 

smokers feel about smoking and how 

you might be able to help them quit) 

If you plan to use diaries or activity logs to 

gauge the quality of program planning or 

execution, be sure the diaries and logs are 

started as soon as you begin program planning. Have program managers or participants 

78 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 3.5: Pros and Cons of Survey Formats 

Format Pros Cons 

Mail 

• Mail can be a cost-effective way 

to access hard-to-reach populations (e.g., the homebound or 

rural residents). 

• Respondents can answer questions when it’s most convenient 

for them. 

• Mail is not appropriate for 

respondents with limited 

literacy skills. 

• Low response rate diminishes 

the value of results. 

• Expensive follow-up by mail or 

telephone may be necessary to 

increase the response rate. 

• Respondents may return 

incomplete questionnaires. 

• Responses can be difficult to 

read. 

• Receiving enough responses 

may take a long time. 

• Postage may be expensive if the 

sample is large or the questionnaire is long. 

Telephone 

With interviewer using 

paper-and-pencil questionnaires. 

• Telephone is appropriate for 

those with limited literacy 

skills. 

• Questionnaires can be more 

complete. 

• The sequence of questions can 

be controlled. 

• Potential respondents without 

telephones can’t participate. 

• Respondents may hang up if 

they believe the survey is part 

of a solicitation call or if they 

don’t want to take the time to 

participate. 

• Response rates are declining, 

especially for telephone and 

Internet surveys (Singer, et al. 

2000). 

With interviewer using 

computer-assisted 

telephone interviewing 

(CATI). 

• “Skip patterns” can be 

included, which is useful for 

complex questionnaires. 

• The need for data entry is 

eliminated. 

• CATI software and computers 

are required. 

• Extensive interviewer training is 

needed. 

• Time is required to program 

questionnaire into CATI. 

Continues 

Chapter 3: Gaining and Using Target Audience Insights 79 
Table 3.5: Pros and Cons of Survey Formats (cont.) 

Format Pros Cons 

In Person 

Administered by 

interviewer. 

• Face-to-face persuasion tactics 

can be used to increase response 

rates. 

• Participants with limited literacy 

skills can use this method. 

• The method is useful with hardto-reach populations (e.g., 

homeless or with low literacy) or 

when the intended audience can’t 

be surveyed by using other datacollection methods. 

• Interviewer can clarify questions 

for respondents. 

• More questionnaires are completed.

• Administration is more expensive than self-administered 

surveys or telephone data 

collection. 

• This method may not be 

appropriate for sensitive issues 

because respondents may not 

answer as truthfully in person. 

Self-administered: 

Respondents asked to 

complete survey at a location frequented by the 

target population (e.g., 

during a conference, in a 

classroom, or after viewing an exhibit at a health 

fair). 

• Harder-to-reach respondents can 

be contacted in locations convenient and comfortable for them. 

• The survey can be conducted 

quickly. 

• Data can be gathered cost-effectively in a relatively short time. 

• Selecting an appropriate location 

can result in an increased number 

of respondents from intended 

population. 

• The ability to reach respondents 

in person at a central location or 

gathering is required. 

• Respondents must have 

complex, mature literacy skills. 

Self-administered on 

computer: 

Questionnaire is displayed 

on a computer screen and 

respondents key in 

answers. 

• “Skip patterns” can be included, 

which is useful for complex 

questionnaires. 

• The sequence of questions can 

be controlled. 

• Need for data entry is eliminated, 

and quick summary and analysis 

of results are provided. 

• Use is not appropriate for audiences with limited literacy skills 

or those uncomfortable with 

computers. 

• Expensive technical equipment is 

required that may not be readily 

available or may be cumbersome 

in many settings. 

• Respondents must have access to 

programmed computers and be 

comfortable using computers. 

80 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 3.5: Pros and Cons of Survey Formats (cont.) 

Format Pros Cons 

Internet 

Self-administered on 

computer: 

Questionnaire displayed 

on respondent’s computer screen through a Web 

site. 

• “Skip patterns” can be included, 

which is useful for complex 

questionnaires. 

• The sequence of questions can be 

controlled. 

• The need for data entry is eliminated, and quick summary and 

analysis of results are provided. 

• Use is not appropriate for audiences 

with limited literacy skills or those 

uncomfortable with computers. 

• Respondents must have Internet 

access and be comfortable using 

computers. 

• There’s no way to confirm the 

validity of identifying information 

provided by respondents. 

• Response rates are declining, especially for telephone and Internet 

surveys (Singer, et al. 2000). 

• Samples are not representative. 

put the diary or log information into a specific 

format. This information may cover issues 

such as the quality of program components or 

how your audience uses the components. (See 

Chapter 5: Evaluating the Success of Your 

Counter-Marketing Program for guidance on 

planning and conducting program evaluation.) 

Pros: 

■	 Diaries and logs give respondents
 

flexibility in their answers. 
 

■	 These records enable researchers to 

observe behavior over time, rather than 

only once. 

Cons: 

■	 Diaries and logs require considerable 

effort by respondents and may not be 

filled out in a timely or thorough 

manner. For this reason, offering 

incentives for completing the diaries or 


logs is important. 


■	 The data may be voluminous and 

challenging to code and compare. 

■	 These records can be hard to read and 

are thus not appropriate for respondents with low literacy or poor writing 

skills or penmanship.Here are the five 

major steps for diary or activity log 

research: 

1. 	 Plan the research. 

2. 	 Identify who will complete the 


diaries or activity logs. 


3. 	 Develop and pretest the form for 


collecting information. 


4. 	 Collect the data. 

5. 	 Analyze the results. 

Chapter 3: Gaining and Using Target Audience Insights 81 
Step 1: Plan the research. 

Determine the following information: 

■	 What you want to learn 

■	 How much information you need 

■	 When you need the information 

■	 How you’ll apply what you learn 

■	 What your budget is 

■	 What your criteria are for participants 

Step 2: Identify who will complete the 

diaries or activity logs. 

The participants you select depend on the 

goals of your research. If you’re focusing on 

your audience’s day-to-day experiences in 

relation to some aspect of tobacco use, you’ll 

want audience members to complete the 

diaries. For example, if you want teenagers to 

keep diaries documenting when they 

encountered tobacco among friends, family 

members, and others in their lives and how 

those encounters made them feel, recruit 

teenagers willing to participate. (When 

recruiting youth respondents, you may need 

parental permission.) 

If you’re focusing on participants’ experience 

with a program as a pilot test, you’ll want the 

participants to keep the diaries. You’re likely to 

recruit participants on site. You’ll probably 

need to provide an incentive (e.g., a gift 

certificate once the completed diary is 

received), and you also may need to remind 

participants to return the diaries at the end of 

the research period. 

Step 3: Develop and pretest the form for 

collecting information. 

Here’s how to create a user-friendly document 

to collect the data: 

■	 Write questions that are specific to your 

objectives. For example, for a pilot test 

of a health education program, provide 

a description of the module(s) used 

each day and include entries such as 

the following: 

– 	Date 

– 	 Title of module used 

– 	 Description of activities completed 

– 	 Record of how long activities took to 

complete 

– 	 Response to whether the respondent 

would participate in these activities 

again 

– 	 Reasons the respondent would or 

would not participate again 

■	 Include examples of participant 
 

feedback. 
 

■	 For a log related to smoking behavior, 

you might include entries such as the 

following: 

– 	 When the first cigarette of the day 

was smoked 

– 	 What the person was doing when 

smoking each cigarette 

– 	 Whom the person was with when 

smoking each cigarette 

– 	 How the person was feeling when he 

or she most wanted a cigarette 

82 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Pretest the draft diary or log with
 

members of your audience.
 

■	 Revise questions people found 

confusing during the pretest. If a 

question was confusing to only one 

person, use your judgment about 

whether to change the question. If you 

make substantial changes to the diary 

or log, conduct another pretest before 

finalizing the form. 

Step 4: Collect the data. 

Produce enough diaries or logs so that each 

respondent has several extra forms in case 

they are needed. Attach detailed written 

instructions to each form. Deliver the diaries 

or logs to respondents before training, as 

necessary or at least one week before the 

research begins. If you’re asking program 

participants to complete diaries or logs, you’ll 

have to distribute the materials on site. Give 

respondents a fixed time frame to complete 

these records (e.g., one week or six months), 

and provide a way to return the data to you 

(e.g., an envelope and postage). If your research 

period is longer than one or two weeks, you 

may want to ask respondents to send the first 

week of data, so you can review the logs for 

accuracy and completeness and even begin to 

tally information. Collect the logs at several 

points during the research period, to ensure 

that participants are filling them out regularly; 

otherwise they may fill them out all at once at 

the end of the period. 

Step 5: Analyze the results. 

In the planning phase, you determined what 

you wanted to learn from the research. Now 

you can look through the diaries or logs to 

answer those questions. Diaries generally 

contain qualitative information. Activity logs 

may contain both quantitative information 

you can tabulate easily (e.g., how many people 

called a hotline each day) and qualitative 

information (e.g., reasons people liked or 

participated in an activity). Here are some 

suggestions for analyzing both types of 

information: 

■	 To analyze qualitative information, 


search the data for similarities and 


differences among diaries or logs, for all 


the questions. Look for general themes 


or patterns. The best way to analyze 


these themes is to develop categories for 


the responses. For example, if you want 


to know why teachers thought their 


students liked or disliked a certain 


educational module in your program, 


you might group responses into 


categories such as “challenging,” “fun,” 


“too much work,” and “boring.” You may 


add or combine categories as you go 


along. You can make inferences about 


the diary information (e.g., “most 


teachers liked the module because...”), 


but resist the temptation to quantify this 


information. 


■	 To analyze quantitative responses, cre­


ate a coding sheet for each quantitative 


Chapter 3: Gaining and Using Target Audience Insights 83 
question, writing the question at the top 

and creating columns for each possible 

response. For example, for a question in 

an activity log about how many people 

picked up particular brochures, you 

could create these columns: 0, 1–5, 6–10, 

11–15, 16–20, and >20. Then record the 

response from each log by making a 

check mark in the appropriate column. 

Tally the check marks in each column, 

and calculate the percentage of participants who gave each type of response. 

Gatekeeper Reviews 

Educational materials for the public and for 

patients often are routed to their intended 

audiences through health professionals or 

other individuals or organizations that can 

communicate for you. These intermediaries 

act as gatekeepers, controlling the distribution 

channels that reach your audiences. Their 

approval or disapproval of your materials can 

be a critical factor in your program’s success. If 

they don’t like a poster or don’t believe it’s 

credible or scientifically accurate, it may never 

reach your audience. 

Gatekeeper review of rough materials should 

be considered part of the pretesting process, 

although it’s no substitute for pretesting 

materials with audience members. It’s also no 

substitute for obtaining clearances or expert 

review for technical accuracy; that should be 

done before pretesting. Sometimes telling the 

gatekeeper that technical experts have reviewed the material for accuracy will reassure them 

and may speed approval of your message. 

How you obtain gatekeeper reviews depends 

on your resources, including time and budget. 

Two methods are common: 

1.	 Self-administered questionnaires. 

Gatekeepers are sent the materials and 

the questionnaire at the same time. (See 

Appendix 3.5 for an example.) 

2.	 Interviewer-administered questionnaires. 

Typically, an appointment for the interview is scheduled with the gatekeeper, 

and the materials are sent for review in 

advance. 

Questionnaires should be written to ask about 

overall reactions to the materials, including an 

assessment of whether the information is 

appropriate and useful. 

In some cases, a formal questionnaire might 

not be feasible, especially if you don’t think the 

gatekeeper will take the time to fill it out. 

Arrange a telephone or personal conversation 

or a meeting to review the materials. Consider 

in advance which questions you want to ask, 

and bring a list of these questions with you. 

One advantage of this approach is that you can 

use the discussion with gatekeepers to introduce them to your program and to ask if they 

want to become involved. 

84 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Readability Pretesting 

Readability formulas often are used to assess 

the reading level of materials. Reading level 

refers to the number of years of education 

required for a reader to understand a written 

passage. Some experts suggest aiming for a 

level that is two to five grades lower than the 

average grade your audience has achieved, to 

account for a probable decline in reading skills 

over time. Others say a third- to fifth-grade 

level is frequently appropriate for readers with 

low literacy. 

When the target audience is the general 

population, keep publications as simple as 

possible to increase reader comprehension. 

However, if publications are meant for a more 

educated, professional audience, simple 

materials might be considered insulting. 

You’ll need to decide which reading level is 

appropriate for your materials. Then use one 

or more readability formulas to determine 

whether your text is written at that level. Fry, 

Flesch, FOG, and SMOG are among the most 

commonly used readability formulas (NCI 

2002). Applying these formulas is a simple 

process that can be done manually or with a 

computer program in only a few minutes. (See 

the National Cancer Institute’s Making Health 

Communication Programs Work: A Planner’s 

Guide [2002] for more information on 

readability formulas.) 

Typically, readability formulas measure the 

difficulty of the vocabulary used and the 

average sentence length. Readability software 

such as RightWriter and Grammatik analyze a 

document’s grammar, style, word usage, and 

punctuation and then assign a reading level. 

Some popular software programs such as 

Microsoft Word include a readability-testing 

function. However, these formulas don’t 

measure the reader’s level of comprehension. 

Researchers in one study suggest three 

principles for the use of readability formulas 

(NCI 1994): 

1. 	 Use readability formulas only in concert 

with other means of assessing the 

effectiveness of the material. 

2. 	 Use a formula only when the readers 

for whom a text is intended are similar 

to those on whom the formula was 

validated. 

3. 	 Do not write a text with readability 

formulas in mind. 

Chapter 3: Gaining and Using Target Audience Insights 85 
Points To Remember 

■	 Gaining insights about the target audience is central to developing effective countermarketing strategies, tactics, and messages. 

■	 Market research should be an integral part of your counter-marketing program. 

■	 Market research isn’t a do-it-yourself effort. Not only do you need to be knowledgeable, but you also need to seek the appropriate resources to ensure that your 

research is successfully designed and conducted. 

■	 Many tobacco control program staff have used market research and are good 

sources of advice on design, instruments, analysis, and findings. 

■	 Market research findings must be used to be worthwhile. Before you conduct 

research, decide how you’ll use the results to plan, alter, justify, support, and/or 

promote aspects of your program. 

Bibliography 

American Marketing Association, New York Chapter. GreenBook: Worldwide Directory of Focus 

Group Companies and Services. New York, NY: American Marketing Association, 2003. 

American Marketing Association, New York Chapter. GreenBook: Worldwide Directory of Marketing 

Research Companies and Services. New York, NY: American Marketing Association, 2003. 

Marketing Research Association. Blue Book Research Services Directory. White Plains, MD: 

Marketing Research Association, 2003. 

National Cancer Institute. Clear and Simple: Developing Effective Print Materials for Low-Literate 

Readers. Bethesda, MD: National Cancer Institute, 1994. Pub. No. T936. 

NCI. Making Health Communication Programs Work: A Planner’s Guide. Bethesda, MD: U.S. 

Department of Health and Human Services, Public Health Service, National Institutes of Health, 

NCI, 2002. Pub. No. T-0638. 

Singer E, et al. Experiments with incentives in telephone surveys. Public Opinion Quarterly 

2000;64:171–88. 

Teenage Research Unlimited. Counter-Tobacco Advertising Exploratory, Summary Report, 

January–March 1999. Unpublished. 

86 Chapter 3: Gaining and Using Target Audience Insights 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 4 

Reaching Specific 

Populations 

[Cultural] competence is not just changing how somebody 

looks in an ad or the language. It’s about understanding 

people as whole entities: their history, their culture, their 

context, and their geography. 

— Robert Robinson, Office on Smoking and Health 

Centers for Disease Control and Prevention 

In This Chapter
 

• Developing Cultural 

Competence 

• Identifying and 

Describing Specific 

Populations 

• Conducting 

Formative Research 

Although the main emphasis of your tobacco counter-marketing campaign 

may be on one or more broad target audiences, you may also want to conduct efforts that focus on specific populations—groups of individuals who 

share unique characteristics and may be particularly affected by tobacco. 

These shared characteristics include racial, ethnic, cultural, geographic, age, 

physical, and socioeconomic traits, and level of education. Examples of 

specific populations include: 

■ Racial/ethnic minority groups 

■ Gay, lesbian, bisexual, and transgender populations 

■ Rural residents 

■ Groups with low socioeconomic status 

■ People with disabilities 

■ College students 

■ Restaurant workers 

■ Blue-collar workers 

• Additional 

Considerations in 

Reaching Specific 

Populations 

Chapter 4: Reaching Specific Populations 87 
Developing and implementing successful 

counter-marketing strategies to reach these 

populations may be challenging. Although 

you’ll follow the same basic processes used to 

design any counter-marketing campaign, 

reaching specific populations requires additional approaches and considerations. For 

example, you may need to take a closer look at 

your organization’s operating practices to 

ensure that they are inclusive, culturally 

competent, and adequately address the needs 

of the specific populations in your state. You 

will also need to develop an understanding of 

the specific populations you plan to target to 

ensure that messages, language, imagery, and 

other aspects of your counter-marketing 

materials and interventions are appropriate 

and effective. 

It is important to devote adequate resources to 

reaching the specific populations in your state. 

When appropriate, it can be cost-effective to 

design your specific population campaign to 

supplement your mainstream effort. Creating 

messages that are coordinated with your mainstream campaign can help provide specific 

populations with the multiple exposures 

needed to contribute to attitude and behavior 

change, as well as to build support in populations for tobacco control policies. 

If your budget won’t permit you to reach all 

audiences at once, you’ll need to decide which 

audiences you can reach with your current 

funding, and which audiences you’ll want to 

target if your funding increases. Lack of information may also constrain the breadth of your 

efforts and may require that some population 

groups not be included initially. 

Developing Cultural Competence 

When developing a counter-marketing effort 

for a specific population, the first step is to 

look at your organization’s level of cultural 

competency. The main goal of building an 

organization’s cultural competence is to be 

more effective in representing and serving its 

constituents by developing strategies and 

programs that reflect the needs and priorities 

of those served. An organizational and 

philosophical commitment to diversity and 

inclusivity provides the basis for achieving 

cultural competence. In essence, it reflects the 

commitment to understanding specific 

populations and taking actions to serve them. 

Developers of tobacco counter-marketing 

programs need to recognize the differences 

and similarities within and among groups, 

including how they are influenced by their 

particular cultures, histories, the prevailing 

social and economic contexts, and the geographies in which they live. Developing cultural 

competence may require your organization to 

assess its physical environment, materials and 

resources, policies and procedures, training, 

and professional development. 

Developing cultural competence may also 

require your staff and anyone else who works 

on your program to reflect on their own values 

and attitudes, communication style, and which 

community or audience they are representing, 

so that they are prepared to relate to diverse 

populations and to be responsive during 

interactions with them. Even if an organization 

has individuals from a specific population on 

its staff, cultural competence may still need to 

be addressed. Because each person has 

88 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

different biases and experiences, it’s important 

for every staff member to recognize the value 

of being culturally competent. 

Developing cultural competence within your 

organization should enable you to work more 

effectively with the communication agencies 

that you have hired to focus on the specific 

population(s) you are targeting. This will help 

ensure the development of culturally competent messages and materials. 

Cultural competence goes beyond recognizing 

and incorporating the language of target 

audiences in your programs. For example, to 

make a tobacco cessation counseling program 

culturally competent, the program manager 

may need to: 

■	 Develop an organizational commitment 

to cultural competence 

■	 Employ counselors who speak languages other than English 

■	 Develop and pretest, with each subpopulation, concepts and materials that 

reflect issues related to smoking in the 

community 

■	 Develop and pretest materials in appropriate languages for specific communities 

■	 Include community representatives on 

planning committees 

■	 Train staff to be sensitive to cultural 

issues when providing tobacco 

cessation counseling 

Chapter 4: Reaching Specific Populations 89 
■	 Hold staff accountable for the way they 

interact with counseling program clients 

■ Training 

■	 Visionary leadership 

Wisconsin’s Division of Public Health provides 

an example of how cultural competence can 

be developed and promoted (National Center 

for Cultural Competence 1999). Its staff formulated guiding principles and strategies to 

promote cultural competence in the design of 

health programs, including the following: 

■	 Audits of an organization’s existing 

culture	 

■	 Clarification of the mission of diversity 

enhancement 

■	 Strategic goals 

■	 Examination of assumptions dealing 

with cultural competence 

The National Center for Cultural Competence, 

at Georgetown University Center for Child 

and Human Development, offers several 

helpful self-assessment tools that you can 

adapt and use to gauge cultural competence 

within your own organization. These checklists 

are available online at www.georgetown.edu/ 

research/gucdc/nccc/products.html. You may 

want to consider hiring a consultant to help 

your organization become as culturally 

competent as possible or to assess your 

organization’s cultural competence. You may 

even want to add a diversity specialist to your 

staff to help increase the staff’s cultural 

competence. 

Checklist for Developing Cultural Competence in an Organization 

❑	 Reflect an organizational commitment to developing cultural competence in all of the 

organization’s policies, procedures, physical environments, programs, and activities. 

❑	 Promote cultural competence among your staff as a developmental process though an 

ongoing organizational commitment to self-assessment, professional development, 

training, policy development, and implementation. This process will help your 

organization build the capacity to understand and meet the needs of the specific 

population(s) it serves. 

❑	 Encourage key staff to conduct cultural self-assessments. (Sample tools are available 

from the Wisconsin Division of Public Health and the Georgetown University Center 

for Child and Human Development). 

❑	 Don’t make assumptions about a population’s culture. Become knowledgeable 

regarding aspects of the specific populations (e.g., values, attitudes, communication 

styles, language, literacy levels, physical environments, histories, cultures, social and 

economic contexts, and geographies) served by your organization. 

90 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Identifying and Describing Specific 

Populations 

Identifying and Prioritizing Specific 

Populations in Your State 

Specific populations traditionally have been 

defined by demographic characteristics such as 

age, race/ethnicity, income, and educational 

level. However, you may need to go beyond 

basic demographics to adequately describe the 

specific populations in your state. Specific 

populations will also be shaped by history, 

culture, context, and geography—factors that 

are only partially reflected in the sociodemographic descriptors and that can affect attitudes and preferences. Group identity can also 

be reinforced by particular experiences with 

educational institutions, religions, government, businesses, and other institutions. 

Identifying different specific populations is 

further complicated by the diversity within 

respective populations. For example, the 

broader category of Hispanics/Latinos can be 

further delineated into subgroups such as 

Cubans, Mexicans, and Puerto Ricans, each 

with its unique characteristics. Similarly, the 

gay, lesbian, bisexual, and transgender (GLBT) 

community is composed of subgroups with 

very different characteristics. Making this issue 

even more complex is the overlap among 

groups made up of individuals who share some 

characteristics but also identify with other 

populations as well. For example, people with 

disabilities, members of the GLBT community, 

and restaurant workers who are exposed to 

secondhand smoke at work may also identify 

with specific racial or ethnic groups. 

The first task in selecting and prioritizing 

specific populations that your tobacco 

counter-marketing efforts will target is to 

identify and describe each group affected by 

tobacco use in your state. Sources that might 

help you identify these groups include U.S. 

Census Bureau data, public health department 

reports, public school data, media outlets, 

national organizations, immigrant assistance 

or resettlement programs, and language 

institutes, which may show trends in demand 

for translators or interpreters. Although these 

sources can help you determine the representation of various populations in your state, 

they also have limitations. For example, they 

may underestimate the size of specific groups 

(e.g., Cambodians within the Asian/Pacific 

Islander community). These sources may also 

fail to identify certain groups if the appropriate 

questions are not asked (e.g., sexual identity 

questions to identify GLBTs). Depending on 

the quantity, quality, and types of data available from existing sources, you may need to 

conduct new research to gain enough information about the specific populations in your 

state or community to make well-informed 

decisions. 

In determining which specific populations 

should be priority audiences for your countermarketing efforts, you’ll also need to study 

epidemiologic data, media consumption 

patterns, and other available qualitative data 

to assess whether counter-marketing is an 

effective intervention for a particular group. 

Some population groups can’t be reached 

efficiently through mass media or other 

traditional counter-marketing techniques, 

Chapter 4: Reaching Specific Populations 91 
so you may want to use other program 

components to reach those groups. 

Understanding Your Priority Audiences 

Once you have chosen a specific population 

group as a target audience, you must learn about 

the characteristics shared by individuals in that 

group. For many populations, this means 

understanding such factors as their culture. 

Culture has been defined as “the shared values, 

traditions, norms, customs, arts, history, folklore, 

and institutions of a group of people unified by 

race, ethnicity, language, nationality, or religion.” 

Culture affects how people pattern their 

behavior, see the world around them, and 

structure their environment, especially their 

families and communities (USDHHS 1996). 

However, culture provides only one window 

into a community. Your tobacco countermarketing strategies should also take into 

account and reflect other factors that drive 

any community. Geography is another way to 

understand how communities are differentiated. For example, African Americans who live in 

large urban areas will likely have different 

characteristics than African Americans who 

live in rural tobacco-growing communities, 

where tobacco is an important part of the 

economic and cultural fabric. Age, gender, and 

sexual orientation are other factors that impact 

the attitudes and behaviors of the group being 

targeted. 

While there is heterogeneity within any group, 

it is important to understand that there are still 

likely to be common elements that bring these 

groups together as a broader community. It is 

these commonalities that allow countermarketing programs to target such groups 

efficiently. 

Defining Specific Populations and 

Targeted Segments 

The challenge is to describe your target audience using the most relevant, unbiased, and 

data-driven characteristics possible, as well as 

information based on how the group describes 

itself and how others describe it. Formative 

research may reveal characteristics that 

provide a more accurate and appropriate 

description of the target group. Including more 

detail in the description of an audience may 

uncover information useful for your countermarketing efforts. A more detailed audience 

profile may include media or consumer habits, 

lifestyle characteristics, level of acculturation, 

region, or place of residence (e.g., urban or 

rural). 

92 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

You’ll also want to gain an understanding of 

the social context of your audience by examining the social influences that may affect 

behavior. For example, determining the roles 

that family members and friends play within a 

specific population and identifying other 

supporters, such as those from whom a 

population’s members seek advice, are parts of 

defining a population’s social context. This 

kind of information can yield valuable insights 

into your target audience, how they interact 

with others, and how they interact with and 

are influenced by tobacco. Other contextual 

factors that may impact campaign development are the proportion of people of low 

socioeconomic status, the availability of 

cessation services, and the relevance of 

tobacco use relative to other problems 

confronting the target audience. 

You can also target your marketing efforts 

more precisely if you consider subgroups 

within major populations. For example, recent 

immigrants may smoke less than members of 

their population who have lived in the United 

States longer and who have been exposed to 

higher levels of tobacco industry marketing. In 

addition, these two subgroups may consume 

different kinds or amounts of media. If you are 

focusing on a population with such subgroups, 

then you may want to reach recent immigrants 

(who have lower prevalence) with a prevention 

message and those who are more assimilated 

(who have higher prevalence) with a cessation 

message. There may be differences among 

people from the same major group based on 

the country of origin. For example, Asian 

Americans who come from China, Japan, 

Korea, Vietnam, or another country may have 

very different characteristics, attitudes, and 

behaviors. There also may be differences 

among people from the same country based 

on the region of origin. These differences can 

be understood through an assessment of 

particular histories, cultures, contexts, and 

geographies. You’ll need to consider these 

differences when deciding what messages, 

tone, channels, activities, and other factors 

would be most appropriate for specific populations in your community or state. For 

example, some ads work well among all 

Hispanic/Latino groups, while others communicate effectively to only a few groups, 

based on the particular accents, vocabulary, 

and other ad elements chosen to reflect 

particular groups’ lifestyles. 

When your target audience has many different 

segments, testing messages and materials is 

critical to assess different potential responses 

among the different segments. Test messages 

with representatives of the target audience and 

other stakeholders to be sure they are understood and accepted and to avoid possible 

unintended negative effects. (See Chapter 3: 

Gaining and Using Target Audience Insights for 

more information on testing methods.) When 

evaluating messages, don’t rely on the 

opinions of your organization’s staff. Even if 

they are members of the target audience, 

they’re likely to have a knowledge base about 

tobacco and public health that makes them 

atypical of the audience as a whole. 

Chapter 4: Reaching Specific Populations 93 
Checklist for Identifying and Defining Specific Populations 

❑	 Identify and describe the specific populations that are affected by tobacco use in your state. 

❑	 Assess whether counter-marketing is an effective intervention for the groups you have identified. 

❑	 Define your target group using demographics, epidemiologic data, consumer habits, lifestyle data, 

and other sources of information. 

❑	 Recognize the diversity among certain specific populations, as well as among their subpopulations. 

❑	 Pay close attention to the level of acculturation among immigrant groups, because the characteristics, attitudes, behaviors, and responses of recent immigrants may be very different from those of 

immigrants who have lived in the United States for several years. 

❑	 Make attempts to understand the tobacco-related social norms among the specific populations your 

program is targeting. 

Conducting Formative Research 

Findings from formative research can be 

used to help develop, or “form,” a countermarketing program. Formative research may 

consist of several parts, including environmental profiles, inventories of community 

resources, and audience research. As 

mentioned earlier in this chapter, formative 

research can help you understand how to 

separate the population into groups or 

segments that tend to think or act in similar 

ways or are affected by similar influences. It 

can also help you to understand the causes, or 

determinants, of tobacco use and other health 

risk behaviors, and the protective factors in 

target audiences. This research is also used to 

investigate which interventions might 

influence target audiences to change their 

behavior(s). (See Chapter 3: Gaining and 

Using Target Audience Insights for detailed 

information on research.) 

Conducting an Environmental Scan 

When you begin the research process, it can be 

extremely helpful to look at whether existing 

tobacco counter-marketing programs have 

been successful in helping to reduce tobacco 

use among the specific populations you’ve 

chosen to target. Look at programs that other 

organizations have implemented in your state, 

as well as those implemented by other states. 

Contact your representative in the Office on 

Smoking and Health, Centers for Disease 

Control and Prevention for information 

compiled from state efforts. Or, if you want 

information about a specific state’s program, 

you can contact individuals or search Web sites 

within that state. If components of another 

state’s programs appear applicable to your state, 

test those components—including ads and 

other materials—in your state before you 

implement them to confirm that they are likely 

to work in your area with your specific 

94 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

population. One excellent resource for 

accessing and using tobacco counteradvertising produced by states, organizations, 

and federal agencies is CDC’s Media Campaign 

Resource Center, available online at 

http://www.cdc.gov/tobacco/mcrc. 

You will also want to learn about organizations 

and individuals working with various specific 

populations who might be able to serve as 

resources to help you develop the campaign. 

Investigate which of these resources have the 

strongest expertise in developing programs, 

interventions, and materials for the specific 

populations you’re targeting. Some of these 

organizations and individuals may be key 

stakeholders for your program. (See Chapter 8: 

Public Relations for more information on 

stakeholders.) Your public relations efforts will 

also include identifying media outlets that 

target your specific audiences. You need to 

work with these media outlets for your paid 

media placements and earned media 

coverage. 

Applying Research Results to 

Campaign Development 

To help ensure that your campaign reaches the 

specific populations you plan to target, you 

will want to follow the same guidance and 

processes used for general market campaigns 

outlined in this manual. (See Chapter 2: 

Planning Your Counter-Marketing Program, 

Chapter 3: Gaining and Using Target Audience 

Insights, Chapter 7: Advertising, Chapter 8: 

Public Relations, Chapter 9: Media Advocacy, 

Chapter 10: Grassroots Marketing, and 

Chapter 11: Media Literacy.) You’ll also want to 

develop and implement an evaluation plan 

that includes evaluation of the efforts targeting 

specific populations. (See Chapter 5: 

Evaluating the Success of Your CounterMarketing Program.) 

Findings from qualitative research can be used 

to strategically develop materials that will 

reach the target audience with the intended 

messages. Through qualitative research, you 

can glean insights about your audience(s), 

solicit feedback on the materials and messages 

you are developing, and brainstorm about 

additional interventions that appeal to them. 

These findings can help you in making 

decisions throughout the campaign development process about aspects of the campaign, 

such as strategies, messages, tactics, and 

materials. (See Chapter 2: Planning Your 

Counter-Marketing Program for a more 

complete discussion of campaign planning 

steps.) It is important to remember that the 

findings from qualitative formative research 

techniques (e.g., focus groups) cannot be 

generalized to the population as a whole, but 

quantitative research techniques can provide 

findings that can be generalized to the entire 

group (see Chapter 3: Gaining and Using 

Target Audience Insights). 

The first step is to set an overall program goal 

and select which specific populations you will 

target. For example, your overall program goal 

might be to increase cessation among adults, 

and you may have decided to supplement 

your general market cessation campaign with 

a campaign specifically targeting Hispanic/ 

Latino men to persuade them to try to quit 

Chapter 4: Reaching Specific Populations 95 
smoking. To accomplish your goal, you will 

need to develop strategies for communicating 

with your target audience(s). If your formative 

research reveals that smoking is supported by 

the cultural values of this audience, you might 

develop a strategy to communicate the cultural 

value of family well-being and the harm of 

secondhand smoke to family members. This 

strategy might be used to help counter the 

values that support smoking. Another strategy 

might be to show the benefits that audience 

members are likely to enjoy when they quit 

smoking or the negative consequences they 

might suffer if they continue to smoke. 

to communicate to your target audience. For 

example, your messages to a Hispanic/Latino 

adult male smoker may include how much his 

family would suffer if he were to become ill or 

die from smoking, how much he would suffer 

physically and emotionally from the consequences of smoking, or how ill his children 

might become from being exposed to his 

second-hand smoke. These messages should 

be developed based on the findings of your 

formative research. 

The next step is to develop specific messages, 

which are the two or three key points you want 

You’ll want to develop specific tactics and 

activities to use in implementing your strategies. If your environmental scan identified 

qualified organizations and individuals in your 

state or community who work with the specific 

population(s) you have chosen, 

they may be able to provide 

valuable input to the 

development of tactics and 

activities based on their 

experiences and expertise. For 

example, one tactic would be to 

have people share their experiences of being harmed by 

smoking. Such stories can be 

effective because they personalize the risk of smoking. You 

could work with hospitals or 

Hispanic/Latino health 

organizations to identify and 

interview affected individuals 

and select the most powerful 

stories. This approach was used 

in a smoking cessation 

campaign in Massachusetts that 

featured a Hispanic/Latino man 

96 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

who developed emphysema early in his life 

from smoking. He eventually lost his voice and 

had to speak through an artificial-voice device. 

The Massachusetts Tobacco Control Program 

developed this story into poignant television 

and radio ads. 

Review all your options for use of paid media 

to reach your audience(s), and choose ones 

that are cost-effective. In addition to broadcast 

and print media, your campaign could include 

billboard ads, postcards that people could send 

to loved ones encouraging them to quit smoking, and signs on public transit vehicles. You 

could also develop posters for places where 

people tend to meet, such as community centers. 

As part of your earned media outreach efforts, 

you could contact reporters at the Hispanic/ 

Latino media outlets you have identified and 

pitch a story about the consequences of an 

individual’s smoking. You can put reporters in 

touch with the individuals featured in your ads 

as a way to weave your messages into a personal 

story. 

You may want to hold a kickoff event to introduce your campaign, inviting people from 

your specific population, organizations that 

represent them, and the media. Use such an 

event as an opportunity to highlight your 

program and to give credit publicly to local individuals who helped to develop the program. 

Once the campaign has started, you can begin 

to measure its effect. Using the same measures 

and indicators you used to conduct baseline 

research before the campaign started, conduct 

follow-up research after the first phase of the 

campaign and after the campaign ends. This 

evaluation will enable you to identify what 

worked, what progress was made, and what 

changes need to be made for additional 

campaign phases. (See Chapter 5: Evaluating 

the Success of Your Counter-Marketing 

Program for more information.) As with any 

counter-marketing campaign, developing 

campaigns to reach specific populations is an 

evolutionary process; you’ll learn what works 

and what doesn’t work as you go along, and 

you will make adjustments as necessary. 

Involving Specific Populations in 

Research 

Representatives of the targeted audience(s) 

should participate in the research to increase 

their ownership of, comfort with, level of 

support for, and the face validity of the 

counter-marketing efforts. It’s important to 

enlist cooperation from community organizations that represent these populations. 

Because they are familiar with the community, 

they may be able to help you select contractors 

and facilitators who have the right skills and 

expertise to work with your target audience(s). 

You may even be able to identify and train 

local people to conduct the research. These 

members of the community—possibly social 

workers, community workers, religious and 

peer leaders, and health professionals— 

understand the community from the inside 

and have established trust with other 

community members. Thus, they may be able 

to probe more deeply into the attitudes, 

behaviors, and practices of the specific 

population you’re trying to reach, and to elicit 

information that can more effectively guide 

campaign development. However, you may 

Chapter 4: Reaching Specific Populations 97 
Checklist for Conducting Formative Research 

❑	 Choose qualified researchers who understand cultural competence. 

❑	 Involve specific populations at every phase of the formative research. 

❑	 Research specific populations’ responses to the tones of different messages. 

❑	 Address concerns and fears expressed by the specific populations and identified in 

scientific literature. 

❑	 Share findings with the organizations that represent specific populations to keep 

them updated on the development of the campaign. 

❑	 Use research findings to help encourage specific populations to support the resulting 

strategies and activities of the counter-marketing program. 

❑	 Use research findings to help guide decisions during the development 
 

of the campaign.
 

run the risk of focus group participants not 

feeling safe with a moderator they know 

because of issues of confidentiality and 

disclosure of personal information. In addition, you must be confident that these 

members of the community are qualified to 

conduct the research. Although the process to 

train and develop a set of skilled moderators 

for specific populations may be time consuming, you may find that the audience 

insights you gain are a valuable long-term investment in making your campaign a success. 

When conducting qualitative research, you 

should pay close attention to ties to the tobacco 

industry or other potential conflicts of interest 

that could serve to bias results of the research. 

You may need to make a special effort to 

address concerns that communities may have 

about research. These concerns could be 

based on negative historical experiences such 

as the Tuskegee Study, a research project in 

Chapter 4: Reaching Specific Populations 

which treatment was secretly withheld from 

African-American men with syphilis. Or they 

could be based on the belief that the community has been overly researched and 

exploited by scientists more interested in 

publishing papers than in solving problems. 

Efforts may include dispelling fears, promoting 

involvement in the formative research at every 

stage, and obtaining input about how the data 

will be used. These efforts can help considerably to raise trust and maintain a sense of 

ownership of the research and its products. 

Additional Considerations in 

Reaching Specific Populations 

When developing and implementing a campaign for a specific population, you should pay 

close attention to the following areas: 

■ 	 Involving the target population in the 

development process 

98 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Using appropriate language and images 

in materials development 

■	 Identifying and addressing potential 

barriers arising from concerns of the 

target audience (audience barriers) 

Involving the Specific Populations in 

the Development Process 

Tobacco counter-marketing programs should 

include the target audience’s participation 

throughout the life of the program. This 

representation ensures that programs reflect 

the specific population’s values, norms, 

behaviors, perspectives, and needs. 

Each planning phase should include developing relationships and partnerships with specific 

populations and persons and groups that 

serve or have access to them. These may 

include professional and fraternal organizations; African-American, Asian, Hispanic/ 

Latino, or American Indian/Alaska Native 

chambers of commerce; or professional media 

organizations, such as publishers of minority 

newspapers or magazines. 

Give all partners the opportunity to declare 

conflicts of interest early in the planning 

process. Tobacco companies have a great deal 

of influence in most communities and with 

the media, including communities and media 

of specific population groups. Some ethnic 

media outlets receive substantial revenue from 

the tobacco industry and thus may not be 

suitable partners for developing antitobacco 

media strategies. Although your state may not 

want to partner with those outlets, you’ll 

probably want to place antitobacco ads in the 

same outlets to counter the protobacco 

messages. In addition, because some media 

outlets in communities of color have depended 

on revenue from tobacco industry advertising, 

it may be strategically important to acknowledge this history when defining your relationship with those outlets. A flexible approach in 

the short term may make you more likely to 

achieve your long-term goals. 

Checklist for Involving Specific Populations in the Development 

Process 

❑	 Assess your agency’s cultural competence to avoid any bias in choosing partners. 

❑	 Include representatives of the specific population in all phases of the program, from 


formative research and planning through implementation and evaluation. 


❑	 Select people or groups that represent the specific population’s diversity and
 

perspectives and that are credible with the target audience.
 

❑	 Include representatives who have access to large numbers of specific population 


members, such as media outlets (e.g., radio, TV, and magazines) and organizations 


(e.g., racial/ethnic, professional, religious, schools). 


Chapter 4: Reaching Specific Populations 99 
100 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

One way to gain target audiences’ support for 

your program is to help them recognize how 

tobacco use harms their community and how 

they can help address the problem. For example, sharing with the GLBT community 

information about disproportionate rates of 

tobacco-related morbidity and mortality in 

their community may help members become 

more interested in the issue. Then, facilitating 

a discussion with GLBT leaders in which 

tobacco industry targeting of their community 

is highlighted may motivate them to take 

action against these marketing practices. 

When sharing information with members of 

a specific population, it is important to cite 

sources that are credible and relevant to that 

audience. These sources may be members 

of the specific population. 

Using Appropriate Language and 

Imagery in Materials Development 

Ideally, you should develop messages and 

materials in the language of your target 

audience from the start. Try to involve native 

speakers of the language to write and review 

the text, design, graphics, and images. When 

the language is not English, you may also want 

to conduct a reverse translation, in which you 

translate the foreign-language document into 

English. This serves as a quality control 

measure to ensure that the key messages and 

concepts will be communicated as intended. 

If you cannot develop language-specific and 

culturally appropriate materials and instead 

must start with the original (often English) 

version, don’t rely on a direct translation of a 

message. Always test the translation first. When 

the text is finalized, it’s often helpful to have a 

second translator conduct a reverse translation. 

You should check references on translators to 

determine whether they have met the needs of 

previous clients. The following example 

illustrates the steps in addressing language 

differences: 

In 1997, the CDC Prevention Marketing 

Initiative Nashville Demonstration Site 

developed an English-language radio soap 

opera as a mass media intervention to reach 

African-American teens with messages on 

prevention of HIV (human immunodeficiency 

virus) and sexually transmitted diseases. When 

the intervention was replicated to reach 

Spanish-speaking teens, focus groups and 

three translations of the script were needed to 

make the intervention appropriate for teens 

from the various Hispanic/Latino cultures of 

Central America, Mexico, Puerto Rico, and 

South America. 

The first translation was completed by the 

Tennessee Foreign Language Institute, the 

second by a committee from the local 

Spanish-speaking community, and the third by 

a group of Hispanic/Latino teens who adapted 

the script to accommodate teen culture and 

language within the Hispanic/Latino community (CDC 1997). The final product was a 

consensus script that incorporated all three 

translations. One critical aspect of the 

translation was the presence of the Hispanic/ 

Latino teens during the final translation and 

during the production of the soap opera. Their 

Chapter 4: Reaching Specific Populations 101 
102 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Checklist for Developing Appropriate Materials 

❑	 Use language and images that are sensitive and appropriate. 

❑	 Use native speakers to create foreign-language materials when possible. 

❑	 Ask for and check references to ensure that your translator’s past work met client 

needs. 

❑	 Pretest all materials to ensure that messages and images are clear, that content is 

appropriate, and that language and images are not offensive to the target group or 

its community. 

❑	 Conduct a reverse translation to ensure that messages and key concepts are
 

communicated accurately.
 

attendance prevented grammatical errors and 

ensured that a correct script was followed for 

each episode of the soap opera. Each step in 

the replication process ultimately contributed 

to the production of a culturally and linguistically acceptable mass media intervention for 

Hispanic/Latino teens. 

Even if the language of the specific population 

is English, members of that population may 

have unique ways of speaking, or may use 

jargon or slang, so it’s always important to test 

the materials among audience representatives 

to ensure that communication is as clear and 

effective as possible. 

Materials development should also be guided 

by the use of appropriate and salient imagery. 

Positive imagery generally reflects a constructive visual of the target audience that is 

appropriate for the theme of the campaign. 

For example, an ad showing family members 

supporting a smoker’s attempt to quit may be 

effective among the Hispanic/Latino community where close family ties are a priority. 

Salient imagery reflects visuals that are particularly important to a target audience, helping 

attract audience members’ attention to the 

materials. For example, materials that 

integrate a rainbow image, which has been 

used by the GLBT community as an identifier 

and symbol of pride, could appeal to members 

of that community. 

Identifying and Addressing Potential 

Audience Barriers 

When developing your counter-marketing 

programs for specific populations, you may 

need to address existing audience barriers, 

such as historical mistrust of research; a resistance to targeted programs or efforts; and 

potentially positive perceptions of the tobacco 

industry, based on tobacco industry funding of 

Chapter 4: Reaching Specific Populations 103 
community organizations and events. In 

addition, some racial and ethnic communities 

are extremely sensitive about how their image 

has been portrayed in the media. For example, 

many African Americans are concerned about 

the mass media overrepresentation of AfricanAmerican drug use. Such experiences of 

specific populations could produce negative 

perceptions about the integrity of targeted 

programs or strategies. 

If you identify audience barriers in a specific 

population in your state, it is important that 

you address them. One way you can work to 

overcome these issues is by including the 

population in the campaign development 

process. You should work with their 

community leaders to communicate the value 

of your program. You must also be open and 

responsive to questions and concerns. For 

example, some recent immigrants may be 

reluctant to go to an unknown facility to 

participate in research or access health 

Checklist for Identifying and Overcoming Audience Barriers 

❑	 Use formative research to identify issues, including barriers that arise from concerns of 

the target group. 

❑	 Use target group representatives and community partners to help define and address 

audience barriers. 

❑	 When possible, develop strategies for overcoming barriers, including offering benefits 

that have value to the specific population. 

104 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

services because they fear that they could be 

turned in to the U.S. Immigration and 

Naturalization Service or because of negative 

experiences in their former countries. In a case 

like this, you might conduct research or 

provide health services in more familiar and 

comfortable locations. You could also enlist 

credible local spokespeople to build trust in 

the institutions and the facilities. 

Chapter 4: Reaching Specific Populations 105 
Case Study: California Smokers’ Helpline (1998) 

Background. The California Department of Health Services (CDHS) initiated a comprehensive tobacco 

control program in 1989 that was funded by revenue from an excise tax on tobacco. The main goal of the 

program was to reduce illness and mortality among smokers and nonsmokers caused by tobacco use. 

The program’s strategies included exposing the truth about tobacco industry practices and products, 

educating Californians about the harmful effects of smoking and secondhand smoke, and providing 

services and support to people who wanted to quit smoking. 

Developing cultural competence. The state of California has a diverse mix of residents. The CDHS 

tobacco control program staff needed to understand the composition of the population and why specific 

populations were important for reducing tobacco use. The tobacco control staff didn’t simply rely on their 

own knowledge; they hired outside experts to teach them about the specific populations in California. 

They made it a priority to embrace the racial/ethnic diversity in their state. They knew that a “general 

population” program would not meet the needs of all groups because of language and culture differences. 

Identifying and describing specific populations. Once the program staff decided to reach specific 

populations in California, they needed to determine some critical information: 

1. 	 The percentage of California’s population that was made up of Asians/Pacific Islanders, 

Hispanics/Latinos, African Americans, and other major specific populations, and whether those 

groups were increasing in numbers 

2. 	 The major subpopulations within each of those large groups and the important differences among 

subgroups in areas such as language and culture 

3. 	 The absolute levels of tobacco use in each specific population and trends in tobacco use 

4. 	 How, when, and with whom tobacco was being used, and what factors were influencing each group 

to smoke more or to smoke less 

Again, experts were hired to work with the staff to gather information in these four areas. Asians/Pacific 

Islanders were identified as an important specific population because of their large numbers within 

California and high population growth over the previous several years. The state tobacco control staff 

learned that Asians/Pacific Islanders included people from China, Japan, Korea, Laos, Singapore, and 

Vietnam, so they knew they could not communicate with all these populations in the same way. They 

also learned that Asian/Pacific Islander men had very high rates of smoking (up to 70 percent) and that 

they typically smoked in front of family members and friends when at home or socializing. The prevalence of smoking for Asian/Pacific Islander women was typically far lower (less than 10 percent), but 

they were an important secondary audience in terms of potential influence on their smoking husbands, 

brothers, or fathers. Thus, the tobacco control staff identified one primary audience (Asian/Pacific 

106 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Islander male smokers) to target for reducing smoking when around others for cessation, and one secondary audience (Asian/Pacific Islander female nonsmokers) to target for influencing the male smokers in 

their families. The staff also decided to communicate the main messages of the campaign in the four major 

Asian languages of the Asian/Pacific Islander population (Cantonese, Korean, Mandarin, and Vietnamese). 

Conducting research. The first ads that were developed simply suggested that Asian/Pacific Islander 

smokers call the Quitline to get help from a counselor. The message was similar to the message for 

California’s general population, but the ads for Asians/Pacific Islanders were developed using Asian 

talent. Awareness of, and calls to, the Quitline remained low, even though the ads and the Quitline 

were in the four Asian languages. 

The CDHS tobacco control staff worked with its advertising agency to plan and conduct qualitative 

research to glean insights about why initial efforts were not working and what they could do to generate 

more calls to the Quitline. Research included interviews with smokers, as well as analysis of existing 

Quitline operations and promotions, to determine factors contributing to the low volume of calls. One 

important insight they uncovered was that in Asian culture, particularly among men, calling a counselor 

to ask for help was seen as a sign of weakness or an admission that the caller had a problem. 

Developing and implementing the campaign. Based on the research findings, the Quitline was repositioned as a source for free information on how to quit smoking, rather than a counseling service. The 

new campaign included several elements. The “Jungle” campaign featured radio and print advertising 

that dramatized how smokers feel when they try to quit smoking: lost, trapped, hopeless, and unable to 

break free from their addiction to cigarettes. The ads encouraged smokers to call the toll-free number to 

obtain free information on ways to quit smoking. 

A three-minute television ad, which was developed and aired in the four key languages, demonstrated 

for viewers what happens when someone calls the Quitline. The ad showed that the operator would be 

helpful, respectful, patient, and understanding. 

In addition, an advertorial (advertisement in a format that resembles editorial content) in key print 

publications discussed step by step how the Quitline operates and emphasized that it was a free 

resource. The article featured quotes from the Asian-language Quitline staff discussing the benefits of 

calling. Print ads, radio ads, and advertorials were all produced in Cantonese, Korean, Mandarin, and 

Vietnamese and were placed in the appropriate media outlets. 

Within two months of the campaign launch, the Asian-language Quitline received nearly 1,100 calls— 

more than all previous years combined, and a 10,000 percent increase over the previous year. Ad 

placements had to be suspended temporarily because the Quitline exceeded its capacity. Today, the 

Quitline receives a steady stream of phone calls each month because the advertising content and 

placement have been optimized over time. 

Chapter 4: Reaching Specific Populations 107 
Bibliography 

Centers for Disease Control and Prevention. Prevention Marketing Initiative Nashville Demonstration Site. 

“Reality Check”: A Teen-Oriented Radio Soap Opera. Nashville, TN: CDC, 1997. 

National Center for Cultural Competence. The Journey Towards Cultural Competence—The Wisconsin Story. 

Washington, DC: Georgetown University Center for Child and Human Development, 1999. 

Ryan H, Wortley PM, Easton A, et al. Smoking among lesbians, gays, and bisexuals: a review of the literature. 

American Journal of Preventive Medicine 2001;21:142–9. 

U.S. Department of Health and Human Services. Guidelines to Help Assess Cultural Competence in Program 

Design, Application, and Management. Bethesda, MD: USDHHS, Health Resources and Services 

Administration, Bureau of Primary Health Care, Office on Minority and Women’s Health, 1996. 

108 Chapter 4: Reaching Specific Populations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 5 

Evaluating the Success of Your 

Counter-Marketing Program 

To ensure accountability and enable future improvements 

in tobacco control programs, state tobacco control 

programs must be evaluated and have explicit goals 

coupled to performance measures. 

—	 National Cancer Policy Board, 2000 

Evaluation plays a critical role in tobacco counter-marketing campaigns. 

Programs should be evaluated regularly to enable the program manager 

to build on successes, to switch to new strategies if necessary, and to be 

accountable to all those with an interest in the program’s outcome. 

Evaluation can help you to answer questions such as the following: 

■	 What impact is the counter-marketing program having? 

■	 Is the program being implemented as planned? 

■	 Are the audience’s attitudes or beliefs about tobacco being changed 

by the program? 

■	 Is the program helping to improve the health status of the 
 

target population?
 

■	 How can the program be improved? 

■	 Is the funding level appropriate for accomplishing the 
 

program’s objectives?
 

In This Chapter
 

•	 Evaluation and 

Surveillance 

•	 Types of Evaluation 

•	 What Evaluation 

Can Do 

•	 When To Conduct 

an Evaluation 

•	 Scope of the 

Evaluation 

•	 How To Conduct 

an Evaluation 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 109 
Systematic collection of data for evaluation of 

the counter-marketing program can help to 

inform decisions of program managers and 

marketing managers, so the program can be 

improved and its outcomes demonstrated. 

However, this process doesn’t take place in a 

vacuum. You’ll need to define the purpose of 

the evaluation and decide which evaluation 

questions to ask, when evaluation should take 

place, how to present the questions to obtain 

the information needed, and how to provide 

this information to those who need it, in a way 

that facilitates its use. 

An evaluation must be practical and must 

cover issues related to time, money, and the 

political context. For example, the more costly 

and visible the program is, the more comprehensive and rigorous the evaluation may need 

to be. The design of evaluation should be based 

on the expected use of the findings. Furthermore, it should be conducted in an ethical and 

high-quality manner, so results can withstand 

scientific scrutiny (Joint Committee on Standards for Educational Evaluation 1994; Patton 

1997; CDC 2001). 

Evaluation efforts should be planned during 

initial development of the program. Thinking 

about evaluation early improves both the 

program and the evaluation. In addition, most 

outcome evaluation requires a baseline study 

that must be conducted before any program 

activities take place. Evaluation should be 

coordinated with the program’s implementation, so the results are timely and useful. If 

results are given to the program managers as 

they are generated, the managers can make 

adjustments to the program and share results 

with stakeholders. 

CDC offers several resources to help you with 

evaluation. The Evaluation Working Group’s 

Framework for Program Evaluation in Public 

Health (CDC 1999b) provides general 

evaluation guidance. The National Tobacco 

Control Program: An Introduction to Program 

Evaluation for Comprehensive Tobacco Control 

Program Evaluation, from the Office on 

Smoking and Health (OSH) (CDC 2001), 

presents an evaluation approach useful for 

tobacco control programs. CDC/OSH is 

preparing a manual that focuses on outcome 

evaluation specifically for paid counteradvertising campaigns. (Check 

http://www.cdc.gov/tobacco for availability.) 

States may also contact their CDC project 

officers for information about how to obtain 

resources and contact evaluation experts. 

This chapter provides the basics of process and 

outcome evaluation for counter-marketing 

campaigns. It is consistent with the other CDC 

evaluation resources. The chapter addresses 

the difference between evaluation and surveillance, types of evaluation, what evaluation can 

do for you, and the various steps in conducting 

an evaluation. Additional guidance specific to 

each of the counter-marketing components 

can be found in the chapters on those topics 

(Chapter 7: Advertising, Chapter 8: Public 

Relations, Chapter 9: Media Advocacy, Chapter 

10: Grassroots Marketing, and Chapter 11: 

Media Literacy). 

110 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Evaluation and Surveillance 

The terms evaluation and surveillance are 

often used together, but they are distinct 

concepts. Program evaluation is “the systematic collection of information about the 

activities, characteristics, and outcomes of 

programs to make judgments about the 

program, improve program effectiveness, 

and/or inform decisions about future program 

development” (Patton 1997; CDC 2001). 

Surveillance is “the continuous monitoring or 

routine collection of data (e.g., behaviors, 

attitudes, deaths) over a regular interval of 

time” (CDC 2001). The Behavioral Risk Factor 

Surveillance System is an example of 

surveillance based on state data. 

Although you may use surveillance systems 

and program evaluation methods to collect 

data on similar items, these data shouldn’t be 

used for the same purpose. Surveillance data 

can be used to monitor overall trends in a 

population, but they can’t be used to attribute 

observed improvements to a specific program. 

If a program is implemented on a sufficiently 

large scale and consistently across various 

sites, surveillance data can help to validate 

findings from the program evaluation. 

However, states should consider supplementing traditional surveillance systems that 

regularly monitor smoking behaviors and 

other tobacco-related variables with additional 

data collection designed to evaluate state 

counter-marketing programs. 

Types of Evaluation 

Several types of evaluation can help you to 

develop and assess your counter-marketing 

program. Three main types—formative, 

process, and outcome evaluation—form a 

continuum. Formative research and evaluation 

are conducted during program planning and 

development. (See Chapter 3: Gaining and 

Using Target Audience Insights and Chapter 7: 

Advertising for further information.) Formative 

research and evaluation help to answer these 

questions: 

■	 How should I design my program? 

■	 How well designed is each component 

of my program? 

Formative research and evaluation help you to 

decide what to do and how to do it. Formative 

research is used to glean insights about the 

issue and your target audience(s) and to determine which messages and interventions might 

be effective. Formative evaluation is used to 

test concepts, materials, and messages, to 

determine whether they are communicating 

the intended messages and having the desired 

influence on your target audience. 

Process and outcome evaluations, the focus of 

this chapter, are planned during the strategic 

planning stage and conducted during and after 

the implementation stage. Process evaluation 

helps you to answer these questions: 

■	 Are we implementing the program as 

planned, and is it on schedule? 

■	 What are we doing that was not in our 

original plan? 

Process evaluation examines how your 

program is working while it is being implemented. It helps you to determine whether 

you’re implementing with “fidelity”—whether 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 111 
you’re sticking to your original program design. 

For an ad campaign, this evaluation might 

include assessments of whether the ad was 

aired at the times you proposed and whether 

your target group was exposed to the message. 

In addition, you might record unforeseen 

obstacles and potentially confounding environmental events to help you interpret findings. 

For public relations, process evaluation could 

involve documenting whether targeted key 

journalists were reached, the content of the 

pitch, and whether certain planned events took 

place. For a media literacy program, it might 

mean counting how many times the program 

was delivered, finding out if all the curriculum’s 

lessons were implemented, and determining 

whether participants were satisfied with the 

content and delivery. Process evaluation enables 

you to report to stakeholders the plans you are 

implementing and the progress of your efforts. 

Lesson Learned: Coordination 

the expected short-term, intermediate, and 

long-term outcomes. Typically, outcomes are 

expected changes in the audiences targeted for 

the counter-marketing program. For example, 

in an ad campaign, the outcome evaluation 

can show whether there’s any change in the 

target audience’s awareness and recall of the 

message; tobacco-related attitudes, beliefs, 

and other psychosocial factors; and behavior. 

For a grassroots marketing initiative, the 

outcome evaluation can show changes in the 

community’s level of involvement in, and 

commitment to, the program. For a media 

advocacy component, the outcome evaluation 

can assess whether your efforts led to a change 

in tobacco-related policy. For public relations 

activities, your assessment might determine 

whether the target audience was aware of and 

understood the messages in your stories. In 

addition to these expected outcomes, 

unexpected outcomes sometimes arise, and 

these need to be acknowledged and included 

in your evaluation analysis. 

Outcome evaluation helps you to answer the 

question: What effect are we having? It helps 

you to determine whether you’re achieving 

The Mistake: One state didn’t establish a regular working relationship between program staff and 

evaluation staff. The program staff decided to stop running an ad but didn’t tell the evaluation team. The 

evaluation team didn’t check with the program staff to ensure that the ads were continuing to be aired as 

planned and continued to ask audience members, in subsequent waves of advertising awareness research, 

if they had seen the ad. Reported awareness of the ad dropped off, and the evaluation team concluded 

that the ad was ineffective. Fortunately, the mistake was discovered before the research report was widely 

disseminated. 

The Lesson: Establish regular communication and coordination between the program management and 

evaluation teams. 

112 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

What Evaluation Can Do 

Program evaluation has two general purposes. 

First, it helps program managers to revise and 

improve their programs. Second, it helps them 

be accountable to stakeholders, demonstrate 

the value of the investment, and maintain or 

increase support and funding for program 

efforts. Your stakeholders range from state 

administrators, legislators, policy makers, and 

taxpayers, to tobacco control and public 

health decision makers, to your bosses and 

partners. Well-conducted evaluations can: 

■	 Allow you to compare the program’s 

effect among groups, particularly those 

most affected by tobacco’s harms 

■	 Demonstrate the role of effective counter-marketing campaigns in reducing 

tobacco use and exposure to secondhand smoke, thereby gaining credibility 

for the counter-marketing elements of 

the tobacco control program 

■	 Guide administrative decisions about 

including counter-marketing efforts 

in comprehensive tobacco control 

programs 

■	 Provide concrete results that can be 

shared with partners and the community 

■	 Support replication, in your state or 

others, of counter-marketing strategies 

that work 

■	 Advance the field by publishing results 

If you’ve been working in public health for a 

while, evaluation won’t be new to you. You 

evaluate your work all the time when you ask 

questions, consult partners, make assessments 

based on feedback, and then use those judgments to improve your work. Those informal 

processes may be sufficient for regular, ongoing 

assessment needs, but in a statewide tobacco 

counter-marketing program, the stakes are 

usually higher. Most tobacco counter-marketing 

programs affect many people and involve a good 

deal of time and money, so you’ll need to use 

evaluation procedures that are more systematic, 

formal, visible, and justifiable. 

When To Conduct an Evaluation 

As noted earlier, evaluation is a continuous 

activity that needs to be planned along with 

overall program planning. Too often, evaluation is considered to be an “optional activity” 

rather than an integral component of countermarketing that is included in program 

planning from the start. 

In outcome evaluation, the timing of assessments and reports should be coordinated with 

the changes you expect to see in the target 

audience. For example, early in the campaign, 

you should expect changes in awareness and 

recall of your ads’ messages. As the campaign 

matures, you would expect changes in 

attitudes and beliefs. Only after building 

awareness and seeing changes in underlying 

beliefs should you expect changes in intended 

behaviors and claimed behaviors. Behavior 

change, which is reflected by evidence such as 

reduction in smoking prevalence, is most likely 

to occur when counter-marketing is part of a 

more comprehensive tobacco control effort. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 113 
It’s unrealistic to expect that counter-marketing 

efforts alone will lead to substantial changes in 

behavior related to tobacco use. 

Some stakeholders will want the first wave of 

outcome evaluation results within six months 

of launching the program. In this case, your 

first wave of evaluation should concentrate on 

process measures and short-term and intermediate outcome measures (e.g., increases in 

calls to a quitline, improvements in advertising 

awareness, or changes in knowledge) rather 

than longer-term behavior changes. 

Scope of the Evaluation 

Every state should evaluate its countermarketing activities as part of the overall 

evaluation of the tobacco control program. 

CDC recommends that 10 percent of a state’s 

tobacco control funds be allocated to surveillance and evaluation (CDC 1999a). You’ll need 

to decide the best way to allocate the funds 

and how rigorously to evaluate each activity. 

At a minimum, good process evaluation of 

each counter-marketing activity will enable 

the program manager to monitor the scope 

and quality of activities and to determine 

Lesson Learned: Planning 

whether the program is being conducted as 

planned. These results will help you consider 

the realities of conducting the program and 

make adjustments in its design. 

Outcome evaluation is needed to determine 

whether your program is having the intended 

effects. The more rigorous an outcome evaluation is, the more expensive it is, and the more 

difficult it is to conduct. As a rule of thumb, 

you should conduct more rigorous evaluation 

under the following conditions: 

■	 The program is costly, highly visible or 

controversial, or represents a new and 

untested approach. 

■	 Sound methods for rigorous evaluation 

exist. 

■	 Future funding depends on the
 

program’s success. 
 

Because many of these characteristics apply to 

the counter-advertising campaign, you’ll probably want to allocate a significant proportion 

of your evaluation resources to this component of your counter-marketing program. 

Counter-advertising campaigns are new to 

114 

The Mistake: One state didn’t think about evaluation early enough and didn’t do a baseline assessment before 

launching a paid media campaign. Consequently, the state will never know the results produced by the paid 

media campaign. Well-funded, paid media campaigns often produce substantial changes in awareness, 

attitudes, and beliefs shortly after they are run. 

The Lesson: Start planning your evaluation when you start planning the program. Then you can conduct a 

baseline assessment before you begin to implement the program. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

many states, and there is growing demand 

for more rigorous outcome evaluations. 

developed by the CDC Evaluation Working 

Group (CDC 1999b). 

To conduct a systematic evaluation of a 

tobacco counter-marketing program, you 

need to consider several steps. This detailed 

discussion of the steps follows the format 

The evaluation of the counter-marketing 

efforts should be coordinated with the evaluation of the whole tobacco control program. 

Counter-marketing activities are just one 

component of a complete tobacco control 

program, and evaluation can help to show 

whether all activities and components are 

working together effectively. 

Step 1: Identify stakeholders, and 

establish an evaluation team. 

Like planning and implementation, evaluation 

can’t be done in isolation. It involves partnerships. To identify the stakeholders, ask yourself: Who is the audience for the evaluation? 

What do they care about? The CDC Evaluation 

Working Group identified three overlapping 

groups that are integral to program evaluation 

How To Conduct an Evaluation (CDC 1999b): 

■ People involved in the campaign’s 

operation, such as management, 

program staff, partners, the funding 

agency, and coalition members 

Steps for Conducting an Evaluation 

Step 1. Identify stakeholders, and establish an evaluation team. 

Identify and involve those who will use or are affected by the evaluation. 

Step 2. Describe your counter-marketing program. 

Establish the need for an intervention, articulate your goals and objectives, and develop a 

program logic model. 

Step 3. Focus the evaluation design. 

Identify the purpose of the evaluation, develop and prioritize evaluation questions, and choose 

the evaluation study design. 

Step 4. Gather credible evidence. 

Develop outcome measures; identify indicators; select data-collection methods that are 

trustworthy, valid, and reliable; and collect the data. 

Step 5. Justify conclusions. 

Analyze and interpret the data, draw conclusions, and make recommendations. 

Step 6. Ensure use of results and share lessons learned. 

See that results are disseminated and used to inform decisions. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 115 
■	 People served by the campaign, such as 

advocacy groups and members of the 

target audience; elected officials; and 

any others who would be affected if the 

campaign were expanded, limited, or 

ended as a result of the evaluation 

■	 The primary intended users of the 

evaluation or anyone in a position to 

make decisions about the countermarketing efforts, such as health 

department decision makers, public 

health officials, and state legislators 

A Good Evaluator 

appropriate staff from these agencies should 

be involved in the evaluation planning. 

In addition, if you’re working with an ad
 

agency, a public relations agency, or both,
 

Any serious effort to evaluate a program must 

consider the different values stakeholders 

have, ensure that their perspectives are 

understood, and try to respond to their unique 

information needs (Patton 1997). If stakeholders aren’t appropriately involved, it’s more 

likely that evaluation findings will be ignored, 

criticized, or resisted. If they are involved, 

they’re likely to feel ownership and help you to 

gain allies who will defend the evaluation and 

its findings. 

To choose a good evaluator, consider whether the person: 

■	 Has experience evaluating health promotion programs, with particular emphasis on tobacco 
 

control, marketing campaigns, or health communication programs
 

■	 Can provide references (Check all references carefully before you contract with an outside 
 

consultant.)
 

■	 Can walk you through some of his or her recent research projects, to demonstrate skill and 
 

experience
 

■	 Can work with a wide variety of people, from representatives of the target audience to high-level 

public officials 

■	 Develops innovative approaches to evaluation while considering budget limitations and other 

realities 

■	 Complements the in-house evaluation team and increases its evaluation capacity 

■	 Shares all findings with the program staff regularly 

■	 Demonstrates the ability to include cultural competency in the evaluation 

116 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

You can involve stakeholders in the evaluation 

in various ways. The following approach has 

been adapted from the CDC Evaluation 

Working Group’s Framework for Program 

Evaluation in Public Health (CDC 1999b). 

1a: Establish an evaluation team. 

An evaluation team should consist of the 

program manager, external stakeholders, and 

people with evaluation expertise. The program 

manager or someone on the countermarketing staff should act as a liaison with the 

evaluation team and should be responsible for: 

■	 Budgeting for the evaluation 

■	 Developing and communicating program objectives and the logic model 

■	 Managing evaluation contracts 

■	 Coordinating evaluation activities
 

between program staff and the 
 

evaluation team
 

■	 Incorporating evaluation findings into 

program planning and revision 

Although the program manager should be able 

to understand and provide input on evaluation 

activities, he or she will need to find someone 

with the technical expertise to design and 

implement specific evaluation tasks. 

If your health department has personnel with 

technical expertise, they can be part of the 

evaluation team, but you should also involve 

outside evaluation experts. Your countermarketing program—especially the counteradvertising component—will be highly visible 

and possibly controversial, and the audience 

for the evaluation may not view the findings as 

credible unless they’re generated and reported 

by outside experts. Stakeholders often see 

outside evaluators as being neutral and objective and without the vested interests of those 

inside the organization that is implementing 

the program. Technical expertise may be 

available through external partners (e.g., 

organizations, universities, companies, and 

tobacco control programs in other states) or 

through CDC and its Prevention Research 

Centers program. This national network of 24 

academic research centers is committed to 

prevention research (CDC 2001). (Contact 

information is available at www.cdc.gov/prc.) 

States may consult with their CDC project 

officers for advice on finding the appropriate 

outside experts and working with them. 

Step 2: Describe your countermarketing program. 

To effectively plan the evaluation, you’ll need 

to have a clear description of your countermarketing program. This description should 

include background information justifying the 

need for the program, appropriate program 

goals and objectives, and a logic model to help 

define what you hope to achieve and to guide 

the evaluation. Negotiating with stakeholders 

about a concise program description will help 

to gain their support and allow them to 

provide insights that might be useful for 

program planning (Patton 1997; CDC 2001). 

If you followed the guidance in Chapter 2: 

Planning Your Counter-Marketing Program, 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 117 
this step will have already been completed. 

If you have not described your countermarketing program, refer to the planning 

chapter, which offers more information on 

two of the program planning steps that are 

essential to planning an evaluation: articulating program goals and objectives and 

developing a logic model. 

2a: Articulate program goals and 

objectives. 

Before an evaluation can be effectively 

planned, you’ll need to determine what your 

program needs to accomplish and what can be 

realistically accomplished within the budget 

and time frame. If your formative research has 

already been conducted, the findings can be 

helpful here. These results should have allowed 

you to identify the populations most in need 

and the behaviors and behavioral determinants that should be targeted for change. In 

addition, through pretesting of your messages 

and program approaches and your review of 

how similar approaches worked in other 

states, you should have gauged the amount 

of change to expect in your target audience. 

Formative research results should be used to 

determine your program’s goals and objectives. These goals and objectives are also 

critical to the evaluation, because they 

establish how you’ll determine whether your 

program is being implemented as planned and 

how you’ll measure your program’s success. 

A goal is the overall mission or purpose that 

helps to guide a program’s development. In 

tobacco counter-marketing, as with all 

tobacco prevention and control components, 

the overall goal is to reduce tobacco-related 

morbidity and mortality. To fulfill this vision, 

CDC has identified four more specific goals, 

one or more of which will be relevant to your 

program (CDC 2001): 

1. 	 Prevent the initiation of tobacco use 

among young people. 

2. 	 Promote quitting among young people 

and adults. 

3. 	 Eliminate exposure to secondhand 

smoke. 

4. 	 Identify and eliminate the disparities 

related to tobacco use and its effects 

among different population groups. 

Objectives are statements that describe the 

desired results. Tobacco control and prevention 

programs are complex and have multiple steps 

and effects. Select a limited set of objectives 

that will allow you to focus your evaluation on 

the most important results that are feasible to 

obtain. In addition, objectives should be conceptually linked, so that objectives at the local 

level are logical extensions of national and 

state objectives. The specific objectives outlined 

in Healthy People 2010 are a good starting point 

for tobacco control efforts (U.S. Department of 

Health and Human Services 2000, available at 

http://www.health.gov/healthypeople/ 

Document/HTML/Volume2/27Tobacco.htm). 

Good objectives are specific and measurable 

(CDC 2001). Well-written and clearly defined 

objectives will help you to set your program 

priorities, aid you in monitoring progress, and 

serve as targets for accountability. Objectives 

should be SMART: 

118 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■ Specific. The objective must identify 

a specific event or action that will 

take place. 

■	 Measurable. The objective must 

identify the amount of change to be 

achieved, and there must be a way to 

measure the change. 

■	 Achievable. The objective must be 

realistic and achievable. 

■	 Relevant. The objective must be logical 

and relate to the program goal. 

■	 Time-bound. The objective must 

provide a time by which the objective 

will be achieved. 

One example of an objective is that, in a certain 

state, the proportion of restaurants with smokefree policies will increase from 40 percent to 

60 percent by the end of 2005. 

This objective is specific because it states that 

restaurants will have smokefree policies in 

place. It could be made more specific if it 

identified which types of restaurants and 

which types of smokefree policies. It’s measurable because it identifies the current or 

baseline value and a level of change that is 

expected. It’s achievable because it outlines a 

realistic amount of change, assuming a strong 

counter-marketing program focused on this 

objective. The degree to which it’s achievable 

will depend on the context and realities within 

the state and the resources available. It’s 

relevant because having smokefree policies 

will help to eliminate exposure to secondhand 

smoke. It’s time-bound because a specified 

time frame is given. 

There are two general types of objectives: 

process objectives and outcome objectives. 

Process objectives describe the scope and 

quality of the activities that will be implemented and the population and other entities 

(i.e., individuals and organizations) that will 

take part in these activities. A process evaluation examines how well you’re achieving your 

process objectives or how well you’re implementing your program, compared with the 

objectives in the original plan. If you’re conducting a counter-advertising campaign in the 

spring to prevent initiation of smoking among 

youths, process objectives might be: 

■	 By February 2003, pretest an ad countering a tobacco industry message with 

six focus groups of 12-to-17 year-olds. 

■	 By March 2003, run the youth ad on TV 

so that 70 percent of the state’s 12- to 17­

year-olds are potentially exposed to the 

ad a minimum of three times on average 

per four-week period. 

Outcome objectives describe the results you 

expect from the program. They quantify 

anticipated program effects by specifying “the 

amount of change expected for a given health 

problem/condition for a specified population 

within a given time frame” (University of Texas 

1998; CDC 2001). 

Outcome objectives are often divided into 

short-term, intermediate, and long-term 

outcomes (Green and Lewis 1986; Green and 

Kreuter 1999; Green and Ottoson 1999; CDC 

2001). An example of a short-term outcome 

objective might be: Increase the proportion of 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 119 
high school youth with confirmed awareness 

of the youth ad campaign from 5 percent in 

January 2003 to 50 percent in June 2003. 

An example of an intermediate outcome 

objective might be: Increase the proportion of 

high school youth who report they believe that 

the tobacco industry deliberately uses advertising to get young people to start smoking 

from 40 percent in January 2003 to 60 percent 

in December 2003. 

Examples of long-term objectives might be: 

■	 Decrease the proportion of high school 

youth who report smoking a cigarette in 

the past 30 days from 40 percent in 2001 

to 30 percent in 2003. 

■	 Decrease the prevalence of high school 

youth who report smoking five or more 

cigarettes a day from 25 percent in 2001 

to 20 percent in 2003. 

2b: Develop a logic model. 

Developing a logic model of your countermarketing program is a good way to fully 

explain how the program is supposed to work. 

(See Chapter 2: Planning Your CounterMarketing Program for further information on 

developing a logic model.) A logic model is a 

flowchart of your program that shows the 

sequence of events in a chain of causation. 

Elements of a logic model can vary, but they 

generally include the following (United Way of 

America 1996): 

■	 Inputs—what is invested in the program 

to support it 

■	 Activities—the actual events or actions 

that take place 

■	 Outputs—the immediate products of 

these activities 

■	 Outcomes—the intended effects of 

the program, initial, intermediate, and 

long-term 

Some examples of inputs, activities, outputs, 

and outcomes for various components of a 

counter-marketing program are shown in 

Appendix 5.1. The inputs are the monetary and 

human resources needed to do the work and 

the infrastructure required to support the 

program. These factors include funding, staff, 

technical assistance, partner organizations, 

contracts, equipment, materials, and a sound 

program design. The type of staff, amount of 

funding, and program design will often differ 

for each component of your program. 

Activities are the actions the countermarketing staff will take to carry out the 

program. Examples of such actions are 

identifying audiences, writing plans, creating 

and revising materials, contacting individuals 

and organizations, and organizing events. 

Program outputs (sometimes called process 

outcomes) are the immediate products of 

these activities; outputs include ads that are 

run, stories that are placed, events that are 

attended, and media literacy sessions that are 

conducted. 

120 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Figure 5.1: Logic Model for Youth Tobacco Use 

Prevention Advertising Campaign 

Input 

Funds for paid media 

Activity 

Design industry manipulation ad 

Output 

Industry manipulation ad is aired on the 

stations and at the time to reach youth; 

youth are potentially exposed 

Short-Term Outcome 

Youth report awareness of the specific ad 

and react positively to it 

Intermediate Outcome 

Youth are more likely to believe that 
 

tobacco companies try to get people to smoke 

and less likely to believe smoking is cool
 


 

Long-Term Outcome 

Fewer youth report trying 

cigarette smoking 

Outcomes are the results you hope your efforts 


will achieve; they are divided into short-term, 


intermediate, and long-term (Campbell and 


Stanley 1963). More important than the label 


for the outcome, however, is the chain of 


causation linking one outcome logically to 


another. A logic model shows how you expect 


change to occur or how the immediate prod­


ucts of your activities will lead to short-term, 


then intermediate, then long-term outcomes. 


As much as possible, the logic model should 


be tailored to your particular campaign, target 


audience, strategy for influencing behavior, 


and specific behavioral objective. Figure 5.1 


shows an example of a logic model for a 


tobacco counter-advertising campaign 


designed to prevent youth from starting to 


smoke tobacco. The campaign points out that 


the tobacco companies try to influence young 


people to start smoking by convincing them 


that smoking is cool. Appendix 5.1 provides 


other examples of logic models for the 


components of a counter-marketing program. 


Although the sample logic models list 


behavioral outcomes, behavior change 


typically results only through a combination of 


interventions. For example, a media literacy 


program would not be expected to result in a 


reduction in youth smoking unless other 


components of the counter-marketing 


program were also influencing these youth. 


The elements of the logic model are linked in a 


series of if-then statements. If the ad is aired 


on the selected channels, then audience 


members who watch the channel can be 


aware of, comprehend, and react positively to 


Chapter 5: Evaluating the Success of Your Counter-Marketing Program 121 
the ad. If the audience is exposed to, aware of, 

and recalls the ad, then their attitudes, beliefs, 

and other psychosocial factors might change. 

(Psychosocial factors are characteristics such 

as attitudes, beliefs, perceived norms, and selfefficacy that, according to the major theories 

of behavior, are the determinants of people’s 

behavior.) If changes in psychosocial factors 

occur, then one would expect changes in 

behavior. 

This logic model is the model for one type of 

effort, a youth counter-advertising campaign. 

You could also develop a logic model for your 

entire counter-marketing program that shows 

how each component works individually and 

is coordinated into an integrated program. 

Another option is to develop a logic model for 

the entire state tobacco control program that 

shows how the various counter-marketing 

efforts work in combination with the other 

elements of the tobacco control program. 

Some good examples of logic models can be 

found in the CDC/OSH tobacco control 

evaluation manual, Introduction to Program 

Evaluation for Comprehensive Tobacco Control 

Programs (CDC 2001). 

It’s not uncommon for people to have different 

interpretations of the short-term, intermediate, 

and long-term outcomes for a particular 

program. What may be an intermediate 

outcome to some may be a long-term 

outcome to others. For example, one person 

may consider “quitting smoking” to be a longterm outcome for a particular smoking 

cessation program, while another may consider quitting smoking to be an intermediate 

outcome and “long-term abstinence from 

tobacco use” to be the long-term outcome. 

The logical sequence of short-term, intermediate, and long-term outcomes, based on 

your program’s theoretical under-pinnings and 

the types of change that can be expected, is 

more important than the labels. 

There are also different interpretations of how 

program outputs and short-term outcomes are 

articulated in program logic models. In a 

public relations effort, for example, one may 

consider the public relations activities of 

identifying and connecting with key journalists 

to be the program outputs and getting press 

coverage and audience exposure to be a shortterm outcome. Others may consider the PR 

activities, news coverage, and audience exposure all as outputs and the target audience’s 

actual awareness of the counter-marketing 

message as the short-term outcome. Here we 

use the latter interpretation across all countermarketing programs, so that program outputs 

include multiple “products of activities” that 

allow the target audience to be exposed to 

counter-marketing messages and short-term 

outcomes include the target audience’s 

increased awareness of these messages. 

Step 3: Focus the evaluation design. 

An evaluation can easily become too extensive 

and complex. In collaboration with stakeholders, the evaluation team will need to decide 

the evaluation’s purpose and how results will 

be used. The evaluation plan should outline 

the questions you plan to answer, the process 

you’ll follow, what will be measured, which 

methods will be used, who will perform 

various evaluation activities, what you will 

122 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

do with the information after it’s collected, 

and how the results will be disseminated. 

3a: Determine the purpose and 

questions for the evaluation. 

You can help to focus the evaluation by determining the information you need and setting 

priorities for the evaluation questions used to get 

that information. Because the prioritized questions will guide the methods for gathering the 

information, decisions about the questions 

should be made before choosing the methods. 

To prioritize the evaluation questions, the evaluation team should brainstorm with the stakeholders and intended users. You should use your 

process and outcome objectives to guide this 

discussion, so the objectives are linked to the 

questions you want the evaluation to answer. 

Develop evaluation questions for each component of your counter-marketing campaign. One 

study won’t effectively answer all your evaluation 

questions, so consider conducting several studies 

that will make up an evaluation portfolio. Put 

together a table that summarizes the objectives 

Table 5.1: Sample Program Objectives and Corresponding Evaluation Questions 

Objectives Evaluation Questions 

Advertising Component 

Process Objective 

By the end of 2003, an ad for a branded 

state counter-advertising campaign 

aimed at youth will have been aired on 

TV to reach 80 percent of 12- to 17-yearolds an average of six times per fourweek period. 

Did youth react positively to the ad in the campaign during 

the formative research? 

Based on the TV show ratings during which the ad was

broadcast and its corresponding reach of the audience, were 

at least 80 percent of the 12- to 17-year-olds theoretically

exposed to the ad at least six times? During which time 

periods was the ad aired? 

Outcome Objective 

By the end of 2003, 60 percent of 12- to 

17-year-olds will confirm their awareness 

of one or more of the TV ads in the state 

youth advertising campaign, and 50 

percent will correctly recall the main 

message(s). 

Decrease the proportion of high school 

youth who report trying a cigarette from 

40 percent in 2001 to 30 percent in 2003. 

Among 12- to 17-year olds, were 60 percent or more aware of 

the ad? 

Were 50 percent or more able to recall the message? Were there 

differences in awareness and recall that were based on sex, age, 

or ethnic background of the youth? 

Did the proportion of high school youth who initiated cigarette 

smoking decrease from 40 percent to 30 percent? 

Were there differences in the decrease of initiation of cigarette 

smoking that were based on the sex, age, or ethnic background 

of youth? 

How does the change in youth initiation of cigarette smoking in 

the state compare with that in the nation? Can some of the 

change be confidently attributed to the advertising campaign? 

Continues 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 123 
Table 5.1: Sample Program Objectives and Corresponding Evaluation Questions (cont.) 

Objectives Evaluation Questions 

Public Relations Component 

Process Objective 

By the end of 2003, representatives from 

the top 10 print and broadcast media 

outlets will have been reached with 

counter-marketing messages at least five 

times through phone, mail, and press 

conferences; five of these media outlets 

will have included these messages in 

their coverage and 50 percent of the 

target audience will have been exposed 

to the messages. 

Were the required number of media representatives reached 

the designated number of times? 

Did the required number of media outlets cover the countermarketing messages? 

How well were the messages covered (e.g., how much space 

and time for stories with protobacco slant and for stories with 

antitobacco slant)? 

Which outlets responded? 

How many target audience members were exposed to 

these messages? 

Outcome Objective 

Increase the target audience’s awareness 

of counter-marketing messages in media 

outlets by 25 percent from 2002 to 2003. 

Did the target audience increase its awareness of countermarketing messages by 25 percent? 

Media Literacy Component 

Process Objective 

By December 2003, at least 1,000 middle 

school children will have been reached 

with media literacy sessions through 

programs offered in 10 schools and 

through 10 youth-serving organizations 

in the state. 

Were media literacy sessions offered in the designated number 

of schools and organizations? Did these sessions reach the 

required number of children? 

What were the ages, gender, and race/ethnicity of the 

children reached? 

Outcome Objective 

Increase by 50 percent the number 

of program participants who can 

competently deconstruct a tobacco 

industry ad and produce their own 

counter-marketing message. 

As a result of the program, did participants increase their media 

literacy skills sufficiently to be able to deconstruct industry ads 

and develop tobacco counter-marketing messages? 

124 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

and corresponding evaluation questions for each 

component (e.g., Table 5.1). This table will help 

you take the next step of determining the studies 

that should be in your portfolio. 

3b: Select the evaluation design. 

The evaluation design is the structure or plan 

for data collection that specifies which groups 

will be studied and when. The design you 

select influences the timing of data collection, 

how you analyze the data, and the types of 

conclusions you can draw from your findings. 

Choosing the appropriate evaluation design is 

particularly important if you’re planning an 

outcome evaluation. Outcome evaluation tests 

the effectiveness of an intervention, and the 

evaluation design’s strength will affect your 

ability to attribute change to the intervention. 

Because you may be under considerable 

pressure to demonstrate the effectiveness of 

your program—especially the advertising 

component—your evaluation team needs to 

be familiar with various designs. This section 

touches briefly on various designs, but you 

may also need to consult other resources to 

help you make decisions about study design 

(Campbell and Stanley 1963; Spector 1981; 

Wimmer and Dominick 1987; Fletcher and 

Bowers 1988; Flay and Cook 2001; Rice and 

Atkins 2001; Hedrick et al. 1993; Hornik 1997; 

Rothman and Greenland 1998; Siegel and 

Doner 1998; Freimuth et al. 2001). Feasibility, 

scientific appropriateness, and costs must be 

considered in selecting a design, as well as 

your immediate and longer-term needs for 

data collection. You’ll also need to know your 

stakeholders’ standards, so you can choose a 

design that meets those standards. 

Evaluation designs can be broadly divided into 

three types: experimental, quasi-experimental, 

and observational. As CDC (2001) notes, 

“Experimental designs use random assignment 

to compare the effect of an intervention in one 

or more groups with the effect in an otherwise 

equivalent group or groups that don’t receive 

the intervention.” For example, you could 

identify a set of schools willing to participate in 

an outcome evaluation of a media literacy 

curriculum. One-half of the schools could be 

randomly assigned to begin to use the 

curriculum immediately (test group) and onehalf to use it after the study is completed 

(control group). 

An experimental design is often unrealistic for 

a counter-advertising campaign, because 

exposure to the message is widespread and 

you can’t control who gets it. Many times, 

people have ethical concerns with experimental designs, because interventions are at 

least temporarily withheld, during the time of 

the study, from those who need them. To determine whether you need an experimental 

design for an outcome evaluation of your 

counter-marketing program, consult an expert 

and consider issues such as scientific appropriateness and costs. 

Many program managers find a quasiexperimental design easier to use than an 

experimental design, but a quasi-experimental 

design is not as scientifically strong. CDC 

(2001) comments that “this design makes 

comparisons between nonequivalent groups 

and doesn’t involve random assignment to 

intervention or control groups.” A simple 

example of a quasi-experimental design would 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 125 
be measuring the attitudes, beliefs, and 

behaviors of two communities, one of which 

chose to conduct a counter-marketing 

campaign and the other had no intervention. 

The community with no intervention would be 

selected for its similarity to the first community. 

According to CDC (2001), “Observational 

designs include, but are not limited to, timeseries analysis, cross-sectional surveys, and 

case studies.” Case studies are generally 

descriptive and exploratory. If your program or 

your application is unique or you’re working in 

an unpredictable environment, you might 

want to consider a case study. Case studies are 

often used to evaluate media advocacy 

projects, to provide an in-depth examination 

of how media coverage on a particular topic 

was framed and how community advocates 

were involved in the media advocacy 

initiatives (Wallack et al. 1999). Cross-sectional 

surveys, such as the Youth Tobacco Survey 

(YTS) and surveys performed using a timeseries analysis, can be conducted with a target 

audience to help determine whether the 

desired outcomes of your counter-marketing 

program (e.g., reduced tobacco use) have been 

achieved. Cross-sectional surveys are administered to independent samples of the target 

population. For a time-series analysis, the 

target population is surveyed a number of 

times both before and during program implementation. Although this type of analysis can 

require considerable resources and time, the 

more times the target population can be 

surveyed and the more closely the timing of the 

survey can mirror the timing of your intervention (e.g., through ads in a paid media 

campaign) the more confident you can be that 

the changes in program outcomes are to some 

extent attributable to the program. 

Step 4: Gather credible evidence. 

So far, you’ve written measurable objectives, 

developed a logic model, selected the types of 

evaluation and the evaluation questions, and 

determined the study design(s) you’ll use. The 

next step is to decide on specific outcomes to 

address and identify the indicators you’ll use 

to measure progress. Once these are in place, 

you’ll be ready to figure out which sources of 

data and data collection methods should be 

used to obtain the information you need. 

4a: Develop outcomes and identify 

indicators. 

By now, you should have decided what kind of 

outcome evaluation you’ll conduct and which 

components of the counter-marketing program 

will be addressed in the evaluation. Make sure 

that the outcomes you choose reflect the 

evaluation’s purpose(s), audience(s), and the 

intended uses of the results and that they’re 

relevant to the component(s) you’re studying. 

If your ad campaign has been running for an 

extended period and the legislators want to 

know whether youth smoking has decreased 

and the campaign is worthy of continued 

funding, then behavioral outcomes should be 

the evaluation’s primary focus. 

After you’ve selected the outcomes, determine 

which indicators you can use to show whether 

you’ve achieved these outcomes. Indicators are 

specific, observable, and measurable 

126 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

characteristics or changes that show the 

progress a program is making toward achieving 

a specified outcome (Campbell and Stanley 

1963; CDC 1999b; CDC 2001). Indicators 

translate general concepts related to the 

program, its content, and its expected effects 

into specific measures that can be interpreted. 

For example, the percentage of high school 

youth who report that they’ve tried smoking a 

cigarette, even a puff or two, is an indicator that 

can be used to measure the long-term outcome 

of efforts to decrease smoking among youth. 

Also, the percentage of high school youth who 

report that tobacco companies deliberately use 

advertising to get them to start smoking is an 

indicator of the short-term outcome of efforts 

to increase negative beliefs about the tobacco 

industry. 

Each outcome should have at least one 

indicator, and each indicator should measure 

an important dimension of the outcome. You 

must be specific about what each indicator will 

measure. Indicators define the criteria you’ll 

use to judge your progress in achieving the 

desired outcomes. You can assess behavior in 

several ways. Identifying the best indicator 

depends on the type of behavioral outcome 

you’re addressing. Indicators that may be 

useful for monitoring long-term trends in 

smoking prevalence (e.g., “whether a person 

smoked 100 cigarettes in his or her lifetime”) 

will yield a different estimate of behavior than 

indicators that are appropriate for evaluating 

the impact of a counter-advertising campaign 

on a population (e.g., “on how many of the past 

30 days a person smoked”). 

4b: Collect data. 

Next, you’ll need to decide which methods to 

use to gather data about your outcomes and 

indicators. Each method has advantages and 

disadvantages. Some methods are appropriate 

for process evaluation; others are appropriate 

for outcome evaluation. A number of common 

data-collection tools and methods are used for 

process evaluation, outcome evaluation, or 

both. (See Appendix 5.2: Key Data Collection 

Tools and Methods.) 

Try to use methods that your stakeholders 

perceive as credible. Some stakeholders may 

want you to use an interview method to gather 

qualitative feedback from the community; 

others may want you to conduct an extensive 

population-based survey. Be prepared to 

explain the value of more rigorous methods to 

stakeholders less familiar with evaluation. 

Consider conducting a custom survey. 

Surveys are likely to be part of every countermarketing evaluation. They can be roughly 

divided into two types: (1) primary data surveys 

(custom surveys), which are designed for your 

specific needs, and (2) secondary data surveys, 

which must be used as they are, because they 

have been developed by other individuals or 

organizations for particular purposes. 

Primary data surveys. In most states, some 

form of primary data collection will be needed 

to evaluate the specific outcomes of the 

counter-marketing efforts, particularly the 

advertising component. Although surveys for 

collection of primary data can be expensive, 

they have many advantages. These surveys can 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 127 
be customized with specific items, sampling 

plans, and timing of administration to fit your 

counter-marketing campaign. You can track 

awareness of your specific ads and themes, the 

attitudes and beliefs relevant to your campaign, 

and behaviors in your target population. These 

data can be used to help you make decisions 

about how to improve and when to change the 

campaign. Many states have used custom 

surveys to demonstrate the effectiveness of 

their counter-advertising efforts. 

Depending on your resources, you should 

consider custom surveys for each of the large 

components of your counter-marketing 

program. Alternatively, one way to integrate 

the outcome evaluation of several components 

is by conducting a customized survey to assess 

the full range of audience outcomes for all 

components of your counter-marketing 

(advertising, news articles and stories, 

grassroots events, media literacy, and media 

advocacy). This approach may appear to be 

more efficient, but it may not yield the same 

quality of data that could be generated from 

conducting an individual survey on each 

component. 

In most cases, you should contract with an 

outside expert to design a customized survey 

for use in collecting these primary data. For 

assistance in finding and working with an 

appropriate contractor, states may consult 

with their CDC project officers. A good way to 

start work on a survey is to discuss with your 

evaluation expert questions associated with 

design, sampling and sample size, measurement, and data collection and analysis. (See 

Table 5.2 for sample questions.) Your survey 

probably will measure variables such as the 

target audience’s awareness and recall of the 

counter-marketing messages and the attitudes, 

beliefs, intentions, and behaviors related to 

tobacco use. (See Appendix 5.3 for sample 

survey items.) Another resource is primary 

surveys that have been developed to evaluate 

other state counter-marketing campaigns. 

Some research methods require Institutional 

Review Board (IRB) approval. Nearly all government agencies, academic institutions, and 

other organizations require an assessment of 

the impact on human subjects involved in 

qualitative and quantitative research, including the protection of collected data. Some datacollection efforts are exempt from IRB 

approval. For each research project undertaken, it is recommended that you consult the 

IRB expert in your organization. 

Secondary data surveys and data collection 

systems. All states have access to secondary 

data, particularly on behavior. Several 

secondary data sets are described in CDC’s 

Surveillance and Evaluation Data Resources for 

Comprehensive Tobacco Control Programs (Yee 

and Schooley 2001). These sources may 

include data that can be disaggregated at your 

state’s level. Sources include the following: 

■	 Adult Tobacco Survey 

■	 Behavioral Risk Factor Surveillance 

System 

■	 Current Population Survey Tobacco Use 

Supplements 

■	 Monitoring the Future 

128 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 5.2: Questions To Ask in Designing a Survey To Evaluate Counter-Marketing Efforts 

Design: How should I structure the study? 

• How should I establish control or comparison points against which I can assess impact? 

• When and how many times do I want to survey people? 

• Should I survey the same or different people each time? 

Sampling: Whom should I study, and how should I select the study participants? 

• Whom should I survey? 

• What sampling plan should I use? 

• How many people should I survey? 

• How large a sample do I need to make the comparisons I want to make with sufficient statistical power? 

Measurement: What questions should I ask, and how should I ask them? 

• What variables do I need to measure? 

• How many items do I need for each variable? 

• How do I ensure that my measures are reliable and valid? 

• Do I create my own items, or can I use someone else’s items? 

Data collection: How should I collect the data? 

• Should I collect custom data or use existing data? 

• How should I administer my survey? 

• How can I ensure a high response rate? 

• What data do I need in addition to survey data? 

Analysis: How should I analyze the data to answer the evaluation questions? 

• Which descriptive statistics should I use to help describe and summarize the data (e.g., frequency 

data, raw numbers, and percentages)? 

• Which inferential statistics should I use to allow generalization from my sample to a wider population 

and to enable me to test hypotheses that the data are consistent with research predictions? 

• What analyses can I conduct to determine whether the program is effective? 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 129 
■	 National Health Interview Survey 

■	 National Household Survey on 
 

Drug Abuse 
 

■	 Pregnancy Risk Assessment 
 

Monitoring System
 

■	 State Tobacco Activities Tracking and 

Evaluation System 

■	 Youth Risk Behavior Surveillance System 

■	 Youth Tobacco Survey 

Although these secondary sources are unlikely 

to be ideal for evaluating your countermarketing program, they can provide 

important information on trends, especially 

for attitudes, intentions, and behaviors. In 

many states, current studies can be modified 

to make them more relevant to the countermarketing component. It might be possible to 

add items or modules, modify the sampling 

plan, increase the sample size of some 

segments, or adjust the timing. Alternatively, 

you could time the launch of your program to 

fit the timing of the routine collection of data. 

Early in the planning of your evaluation, 

review what secondary sources are available in 

your state and see if they would improve your 

evaluation. For example, many states conduct 

the Youth Risk Behavior Survey (YRBS), a 

school-based survey of youth risk behaviors. 

The instrument includes several items on 

smoking behavior that can be used to track 

long-term trends and provide state-level 

estimates of students in grades 9 through 12. 

National data are available for comparison, and 

data from nearby states also might be available. 

Disadvantages of these data are that they are 

collected only every two years, in the spring, 

and that the instrument assesses only behavior. 

The YRBS could be and has been enhanced in 

many states by adding questions. Vermont, for 

example, has added items that help (1) to 

measure how easy it is for youth to get cigarettes and (2) to assess youths’ opinions of their 

parents’ attitudes toward their own cigarette 

use. Alabama has added an item that helps to 

determine whether a youth’s health care 

provider addresses tobacco use prevention. For 

some states, the YRBS might prove to be a 

useful data source to include in portfolios. 

Step 5: Justify conclusions. 

Once the data are gathered, you’ll need to 

analyze and interpret the data and formulate 

conclusions and recommendations. Your 

analysis and interpretation should be related 

to the evaluation questions. Essentially, analysis 

and interpretation are a matter of tracking 

what happens along each step of the logic 

model. (See Table 5.3 for the key evaluation 

questions in tobacco counter-marketing and 

examples of data analysis approaches for each 

question.) 

130 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 5.3: Evaluation Analysis 

Evaluation Questions Data Analysis Approach 

Process Evaluation: Is the state’s counter marketing program being implemented as planned? 

Are the program activities being conducted 

at the planned level (quantity and quality)? 

• Summary of data on the number and quality of media 

literacy sessions conducted 

Are members of the target population 

exposed to the ad and participating in 

the program? 

• Summary of ratings of TV shows during which paid 

counter-advertisements were aired 

• Summary of data on the number of participants in a 

youth summit 

Short-Term Outcome Evaluation: Is the state’s counter-marketing program having the intended effects? 

Who is aware of the ad? Who is aware of 

the program? 

Are all segments of the target population 

aware of the ad? Are all segments aware of 

the program? 

• Collecting data on the percentage of the state’s adult voters 

who recalled seeing a story or article about tobacco in a 

newspaper or magazine in the past month 

• Obtaining data on the percentage of 12- to 17-year-olds 

who reported seeing one of the state’s counter-marketing 

ads in the past month 

• Acquiring data on the level of awareness of the campaign’s 

brand among youth by gender, age, race/ethnicity, and 

community 

• Collecting data on the percentage of restaurant owners 

who reported knowing about the state’s policies on 

secondhand smoke 

Is the right message getting across? • Obtaining data on the percentage of participants who were 

aware of the advertising campaign and could correctly 

recall the intended message 

• Acquiring data on the percentage of the articles on the 

counter-marketing theme that conveyed the intended 

message 

How is the target population’s awareness 

of the program changing over time? 

How is it changing in relation to specific 

counter-marketing efforts? 

• Tracking data at several points over time to indicate (1) the 

percentage of the state’s population that is aware of the 

counter-advertising campaign; (2) whether the percentage 

is higher immediately after the counter-marketing efforts; 

and (3) when the percentage starts to decrease, suggesting 

that the effects of the state’s ads have peaked or that the 

state has reduced its media buying 

Continues 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 131 
Table 5.3: Evaluation Analysis (cont.) 

Evaluation Questions Data Analysis Approach 

Short-Term Outcome Evaluation: Is the state’s counter-marketing program having the intended effects? 

Are attitudes, beliefs, and other 

psychosocial factors moving in the 

desired direction? 

• Pretest and posttest tracking of data (1) on restaurant owners’ 

belief that secondhand smoke is harmful to health and (2) on 

the public’s attitudes toward policies on exposure to 

secondhand smoke 

Is behavior changing? • Tracking data at several points over time that indicate the 

percentage of high school students who reported trying a 

cigarette or using chewing tobacco 

• Tracking data at several points over time that indicate the 

percentage of smokers who reported trying to quit smoking 

Are the counter-marketing efforts 

contributing to the changes in attitudes, 

beliefs, policies, and behavior? 

• Collecting data to address whether change can be attributed 

to the intervention: (1) the percentage of participants who 

believe in negative health consequences of smoking, among 

those who are aware of the state’s ads on health consequences 

versus those who are not aware and (2) the percentage who 

understand the tactics of tobacco advertising, among those 

who participated in the media literacy workshop versus those 

who did not participate 

• Monitoring data on tobacco-related policies to document 

their stage of development, implementation, and enforcement, 

and comparing the timing of these stages with the timing of 

activities in the tobacco counter-marketing campaign 

As part of the state’s entire tobacco 

control program, do the state surveillance 

data indicate progress toward goal(s)? 

Long-Term Outcome Evaluation: Is the state counter-marketing program achieving its long-term goals? 

• Monitoring surveillance data on the prevalence of smoking 

or public exposure to secondhand smoke and comparing 

these data with data from the tobacco control program 

(customized survey) 

Descriptive Analyses 

Analysis and interpretation of your process 

evaluation data will be descriptive. The data 

will consist of raw numbers and percentages 

(e.g., frequency data) that simply describe the 

level of activities and outputs that have taken 

place. As a manager, you’ll want to review 

monthly reports on each component, to 

ensure that the activities are being implemented as planned. Relevant questions 

include the following: 

■	 Is the public relations specialist conducting all the planned press activities? 

132 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Have quitline operators been 
 

trained appropriately? 
 

■	 Are all the media literacy sessions 
 

being held? 
 

■	 Have the ads been designed, tested, 

and produced? 

■	 Is the state on target in its media buying? 

If the expected level of activity isn’t being 

achieved, you need to determine what needs 

to be done to ensure that the necessary 

resources and support are available. 

As another descriptive analysis, you’ll want to 

determine whether the program is reaching 

enough people. Are audience members aware 

of the advertising campaign? Are enough 

articles and editorials being published? Look at 

the quality of the reach as well as the quantity. 

You’ll need to know not only the column 

inches and placement of the ad coverage, but 

also its content and slant. (See Chapter 7: 

Advertising and Chapter 8: Public Relations for 

more information.) If the intended message 

isn’t getting across, you may need to modify 

your materials or your approach. 

Although this type of tracking of the campaign’s 

reach is more a matter of management than 

evaluation, it’s a critical step. If the outcomes 

of intervention are not ultimately achieved, it 

may be simply because the intervention was 

not implemented as planned. The regular 

review of these descriptive data will help you 

to monitor your implementation efforts. 

Comparative Analyses. Beyond descriptive 

analyses, you’ll also want to perform comparative analyses to determine whether your 

program is successful. In conducting comparative analyses, you’ll need to use inferential 

statistics to determine whether the differences 

you observe are great enough to be statistically 

significant. Consider at least four types of comparisons: over segments of your target population, over time, over regions, and over levels of 

awareness of the counter-marketing effort. 

Analyses by segments. Comparisons of levels 

of awareness, attitudes, beliefs, and behaviors 

by segments of your target population will tell 

you whether you’re reaching a substantial 

proportion of each segment and how your 

efforts are influencing each segment. Consider 

analyzing the data by gender, age, and race/ 

ethnicity. Counter-advertising programs with 

youth, for example, sometimes have been 

found to be more effective with those younger 

than 16 than with those 16 or older. Early 

analyses by race/ethnicity demonstrated to 

some states that they weren’t influencing some 

segments of their target population. The media 

buys, media outlets, and messages needed to 

be adjusted. 

Analyses by time. Comparisons over time will 

show you how the awareness, reach, and effect 

of your program are increasing with time, the 

level of your program activities, or both. Some 

variables should change gradually, and others 

should change abruptly. For example, the 

proportion of the population that is smoking or 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 133 
the percentage of youth that has tried a cigarette should decline gradually and smoothly. 

This result is most likely when, at the onset of 

the program, there is a large pool of 

“susceptibles” made up of individuals who 

have not been reached by similar interventions. 

Levels of exposure to the activities of your 

counter-marketing campaign increase as the 

program gradually scales up. After you run 

articles and ads about industry manipulation 

in your state, there should be sudden increases 

in awareness of the ads and a subsequent increase in the belief that the industry is trying to 

influence consumers to buy cigarettes. Examine the pattern of results with respect to time 

and the timing of your program activities. After 

the most receptive members of the population 

have been influenced by program messages, 

leaving the more resistant ones, results will 

show a slowdown in measurable improvement. 

Analyses by region. You can also examine the 

pattern of awareness, beliefs, attitudes, and 

behaviors by region. If the different regions of 

your state have different amounts of program 

activity, this difference should show up in the 

findings. In Texas, for example, countermarketing managers purposely implemented 

different patterns of programs in different 

communities, to evaluate the programs’ effects. 

In 14 areas across the state, they implemented 

a mix of three levels of media activity (no 

campaign, low-level campaign, or high-level 

campaign) and five community program 

options (no programs, cessation programs, law 

enforcement programs, school-community 

programs, or all three programs combined). 

Their evaluation found a significant relative 

reduction in the prevalence of daily smoking 

in the areas where a high-level media campaign was conducted in combination with 

either school-community or multiple programs 

(Texas Tobacco Prevention Initiative 2001). 

Analyses by level of awareness of the countermarketing effort. A common approach for 

analysis to evaluate counter-marketing efforts, 

particularly counter-advertising, is to compare 

attitudes, beliefs, and behaviors in different 

groups by level of awareness of advertising. 

Such analysis can help you determine whether 

there have been more positive changes in 

attitudes, beliefs, and behaviors among those 

who are aware of the program than among 

those who aren’t aware. 

Attribution in Outcome Evaluation 

Finding change is not conclusive evidence that 

the change is attributable to the effectiveness 

of your program. To demonstrate that a 

program is effective, you need data that show 

(1) a change or difference, and (2) that your 

program was to some extent responsible for 

that change or difference. 

The first part is relatively simple. By conducting surveys before and after your programs, 

you can show increases in awareness and 

desirable changes in attitudes, beliefs, and 

behaviors over time. By comparing levels of 

attitudes, beliefs, and behaviors across levels 

of exposure to a program, you can show that 

people exposed to the program have better 

outcomes. By comparing people in regions 

where programs were implemented to those in 

regions where they weren’t implemented, you 

can show better attitudes, beliefs, and behaviors in areas with the programs. 

134 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

The second part is difficult. Methodologically 

sophisticated stakeholders can and do criticize 

each of the analyses described and claim the 

changes or differences observed could have 

resulted from factors other than the countermarketing program. Critics can correctly claim 

that the differences or changes result from 

factors such as general trends in smoking, 

policy and pricing changes in the state, 

national media campaigns, or changes in the 

activities of the tobacco industry. 

As noted earlier, it’s usually not feasible to use a 

true experimental design with random assignment to evaluate your counter-advertising 

component, because it’s difficult to control 

who is exposed to what. But there are some 

things you can do to avoid criticism of the evaluation. From a process perspective, you can: 

■	 Find out early if your stakeholders 

want a rigorous assessment of the 

degree to which the counter-marketing 

program was responsible for changes 

or differences 

■	 Allocate additional resources for 
 

that assessment
 

■	 Alert your evaluation experts, and discuss the alternative methods with them 

■	 Find out what other states have done 

■	 Arm yourself with high-quality studies 

from a variety of sources showing that 

strong counter-marketing efforts 

generally can lead to better outcomes 

■	 Be prepared to answer questions about 

attribution when you present your 

results 

From a technical or analytic perspective, your 

evaluation team can: 

■ 

■	 

■	 

■	 

Conduct several types of analyses to 

demonstrate change. For example, 

(1) show change from time A to time B; 

(2) show better outcomes among people 

who are exposed to counter-marketing 

activities than among those who aren’t 

exposed; and (3) compare results for 

your state with those for areas of the 

country that have fewer or different 

counter-marketing programs. 

Perform complex multivariate analyses. 

For example, you can determine the 

effects of multiple independent 

variables (e.g., timing of the ads and 

changes in awareness, attitudes, and 

beliefs) on the dependent variable (e.g., 

change in smoking behavior), controlling for the effects of other variables 

(e.g., gender, age, and race/ethnicity). 

Measure attitudes, beliefs, and behaviors that you expect to be influenced by 

your program, as well as those that you 

do not expect to be changed. Then show 

that the differences for the items specific 

to your program are greater than the 

differences for the other items. 

Conduct a longitudinal study that 

follows a cohort across time in order to 

show the causal chain of effects. This 

approach allows you to conduct more 

complex analyses to determine whether 

the degree of program exposure is 

associated with changes in attitudes and 

beliefs, and whether the changes in 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 135 
attitudes and beliefs are associated with 

changes in behavior. 

■	 Perform a quasi-experimental study to 

assess the impact of different program 

components that have been implemented in different communities in 

your state. This approach can help you 

determine how much different program 

components have changed attitudes, 

beliefs, and behaviors. 

Step 6: Ensure use of results and share 

lessons learned. 

The main purpose of your evaluation is to 

produce findings that will help to inform your 

decision making and help you to be accountable to stakeholders. Despite the potential 

usefulness of an evaluation, however, its 

findings, conclusions, and recommendations 

don’t automatically translate into informed 

decision making and appropriate action. You 

must have a plan for making sure that the 

evaluation results are disseminated in a timely 

and understandable fashion and that they are 

used to improve programs and to help ensure 

support and funding for future programs. Each 

of the steps in the evaluation process must be 

executed in a way that ensures use. 

6a: Develop a clear and focused 

evaluation plan. 

The first step in using results is to have a clear 

evaluation plan that links the program 

objectives, the evaluation questions, and the 

methods. Linking the data source to the 

question not only helps you to keep your data 

collection pared down to the essentials, it also 

keeps you aware of the data’s value in decision 

making. 

6b: Consider the implications of different 

results. 

In collaboration with your stakeholders, 

consider the decisions that would be made on 

the bases of specific patterns of results. During 

different stages of evaluation planning, pose 

various hypothetical results and discuss their 

implications for modifying the program. If no 

action would be taken, you might need to 

rethink the proposed evaluation plan to make 

sure you’re asking the right questions. 

Consideration of the possible results also 

allows stakeholders to explore the positive and 

negative implications of those results and gives 

them time to develop options. 

6c: Communicate with stakeholders 

during each step of the evaluation 

process. 

Let all interested parties know how the 

evaluation is going. Involve them in the 

evaluation planning, in an effort to manage 

their expectations about what questions the 

evaluation will answer and when. Keep them 

informed, and hold periodic discussions about 

interim results, early interpretations, draft 

reports, and the final report. 

136 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

6d: Follow up with stakeholders to 

ensure that results are used in 

decision making. 

the evaluation team is needed to remind 

stakeholders of the intended uses for the 

results and to help prevent results from being 

lost or ignored when complex, politically 

sensitive decisions are being made. 

Efforts to make sure that results are used don’t 

end with a final report that reaches conclusions 

and makes recommendations. Follow-up by 

Tips for an Effective Evaluation Report 

■	 Include an executive summary. 

■	 Describe the stakeholders and how they were involved. 

■	 Describe the essential features of the program, including the logic model. 

■	 Outline the key evaluation questions. 

■	 Include a description of the methods. 

■	 List methodological strengths and weaknesses. No study is perfect; don’t pretend yours has no flaws. 

■	 Present results and conclusions. 

■	 Put results into context. (Help readers to understand what is reasonable at this point and how the 

results should be interpreted.) 

■	 Translate findings into recommendations. 

■	 Organize the report logically. 

■	 Minimize technical jargon. 

■	 Provide detailed information in appendices. 

■	 Use examples, illustrations, graphics, and stories. 

■	 Involve stakeholders in preparation of the report. 

■	 Consider how the findings might affect others. 

■	 Develop additional communication products suited to a variety of audiences, for sharing the results. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 137 
6e: Use a variety of channels and 

approaches in disseminating results. 

Dissemination is a form of communication. 

As with any communication, you should 

consider the target audience and purpose 

when deciding how to disseminate the results. 

Some people connect with numbers, some 

with text, some with graphs and pictures, and 

some with stories. 

You should also think about the timing of the 

release of your results: 

■	 Who should receive results first? 

■	 When should the media be notified? 

■	 How often should each set of
 

stakeholders receive results? 
 

■	 Who should release results to 
 

which audiences?
 

In addition, consider the potential criticisms 

that your results may receive. You may present 

a certain percentage decline in tobacco use as a 

success, but others may see that same decline 

as a failure. You should prepare responses to 

any potential criticisms you foresee and train 

your spokespeople to respond to attacks on 

your campaign. Stakeholders can be especially 

valuable in defending your results. For more 

information on preparing for and responding 

to media inquiries, see Chapter 9: Media 

Advocacy and Chapter 8: Public Relations. 

A formal evaluation report shouldn’t be the 

only product you disseminate. Work with 

various stakeholders to develop other products 

and to make sure the products’ timing, style, 

tone, message, and format are appropriate for 

their audience(s). For example: 

■	 Consider providing a briefing sheet that 

public health officials can use in presentations to state legislatures. 

■	 Work with the public relations staff to 

develop materials for the news media. 

■	 Consider a press conference to 
 

release results. 
 

■	 Hold a community forum. 

■	 Provide materials with more details, 

containing statistics and other data for 

technical audiences. 

■	 Arrange to summarize key findings or 

complete reports and instruments on 

Web sites. 

■	 Make your findings, reports, and 

materials available to other states and 

other people involved in tobacco 

control and prevention. 

These ideas can help to ensure that your 

evaluation efforts don’t go to waste. Again, 

your evaluation is useless if the results aren’t 

understood and used to make decisions about 

the program. 

138 Chapter 5: Evaluating the Success of Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Points To Remember 

■	 

■	 Build an effective evaluation team. The evaluation team should include counter-marketing staff, 

evaluation expertise, and stakeholder input. At the state level, the program manager should be 

responsible for putting the team together. Make sure the team has sufficient expertise in technical 

evaluation and that it includes an external evaluator who is perceived by stakeholders as objective 

and capable. Many states have found it helpful to have a mix of experts from different backgrounds, 

such as a market researcher from the corporate sector, a public health epidemiologist, and a 

university-based communication researcher. Stakeholders are important to program evaluation, 

because their support of the process, results, and recommendations will help to ensure that the 

evaluation is accepted and used. Without stakeholder involvement, the evaluation may lack 

credibility, and the findings may be ignored. 

■	 

■	 

■	 

■	 

Consider evaluation early and often. Evaluation shouldn’t be left until the end of the program. 

Considering evaluation while the program is being planned helps to ensure that the plan is specific 

and clear about what the program is trying to achieve. Developing a logic model that links inputs to 

activities to outputs and, finally, to outcomes forces planners to articulate their assumptions about 

how the program will work. These assumptions can be reviewed to determine whether they’re 

consistent with available evidence. Considering evaluation before you begin to implement your 

program also helps to ensure that baseline data are collected. 

Although you may be pressured to roll out your program quickly, if you don’t collect baseline data, 

you’ll never be able to clearly measure the changes caused by your intervention. Regular monitoring of activities and outputs helps the counter-marketing manager to troubleshoot and make 

adjustments in the program. Assessing short-term outcomes helps in modifying the program, and 

assessing long-term outcomes is necessary for accountability and to ensure continued funding for 

the program. 

Develop and follow an evaluation plan that is appropriate to your state in terms of context, 

timing, cost, and rigor. In evaluation, one size doesn’t fit all. There’s no one best evaluation plan. 

Different states will face different marketing challenges, will have different resources, and will be working 

in a different context. The evaluation plan should reflect these factors. As a general rule, you should 

allocate 10 percent of your resources to evaluation. Evaluate as rigorously as your resources allow, and be 

sure to use more rigorous evaluation methods when the programs are more costly, visible, or controversial. 

Make sure findings are shared and used. Evaluation that ends as a report sitting on a shelf is wasted. 

Evaluation findings must be shared in such a way that they inform program decisions. Ensuring the 

use of results begins in the early stages of planning, as you ask what the program’s objectives are, 

what questions need to be answered, and how the results will affect decisions. The evaluation 

report is a communication, so it must be appropriate for the audience. 

Build on what others have learned. In conducting outcome evaluation for your counter-marketing 

program, you may encounter a number of challenges. Fortunately, you’re not alone. Others, such as CDC, 

the American Legacy Foundation, and other states, have faced the same issues and have begun to develop 

solutions. Talk to others, read the literature and reports, and share your experiences. 

Consult other CDC resources. This chapter provides a brief overview of what you should consider in 

evaluating a counter-marketing program. Consider reviewing other CDC resources and consulting 

your CDC project officer for specific advice. Seeking these resources and specific advice is especially 

important if you’re conducting an outcome evaluation of a paid media campaign. 

Chapter 5: Evaluating the Success of Your Counter-Marketing Program 139 
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Chapter 5: Evaluating the Success of Your Counter-Marketing Program 141 
142 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 6 

Managing and Implementing 

Your Counter-Marketing Program 

I won’t kid you; pulling all the pieces together is hard 

work. But it works. And when you look back and realize 

your efforts have impacted not only individual behavior 

but the culture as a whole, you’ll know it was worth 

the effort. 

—	 Colleen Stevens, Tobacco Control Section, 

California Department of Health Services 

In This Chapter
 

• Setting Up Your 

Counter-Marketing 

Team 

• Selecting 

Contractors 

• Developing an 

Annual Marketing 

Plan 

To have a successful counter-marketing program, you’ll need to have the right 

team and set up the right processes to implement your program and keep it on 

track. Whether your budget is $100,000, $25 million, or anything in between, 

the steps are the same. Each step is described in detail in this chapter. 

Setting Up Your Counter-Marketing Team 

Finding the appropriate mix of people and expertise may be the most important thing you do. To implement your program, you’ll need to establish 

four groups: 

1. 	 Health department staff to develop and monitor activities 

2. 	 Communication agencies, communication specialists, or both, to 

develop and place ads, create public relations campaigns, plan events, 

and conduct other activities 

3. 	 An evaluation firm or staff to monitor and measure the results of your efforts 

• Reviewing Marketing 

Materials 

• Monitoring the 

Counter-Marketing 

Budget 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 143 
4. 	 Community stakeholders, whose support 

is critical, to provide input on various elements of the program 

Health Department Staff 

Staffing will vary depending on your budget 

and timeline, but you need at least one person 

dedicated to counter-marketing activities. Even 

with a small budget, you must have a skilled 

person to work with the news media, develop 

and distribute materials, and plan tobacco 

control events with community groups. 

If your program has a large budget, you 

should consider several counter-marketing 

staff positions: 

■	 Marketing director—oversees the entire 

counter-marketing program 

■	 Advertising manager—manages the 

work of the ad agency 

■	 Press secretary—handles press relations 

and works with your public relations 

firm 

■	 Manager of community relations and 

local programs—works with stakeholders and health organizations throughout 

your state 

■	 Evaluator—manages evaluation of 

counter-marketing activities 

■	 Financial manager—reviews bills and 

monitors financial aspects of contracts 

Some of these positions, such as the finance 

manager and the evaluator, may be shared 

within the larger tobacco control program or, 

in some states, within the larger chronic disease program. In your program, you may use 

different job titles, but the functions will be the 

same as the positions described here. 

Each key position will need support staff if 

you’re implementing a large program. The 

counter-marketing staff should have experience or credentials in health communication, 

advertising, marketing, journalism, or related 

areas. Experience with other health-related 

campaigns or communication programs in the 

state is also extremely helpful. 

If you’re limited in the number of staff you can 

hire, consider contracting with consultants. 

They can help you to manage separate aspects 

of your program. For example, you may hire an 

advertising expert to help you monitor the 

development and production of ads. 

If the staff is small, typically all of the countermarketing staff members report to the tobacco 

control program manager. If the staff is large 

like the one listed above, the advertising manager, press secretary, and others would report 

to the marketing director, who would report to 

the overall program manager. 

The program manager is responsible for ensuring that the counter-marketing program and 

all other program elements support each other 

and reinforce the larger state tobacco control 

effort. Counter-marketing is one part of a comprehensive tobacco control program, and your 

communication effort must be integrated with 

the overall program. For example, if the state’s 

144 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

tobacco control program focuses on prevention of smoking among youth, the countermarketing effort should focus on messages 

and interventions for youth and secondary 

audiences that influence youth. 

You’ll probably also need to coordinate with 

other health department staff and state government staff, such as the governor’s and the 

health department’s communication teams. 

Appropriate political officials and their staff 

should be kept abreast of your program’s 

initiatives, as well as its opposition. Some of 

these political officials may need to answer for 

the program, so you should be proactive in 

keeping them up to date, especially on newsworthy issues. If they support the tobacco control program, they can be strong allies. Even if 

they don’t support the program, you need to 

keep them updated on what you’re doing and 

why (i.e., how the initiatives contribute to the 

program’s overall goals). “Keeping people in 

the loop can be a constant balancing act,” says 

one state program director. “It is important to 

let people know what is happening with the 

program and to get input on various issues or 

ideas. However, ‘too many cooks’ may turn 

your campaign into a vanilla, politically correct, ineffective one.” 

Finally, your campaign should be coordinated 

with local program activities. Ideally the campaign should complement and reinforce 

programs “on the ground.” Coordinate with 

local tobacco control programs, especially 

media programs. Involve them in planning, 

and let them know when you plan to launch 

various activities. 

Communication Agencies 

Creating a comprehensive counter-marketing 

program requires a variety of specialized skills. 

These skills include selecting, producing, and 

placing ads; working with the media; planning 

large events; and coordinating grassroots 

activities. To create professional-quality communications, you’ll probably need to hire one 

or more communication firms. 

For its national “truth” campaign, the 

American Legacy Foundation works with 

several media firms: two general market ad 

agencies, a PR agency, an events firm, and a 

Web design company, along with agencies that 

focus on specific populations, such as African 

Americans, Asian Americans, Hispanics/ 

Latinos, and Native Americans; the gay, lesbian, 

bisexual, and transgender community; and 

people of low socioeconomic status. However, 

the budget for Legacy’s media campaign is 

higher than the budget for any single state’s 

tobacco control program. A state typically 

couldn’t afford and wouldn’t need the number 

of agencies Legacy hired. The main point is 

that a comprehensive counter-marketing program has many elements, and each one is very 

time consuming and requires the expertise 

that agencies and individuals specializing in 

communications can bring. If your program’s 

budget is moderate to large, you may be able 

to hire agencies or individual consultants in 

several of the categories listed here, but for less 

of their time than the American Legacy 

Foundation would require. 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 145 
Agencies come in all shapes and sizes. Most 

large communication firms offer a range of 

advertising and PR services. These services usually include strategic planning, market research, 

creative development, advertising and materials 

production, media planning, purchasing of 

media time, and tracking media placement. 

Other firms focus on a single area. Some firms 

specialize in advertising only or PR only or in 

advertising for specific audiences (e.g., African 

Americans, Asian Americans, or youth). Some 

firms focus on communication and marketing, 

others specialize in policy or advocacy, and still 

others specialize in planning events. 

There are no hard and fast rules for what type 

of firm to hire. Most states contract with a lead 

ad agency that then subcontracts with agencies specializing in PR, planning events, or 

communication with specific populations. 

California has separate contracts for advertising and PR, so the state can work directly with 

its PR agency when time is limited (e.g., when 

a quick response is needed). If your state has a 

very heated political climate or you anticipate 

frequent attacks from the tobacco industry, 

consider having a separate PR contract. In a 

charged environment, maintaining the right 

dialogue on the public airwaves in a timely 

manner may be one of the most important 

things you do. 

Communication firms usually perform the 

following functions: 

■	 Develop creative approaches to achieve 

your objectives 

■	 Recommend the type(s) of media vehicles for your messages and target audience(s) 

■	 Identify requirements for media placement to reach your target audience(s) 

■	 Arrange opportunities for news coverage 

of your messages, your program, or both 

■	 Organize community-based activities to 

promote your message 

■	 Develop relationships with community 

stakeholders 

Running a media campaign can be intimidating for those with 

public health backgrounds. Don’t be afraid to ask lots of questions. 

Agencies will always be better staffed and move faster than the health 

department, so be prepared to take control and slow down the process 

until you understand all the concepts and are comfortable with 

moving forward. 

—	 Sandi Hammond, Tobacco Control Program 

Massachusetts Department of Public Health 

146 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Although communication agencies bring 

specific expertise and create many of the 

campaign elements, your program staff should 

be closely involved and provide direction to 

the agencies. In general, you should work with 

them to develop the counter-marketing plan, 

then review their work to make sure it meets 

your objectives and stays on course. “Without 

ongoing direction and involvement of program 

staff,” says one state health department manager, “even the best agencies can stray or could 

end up with clever creative [advertising concepts] that has little likelihood of efficacy.” 

Evaluation Companies and 

Consultants 

An evaluation contractor will help you to 

measure your program’s effectiveness. You can 

hire specialists who evaluate public health 

communications, a private company that specializes in marketing and advertising research 

and evaluation, a university-based group that 

is experienced in media evaluation, or a combination of such companies and consultants. 

Duties involved in evaluation include: 

■	 Identifying key measures on the basis of 

your communication objectives 

■	 Determining the baseline, process, 

and outcome information needed to 

measure the impact of your activities 

■	 Preparing an evaluation plan and 

budget for the counter-marketing effort 

■	 Conducting appropriate research 

before, during, and after your program 

is launched 

■	 Developing reports on the research that 

clearly present the data, findings, and 

conclusions 

Don’t wait until the last minute to include the 

evaluation team! Engage evaluators in the 

planning and implementation of the program 

from the beginning. They can help you to 

determine and define your program objectives, which you can measure and report to 

state officials and other stakeholders. Plus, 

they can help to ensure that baseline data are 

gathered before your program is launched, so 

you don’t miss a valuable opportunity to gauge 

the effect of your program. (See Chapter 5: 

Evaluating the Success of Your CounterMarketing Program for more information.) 

Stakeholders, Gatekeepers, and Local 

Programs 

Stakeholders are people and organizations that 

have an interest (stake) in your program’s success. For example, local groups representing 

the African-American community will be 

interested in campaigns that target African 

Americans. Gatekeepers are individuals or 

organizations that can help you to reach target 

audiences with your program messages. Sometimes overlap exists between stakeholders and 

gatekeepers. Local programs are tobacco control efforts that focus on a specific county, city, 

or region of your state. State programs can’t 

and shouldn’t be developed in a vacuum, so it’s 

essential that you address and involve these 

three important audiences from the start. 

Community organizations, voluntary organizations (e.g., the American Cancer Society, the 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 147 
American Lung Association, and the American 

Heart Association), religious institutions, parent groups, businesses, and other groups can 

be instrumental in supporting your program 

and promoting the tobacco control messages. 

Community groups and local programs can 

work on counter-marketing activities by: 

■	 Carrying and publicizing the program 

messages to constituents 

■	 Developing programs that tie directly 

into your messages 

■	 Cosponsoring community programs 

■	 Speaking on behalf of the program 

■	 Supporting local legislation and policies 

that contribute to reducing tobacco use 

■	 Advocating for and protecting the program and its goals 

Counter-marketing programs are often highly 

visible and can be controversial. They can stir 

up negative publicity or comments from constituents in the state. Involving key stakeholders in your program’s development will help 

you to identify controversial issues up front 

and gain the stakeholders’ support. For example, you should solicit input from individuals 

representing targeted communities before, 

during, and after the program is launched (see 

Chapter 4: Reaching Specific Populations for 

more information). 

One of the best ways to involve stakeholders is 

to set up an informal steering or advisory committee for your effort and include key members 

from stakeholder groups, as well as members 

of your target audience. This approach institutionalizes the involvement of stakeholders and 

gives you something concrete to point to as an 

example of your inclusiveness. Have this group 

review plans, concepts, and draft materials. 

Listen carefully to their input. You won’t always 

be able to incorporate everyone’s suggestions, 

but you should understand their perspectives 

and what is most important to them. In many 

states, the media campaign fuels controversy. 

Having stakeholders and members of the 

target audience on board from the beginning 

gives you a source of spokespeople to defend 

the campaign. 

Keep community leaders and local programs 

involved in your program. Everyone likes to be 

involved in a successful program effort. Many 

programs have a newsletter, Web site, or e-mail 

distribution list that keeps stakeholders and 

gatekeepers informed of the program’s 

progress and successes. If you’re reporting 

results that demonstrate progress, such as 

survey results that show your campaign has 

helped reduce smoking, involve the appropriate stakeholders in the announcement of these 

results. If your program receives negative 

press, keep stakeholders and gatekeepers 

informed, so they won’t be surprised or caught 

off guard; seek their help and support when 

needed. For example, if a state’s quitline 

service comes under attack, the state may ask 

a partner who has experience with smoking 

cessation issues, such as the local branch of 

the American Cancer Society or the American 

Lung Association, to comment on the necessity 

and efficacy of the quitline. 

148 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Look for specific opportunities for stakeholders to get involved in your program. For example, you may help a local radio station develop 

a day of radio programming about quitting 

smoking. When a local company goes smokefree, you can help the company get media 

attention for its effort. When there’s an important tobacco control message, such as the 

release of a Surgeon General’s report, create 

press materials independently or augment 

press materials from the Centers for Disease 

Control and Prevention (CDC), so the stakeholders can use them to help you publicize the 

information. Invite stakeholders to participate 

in community events, award ceremonies, and 

other campaign-related events. Stakeholders 

can advance policy issues and legislation related to tobacco control, a role not normally 

available for state staff. Supportive media gatekeepers can work with you or your agencies to 

develop special programming, newspaper 

inserts, or community events with media 

tie-ins. 

Your communication agencies may think that 

working with stakeholders is a burden, 

because many of them are used to working 

with commercial clients who have few stakeholders. Although agencies often focus on 

expediency, it’s important for you to explain 

the value of working with stakeholders and to 

specifically outline to your agency how stakeholders will be involved. 

Steps for Selecting an Agency 

To hire an agency, you need to: 

■	 Outline the specific work you want 

the contractor to do. Don’t be too 

prescriptive in the request for proposals (RFP), but do be clear about 

the overall goal(s) and the campaign’s 

specific objectives. Allow the agencies 

to respond creatively. 

■	 Issue an RFP for the work. 

■	 Organize a group of knowledgeable 

reviewers from within and outside 

your organization. 

■	 Eliminate proposals that don’t meet 

the technical requirements specified 

in the RFP (e.g., deadline and format). 

■	 Work with your review group to 
 

evaluate the proposals.
 

■	 Compare cost proposals. 

■	 Invite and observe presentations
 

from finalists.
 

■	 Check finalists’ references. 

■	 Select the firm that appears to be the 

most capable and to offer the most 

value for its fees. 

■	 Inform other agencies that they didn’t 

win the contract. 

■	 Sign a contract. 

■	 Begin briefing meetings with the
 

agency.
 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 149 
Selecting Contractors 

Once you determine the configuration of the counter-marketing team, 

you’ll start the formal process of 

hiring contractors. This section provides you with guidelines for this 

process. (See Chapter 7: Advertising 

and Chapter 8: Public Relations for 

more information about working 

with contractors.) 

Beginning to work with a contractor 

is like beginning any relationship. 

Relationships require trust, respect, and an 

understanding of each participant’s strengths 

and weaknesses. In this relationship, you bring 

to the table your technical expertise on content, your political acuity, and your understanding of the sometimes complex government approval process. The communication 

firms offer creative approaches to the message, 

expertise in how to develop effective communication pieces, and knowledge of the media 

needed to reach your audience(s). The evaluation contractor provides the technical knowhow to assess how successful your messages 

and initiatives have been in reaching the target 

audiences and what the effects of those interventions have been. 

The focus here is on communication and evaluation firms, but the advice can apply to hiring 

any private company. 

Before the Bidding Process 

Don’t rush into issuing an RFP. Take some time to: 

■	 Learn what your budget can buy in 

your state. Media and production costs 

vary in each state. Find out what it 

should cost to reach your audience(s) in 

your state. One approach is to talk to the 

manager of another state-funded media 

campaign in your state (e.g., the lottery 

or tourism). Your state may have a commercial campaign you can examine, too. 

You should also look at other states’ 

tobacco counter-marketing efforts to see 

what they received for the money they 

spent. Find out what they spent per 

capita and in total, so you can make an 

accurate comparison with what you 

plan to spend. 

■	 Look at what has been done by other 

programs in your state. Learn how 

other state programs selected an agency; 

again, the lottery and tourism programs 

may be a good place to start. State 

media campaigns can be valuable 

sources of government information, 

advice, and insights into your state’s 

approval process. 

■	 Explore approaches used in other states. 

Examine RFPs for media contractors in 

150 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

other states and the contracts awarded. 

The State Information Forum, a Web site 

operated by CDC’s Office on Smoking 

and Health, is a source of information, 

resources, and other materials for state 

tobacco control programs. Many state 

RFPs are available online on the State 

Infor-mation Forum, at 

http://.ntcp.forum.cdc.gov. This Web 

site is password protected, so you’ll 

need to contact CDC/OSH’s Health 

Communications Branch to gain 

access if you’re not a current user. 

■	 Learn the ins and outs of your state’s 

contracting rules. Find someone in 

your state financial or contracting office 

to guide you through the state’s contracting procedures and to help you 

develop language for an RFP. A good 

way to start is by reviewing media RFPs 

from other organizations in your state. 

(See Appendix 6.1: Key Elements of a 

Request for Proposals for a Media 

Campaign for a description of common 

items included in many state tobacco 

control program RFPs.) Make sure that 

you understand the RFP and that your 

contracting office has reviewed the 

process for your RFP. You should be 

comfortable with the wording of the 

RFP and the deliverables it describes. 

Decide whether to ask for “speculative 

creative” (sample materials that a firm 

provides before a contract is awarded) 

as part of the proposal. If you make this 

request, you must include language in 

the RFP indicating that the state retains 

ownership of any creative materials 

presented during the bidding process. 

This language will protect you from legal 

action by a firm that isn’t awarded the 

contract and may have presented creative similar to that of the winning firm. 

■	 Decide on the configuration of firms 

for your program. Do you want one 

all-purpose agency that can give you a 

range of communication services or a 

set of specialized firms that work together as a team? Do you have the staff to 

oversee contracts with more than one 

firm, such as separate advertising and 

PR companies? 

■	 Avoid firms that work with tobacco 

companies. Just as Coca-Cola doesn’t 

hire firms that work for Pepsi, you 

shouldn’t hire firms that work for the 

competition. This recommendation has 

become more complicated with the 

recent trend toward acquisitions and 

mergers. Many agencies that don’t work 

with the tobacco industry have been 

bought by conglomerates that may own 

other firms with tobacco accounts. At a 

minimum, the agency you hire should 

have no direct connections with the 

tobacco industry or its affiliates (e.g., 

Kraft, which is owned by Altria, formerly 

called Philip Morris). You’ll have to consider the advantages and disadvantages 

of hiring a firm that does no tobacco 

work but has sister agencies that do. 

Adweek, an advertising industry publication, publishes a directory of ad firms 

that lists their clients and affiliation with 

advertising conglomerates and holding 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 151 
companies. You should require that all 

bidding agencies disclose any connection, direct or indirect, with the tobacco 

industry or its partner companies, so 

you can consider that information in 

selecting an agency. If an agency you 

may want to use has such a connection, 

ask the bidder to submit a plan for providing a fire wall between your program 

and any potential conflicts of interest. 

■ Recruit a diverse review committee. 

The members of your review committee 

should have a wide range of expertise 

and backgrounds, including experience 

with health issues and the communication techniques you plan to use in your 

program (e.g., advertising, public relations, and media advocacy). Check your 

state’s restrictions about using out-ofstate reviewers. 

During the Bidding Process 

Most contracting rules limit your ability to 

com-municate directly with firms bidding on 

your proposal. Nonetheless, the review process 

gives you opportunities to learn about the firms. 

As you review proposals and listen to bids from 

each firm, keep these questions in mind: 

■	 How strategic and thoughtful are the 

decisions the firm makes and the work it 

produces? 

■	 How creative is the firm? 

■	 Does the firm describe how it would 

approach the subject of tobacco, and, if 

so, do you like what you hear? 

■	 Does the firm have experience working 

with community groups? 

■	 Does the firm have experience with your 

target audience(s)? 

■	 Does the firm have experience with 

tobacco control, social marketing, or 

other health-related work? If not, you 

don’t necessarily have to rule it out; it 

would be much easier for you to teach 

the firm’s staff about tobacco control 

than to teach them about developing 

and placing ads! 

■	 Do the firm’s references and samples 

give you insights into the quality of the 

work and skills of the staff assigned to 

your account? 

■	 Does the firm have a track record of 

developing campaigns that have generated measurable results? Ask for examples. 

■	 Has the firm bought media in every 

market in your state? Does it have experience in evaluating and buying a wide 

variety of media? 

■	 Is the team proposed by the firm a mix 

of senior, midlevel, and junior staff? 

■	 What is the experience of the primary 

staff to be assigned to your account? 

■	 Are support staff in specific functional 

areas (e.g., market research or media 

buying) assigned to work on your project for a sufficient percentage of their 

time? 

152 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■ 	 Do you think you can work comfortably 

with the staff proposed for the project?	 

■	 Does the firm have the number of staff 

and appropriate facilities to do the work? 

■	 Do staff of the firm have experience in 

negotiating for bonus airings or add-ons 

as part of a media buy? 

(For more information on the RFP process, see 

Appendix 6.1: Key Elements of a Request for 

Proposals for a Media Campaign and Appendix 

6.2: Questions and Answers on RFPs.) 

Once You’ve Selected a Firm 

Develop a team relationship with the firm that 

is awarded the contract. Work closely with the 

staff as individuals, and get to know them. 

Avoid thinking of them as the “suppliers” who 

simply deliver the goods to you; instead, think 

of them as an extension of your staff or as your 

equal partners. The better the relationship, the 

easier it will be to work through issues on 

which you may not agree. 

Teach the agency what it needs to know about 

effective tobacco counter-marketing messages. 

There’s a wealth of television, radio, outdoor, 

and print materials on tobacco control. 

Sharing those materials with them may help to 

inspire creative ideas or identify materials 

from other states that can be reapplied or 

adapted for use in your state. Although most 

agencies prefer to create original ads tailored 

specifically for the state, many states have 

combined new ads with available ads proven 

effective in other states. Ask the firm’s staff to 

become familiar with the advertising materials 

Tips for Selecting an Agency to Reach Specific Populations 

If you decide to hire a firm to reach specific populations, choose one that offers: 

■	 Experience in working on communication campaigns 

■	 Examples of past communication work that an independent evaluation has shown to be 


successful 


■	 References from clients for whom the firm has done similar work 

■	 Adequate staff and facilities to do the work 

■	 Experience in developing effective, culturally appropriate material 

■	 Strong ties to the community 

Don’t pick a firm simply because its staff includes members of a specific population; choose a firm 

because of the merits of its work. At the same time, recognize the role that members of a specific 

population can play in a firm’s ability to be culturally competent and culturally appropriate. 

(See Chapter 4: Reaching Specific Populations for more information.) 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 153 
Tips for Selecting an Evaluation Contractor 

Choose an evaluation contractor that demonstrates: 

■	 Experience in evaluating tobacco control programs, health communication campaigns, or both 

■	 Ability to work with a wide variety of stakeholders, including representatives of populations 

affected most by tobacco use 

■	 Innovative approaches to evaluation, coupled with consideration of budget limitations and 

other program realities 

■	 Skills that complement those of the in-house evaluation team and that increase the evaluation 

capacity of that team 

■	 Regular sharing of raw data, preliminary results, and full findings with the program staff 

■	 Cultural competency in conducting evaluations among various racial and ethnic groups 

■	 Expertise you need and can afford 

Hire your evaluation staff early in the process and involve them from the start. Don’t wait until the campaign is about to be launched. The evaluation of your efforts must be seen as independent and objective, so 

it’s important to hire a separate evaluation firm, instead of having your ad agency subcontract with one. 

in CDC’s Media Campaign Resource Center 

(MCRC), available online at 

http://www.cdc.gov/tobacco/mcrc. The MCRC 

Web site offers an online database of materials 

the communication firm can review. In addition, involving the agency’s staff in strategic 

planning meetings, focus groups, community 

meetings, and other activities will help them to 

develop an in-depth understanding of the 

important issues. You should establish a clear 

process for review and approval. Mistakes can 

be costly to fix. Pay careful attention to the 

visuals and words in all communication 

pieces, the results of market research, and the 

internal and external comments about the ads. 

Restrain yourself from becoming the creative 

director. You pay the firm to fill that role. Avoid 

giving prescriptive instructions about what to 

change. For example, don’t make detailed suggestions about a proposed ad, by saying to the 

firm: “If you could just make this woman who 

stopped smoking look happier, and maybe you 

could have her whole family standing around 

her looking happy, too, and...” A better 

approach is to offer the agency feedback about 

what you’d like to change conceptually, and let 

their staff explore the specific creative alternatives. When you comment about the work the 

firm submits, focus on goals. For example, tell 

the agency: “The goal would be to make this 

154 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

ad focus more on the positives of quitting 

smoking, instead of the negatives of previous 

failed attempts.” 

Developing an Annual 

Marketing Plan 

Once you’ve assembled your program staff, 

hired contractors, and gone through the 

planning process (see Chapter 2: Planning 

Your Counter-Marketing Program for more 

information on planning process), you’ll 

need to develop a marketing plan. This plan 

will be the blueprint for implementing your 

counter-marketing tasks and activities. It 

should list the specific tasks, staff, time frame, 

and budget needs for each objective developed during the planning phase. The plan 

should encompass all the components you’re 

using (e.g., advertising, PR, media advocacy, 

grassroots initiatives, and media literacy activities), and its timeline should allow sufficient 

time for technical review and approval. This 

marketing plan can be used to monitor program activities, and you may need to update it 

as you conduct the process evaluation 

throughout the year. (See Appendix 2.1: 

Counter-Marketing Planning Worksheet for 

guidance in developing a marketing plan.) 

You may be tempted to skip the development 

of a marketing plan, but doing so will cause 

you to be reactive instead of proactive in working with your communication agencies, your 

target audience(s), and your management. 

This plan is an important tool for keeping 

everyone focused on how your goals will be 

accomplished. By developing a marketing 

plan, you’ll ensure that your agency doesn’t 

lead the campaign in a direction different from 

the one you intended. Providing a yearly marketing plan will also help the agency to know 

what to expect well in advance, so the staff can 

manage your account effectively. 

Reviewing Marketing Materials 

One of the key functions of the program staff 

will be to review the marketing materials created by the communication firm(s). You’ll be 

responsible for reviewing these materials in 

three key areas: strategy, accuracy of technical 

content, and cultural appropriateness. 

Keeping Materials on Strategy 

Ad agencies pride themselves on their creativity because creative ads get noticed, are entertaining, and can influence behavior. But just 

because an ad is entertaining doesn’t mean it’s 

on strategy. For each key marketing piece, you 

and your agency should develop a creative 

brief. Use this creative brief to review each ad 

or communication piece to ensure that it’s on 

target. 

Ensuring Accurate Technical Content 

Communication materials have to be on strategy, but they also have to be accurate. Any factual errors will undermine the credibility of your 

efforts and make your program vulnerable to 

criticism. Here are some ways to keep your 

communication work consistently accurate: 

■	 Provide your agency with the most 

current tobacco-related data, and keep 

agency staff informed by promptly 

forwarding new data to them. 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 155 
What Is a Creative Brief? 

For almost any work with a communication agency, you’ll need a creative brief (communication brief). This document spells out: 

■	 The specific assignment—the product the agency is being asked to develop 

■	 The goal of the communication piece(s) 

■	 The main message(s) 

■	 Demographic, psychographic, and other information about the audience 

■	 Key insights about the audience that should be considered during development of
 

the communication piece(s)
 

■	 The audience’s perceived barriers to the desired behavior change 

■	 Benefits the audience might receive from the behavior change 

■	 Actions you want the target audience to take 

The creative brief is typically drafted by the agency account team, but the health department 

staff can initiate it or provide input to it. It gives the agency creative team the basic message 

for each creative product and clarifies what the agency is being asked to do. Once the product is completed, everyone involved can refer to the creative brief to make sure the product 

meets the criteria in the brief. (See Appendix 6.3: Elements of a Creative Brief and 

Appendices 6.4, 6.5, and 6.6 for sample creative briefs.) 

■	 Require the firm to provide documentation for all statements, facts, and figures 

that appear in the materials and ads it 

presents, even if you provided the original data. Always use the original source 

to substantiate data. Quotes from newspaper reports about study results may 

not accurately reflect the true findings. 

■	 

asked to back up the information in ads, 

sometimes months or even years after 

the ads were placed or aired. 

Maintain an easily accessible file of the 

ad scripts and corresponding substantiation. Program managers are often 

■	 Identify technical experts within your 

department who can sign off on the 

technical content in ads and other 

communication materials. 

■	 Develop a review and approval process 

that includes all of the key decision 

makers but doesn’t delay ad production 

longer than necessary. 

156 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Producing Culturally Appropriate 

Materials 

Communication materials must be culturally 

appropriate for your target audience(s). A critical step is to share the draft materials with 

members of the target audience early in the 

development process and before work on the 

materials is completed. You should also assess 

how the materials will be received by the larger 

community. For example, some ads designed 

for rebellious youth may be considered irreverent and disrespectful by adults. The state may 

still decide to use the ads but may choose to 

tightly control media placement to limit the 

number of adults exposed to them. 

If stakeholders and members of your target 

community are on an advisory or steering 

committee for your program, you may be able 

to use their input to assess the cultural appropriateness of your materials. To help assess 

their impact on the larger community, especially if you think your messages may offend 

certain groups, you may need to be proactive 

in meeting with the community to explain the 

materials and your approach. This move will 

help to defuse potential criticism of your 

campaign and build relationships with stakeholders. For example, with its “Making Blacks 

History” campaign, the American Legacy 

Foundation met with the NAACP (National 

Association for the Advancement of Colored 

People), the National Urban League, the 

National Black Nurses Association, and other 

groups to explain the strategy of the campaign 

and get their reaction. By sharing these ads 

before they hit the airwaves, Legacy was 

reassured that the ads wouldn’t be controversial because of the “Making Blacks History” 

phrase. (See Chapter 4: Reaching Specific 

Populations for more information on designing culturally appropriate materials.) 

Monitoring the Counter-Marketing 

Budget 

Managing the fiscal component of a program 

can be intimidating. Most people hired to 

manage public health communication campaigns aren’t financial managers and don’t 

have much experience with media buying, 

production costs, talent fees, and the range of 

expenses related to communication programs. 

These tips can help you to develop a realistic 

budget: 

■	 According to CDC’s Best Practices for 

Comprehensive Tobacco Control 

Programs, published in 1999, state 

tobacco control programs should 

allocate $1 to $3 per capita per year to 

counter-marketing programs. Although 

this amount is the minimum goal for 

most states, few states have been able to 

maintain this level of funding. 

■	 Look at budgets for other statewide 

efforts, such as lottery campaigns, travel 

and tourism, or promotion of agricultural products (e.g., citrus fruit in Florida). 

These programs can give you ballpark 

estimates on costs for media campaigns. 

■	 Find out what other states have spent 

on tobacco counter-marketing programs and determine whether any of 

the states have per capita and total 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 157 
budgets similar to yours. Learn how 

those funds were allocated, and ask the 

program managers what they would do 

differently if they could spend the funds 

again. 

■	 Consider hiring a compensation consultant to help you negotiate your agencies’ budgets. This consultant can help 

you to determine the appropriate profit 

margin for the agency and assist you in 

understanding how agencies bill for 

their work. 

■	 Determine the amount(s) you can afford 

to spend and the best approach for allocating funds in your particular budget. If 

your budget is small, you may consider a 

greater mix of PR, media advocacy, 

media literacy, and grassroots communications rather than a paid media 

campaign. You can conduct innovative 

and effective media efforts without 

expensive ads. 

■	 Conduct a media audit of your advertising media buys to ensure that you’re 

getting your money’s worth. If you have 

limited resources, you may want to 

conduct a partial audit, from a specific 

ad flight, to get a snapshot of the quality 

of your media buy. Because much of 

your budget may go to paid media, you 

need to ensure that the funds are spent 

appropriately. 

Variables that affect a communication budget 

include the following: 

■	 Cost of buying media in your state 

■	 Amount and level of ad production (e.g., 

number of ads produced or reapplied 

and complexity of ads produced) 

■	 Number and choice of media outlets 

■	 Intensity and duration of campaign 

■	 Use of existing versus original advertising 

■	 Single focus versus multiple focuses 

(e.g., number of overall goals and 

number of target audiences) 

■	 Number of events and activities (e.g., PR, 

grassroots and media advocacy) 

■	 Communication in English only, other 

language, or both 

Here are some rules of thumb for managing 

the budget of a counter-marketing program: 

■	 Regardless of the size of the budget, 

remember that you’re spending taxpayers’ money. Be sure that your spending 

decisions are well informed and that 

every initiative is focused on the program’s goals and objectives. Select initiatives that are most likely to contribute 

to your program’s progress in a costeffective way. 

158 Chapter 6: Managing and Implementing Your Counter-Marketing Program 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Obtain estimates, so you know how 

much a project will cost before you start. 

■	 Approve all costs before any work begins 

and money is spent. 

■	 Review monthly expenditures carefully. 

Track expenses for each product, as 

well as the overall counter-marketing 

budget. A number of financial tracking 

systems are available to help you monitor expenses and project monthly 

expenditures. You may want to ask 

managers of other state campaigns (e.g., 

the lottery or tourism) about the procedures and tracking systems they use. 

■	 If any products must be changed, tell 

staff and consultants that you must discuss and approve any additional costs in 

advance. 

■	 Hold monthly budget meetings with 

contractors and staff to keep your 

expenses on track. 

■	 Include evaluation costs in the overall 

campaign budget, unless they are 

included in another part of the tobacco 

control budget. 

■	 Buy the rights to creative materials (e.g., 

photos and ads), whenever possible, so 

they can be reused by you or others. 

■	 Ask questions at each step to better 

understand what you’re buying and 

what your options are. Keep asking 

questions until you understand all 

aspects of media production and 

placement. 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 159 
160 Chapter 6: Managing and Implementing Your Counter-Marketing Program 

Points To Remember 

■	 Don’t skip the development of the marketing plan. Creating this blueprint will force you and your 

contractors to outline the specific tasks needed to reach your goals and objectives and to have all 

key decision makers agree. It will be a valuable tool in tracking your progress and monitoring the 

performance of your team and contractors. An approved marketing plan will also help you to stay 

on track when outside groups try to influence the direction of your program. 

■	 Track every penny spent. You should be able to report to government officials and other funders 

what your specific activities cost and what you delivered for those costs. Closely monitoring the 

budget will help you to determine which activities were cost-effective and which were not. It will 

also provide you with benchmark costs for your program in future years. 

■	 Never let anything go out the door without reviewing it. Because of the multiple reviews during the 

development process, you may be tempted to simply scan a product before it’s finalized, but make 

sure you give it one last, thorough review. You need to be certain that the material is on strategy, has 

no technical errors, is culturally competent, and reflects the program’s position. Determine your review process up front for each type of product (e.g., ads and press releases), and follow it to the letter. 

■	 Make stakeholders and local programs your partners. Involving stakeholders in the development of 

your campaign is vital. This move will develop strong relationships with stakeholders, will build 

support for your program, and may help you to identify potential criticisms of your program and be 

prepared to address them proactively. On the other hand, don’t feel that you have to incorporate 

every comment by every stakeholder. Consider all comments and feedback, but keep your campaign on target. 

■	 Keep your eye on your goal at all times. Implementing an integrated, multifaceted program isn’t 

easy. You may be getting input from the governor’s staff, stakeholders, various contractors, and your 

own staff. There’s a lot to consider and sort through, but no matter how exciting an ad or activity 

may seem or how much a key person or group pushes for something, if it doesn’t support your 

overall goal, don’t pursue it. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Bibliography 

Bjornson W, Moore JM. Designing an effective counteradvertising campaign—Oregon. Cancer 1998;83 

(12 Suppl):2752–4. 

Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs— 

August 1999. Atlanta, GA: CDC, National Center for Chronic Disease Prevention and Health Promotion, Office 

on Smoking and Health, 1999. 

Miller A. Designing an effective counteradvertising campaign—Massachusetts. Cancer 1998;83 

(12 Suppl):2742–5. 

Reister T, Linton M. Designing an effective counteradvertising campaign—Arizona. Cancer 1998;83 

(12 Suppl):2746–51. 

Stevens C. Designing an effective counteradvertising campaign—California. Cancer 1998;83 

(12 Suppl):2736–41. 

Chapter 6: Managing and Implementing Your Counter-Marketing Program 161 
162 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 7 

Advertising
 

The (advertising) campaign is a tool to frame the debate. 

It can introduce an issue and create ‘noise.’ This not only 

sparks dialogue but can itself become the environment. 

— Anne Miller, Arnold Worldwide 

Massachusetts Tobacco Control Program 

Advertising is a way to speak to your audience. It’s a communication tactic. 

For example, if you want people who use tobacco to quit, you need to give 

them a reason to do—so, something in exchange for giving up their perceived 

benefits of smoking—the nicotine high or the feeling of independence. 

Advertising is one way to present, in a clear and persuasive manner, the 

benefits of quitting tobacco use. 

If you think of a tobacco counter-marketing campaign as a conversation, 

advertising, like public relations, is about how you do the talking. In public 

relations, the message is delivered through an intermediary, such as the press. 

In advertising, the message is delivered directly to a mass audience. With 

public relations, the message may change, depending on who relays it. In 

advertising, the audience is exposed repeatedly to the same ad. In public 

relations, you gain the credibility of an intermediary, but you give up a lot of 

control. In advertising, you don’t benefit from an intermediary’s credibility, 

but you can more tightly craft the tone and content of your message, as well 

as when, where, and how often people hear it. You pay a premium for this 

control, however, when you produce an ad or make a media buy. 

Effective advertising can increase knowledge, correct myths, change attitudes, 

and even help to influence behavior. For example, Florida launched a major 

teen-oriented mass media campaign aimed at revealing the manipulative 

In This Chapter
 

• Logistics: Hiring 

and Managing 

Advertising 

Contractors 

• Strategy: Developing 

Effective Messages 

• Creative: Breaking 

Through the Clutter 

• Exposure: Show the 

Message Enough for 

It to Sink In 

• Choosing a Media 

Approach: Paid 

Media, Public 

Service Announcements, and Earned 

Media 

• Evaluating 

Advertising Efforts 

Chapter 7: Advertising 163 
What Advertising Can and Can’t Do 

Can 

■	 Communicate a message 

■	 Reach many people 

■	 Change attitudes 

■	 Create an image for the campaign 

and deceptive tactics of the tobacco industry. 

After six months, more teens felt strongly that 

the tobacco industry wanted them to begin 

smoking to replace dying smokers. A year into 

the campaign, tobacco use by middle school 

and high school students in the state declined 

considerably, in part because advertising had 

changed their attitudes about cigarettes and 

tobacco companies. 

For advertising to work, however, it must meet 

the following minimal criteria: 

■	 Offer members of the target audience a 

benefit they value, thus influencing 

them to change their beliefs, attitudes, 

and behaviors 

■	 Reach the target audience enough times 

that the message is understood and 

internalized 

■	 Engage audience members in a way that 

they can understand and that makes 

them feel understood 

Although most effective advertising is created 

by advertising agencies—firms that specialize 

Can’t 

■	 Substitute for strategy 

■	 Present complicated information 

■	 Provide feedback 

■	 Provide services 

in analyzing audiences and finding creative 

ways to reach them—the counter-marketing 

program manager doesn’t simply pay the bills 

and sign off on what the agency does. As with 

any program approach, the manager must 

ensure that the ads are more than just entertaining or informative. The program manager 

must make sure that the ads further the program’s overall objectives and that the three 

minimal criteria are met. Furthermore, the 

manager must make sure these efforts are 

accomplished within a set budget and time 

frame. This chapter takes you step by step 

through the four key aspects of managing a 

successful advertising campaign: logistics, 

strategy, creative (advertising concepts), and 

exposure. 

Logistics: Hiring and Managing 

Advertising Contractors 

Campaigns that rely solely on public service 

announcements are unlikely to reach a target 

audience with sufficient regularity to make an 

impact because they air during time slots 

donated by the TV or radio stations, so most 

states hire contractors to create new advertising, 

164 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

to buy the media needed to place the ads, or to 

perform both tasks. Some state tobacco control 

programs with limited emphasis on paid advertising may not need to hire an ad agency, social 

marketing firm, or media buyer, but states that 

plan to make advertising a significant part of 

their overall tobacco control program probably 

do. Even states planning to use creative materials produced by others will need to make a 

media buy, and they’re likely to get a better 

price and more effective placements if they hire 

professionals to do the buying. 

Once a contractor is hired, the challenges are 

far from over. A counter-marketing manager 

and the creative agency should set up guidelines for everything from schedules for payment to the process for approving creative 

materials. Then, during the day-to-day 

management of the campaign, the countermarketing manager and the agency must balance the agency’s need for creative freedom 

with the marketing manager’s need for 

strategic control. It’s no easy task. 

Selecting Marketing Contractors 

Hiring an agency, media buyer, or social 

marketing firm is often the first challenge a 

counter-marketing manager must face. The 

typical first step is writing a request for proposals (RFP) or a similar document. The rules 

about writing RFPs vary by state, but one 

simple way to start is to look at what others 

have done. People who write RFPs usually 

review previous RFPs for government-run 

marketing campaigns in their state (e.g., a 

lottery or tourism effort) and for countermarketing campaigns in other states. (See the 

State Information Forum Web site of the 

Centers for Disease Control and Prevention at 

http://ntcp.forum.cdc.gov for sample RFPs.) 

Take the language that is most relevant to the 

challenges you face, and refine it to fit your situation. The RFP should provide potential bidders with specific objectives, a description of 

the behavior you want to change, a list that 

ranks the target audiences, and a statement of 

your potential budget. 

Most counter-marketing programs use selection committees to choose firms for creative 

services. A state agency can be protected from 

the appearance of favoritism by asking a 

multidisciplinary group of highly respected 

experts to make a recommendation or to 

select the marketing contractor on the basis of 

a thorough review of the proposals submitted 

and oral presentations. This approach also 

adds a degree of buy-in from the committee 

members and brings needed expertise to the 

decision-making process. There’s no perfect 

recipe for a selection committee, but most 

states include marketing and advertising 

experts, grassroots tobacco control activists, 

policy makers, health professionals, an evaluation expert, and representatives from the 

organization managing the campaign. (See 

Chapter 6: Managing and Implementing Your 

Counter-Marketing Program for more information on the RFP process.) 

Ultimately, the process should help ensure 

hiring of a firm that can understand your target audience, be responsive to your program’s 

Chapter 7: Advertising 165 
166 Chapter 7: Advertising 

needs, offer breakthrough creative ideas, 

maximize exposure to the message, and be 

accountable for its use of government funds. 

Try to stay focused on these goals throughout 

the selection process. Firms that provide creative services are in the business of making 

things appealing. Part of your job is to make 

sure that an advertising approach—no matter 

how funny or interesting it may be—offers a 

logical, research-based strategy that fits within 

the approach of your overall program. 

Ask three key questions about firms making 

a pitch: 

1. 	 Are they strategic? Do they have a clear 

idea about how their plan will help to 

encourage changes in attitudes and 

behaviors, not just build awareness or 

interest people in the topic? Do their 

examples of previous work reflect sound 

strategic thinking and positive, databased outcomes? 

2.	 Are they capable? Do they and their 

partners have the ability to produce 

breakthrough, memorable ads that can 

help to change beliefs and attitudes and 

to encourage changes in behavior? Can 

they manage the media buys you might 

want? Can they handle the financial 

responsibilities required by the state? Do 

they have sufficient staff to service your 

needs? 

3. 	 Are they listening to you, to the audience, to the research? Will they be 

responsive and incorporate data and 

expert perspectives into their plans? 

Creative Media 

Production Account 

Planning 

Client 

Account 

Services* 

Billing 

* Most of your interactions will be with Account Services; they will facilitate your interactions with the other 

core service areas. 

Typical Ad Agency Team 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Managing a Marketing Contractor 

To manage an advertising agency, it’s helpful to 

understand how agencies make money and 

how they handle the work you request. Most 

ad agencies offer these core services: 

■	 Account service (also known as client 

service). All ad agencies have specialists 

who are responsible for responding to 

your needs and managing the work the 

agency is doing for you. The account 

service staff are your day-to-day link to 

the agency. 

■	 Creative. An agency’s creative services 

staff develop a range of advertising 

products, from TV spots to logos to billboards. Advertising concepts, typically 

called “creative,” are developed by a 

copywriter and an art director. The staff, 

called “creatives,” work on many 

accounts and are assigned to your projects by the account staff, as needed. 

■	 Account planning. Most ad agencies 

have in-house experts who conduct and 

analyze market research, then help to 

develop an overall strategy. Account 

planners are experts on the consumer, 

and they provide the creatives with 

insights to help in development of 

advertising ideas. Some agencies do not 

have an account planning department, 

but have a market research department 

that focuses on conducting and analyzing research. 

■	 Media. Agencies can buy media time or 

space for you, either in-house or through 

a subcontract with a media buyer. They 

keep abreast of current rates and negotiate for TV and radio time, newspaper 

and magazine space, outdoor advertising, and other opportunities to place 

your message before the audience. They 

offer expertise in finding cost-effective 

ways to reach specific audiences by 

selecting the best places to run your 

advertising and negotiating the best 

rates for these media placements. Some 

agencies hire another firm that specializes in media buying to handle this work. 

■	 Production. Agencies often have inhouse staff who produce materials, 

manage outside vendors, and help them 

to produce broadcast spots and other 

advertising. 

When you contract directly with an ad agency, 

you hire a firm whose core business is to create 

and disseminate advertising products, typically print ads, billboards, and broadcast spots, 

based on a strategy the agency develops or 

helps to develop. The agency makes money by 

charging for creating the product, buying the 

media time, or both. Most agencies are paid 

through one or more of the following arrangements: 

■	 Commission. A percentage of the media 

buy and, in some cases, production costs 

■	 Project fee. A straight fee paid for a 

specific set of deliverables (Partial payments may be made as deliverables are 

completed.) 

Chapter 7: Advertising 167 
■	 Retainer. A fee, typically paid monthly, 

for a specified scope of work (Sometimes 

there’s a guaranteed retainer and the 

possibility of additional charges based 

on the workload for a particular month.) 

■	 Time and materials. A payment system 

consisting of an hourly rate for labor; a 

number by which the hourly rates are 

multiplied (“multiplier”) to underwrite 

overhead; and direct reimbursement of 

other expenses (e.g., production costs 

and the media buy) 

■	 Performance based. Compensation 

related to outcomes (For example, a 

portion of the payment may be based 

on the level of confirmed audience 

awareness of the advertising.) 

The government rarely compensates agencies 

on the basis of results. However, such compensation is becoming more common in the private 

sector and some states are using performancebased compensation for tobacco control 

efforts. Florida, for example, hired a compensation consultant to help link the ad agency’s 

multiplier to awareness, attitude, and behavior 

measures selected by the state’s Tobacco Pilot 

Program. In Florida, Minnesota, and other 

states, the agencies have been guaranteed a 

base multiplier and growth of the multiplier 

that is contingent on achievement of certain 

targets. 

to applicable state policies. Whatever your 

state’s policy is, the best approach is to create 

an arrangement that allows the agency to make 

a reasonable profit by creating and placing 

strategically sound, memorable, insightful 

communication products for your target 

audience. The ad firm should be rewarded in 

particular for contributing to desired changes 

in the audience’s awareness, knowledge, 

attitudes, intentions, and behaviors. 

Responses to the RFP often recommend the 

reimbursement arrangement as part of a cost 

proposal. In some states, an ad agency is 

selected and then the arrangement for reimbursement is negotiated from scratch, according 

A good marketing manager should support 

the agency in ways that will help its creative 

staff develop the most effective communication products possible, while maintaining 

appropriate financial and creative control. 

How can you do that? 

■	 Establish guidelines early. 

■	 Designate a primary contact. 

■	 Trust the creative expertise you hire. 

■	 Tap expertise, not just opinions. 

■	 Protect the agency from politics. 

■	 Agree to brief, written copy strategies. 

Establish guidelines early. If both the program 

manager and the ad agency know what to 

expect, management is always easier. States 

have established all types of guidelines to 

ensure that expectations are clear. Two of the 

most important guidelines relate to approval of 

creative materials and media buys. You should 

decide with the contractor how long these approvals will take, who will be involved, and how 

revisions will be handled. Make these decisions 

in advance of the first recommendations from 

168 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

the ad agency, not as the ad development 

process takes place. Then you need to hold up 

your end of the bargain: Don’t promise five-day 

approvals if you can’t deliver. Also, you should 

think in terms of the entire process. If you plan 

to require pretesting, schedule it. In addition, 

consider developing guidelines for media buying and billing. Media-buying guidelines set 

rules for what types of media and what kind of 

exposure the firm should buy. Billing guidelines 

create deadlines and other restrictions for 

prompt and accurate billing and payment. You 

also may want to consider placing limits on the 

agency’s scope of work. For example, you may 

want to restrict a firm hired at the state level 

from soliciting additional tobacco control business—and more money—from your partners 

at the local level. 

Designate a primary contact. Just as an ad 

agency assigns specific account staff to your 

program, the state must assign a primary 

contact for the agency. This person should 

coordinate everything the ad agency is asked 

to do, so the agency isn’t pulled in several 

directions at once. This state staff person 

should have the ability to make decisions and 

represent the needs of the overall program. 

Trust the creative expertise you hire. 

Outstanding advertising is rarely the result 

of endless tinkering or a lengthy approval 

process. Instead, it results from strong strategic 

planning that uses audience insights, creativity, 

and judgment. Once a creative agency is carefully selected and hired, marketing managers 

need to place some trust in the agency. If an 

agency is hired for its ability to connect with 

“hip” teens, for example, a middle-aged health 

department official probably shouldn’t question the choice of colors for a youth-targeted 

flier. On the other hand, don’t hesitate to question whether an ad concept will be understood, 

will be perceived as relevant, will seem credible, or is consistent with your program’s goals. 

These are questions you may want to test with 

audience research. Using qualitative research, 

you can expose your target audience to a concept and analyze their reaction. (See Chapter 

3: Gaining and Using Target Audience Insights 

for more information on performing qualitative research.) 

Tap expertise, not just opinions. Your advertising doesn’t need to work for everyone 

reviewing the ad; it needs to work only for the 

target audience. As you share a product with 

your peers and superiors, try to tap their 

expertise, not their taste. For example, ask the 

disease expert if the disease references are 

accurate, not whether he or she “liked” the ad. 

Consider allowing as many final decisions as 

possible to be made by the marketing manager, 

not a more senior political appointee. Some 

states have allowed a properly tested TV spot 

to air on the sole basis of a marketing director’s 

approval. You must balance issues of control 

and accountability with an agency’s ability to 

create something new, insightful, interesting, 

and effective. 

Protect the agency from politics. Policy 

makers are very important in tobacco control, 

but they may not always be the best marketers. 

As much as possible, avoid pressuring your 

agency to make advertising decisions based on 

Chapter 7: Advertising 169 
a politician’s preferences. Many creative firms 

are very client oriented and may respond to 

political pressures that could be better handled 

by the secretary of health or another ally. Your 

ad agency should never be asked to lobby the 

legislature for funding, nor should a legislator 

lobby the ad agency to, for example, select for 

the campaign a certain celebrity who may not 

appeal to the audience. Many program managers inform policy makers that key marketing 

decisions should be made by the marketing 

staff because they are closest to the audience 

research and are skilled at interpreting it. The 

marketing manager has a responsibility to 

ensure that advertising decisions are not based 

on politics but on marketing information— 

insights about what might influence the 

audience and get results. On the other hand, 

the marketing manager should communicate 

regularly with state officials who make funding 

decisions, so they understand the campaign 

and will not be alienated, surprised, or offended by the ads they see, hear, or read. 

Agree to brief, written copy strategies. 

Keeping on strategy is one of the greatest 

challenges of any advertising campaign. 

Advertising is full of creative people eager to 

break through the media clutter with something new and exciting. Your job, however, is to 

change behavior and build support for policies, not to win advertising awards or please 

everyone. You and the agency need to agree— 

in writing—on what kinds of messages will 

affect attitudes in a way that will lead to behavior change. Write a brief copy strategy that 

clearly and simply states what you’re trying to 

do, and check everything you do against this 

written agreement. For each new advertising 

assignment, you and the agency will develop a 

“creative brief” that describes in detail what 

you are trying to achieve with each ad or campaign. This brief should include your copy 

strategy and more details. (See Appendix 6.3: 

Elements of a Creative Brief and Appendices 

6.4, 6.5, and 6.6 for sample creative briefs.) By 

requiring all your advertising to fall under a 

copy strategy, you may decide not to produce 

some very entertaining ads, but what you do 

produce will be more effective. 

The bottom line in logistics is to make it as 

easy as possible for your creative agency to 

develop effective advertising. As a marketing 

manager, you’re not only an agency’s client— 

you and the agency are partners. 

Strategy: Developing Effective 

Messages 

Just as your program must have an underlying 

logic to it, so must your advertising. As with 

your entire program, your advertising strategy 

should be based partly on a situational analysis—an understanding of the environment in 

which you operate. Who is your competition? 

What are they doing? How is your product— 

the behavior you’re seeking—viewed in the 

marketplace? One simple type of situational 

analysis marketers use is a list of the strengths, 

weaknesses, opportunities, and threats 

(SWOTs) surrounding the campaign’s goals. 

This analysis should help you to understand 

the current situation, so you have a clearer 

idea about what must change. 

170 Chapter 7: Advertising 
Chapter 7: Advertising 171 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

In Principles of Marketing, Kotler and 

Armstrong (2001) discuss two elements of 

advertising strategy: messages and media. A 

message should be designed to change an attitude or tell people something they don’t already 

know. Media—TV, radio, newspapers, billboards, or some other outlet—are the channels 

used to expose people to the message. (See the 

Creative and Exposure sections later in this 

chapter for information about choosing media.) 

The Message 

What makes a tobacco control message 

effective? This is a hot topic debated among 

the tobacco control community. No single 

message can claim to be the silver bullet for 

every audience in every state. Perhaps the 

most effective messages have yet to be developed, but some messages have already shown 

promise with at least one type of audience. 

Several message strategies are commonly used 

in tobacco control. You should test messages 

with your audiences before you decide 

whether your assumptions about what might 

work are correct. The brief descriptions here 

may help you to decide on the messages that 

are worth testing with the audiences you select 

for your state program. 

Health effects. The oldest and most obvious 

appeal in tobacco control is the argument that 

tobacco is bad for your health. It’s the message 

the Surgeon General’s warning carries on every 

pack of cigarettes. Messages range in intensity: 

some emphasize death, and others focus on 

sickness. The message can come as statistics, 

graphics, pictures, personal testimonials, or a 

combination of these forms. What makes the 

messages similar is the underlying logic: 

Health effect messages try to communicate, 

and often dramatize, the health risks of smoking or chewing tobacco. Some messages on 

health effects focus on the long term (having a 

shorter life or an agonizing death) while others 

focus on the short term (health effects suffered 

while one is young). Although their logic may 

seem counterintuitive, some researchers argue 
that for many smokers, especially teens and 

young adults, the idea of living with the effects 

of smoking is more frightening than the 

thought of dying from them. 

The approach that emphasizes health effects is 

criticized by some people as ineffective. They 

argue that even though most people today 

know tobacco is unsafe, many still smoke. 

However, health concerns are probably what 

led to the substantial drop in cigarette use after 

the first Surgeon General’s report on smoking 

and health, in 1964. Health concerns also 

probably led to the subsequent decline in 

smoking after the “Fairness Doctrine”1 advertising from 1967 through 1970, which broadly 

communicated tobacco’s health effects for the 

first time (USDHHS 1989). Today it’s important 

to present health-risk information that is new 

or that comes from a novel, insightful 

perspective. One example of this approach is 

California’s recent campaign linking tobacco 

use to impotence. The new information in this 

campaign alarmed some men and caused 

them to think about their tobacco use differently. Another example is the “Every Cigarette 

Is Doing You Damage” campaign from 

Australia. The campaign was aired in six 

countries, and data from follow-up research 

supported the effectiveness of the campaign in 

at least five of those countries. In this campaign, 

graphic visuals of a rotting lung, a brain with a 

blood clot, a clogged artery, and a developing 

tumor were coupled with the news that every 

cigarette smoked can contribute to similar 

damage. Other examples of the health effects 

approach are the testimonial ads developed 

and aired by many states and other countries. 

These ads poignantly describe the physical 

and emotional tolls that tobacco has taken on 

real-life smokers and their families, in the 

words of those individuals. The ads personalize 

the health effects and make them relevant to 

smokers and their friends and families. One 

caveat when using the health effects approach 

is that people sometimes don’t believe dramatizations that are overexaggerated or are too 

removed from what they see every day or what 

they can imagine. 

Secondhand smoke. Perhaps the most widely 

used strategy today focuses on the dangers of 

1 The Fairness Doctrine was an agreement within the broadcast industry to air one antitobacco message for every 

three protobacco advertisements aired. As a result, significant levels of media presence for tobacco counteradvertising messages were reached for the first time for long enough to achieve a high level of awareness. 

172 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

exposure to secondhand smoke. For more 

than a decade, counter-marketing programs 

across the country have communicated and 

dramatized the health effects of secondhand 

smoke on nonsmokers—to encourage smokers to protect their loved ones, discourage 

smoking in public places, and support policy 

initiatives, such as smokefree workplaces. 

California relied heavily on these types of messages in its successful push to support some of 

the nation’s strongest statewide tobacco control policies, such as smokefree bars and 

restaurants. These messages encourage nonsmokers to question a behavior that decades 

of tobacco advertising have tried to frame as a 

norm. Secondhand smoke messages also have 

been found to encourage smoking cessation 

because smokers have fewer places to smoke, 

fewer people will permit a smoker to light up 

around them, and fewer smokers want to 

smoke around friends and family. The strategy 

also counters the tobacco industry’s claim that 

smoking is an “individual choice.” 

Industry manipulation. This strategy aims to 

reveal to potential and current smokers how 

the tobacco industry uses manipulative and 

deceptive practices to win new customers and 

maintain current ones, regardless of the health 

consequences. These messages often talk 

about the industry’s advertising tactics, profit 

motives, history of targeting children, and 

efforts to downplay or simply deny the health 

dangers of smoking. One common message is 

that the industry targets teens as “replacement 

smokers” to take the place of smokers who 

have died. An early California ad using this 

approach is one of the most memorable TV 

spots the state tobacco control program has 

ever produced. 

Repositioning. Aimed at teens, this approach 

is a close cousin of industry manipulation, but 

its messages are part of a larger strategy that 

not only repositions the tobacco industry as a 

manipulative adult institution, but also gives 

tobacco control advocates an opportunity to 

take on the role of hip rebels. The goal is to 

undermine two benefits offered by cigarette 

brands popular with teens—rebellion and 

independence—and to offer those benefits to 

nonsmokers. Florida took this approach by 

creating and branding an edgy, rebellious antitobacco effort called “truth.” Although teens 

actually played a large role in directing the 

campaign, much of the work and development 

needed to be performed by the health department and its contractors. By making the campaign appear to be organized entirely by hip 

teens, however, this effort repositioned the 

“truth” movement, and thus nonsmoking, as 

young and hip, while making smoking seem 

old and corporate. This strategy is now the 

basis of the national “truth” campaign funded 

by the American Legacy Foundation. 

Defining the norm. Because most people 

don’t smoke, some programs use the “followthe-crowd” approach to let people know that 

smokers are in the minority. One TV spot, for 

example, informed teens that three of four 

teenagers don’t smoke. The theory is that teens 

sometimes consider smoking because they 

think everyone is doing it. They’re conforming 

to a perceived social norm. These messages 

Chapter 7: Advertising 173 
simply deflate the myth that “everyone is 

doing it.” In addition, showing that nonsmokers are the majority may empower them to 

speak up about secondhand smoke. On the 

other hand, critics of this approach worry that 

some independent and more rebellious teens 

might be attracted to smoking, because most 

people don’t do it. 

Social consequences. Messages on social 

consequences consider how tobacco use 

might affect a person’s social standing, dating 

opportunities, and other situations. Although 

teens are concerned with social consequences, 

messages from state health departments about 

social consequences in the teen culture face 

the same credibility challenges that parents of 

teens often face. One tactic to address this 

challenge is featuring older and seemingly hip 

teens as spokespeople, which gives them an 

authentic voice. Some states are also beginning to look at the social consequences in a 

global sense, considering tobacco’s impact on 

issues such as child labor, the environment, 

and poverty in the developing world. 

Chemical disclosure. Another strategy is to tell 

people about the chemicals in cigarette smoke 

or about the hundreds of chemical additives in 

cigarettes. This advertising typically tries to 

dramatize the implications of being exposed to 

the deadly chemicals known to be associated 

with smoking. One TV spot showed a family 

drinking these chemicals from beakers. 

Another ad interviewed professionals who 

worked with toxic chemicals and used protective clothing to shield themselves from those 

chemicals. The message highlighted their 

shock that the same chemicals were found in 

secondhand smoke inhaled every day by many 

people, who are unprotected from its effects. 

Addiction. Several programs have attempted 

to illustrate the power of nicotine addiction: 

Once someone decides to smoke, that decision 

isn’t always easy to reverse. One difficulty with 

this strategy is the message it sends to current 

smokers. After hearing these messages, some 

smokers may believe cessation attempts are 

hopeless. Making the addiction claim convincing for youth also has been a challenge. In 

focus groups, even teens who acknowledge 

that nicotine is addictive don’t always seem to 

understand what that means. “Once I feel I’m 

getting addicted,” one teen said, “I’ll quit.” 

An addiction message may be better used to 

supplement another message. For example, 

174 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

addiction has been mentioned in industry 

manipulation to emphasize how tobacco 

companies recruit “customers for life.” The 

power of addiction also is noted often in 

smoking cessation messages. 

Heroes and celebrities. Many tobacco control 

ads use famous actors, musicians, models, and 

athletes in the same way that commercial 

brands use these celebrities: to associate the 

product (i.e., the behavior of not smoking) 

with someone who is loved and admired. 

These heroes and celebrities have included 

supermodel Christy Turlington, actor Esai 

Morales, the musical group Boyz II Men, and 

the national women’s soccer team. Celebrities 

can also attract news media. However, it’s 

important to carefully select the heroes and 

celebrities to use as spokespeople, because 

working with them can have downsides. They 

can quickly fall from popularity, may suddenly 

become bad role models by adopting the 

behaviors you’re trying to change in the target 

audience, may command significant fees, and 

often demand a lot of creative control. 

Role models. Another strategy focuses on how 

adults and older teens are role models themselves, most commonly to their children and 

younger siblings, respectively. The essential 

message is that if you decide to smoke, others 

will follow. One ad shows a couple peering into 

their bedroom, where their children are playing dress up and are pretending to be adults. 

The couple is aghast when they see the children pretend to smoke, copying their behavior. 

This approach has been used with populations 

such as African Americans, Asians, and 

Hispanics/Latinos in which family connections 

are often very important. Counter-marketing 

programs have also used the role model theme 

to promote tobacco control advocacy. The 

“truth” campaign, both in Florida and nationally, under the American Legacy Foundation, 

showed teens taking a stand against tobacco 

advertising. One Florida ad featured teens ripping tobacco ads from magazines. Another ad, 

developed by Massachusetts, told the story of 

a group of teens who pressured a mall to go 

smokefree. 

Cosmetic effects. Like messages about social 

consequences, messages about the effects of 

tobacco use are more about appearance than 

health. Put simply, tobacco use can be disgusting. Messages about cosmetic effects rely on 

people’s concern about their appearance. By 

dramatizing consequences such as yellow 

teeth or cigarette breath, such messages tell an 

audience that tobacco makes them less 

appealing. Some messages emphasize the 

results of these effects: A Massachusetts ad 

shows an attractive teenage girl talking about 

how smokers turn her off. However, experts 

debate the efficacy of this approach. In focus 

groups, teens often say they can mask these 

effects of cigarettes with perfume, with breath 

mints, or in some other way. 

Refusal skills or individual choice. Campaigns 

centered on refusal skills or individual choice, 

which nearly always target youth, typically 

show a teenager or group of teenagers discussing their own decisions not to smoke. 

These ads try to build credibility by appearing 

to respect a teen’s ability to make an individual 

choice about tobacco use. Philip Morris 

Chapter 7: Advertising 175 
(now renamed as Altria), the maker of the 

nation’s most popular cigarette, Marlboro, 

created the largest and best known individual 

choice campaign, which carried the tag line: 

“Think. Don’t Smoke.” Qualitative and quantitative research on ads from that campaign 

showed that those ads didn’t perform as well as 

ads from tobacco control campaigns using 

other approaches. Qualitative research demonstrated that individual choice ads developed by 

state programs did not perform well either. 

Survey respondents thought that giving youth 

the choice to smoke without giving them good 

rationale for not smoking (e.g., information on 

health effects) was not a strong or helpful message and would cause some youth to choose to 

smoke. (More information about the quantitative research is available from the American 

Legacy Foundation’s First Look Report 9, Getting 

to the Truth: Assessing Youths’ Reactions to the 

“truth” and “Think. Don’t Smoke” Tobacco 

Countermarketing Campaigns (2002). 

Smoking cessation. A number of messages 

have been used to encourage people to quit 

smoking or call a hotline to help them quit. 

Many use the messages described earlier with a 

twist that will appeal to certain smokers, such 

as telling parents about the dangers to their 

children of secondhand smoke or graphically 

exposing for pack-a-day smokers the health 

effects of their smoking. In some cases, ads to 

promote smoking cessation emphasize the 

health benefits of quitting as opposed to the 

dangers of continued use of tobacco. Also, 

cessation ads sometimes focus on efficacy, 

recognizing that it is difficult but very possible 

to stop smoking. Occasionally, these ads offer 

tips on how to quit. The most successful cessation ads nearly always include an easy-toremember number for quitline services that are 

supported by well-qualified staff. 

By jointly agreeing to a copy strategy with your 

creative agency, you have logic against which to 

judge particular advertising products. One way 

to do this is to determine which strategies are 

likely to work best, test them with your audience, and then select the strategy that seems 

the most powerful. Try to capture the approach 

in a short and simple statement, perhaps a single sentence. For example, a statement that sets 

direction for a secondhand smoke ad could say: 

To increase support from nonsmokers 

for restrictions on tobacco use in homes 

and public places, we will show nonsmokers how secondhand smoke 

endangers them. 

An ad focused solely on the health dangers to 

smokers, as opposed to nonsmokers, would be 

off strategy when it comes to this objective. It 

might be interesting and even frightening to 

nonsmokers, but a message that smoking is 

dangerous for smokers isn’t based on the logic 

of the message strategy on secondhand smoke. 

If you don’t stick to your strategy, you’re not 

giving the strategy you developed a chance 

to work. 

You may have several copy strategies aimed at 

different audiences, but try not to create too 

many for each audience. Too many messages 

aimed at the same audience can have the result 

that no single message reaches the audience 

176 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

enough times to make a difference. Attitudes 

are changed only after people are repeatedly 

exposed to the same basic message. To stick to 

the strategy without wearing out a particular ad 

or message, you’ll probably want to illustrate 

the same message in different ways. You can 

produce or reuse different creative executions 

that carry the same basic message. You may 

want to use various media vehicles (communication channels), knowing they’ll work synergistically to strengthen the message’s impact. A 

vehicle is a route or method used to reach a 

target audience with a message. Examples of 

media vehicles are TV, radio, the Internet, bus 

signs, billboards, brochures, and notepads in 

physicians’ offices. 

Context of the Message 

You should also consider the context of your 

message. You’re not the only one talking to 

your audience. Your target audiences are 

being exposed to hundreds of messages every 

Chapter 7: Advertising 177 
day. Some may directly pertain to tobacco. 

Others may not mention tobacco, but still may 

influence what your audience thinks is right, 

fashionable, or simply believable. These other 

messages will affect how the audience receives 

your message. 

People consider information from many 

sources when they form opinions. Your audience may already be hearing from the tobacco 

industry, voluntary health organizations (e.g., 

the American Cancer Society), and the 

American Legacy Foundation, which is the 

antitobacco foundation created by the national 

settlement with the tobacco industry. Each 

campaign may have a different message, and 

your target audience may not recall who is 

saying what. For example, your audience may 

think the state health department’s antitobacco 

program and the Philip Morris youth smoking 

prevention effort are the same campaign. 

You can’t coordinate everyone’s messages, but 

you can consider how your effort might fit. For 

example, Legacy’s “truth” campaign is spending heavily to reach teens and young adults 

with industry manipulation and repositioning 

messages. Instead of competing for teens’ 

attention, you could choose to support this 

strategy, not with additional ads but with onthe-ground marketing efforts, such as the creation of youth antitobacco groups or “collateral 

materials” (promotional and other items such 

as T-shirts, posters, and fliers) to be used by 

interested teens. (See Chapter 10: Grassroots 

Marketing for more about promoting youth 

activism.) Or you may choose to target adults 

with messages that focus on changing norms 

around secondhand smoke or on cessation, 

both of which are likely to contribute to lower 

youth tobacco use over time. 

Creative: Breaking Through the 

Clutter 

Once you’ve explored various message strategies for the target audience and determined 

the one you believe has the most potential to 

influence the audience as desired, you’ll begin 

working toward creative development of ads. 

Instead of developing ads, you may decide to 

save time and resources and reapply previously 

produced ads from other states, organizations, 

or countries. Although some parts of this section are relevant both to ad reapplication and 

developing new ads (for example, the process 

you will go through in critiquing ads), this section focuses mainly on topics relevant ONLY to 

developing new advertising. It’s not an easy task 

to effectively translate your chosen message 

strategy into creative concepts and then to 

produce ads based on those concepts. This 

task requires a high level of strategic discipline 

and teamwork between you and the ad agency, 

with all parties contributing their talents to the 

effort. 

In advertising, details matter as much as message strategy. Two TV spots might share the 

same message strategy and even the same 

script but may be executed very differently. 

Who is talking and how they present themselves will affect the impact of the final ad. Is 

this a message from the band 98 Degrees or 

from the governor? One might be more credible defining what’s cool to teens; the other 

might be more credible with parents. Even 

178 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 7.1: Pros and Cons of Advertising Media 

Format Pros Cons 

TV Spots 

TV spots are usually 15, 

30, or 60 seconds long. 

Most run 30 seconds. The 

longer spots are more 

expensive to air. 

• Reach a broad audience 

• Deliver audiovisual impact 

• Have a flexible format 

• Expensive to air 

• Fleeting exposure 

• Insufficient time for complex 

explanations 

• Typically expensive to produce 

new ads 

Radio Spots 

Paid radio spots are typically 60 seconds long; 

public service announcements tend to be 30 seconds long. You can also 

use live announcer scripts 

(“live copy ads”). 

• Are cheaper than TV spots 

• Can typically have a narrower 

target than TV spots 

• Can be produced quickly 

• Are typically longer than TV 

spots, allowing more complex 

messages 

• Audio impact only 

• Narrow reach per station 

Print Ads 

Print ads run in newspapers, magazines, and student publications and can 

be one-quarter or onehalf page or a full page. 

• Reach a specific audience, 

often including opinion leaders 

• Have short lead time (newspapers) and immediate impact 

• Very short life span 

• Compete in cluttered advertising 

environment 

• Youth and people of lower economic status often missed 

• Long lead time (magazines) 

Outdoor Ads 

Ads include billboards 

and signs on storefronts, 

buses, trains, and 

benches. 

• Can reinforce messages placed 

elsewhere (e.g., TV or radio) 

• Can repeatedly expose commuters to message 

• Can be inexpensive (e.g., transit 

space) 

• Can give high exposure 

• Limited message space 

• Damage from weather and graffiti 

• Difficult to target narrowly 

(Everyone will see it.) 

Continues 

Chapter 7: Advertising 179 
Table 7.1: Pros and Cons of Advertising Media (cont.) 

Format Pros Cons 

Point-of-Purchase Ads 

Ads are placed in stores 

where tobacco is sold. 

• Can counter tobacco advertising where the product is bought • Difficult to place (Tobacco 

industry is major point-ofpurchase advertiser.) 

Movie Trailers and Slides 

Ads appear in video or 

still photos shown before 

a movie begins. 

• Target frequent moviegoers 

(e.g., teens) 

• Can have high impact and may 

serve to “inoculate” viewers 

against images of people smoking in movies 

• Production and placement of 

trailers can be expensive 

(Production costs can be saved by 

using an existing TV spot.) 

• Targeting of specific kinds of 

movies not usually allowed by 

theaters 

• Ad trailers not allowed by some 

film distributors 

Print Materials 

Many programs use informational brochures; 

some aim materials at a 

specific market. 

• Can be inexpensive to produce 

• Have longer life 

• Allow large amount of message 

space 

• Not an “interruption” medium. 

(Target audiences must want to 

read materials.) 

• Dissemination required 

• Possibility of duplicates to the 

same individuals 

Web Banners 

“Click-through” banners 

can link commercial and 

partner Web sites to a 

program. 

• Broaden exposure on new media 

• Can be inexpensive 

• “Click-through” rates typically low 

• Pop-up ads considered annoying 

distractions by most people 

• Small message space 

Web Sites 

Many programs build 

Web sites; some sites are 

aimed at specific audiences. 

• Can be relatively inexpensive 

• Are constantly present 

• Have unlimited message area 

• Can be updated quickly 

• Need to drive traffic to Web sites 

• Compete with a large number of 

other sites 

• Maintenance and monitoring often 

required 

180 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Table 7.1: Pros and Cons of Advertising Media (cont.) 

Format Pros Cons 

Sponsorships 

Payments are made in 

return for promotion as a 

sponsor of a concert, 

sports contest, or other 

event. The goal is to create 

a positive image for the 

campaign by associating it 

with something perceived 

as popular or attractive by 

the target audience. 

• Are typically turnkey promotional opportunities in which 

you can pay for services of staff 

to handle the event 

• Associate program’s “brand” 

with well-liked celebrities, 

brands, or events 

• Possibly expensive 

• Perception of negative association 

by some audiences 

• Creation of expectation of continued support that may not be possible 

• More limited reach than mass 

media 

Collateral Materials 

Programs may create promotional materials (e.g., 

T-shirts, key chains, and 

refrigerator magnets). 

• Can provide continued but limited exposure to target audience 

• Benefits people involved in 

activities 

• Distribution required 

• High cost for limited exposure 

what people wear can make a difference. In 

Florida’s “truth” campaign, for example, the 

real Florida teens recruited for TV spots 

changed clothes before they went on the air. 

The program’s ad agency worked with a 

wardrobe expert to select clothing that was 

more hip than the teens’ own clothes. 

Producing good creative is an art form. Beyond 

sending a clear message, advertising must be 

salient and interesting. The audience should 

feel understood and respected. Advertising can 

be tested to determine which concepts or finished ads have the highest likelihood of success, but just how it may work in the real world 

is always partly a mystery. The artistic expertise for which the creative firms are hired must 

be valued and appreciated, but it also must be 

balanced with the tobacco control experience 

and technical expertise that you bring to the 

process. You are ultimately responsible for 

ensuring that the ads that are approved have 

the highest likelihood of contributing to your 

tobacco control goal. 

Managers evaluate potential advertising in 

different ways. The key is to think broadly and 

avoid nitpicking any product to meet your 

personal tastes. If you relate everything to 

what you know about your audience and your 

strategy, you can provide the creative firm with 

the needed perspective. Consider four key 

questions: 

1. 	 Is the creative product something you can 

disseminate effectively to your audience? 

For example, you may not want to produce 

Chapter 7: Advertising 181 
a TV spot if you don’t have much money for 

a media buy; instead, radio might be a 

more cost-efficient option. 

2. 	 Is the creative product on strategy? For 

example, the product shouldn’t dwell solely 

on health effects if your strategy is industry 

manipulation. 

3. 	 Does the product reflect what you know 

about your audience? Think about 

whether it communicates persuasively to 

your audience. Will they understand it? Will 

they feel understood? Is it persuasive? Will 

the audience respond to the actors in terms 

of age, diversity, and attitude? 

4. 	 Might unintended negative consequences 

occur? Advertising exposure can’t be tightly 

controlled; other audiences will be exposed 

to these products. Consider the implications of that scenario. For example, teens 

who view a message aimed at adults about 

how many teens are smoking might begin 

to see smoking as the norm. 

Types of Creative 

Work with your creative firm to decide what 

kinds of products to use. Will billboards work? 

Should you buy radio time? What about a 

brochure? Does your budget allow for this 

advertising? The creative firm should present 

you with a plan to use several different types of 

advertising materials in a campaign. The 

materials should complement one another to 

completely reach members of your target 

audience, whether they watch TV, read newspapers, or only see billboards. (See Table 7.1 

for a list of the most common types of advertising and the benefits and drawbacks associated with each product.) 

Table 7.1 lists only some of the types of advertising available. Advertising messages are 

placed everywhere these days, from a banner 

flown above a beach to the well of a urinal. 

Your job is to determine the most appropriate 

and cost-efficient place for the audience to 

see your message, so it’s clear, widely viewed, 

persuasive, and without unintended negative 

consequences. 

You should also consider using creative materials that already exist. Even states with large 

campaigns that produce a large percentage of 

their own materials (e.g., California, Florida, 

and Massachusetts) have borrowed advertising 

executions from other states and countries. To 

help states share materials, the CDC Media 

Campaign Resource Center (MCRC) maintains 

an inventory of existing tobacco counteradvertising materials developed by a number 

of states, organizations, and federal agencies. 

By providing access to existing advertising 

materials, the resource center allows states, 

organizations, and government agencies to 

save the time and high cost of producing new 

ads. The MCRC collection includes ads for TV, 

radio, print, and outdoor use that address a 

variety of themes and target audiences. In 

addition, the MCRC negotiates rights and talent fees to simplify the process of using the ads 

in different states. (More information and a 

searchable database are available on the 

MCRC Web site, http://www.cdc.gov/ 

tobacco/mcrc). 

182 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

E-mail: mcrc@cdc.gov 

Phone: (770) 488-5705, press 2 

Web site: www.cdc.gov/tobacco/mcrc 

Media Campaign Resource Center 

In general, you’ll want to select vehicles with 

the lowest cost per thousand audience members potentially reached (CPM). However, CPM 

should be balanced with the need for highquality exposure. For example, showing ads to 

promote smoking cessation in a physician’s 

waiting room may have a high cost and low 

overall reach, but the exposures are very high 

quality, because you have a captive audience 

consisting of people preparing to talk to their 

physician about their health. 

Pretesting Creative 

Advertising can be very expensive. Producing 

a high-quality, 30-second TV spot by using 

union talent can easily cost more than 

$250,000. Airing the spot can cost much, much 

more, so before major advertisers invest 

money in airing or placing an ad, they typically 

test it to determine whether it clearly conveys 

the intended message. 

Pretesting can be performed at several stages 

in the creative process. You can pretest a 

concept, a script, a rough cut of a broadcast 

spot, or a storyboard (visuals and words that 

portray the actions in a proposed TV spot). 

(See Appendices 7.2 and 7.3 for sample storyboards.) Also, the finished ad itself can be used 

in a pretest. Pretesting won’t tell you whether 

the ad will “work”; you’ll find that out only 

after you place the ad and measure attitudinal 

changes or other results in the context of your 

entire campaign. However, pretesting can give 

you important information about whether your 

intended message is being communicated clearly to your target audience. The most common 

conclusions you can draw from pretesting are: 

■	 Overall reaction. How is the ad likely to 

make the audience feel? 

■	 Communication of a message. What 

message is your audience likely to take 

away from the ad? 

■	 Likes and dislikes. What parts of the ad are 

likely to please or anger your audience? 

■	 Confusing aspects. What parts of the ad 

are likely to confuse your audience? 

■	 Credibility. Is your audience likely to 

find the ad believable? 

■	 Relevance. Does the audience think this 

is a message for “people like them”? 

Does it apply to their lives? 

■	 Perceived motivational aspects. Is your 

audience likely to think the ad will 

prompt them to change anything? Do 

they find the ad convincing? (Attempting 

to measure the ad’s potential influence 

can be very misleading. People don’t like 

to admit that advertising might affect 

their behavior. What’s more, the ad may 

only need to affect an attitude as part of 

an overall program that will change 

behavior.) 

Chapter 7: Advertising 183 
Some pretesting efforts use larger sample sizes 

and try to measure people’s intention to 

change behavior. On the opposite extreme, 

some pretesting can be abbreviated as a qualitative communication check. The testing 

measures whether the “take-away” (messages 

and impressions left with the audience after 

viewing of the ad) was what you intended. 

Before you pretest, decide what you need to 

learn. You need to be realistic about what you 

can learn and whether you’re learning something that can be the basis for some action. 

Don’t ignore the results of your pretesting, but 

rather use them in your decision making. 

As a program manager, you can 

require your creative firm to 

pretest (1) some or all of the ads 

you’re considering for use in the 

counter-marketing campaign, (2) 

only the ads targeted at a specific 

group, or (3) only the ads that you 

believe could pose problems. You 

can also decide at what stage the 

testing would be most useful. The 

testing can be performed by the 

creative firm, a subcontractor to 

the creative firm, or another contractor you hire separately. Some 

people worry that creative firms 

won’t test their own creative products fairly, but good firms know 

it’s to their advantage to honestly 

pretest their products to find 

problems before they’re widely 

distributed. You should understand and agree to the testing 

methods selected. You’ll also want to observe 

the research, if possible, and fully understand 

the analysis. Firsthand observations will better 

prepare you to fight for the production of 

an ad or defend it once it’s produced. (See 

Chapter 3: Gaining and Using Target Audience 

Insights for more information on pretesting.) 

You and the agency should be partners in the 

planning and execution of the research and in 

drawing conclusions from the results. 

Creating a Standard Review Process 

The final version of a creative product should 

not surprise you. A TV spot, magazine ad, or 

other creative product should be the result of a 

184 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

joint effort by the creative firm and you. Again, 

as a program manager, your role is to continually evaluate whether the product is persuasive 

and on strategy, can be disseminated to your 

audience, reflects what you know about your 

audience, and is not likely to cause unintended 

negative consequences. 

You can make these judgments at several 

points in the creative process. You and your 

creative firm should agree on when your 

review is necessary. A list and discussion of 

the milestones for reviewing a TV spot are 

provided here. The TV spot is one of the more 

complicated and costly products a creative 

firm can produce and place. The process is 

similar for other creative products, such as 

print ads and radio spots. You may not have 

time to perform every step for every creative 

product, but you and your creative firm can 

decide jointly when your input would be most 

valuable. 

The milestones are as follows: 

■	 Read the creative brief. 

■	 Review the scripts or storyboards. 

■	 Attend pretesting focus groups or interviews. 

■	 Attend or listen in on the preproduction 

meeting. 

■	 Attend the shoot. 

■	 View the first cut. 

■	 View and approve the edited spot. 

Read the creative brief. The first thing you 

should review when overseeing the production 

of a TV spot is the creative brief. You may even 

want to be involved in helping write the creative brief. Some ad agencies consider the creative brief to be an internal function of the ad 

agency, developed by agency planners and 

account staff, and shared exclusively with the 

creatives. However, you have the right and 

responsibility to ensure that it’s strategically 

focused and communicates the key information and insights the creatives will need to do 

their work. This is the document that tells the 

agency’s writers and artists—the people who 

create the ad—what you want. Because the 

function of the creative brief is to translate 

your strategy into specific guidelines for the 

creative team, you may want to help develop it 

or at least review it before it goes to the creative staff. (See Appendix 6.3: Elements of a 

Creative Brief and Appendices 6.4, 6.5, and 6.6 

for samples of creative briefs.) 

Review the scripts or storyboards. After the 

creative brief is shared with the creatives, 

they’ll develop ideas for creative executions 

(e.g., the script or storyboards for a TV spot; see 

Appendices 7.2 and 7.3 for sample storyboards). 

The creative executions may be presented to 

you in a meeting. When you review the script or 

storyboard and see the intended visuals, think 

about how your audience might react and 

whether these creative concepts accomplish 

what you set out to do in the creative brief. This 

task won’t always be easy. At first, you may not 

see how the proposed ad can accomplish your 

goal. Some advertising executions cannot be 

interpreted literally. In all cases, the firm should 

be able to explain how the ad can accomplish 

Chapter 7: Advertising 185 
the goal(s) you set out in the creative brief. (See 

Appendix 7.1 for help in organizing your comments and questions about the creative concepts.) Raise any concerns you have about taste, 

language, or how you see the ad taking shape. 

Are the visuals reinforcing what’s being said? Is 

the language appropriate and understandable 

for this audience? Is there anything that might 

unnecessarily offend the audience or mislead 

people? As the content expert, you must ensure 

that the “facts” in the ad are true and can be 

substantiated. 

Attend pretesting focus groups or interviews. 

At this stage, the scripts and storyboards can 

be presented to members of your target audience to get their reactions. You should observe 

the pretesting to be sure that the audience 

understands the messages and finds the ad 

concepts relevant and clear. If you can’t attend 

the testing, read the transcripts or the report of 

the findings, watch the video, or listen to the 

audiotape. The agency personnel (e.g., account 

service, research and planning, and creative 

staff) should also attend the sessions. You may 

also want other members of your staff to 

attend. Consider inviting key stakeholders to 

observe focus groups of specific populations 

that they represent. Even though these stakeholders share many characteristics with the 

specific population, they may differ in significant ways (such as education or income), and 

observing a focus group may help them to 

better understand the participants. 

You may wish to pretest again after production 

of the TV spot, because storyboards don’t 

always adequately convey the experience of 

seeing the finished ad. You can also pretest 

using animatics or a rough version of a spot 

or print ad. One caveat is that some creative 

concepts don’t lend themselves well to focus 

group testing of a storyboard. For example, an 

ad that relies on clever special effects or a testimonial ad that relies on the candid emotions 

of a person negatively affected by tobacco use 

may not be convincing or engaging in focus 

groups where those special elements are missing. In these cases, you won’t be able to judge 

the persuasiveness of the ad concepts, but you 

still should be able to determine whether the 

audience understood the messages and found 

them relevant. 

Attend or listen in on the preproduction 

meeting. Shortly before the production of an 

ad (the shoot), a preproduction meeting is 

held for the agency’s creative staff to meet with 

the people who will actually produce the spot. 

They discuss locations, wardrobe, talent, and 

other production issues. The meeting is often 

held where the shoot will take place. If you 

can’t be there in person, it’s a good idea to join 

the meeting by phone. Most production decisions are probably best left to the agency and 

the production crew, but occasionally you may 

want to address certain issues. For example, 

you would raise an objection if they were planning something you think might offend the 

audience or might not be appropriate for your 

campaign. If you have questions or concerns, 

don’t be afraid to raise them. It’s much harder 

to make changes once the shoot is complete. 

Attend the shoot. Many marketing managers 

attend the filming of the ad (the shoot), though 

it’s not a necessity. Your role usually will be 

limited, but your attendance will be more 

186 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

important in cases where you need to weigh in 

on unanticipated issues. For example, Florida 

and Minnesota developed ads using video of 

unscripted teens criticizing the industry’s 

practices. It was important for the marketing 

manager to be present because the script was 

essentially being written and approved on the 

spot. 

View the first cut. After the shoot and some 

editing, the agency can show you a rough cut 

of the production that may not yet include all 

the edits or production enhancements the 

creative firm is planning, such as color correction, sound adjustment, sound effects, and 

music. This step will give you a chance to 

review the spot before the creative firm invests 

a lot of time and money in postproduction 

processes. The agency can tell you what can be 

changed at this point. If you have concerns 

about some aspect(s) of the ad, you may also 

want to test the ad with the target audience to 

see if your concerns are valid. Sometimes ads 

are produced and never aired. This may seem 

wasteful, but it’s smarter than spending a lot 

more money buying time to air an ineffective 

or offensive ad that will cause you problems. 

Many veteran marketers can tell you about an 

ad that never ran and how happy they are that 

it didn’t run. 

View and approve the edited spot. You should 

always review the version of the spot that you 

intend to air but try to avoid having to get 

clearance from a large number of people. 

Everyone is a critic, and sometimes it’s difficult 

to remind your superiors that what really matters is how the audience sees the spot, not how 

it’s viewed inside your department or agency. 

In many states, a large number of reviews can’t 

be avoided. Try to remind every reviewer what 

the ad is supposed to do and which audience 

it’s intended to reach. Use the pretesting 

results to support the relevance of the message 

to your audience. 

In the end, your role in the creative process 

is one of quality control. You’re not a critic, 

an editor, or an artist, but you are the person 

ultimately responsible for ensuring that your 

advertising is on strategy and effective with the 

intended audience. You may not even like the 

ad. That’s okay. You just need to believe it will 

work. 

Exposure: Show the Message 

Enough for It to Sink In 

Great advertising is worthless if nobody sees it. 

A program manager or marketing manager 

needs to ensure that the right people get the 

Chapter 7: Advertising 187 
right message multiple times. You need your 

target audience to become familiar enough 

with your message that it raises awareness, 

changes an attitude, or prompts action. This 

means they have to see it more than once. 

Many advertising experts say that, in general, 

people won’t even remember a commercial 

unless they’ve seen it at least three times. 

Others contend that TV spots must be seen 

three to seven times to be effective. In reality, 

the success of an ad largely depends on the 

quality of the creative execution and production. There are no set criteria, but one thing is 

for sure: Once is not enough. 

Advertising is not a vaccine. In a global review 

of smoking cessation campaigns by CDC and 

the World Health Organization, successful 

cessation efforts required both a “strong” and 

“ongoing” media presence. When levels of 

advertising drop, so do the calls to cessation 

helplines. You can expect levels of ad awareness to mirror the schedule of your media 

buys. Awareness may be high while TV spots 

are on the air, but it will likely drop once the 

ads stop running. 

You also need to think about when and how 

you reach your audience. The fact that you can 

reach the audience with your message at a 

certain time and through a certain channel 

does not mean you always should. For example, you might not want to run an ad on breast 

cancer during a Sunday football game. It’s a 

bad “aperture” for a media message on breast 

cancer, because football fans aren’t likely to 

change their thinking from rooting for a team 

to considering how the disease might affect 

them or their spouses. When Florida launched 

its rebellious youth antitobacco brand, the 

state could have disseminated its message in 

schools. After all, where better to reach teens? 

But the state shunned that dissemination 

approach. If teachers and principals promoted 

the “truth” brand, program managers reasoned, it would seem anything but young, 

cool, and rebellious. The approach would 

undermine the brand’s value, and in the 

process, the strategy. 

Exposure is usually measured by reach and 

frequency, which are typically translated into 

“rating points.” A rating point is the percentage 

of the target audience potentially reached 

(reach) multiplied by the number of times 

the audience will potentially see the message 

(frequency). If, on the basis of your media buy, 

50 percent of the targeted audience is expected 

to see your ad an average of three times, you’ve 

purchased 150 target rating points (TRPs). (The 

term target rating points is meant to convey 

that the rating points are specifically for your 

target audience.) Rating points are usually 

expressed in four-week figures, but you must 

always ask to be sure. An agency may add rating points together over a longer or shorter 

period. For example, an agency may talk about 

buying 1,200 rating points during the launch of 

your campaign. That statement may mean 300 

points a week for four weeks or 150 points over 

eight weeks. 

You may also hear media planners refer to 

“gross rating points” (GRPs). By definition, 

both GRPs and TRPs represent the total 

amount of rating points bought over a period 

of time in relation to an audience. Typically, a 

planner will use GRPs or TRPs to represent 

188 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

rating points for your target audience, not 

rating points for a general audience, but you 

need to check to make sure. 

Rating points vary depending on which audience is being targeted. For example, “Sabrina 

the Teenage Witch,” a TV show produced by 

Warner Bros. Television Network, would have 

much higher rating points for adolescent girls 

than for 40-year-old men, and network news 

would have higher rating points for retirees 

than for teenagers. 

Because buying media is so expensive, programs typically buy media in “flights” of three 

to six weeks, then go off the air for two to six 

weeks. If you’re introducing a campaign, you 

should be on the air as continuously as possible during the first six to 12 months, and that 

strategy is even more important if you’re trying 

to establish a brand. Awareness of the campaign will vary depending on how long a flight 

has been on the air, when it aired (e.g., time of 

day, season, programs), and how many flights 

were used over a period of time, but media are 

typically bought in a way that preserves some 

baseline level of awareness. Although ads are 

not on the air constantly, an effort is made to 

keep the program’s message constantly in people’s minds. The broadcast buy is supplemented by other vehicles, such as outdoor advertising, which is typically bought in month-long 

increments. These supplemental ads remain in 

place during the off weeks of a broadcast buy, 

and broadcast ads return to the airways before 

a dramatic dip in awareness occurs. You 

should be given a media flowchart (including 

dates, TRPs, and markets) that shows how 

each flight will take place for different audience segments. The media experts at your ad 

agency can advise you on how to maximize the 

impact of your budget. 

Again, media messages aren’t like inoculations: 

No audience becomes immune to an unhealthy 

behavior after a certain number of exposures 

to a message. Just as Coca-Cola must continue 

advertising even though the soft drink is very 

well known, tobacco control programs can’t 

simply air a message, then disappear. A constant and evolving media program with new 

and engaging messages is needed to counter 

the competitive influences on the audience to 

smoke or chew tobacco. 

How much exposure should you buy? That 

depends on your strategy, the stage of your 

campaign, the other counter-marketing activities, and your budget. Some strategies require 

more exposure than others. Some programs 

depend less on advertising and more on other 

interventions, such as smoking restrictions, 

education programs, or cigarette taxes. There’s 

no one-size-fits-all formula. 

Programs generally start with stronger media 

buys to win the audience’s attention. When 

California launched the nation’s first major 

tobacco counter-marketing campaign in 1990, 

the state was on the air almost continuously 

from April to November, buying 125 to 175 TRPs 

a week for adults and about 100 TRPs a week 

for teens. The program is now very well known 

inside the state, so media buys usually run 

three- or four-week flights of 100 to 150 TRPs 

per week, with breaks that last about a month. 

Chapter 7: Advertising 189 
“We have a maintenance level of 100 [TRPs] 

per week on the major networks,” says Colleen 

Stevens, the program’s marketing director. “If 

we have something new, we increase the buy 

to at least 150 [TRPs]. Admittedly, we’d like to 

air at higher TRP levels, but our budget doesn’t 

allow for higher levels.” 

In some cases, the best guide to scaling your 

media buy is doing what commercial marketers with similar strategies do. When Florida 

decided to base its teen-targeted campaign on 

the creation of a hip, rebellious antitobacco 

brand, the state’s ad agency looked at the 

media buys made during the launch of other 

youth brands. The state decided on a very 

aggressive buy, purchasing an average of 244 

TRPs a week on TV alone for two months and 

supplementing this presence with radio ads. 

Your creative firm’s media-buying recommendation probably will be based largely on your 

budget. One reason Florida made such an 

aggressive buy was that the state could afford 

it. The state’s tobacco settlement had specifically allocated tens of millions of dollars to the 

tobacco control program, about one-third of 

which was invested in marketing. Program 

staff also knew that many people were watching carefully to see whether the program 

would succeed. 

It’s probably a good idea to buy as much 

exposure as you can afford. If your strategy is 

sound, your message is effective, and your 

creative executions are clear and attentiongetting, the only thing standing between your 

advertising and success is exposure. 

Choosing a Media Approach: Paid 

Media, PSAs, and Earned Media 

Typically, the most effective marketing 

campaigns use multiple communication 

approaches. This is true for selling soap, persuading drivers to buckle up, or encouraging 

people not to smoke around others. Paid 

advertising campaigns, public service 

announcement (PSA) campaigns, and “earned 

media” efforts all have advantages and drawbacks, but used in combination, they offer an 

opportunity to reach audiences with multiple 

yet complementary messages. In tobacco 

control, where significant media buys have 

been taking place for some time, this sort of 

combination approach is common. 

Here’s a look at these three approaches, along 

with discussions about using them in combination and using only PSAs and earned media 

when paid campaigns are too expensive. 

Conducting a Paid Advertising 

Campaign 

A paid advertising campaign is the most effective communication tool for reaching large 

audiences with a relatively simple message. It 

lets you target specific audiences with persuasive messages that can affect a person’s awareness, attitudes, beliefs, and, potentially, behavior. 

However, conducting a sustained paid advertising campaign is expensive. Successful paid 

media campaigns conducted by states have 

ranged in cost from approximately $.50 to 

$3.50 per capita a year, and a significant portion of those funds were for paid advertising. 

190 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

A successful paid advertising campaign has a 

few key features: 

■	 Thorough campaign planning. Before 

developing a paid media campaign, you 

must completely understand the members 

of your target audience, the messages 

that influence them, and how to reach 

them. You should outline the specific 

objectives you want to achieve and then 

determine which audiences, messages, 

and media vehicles are most appropriate 

for reaching those objectives. 

■	 Sufficient budget to achieve optimal 

levels of reach and frequency. By working with a media planner, you can determine the levels of reach and frequency 

you can achieve with your budget. By 

analyzing what you can achieve with 

your resources, you can use them more 

effectively and efficiently. If you don’t 

have the resources to conduct a paid 

advertising campaign properly, it may 

be better to use the resources on another 

form of communication or to limit the 

focus of the campaign to one target 

audience or one message strategy. 

When funding increases, you can focus 

more broadly. If you choose to focus 

very narrowly at first, you’ll need to set 

expectations appropriately. 

■	 Advertising that is on strategy and 

breaks through ad clutter. Spending 

millions of dollars on ad placement 

won’t suffice if your advertising is off 

strategy or doesn’t get noticed. Your ads 

must effectively communicate a message 

that will influence your target audience. 

Effectiveness can be determined by testing your commercials among the audience. With the amount of advertising in 

today’s media vehicles, your ads must 

also stand out enough that the audience 

notices and remembers them, and they 

must be sufficiently persuasive to move 

the audience toward different beliefs, 

attitudes, and/or behaviors. 

■	 Initial, ongoing, and postcampaign
 

evaluations. To determine whether your
 

campaign has achieved its objectives,
 

you’ll need to conduct multiple research
 

studies. If possible, you should provide for:
 

– 	 A baseline measure of your audience’s precampaign awareness, 


attitudes, beliefs, and behaviors
 

–	 Midcampaign measures of your audience’s response to the advertising 

and progress toward changing 

attitudes, beliefs, and other factors, 

so you can revise your ads or media 

strategy if necessary 

– 	 A postcampaign evaluation to measure the results of your effort 

Placing a Public Service 

Announcement 

PSAs are typically useful only for reaching a 

general audience with a general message. 

Because stations are donating time, the sponsoring organization has no control over when, 

where, and how often the PSA airs. Tracking 

Chapter 7: Advertising 191 
Table 7.2: Media Characteristics 

Paid Media Public Service 

Announcement Earned Media 

Targeted Not targeted Somewhat targeted, but some audiences (e.g., low-literacy adults and 

teens) may be difficult to reach 

because they are not big consumers 

of news 

Expensive to place Inexpensive to place Inexpensive to place 

Total control of message Nearly total control of message Not much control of message but 

much more control when done well 

Expensive to produce but 

existing ads can be reapplied inexpensively 

Expensive to produce but existing 

ads can be reapplied inexpensively 

Expense dependent on event or story 

Sometimes no financial cost other 

than time 

Talent fees paid every 13 

weeks 

Credibility depends on ad 

execution and audience’s 

perspective 

Talent fees paid yearly 

Credibility depends on ad execution and audience’s perspective 

No talent fees 

Credibility typically greater for 

press stories than for ads 

Credibility somewhat dependent 

on media outlet 

data from past PSA campaigns have shown 

that as many as one-half of PSAs are run late at 

night. This lack of control over the media 

placement makes PSAs ineffective for reaching 

specific or hard-to-reach audiences and makes 

their impact on audiences unreliable. PSAs are 

better used to raise the public’s general awareness of an issue. For this reason, PSA placement is generally not recommended when 

states are trying to make a significant impact, 

unless they have no alternative because of 

funding limits. 

You have a few options for trying to place your 

PSA. The Ad Council selects certain issues for 

which it will support the creative development 

and placement of PSAs. But the organizations 

selected must provide the funds to produce 

the ads, and often, only national organizations 

or national causes are chosen. You can also 

work directly with the public affairs directors 

at networks and local stations to persuade 

them to air your PSA. 

PSAs are most successfully placed when they 

have the following characteristics: 

192 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Strong public service appeal that will 

benefit most of the station’s audience 

■	 Local relevance to the station’s viewing 

area (Relevance can be achieved by tagging the ad with a local organization’s 

name, phone number, or both.) 

■	 Coordinated as part of the bonus time 

of the paid portion of a campaign (See 

section on “Combining Approaches” 

later in this chapter.) 

■	 High-quality production value 

A little-known option for securing PSA placement is to work through state broadcasters’ 

associations. These groups offer NonCommercial Sustaining Announcement 

(NCSA) programs, in which you pay the association a fee to guarantee that your PSA will run. 

In one large state, for about $30,000 for a 

month-long program, the association will 

guarantee that 70 percent of its member TV 

and radio stations will each air the spot 15 

times, with an equal split among prime time, 

daytime, and other times. This type of arrangement is officially considered PSA use, because 

the stations are donating the airtime. The program is available only to government agencies 

or nonprofit groups. At the end of the month, 

the association provides a performance report 

outlining when and where the ads ran. This 

option is often used when funding is insufficient to conduct a paid campaign. 

Obtaining Earned Media 

Having your campaign messages reported in 

the popular press can greatly enhance the 

effectiveness of your media campaign. This 

approach is called earned media, because your 

program staff must work diligently with reporters and editors to gain news media coverage of 

your issue. These efforts can give your campaign 

credibility and additional exposure. Because 

most audiences view news media content as 

more objective than advertising, they’re often 

more receptive to the messages and perceive 

them as more credible. (See Chapter 8: Public 

Relations for in-depth discussion of earned 

media.) 

How do you gain media coverage? 

■	 Identify the appropriate contacts within the media. You can determine the
 

appropriate contacts within the media
 

by seeing who reports on your issue or
 

by calling the news outlets. You may also
 

want to note how the reporter frames
 

the issue: Does he or she seem receptive
 

to your message? 


■	 Establish yourself or your program as a
 

resource for the media. You can build a
 

productive relationship with reporters
 

and editors by providing data and background information. By positioning
 

yourself as a resource for reporters and
 

editors, you can help them in development of their stories. This relationship
 

will increase the likelihood that they’ll
 

contact you when they’re developing a
 

future story on your issue.
 

■	 Present newsworthy stories. Mass
 

media outlets are deluged with press releases and other suggestions for stories.
 

Chapter 7: Advertising 193 
When you “pitch” a story to a media 

outlet, make sure the story has true 

value for its audience. 

■	 Provide supporting materials. Doing 

the legwork for the writer or reporter 

will increase the chances of getting 

coverage of your story. Provide a press 

release, fact sheets, pictures, background information, video footage, 

short biographic sketches of key people, 

and other information, as appropriate. 

■	 Track your contacts with the media. 

Keep notes each time you contact the 

media, listing the topics of your discussions, the information conveyed, the 

reporters and media contacted, and the 

angle used in covering your issue. This 

information will make your future 

efforts more effective. 

Combining Approaches 

As mentioned earlier, mass media campaigns 

work best when paid media campaigns, PSAs 

(primarily for cost-efficiency), and earned 

media are used together. In this scenario, the 

paid media campaign serves as the core tool 

for reaching your target audience(s) with a controlled, sustained message that is most likely to 

be influential. PSAs and earned media are then 

used to supplement the paid campaign by 

reaching secondary audiences and providing a 

broader context for your campaign. 

With most paid media campaigns, you can 

negotiate bonus weight, which is extra media 

time or placements given free by the media 

outlets for your purchase of other media time 

or placements. This bonus time is usually 

given on shows for which the station hasn’t 

sold all the advertising slots. Because you can’t 

choose the time of your ad’s placement, bonus 

time may not reach your exact target, so it’s 

more suitable for a message to the general 

audience that supplements the messages of 

your paid campaign and increases overall 

public support for your issue. 

Earned media allows you to target your primary and secondary audiences more precisely. 

Media outreach will give your paid campaign 

credibility by encouraging the media to reinforce your messages. It will also provide more 

detail and supporting information than can be 

communicated in a 30-second TV spot. You 

can use media outreach to target practically 

any segment that watches or reads news and 

informational media, such as opinion leaders 

through editorial pages and news talk shows or 

parents through specialty magazines. 

Using these three approaches in combination 

will provide a greater opportunity for your 

audience to be exposed to and influenced by 

your message. 

Working With Limited Resources 

Not every organization has the resources to 

conduct a paid advertising campaign. When 

paid campaigns aren’t possible, it’s harder to 

target specific populations, but it’s still possible 

to reach broad groups or the general public. 

If you can’t afford a paid campaign, you should 

consider reusing or producing one or more ads 

for PSA use for a general audience, to increase 

awareness of your issue; then use earned 

194 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

media to focus on specific aspects of your 

issue with different audiences. The process for 

PSA and media relations efforts will be generally the same even if you don’t have a paid 

campaign, though you may have to work harder to persuade the media to cover your story. 

You can do this by conducting newsworthy 

events (e.g., press conferences), releasing new 

data, and taking advantage of any chance for 

media attention when your issue is raised by 

some outside influence (e.g., a well-known 

figure dies relatively young of lung cancer). 

Without a paid campaign, you’ll have to adjust 

your objectives to account for your lack of 

control over placement of your message. 

Evaluating Advertising Efforts 

Advertising is often the most expensive and 

time-consuming component of a tobacco 

counter-marketing campaign. With so much 

invested, several stakeholders will want to 

know whether you’re making a difference and 

whether funds are being used wisely. To 

demonstrate the success of your efforts, you 

should consider using three types of assessment: formative, process, and outcome evaluation. It’s also very important to involve an 

evaluation expert to help you develop and 

implement a rigorous evaluation appropriate 

for your campaign. 

Rigorous evaluation can help you to justify 

your spending to stakeholders by showing that 

the ad campaign, not other factors, accounted 

for changes in the target audience. Formative 

evaluation can help you to determine whether 

you have the right strategy, message, and creative products, before you invest in media 

buys. Process evaluation allows you to keep 

track of what your ad agency and other 

contractors are implementing and to ensure 

that those activities meet your guidelines and 

objectives. Once your ads have been run, the 

outcome evaluation can help you to monitor 

the exposure of the target audience to your 

message(s), their awareness of the ads, and 

their ability to recall the message(s). Most 

important, you can use outcome evaluation to 

help you determine whether changes have 

occurred in the tobacco-related knowledge, 

attitudes, beliefs, intentions, or behaviors of 

your target audience. 

How To Evaluate the Advertising 

Campaign 

Depending on the scope and costs of your 

advertising effort, you should consider using 

formative evaluation during planning of your 

advertising campaign, process evaluation 

during implementation, and outcome evaluation during follow-up. Conducting formative 

evaluation during the planning phase will help 

you to learn which communication strategies 

and ad concepts have the highest likelihood 

of being effective and whether the communication pieces you’re developing leave the 

audience with the messages and impressions 

you intended. This evaluation can include 

research such as exploratory focus groups for 

audience insights, expert reviews, pretesting 

messages and materials, and pilot testing of an 

ad campaign that uses several communication 

channels (e.g., TV, radio, print, and billboards). 

Process evaluation should be conducted as 

you implement your advertising activities, to 

Chapter 7: Advertising 195 
make sure your efforts are on track and in line 

with your guidelines and objectives. You’ll 

need to conduct rigorous monitoring by regularly completing or reviewing logs and other 

documentation tools. For example, if your 

contractor agrees to pretest an ad by a certain 

date, a log can show whether all the steps to 

conduct the pretest were completed and 

whether they were done on time. 

Process evaluation should also include monitoring your target audience’s exposure to your 

advertising. You can obtain data on exposure, 

usually measured in reach and frequency, from 

your ad agency’s reports on your media buy. 

These reports show information such as when 

and where your ads were aired, how many 

members of your target audience were 

exposed, and costs. Reports from companies 

such as Nielsen, Arbitron, and the Audit 

Bureau of Circulations are other sources of 

data on exposure. The reports can also tell you 

the demographics of the audience reached, 

when the ad ran or was aired, and the format 

of the stations that ran the ad. 

Outcome evaluation will help you to learn 

what effect your advertising is having. As 

noted earlier, you’ll at least need to conduct 

initial, ongoing, and postcampaign evaluations 

to determine whether your efforts are meeting 

your objectives. You and your evaluation 

expert will need to make certain decisions 

about methods to be used in conducting an 

outcome evaluation that’s right for you. First, 

to design the evaluation, you’ll have to decide 

which groups will be studied (e.g., smokers 

and nonsmokers) and when. Then you’ll need 

to determine who will be in your sample and 

how it will be selected. Next you should decide 

what questions to ask your sample and what 

methods to use to get the data you need. 

Finally, you must determine how the data will 

be analyzed to obtain the answers you need 

for your evaluation. 

Using Evaluation Results for 

Decision Making 

If the evaluations are conducted well, your 

efforts can yield results that provide a sound 

basis for making project decisions. For example, the findings from your ad agency’s reports 

on the media buy can help you to make 

decisions about ad placement over time. You 

can use the findings to compare results across 

markets in your state to see what worked and 

where. Also, reports that show ad placement by 

week can help you to decide how to time your 

outcome evaluation so you can gauge your 

audience’s awareness of your advertising. 

Tracking a target audience’s awareness and 

message recall of an ad, as well as their overall 

reactions, can allow you to analyze the data by 

subgroups (e.g., age and race/ethnicity), to 

determine whether the ad has different effects 

on different groups. You can then make decisions about ad design and future placement of 

ads directed to these subgroups. If you’re doing 

several types of advertising (e.g., TV, radio, and 

billboards), efforts to track awareness, recall, 

and reaction for each type can help you to 

determine which is the most effective and 

where to spend your advertising dollars. If you 

track your target audience’s tobacco-related 

knowledge, attitudes, beliefs, and behaviors at 

several points during the flights of an ad, you 

also can gauge the ad’s effectiveness over time. 

196 Chapter 7: Advertising 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources for Evaluation 

This chapter covers some of the basics of evaluating an ad campaign. You also should review 

Chapter 5: Evaluating the Success of Your 

Counter-Marketing Program for more information about how to assess the impact of your 

whole counter-marketing program. CDC’s 

Office on Smoking and Health (OSH) is also 

preparing a manual that focuses on outcome 

evaluation for paid counter-advertising campaigns, which is scheduled for publication in 

late 2003. (Check http://www.cdc.gov/tobacco 

for updates on the availability of this manual.) 

Another publication offering evaluation information is CDC’s Introduction to Program 

Evaluation for Comprehensive Tobacco Control 

Programs, published in 2001. 

Points To Remember 

Although creative firms produce advertising, a manager within the tobacco control program must be the 

ultimate authority on what kind of advertising to produce. To effectively manage a creative firm, while still 

encouraging innovative ideas, the manager should focus on a handful of critical questions in four areas— 

logistics, strategy, creative, and exposure. 

Logistics 

■	 What contractual arrangements (e.g., incentives, results-based payments, and penalties) might 

encourage the creative firm to focus on your goals of behavior change? 

■	 What guidelines are needed to set common expectations and ensure quality control of creative 

materials, media buys, billing, scope-of-work restrictions, and other important issues? 

Strategy 

■	 Have you and your agency developed a clear, written set of message strategies for each audience? 

■	 Do the advertising strategies coordinate with other parts of the program at both the local and state 

levels? 

■	 Considering that the tobacco industry, voluntary health organizations, the American Legacy 

Foundation, and other groups may already be reaching your audience, how does your campaign fit 

into the overall context of what your audience is hearing? How might you need to alter the campaign to be most cost efficient and effective? 

Creative 

■	 Is each creative product, from a TV spot to a T-shirt, on strategy? 

■	 Can each product be disseminated effectively to your audience? 

■	 Does each product reflect what you know about your audience? 

■	 Once people are exposed to this creative product, could unintended negative consequences occur? 

Exposure 

■	 Are you reaching your audience effectively (i.e., gaining their attention and clearly communicating 

a message) and efficiently (i.e., for a reasonable price)? 

■	 Are you reaching your audience through the right channel, at the right time, and in the right place? 

Chapter 7: Advertising 197 
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Chapter 7: Advertising 199 
200 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 8 

Public Relations
 

While the advertising in California’s tobacco education 

media campaign has received a lot of positive 

recognition, the public relations component has been 

the unsung hero of the campaign. The public relations 

work is equal in importance to the advertising. 

—	 Colleen Stevens, Tobacco Control Section, California 

Department of Health Services 

Like advertising, public relations (PR) is a way of reaching people with a 

message. But while advertising space or time must be bought or donated, 

PR exposure is “earned” by working with the news media, opinion leaders, 

or others. That’s why the media coverage generated from PR is dubbed 

“earned media”: You must earn the coverage by developing materials, by 

working with reporters, and by expending resources through a continuing, 

systematic process. 

Enhancing the credibility of your message is a key feature of PR. Because 

audiences know that an ad is designed to influence them, they may evaluate 

its message more critically than the information that’s received through the 

news media, which is often seen as less biased. Although audiences may 

question some of what they read in newspapers or see on the news, most 

still consider these sources to be more objective and accurate than advertising, and they generally accept the information more readily. For example, 

many would believe the information released in an article in the Wall Street 

Journal, yet may not be convinced by an ad on the same topic with the same 

message. The same is true of other credible sources. The job of PR is to 

encourage the dissemination of your messages through others, most notably 

the news media. 

In This Chapter 

•	 Setting Goals and 

Selecting Tactics 

•	 Preparing for 

Implementation of 

Your Public 

Relations Program 

•	 Working With the 

News Media 

•	 Developing Press 

Materials 

•	 Responding To 

Negative News 

Stories 

•	 Evaluating Your 

Public Relations 

Efforts 

Chapter 8: Public Relations 201 
To help you create an effective PR campaign, 

this chapter covers four main topics: 

1. 	 Setting goals and selecting tactics for 

your PR activities, including efforts to 

reach your target audiences and important stakeholders. 

2. 	 Preparing for the implementation of 

your PR program, including developing 

a PR plan and managing a PR firm. 

3. 	 Working with the news media, including 

creating press materials and responding 

to negative news stories. 

4. 	 Evaluating your PR efforts. 

Setting Goals and Selecting Tactics 

PR is an essential component of a tobacco 

counter-marketing program because it offers 

credibility, objectivity, and a de facto endorsement of your campaign (as long as the media 

coverage is positive). When you have a small 

paid media budget, PR becomes your primary 

method of communicating with various audiences. Even if you have a large paid media 

budget, PR will complement and support your 

paid media efforts. Without an effective PR 

effort, even the most expensive and creative 

paid media campaign can founder. 

What PR Can and Can’t Do 

PR can 

■ Provide quick responses to hot issues and sudden events 

■ Establish relationships with media, stakeholders, opinion leaders, and others 

■ Reach audiences on an ongoing basis with information that may be seen as more 

credible than advertising messages 

■ Enhance the credibility of your advertising/paid media messages 

■ Gain public support and create an environment conducive to your other tobacco 

control initiatives 

■ Expose the practices of your competitors (i.e., the tobacco industry, smokers’ rights 

groups, and others) and provide a contrasting perspective 

■ Provide a framework for effective crisis communication 

PR can’t 

■ Guarantee your message placement, focus or slant, specific content, or accuracy in 

the media or other venues 

■ Substitute for other components of an integrated and comprehensive program 

202 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

In general, PR complements your counteradvertising program and other efforts by: 

■	 Reaching your target audience with 

in-depth messages that elaborate on 

your key points in ways that ads can’t 

■	 Helping to create positive views of your 

campaign and your organization among 

the news media, stakeholders, policy 

makers, and opinion leaders 

■	 Helping to influence policy change 

through long-term relationships, partnership and coalition building, and consistent efforts to expand the support 

base 

An integrated counter-marketing program will 

use PR to serve all three of these functions. 

This section discusses the first two functions: 

(1) using PR to reach your target audience and 

(2) using PR to promote your program with 

opinion leaders and stakeholders. The third 

function, discussed in another chapter, is 

changing policy. (See Chapter 9: Media 

Advocacy for more information.) 

Target Audience Public Relations 

PR can be a strategic communication tool for 

sending key messages to targeted audiences 

and for complementing advertising messages. 

This use of PR will be referred to in this manual as “Target Audience PR.” 

Developing Target Audience PR activities is 

similar to developing an advertising campaign: 

You need to clarify your overall goal, determine 

target audience(s), set specific objectives, 

select key message strategies, and select the 

best channels. Much of your advertising 

research will also apply to your Target 

Audience PR activities. However, rather than 

buying ad space, you’ll be working with 

reporters and editors to encourage them to 

run stories, op-eds, and editorials that convey 

the key messages of your campaign. These 

stories can provide additional context—and 

additional credibility—that will make the 

advertising component of your campaign 

more powerful. 

For example, if your goal is to increase cessation and your key audience is adult smokers 

with children, your message strategy might be 

to highlight the pain that smokers may cause 

their families if they die or get sick. Your advertising efforts might include running TV spots 

of testimonials from a smoker’s relatives about 

how they have suffered from the smoker’s 

tobacco-related death or illness. Your Target 

Audience PR might include directing reporters 

to “real-life” human interest stories about local 

families who have suffered with this situation, 

possibly even the individuals who are featured 

in your ads. 

In addition to working with reporters to get the 

message out through the news media, you 

might also coordinate a lunch meeting with 

chamber of commerce members to discuss 

various ways to help working parents gain 

access to cessation support in the workplace. 

You might also make a presentation at a Parent 

Teacher Association (PTA) meeting about 

smoking cessation support groups or quitlines, 

and bring fliers with recommended steps for 

quitting and the local quitline phone number. 

Chapter 8: Public Relations 203 
How do you make Target Audience PR a reality 

in your program? Once you know your goals, 

audiences, and messages, you or your PR firm 

should first identify the organizations or news 

media outlets that reach your target audience. 

Second, you should determine how you can 

encourage those organizations or media outlets to disseminate your messages. 

Finding Media Outlets That Reach 

the Audience 

One easy way to find media outlets that reach 

your target audience is to examine your advertising media buy. The newspapers, magazines, 

and other outlets included in the media buy 

will have been analyzed by the media planners 

and buyers to ensure that they reach your core 

audience. They also may be ideal for your 

Target Audience PR activities. You should also 

consider the media that weren’t part of the 

media buy. For example, even if your ad 

campaign doesn’t include Web advertising or 

newspapers, you may want to use these outlets 

in your PR effort. Depending on your target 

audience, you may also want to consider community-based media, such as church bulletins, 

newsletters, and fliers from local organizations. 

If you’re working with a PR firm or consultant, 

they’ll be able to identify the optimal media 

outlets for your target audiences based not 

only on efficiency (how many target audience 

members they reach for the resources expended), but also on the quality of communication 

(e.g., how credible the sources are and how 

appropriate they are for the message). 

Gaining Exposure Through Media Outlets 

Once you identify the outlets that reach your 

target audience(s), you must generate those 

intermediaries’ interest in disseminating your 

message. In Target Audience PR, the most 

common intermediary is the news media. The 

best way to get your message in the media is to 

help reporters make that message appear new 

and interesting to their audience (readers, 

listeners, or viewers). Here are some of the 

most common tactics: 

■	 Create an event. Reporters will often 

cover your newsworthy campaign 

events, including summits, community 

activities, rallies, and so forth. 

■	 Set up interviews with program participants. Everyone loves a good personal 

story (witness Art and Entertainment’s 

“Biography,” VH1’s “Behind the Music,” 

204 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

and Lifetime’s “Intimate Portrait”). Some 

participants in your campaign may have 

interesting personal stories related to 

tobacco. These personal profiles work 

well for magazines and newspapers’ 

lifestyle sections, and they humanize 

your efforts. 

■	 Set up interviews with local residents 

affected by the issue. In addition to 

campaign participants’ stories, you 

might want to identify local residents 

affected by your issue who can talk to 

the media. The resident is more likely to 

generate news coverage if he or she is a 

prominent member of the community, 

such as a sports celebrity or an elected 

official. But remember that these community members must appeal to your 

target audience—if you’re targeting 

teens, don’t use the authoritarian, 

middle-aged mayor. 

■	 Offer reporters “behind-the-scenes” 

access. You can give reporters a look 

behind the scenes of making an ad, or 

let them follow one of the actors during 

the shoot (similar to MTV’s “Making 

the Video”). 

■	 Try a stunt. You can conduct unique 

events for the sole purpose of getting 

news media coverage. Mississippi set 

up its own version of MTV’s “The Real 

World” and placed a group of smokers 

who wanted to quit in a house with 

Web cameras so that people could see 

who gave up smoking first. This tactic 

received national exposure and educated the audience about cessation. 

■	 Create a speakers bureau. A speakers 

bureau will help make your subject 

matter experts more easily available for 

speaking engagements with associations, 

groups, and businesses at conferences 

and other events, and prepare these 

speakers for media interviews. 

■	 Announce the results of a study or 

survey. Sometimes when you do this, 

you’ll get featured twice: once when you 

announce the launch of the study or 

survey and again when you announce 

the results. 

■	 Develop a publication or Web page. You 

can develop publications or add information to your Web site that will encourage 

readers to pass on your message to other 

interested parties or to those who could 

benefit from the information. Your tobacco control campaign’s Web site can include 

copies of and links to the media coverage 

that you’ve received, which will increase 

the reach of this coverage. These efforts 

will need to be coordinated with your 

advertising activities. 

You can also leverage your advertising spending to create Target Audience PR opportunities. 

Many media outlets offer “bonus weight time,” 

which is extra space or time given to you as an 

incentive for purchasing advertising with 

them. This bonus weight time can be used for 

communications other than additional ads. 

For example, you can work with the outlet on 

promotional or sponsorship opportunities. 

For the national “truth” campaign, the 

American Legacy Foundation worked with 

teen magazines to include “truth” gear in their 

Chapter 8: Public Relations 205 
“What’s Cool” fashion sections, rather than run 

additional ads. You can also work with media 

outlets to get interviews for campaign leaders 

and others involved in the campaign. 

These are just a handful of the ways that programs win attention for their messages. Pick 

the ideas that may work for your program. 

There are plenty of other possibilities—try 

inventing your own. 

Capitalizing on Outside Events To 

Increase Exposure to the Message 

Events independent of your tobacco control 

campaign may generate news stories that offer 

opportunities for media coverage. These stories can either undermine or support your 

campaign. In either case, you should respond 

to related stories to ensure that your campaign 

messages are heard. It’s especially critical that 

you respond to any challenges to your campaign messages. Even if you don’t get equal 

coverage for your response, you will have 

educated the reporters about the issue, which 

will be to your benefit for future stories. How 

to respond to negative news stories is covered 

later in this chapter. 

For example, if you’re targeting teens and a 

positive story about the Philip Morris “Think. 

Don’t Smoke” campaign runs in a publication 

that reaches this audience, you can submit 

data to the reporters on how “Don’t Smoke” 

efforts are ineffective and how other approaches (such as those used in your campaign) are 

more effective. In these cases, it may be helpful 

to contact local nongovernment organizations, 

such as the American Cancer Society, the 

American Lung Association, the American 

Heart Association, the Campaign for TobaccoFree Kids, and others, to see if you can coordinate your responses. 

Your counter-marketing program will be 

conducted in the context of national tobacco 

control efforts. You’ll need to anticipate events, 

such as the release of a Surgeon General’s 

report, newly published scientific findings, the 

American Legacy Foundation’s campaigns, 

state or federal tobacco legislation, and the 

advocacy efforts of volunteer and nonprofit 

organizations (such as the Campaign for 

Tobacco-Free Kids). Staying abreast of these 

activities may involve subscribing to national 

tobacco news services, signing up for various 

tobacco-related e-mail distribution lists, and 

participating in national forums (such as the 

Centers for Disease Control and Prevention’s 

Media Network). 

You can also piggyback on national PR events, 

such as the Great American Smokeout, Kick 

Butts Day, and World No-Tobacco Day. When 

you’re planning your PR campaign, do some 

research on these national events and include 

tie-ins to the events that are appropriate for 

your audience. Using these events to gain 

exposure for your messages can be a more 

efficient tactic than creating your own events. 

A Tobacco Control Media Events Calendar, 

along with accompanying media materials, is 

available on the CDC’s Office on Smoking and 

Health Web site at http://www.cdc.gov/tobacco 

/calendar/calendar.htm. 

You’ll also need to monitor the competition’s 

PR activities. You can track news releases issued 

by the tobacco industry by searching the PR 

206 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Target Audience PR in Florida’s “truth” Campaign 

With $70 million from its landmark settlement with the tobacco industry, Florida launched the Florida 

Tobacco Pilot Program in 1998. It was the nation’s first antitobacco education program funded with 

tobacco industry money. The program’s “truth” campaign is designed to create an antitobacco brand that 

appeals to teens the way that the major tobacco brands do. 

Target Audience PR played a key role in the “truth” campaign. Much of the media coverage resulted from 

the efforts of Students Working Against Tobacco (SWAT), the program’s youth advocacy group. The group’s 

activities were designed to engage teens and to garner media coverage that complemented the ad campaign’s messages and tone. Examples of their PR activities include: 

■	 In the summer of 1998, the campaign offered the “truth” tour, a 10-day, 13-city whistlestop train 

tour and concert series across Florida. Then-Governor Lawton Chiles rode the train, joining the 

teen spokespeople who conducted their own press conferences at every stop. SWAT members 

trained their peers in advocacy and media relations along the way, empowering teens throughout 

the state to join in the movement’s rebellion against the tobacco industry. 

■	 During the fall of 1999, SWAT took on tobacco magazine advertising with “Big Tobacco on the Run.” 

SWAT members tore cigarette ads from the magazines they read, plastered them with a neonorange “Rejected. Rebuffed. Returned.” sticker and mailed them to tobacco company executives 

along with a request to meet with SWAT to discuss youth marketing guidelines. The Brown & 

Williamson Tobacco Corporation accepted the invitation and sent a representative to meet with 

the SWAT board of directors. 

The media coverage of these and other events, handled by the PR firm supporting the Florida Tobacco 

Pilot Program, resulted in more than 845 million media impressions (the combined audiences reached by 

all of the media vehicles covering the events). Coverage included stories on “Good Morning America” on 

the American Broadcasting Company (ABC); on the “Evening News’ Eye on America,” “60 Minutes,” and 

“CBS News Sunday Morning” on the Columbia Broadcasting System (CBS); on the Cable News Network 

(CNN) and network affiliates throughout Florida, as well as outlets in New York, Chicago, Los Angeles, 

Dallas, Cincinnati, Indianapolis, and elsewhere. Print coverage included The New York Times, The Wall 

Street Journal, The Washington Post, USA Today, Seventeen, and Teen People, as well as every major-market 

Florida newspaper and numerous minority outlets. 

Chapter 8: Public Relations 207 
newswire (http://biz.yahoo.com/prnews). 

Another comprehensive source of tobaccorelated news is at http://www.tobacco.org, 

which e-mails daily news briefings to subscribers. These briefings will help you to stay 

informed about the latest national and state 

tobacco-related news. 

Stakeholder Public Relations 

A comprehensive PR program will reach not 

only your target audience(s), but also your 

stakeholders, which may include opinion leaders, business leaders, policy makers, local 

advocates, and the public. While the primary 

goal of your Target Audience PR is to reinforce 

your campaign messages, the primary goal of 

your Stakeholder PR efforts is to garner support for your program and its funding. By 

demonstrating your program’s effectiveness 

and value, Stakeholder PR may help to 

increase your program’s longevity. 

To conduct effective Stakeholder PR, you must: 

■	 Identify your stakeholders 

■	 Identify ways to reach those stakeholders 

■	 Identify and capitalize on media opportunities to reach stakeholders 

■	 Involve stakeholders in the campaign— 

and keep them involved 

Identifying the Stakeholders 

The first step in Stakeholder PR is identifying 

your stakeholders. You must determine whose 

support is critical to your campaign and who 

can add to the credibility of your campaign. 

These are your core stakeholders. You’ll probably want the public’s support as well because 

policy makers may follow public opinion if the 

support—or lack of support—is great enough. 

Think beyond the state level and identify 

stakeholders at the community level, especially 

if your program provides grants or funding for 

activities at that level. 

You should identify your stakeholders before 

you begin planning your program because one 

of the best ways to win support is to involve 

key stakeholders early in your planning. Think 

of ways to encourage them to have a stake in 

the program or to view it as partly their program. You may also want to include your 

potential detractors in certain meetings so that 

you can understand the opposition and develop a response or modify your plans. These 

accommodations, if they don’t detract from 

your goals and objectives, may be the key to 

turning a detractor into a supporter. For example, if you’re going to focus on smokefree 

workplaces (including bars and restaurants), 

you’ll want to include some restaurant and bar 

owners and workers in your effort. By seeking 

their input and making adjustments to address 

their concerns, you could earn their support 

up front and help your initiative. 

There are many individuals and organizations 

that you should consider as potential stakeholders, including local businesses and 

employers, business associations, chambers of 

commerce, volunteer and community-based 

organizations, places of worship and faithbased groups, hospitals and health care facilities, neighborhood associations, social clubs, 

208 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

health and other professional groups or associations, state and local government officials, 

school boards and PTAs, public and private 

universities and community colleges, vocational and continuing-education schools, and 

daycare and childcare centers. 

Identifying Outlets That Reach the 

Stakeholders 

Once you have identified your stakeholders, 

you will need to find ways to connect with 

them through various communication channels. These channels will include not only 

media outlets, but also conferences, personal 

meetings, and other communication opportunities. The media outlets are likely to 

include traditional news outlets (daily newspapers, TV and radio news programs, and TV 

and radio talk shows), along with health- and 

tobacco-related publications, Web sites, and 

policy-related publications. You may also 

consider community-based media, such as 

bulletins published by local, faith-based, and 

other organizations. 

Mass media may not be the most appropriate way to reach your core stakeholders. 

Some people and groups will require more 

personal forms of outreach, including phone 

calls, meetings, and individualized letters. 

Other ways to communicate with your stakeholders are through customized outlets, such 

as the following: 

■	 Newsletters. You can create a campaign 

newsletter to inform and entertain supporters and to recognize their efforts. 

You can also send print or electronic 

bulletins on the campaign to partner 

organizations so that they can include 

them in their newsletters. (See Appendix 

8.1 for a sample printed campaign newsletter and Appendix 8.2 for a sample 

online newsletter.) 

■	 Speaking engagements. In-person communication is valuable because stakeholders can ask you questions directly. 

Not only can you provide them with the 

information that they want, but you can 

also learn the issues that are most 

important to them, which will help you 

tailor future outreach. Set up a yearly 

schedule of opportunities to deliver 

messages to your stakeholders at their 

meetings; you should also hold meetings of your own and invite them. 

■	 Web sites. You can create a Web site 

solely for stakeholders. For example, 

Legacy created two Web sites for its 

“truth” campaign. One site is for teens 

(http://www.thetruth.com) and focuses 

on campaign messages. The second 

site is a password-protected site 

(http://www.truthpartners.com), specifically for stakeholders; it disseminates 

research, strategies, and other information to the campaign’s partners. It has a 

mass e-mail function that can be used 

to notify partners of important 

announcements or updates. 

Identifying Media Opportunities To Reach 

Stakeholders 

Certain kinds of campaign activities are more 

likely to attract the attention of large groups 

of stakeholders: 

Chapter 8: Public Relations 209 
■ Campaign launch. This is your prime 

opportunity to get significant news 

media coverage about your campaign. 

All of your main stakeholders and policy 

makers will be interested because the 

campaign is new. You’ll want to focus on 

the campaign’s goals and create a sense 

of excitement. 

controversial. A flight or set of ads also 

demonstrates progress toward the campaign goals. However, it is important to 

notify particular stakeholders (such as 

the local programs and volunteers) of 

new ads before they are run, so that the 

stakeholders can be prepared for 

inquiries from reporters or the public. 

■ Specific advertising flights. Although 

less of an opportunity than the campaign launch, releasing a collection of 

ads can garner news media coverage, 

especially if the ads are unique or 

■ Events. Related summits, speaking 

engagements, health fairs, and other 

events are opportunities to reach out to 

stakeholders and gain coverage. 

Stakeholder Involvement in California’s PR Campaign 

California has been at the forefront of integrating many components of a comprehensive tobacco countermarketing program. One California PR effort illustrates how to successfully meld local programs, grassroots efforts, and advertising with stakeholder involvement to disseminate campaign messages in the 

news. 

In the spring of 1995, California’s tobacco education program worked with local programs throughout the 

state on Operation Storefront. More than 700 trained youth and adult volunteers surveyed more than 5,700 

tobacco retailers throughout California, including grocery stores, supermarkets, drugstores, convenience 

stores, small pharmacies, gas stations, and liquor stores. These volunteers documented the number of 

indoor and outdoor storefront tobacco ads in the retailers’ establishments, including window signs, posters, 

banners, display racks, decals, clocks, neon signs, doormats, ashtrays, counter mats, and other items that 

included tobacco brands or slogans. 

The survey found a significantly higher average number of tobacco ads and promotions in stores near 

schools (within 1,000 feet) than in stores not near schools. Tobacco retailers near schools were more likely 

to place tobacco advertisements close to candy racks or less than 3 feet from the floor, where children 

were most likely to see them. 

The survey’s results were released at 19 local press conferences throughout the state. With the coordination by the PR staff at the state health department and at the PR firm, each local program was able to 

attract local press coverage and to contribute to the powerful statewide and national impact of the 

results. The survey results were subsequently incorporated into ads that exposed tobacco industry 

advertising tactics directed toward children. 

210 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Evaluation reports. Stakeholders as well 

as detractors will be interested in 

whether your campaign is working. If 

your results are positive, you’ll definitely 

want to spread the word. If your goals 

aren’t met, you will still want to share 

with your core partners the results as 

well as the reasons why you believe that 

the results were not as strong as hoped, 

so that your stakeholders can help you 

develop new directions and defend your 

efforts from attacks. 

Capitalizing on Media Opportunities 

Responding to attacks on your campaign is 

essential to maintaining its credibility and support from stakeholders. Be prepared to work 

quickly with reporters and to draft news 

releases, editorials, and op-eds in response to 

attacks. When you respond to the attacks, it is 

important to use the right tone. Sometimes a 

forceful approach is appropriate, while, at 

other times, you should present a calm, nonconfrontational response. In either case, don’t 

sound defensive and be sure that your 

responses are supported with appropriate 

data. If you’ve built good relationships with 

your partners, ask them to support your program by issuing their own responses to the 

attacks. Quick decision making and action are 

essential in these situations. 

As with Target Audience PR, you’ll also want to 

monitor the activities of the tobacco industry. 

Keep an eye out for fake grassroots efforts 

organized by the tobacco industry or other 

opponents. You should counter these efforts by 

exposing them as coordinated by the tobacco 

industry. For example, a smokers’ rights 

campaign may successfully cloud the issue of 

secondhand smoke by claiming that free 

choice is being threatened. If you have concrete 

evidence that these efforts are funded or coordinated either directly or indirectly by the 

tobacco industry, then you may provide that 

information to the news media to ensure that 

they have all of the facts. If you’re not completely sure of the information, don’t risk your 

credibility by speculating. 

Don’t forget to look for good news about 

counter-marketing efforts (even in other 

states) that support your campaign. 

Highlighting the successes of similar efforts 

will show stakeholders that you’re following a 

proven path. 

Involving Stakeholders in Your Campaign 

Once you have identified potential partners or 

stakeholders, directly involving them (especially local coalitions and advocates) in your 

counter-marketing effort can be an excellent 

method of retaining their interest and support. 

You’ll also gain the benefit of their insight and 

expertise. Stakeholder involvement may be 

valuable in: 

■ Campaign planning (especially when 

working with specific populations) 

■	 Research and evaluation planning 

■	 Key phases of implementation (for 

example, invite stakeholders to be part 

of your proposal review committee after 

you issue a Request for Proposals for 

work to be done by contractors) 

Chapter 8: Public Relations 211 
■	 Advertising development 

■	 Visibly supporting your campaign when 

it’s facing a threat from detractors 

■	 Planning and implementing media 

advocacy and grassroots events 

The more that you genuinely involve key 

stakeholders in your efforts, the more time, 

resources, and effort they’ll invest in protecting 

your program and ensuring its success. 

Defining the stakeholders’ role in your efforts 

helps them understand the rationale for their 

involvement and will motivate them to become 

involved and stay involved. These reasons will 

differ, depending on the interests and focus of 

each stakeholder. For example, the business 

and labor sectors have a significant interest in 

the health of local families and communities. In 

addition, private sector industries are interested 

in being “good neighbors” in the communities 

in which they operate, since the community 

supplies their workforce, and often, their 

markets. However, because each entity has a 

different agenda, you’ll need to tell them individually why they need to get involved with 

your cause and how they can help. Consider 

the ways in which the participation of partners 

will help them. What incentives and benefits 

exist or can be created to help win their support? Consider what these people and their 

institutions are already doing to help the community. Building community goodwill, for 

example, can be a motivating factor for 

some partners. 

Preparing for Implementation of 

Your Public Relations Program 

The first section of this chapter provided a 

conceptual framework for organizing your PR 

activities into Target Audience PR and Stakeholder PR. This section provides information 

on preparing for the implementation of your 

PR activities, including developing a PR plan 

and managing a PR firm. 

Developing a PR Plan 

Because your PR efforts should be conducted 

in the context of a strategic communication 

effort, you should develop a PR plan for each 

of your major tobacco control program initiatives. As you develop the plan, you’ll need to 

be mindful of what role your organization 

plays in tobacco control (e.g., public education, advocacy, lobbying, and health care). 

Outlining the goals, objectives and associated 

tactics, and timing for each effort will ensure 

that no steps are overlooked. Tracking the 

activities as they are implemented will provide 

you with a record of what was done, which will 

help you to evaluate your efforts and to 

improve future PR outreach. 

The PR plan should answer four basic questions for each outreach effort: 

1. 	 What do you want to accomplish? 

Describe your goal in as much detail as 

possible so you’ll be able to determine 

whether you are moving toward this goal. 

2. 	 How will you accomplish it? Detail your 

objectives and associated tactics, 

including activities that you plan to 

212 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

undertake, materials that need to be 

developed in support of those activities, 

a materials dissemination plan, a list of 

intended media contacts, follow-up 

contact plans, planned press events, and 

spokespeople. You may want to outline 

partners who will assist and what their 

roles will be. 

3. 	 When will you accomplish it? Create a 

timetable that shows when each of your 

activities will be completed. 

4. 	 How will you determine if your goals 

were met? Describe how you’re going to 

measure your effort. You should decide 

up front what indicators you’ll use to 

measure the results and how you’ll collect the information. Indicators may 

include the number of media “hits” that 

you received or the number of people 

exposed to your messages through the 

news media. Other key indicators 

include the focus, slant, and placement 

of news stories in which you’ve tried to 

communicate your key messages. For 

example, if the stories written have a 

pro-industry slant, then you may not 

have met your goal, even though you 

have received substantial media 

coverage. 

As part of your overall PR plan, you should 

develop a crisis communications plan that 

outlines the process for dealing with attacks on 

your campaign. Because you’ll have to 

respond quickly to such attacks, you may need 

to develop a shortened review process to 

replace the usual lengthy review process. Your 

shortened process may include having your 

head PR person craft a response and having it 

quickly approved by the program manager or 

the marketing director. Receiving a call from a 

reporter for your response to an attack is a 

valuable opportunity to convey your campaign 

messages that you will not want to miss. 

Planning ahead will allow you to include recommendations of experts and partners who 

can support your efforts. If you don’t develop 

such a plan proactively, you may find yourself 

being attacked without time to do the necessary planning to provide a strategic response. 

(Responding to negative news stories is covered later in this chapter.) 

Your program is likely to be scrutinized by the 

media, the public, and the tobacco industry. To 

help prevent criticism, you should proactively 

consider how your messages and activities 

may be perceived by these audiences. Hold 

yourself and your program to high standards 

of ethics, accuracy, and accountability about 

how you position your messages and what 

activities you choose to conduct. 

Managing a PR Firm 

PR firms provide a range of services and can 

be valuable for conducting target audience 

and stakeholder outreach in support of large 

campaigns. Although your PR firm will have 

staff who can handle most, if not all, of the 

communication functions, you should stay 

well informed about all PR activities so that 

you maintain the lead role in decision making. 

Many firms like to set a monthly retainer for 

their services that is based on the expected 

level of services to be provided, while others 

will establish a yearly budget for your program, 

Chapter 8: Public Relations 213 
then bill only the incurred labor and other 

costs each month under some maximum 

annual ceiling. With large counter-marketing 

programs, the latter arrangement may be preferred because each monthly invoice reflects 

the level of the work actually performed and 

allows for easier tracking of the specific costs. 

If you want to reach specific populations in 

your state (e.g., African Americans; Hispanics/ 

Latinos; Native Americans; the gay, lesbian, 

bisexual, and transgender community; and 

people with disabilities or other special needs), 

then you may want to look for one or more 

firms that specialize in reaching these populations. The firms may recognize specific communication challenges with these groups and 

may have stronger and broader relationships 

with the media and stakeholders that are 

important to them. Often, these specialty PR 

firms can subcontract with your primary PR 

firm, removing the need for separate competitive bids. 

If you do arrange for subcontractor PR firms, 

make sure that you can establish direct contact 

with each firm when needed and that you stay 

fully informed about their activities. Although 

most of the work may flow through the prime 

contractor to the subcontractors and back, 

there may be times when it’s critical to have 

direct access to a subcontractor. Keep in mind, 

though, that the prime contractor is legally 

responsible for all work done on the contract, 

even by subcontractors, so make sure that 

they’re aware of any contact that you have 

with subcontractors. 

To locate specialized firms in your area, you 

can review directories such as the Directory of 

Multicultural Relations Professionals and 

Firms, which is offered by the Public Relations 

Society of America. 

Key PR Firm Functions 

A PR firm can perform several functions for you: 

■	 Strategy—helping you to develop your 

overall image and supporting communication strategies to reach your goals 

■	 Counsel—giving you advice on how to 

handle issues and situations to maintain 

image and reputation and to support 

your messages 

■	 Research—conducting research on 

the target audience, messages, and 

public opinion 

■	 Message and materials development— 

developing messages to fit your strategies, developing materials for the news 

media and others 

■	 Media relations—working directly with 

the media to get coverage 

■	 Spokesperson training—identifying 

and training spokespeople who support 

your campaign 

■	 Stakeholder relations—facilitating 

meetings with partners and other key 

stakeholders 

■	 Issues monitoring—reviewing the 

news to see how your issue and campaign 

are covered 

214 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 Event planning—creating events and 

holding press conferences to attract 

media coverage 

■	 Creative—creating “collateral materials” 

(items such as posters, brochures, and 

fliers that are given to your target audience), Web sites, and other communication tools to convey your key messages 

You may not need all of these services from 

your PR firm. For example, you may rely on 

your ad agency for strategy development and 

on a contract with a state university for 

research. However, you should be aware that 

PR firms offer a perspective that differs from 

most ad agencies or other vendors, so you’ll 

probably want to tap PR expertise when making crucial strategic decisions. If you are relying on multiple sources for support, make sure 

that all of the sources are coordinating their 

efforts while you maintain the lead for overseeing the work. Coordination among all of the 

individuals and entities involved is essential to 

avoid a PR crisis that could occur if everyone is 

not on the same page. 

Coordinating Your PR Firm With Your Ad 

Agency 

Many of the services offered by PR firms 

overlap with those offered by ad agencies, 

event management firms, and others. Be sure 

to designate a lead agency for certain functions, like establishing your overall strategy. 

Many people on the counter-marketing team, 

including those at the advertising agency, will 

have opinions on what will generate news 

coverage. Listening to these opinions is important because you may get some great ideas, 

but give special consideration to the advice of 

the PR firm staff on news media issues. They 

have worked with reporters and know what is 

more likely to attract coverage and how that 

coverage can be managed. Because you are 

ultimately responsible for the activities of your 

organization, it’s important that you consider 

all of the input and advice and make the final 

decisions on major issues yourself. 

Bring in your PR staff early in the development 

of the whole counter-marketing program. 

Involvement from the start will help PR agencies develop ideas and give them time to plan 

effective outreach and events to achieve your 

goals. Calling a PR firm a few days before you 

release a new ad campaign will not give you or 

the PR firm time to maximize media opportunities or to plan for other components of a 

comprehensive approach. Therefore, you may 

not have the necessary partner support and 

media relationships in place to complement 

an ad campaign. With these components in 

place, your campaign will be more likely to 

gain valuable media coverage and collaboration among partners. Involvement during the 

campaign’s development will also allow the PR 

experts to identify potentially negative or controversial issues and to develop contingency 

plans for them. 

Handling PR In-House 

Although PR firms are uniquely qualified to 

conduct outreach to media, stakeholders, and 

others, you can also handle the public relations functions in-house if you have the right 

staff and resources. You’ll need to designate 

someone to manage the PR tasks. Major 

Chapter 8: Public Relations 215 
tobacco control programs often employ fulltime staff solely to manage news media relations, especially in the program’s initial stages. 

In Florida, for example, the counter-marketing 

program employed a press secretary, a deputy 

press secretary, and two interns to manage the 

news media when the campaign was most visible. If you choose to handle all of your PR inhouse, you will need at least a press secretary 

and probably others to work with reporters, 

develop materials, train spokespeople, and 

develop strategies that include partnership 

building and special events planning. 

Working With the News Media 

The news media can be difficult to work with if 

you don’t understand their needs and if you 

don’t develop good working relationships with 

them. However, successfully working with the 

news media can greatly support your programs 

and enhance the image of your campaign and 

organization. To work 

effectively with the 

news media, you will 

need to consider: 

■	 What the 


media want
 

■	 What they 


consider 


newsworthy
 

■	 Who they are 

specifically and 

how you can 

reach them 

■	 How you might gain their attention 

and pitch a story 

■	 How to keep them interested in the program though press conferences, editorial board meetings, and Web-based 

“press rooms” 

■	 How to place your messages in the 

media through letters to the editor, 

op-ed pieces, and calendar items 

■	 How to respond to their unsolicited 

inquiries 

■	 How to develop spokespeople 

■	 How to develop the optimal materials 

for the news media 

■	 How to meet media deadlines, which 

often are short 

216 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Checklist To Determine Newsworthiness 

❑	 Is the story timely? Is new information being offered, perhaps newly collected data? 

❑	 Is the story distinct, unusual, or unexpected? Is the issue or some aspect of it new to the public? 

❑	 Does the story indicate a trend or relate to other breaking news? 

❑	 Is the information essential? Does it convey something people want or need to know? 

❑	 Will it affect many people in the community? Does it hit close to home? Localizing a national story 

by adding local statistics, spokespeople, and experts significantly increases a story’s chances of 

being picked up. 

❑	 Is the information useful to readers? 

❑	 Does the story have emotional appeal? A human-interest element? 

❑	 Do you have compelling visuals to accompany the story? Offering a reporter visuals may increase 

the appeal of a story and may increase its chances of being run. 

❑	 Does the story involve a national or local celebrity? 

Knowing What the Media Want 

Most media companies are in business to 

make a profit. They make money by developing and disseminating accurate, informative, 

and sometimes entertaining media content 

(for newspapers, magazines, TV programs, and 

radio stations) with two goals in mind: (1) 

attracting or retaining readers, viewers, or listeners; and (2) selling advertising. The more 

readers, viewers, or listeners that they have, 

the more they can charge advertisers for 

advertising space or broadcast time, and the 

more money they can make. Competition 

among media outlets for consumers is intense, 

as is the continuing search for compelling 

information and high-quality entertainment. 

Keep the media’s goals in mind when you’re 

developing stories that you want placed. 

Determining What Is Newsworthy 

To attract coverage of your issue, you must 

have something newsworthy to say. You’re 

competing with countless other issues and 

organizations for scarce space or airtime. 

Before you pick up the phone or write one 

word, put yourself in the place of a reporter, 

editor, or producer and ask yourself why 

people should be interested in your story at 

this time. The same facts can produce entirely 

different stories. You’ll need to have a new 

“hook” or “angle”—some piece of information 

that’s new or could be examined in a new and 

interesting way. To gauge the potential of the 

story idea that you want to pitch, check the 

proposed news hook against the criteria in the 

checklist provided. If your story is timely and if 

you answer “yes” to at least two other criteria, 

Chapter 8: Public Relations 217 
Typical Entries for a Media 

Contact List 

■	 Date when the information was 

most recently updated 

■	 First and last name and title of 

the reporter or the editor 

■	 Name of the media outlet 

■	 Complete mailing address: 

street, city, state, and ZIP code 

■	 Telephone, fax, and e-mail 

■	 Field of interest or beat 

■	 Deadline and schedule 

■	 Other relevant information, 

such as ABC network affiliate, 

radio, monthly magazine, or 

daily newspaper 

■	 Reach and circulation 

the odds are that the media professionals will 

consider it newsworthy. 

Developing and Maintaining a 

Media List 

Maintaining up-to-date media outlet lists for 

your area is key to a functioning PR program. 

Media lists contain key information about all 

of the journalists that you work with or would 

like to reach. 

If you are putting together a media list yourself, one easy way to get started is to look on 

the Internet for listings of media outlets in 

your area. For example, you can find listings of 

established media outlets at http://www. 

emonline. com/links/index.html and 

http://newsdirectory.tucows.com/news/press 

/na/us. Other sources for information about 

media outlets in your area include chambers 

of commerce and the yellow pages. You can 

also purchase publications that provide listings of media outlets. Don’t forget to perform 

searches for the media outlets that reach the 

various ethnic communities and diverse 

populations within your area. Your partner 

organizations may be able to provide you with 

the media lists that they’ve used. 

The PR firm or consultant with whom you are 

working should be able to identify the optimal 

media outlets for your target audience(s), 

based not only on audience reach, but also on 

the credibility of each outlet with your audience(s). Most PR firms have access to databases 

of reporters and editors and can generate 

media lists quickly. You will probably want 

your PR firm to develop a custom database 

and to track your contacts with key reporters 

and what they like to cover. 

Your media list will likely include: 

■	 Newspapers (dailies, weeklies, and 

monthlies) 

■	 Local trade and business publications 

■	 Other local publications, such as university papers, bulletins from places of 

worship, and community newsletters 

■	 Local TV and radio stations (including 

college and university networks) 

218 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Working with Minority Media 

Many state programs include a focus on specific populations disproportionately affected by tobacco 

use. (See Chapter 4: Reaching Specific Populations for more information.) To reach these populations, 

you often have to augment your general media selection with minority news media. Specialized PR 

firms can provide media lists and contacts for media that reach specific audiences. However, some 

minority media outlets may be less likely to publish tobacco control articles if they accept and depend 

on money from the tobacco industry for advertising, events, or promotions. When working with 

minority media, you must be aware of their position on the issue. 

When pitching a news story to minority media outlets, be sure to: 

■	 Highlight the toll that tobacco use has on their audience 

■	 Explain the positive role that they can play in solving the problem 

■	 Provide them with information on your efforts 

■	 Include members of the relevant stakeholder organization(s) on your team when holding 


in-person meetings
 

As mentioned, the minority media outlets that you’re approaching may be accepting advertising, 

event, or promotional dollars from the tobacco industry. Many minority media outlets are on tight 

budgets and rely on tobacco advertising as part of the revenue mix that supports their publications. 

You should sympathize with their situation so that they don’t feel chastised by you or your program, 

but you should not condone or support their receipt of this money. If your campaign includes paid 

placements in their media outlets, mentioning this when you meet with them may show that you 

value their outlets as paid media channels. 

■	 Local cable stations If you are conducting a paid advertising media 

buy, be sure to include all of the newspapers, 

magazines, TV and radio stations, and other 

media outlets in your advertising buy. 

■	 Freelance writers who may be looking for 

stories to feed to media outlets 

■	 Public broadcasting stations (which may 

have community-affairs programming) 

■	 Public information officers at military 

bases (many bases have broadcast stations and newsletters that reach service 

members and their families) 

Once you have collected the media listings, you 

must determine who your contacts are with 

these outlets. You will not have much success if 

you simply collect media outlet fax numbers and 

send unannounced news releases and advisories. You must call the media outlets and ask 

Chapter 8: Public Relations 219 
who in their organization covers topics related

to tobacco. Don’t limit yourself to health 

reporters, although they will be key. You may 

be interested in the reporters who cover stories 

related to restaurants and other businesses so 

that you can prepare them for your smokefree 

restaurants campaign. You may also want to 

know who covers education, family, recreation, 

and other relevant areas. Staff turnover is frequent at many media outlets, so update your 

contact list or database often. 

The next step is to contact the identified 

reporters to introduce yourself. Become a 

“source” for them—someone who can tip 

them off to news about tobacco, explain the 

context, provide background information and 

additional data, and connect them with relevant people for interviews or quotes. 

If you want your story to run nationally, you 

should know that many newspapers are members of one or more wire services (e.g., 

Associated Press [AP], United Press 

International [UPI], and Reuters), and rely on 

these services to provide their readers with 

national news and features. A story that goes 

over the AP wire is commonly picked up by 

200 or more newspapers. That’s a quick way to 

get national coverage of your story. Often, larger circulation papers feed stories to wire services. You can contact the services directly or 

develop media contacts with the larger papers 

in your area to gain access to these services. 

Another idea often used in larger media markets is to join a press association and network 

to find reporters who will competently cover 

your issue. 

Developing and Cultivating Good 

Media Relationships 

Reporters are inundated with information 

every day. You’ll need to take steps to attract 

the reporter to the information that you have 

to offer. Make it as easy as possible for the 

reporter to write the story that you want without having to contact you. Make your information concise and to the point. Be available to 

give the reporter direct quotes and additional 

information; the reporter is likely to need these 

for most major news or feature stories. When 

you talk with reporters, be sure to: 

■	 Treat reporters as respected individuals. 

Learn their beats and interests. Journalists 

are almost always pressed for time. To 

cultivate positive coverage, be courteous, 

concise, timely, relevant, and objective. 

Ask how they prefer to get information 

(e.g., by fax or e-mail) and abide by their 

request. Don’t send large e-mail attachments with big graphics. 

■	 Be prepared and credible. Have backgrounders, fact sheets, and lists of 

experts ready to discuss the issue, and 

fax the information to the media outlets 

before contacting the journalists. 

■	 Respect deadlines. All media outlets 

operate on deadlines. When you call the 

assignment editor to learn who covers 

what, find out when the deadlines are 

and respect them. Information sent too 

early may be forgotten. A hot, lastminute story can be pitched on the 

phone. In general, mail news releases so 

that they arrive three to five days before 

220 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

an event. This extra time will allow the 

editors to assign someone to your story. 

If you are phoning in a story, do so at 

least one day ahead of time. 

■	 Be polite. If the journalist just isn’t interested, accept it. The reporter may suggest that someone else at the media 

outlet cover the story, be interested in 

the next story idea that you offer, or 

learn that you are a source and come to 

you for information or ideas in the 

future. Don’t burn any bridges. 

Pitching Your Story to Reporters 

Pitching a story means contacting reporters to 

persuade them to cover a story or event. 

Journalists want to hear about good story ideas 

because your ideas can help them put together 

more compelling stories. When pitching a 

story to a reporter, you must: 

■	 Be succinct. Jot down a few sentences 

that clearly and briefly state what you 

want to tell the reporter. You can use 

these notes as a script to prompt you. The 

purpose of a story pitch is to pique the 

interest of a journalist, not to communicate everything there is to know about a 

subject. In most cases, less is more. 

■	 State clearly who you are and why you’re 

calling. Then convey the essence of your 

issue or event in the first 15 seconds. 

Think about what you’re pitching as 

though it were a headline that will grab 

the journalist’s attention immediately. 

The first sentence of the conversation 

should emphasize why people will care 

about this story. 

■	 Ask whether the reporter has time to 

talk. If the answer is “no,” inquire about 

a better time. If the reporter agrees to 

chat for a moment but is rushed, be 

brief and get to the point quickly. 

Journalists will elect to keep you on the 

phone longer if they’re interested in 

your story. They’ll also make themselves 

more available to you in the future if 

they feel assured that you will be 

respectful of their time. 

■	 Be sensitive to the time of day. Different 

media outlets work on different schedules and deadlines. Find out the best 

time to contact each outlet on your 

media list. A general rule of thumb is 

that newsroom editors are the most 

open to discussing story ideas after the 

morning meetings have concluded— 

usually after 10:30 a.m. Avoid calling 

newsrooms after 3 p.m. because journalists are often focused on meeting 

tight deadlines at the end of the day. 

■	 Position your story as one that is 

receiving attention right now. Then 

ensure that your pitch includes an angle 

that’s timely, topical, and pertinent to a 

current news peg. 

■	 Whenever possible, humanize a story. 

Providing compelling visuals, personal 

storylines, and interesting anecdotes with 

the initial pitch will afford journalists the 

Chapter 8: Public Relations 221 
luxury of acting on a story idea quickly 

without having to do a lot of homework. 

■	 Preserve your credibility. Avoid making 

claims about a story that won’t hold 

under further scrutiny. Making claims 

that can’t be substantiated will compromise your credibility and limit your success with future pitches. 

■	 Avoid repackaging the same old information. If a story does not reveal new 

information, do the necessary research 

to find a fresh hook, a recent statistic, or 

a different angle to justify running the 

story again. For example, if you’re pitching a story on smoking cessation programs that have been covered in the 

past, narrow your pitch to include a 

timely news peg, such as recent statistics on smoking among teenagers and 

adapt your message points to support 

that angle of your story. 

■	 Become an ally to the news media. 

News outlets want stories that will 

appeal to their audiences. Understanding the audience base of a news 

organization will help you to pitch stories that will interest them. 

Conducting a Press Conference 

Holding a press conference is a great way to 

get information to the media. Before planning 

a press conference, determine if there’s a compelling reason to have one, such as a release of 

new information or another significant event. 

If you can create a local angle for a story or 

create a local link to a nationally breaking 

story, you are more likely to get local media 

outlets to attend your press conference and to 

cover the story. To make sure that your press 

conference goes smoothly, take these steps: 

■	 Choose a location. If you choose a public location, make sure that you apply 

for any necessary permits or get permission from the appropriate person. 

■	 Set the date and time. Midmorning on a 

Tuesday or Wednesday is generally the 

best time to attract reporters. 

■	 Select speakers. Determine who will 

speak at the press conference, what 

each person’s topics will be, and how 

long the press conference will last (usually 30 to 45 minutes). Generally, you’ll 

want someone to make an opening 

statement (five to 10 minutes), followed 

by other speakers who can share different 

perspectives or secondary information 

(10 to 15 minutes). The remaining time 

should be used for a question-andanswer period. You should have a moderator who can direct the questions to 

the appropriate participants and can 

maintain order—especially if you are 

dealing with a controversial topic. 

■	 Invite public figures. Invite “VIP” 

guests, such as the governor, the mayor, 

or other public figures, well in advance 

to increase the likelihood that they can 

attend. Having such public figures in 

attendance can provide an implicit 

endorsement of your message. Follow 

up as the date gets closer in case there 

222 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

are cancellations. You don’t want to promote their attendance if they can’t make 

it. Make sure that you coordinate with 

their PR staff. 

■	 Decide which pictures or visuals will 

best convey your message. You can create enlarged photos or giant posters that 

show your findings. Use your logo and 

make your organization’s name visible 

on a big sign. 

■	 Prepare a news advisory. Include a 

point of contact and phone number on 

it, and mail or fax it to reporters on your 

media list early enough to arrive one 

week before the event. 

■	 Encourage reporters to attend. A few 

days before the event, phone the 

reporters to remind them of the press 

conference and encourage them to 

attend. 

■	 Assemble media kits or handouts. 

Include summaries of the topic that 

you’re presenting, prepared statements to 

be read, and photos and graphics illustrating the topic of the press conferences. 

■	 Set up the room. On the day of the 

event, leave enough space for TV cameras on the sides or in the back of the 

room. Be sure that there are functioning 

electrical outlets available where the 

reporters will set up. 

■	 Have all members of the media sign in. 

Give them a copy of your media kit 

or handouts. 

■	 Prepare an agenda. Give all attendees 

an agenda for the press conference that 

includes key speakers and timing for 

the event. 

■	 Be punctual. Start and end the press 

conference on time. 

■	 Say thanks. Thank the media and 

your guests for attending. 

■	 Follow up. Contact reporters who
 

request additional information.
 

Meeting With Editorial Boards 

One way to add to your program’s credibility is 

to encourage favorable editorials. Editorials are 

articles that express opinions and are usually 

not signed by an individual because they are 

seen as representing the official position of the 

newspaper. To educate a newspaper about 

tobacco control and to properly introduce 

major elements of your campaign, consider 

meeting with newspaper editorial boards. The 

editorial board sets the paper’s general editorial 

policy and includes the people who write the 

editorials that appear in the paper. The editorial 

board of a major metropolitan newspaper usually consists of the publisher, the editor, the 

editorial page editor, and some columnists and 

editorial writers. However, most editorial board 

meetings include only the editorial page editor, 

the editorial writers, and/or the columnists. At 

a smaller paper, a single person may handle the 

entire editorial page. 

Editorial boards each have their own schedules 

and procedures, so call the one that you’re 

Chapter 8: Public Relations 223 
Checklist for Press Conference Planning 

Facility Accommodations and Appearances 

Be sure to select a location with 

❑	 Adequate space for attendees and equipment, 

including tables and chairs 

❑	 Enough electrical outlets for equipment 

❑	 Adequate parking available 

❑	 Accessibility for senior 


citizens and people with disabilities
 

❑	 Adequate lighting 

❑	 Properly functioning air conditioning or 

heating 

❑	 Good acoustics for speaking and recording 

Be sure to have alternative plans in case of bad 

weather. 

Other accommodations and equipment that you 

may want to consider include: 

❑	 Lectern and/or platform and stage 

❑	 Reception area 

❑	 Videotape equipment 

❑	 Microphones and amplifier 

❑	 Recording equipment 

❑	 Audiovisual aids (e.g., screens, charts, easels, 

chalkboards, slide projectors, computers, and 

projectors) 

❑	 Photographer and video crew 

Test all of the equipment in advance and allow time 

to get any needed replacements. 

Before the Event 

❑	 Conduct a “walk-through” to determine the 

appearance of the facility 

❑	 Check the condition and location of the signs 

❑	 Before the press conference, test the equipment again with the actual material that you 

plan to use 

Materials 

Make sure that your spokespeople and staff are 

equipped with the materials that they need to 

effectively deliver your messages and to meet event 

objectives. Examples of materials include the 

following: 

❑	 Agenda, schedule, and program 

❑	 Gifts or awards 

❑	 Brochures 

❑	 Media kits 

❑	 Direction signs 

❑	 Name tags 

❑	 Host badges or ribbons 

❑	 Guest book or sign-in sheet 

❑	 Posters or banners 

❑	 Placards for speakers or guests of honor 

Staffing 

Make sure that staff are available to oversee these 

functions: 

❑	 Rehearsal 

❑	 Parking and traffic control 

❑	 Registration and guest sign-in 

❑	 Master of ceremonies 

❑	 Photography and/or videotaping 

❑	 Audiovisual arrangements 

❑	 Decorations and catering 

❑	 Setup/cleanup 

NOTE: If your event involves a presentation or demonstration, you may wish to have prepared questions for 

designated questioners in the audience to facilitate a 

question-and-answer discussion. 

224 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

targeting to find out how it functions. Many 

editorial boards hold regular meetings with 

outside groups. If you can get on the agenda for 

one of these meetings, make sure that you’re 

thoroughly familiar with the media outlet and 

its position on tobacco. Also, you should: 

■	 Attend the meeting with no more than 

three people 

■	 Prepare a 5- to 10-minute presentation 

(no longer) that states your main message and the importance of your issue to 

the community 

■	 Take materials to hand out, including a 

succinct explanation of the issue, a fact 

sheet on your issue, and the names and 

contact information of people who can 

be reached for more information 

■	 Be prepared for a pointed group discussion in which everyone asks questions 

and voices opinions 

If you can’t meet with the editorial board, you 

can write an editorial board memo. This 

memo will contain the same basic information 

that you would have presented in person. If a 

hot issue is in the news, you can use editorial 

board memos to target columnists by providing an interesting point of view on the issue. 

Letters to the Editor 

Letters to the editor are an effective way for 

you to voice an opinion to policy makers and 

to educate the community about your tobacco-related issues. Use these letters to correct 

facts in an inaccurate or biased news article, to 

explain the connection between a news item 

and your activities, or to praise or criticize a 

recent article. Your program may send the 

editor as many different letters on the same 

subject as you have allies to write and sign 

them. To increase your odds that your letter 

will appear with little or no editing by the 

paper, consider these guidelines: 

■	 Avoid general salutations. Whenever 

possible, use the actual name of the editor. If you don’t know the name, address 

your letter to Dear Editor. Do not use 

general salutations like “Dear Sir” or “To 

Whom It May Concern.” 

■	 Keep the letter short. A maximum of 

three to five short paragraphs or 200 to 

300 words should be sufficient. Some 

newspapers have length restrictions. 

Some newspapers also reserve the right 

to edit for length and may not edit a 

letter the way that you would want. 

Find out about these policies before 

submitting a letter. 

■	 Keep it simple and succinct. Make sure 

that your first sentence is short yet compelling. Don’t be afraid to be direct, 

engaging, and even controversial. 

■	 Get personal. Demonstrate local 

relevance with your letter. Use local statistics, personal stories, and names to 

make your point. If you are going to tell 

someone else’s personal story, be sure to 

get his or her permission in advance. 

■	 Be timely. Capitalize on recent news, 

events, editorials, and public-awareness 

campaigns. If you are responding to a 

Chapter 8: Public Relations 225 
recently published article, refer to the 

headline of the article and the date that 

it was published at the beginning of 

your letter. 

■	 Correct but don’t emphasize inaccuracies. 

If the letter is to correct an inaccuracy, 

very briefly mention the misconception 

or inaccuracy, but do not give it much 

space (you don't want to introduce the 

negative point to an even wider audience). Then set the record straight in no 

uncertain terms and back up your statements. In the last paragraph, draw a 

conclusion or ask for an action, such as 

“call a toll-free number for more information or visit a Web site.” 

■	 Don’t forget to give your full name, 

address, and telephone number. The 

editor may want to confirm your identity and organization/affiliation, or to 

clarify some point in the letter. Include 

a phone number where you can be 

reached in the evening, especially if your 

issue is urgent. 

■	 Follow up. Don’t be discouraged if your 

letter isn’t printed. Keep trying. You may 

want to submit a revised letter with a different angle on the issue at a later date. 

Op-Eds 

The op-ed (“opinion/editorial” or “opposite 

the editorial page”) expresses a forceful opinion on an issue, backed by well-researched 

and documented facts. While a letter to the 

editor often provides a concise and direct 

response to a specific article or broadcast, the 

op-ed may be more detailed. Here are some 

suggestions for content and format: 

■	 Be timely. Connect the op-ed to the 

release of a new survey, a recent article, 

or a community event. Timing is key for 

an op-ed. 

■	 Follow the standard format. Provide the 

author’s name, title, and occupation. 

Mention the author’s connection to your 

organization. Double-space the text and 

keep the article between 500 and 800 

words. Localize the article with statistics 

and stories that provoke discussion and 

provide practical solutions to the issue. 

End with an overview of your group’s 

mission. 

■	 Select a messenger. Identify the best 

author or signer for the op-ed. Selection 

of the most appropriate author is critical 

in getting the article published and 

maximizing its impact. Even if you collaborate on the research and writing, ask 

a board member or a local influential 

politician to sign the op-ed. The more 

prominent the signer, the more likely 

the piece is to be published. 

■	 Follow up. Call the paper three to 10 

days after sending your op-ed to ask if 

it is being considered for publication. 

The follow-up call is also an opportunity to educate your contact about your 

tobacco-related issue, even if the op-ed 

isn’t published. 

(See Appendix 8.3 for a sample editorial, 

Appendix 8.4 for a sample letter to the editor, 

and Appendix 8.5 for a sample op-ed.) 

226 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Calendar Items 

Newspapers, radio and TV stations, and local 

access/community cable TV channels often 

mention special events and meetings. This 

publicity is free and easy to obtain. When your 

event or meeting is open to the public, send 

the calendar editor a one-paragraph description of the program, plus information about 

the event’s time, date, place, and cost, along 

with a contact name and phone number. This 

information is best sent two to three weeks in 

advance of the event. Respect the media outlets’ deadlines. 

Developing a Web-Based Pressroom 

Making information about your program 

easily accessible to reporters will help you get 

more accurate coverage. Members of the 

media are increasingly turning to the Web for 

information about the topics that they cover, 

and creating a Web-based pressroom will 

make it fast and easy for reporters to get 

information about your effort. 

Although your general Web site may contain a 

wealth of useful information, it may not 

include your latest news or clearly address 

what a reporter will want to know. Creating a 

special section tailored to reporters’ needs can 

make it easier for them to get the story right. 

Some tips for creating your online pressroom: 

■	 Post the same elements online that are 

in your media kits. These include news 

releases, media advisories, fact sheets, 

backgrounders, speeches or articles by 

organization leaders, biographies of key 

people, an annual report, a calendar of 

events, photos with identifying captions, 

and contact information. (See the Media 

Kit section later in this chapter for more 

information on the contents of media 

kits.) 

■	 Put your ads online. Digitize your ads 

and put them on the Web site so that 

reporters can see them. Be sure to secure 

all of the necessary permissions and pay 

all of the required talent fees before you 

place any ad online. The Web version of 

the ad should be low resolution so that it 

can’t be downloaded to ensure that 

reporters or others don’t use the ad in a 

news program or for any other purpose 

without your knowledge and express 

permission. Provide information on the 

Web site about how a reporter can 

quickly receive a videotape with your latest ad(s) for use in a news story. 

■	 Include screen captures of your TV ads. 

Place screen captures (stills from a 

video) of the ads on the site so reporters 

for print publications can download 

them to use with their story. Screen captures should be of a high enough quality 

to be used in a publication. Contact your 

ad agency or the CDC’s Media Campaign 

Resource Center in advance to make 

sure that all of the permissions are 

secured and that the talent fees are paid. 

■	 Make the links easy to navigate. Make 

sure that the link to the pressroom is on 

the main page of your Web site. Don’t 

create several layers of links in the press 

Chapter 8: Public Relations 227 
area; every key piece of information 

should have a link from the first pressroom page. 

■	 Make it easy for a reporter to contact 

your organization. Each page should 

have a link where the reporter can send 

an e-mail to your organization’s media 

contact for more information. 

■	 Track usage. Use a log-in function to 

track who is using the pressroom and 

when. 

■	 Send automatic e-mail updates. 

Consider programming an automatic 

e-mail notification function that sends a 

message to reporters when new information is posted. 

■	 Keep the Web site current. All news 

releases and other information should 

be posted to the pressroom at the same 

time that they are distributed by fax, 

e-mail, or another method. 

■	 Continue your other media activities. 

Realize that the online pressroom only 

supplements—but doesn’t replace— 

regular phone calls, faxes, and other 

contact with reporters. 

Responding to Unsolicited 

Media Inquiries 

When you get a call from a reporter for information about your campaign, you should 

■	 Ask for particulars. Find out what news 

outlet the reporter represents, what the 

full story is about, when the story will 

run, what questions the reporter has, and 

who else he or she plans to interview. 

■	 Ask about deadlines. You are under no 

obligation to respond on the spot. 

However, it is important to respond to 

the reporter in a timely fashion. You may 

want to find out more or discuss the 

question with others before responding—before the reporter’s deadline. 

■	 Determine who is the best source and 

respondent. If it isn’t you, brief the 

person who is the best source and have 

that person return the call. 

■	 Note the reporter’s name, affiliation, 

phone number, and deadline. If you’re 

unfamiliar with the media outlet, do a 

little research, perhaps on the Internet. 

■	 Check the information. Check all the 

facts carefully and collect your thoughts 

before you return a call. 

■	 Always call back. Respect deadlines. Set 

a time to return the call, and make sure 

that you don’t keep a reporter waiting. 

Selecting and Training Spokespeople 

Selecting and training spokespeople who will 

carry your message to your audiences are 

essential for disseminating your messages and 

for creating and maintaining a positive image 

for your campaign and organization. Your 

spokespeople should be ready to speak on the 

record and on the air with reporters. Make sure 

that they understand that discussions with 

reporters should always be considered “on the 

record.” Many organizations have full-time 

spokespeople, although the role often falls to 

228 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Bridging Statements 

“Bridging” is responding to a question by answering the question that you want to answer, not the one that 

was asked. You should never have to say “No comment.” Bridging is a way to keep the interview on track, to 

control it, and to get your message out. Here are just a few examples of bridging statements: 

■	 “I think it’s important to know...” 

■	 “We see it from a different perspective...” 

■	 “What I’d like people to remember is...” 

■	 “Let’s talk about what’s happening...” 

■	 “Our perspective is...” 

the director of a program. When selecting 

spokespeople, you should choose spokespeople who have the following characteristics: 

■	 Represent the image that you want to 

project for your message, campaign, or 

organization. They may be friendly and 

energetic, scientific, or very polished or 

casual in their appearance. Your selection depends on the message and image 

that you are trying to convey. It helps if 

your spokespeople are viewed as likable 

as well as credible. 

■	 Represent your target audience. You 

want the spokesperson to be seen as 

credible. If your target is kids, you may 

want a youth spokesperson; if it’s policy 

makers, you may want a respected 

leader of a community organization. 

■	 Are well spoken, articulate, and fast 

thinkers. However, do not assume that 

people who are articulate in conversation will be “naturals” at being spokespeople. Make sure that you provide 

training and that they are prepared to 

deliver your messages. 

It is helpful to have a list of spokespeople that 

you’ve trained so that you can quickly refer 

reporters to them for quotes and interviews. You 

can record key information about your trained 

spokespeople by using a spokesperson profile 

sheet. (See Appendix 8.6 for an example.) When 

you want to refer reporters to your spokespeople, you can use these profiles to help select 

the most appropriate person to contact. 

All of your spokespeople should go through 

media training to perfect their on-air presence. 

Most PR agencies offer media training as a core 

service. Many independent media trainers are 

also available and can be hired as freelancers. 

Most media training sessions include videotaping mock interviews and then critiquing the 

performance. Most people improve significantly with just a few practice sessions. When 

reviewing a taped mock interview, look for: 

■	 Clear and believable answers 

■	 Main points repeated in quick, appealing sound bites 

■	 A relaxed and comfortable interviewee 

Chapter 8: Public Relations 229 
General Interview Tips 

■	 When working with reporters, try your best to correct factual inaccuracies; otherwise, they will 

be accepted as fact. 

■	 Pair the use of statistics with personal stories or case studies that bring them to life. 

■	 Repeat important information to reinforce key message points. 

■	 Know your campaign goals and objectives, and be prepared to provide information and answer 

questions in depth. 

■	 Don’t speak to issues that are not your area of expertise. If a reporter asks you about another 

unrelated health issue, refer the reporter to an appropriate subject matter expert if you are not 

knowledgeable on the subject. 

■	 Don’t speculate or lie to reporters. Always be honest and stick to the facts. If you don’t know an 

answer to a question, say so, and offer to find the answer or refer the reporter to someone who can. 

■	 Always make your own statement. If a reporter asks, “Would you say . . . ” and then adds a quote for 

you to agree to, don’t take the bait. Instead, succinctly state the main message you are trying to convey. 

■	 Assume that everything is on the record and that everything is for attribution. Don’t confide in a 

journalist. Say only what you would want to appear in a headline or lead of a story. 

■	 Don’t offer personal opinions when speaking on behalf of your organization. 

Tips for Print Interviews 

■	 Take notes during the interview, mainly about points that you want to address. Interviews are highpressure situations; don’t count on keeping it all straight in your head. 

■	 Smile, stand up, and move around. You’ll be more animated, and it will come through over the 

telephone. 

Tips for Radio/TV Interviews and Talk Shows 

■	 Before the appearance you should: 

– Become familiar with the show. 

– Role-play with a stand-in for the host. 

230 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

– Jot down likely questions and answers. 

– List three or fewer key points that you want people to remember. Keep them simple and be 

prepared to repeat them using varied wording throughout the interview. 

– Prepare anecdotes, examples, or research to support your messages. 

■	 During the appearance, you should: 

– Be confident, personable, and honest. If you don’t know an answer, say so. 

– Talk more slowly than usual and speak in short sound bites. 

– Dress for success. For TV, wear medium tones; don’t wear stripes, bold plaids, or wild prints. 

Stay away from bright white, too. Keep jewelry and ties simple. 

– Always assume that a microphone is live. Never say anything within earshot of a microphone 

or a reporter that you wouldn’t want to be broadcast or recorded. 

Developing Press Materials 

If you want to get your message in the news media, 

you’ll need to make your message—and your supporting points behind it—very easy for the media 

to find and use. Over the years, PR professionals 

have developed a standard way of organizing 

information into materials to suit this purpose. 

These materials are often packaged together in a 

media kit (also called a press kit, a press packet, 

or an information kit). 

Media Kit 

A media kit generally contains a lead or main news 

release and related elements (brochure, fact sheet, 

and photos) that tell a complete story. Effective media 

kits offer an appropriate amount of unduplicated 

information, arranged in the order of importance to 

the recipient. The most recent news release should 

be the first thing visible when the kit is opened. The 

contents should be compiled with the needs of the 

intended audience(s) in mind. 

Media kits usually take the form of a two-pocket 

folder with a cover label featuring the name of the 

organization providing the information. (Use a 

computer-generated label to identify your organization and the kit’s contents if customized printed 

folders are unavailable.) 

Media kit components include: 

■	 Table of contents 

■	 Pitch letter (described below) 

■	 Media advisory (described below) 

■	 News release(s) (described below) 

■	 Fact sheet or backgrounder on the issue and 

your organization (described below) 

■	 Photo(s) with identifying captions 

■	 Business card or label with contact information for your organization’s main media 

contact 

Chapter 8: Public Relations 231 
■	 Additional information, such as 


the following:
 

– Printed brochure 

– 	 Reprints of speeches or articles by 

organization leaders 

– 	 Biographies of key people 

– 	 Press clippings from previous coverage 

of the organization 

– Annual report 

– 	 Calendar of events 

– 	 Video news release 

Pitch Letter 

The pitch letter is designed to persuade reporters to 

cover a specific story. More than a phone call, a 

pitch letter or e-mail lets you outline what you’re 

doing and why it is newsworthy. A good pitch letter 

has staying power. (See Appendix 8.7 for a sample 

pitch letter.) If it doesn’t generate a story today, it 

may tomorrow. Here are some format and style 

suggestions: 

■	 Target pitch letters and news releases. Send 

correspondence to one journalist at each 

publication or media outlet. Avoid having 

two journalists at the same outlet compete 

for the same story. 

■	 Be timely. Play off recent or anticipated 

events. 

■	 Be concise. The pitch letter should be one 

typewritten page or less. Aim for no more 

than four or five paragraphs. 

■	 “Sell” the story idea’s newsworthiness. 

Propose a news hook, state why it’s a hot 

story, and suggest photos or other possibilities for visuals. Providing good visuals is 

especially critical to a TV pitch. 

■	 Skip the hype. Forget cute leads, flowery 

text, and self-congratulatory language. 

■	 Organize the letter like a news story. Don’t 

beat around the bush. Make the opening tell 

the story, then provide background information. 

■	 ALWAYS include a contact name and a 

phone number. 

■	 Advance the story. Offer the names of interview subjects and experts who complement 

the contents of the accompanying news 

releases or materials. 

■	 Localize. Generate local statistics and provide local anecdotes to tie your story to a 

national story on the same subject. 

■	 Conclude with your intention to follow up 

by phone. Include your phone number. 

■	 Follow up. Phone in a few days to explore 

different angles, but don’t be pushy. Your 

job is to let reporters know what's going 

on, and their job is to decide whether it’s 

newsworthy. Always thank reporters for 

their time. If the idea is rejected today, it 

may be more relevant tomorrow. 

■	 Use organizational letterhead and hand 

address the envelope. 

232 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Common Traps 

There are some common “traps” that people fall into when giving interviews. Sometimes, 

reporters will intentionally set up the interviewee to get a better quote; sometimes, these happen spontaneously. In either event, keep them in mind when being interviewed. Always keep 

your cool and never argue with or be condescending to a reporter. 

■	 Off the record. You are never off the record. Consider anything that you say to a
 

reporter as a potential quote.
 

■	 The long pause. Sometimes, a reporter will pause after you’ve answered in an effort to keep 

you talking. When you’ve finished answering a question, don’t feel compelled to fill a silence 

by continuing to talk. 

■	 The derogatory remark. If a reporter makes a derogatory remark, don’t take the bait. 

Ignore the comment and bridge to your key message. 

■	 The phantom authority. The reporter makes a vague reference to a study or a quote by 

an unnamed authority. Don’t respond unless the reporter can provide exact information 

about the study and author. 

■	 Badgering. The reporter asks the same question over and over or asks the same question in several different ways in an effort to get the response for which he or she is looking. Don’t concede the point. Bridge to your message. 

■	 Irrelevant questions. If a reporter asks a question that’s not relevant to the topic or your 

area of expertise, bridge to your message. 

■	 “A” or “B” dilemma. The reporter gives a dilemma, “Do you prefer X or Y?” Don’t let the 

reporter limit your choices. State what you think is best and don’t hesitate to state several 

options if that’s preferable. 

■	 Multiple or rapid questions. A reporter asks several questions in rapid order or asks 

questions with multiple parts. Respond by taking the issues one at a time. If the reporter 

has asked several questions, answer the one that you want to answer and ignore the 

other ones. 

Chapter 8: Public Relations 233 
Media Advisory 

A media advisory telegraphs basic information 

about an upcoming event and may catch a busy 

editor’s attention when a longer news release may 

not. It should be very simple and can even be written in bullet format, like an invitation showing 

who, what, when, where, why, point of contact, 

phone number, and date. Send media advisories to 

all local media outlets, as well as to the AP wire 

service, which maintains a daily log of events that 

is sent to all subscribing news outlets in a particular city or state. 

Be sure to indicate a time and a place for the interview or photo opportunities, especially if the event 

is an all-day affair. Make sure that you also provide 

a contact name and phone number on the advisory for reporters who want to get more information 

or schedule interviews. 

News Release 

The news release (also called a press release) is the 

workhorse of media relations. It communicates an 

issue’s newsworthiness in a matter of seconds. If it 

doesn’t, it will be tossed. Although news releases 

are sometimes used as submitted, they most often 

provide the foundation for a story or interview. 

Just as important as the content of the news 

release is the format or look. Neatness counts. 

Make sure that the release date, your organization’s logo, and the necessary contact information 

are shown clearly and prominently. Here are 

some guidelines for the format: 

■	 Style. Indent paragraphs five spaces. 

Double-space and leave wide margins. 

■	 Fonts. Choose one font. Don’t mix fonts or 

type sizes. 

■	 Length. Try to keep your news release to no 

more than two double-spaced pages, about 

400 to 500 words. 

■	 Pagination. For releases that run more than 

one page, type “more” at the bottom of the 

first page. Avoid carrying forward single 

words or lines of text. Make sure that the 

name of your organization, an identifying 

phrase (or “slug”), and the page number 

appear at the top of subsequent pages. 

■	 End. You can denote the end of a release in 

two ways: Type “—30— ”or “###” after the 

final paragraph. 

(See Appendix 8.8 for a sample news release.) 

Also note that you can prepare print news stories 

with images and pay to have them distributed to 

the media. Agencies that provide this kind of service include PR Newswire, North American Precis 

Syndicate, and News USA. 

Video News Release 

The video news release (VNR) is essentially a 

prepackaged 90-second TV news story sent to TV 

stations. You should ask your regular media contacts whether VNRs are useful before investing 

money in creating them. VNRs are useful when 

you’re conducting an event that TV stations can’t 

attend but would be interested in covering. TV stations often take sections of a VNR and use them 

with footage of their anchors. VNRs are often transmitted to TV stations via satellite. You can also digitize them and place them on your Web site so others can see the story. 

234 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Some major media outlets have a policy of not 

using VNRs because VNRs do not meet their 

broadcast standards. An alternative to a VNR is 

to send a satellite video feed featuring sound 

bites and background footage (B-roll) that the 

TV station can use to create its own story. This 

approach is more cost-effective and easier to 

put together because you supply just the raw 

materials instead of a fully packaged news 

story with a voiceover. To let the stations know 

about the feed, you can send a media advisory 

with the time and satellite information, then 

follow up with calls to the news editors. 

Criteria for an Effective News Release 

■	 Does it grab the reader’s attention from the start? 

■	 Does the headline inform the reader? Does it presell the story? 

■	 Does the lead paragraph single out at least two of the five “Ws” (who, what, when, where, and 

why) that explain why the story is important? 

■	 Does the second paragraph address all of the other “Ws”? 

■	 Have you put the most important information up front? 

■	 Have you put the most important quotes up front? 

■	 Have you clearly and accurately provided the title and affiliation of the people 


being quoted?
 

■	 Does it use the inverted pyramid style? Start by giving the reader the conclusion, follow with 

the most important supporting information, and end with background information. This 

allows editors to cut from the bottom and still retain the newsworthy kernel of the release. 

■	 Does the closing paragraph succinctly restate the purpose of your campaign or organization? 

■	 Is the text concise, readable, and easily understood? 

■	 Is the information accurate? Have you double-checked all of the facts and figures? Are all of 

the attributions and sources complete? Are the names, titles, and all of the text spelled correctly? 

■	 Does the release avoid jargon and spell out acronyms in the first mention? 

■	 Are quotations used properly to express opinions, offer ideas, and explain actions, and not 

merely to puff up the story? 

■	 Is a pertinent Web site or other reference information provided? 

■	 Have you provided a date and a point of contact with a phone number at the top of the 

release? 

■	 Does the release clearly indicate when the information can be published (e.g., “For release at 

10:00 a.m. Thursday, Nov. 17” or “Embargoed until noon, Feb. 1”)? 

Chapter 8: Public Relations 235 
Fact Sheet 

The fact sheet or backgrounder provides basic, 

objective, and detailed information on an issue or 

subject. Fact sheets are usually a single page. A fact 

sheet supplements the information in a pitch letter 

or a news release. It adds credibility to any accompanying advertisements, media kits, op-ed pieces, 

or other timely materials. Follow the news release 

format guidelines to create your fact sheet. You may 

also want to use bullets or boldface for key points. If 

appropriate, use a question-and-answer format. 

(See Appendix 8.9 for a sample fact sheet.) 

Responding to Negative News Stories 

Sometimes, despite your best efforts to communicate accurate information and messages that support your program, a news outlet will run a negative 

or inaccurate story. It is important to respond calmly and strategically. 

Tip 1: Remain calm. 

■	 Stay calm and don’t take the negative story 

personally. When you talk to the media, you 

are speaking for your agency or organization. 

No matter how angry you are, reacting 

thoughtlessly or attacking the reporter will 

not only reflect negatively on both you and 

your organization, but it will also hinder your 

efforts to communicate your messages. 

■	 Try to understand the reporter’s point of 

view. Reporters do not always have the time 

to get all of the facts before their deadline, or 

they might fear that if they continue to spend 

time on research, a competing reporter 

might release the story ahead of them. 

■ Look at the situation as an opportunity. 

Always try to think in terms of educating the 

media, thereby building bridges to promote 

accurate stories in the future. 

Tip 2: Analyze the situation. 

■	 Look at your relationship with this reporter 

and media outlet. Following up on a negative news report is usually not the best time 

to work with a reporter or media outlet for 

the first time. Expressing your complaint to 

someone who knows you and knows that 

you’re credible is easier and more productive. 

■	 Keep in mind that reporters don’t work for 

you. Reporters have no obligation to report 

only positive stories for you—although they 

do have a responsibility to inform their audience with accurate information. You can and 

should appeal to their sense of community 

service if the stories that they’re running are 

inaccurate or not in the best interest of the 

public. 

■	 Remember whom you’re trying to reach. 

You’re not trying to win a contest with media 

representatives. You’re trying to reach your 

target audience(s). If the reporter or media 

outlet is unwilling to hear your position, consider trying to get your point across to your 

audience(s) through alternate news sources. 

■	 Determine whether the story you saw or 

heard attempted to express both sides of the 

issue. To many reporters, a balanced piece is 

one that examines the opposing sides of a 

story, even if you perceive one point of view 

as an extreme position and the other as the 

236 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

generally accepted point of view. As long as 

reporters attempt to present both sides, they 

will likely consider this to be fair reporting. 

■	 Determine whether there truly was an inaccuracy or if the reporter simply presented 

the facts with a negative slant. Correcting a 

factual error is relatively simple and straightforward. However, a difference of opinion 

about a subject isn’t as easy to counter. 

Statements that you may perceive as biased, 

uninformed, or sensational reporting may 

not be viewed by reporters as an error on 

their part. You can still respond to the piece, 

but your strategy will be different than if 

you’re simply correcting a factual error. 

■	 If the story is basically true with only minor 

factual errors, you may choose not to comment. Quibbling with a reporter over a minor 

point when a news item is otherwise accurate will not help you build bridges for future 

positive stories. However, you may still want 

to contact the reporter to establish a dialogue 

and offer yourself as a source, which may 

result in more positive stories in the future. 

Tip 3: Know what to request. 

Once you have analyzed the situation and have 

decided that action is necessary, know your 

options. Reporters only have a few possibilities for 

how to respond to your complaint. Decide ahead of 

time your ideal solution as well as your minimal 

solution. Think of this as a negotiation. Here are 

some actions that you may request: 

■	 Ask for a retraction or correction. This is 

reasonable when a grievous error has been 

made and you have supporting material to 

refute the facts or statements reported. Ask 

for a correction immediately, and request 

that it be run as prominently as the original 

piece. Al-though this is not likely to happen, 

you may be able discourage the editor from 

burying the retraction in a section that’s not 

widely read. 

■	 Ask for another piece to air that presents 

your perspective on the issue. A follow-up 

response is a reasonable request if your point 

of view was completely ignored or misrepresented in the original report. Reporters are 

not likely to present a follow-up piece that 

simply contradicts a story that they have 

recently run because they will not want to 

lose credibility. They will be more likely to 

work with you if you give them a fresh perspective or a new angle, or supply some “new 

information” (thereby giving them a way to 

maintain credibility). 

■	 Ask for an apology. Sometimes reporters 

make mistakes unintentionally. If the errors 

are not egregious enough that they will significantly hinder your communication efforts, 

perhaps an acknowledgment of the mistake 

over the phone by the reporter is enough. If 

this is the case, you may use this as an opportunity to develop rapport with this reporter 

and to establish yourself as a source that the 

reporter can contact to confirm the accuracy 

of information in the future. 

■	 Ask that a correction note be placed in the 

permanent record. Ask the reporter or editor 

to place a written correction on file with the 

original piece in the permanent record and 

Chapter 8: Public Relations 237 
to tie the correction to the original 

report. If the mistake is a factual one, 

you do not want to see it repeated. 

Reporters often go back to do research, 

and may report the mistaken information again if they don't realize a correction was made. 

■	 Ask that a letter to the editor or guest 

editorial be printed. A letter to the editor may be an effective response 

because these letters are widely read 

and publications are often very willing 

to print opposing views. Before releasing 

your letter, be sure to coordinate with 

your PR staff and seek concurrence from 

subject matter experts within your 

agency. See tips on writing letters to the 

editor earlier in this chapter. 

Tip 4: Know whom to contact. 

■	 Talk to the reporter first. Always give 

the reporter the first opportunity to 

respond to your concerns before moving 

up the chain of command. Give the 

reporter the benefit of the doubt. An 

editor may have changed a piece without the reporter’s knowledge. A producer putting together the nightly news 

teaser may have misunderstood the 

message that the reporter was communicating in the piece, or “sensationalized” an originally balanced report. Let 

the reporter have an opportunity to 

respond and explain. Know the 

reporter’s position before taking any further action. 

■	 If talking with the reporter doesn’t 

result in the desired action, then speak 

to the news editor or the producer. 

Keep going up the chain until you are 

satisfied with the response or until you 

are convinced that you will not get the 

desired action. 

■	 Consider going to an alternate media 

outlet. If you have doubts about the 

integrity of the media outlet that presented the negative or inaccurate report 

concerning your issue or organization, 

you can go to an alternate media outlet 

to present your information and point 

of view. Of course, go to the alternate 

source with a great story idea, not just a 

complaint about the other media outlet. 

■	 Consider reaching your public through 

many alternate outlets. If all else fails in 

your efforts to set the record straight 

with the original media outlet, redouble 

your efforts to get your message to the 

public through alternative means. For 

example, set up a public forum, make 

your presence known on the Internet, 

and invite partners to write letters or 

make phone calls. Offer articles for community newsletters. Work to establish 

contacts in competing media outlets. 

Tip 5: Know what you want to 

communicate. 

■ Remember who your ultimate audience is. You are ultimately trying to 

reach specific target audiences and 

238 Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

stakeholders. Keep them in mind as you 

craft your messages and responses. 

■	 Develop your message. Have your messages reviewed by advisors and subject 

matter experts in your organization and 

partner organizations. 

■	 Frame messages in a positive way. Don’t 

focus on criticisms or negativity. Don’t get 

distracted by the arguments or concerns 

of your critics unless they’re substantial 

enough to truly be creating obstacles to 

communicating your messages. 

■	 Include a call to action. If appropriate, 

include specific information about what 

audiences can do to respond or become 

involved in the issue. 

Tip 6: Prevent and plan for 

future attacks. 

■ Be ready to voice objections quickly. 

When a surprise negative news story 

hits that relates to your effort or attacks 

your program or tobacco control efforts 

in general, you need to respond very 

quickly (often the same day of the story) 

to take advantage of it. Thus, you may 

need to develop a shortened review 

process to replace the usual lengthy 

review process. Your shortened process 

may include asking your head PR person to craft a response, then having it 

quickly approved by the program manager or marketing director. Having a crisis communications plan on hand will 

facilitate your response. 

■	 Prepare responses in advance. Because 

you know the important issues as well 

as the basic arguments of your critics, 

you and your PR staff can prepare messages and responses ahead of time, 

especially for potentially controversial 

issues. Draft letters to the editor that 

could be altered slightly and sent within 

hours of the airing or printing of an 

inaccurate or negative story. 

■	 Attempt to prevent negative stories. 

Staying in contact with your media list 

and providing them with the most 

recent and accurate information will 

help keep reporters informed about 

your issue and will likely prevent inaccurate or negative stories. 

■	 Let the media outlets know that you’re 

paying attention. Because you are part 

of media outlets’ audience, they have a 

stake in responding to your needs. Let 

them know that you watch or read their 

stories. Maintain regular contact. For 

example, you may call a reporter to 

praise a good story. Build bridges with 

the media at every opportunity. 

■	 Let the media know that you’re a 

potential source for information. Invite 

reporters to call on you for interviews or 

information verification in the future. 

Make sure that you’re available to give 

credible and constructive interviews 

and information. Identify and train 

spokespeople that you can offer as contacts for reporters to interview. 

Chapter 8: Public Relations 239 
240 Chapter 8: Public Relations 

■	 	 Coordinate with your PR team. Make sure 

the team is aware of any ongoing issues with 

the media and are involved in planning 

responses. 

Evaluating Your Public 
 

Relations Efforts 
 

As discussed in Chapter 5: Evaluating the Success 

of Your Counter-Marketing Program, evaluation is 

an essential component of a successful countermarketing program. Evaluation will help you report 

to stakeholders about what you’re doing and will 

give you valuable insight into how to adjust and 

improve your efforts. More specifically, evaluation 

can help you answer questions such as the following: 

■	 	 How is the funding for PR being used? 

■	 	 What activities have you conducted? 

■	 	 What are the results of your efforts? 

■	 	 Did you identify, reach, and involve key 

stakeholders in the PR activities? 

■	 	 Did they view your campaign as effective? 

■	 	 Did you identify and reach your 
 


target audience(s)?
 


■	 	 How can you use the evaluation 

results to adjust your PR plan, reach more of 

the target audience, and 

contribute to the success of the 

counter-marketing program? 

How To Evaluate Your PR Efforts 

First, in a process evaluation, you’ll need to monitor your efforts by tracking exactly what you have 

done. As indicated in Chapter 5: Evaluating the 

Success of Your Counter-Marketing Program, you 

or your PR firm will need to regularly complete 

logs, call sheets, and other tools to track the activities that are linked to the goals and objectives of 

your PR plan. If, for example, one of your process 

objectives is to reach a specified list of journalists 

by a certain date, a call sheet should be created to 

allow you to document what journalists were 

reached and when. (See Appendix 8.10 for an 

example of a media contact record.) If process 

objectives specify that certain events (e.g., press 

conferences, radio and TV appearances, and meetings with editorial boards) will be held or materials 

(e.g., news releases, pitch letters, and a Web-based 

pressroom) will be developed and/or distributed 

within a certain time frame, event and materials 

logs should be designed and used regularly to document your efforts. This tracking system may be 

time consuming, but it’s important to have these 

data on hand. You can use the records to respond 

to inquiries from stakeholders and for planning 

purposes. 

Your process objectives may also specify your 

intention to achieve a certain amount and quality 

of media coverage and target audience exposure. 

To measure media coverage, you’ll probably need 

to use a clipping service, such as Burrelle’s, Bacon’s, 

or Luce. These firms search a list of publications 

that you identify for key words related to your 

efforts. They clip the stories that contain these 

words, compile them, and send them to you on a 

regular schedule. Each clip will contain a slip that 

indicates the source publication, the publication’s 

audience, and other information. You usually pay a 

set-up fee for these services, 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 8: Public Relations 241 

then pay for each clip. You can then analyze 

the clippings to determine whether the slant 

of each story supports your efforts. For an 

additional fee, some clipping services will 

provide reports analyzing the coverage for you. 

Larger newspapers are often available online 

and can be searched electronically, either by 

visiting their individual Web sites or by using a 

search service like Lexis-Nexis. 

You can also track video coverage through 

firms such as VMS and Bacon’s. If you know 

that your topic was covered by the broadcast 

media, you can tell them the name of the 

program and station, and they can get a tape 

for you. They can also search the transcripts 

and provide you with a report of all broadcast 

coverage, including the text transcripts of each 

“hit.” These broadcast-tracking services usually charge by each search, with tapes costing 

extra. You should consider using one of these 

services because it’s generally the only way to 

track your earned media efforts. 

Conducting an outcome evaluation to determine how your PR efforts have affected the 

target audience (i.e., change in awareness, 

attitudes, beliefs, and behaviors) requires considerable time and resources and may include 

surveying the audience exposed to the countermarketing messages. One cost-effective way to 

do that is to collaborate with those who are 

conducting a target audience survey to evaluate counter-advertising and include PR evaluation questions in that survey. 

Using Process Evaluation Results for 

Decision Making 

After you have compiled the news coverage 

that your PR efforts have generated, analyze it 

to see what adjustments and improvements 

you should make. Are certain reporters not 

covering your issue? Perhaps you should pitch 

a different reporter or a different media outlet, 

or perhaps you should consider using a different angle. Are your key messages not getting 

into the coverage? Maybe you need to retrain 

your spokespeople or try new PR tactics. After 

each PR opportunity, determine and then 

document what did and didn’t work so that 

your next opportunity will be more fruitful. By 

regularly evaluating your efforts, you’ll learn 

which stories will likely get good play and 

which approaches will most likely succeed in 

getting the maximum coverage in support of 

your messages and campaign. 
242 

Points To Remember 

■	 	 Create an annual PR plan. For both your Target Audience PR and your Stakeholder PR, create a 

yearly calendar of all the PR opportunities that you plan to pursue. Include national events that 

you’ll tie in to (e.g., Great American Smokeout, World No-Tobacco Day, and Kick Butts Day), holidays and times of the year that lend themselves to certain stories (e.g., New Year’s for cessation and 

back to school and spring break for youth prevention), and your own campaign events. See what 

gaps are in your calendar, and decide how to fill them so that you maintain a high level of coverage 

year-round. Create a PR plan for each activity that indicates the target audience(s), specific objectives, key messages, media channels, tactics, and timeline. 

■	 	 Stay on message. Getting news coverage helps only if the coverage promotes your message. To 
 

make sure that you stay on message, create a limited set of standard talking points and key mes­
 

sages that will be used in all PR activities, whether planned in advance or done in response to an 
 

unplanned PR opportunity. 
 

■	 	 Respond quickly to unplanned PR opportunities. When a surprise news story hits that relates to your 

effort, you will need to respond very quickly (often the same day of the story) to take advantage of it. 

This means that you may have to skip the campaign’s usual lengthy review processes and let your 

head PR person craft the response and have it quickly approved by the program manager or marketing director. In many cases, you may receive a call from a reporter for your reaction. These opportunities require quick thinking, quick decision making, and quick action. 

■	 	 Integrate PR with other counter-marketing activities. PR is most effective when it works in synergy 

with other components of your program. For this to happen, the PR staff must know everything 

about the campaign well in advance so that they can plan the appropriate outreach. Involving PR 

staff in the planning of advertising, grassroots activities, and other efforts will allow them to identify 

potential PR issues, both positive and negative, and to plan appropriately. 

■	 	 Evaluate your PR efforts. For each event or activity, track the coverage you get. You’ll learn quickly 

what works and what doesn’t in getting the coverage that you want. Modify your annual PR plan 

accordingly. If you have the resources, perform a formal content analysis of the coverage to document the campaign messages to which your audiences are being exposed. At a minimum, review all 

of the key news stories to make sure that they reflect your campaign messages. 

Chapter 8: Public Relations 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 8: Public Relations 243 

Bibliography 

ASSIST, Site Trainers Network. Advanced Media Advocacy Module Trainer’s Manual. Rockville, MD: 

National Cancer Institute, 1998. 

Campaign for Tobacco-Free Kids. Kick Butts Day 2000 Activity Guide. Washington, DC: Porter 

Novelli, 2000. 

Catacalos R. Online media room is new part of public relations mix. Houston Business Journal, 

Sept. 17, 1999, Available at: 

http://houston.bizjournals.com/houston/stories/1999/09/20/focus4.html. Accessed October 30, 2002. 

Office of National Drug Control Policy. Media Tool Kit for Anti-Drug Action. Washington, DC: 

Office of National Drug Control Policy, 2000. 

Public Relations Society of America. Directory of Multicultural Relations Professionals and Firms. 

New York, NY: PRSA, 2000. 

Saffir L. Power Public Relations: How to Master the New PR, 2nd ed. Lincolnwood, IL: NTC 

Business Books, 2000. 

Schultz D, Barnes B. Strategic Brand Communication Campaigns, 5th ed. Lincolnwood, IL: NTC 

Business Books, 1999. 

Stevens C. Designing an effective counter-advertising campaign—California. Cancer 1998;83 

(Suppl. 12):2736–41. 
244 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 245 

Chapter 9 

Media Advocacy 
 


Once you “get” media advocacy, you have to do it. 

Or live with the fact that you’re not doing everything 

you can to make a difference. 

—	 Makani Themba-Nixon in News for a Change: 

An Advocate’s Guide to Working With the Media (1999) 

Media advocacy is defined as the strategic use of mass media and community 

advocacy to advance environmental change or a public policy initiative. The 

concept has been used broadly on tobacco control and other issues, and it 

has many applications. One key application is as a response to issues involving well-financed opponents who use money to shape the political and social 

environment. Compared with public relations, media advocacy is more 

focused on a particular policy goal, resulting in social change. It’s also more 

decentralized, community based, and community owned. 

The information in this chapter focuses on the strategy behind media 

advocacy and why it’s important. Practical “how-to” steps for developing 

materials and working with the media are outlined in Chapter 8: Public 

Relations. These steps should be reviewed before you read this chapter. 

Traditionally, health communications used the media to re-create, on a large 

scale, the instructive relationship of a physician to patient or a teacher to 

student. In contrast, media advocacy doesn’t try to persuade individuals to 

make specific behavior changes, but instead seeks to use the media to change 

the social environment in which individuals make personal behavior decisions. Media advocacy focuses on the social forces that shape behavior—that 

is, on public and private policy—rather than on personal behavior. The goal is 

to attain a more sweeping and permanent change in society at large. 

In This Chapter
 


•	 Coordinating Media 

Advocacy Efforts 

•	 Elements of Media 

Advocacy: Focus on 

Strategy 

•	 Media Advocacy in 

Action: the Art of 

Framing 

•	 Evaluating Your 

Media Advocacy 

Efforts 
246 Chapter 9: Media Advocacy 

What Media Advocacy 

Does and Doesn’t Do 

Does 

■ 	 Rely on collaborative 

message development 

■ 	 Reinforce social responsibility for the problem 

of tobacco 

■ 	 Focus on advancing 

policy change 

■ 	 Give people a voice 

■ 	 Train the community in 

media skills 

■ 	 Help communities create long-lasting environmental change 

Doesn’t 

■ 	 Rely solely on profes­
 

sional message develop­


ment 
 

■ 	 Emphasize individual 
 

responsibility for the 
 

problem of tobacco 
 

■ 	 Tell individuals what 
 

they should think 
 

■ 	 Give people a message 

■ 	 Take care of the media 
 

for the community 
 

■ 	 Guarantee individual 
 

behavior change based 
 

on new information 
 

Media advocacy is based on an understanding 

that the media are a tool, not a goal, and that 

media coverage is a means to an end, not an 

end in itself. Through the media, advocates 

gain access and a voice in the social decisionmaking process. But the use of media alone 

won’t accomplish the goal of change. Media 

advocacy efforts should be used in combination with other communications and 

policy initiatives. 

heard and inspiring others to join in your 

cause. It can change attitudes and create a 

flood of support. Media advocacy begins with 

the premise that those closest to a problem are 

the best positioned to fix it and takes advantage of the fact that most media are local. It 

can extend the reach and penetration of any 

statewide media campaign by piggybacking 

national stories and extending the reach of a 

scientific report or finding. 

Media advocacy is a crucial component of a 

comprehensive media campaign because it 

empowers the community and targets policy 

makers. It’s a way of getting your message 

There are no specific “recipes” for media advocacy. The successful use of media advocacy 

requires flexibility and being in tune with community issues, needs, and resources so that 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 247 

opportunities are embraced when they arise. 

Media advocacy is a learning process, and 

skills are developed through practice. Media 

advocacy requires long-term thinking and not 

being discouraged by short-term setbacks. 

When media advocacy efforts begin to succeed, you may face greater challenges as the 

opposition responds. 

Coordinating Media Advocacy 

Efforts 

Unlike other counter-marketing components, 

the role of the state health department in 

media advocacy is to support the policy efforts 

of local coalitions, which are often led by advocacy groups. A major challenge for the countermarketing team is coordinating efforts so that 

everyone is working toward common or complementary goals and that each partner is 

working in the appropriate role. For example, 

public officials may need to avoid lobbying, 

but other partners may focus their attention in 

this area. Some partners may be better at collecting data and analyzing results of initiatives 

to inform changes in strategies. 

To ensure that media advocacy efforts and 

your broader counter-marketing program are 

consistent with, and supportive of, each other, 

your counter-marketing team should coordinate its efforts with those of local coalitions as 

it conducts activities that are best delivered 

from a central source. Your team should: 

■	 	 Identify potential statewide and local 

advocacy groups and individuals that 

can support your efforts 

■	 	 Invite representatives from advocacy 
 

groups to be part of your campaign 
 

advisory board; their involvement in 
 

planning and implementation of key 
 

strategies ensures that everyone’s efforts 
 

support a common goal 
 

■	 	 Share campaign materials with advo­
 

cates so that they can comment on 
 

these materials, help improve them, 
 

help promote the campaign, and deflect 
 

criticism and attacks from the tobacco 
 

industry and others 
 

You also should consider operating an intrastate media network that includes programs 

aligned with state goals. Through your 

network, you can offer: 

■	 	 Technical assistance, including access to 
 

national experts 
 

■	 	 Information sharing, particularly on 
 

your program’s effectiveness and industry 
 

opposition 
 

■	 	 Networking, which offers the opportuni­
 

ty for brainstorming 
 

■	 	 Training in areas, such as message 
 

development and spokesperson training 
 

■	 	 Evaluation and feedback, which are part 
 

of the on-the-job learning that makes 
 

advocates better at what they do 
 

■	 	 Tools, such as press releases and talking 
 

points, that advocates can customize for 
 

their communities 
 

■	 	 Tie-ins to paid media campaigns, which 
 

can help support a program’s paid cam­


paign and generate earned coverage 
 
248 Chapter 9: Media Advocacy 

■	 	 “Action Alerts,” e-mails that describe key 

opportunities and how local advocates 

can take advantage of them 

Sharing activities and events through a media 

network will allow local media advocacy efforts 

and your program to complement and support 

each other. Information on how to develop 

and use media materials and tactics can be 

found in Chapter 8: Public Relations. The 

primary pitfall to avoid is providing grants or 

other funding for local advocacy groups or 

coalitions without central support, training, 

technical assistance, and coordination. 

Without this support, you may find that funds 

aren’t spent efficiently and you may not see the 

results that indicate progress toward your 

state’s goals. 

Interviewing With the Media: When 

Less Is More 

Anyone who has been interviewed for a local 

television news program knows the drill. First, 

you get the call from a producer asking if 

you’re available. Then, you set up an appointment for the video crew to come and tape the 

interview. In the intervening time, you might 

pore over fact sheets and background materials to ensure that you’re familiar with the latest 

information. You might talk to your colleagues 

and co-workers about what you should say, 

straighten up your office (and yourself), and 

maybe call friends and relatives to let them 

know that you’re going to be on TV. When the 

crew arrives, you drop everything to help them 

set up. While they’re framing the shot and 

adjusting the lights and the camera, you talk 

with the producer and/or the interviewer. 

Finally, the interview begins. Under the hot 

lights, you’re asked a few questions and give 

the best answers you can. You may be asked to 

repeat a few statements. The interview may be 

over in five minutes, or it may last as long as 20 

minutes, but half of your day has been devoted 

to it. 

After all of this investment in time and energy, 

if you did a really good job, you may be given 

10 seconds of news time. If the interview was with a newspaper reporter, 

the process has been similar (except 

for the lights and camera) and you 

might be given a one- or twosentence quote in the finished story. 

Is this tiny payoff worth your time 

and effort? Don’t you have more 

important things to do? You have so 

much to say on this important topic! 

How can they reduce it to 10 seconds 

or a few sentences? 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 249 

It may seem like you’ve invested too much 

effort for so little in return, but a few wellchosen, well-placed words can have a greater 

impact than a long treatise. The key is knowing 

how to use those 10 seconds or those two 

sentences strategically by framing your message well and aiming it at the right audience. 

Considering the Industry’s Response 

Media advocacy has been used on a variety of 

social issues, such as housing, alcohol control, 

childhood lead poisoning prevention, and 

violence prevention. Tobacco control advocates 

were generating headlines that reframed society’s 

view of tobacco use from a personal decision 

to a public health problem decades before 

dedicated cigarette tax increases, successful 

lawsuits, and the Master Settlement 

Agreement provided significant funds for 

sophisticated advertising campaigns. They did 

this for a very practical reason—it worked! 

When people think of using the media to help 

solve public health issues, too often their 

imaginations are limited by what they’ve seen 

or done before. Posters, bumper stickers, 

The Roper Report 

The following are excerpts from the 1978 “Study of Public Attitudes Toward Cigarette Smoking and the 
 

Tobacco Industry,” conducted for the Tobacco Institute by the Roper Organization. This study was one of 
 

the first internal industry documents to be revealed to the public after it was subpoenaed by the Federal 
 

Trade Commission in the 1980s. 
 

Implications of the Findings 

The original Surgeon General’s report, followed by the first “hazard” warning on cigarette packages, the 

subsequent “danger” warning on packages, the removal of cigarette advertising from television, and the 

inclusion of the danger warning in cigarette advertising were all “blows” of sorts for the tobacco industry. 

They were, however, blows that the cigarette industry could successfully weather because they were all 

directed against the smoker himself. While the overwhelming majority of the public has been convinced 

by the antismoking forces that smoking is dangerous to the smokers’ health, this has not persuaded very 

many smokers to give up smoking. 

The antismoking forces’ latest tack, however—on the passive smoking issue—is another matter. What the 

smoker does to himself may be his business, but what the smoker does to the nonsmoker is quite a different matter. . . . 

This we see as the most dangerous development to the viability of the tobacco industry that has yet
 

occurred. . . . The issue, as we see it, is no longer what the smoker does to himself, but what he does to
 

others.
 
250 Chapter 9: Media Advocacy 

pamphlets, and public service announcements often have been the media tools of 

choice, not because evidence suggested that 

these were effective options, but because these 

products were most familiar to advocates. By 

looking carefully at how the industry responds 

to media advocacy initiatives, media advocacy 

practitioners are now better able to identify 

the efforts that are the most threatening to the 

tobacco industry. Until recently, tobacco control advocates seldom had sufficient funds for 

solid evaluation research. However, tobacco 

companies have been able to reach into their 

own deep pockets to research their opposition 

carefully. If tobacco companies fight against a 

tobacco control initiative, it’s probably effective; conversely, if tobacco companies support 

or don’t fight against an initiative, then you 

should probably analyze it well to ensure that 

it’s truly effective before using that tactic in 

your program. 

One example of evolving to tactics that presented a greater threat to the industry relates 

to the positioning of media messages. Through 

most of the 1970s, antitobacco media messages tended to be antismoking messages, 

focusing almost exclusively on persuading 

people to either quit or not start smoking. 

Beginning in the early 1980s, advocates 

reframed the issue to focus on the rights of 

nonsmokers and the need to regulate and 

counteract the tobacco industry’s behavior. In 

other words, individual-focused antismoking 

messages became industry-focused antitobacco 

messages. As revealed by the 1978 Roper 

Report (see sidebar on previous page) and by 

many other internal industry documents that 

were subsequently uncovered, this strategy 

was exactly what the industry feared the most 

because it posed the greatest threat to its economic future. 

The Eclecticism of Media Advocacy 

Because many successful media advocacy 

interventions have produced confrontational, 

hard-hitting news stories, many people 

assume that any controversial news story is 

media advocacy, and that media advocacy is 

always combative. 

Media advocacy does focus on policy change 

or environmental change. However, it doesn’t 

have to be confrontational, and it isn’t limited 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 251 

to earned media. Media advocacy can refer to 

a wide range of activities, including: 

■	 	 Initiating calls, faxes, and e-mails to 

reporters (“pitching” stories or angles) 

■	 	 Responding to calls and e-mails from 

reporters 

■	 	 Designing good visual images for 
 


TV cameras
 


■	 	 Helping to develop messages for 
 


targeted paid media campaigns
 


■	 	 Helping to identify or develop good 

storylines that will appeal to media 

representatives 

■	 	 Staging strategic media events 

■	 	 Developing long-term relationships 

with editors, producers, and reporters 

(known as “media gatekeepers”) 

■	 	 Alerting the media about important 

political or other policy-related developments and framing these developments 

for the media 

■	 	 Meeting with newspaper editorial
 


boards
 


■	 	 Writing opinion/editorial (op-ed)
 


columns and letters to the editor
 


■	 	 Conducting creative research to educate 
 

the media and to generate media 
 

attention 
 

This list could go on. Anything that is done 

strategically to use the media to advance 

policy change or policy enforcement could be 

called media advocacy. Like other communication strategies, media advocacy works best 

when it’s designed to advance a specific goal 

and when it’s part of a comprehensive media 

plan that employs a variety of tactics, including paid media. (See Chapter 7: Advertising 

and Chapter 8: Public Relations for more 

information about earned and paid media 

strategies and tactics.) 

Elements of Media Advocacy: Focus 

on Strategy 

As noted earlier, media advocacy is the strategic 

use of media and community advocacy to 
252 Chapter 9: Media Advocacy 

create policy or environmental change. Those 

who work with the media face a range of 

options requiring strategic decisions whenever 

they have (or create) a piece of news: 

■	 	 Should I share this information with 

the press? 

■	 	 Should I call all of the reporters that I 

know or offer the story as an exclusive to 

one reporter? 

■	 	 Is this development worthy of a press 

conference? 

■	 	 Should we stage a press event and hope 

that the media will cover it? 

The answers to these questions vary according 

to the history, the surrounding circumstances, 

and the goal of each media advocacy intervention. In every case, the answers should be 

based on what makes the most strategic sense 

at the time. For example, holding a press conference may be a wise choice, but only if doing 

so will be an efficient and effective way to 

advance toward the overall goal. 

The basis for success in every media advocacy 

intervention is disciplining yourself to answer 

five important questions: 

1. 	 What do you want? This first question 

forces you to begin at the end and work 

backward by defining your policy goal 

or purpose in terms that are as realistic 

and specific as possible. Define the 

problem that you want to solve in terms 

that can be addressed by policy change 

(or policy enforcement), and state the 

solution that you seek in terms of specific 

policy action. You don’t need to articulate a comprehensive solution to the 

problem, just the next concrete step 

along the path to your goal. 

2.	 	Who can give you what you want? 

Define your target audience. Do you 

need cooperation from local merchants? 

Action by the city council? Help from 

the governor? Who has the power to 

provide what you need to accomplish 

your goal? What is their self-interest? 

Who or what influences them? Are there 

secondary audiences that you can reach 

more easily who can influence the primary target? These policy decision makers, not the general public, are typically 

your primary target audience for media 

advocacy. 

3.	 	What do they need to hear? Once 

you’ve determined who has the power 

to provide what you want (i.e., your 

target audience), you need to determine 

what types of messages will most likely 

resonate with them. Begin developing 

your message by learning what your 

audience is thinking; don’t assume that 

they’ll accept your premises. Will they 

be influenced by new health information? By popular opinion in the community? By examples of success stories in 

other states? 

4.	 	From whom should they hear it? 

Identify your messenger by determining who’ll have the greatest chance of 

influencing your target audience. State 

legislators may be more responsive to a 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 253 

concerned parent who is also a constituent than to a trained epidemiologist 

who comes in from out of town. 

Conversely, a local board of health may 

be more responsive to a scientific 

expert. Learn about the decision-making process that you seek to influence so 

that you can choose your spokespeople 

strategically. 

5. How can you reach your target audience? What kind of media coverage will 

attract your target audience’s attention? 

Will a letter to the editor be noticed? Will 

TV news coverage of the results of a new 

scientific study reach them? Will a 

staged media event be effective? 

Case Study: X Marks the Target 

This case study is excerpted from News for a Change: An Advocate’s Guide to Working With the Media 

(Wallack et al. 1999). 

“X” was a proposed cigarette brand that many activists believed appropriated the strong, positive 

sentiment that young African Americans have for Malcolm X for use in selling cigarettes. The brand 

was manufactured by a small Massachusetts company, Star Tobacco Corporation, and marketed and 

distributed by Duffy Distributors. The packaging, marketing, and low price seemed lethal weapons in the 

tobacco industry’s efforts to hook more young African Americans. 

The effort to stop X brand cigarettes evolved out of a network of activists who had been mobilizing 

communities of color around the targeted marketing of tobacco and alcohol products. Brenda BellCaffee, director of the California African American Tobacco Education Network, saw a message about X 

on a computer mailing list for tobacco control advocates and immediately alerted her colleagues. In the 

group’s assessment, the two small companies that manufactured and marketed the product were more 

reachable, winnable targets than any relevant public agencies. The strategy was, therefore, crafted to 

mobilize pressure and shame these companies into revoking the brand. 

The group worked to shame the targeted companies by emphasizing two messages: X brand, whether 

purposely or not, defamed an important leader and cultural icon—Malcolm X; and it was packaged in a 

way that was sure to attract African American youth. The group gave the companies 10 days to withdraw 

the brand. 

Media played a critical role in pressuring the companies to respond. Activists got the word out to both 

African American and corporate-owned media outlets, and articles on X appeared in more than 100 

newspapers nationwide. Succumbing to national pressure, Duffy Distributors issued a statement one 

day after the deadline, which—without any admission of wrongdoing—announced that it had decided 

to withdraw the X brand cigarettes from distribution. 
254 Chapter 9: Media Advocacy 

Answer these questions before you begin planning each media advocacy event. Review your 

answers often during the planning and evaluation process. 

Sometimes the best media advocacy option 

is counterintuitive. For example, if someone 

asked, “What do you do when a reporter asks 

you a question?” most people would probably 

say, “Answer it.” But the most obvious 

response may not be the best. Consider the 

following options: 

■	 	 The reporter’s question may not lead to 

the best information or to information 

in the best “frame” (more on framing 

later). You probably know more about 

the issue than the reporter does. If 

you’re asked a badly framed question 

(e.g., one that presumes tobacco control 

is a battle between smokers and nonsmokers), it may be strategic for you to 

suggest a different question and then 

answer that one instead (e.g., one that 

reframes the issue as a battle of smokers 

and nonsmokers against corporations 

that sell a lethal and addictive product). 

■	 	 You may not be the most strategic person to answer the question. There may 

be someone else whose knowledge, skill, 

reputation, or personal experience 

makes that person a better choice to 

answer the question and a better messenger for the information. The strategic 

choice may be to refer the reporter to 

this other source and explain why. 

■	 	 Perhaps you don’t know the answer or 

don’t know as much as you would like to 

answer the question. The most strategic 

response may be that you’ll investigate 

and get back to the reporter with the 

best information available. 

If you decide to simply answer the question, 

you still have a range of choices. Consider the 

different responses to the question, “What 

does your organization do?” 

■	 	 “We fight cancer and heart disease 

caused by tobacco use.” 

■	 	 “Right now, we’re trying to help encourage local restaurants to go smokefree.” 

■	 	 “We support the community’s efforts to 

reduce tobacco use by young people.” 

■	 	 “We fight to counteract the damage 

done by tobacco companies as they 

try to addict a new generation of 

customers.” 

Even when you’re having a casual conversation 

with a reporter, you might be faced with a 

dozen or more questions, each of which 

produces its own range of strategic options. 

Whether deciding if you should stage a major 

media event or answer a simple question from 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 255 

a reporter, good media advocacy is always 

driven by strategic thinking. Always keep your 

eyes on your policy goal. 

specialists or experts can be hired or appointed to plan and execute the strategy for you. 

However, community-based social change 

can’t be contracted out or delegated; if the 

community doesn’t want to change, change 

won’t happen. When the community does 

want to change, media advocacy is a way that 

community members can make the change

happen themselves. 

Community Empowerment 

The second important part of the definition of 

media advocacy is “community advocacy.” 

True media advocacy does not exist without 

community advocacy. Many traditional media 

strategies are aimed at trying to change individual behaviors or beliefs. Media advocacy 

works with the community to change the environment within which individual decisions are 

made. For example, instead of using the media 

to try to convince people that smoking is 

expensive and dangerous, one media advocacy 

approach would be to try to persuade building 

owners to ban tobacco use on their premises. 

Media Advocacy in Action: the Art 

of Framing 

Ask a group of tobacco control advocates 

whether tobacco receives enough coverage in 

the news media, and most will tell you that it 

doesn’t. Ask that same group whether they’ve 

ever seen any news stories about tobacco that 

distorted the issue or otherwise didn’t help 

advance tobacco control, and they will tell you 

that they’ve seen many such unproductive 

stories. One of the most common complaints 

Working with the community is an important 

part of a media advocacy approach. In many 

other parts of your counter-marketing program, 

When issue advocates sit around a table to talk ‘message,’ they invariably rush to 
 

hatching catchy slogans and clever sound bites. Or they concoct elaborate arguments 
 

put forward by their adversaries. Good sound bites and slogans—and speeches, 
 

policy solutions, meaningful statistics, arguments—all support and reinforce your 
 

message, but they aren’t what communications experts mean by ‘message.’ To com­
 

munications professionals, your message is your organizing theme. And no media 
 

advocacy campaign can succeed without a powerful, coherent organizing theme, a 
 

theme that is at the same time logically persuasive, morally authoritative, and capa­
 

ble of evoking passion. A campaign message must speak at one and the same time to 
 

the brain and the heart. 
 

— Ethel Klein, 

political scientist 
256 Chapter 9: Media Advocacy 

Framing Example: Same Question, Different Answers 

Before you talk to a reporter, you should define your goal and how you hope to accomplish it. Do you 

want to generate publicity for your organization? Are you trying to advance a specific policy? Are you 

trying to focus media attention on the role of tobacco companies? 

Consider this common question: Why do teens smoke? 

Tobacco companies suggest that smoking is normative with this typical answer: “Peer pressure. Teens 

smoke because they want to fit in with their friends.” Through this response, the tobacco companies are 

trying to divert attention from their well-financed marketing programs and draw resources away from 

prevention programs that really do work. This question has many better answers. Each answer brings a 

slightly different focus to the problem or the solution. 

■	 	 Answer: Teens smoke because we make it easy for them to get cigarettes. Therefore, we need to 

keep cigarettes out of the hands of our children. 

■	 	 Focus: Youth access laws 

■	 	 Answer: Teens smoke because the tobacco industry needs them to replace dying older smokers. No 

one knows how to market to a target audience more effectively than this industry. 

■	 	 Focus: Industry behavior 

■	 	 Answer: Actually, teens aren’t smoking as much as they were several years ago. We’re doing a much 

better job of keeping teens away from tobacco. 

■	 	 Focus: The effectiveness of your tobacco control program 

■	 	 Answer: Not all teens are smoking more. African American teens, for example, smoke at a much 

lower rate than whites or Asians. We need to put our resources into the areas that need the most 

help. 

■	 	 Focus: Disparities 

■	 	 Answer: Teens experiment with a lot of things. They continue to smoke for the same reason that 

adults do—nicotine is highly addictive. We need to give teens the same kinds of cessation services 

that we give to adults. 

■	 	 Focus: Youth cessation 

Even though the reporter is asking the questions, your answers have the power to influence the story and 

how it’s framed. By answering strategically, you can help increase the chances that they get the story right. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 257 

about the news media is that “they don’t get 

the story right.” 

Getting the media interested in a story and 

helping to ensure that they get the story right 

are what framing is all about. These two facets 

of framing are called “framing for access” and 

“framing for content.” 

Framing for access is what you do when you’re 

trying to get the media interested in your story. 

By gaining the attention of journalists, you 

gain access to the media. When you’re framing 

for access, you “pitch” a newsworthy aspect of 

your story that will make the reporters want to 

attend your event, interview your spokesperson, and so on. Use the “Checklist to 

Determine Newsworthiness” found in Chapter 

8: Public Relations when selecting the best 

news angle for each story idea. Consider what 

each reporter will be the most interested in 

covering. If you’re trying to educate the 

community about secondhand smoke to lay 

the groundwork for clean indoor air policies, 

and you’re approaching a reporter for the 

newspaper’s business section, perhaps you can 

emphasize the economic costs that the restaurant and bar owners incur when their employees 

become ill from breathing secondhand smoke. 

If you’re approaching a TV reporter who covers 

family-related issues, emphasize the risks of 

secondhand smoke to family members, especially children, who live with smokers. Once 

you have access to the media, you shift to 

framing for content. When framing for content, you focus on the perspective of the story 

and the information that you want to be conveyed. The reporters, editors, and producers 

who create news stories have to be selective 

about what they include and what they leave 

out of a news story. 

The advocate doesn’t make the decisions 

about what’s included within the frame of a 

story and what’s left out, but the advocate can 

influence those decisions. In every interview, 

meeting, and conversation with a journalist, 

the goal of the advocate is to frame the story so 

that it includes the needed information to promote the policy or environmental change goal. 

When helping to frame or reframe a story for 

content, always keep your overall strategy in 

mind. (Review the answers to the five questions listed earlier in the chapter.) Work constantly to frame stories in ways that help 

advance your policy goal by delivering the 

right message to the right target audience. 

For example, if your goal is to strengthen the 

enforcement of youth access laws, you might 

generate some interest by telling a reporter 

that you have a story about youth smoking 

rates in your community. You’ll have a better 

story if you say that you know several 

teenagers who can tell their personal stories 

about how easy it is to buy tobacco in the 

community. You’ll have a great story if you say 

that you know teens who are organizing to 

pressure merchants and law enforcement 

agencies to do a better job of enforcing youth 

access to tobacco laws. 

Developing the Message 

All of the elements of your message—the content, the tone, the messenger, and the medium 

that delivers it—should be determined by your 

answers to the five strategic planning questions. 
258 Chapter 9: Media Advocacy 

Effective Media Bites 

What makes a good media bite? By definition, media bites are short—10 to 15 seconds, or 

one or two sentences, or sometimes just a phrase. Good media bites can capture complex 

concepts in simple ways. They paint mental pictures. They evoke strong feelings. They are 

memorable or witty. But most important, good media bites help advance your strategy. 

Being quoted isn’t worth much if the quotes don’t help you accomplish your goals. 

Here’s one example of an effective media bite: 

“Smoking a ‘safer’ cigarette is like jumping out of the 10th story of a building instead 

of the 12th story.” 

This quote addresses the tobacco industry’s efforts to create products that seem relatively 

safe to consumers, such as low-tar cigarettes. This issue can be tricky for advocates 

because, at first glance, removing some of the harmful ingredients in cigarettes seems like 

a good idea. The following media bite is a clever way of conveying the idea that no matter 

what you do to a cigarette, it remains a lethal product: 

“Tobacco is the only consumer product that, when used as directed, kills the user.” 

One of the tobacco industry’s stock arguments is that tobacco is only one of many products (e.g., alcohol and fatty foods) that can be unhealthy. According to this argument, if 

public health advocates succeed in regulating tobacco use, it will only be a matter of time 

until they also regulate the use of these other products. The quote points to a crucial distinction: alcohol, fatty foods, and similar products kill when abused or consumed in 

excess, whereas tobacco products kill when used in their customary, intended way. 

You can brainstorm good media bites ahead of time to have them ready when you need 

them in an interview. Start by anticipating the questions that you might be asked. Then 

do some research. What have advocates said on this issue before? Modernize bites that 

have been used in the past by tying them to current developments. Try out different 

approaches and new ideas. Practice saying your answers out loud. Ask yourself two questions: 

(1) Would this response be likely to make the news? 

(2) Does this answer help advance my goal? 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 259 

When developing your message, keep it short, 

simple, and direct. Plan as if your audience will 

only remember one thing from your media 

advocacy intervention (think of it as the headline). Decide in advance what that one thing 

should be, and base your entire communication around it. 

Whenever possible, use research techniques, 

like opinion surveys and focus groups, to 

develop and test your message. (See Chapter 3: 

Gaining and Using Target Audience Insights for 

more information.) If you don’t have access to 

these methods, talk to friends and relatives 

who don’t work in the health field. Discuss 

the message with members of your target 

audience (e.g., friendly legislators) who can tell 

you what the message means to them and how 

it might influence their actions. 

Monitor the media to see how they 

treat the issue that your message 

addresses. (See the evaluation section 

of Chapter 8: Public Relations for 

details on tracking media coverage.) 

Monitoring the media will allow you 

to understand how your issue is being 

covered and which tobacco control 

and tobacco industry spokespeople 

reporters are contacting. Understanding how the media covers your 

issue is necessary to inform your 

message strategy. Different audiences 

may respond to different messages. 

Your message may (and probably will) 

have to change over time in response 

to a changing environment. If you 

keep your strategic plan in mind, you 

can adapt effectively to these changes. Once 

your messages have been developed, it’s important to share them with your fellow advocates 

so that your message will penetrate the market. 

It takes many different people saying the same 

thing to have an impact on policy makers. 

Link your message to widely held cultural values. Most Americans have a common core set 

of values, including concern for health, equality, fairness, protection of children, respect for 

science, intolerance of deception, and belief in 

the right to a safe and clean environment. You 

don’t have to convince your audience that 

these are good things. You only need to show 

them how these values relate to your message. 
260 Chapter 9: Media Advocacy 

Case Study: Giving the Target a Choice 

Tony Schwartz provided the paradigm of effective targeting. He made cassette tapes of the following 
 

message and sent them to the members of the New York City Council’s Health Committee: 
 

To the members of the Health Committee of the New York City Council. We’d like to have you listen to 

the following two commercials, and tell us which one you will give us the opportunity to run. We are 

People for a Smoke-Free Indoors. Here’s the first commercial. 

You know the people in the New York City Council have the power to do a lot of good or a lot of 

bad. Just a few Committee Members can see to it that a bill gets immediate attention by the whole 

City Council. Or they can bottle up a bill forever, keeping the City Council from acting on it. Well, 

the City Council Committee on Health just took an action that all New Yorkers can be proud of. 

They just voted the smoking pollution control law out of committee, giving the whole City Council 

a chance to act on it. Despite intense lobbying from very powerful cigarette companies, they took 

this action for the health of New Yorkers. And so, with real pride and admiration for what they’ve 

done for New Yorkers, we say thank you Chairman ___, thank you ___, thank you ___. Thank you all 

for caring enough about the health of New Yorkers to not give in to the special interests. People for 

a Smoke-Free Indoors, Inc., paid for this ad to show our appreciation. 

Here is the second ad. 

You know the people in the New York City Council have the power to do a lot of good or a lot of 

bad. Just a few Committee Members can see to it that a bill gets immediate attention by the whole 

City Council. Or they can bottle up a bill forever, keeping the City Council from acting on it. Well, 

the City Council Committee on Health just took an action that shows they care more about special 

interests than about the people of New York. They just voted down the smoking pollution control 

act, giving in to the powerful cigarette companies and preventing the City Council from acting for 

the health of all New Yorkers. If this makes you mad, write or call the Health Committee members 

and tell them how you feel. Tell ___, ___, ___. Tell them all that you don’t appreciate it when they 

show they care more about special interests than they do about the health of New Yorkers. And if 

you don’t tell them now, tell them next election day. Paid for by People for a Smoke-Free Indoors, Inc. 

So call me at ___, and tell me which one you’d like us to run. 

People for a Smoke-Free Indoors had already purchased the radio time to run one of these ads. The bill 

passed out of committee and was eventually approved by the full council. The first ad was aired. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 261 

A good message does three things: 

1.	 	States the concern (e.g., secondhand 

smoke is dangerous to nonsmokers) 

2.	 	Evokes a widely held value (e.g., it’s 

unfair to impose health risks on nonsmokers while they’re trying to earn a 

living or to enjoy public accommodations) 

3.	 	Presents a solution (e.g., because nonsmokers have a right to breathe clean air 

in public places and at work, clean 

indoor air policies should be supported) 

Targeting the Audience 

When you aim at the whole world, you often 

hit no one. Strategic use of the media includes 

knowing exactly whom you want to reach and 

how to reach them. 

All stations and publications that sell advertising know the demographics of their audiences. 

They base their programming on that information and use it to sell advertising. You can use 

that information to communicate your message to target audiences. Tobacco companies 

use it with precision to sell their deadly products. For the purposes of media advocacy, 

don’t think of the media as a way to broadcast 

to the whole world. Rather, think of the media 

as a way to “narrowcast” your message—to 

have a personal conversation with your specific 

target. When narrowcasting is done well, it can 

function as “guerrilla media.” Tony Schwartz is 

one of the great masters of guerrilla media, 

producer of some of the first and most powerful tobacco counter-marketing efforts, and the 

author of The Responsive Chord, which is a 

seminal contribution to media advocacy. He 

prefers radio for precision targeting because 

it’s ubiquitous and inexpensive, and it accompanies many commuters to work. When the 

message is crafted well enough to reflect 

what’s already in the audience’s mind, radio is 

especially effective in piercing the consciousness. As Schwartz points out, “People don’t 

have earlids.” 

Evaluating Your Media Advocacy 

Efforts 

Changing tobacco policy through media 

advocacy can take a long time. It’s a complex 

process that requires balancing focus and 

flexibility. By evaluating your efforts, you can 

continue to improve how you work with 

reporters and become more effective in working with them, thus helping to advance social 

change. 

Evaluation can help you respond to the 

inquiries of various stakeholders. Your funders 

may want to know whether media advocacy is 

a worthwhile investment. Media advocates 

will want to know whether what they did was 

consistent with their plan and whether their 

actions produced the results that they wanted. 

Other media advocates may want to draw 

from the lessons that you’ve learned to 

become more effective themselves. Evaluation 

of your media advocacy efforts can help 

answer questions such as the following: 

■	 	 What happened? 

■	 	 Did you do what you intended? 

■	 	 Was your issue covered by a media 
 

channel that your target audience sees, 
 

reads, or listens to? 
 
262 Chapter 9: Media Advocacy 

■	 	 Was your story told in the way that you 

wanted; that is, did your frame the coverage? 

■	 	 Were you able to build relationships 

with media gatekeepers so that you’re 

now a trusted source for them? 

■	 	 How did those who can effect change 

(e.g., policy makers) and their constituencies react to the media 

advocacy effort? 

■	 	 Did your media work help you build 

community support for the overall policy 

or program goal? 

■	 	 What didn’t go well? What will you
 

change in the future?
 

How To Evaluate Your Media Advocacy 

Efforts 

You may want to review Chapter 5: Evaluating 

the Success of Your Counter-Marketing 

Program, which addresses the evaluation 

process in depth. Be pragmatic in developing 

your evaluation, and use an approach that’s 

geared to the intended use of the results. To do 

this, you’ll want to involve the intended users 

in shaping the evaluation from the start. 

Evaluating media advocacy will be somewhat 

different from evaluating other components of 

a counter-marketing program. Measuring 

media coverage by counting column inches or 

by calculating air time won’t tell you whether 

your efforts have helped to advance your policy goals. Moreover, each media advocacy effort 

is unique, influenced by circumstances and 

shifting to respond to unplanned events and 

breaking news. Many media advocates have 

used case studies to evaluate their efforts. Case 

studies can provide in-depth examinations of 

how media coverage on a particular topic was 

framed and how community advocates were 

involved in the media advocacy initiatives. 

To conduct a process evaluation, you should 

focus mainly on documenting what you did, 

what the media did in response, and whether 

the message was framed in the way that 

you intended. You can use logs and other 

documentation to track your activities and to 

mea-sure whether you’ve achieved your 

process objectives and followed your program 

plan. To document what the media have done, 

clip relevant articles from print sources (or 

electronically search print sources that are also 

published on the Web) and record the TV and 

radio news coverage. Assess whether the stories 

have framed your issue in a way that advanced 

your policy goals. Try to understand why certain news releases or media calls generated 

better coverage than others. Review the coverage with colleagues, friends, and critics, and 

reflect on how the issue was framed. You can 

also hire media tracking services to compile the 

news stories and editorials that appeared during a certain period of time and to categorize 

them by slant, placement, and other factors. In 

addition, interview key parties, such as 

reporters and policy makers. If you find that a 

story didn’t capture the interest of reporters, 

ask them why. These discussions and interviews can help you improve what you do. 

To conduct an outcome evaluation, the most 

important measures relate to changes in social 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 263 

norms and policies, and the specific measures 

will depend on your media advocacy goal. For 

a social norm change, you’ll want to survey the 

knowledge, attitudes, and behaviors of those 

among whom you hope to effect change. For a 

policy change, you’ll want to track any actions 

taken by the key parties to adopt relevant policies. Because these changes often take a long 

time, you can also measure short-term outcomes, such as whether public officials recite 

your key messages, facts, or survey results in 

public forums. 

reporters and your target audience, you’ll want 

to use the information to adjust your strategy. 

Results may tell you, for example, that you 

need to use different communication channels 

because your information isn’t reaching your 

target audience. Or your review may show that 

you succeeded in accessing the media, but the 

information wasn’t framed in a way that would 

advance your intended policy objectives. This 

finding may indicate that you need more practice in defining and articulating your frame. 

Using evaluation in this way can help you stay 

focused, keep the message consistent, reach 

your target audience, and impact policy to 

produce the environmental change that you 

seek. 

Using Evaluation Results for 

Decision Making 

Once you’ve analyzed the news coverage with 

your colleagues and collected feedback from 

Points To Remember 

The following is adapted from News for a Change: An Advocate’s Guide to Working With the Media (Wallack 

et al. 1999): 

■	 	 You can’t have a media advocacy strategy without an overall strategy. Think of media advocacy in
 

support of and in addition to other approaches, rather than instead of or in isolation from them.
 

■	 	 If you want to be taken seriously as a credible source for reporters, you need to take the media 
 

seriously. If you want to work effectively through the media, you’ll need to know the media. You 
 

must pay attention to whether and how your issue is covered so that you can be more effective in
 

your own media efforts.
 

■	 	 Understand the conventions and values that drive journalists. Journalists are professionals. Learn 

how they go about their business and use the common ground that you share to give them good, 

newsworthy stories while advancing your issues. Continues 
264 Chapter 9: Media Advocacy 

Points To Remember (cont.) 

■	 Pitch stories, not issues. Tobacco control has been around for a long time. You need to look for new 

ways to make your issues compelling to journalists and news consumers. Journalists think in terms of 

stories. Issues can be vague and bloodless; advocates need to make issues come alive by crafting 

stories. 

■	 Supply journalists with creative story elements that illustrate the policy solution that you support. 

These include good visuals, media bites, and “authentic voices” who can tell compelling personal stories. These elements will help you focus on your solution. The problem may be easier to talk about 

than the solution, but the solution is more important. 

■	 Make your news events count. Plan carefully. Make sure that the speakers, materials, and the setting all 

reinforce your key message. Know what you want to say, say it, repeat it in different ways, and have 

others say it. 

■	 An interview is not a conversation. Think of interviews as potential vehicles to get your message out. 

Stick to your agenda, not the reporter’s. Don’t get lulled into casual thinking. Be purposeful and make 

your point. 

■	 Use the opinion pages to reach policy makers and opinion leaders. An editorial page strategy, including 

op-ed columns, should be part of your media advocacy efforts. It can be more effective than some 

news events in reaching the people who can make a difference to your issue. 

■	 Consider all kinds of media in your strategy. Paid TV and radio advertising, as well as alternative media 

outlets, all have unique uses and can be effective in advancing your goals. Be sure that you know why a 

particular media outlet or approach is right for you now. Whatever media you choose, reuse the news: 

Send copies of articles, op-ed pieces, and letters to the editor to supporters and policy makers (know 

that all of the policy makers keep clipping files of your issue). 

■	 Use evaluation to refine your media advocacy strategy and to improve your effectiveness. Despite your 

best planning and most rigorous efforts, your approaches will not always work. Take setbacks as 

a challenge: rethink your strategies, try different messages or messengers, but don’t give up. 

The following Web site provides a comprehensive set of tobacco activism resources that you may find helpful 

when developing your program: http://www.tobacco.org/Resources/lbguide.html. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 9: Media Advocacy 265 

Bibliography 

ASSIST, Site Trainers Network. Advanced Media Advocacy Module Trainer’s Manual. Rockville, MD: 

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Chapman S, Lupton D. The Fight for Public Health: Principles and Practice of Media Advocacy. 

London: BMJ Publishing Group, 1994. 

Health Promotion Resource Center, Stanford Center for Research in Disease Prevention. Shaping 

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Medicine, 1973. 

Jernigan DH, Wright PA. Media advocacy: lessons from community experiences. Journal of Public 

Health Policy 1996;17(3):306–330. 

Minnesota Department of Health,, Tobacco Prevention and Control Section. Minnesota Youth 

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Department of Health, Tobacco Prevention and Control Section, 2000. 

Patton MQ. Utilization-Focused Evaluation. The New Century Text. 3rd ed., Edition 3. Thousand 

Oaks, CA: Sage Publications, 1997. 

Pertschuk M, Wilbur P. Media Advocacy: Reframing Public Debate. Washington, DC: The Benton 

Foundation, 1991. 

Schwartz T. The Responsive Chord. Garden City, NY: Anchor Books, 1973. 

Wallack L, Dorman L, Jernigan D, Themba M. Media Advocacy and Public Health: Power for 

Prevention. Thousand Oaks, CA: Sage Publications, 1993. 

Wallack L, Woodruff K, Dorman L, Diaz I. News for a Change: An Advocate’s Guide to Working With 

the Media. Thousand Oaks, CA: Sage Publications, 1999. 

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Bethesda, MD: U.S. Department of Justice, 1999. 
266 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 10: Grassroots Marketing 267 

Chapter 10 

Grassroots Marketing
 

We never said ‘don’t smoke.’ Teens aren’t looking for more 

preaching; they’re looking for the opposite, actually— 

a chance to be independent and rebellious. So that’s what 

Students Working Against Tobacco was all about. We didn’t	 

preach to our friends. We got a bunch of kids together to 

make a statement to the tobacco industry—to rebel 

against them. 

—	 Jared Perez, founding marketing director 
 

Florida’s Students Working Against Tobacco 
 

Grassroots marketing encourages people to participate in your countermarketing program. It gets new people involved, increases the involvement of 

those already reached by your campaign, and employs those already engaged 

to increase your target audience’s exposure to key messages or services. A 

collection of tactics falls under the heading of grassroots marketing: events, 

community organizing, partnerships, and some forms of “permission marketing” (offering benefits to audience members in exchange for permission to 

continue marketing to them). What brings them together is their purpose: 

they’re all about establishing and using participation. (For information on 

grassroots efforts for policy change, see Chapter 9: Media Advocacy.) 

Involving people isn’t easy, but it can help you significantly in achieving your 

goal of decreasing tobacco use or exposure to secondhand smoke. People 

involved in antitobacco activities are less likely to smoke or chew tobacco 

themselves and are more likely to urge their friends or family members to 

quit. Through grassroots marketing, you can build community support for 

your cause—which is critical to every part of your effort—and you can use 

In This Chapter 
 

• 	 Getting People 

Involved 

• 	 Helping Those 

Involved To 

Become More 

Engaged 

• 	 Using Community 

Partners To Reach 

Your Audience 

• 	 Evaluating Your 

Grassroots 

Marketing Efforts 
268 Chapter 10: Grassroots Marketing 

community partners to carry messages to your 

target audience, enhancing exposure (how 

many people get the message), relevance 

(whether they care about it), and, in certain 

cases, credibility (whether they believe it). For 

example, a father might care more about what 

his wife says (“The smoke in restaurants 

bothers our son. I’m going to a rally for smokefree restaurants. Want to come?”) than what he 

hears on television (“Secondhand smoke is 

harmful to children”). The key is to remember 

that different people offer credibility on different topics for different audiences. For example, 

you may trust your doctor for health information, 

but you’d turn to a mechanic for information 

on car repair. 

Keep in mind that community partners aren’t 

commercial spokespeople. They’re not under 

your control, and they don’t always follow the 

script. However, grassroots activities work best 

when community participants are treated as 

partners, at least to some extent. The freedom 

to make choices is part of what makes an activity powerful for the participant. A clear example 

is when grassroots marketing is tied to media 

advocacy. When community members are 

treated as partners in creating an advocacy 

activity, the activity may not be as polished as 

one that’s organized entirely by professionals. 

However, being part of the decision making 

draws the people involved deeper into the 

issue. They emerge more committed and more 

credible on the issue to other community 

members, not because they know every message verbatim, but because they believe in what 

they’re saying. This doesn’t mean that you want 

them to be off strategy, saying or doing things 

that aren’t in line with your central messages or 

goals. The constant challenge for the manager 

of a grassroots marketing program is to find the 

right balance between choices and control. 

This chapter describes some of the tactics that 

successful counter-marketing campaigns have 

used to address the following three goals of 

grassroots marketing: 

1.	 Getting people involved 

2.	 Helping those involved to become 
 

more engaged
 

3.	 Using partners to extend the reach and 

frequency of your messages 

What Grassroots Marketing Can and Can’t Do 

Can 

■	 Involve people 

■	 Create interpersonal exposure 

to a message 

■	 Channel some feedback 

■	 Build community support 

Can’t 

■	 Substitute for strategy 

■	 Be tightly controlled 

■	 Expose a broad audience to 

a very specific message 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■ Offer them something that they want. 

Chapter 10: Grassroots Marketing 269 

Keys to Involvement 

■ Decide whom you want to involve. 

■ Make it easy for them to participate. 

Getting People Involved 

What’s true about marketing in general is also 

true about grassroots marketing: If you want 

people to get involved, you need to offer them 

something that they want. You will also need 

to make it easy for them to participate. To use 

commercial marketing terms, you will need to 

offer potential participants high value at low 

cost. 

Tobacco counter-marketing programs have gotten people 

involved by offering benefits like 

glamour, recognition, and—quite 

simply—fun. Programs hold 

activities when and where people 

can easily attend. This may mean 

scheduling an activity after work 

or school and in the target audience’s neighborhood or, better 

yet, holding an activity at another 

event that is already drawing the 

kind of people that you want. 

Start with identifying the audience that you 

want to reach: Is it young children? Policy 

makers? Hispanic parents? Women? The 

answer will depend on your overall program 

goal and specific grassroots goal. If your program goal is to reduce exposure to secondhand smoke and your specific grassroots goal 

is to change the social norms around tobacco 

use, you may want to include policy makers 

with influence over smokefree restaurant ordinances as one of your target audiences. 

The audience(s) you select will help determine 

the character of the tactic that you use. 

Offering recognition may draw involvement 

from policy makers; a contest may interest 

young children. Be creative: You may want to 

invent something new, but you don’t have to 

start from scratch. Here are tactics that some 

counter-marketing campaigns have used and 

that others have replicated. 

Recognition events. Some of the most important people to recruit in a counter-marketing 

campaign are those with a lot of influence 

over potential and current smokers. These 

“influentials” may be role models or people 

in a position to control widely distributed 

tobacco-related images, such as entertainers, 
270 Chapter 10: Grassroots Marketing 

reporters, and publishers. Recognition events 

are one way to earn the attention of such influentials in the news media and the entertainment industry. By honoring people who do the 

right thing (portray tobacco honestly) or by 

exposing people who do the wrong thing 

(glamorize tobacco), you can offer a benefit 

that many in-fluentials seek—positive publicity. For example, California presents its 

“Thumbs Up! Thumbs Down!” awards for 

tobacco use in movies, and the National 

Institute on Drug Abuse presents its PRISM 

awards for the accurate portrayal of drug, alcohol, and tobacco use in entertainment. These 

types of events might help you recruit influentials to be part of a campaign. 

Glamour events. Building excitement is one 

way to attract people. You can piggyback on 

news events to make your campaign seem 

current and important or invite celebrities to 

participate. The key is to make sure that you 

stay focused on one of your messages. The 

American Lung Association in Sacramento, 

California, does just that to teach media literacy, piggybacking on the Emmy Awards to illustrate how tobacco is glamorized and normalized 

on TV. The American Lung Association’s 

Flemmy Awards are presented each year to TV 

shows that inaccurately depict tobacco. This 

event draws considerable media attention and 

highlights a message about how smoking isn’t 

as glamorous or as common in real life as it is 

depicted on TV. 

Advocacy events. Activities that advocate for 

better tobacco policies, such as restrictions on 

smoking, are not only valuable tools for changing policies, but also a way to get more people 

involved in tobacco control. Among other 

advocacy activities, tobacco control advocates 

have urged restaurants and bars to go smokefree, pleaded with magazines to refuse tobacco 

advertising, and campaigned to limit tobacco 

advertising in stores. States can also piggyback 

on national advocacy events, such as the Campaign for Tobacco-Free Kids’ “Kick Butts Day.” 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 10: Grassroots Marketing 271 

Activities within events. Drawing a crowd— 

or the media—is no easy task. Sometimes, 

instead of trying to create an event, programs 

piggyback on existing events. Activities can 

range from setting up a booth at an ethnic festival to distributing materials at a rock concert. 

Florida’s “truth” campaign sent its “truth truck” 

to rock concerts sponsored by tobacco brands 

to offer a needed counterpoint and to recruit 

youth volunteers. The “truth” campaign also 

set up booths at concerts to collect signatures 

petitioning Hollywood stars for more accurate 

portrayals of tobacco. California distributed its 

“Gold Card,” which was designed to look like a 

gold credit card and contained the state’s quitline number on it, at numerous events. People 

placed the cards in their wallets and, therefore, 

had the quitline number available when they 

needed it. The Gold Card is now the fourthranked source of calls to the quitline. 

Research activities. Hearing about something 

is one thing; learning about it is another. Some 

tobacco control programs create community 

activities in which people collect data about 

their own environment—and become more 

aware of what’s around them as a result. 

California’s Operation Storefront, for example, 

recruited local youth to collect information 

about the amount and type of point-ofpurchase advertising done in grocery and 

convenience stores. Then the youth publicized 

the results. Although youth might not gather 

information that is as reliable as what can be 

gathered by evaluation professionals, the community involvement and subsequent publicity 

can help engage more people in tobaccorelated issues. The Montana “Most of Us” 

project relied on grassroots marketing activities to enhance and broaden the reach of its 

media campaign. Students in a high school 

math class conducted a school survey on 

tobacco use, demonstrating for themselves the 

campaign’s message that the majority of teens 

don’t use tobacco. Another example from Contra 

Costa County, California, involved coalition 

members who conducted informal opinion 

polls, surveying community members about 

their dining preferences (i.e., smoking or nonsmoking section), as a way to personalize attitudes and convey them to local officials during 

hearings on smokefree restaurant ordinances. 

Contests. A prize is one of the most common 

benefits offered in exchange for involvement. 

Poster contests often are used to encourage 

young people, typically those in middle school 

and younger, to think about the downside to 

tobacco use. Unfortunately, young people 

often are asked to create these messages in a 

vacuum: they have no information about what 

kinds of messages might work. Messages 

developed without the benefit of research are 

less likely to be effective. Using these messages 

in a campaign (e.g., by buying space on local 

billboards) is risky. The most effective contests 

are those that stick to your strategy. In Florida’s 

teen-oriented “truth” campaign, the program 

emphasized its messages about industry 

manipulation by creating a contest that asked 

teens what they might say to a tobacco executive. The teen who submitted the winning 

answer received an award from Music 

Television (MTV). 
272 Chapter 10: Grassroots Marketing 

Using specialties and giveaways. Grassroots 

activities often lend themselves to advertising 

specialties and giveaways, such as pens, Tshirts, and stickers. If you plan to use these 

types of materials, first make sure that they fit 

with your strategy (e.g., California distributed 

Gold Cards to promote its quitline). Second, 

don’t let each community or group create their 

own materials. To maintain a consistent 

message and to create efficiencies of scale, 

you’ll want to produce the materials centrally 

and then distribute them to your partners for 

dissemination. 

Helping Those Involved To Become 

More Engaged 

Successful events are good ways to involve 

people initially, but you’ll make a bigger 

impact if you become a more regular part of 

their lives. You’ll want some people to 

become truly engaged in your campaign—to 

feel a part of it. This is critical if one of your 

goals is policy change. A tobacco control 

program can go only so far, especially if it’s 

managed by a government health department 

that can’t lobby for policy changes. At some 

point, people in a community need to press for 

change or it won’t happen, which is why 

community programs are included as a critical 

component in the Centers for Disease Control 

and Prevention’s Best Practices for 

Comprehensive Tobacco Control Programs 

(CDC 1999). 

Different people will be interested in different 

levels of involvement. You should try to 

accommodate as many levels of involvement 

as possible, then “sell up”—encourage them to 

become more involved over time. In marketing, this relationship is sometimes called 

“permission marketing”: You offer benefits to 

audience members in exchange for permission 

to continue marketing to them. The goal is not 

to make a single “sale,” but to develop a 

longer-term relationship that will involve 

many “sales” or interactions over a lifetime. 

For example, sometimes marketers send useful 

information by e-mail in exchange for 

information about your purchase preferences, 

then follow up with an offer to sell you something customized to your needs. The difference 

with tobacco control advocacy is that you’re 

not selling a product; rather, you’re “selling” 

the idea of actively supporting the program. 

Grassroots counter-marketing campaigns have 

several general levels of engagement: 

■	 	 Sampler. The lowest level of engagement 

is when people agree to participate in 

one activity based on the benefits of that 

activity. One example is a child who will 

participate in a poster contest because 

he likes to draw. He may not have 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 10: Grassroots Marketing 273 

bought into the larger antitobacco 

effort. 

■	 	 Ally. An Ally is someone who agrees 

with your overall goals and will be part 

of an activity if it seems interesting, 

fun, or important. 

■	 	 Believer. A Believer wants to help your 

cause and is probably thinking of ways 

to involve others. Believers will participate in almost any activity that they 

think will further the goals of the effort. 

Believers are obviously valuable, but not everybody you reach can be a Believer. Few people 

are committed tobacco control advocates the 

first time that they hear about the issue. People 

change their opinions and level of commitment gradually. Programs attract Samplers, 

whom they try to convert to Allies. Some of 

those Allies eventually become Believers. Just a 

handful of those that you recruit are likely to 

become Believers. 

There are many reasons to have people 

engaged in your program and many ways that 

they can make a difference. Once people get 

involved, you’ll face issues related to organizing, 

effective advocacy tactics, and governance. 

Although those are important issues for the 

program at large, this chapter will only address 

the most salient marketing issue: How do you 

entice people to become more and more 

involved? 

This question has been around for a long time. 

Active, organized grassroots support for tobacco control is often limited 

to the public health community. However, it doesn’t have to be. Successful 

tobacco control programs have enlisted wide 

support on occasion by 

appealing to various 

groups, such as women’s 

organizations, organizations that represent other 

specific populations, and, 

most notably, youth. Five 

of the most common 

ways that programs have engaged people in 

their effort on an ongoing basis are: 

1.	 	Community coalitions. Community 
 

members guide boards that may issue 
 

grants, implement community activities, 
 

or author community planning docu­
 

ments. 
 

2.	 	Advocacy group. Members and their 
 

supporters engage in statewide and 
 

community tobacco control activities. 
 
274 Chapter 10: Grassroots Marketing 

3.	 	Internet communities. A group of 

tobacco advocates can network and 

share ideas through a Web site or an 

e-mail list (listserv). 

4.	 	Professional groups. Such groups 

engage or target influential professionals, such as scriptwriters or physicians, 

to change how their professional group 

deals with tobacco. 

5.	 	Partnerships. The tobacco control 

program creates an ongoing relationship 

with another organization that may support tobacco control, or some aspect of 

it, but may not have tobacco control as 

one of its main goals. The program also 

engages the organization’s members in 

furthering tobacco control goals. 

There are almost as many ways to create these 

relationships as there are established groups. A 

lot will depend on where you’re starting. Does 

a group already exist? Is the group well positioned to broaden its numbers? What kind of 

presence does the government agency overseeing the tobacco control program already 

have at the community level? Regardless of 

where you start, those with experience in 

grassroots marketing say that three principles 

should be followed in nearly every case: 

1.	 	Be clear about the purpose of the relationship. People will want to know 

where they fit with the overall goals of 

the program. The clearer that you are 

about the role you need them to play, 

the more informed they will be about 

whether they want to play that role. 

2.	 	Show your partners that they will be 

doing meaningful work. If people think 

that they’re contributing to something 

they believe will make a difference, 

they’re more likely to stay involved. This 

means that you need to allow for their 

contributions. Your participants need to 

be treated as partners who can help 

mold the effort, rather than servants 

simply being asked to undertake some 

tasks. Once you engage them, you’ll also 

need to show them often that they’re 

making important progress toward the 

goal. Your positive feedback will help to 

keep them motivated to do sometimes 

difficult and time-consuming work. 

3.	 	Make it easy. Try to minimize the barriers to getting involved, such as long or 

numerous meetings. Focus on what 

people want to do, not just on what you 

need them to do. Also, find out more 

about them—their strengths, experiences, and interests—to make the best 

match with the work to be done. For 

example, the former Coalition for a 

Healthy and Responsible Georgia 

(CHARGe) devoted 15 to 20 minutes 

during each of its coalition meetings to 

writing letters to legislators, newspaper 

editors, and other influentials to educate 

them about the tobacco settlement 

issue. They provided all of the necessary 

templates and materials, including 

preaddressed, postage-paid envelopes, 

so that it would be as easy as possible 

for coalition members to take action. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 10: Grassroots Marketing 275 

Using Community Partners To 	 

Reach Your Audience 	 

However, recall that using community partners 

is not the same as paid advertising. You lose 

some control over the message and how it’s 

presented. This can be minimized through 

training, but will always be a consideration. 

You are relying on your partners’ credibility, 

not just your own. This can be positive. For 

example, some people will believe the 

American Cancer Society more than they’ll 

believe the state health department. However, 

it also raises difficult issues. For example, 

youth who become antitobacco advocates 

aren’t always the trendsetters in school. What if 

a teen who’s widely regarded by his peers as 

“uncool” or a “goody two-shoes” is the main 

spokesperson in his school saying smoking

isn’t cool? The message may lack credibility. 

This is another reason that balancing the 

desires of your grassroots advocates with the 

Leveraging the interest and enthusiasm of 

community partners (which may include 

people at both the Ally and Believer levels of 

commitment) is an inexpensive way to boost 

the reach and frequency of your messages. But 

remember that the people you want to change 

are probably not the same people who will be 

involved in your program. Youth smokers, for	 

example, are typically not joiners: They don’t 

want to be part of an antitobacco group or any 

organized group. So although your partners 

aren’t necessarily the people that you’re trying 

to reach, they should be people who can talk 

to your audience—both directly and through 

the attention that their events attract—without 

turning them off.	 

Case Study: Reaching Georgia Legislators 

To encourage more legislators to support the allocation of tobacco settlement funds to tobacco control, 

the former Coalition for a Healthy and Responsible Georgia (CHARGe) organized and executed several 

efforts to involve advocates and community members at a grassroots level. First, they held community 

forums to educate individuals at the local level about the importance of allocating one-third of tobacco 

settlement dollars to tobacco prevention and control efforts. At those educational forums, they provided 

participants with sample letters to the editor, sample letters to legislators, fact sheets, talking points, and 

other materials to make it easy for participants to take action. A few months later, the American Cancer 

Society, the American Heart Association, and the American Lung Association, in partnership with the 

Fletcher Martin Ewing ad agency, developed a trifold brochure that summarized for local advocates the 

key benefits of allocating settlement funds to tobacco prevention and control, and included a tear-card 

that advocates could send to their local legislators about the issue. In addition, CHARGe and the Georgia 

Health Department’s Tobacco Use Prevention Program developed a companion brochure that educated 

Georgians on the burden of tobacco in Georgia. (For more information, see Appendix 10.1: Georgia 

Burden of Tobacco Brochure.) 
276 Chapter 10: Grassroots Marketing 

goals of your program is so important. In the 

example above, this teen could be steered into 

activities where he could be the most effective—perhaps making a presentation to the 

school board instead of lecturing his peers. 

The main guideline here is that you must consider how your audience views your partners. 

Your partners may have credibility with your 

audience on some issues, but not on others. In 

Florida, teachers were encouraged to present 

media literacy modules that help teens deconstruct advertising. However, teachers were 

asked not to distribute any “truth”-branded 

materials because this antitobacco brand was 

supposed to be young and rebellious. It would 

have been much cheaper to promote the 

“truth” brand through the schools than through 

TV and events, but Florida passed up this costeffective dissemination channel because it 

lacked the right kind of credibility to reposition 

tobacco control as hip and young. 

The choices aren’t always clear. Florida went so 

far as to brand its youth advocacy group as 

“Students Working Against Tobacco” (SWAT), instead of the much more widely recognized 

“truth.” This was a way to put distance between 

the state’s real youth advocates (who may or 

may not be seen by their peers as cool) and the 

state’s hip, advertising-driven antitobacco 

brand. On the other hand, Minnesota branded 

both its teen advertising and its youth advocacy 

group as Target Market (TM), to invest more 

marketing muscle in creating activism and to 

save the cost of creating two brands. Both states 

have had documented success. 

When using partners as a dissemination channel, a program manager also must match the 

right message with the right partner. Again, 

partners should only disseminate messages 

that will seem credible coming from them. 

Police, for example, may be good messengers 

on issues of law (such as enforcing smokefree 

restaurant policies or laws on youth access to 

tobacco), but less credible with youth on the 

practices of other youth. (“How would a police 

officer know how many of us smoke?” a teen 

might wonder. “Who is going to tell him?”) 

This is true, regardless of whether the partner 

actually is an authority on the subject. The key 

question is whether the audience perceives 

him or her as an authority. 

Partners can use dozens of tactics to disseminate messages. Four of the most common 

tactics are: 

1.	 	Media events. Partners often hold media 

events that, while not explicitly targeting 

potential tobacco users, are designed to 

send them a message. Many of the antiindustry events are staged with this in 

mind. Few partners expect the industry 

to change, but anti-industry events can 

highlight a message to smokers that the 

industry is trying to manipulate them. 

2.	 	Counter-advertising. Community 

groups rarely have enough money to 

buy a significant amount of media space 

or time. Sometimes they can develop a 

partnership with a local TV station or 

newspaper to place antitobacco advertising at low or no cost. It is also possible 

to develop a partnership with a radio 

disc jockey who is willing to read live 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 10: Grassroots Marketing 277 

announcer radio ads, at no cost to 

the program. 

3.	 	Speaking. Partners can be very credible 

spokespeople when addressing community groups or their peers (especially 

younger peers). Several states have created programs where high school-age 

antitobacco advocates speak to students 

in elementary or middle schools. In 

Contra Costa County, California, coalition members persuasively presented 

qualitative research findings regarding 

community members’ preferences for 

smokefree restaurants to local officials 

during hearings regarding smokefree 

restaurant ordinances. 

4.	 	Advocacy. As mentioned previously, 

advocacy activities can serve a number 

of purposes beyond a change in policy. 

One is positioning the issue with the 

target audience. Advocating for smokefree restaurants, for example, is a way to 

disseminate messages about secondhand 

tobacco smoke. For example, SmokeLess 

States Coalitions throughout the country 

initiated a “tobacco tax challenge” to the 

state governors, challenging them to 

help save lives (and increase state funds) 

by raising their tobacco taxes. 

What makes a dissemination effort by your 

partners effective? Program managers suggest 

several guidelines for making it work: 

■	 	 Involve your partners early. People who 

agree with your goal may not support 

your campaign if they feel like outsiders. 

If they don’t understand your strategy, 

they could inadvertently promote messages that may undermine your effort. 

(If your strategy is to make not smoking 

rebellious, it would probably be counterproductive to warn teens that youth 

caught smoking will be punished.) Help 

them understand what you’re trying to 

achieve (goal, key audiences, and message strategies) and the important role 

that you want them to play. Give them 

as much information as they need or 

want to do a good job and to sense the 

urgency of the issue. 

■	 	 Keep your partners in the loop. When 

you surprise your partners, you run the 

risk of lost opportunities as well as hurt 

feelings. You probably don’t know all of 

the ways that your partners could assist 

you in your marketing effort. By keeping 

them in the loop, you can be apprised of 

opportunities to leverage your investment. 

■	 	 Match the right message with the right 

partner. As mentioned, no one is credible 

with every audience on every subject. 

Encourage your partners to focus on the 

messages that they’re in the best position 

to deliver. They don’t simply need to be 

able to reach the audience efficiently— 

they also need to be effective in what 

they say and how they say it. That 

means that they need to convey messages on which they are credible. 

■	 	 Provide training. If you want your partners to be on message, you will have to 

train them as spokespeople for your 
278 Chapter 10: Grassroots Marketing 

campaign. Provide talking points and 

tips on how to talk to reporters, and let 

them practice if you can. 

Evaluating Your Grassroots 

Marketing Efforts 

To maximize the effectiveness of your grassroots marketing efforts, you’ll need to evaluate 

what you’re doing. Evaluation will not only 

help you report to stakeholders about what 

you’re doing, but it will also give you valuable 

insight about how to improve your approach. 

Adjusting your approach based on evaluation 

results can help you get more types of people 

involved and deepen their commitment 

and involvement. 

Evaluation can help you answer questions 

such as the following: 

■	 	 How is the funding for grassroots 

marketing being used? 

■	 	 Was your approach implemented 

as planned? 

■	 	 Did you reach your target audience, 

and did audience members find your 

approach to be beneficial, fun, accessible, and convenient? 

■	 	 Did you reach a broad range of community partners? Were the partners credible 

to audience members and willing to deliver the antitobacco message to them? 

■	 	 What tactics were most effective in reaching these partners? What tactics did partners use for disseminating 

antitobacco messages, and 

how effective were they in 

reaching the target audience? 

■	 	 Did your effort help increase 

the audience’s level of commitmentor involvement? 

■	 	 How can you use the results 

of the evaluation to improve 

your grassroots approach? 

How to Evaluate Your Grassroots 

Marketing Efforts 

You may want to review Chapter 5: Evaluating 

the Success of Your Counter-Marketing 

Program, which addresses the evaluation 

process in depth. Be pragmatic in developing 

your evaluation, and use an approach based 

on how the results will be used. Once you have 

determined whom the evaluation is for and 

what information they will need, you can 

develop the best questions to find out what 

you need to know, determine how to get the 

answers to those questions, and then provide 

the information to those who need it in a way 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 10: Grassroots Marketing 279 

that they can use. To do this, you’ll want to involve 

those intended users in shaping the evaluation from 

the start. At a minimum, you’ll want to assess both 

your process (process evaluation) and the outcome of 

your efforts (outcome evaluation). To conduct a 

process evaluation, you can use implementation logs 

to 

systematically monitor and track what you’re doing 

and to assess whether you’re meeting your process 

objectives. If your plan designates that certain tactics 

will be used to reach a certain number of targeted 

partners, an outreach log can be used to document 

how many people were reached in an outreach activity and what tactics were used. Data across outreach 

events can be summarized to measure your progress 

in meeting these process objectives. 

To conduct an outcome evaluation, you’ll need to 

determine what realistic outcomes you hope to 

achieve. Once again, these outcomes should be 

linked directly to your program’s goals and objectives. 

Although the monitoring and tracking system can 

help you to determine whether you reached the 

expected number of targeted partners and what tactics were most effective in recruiting them, it won’t tell 

you how your intervention affected these participants. 

One outcome you’ll probably want to achieve is an 

increase in the targeted partners’ involvement in, and 

commitment to, the counter-marketing program. To 

learn whether this occurred, you must develop and 

use valid and reliable measures of commitment and 

involvement. For example, if you hope that your 

efforts will move a certain percentage of partners 

from being Allies to Believers, you’ll need to clearly 

define what constitutes an Ally and a Believer. These 

definitions then should be used to accurately assess 

whether audience members have made this change. 

Short surveys administered before the grassroots 

activity takes place (presurvey or baseline survey) 

and after it concludes (postsurvey) can determine 

participants’ increased commitment to the issue and 

their intention to become more involved in the campaign. You could also follow up with a representative 

sample of the participants to see whether they have 

become more involved or committed. 

Another outcome you’ll want to achieve is making the 

Allies and Believers credible spokespeople. You can 

measure this through surveys among individuals 

aware of the grassroots work. For example, you can ask 

them whether they heard a speech by a representative 

of the organization (e.g., SWAT) or whether they talked 

with a member of the organization. Then you can ask 

them about their impressions of these Allies and 

Believers, what they learned from them, and other 

questions that would provide useful information. 

Using Evaluation Results for Decision 

Making 

If your evaluation results indicate that certain partners 

are more effective than others, this may tell you something about their credibility and help you decide which 

ones to work with in the future. If the results show that 

certain tactics or messages were more effective than 

others in involving the target audience or that they 

were more appealing to Allies than Believers, this information can help you better plan how to involve people 

initially and increase participants’ involvement. After 

each round of grassroots activities, you’ll see what 

worked and what didn’t so that your next opportunity 

will be more fruitful. By evaluating your efforts regularly, you’ll learn more about how to engage your partners 

and target audience, how to solicit their initial involvement in the counter-marketing program, and how to 

increase their commitment. 
280 Chapter 10: Grassroots Marketing 

Points To Remember 

In grassroots marketing, the bottom line is engagement. You’re not just persuading people, you’re 

getting them involved. This activity can be much more challenging than airing advertising or staging 

a press event. You’re working with volunteers, not paid contractors, so they can bow out if they’re not 

feeling motivated, rewarded, or satisfied. However, the potential benefits are enormous. An ad may 

run for several months, but true Believers are around for a long time. 

Bibliography 

Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs– 

August 1999. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and 

Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and 

Health, August 1999. Reprinted with corrections. 

Godin S. Permission Marketing: Turning Strangers into Friends, and Friends into Customers. New York, NY: 

Simon and Schuster, 1999. 

Hall GE, Hord SM. Implementing Change: Patterns, Principles, and Potholes. Boston, MA: Allyn and Bacon, 2001. 

McKenzie-Mohr D, Smith W. Fostering Sustainable Behavior: An Introduction to Community-Based Social 

Marketing. Gabriola Island, BC, Canada: New Society Publishers, 1999. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 281 

Chapter 11 

Media Literacy
 


Media literacy is like the dog in “The Wizard of Oz” who 

pulls back the curtain to reveal the man behind the 

Wizard image. 

—	 Frank Baker, media literacy expert 

In This Chapter
 

• Media Literacy and 

Youth 

• Essential Ingredients 

of Media Literacy 

Media literacy helps people ask questions about what they watch, see, hear, 

and read. It helps them critically assess how the mass media normalize, glamorize, and create role models for unhealthy lifestyles and behaviors, such as 

smoking. Media literacy involves examining the techniques, technologies, 

and institutions involved in media production; critically analyzing media 

messages; and recognizing the role that audiences play in attaching a meaning to those messages. The idea behind media literacy is that teaching people 

to recognize how a message tries to influence them will lessen the impact of 

that message. On a broader level, media literacy can be viewed as a form of 

protection or “inoculation” against unhealthy behaviors shown in the media. 

This chapter gives an overview of media literacy and how it fits into a 

counter-marketing campaign. An extensive resources section at the end 

of this chapter lists media literacy curricula and other planning aids. 

Media Literacy and Youth 

Although some media literacy efforts target adults, most focus on young 

people and teens—and with good reason. Consider the following data: 

■	 	 Adolescents spend 24 hours per week watching television—twice as 

much time as they spend in school over the course of one year (Kaiser 

Family Foundation 1999; Strasburger et al. 2000). 

• How Media Literacy 

Complements 

Counter-Marketing 

• Implementing a 

Media Literacy 

Program 

• Evaluating Your 

Efforts 

• Resources 
282 Chapter 11: Media Literacy 

■	 	 Thirty-seven percent of children ages 6 

to 11 and 55.8 percent of teens ages 12 

to 17 have TV sets in their bedrooms 

(Kaiser Family Foundation 1999; 

Strasburger et al. 2000). 

■	 	 Eighty-two percent of adolescents use 

the Internet (Kaiser Family Foundation 

1999; Strasburger et al. 2000). 

■	 	 Adolescents listen to about 40 hours 

of popular music per week (Kaiser 

Family Foundation 1999; Strasburger 

et al. 2000). 

■	 	 Studies show that many parents don’t 

see their children’s media habits as a 

cause for concern. 

Youth love learning about media. Their culture 

and much of their identities are immersed in 

media. Teaching media literacy is an excellent 

way to attract their attention and to build their 

interest in health and smoking issues. 

Couple these facts with the tobacco industry’s 

advertising and marketing practices: 

■	 	 In 2000, the industry spent $9.57 billion 

to advertise and market tobacco products (Federal Trade Commission 2002). 

■	 	 Although no cigarette advertising 

appears on TV and radio, tobacco 

images are pervasive. They appear in 

movies, on clothing, at sporting events, 

and in other places. One study from 

Dartmouth College and Dartmouth 

Medical School showed that smoking in 

movies is linked to adolescents trying 

their first cigarette (Sargent et al. 2001). 

■	 	 A landmark study in the 1980s showed 

that as many young children recognized 

Joe Camel as they did Mickey Mouse 

(Fischer et al. 1991). 

■	 	 Camel’s market share among underage 

smokers rose from 0.5 percent to 32.8 

percent after the Joe Camel campaign 

was introduced (DiFranza et al. 1991). 

Consequently, media literacy has developed a 

large following among U.S. educators and 

health educators interested in youth. All 50 

states have some requirement for media 

literacy in their education standards (see 

http://www.med.sc.edu:1081/statelit.htm). 

Furthermore, many tested curricula are available to teach about media literacy on tobacco 

and alcohol use. 

Media literacy programs have shown some 

success. For example, research shows that 

media literacy programs addressing alcohol 

ads can help children become more informed; 

can diminish the perception that “everybody” 

is using alcohol; can encourage children to be 

more critical of the alcohol industry’s advertising techniques; and can reduce intentions to 

use alcohol over the short term (Austin 1997; 

Slater 1996). The programs may even help to 

improve long-term cognitive resistance to 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 283 

What Media Literacy Can and Can’t Do 

Can 

■	 	 Help change attitudes 

■	 	 Teach people to recognize how messages are 

designed to influence
 

them
 

■	 	 Contribute to changing 

long-term behavior 

alcohol ads (Slater 1996). Qualitative research 

and the experiences of media literacy experts 

indicate that, if executed well, these programs 

can change people’s knowledge, attitudes, 

and/or behaviors. 

Essential Ingredients of Media 

Literacy 

Media literacy has four main concepts. 

All media: 

■	 	 Are constructed 

■	 	 Have codes and conventions 

■	 	 Convey value messages 

■ Have financial interests 

Media literacy includes these activities: 

■	 	 Critically analyzing media messages 

■	 	 Evaluating the source of information 

■	 	 Discussing issues of bias and credibility 

Can’t 

■	 	 Change long-term 
 

behavior in the absence 
 

of other program ele­
 

ments 
 

■	 	 Replace classes or pro­
 

grams that explain 
 

tobacco’s impact on 
 

health 
 

■	 	 Raising awareness about how media
 


techniques (such as the use of color,
 


sound, editing, or symbolism) influence
 


people’s beliefs, attitudes, and behaviors
 


■	 	 Producing messages using different
 


forms of media
 


Media literacy has four stages: 

1. 	 The first stage is becoming aware of why it’s 

important to manage the amount of time 

spent with TV, videos, electronic games, the 

Internet, films, and various print media. 

2. 	 The second stage is learning specific skills 

of critical viewing, such as analyzing and 

questioning what’s in the “frame” (the 

perspective brought to the subject), how 

it’s constructed, and what may have been 

left out. 

3. 	 The third stage is exploring deeper issues 

of who produces the media we experience 

and why. Questions to explore include: 

Who profits? Who loses? Who decides? 
284 Chapter 11: Media Literacy 

Key Questions in Analyzing Media Messages 

■	 What story is being told? 

■	 From whose perspective is it presented? 

■	 How is it captured? 

■	 How is it edited? 

■	 What type of music is used? 

■	 Whose voice do we hear? 

■	 What is the message? 

■	 Who created the message and why are they sending it? 

■	 Who is speaking? 

■	 Whose viewpoint is not heard? 

■	 Which lifestyles, values, and points of view are represented in the message? 

■	 Who owns the medium? 

■	 What is our role as spectators? 

4. 	 The fourth stage is creating and producing 

one’s own media messages to counter the 

intended message. For example, a cigarette 

ad could be recast to reflect tobacco’s 

effects on health; the ad could then be used 

against the industry. At this stage, the participant’s role is that of an advocate. 

to influence attitudes and behaviors helps 

people to analyze and to decipher tobacco 

industry marketing efforts and also increases 

the effectiveness of counter-marketing efforts. 

Media literacy programs are easy to integrate 

with other counter-marketing components. 

For example, most media literacy programs 

include a module in which youth develop 

messages in response to industry marketing. 

This part of the program can be promoted 

through public relations and incorporated into 

grassroots efforts to educate the entire target 

audience about how the tobacco industry has 

tried to influence youth. 

How Media Literacy Complements 

Counter-Marketing 

Media literacy programs can complement and 

reinforce a state’s counter-marketing program. 

Educating people about advertisers’ motives 

and about the techniques that advertisers use 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 285 

Although media literacy programs can be an 

effective component within any countermarketing effort, they’re most likely to be 

effective when the counter-marketing programs use an industry manipulation or repositioning strategy. (See Chapter 7: Advertising.) 

Florida’s “truth” campaign used media literacy 

strategies to motivate young people to actively 

participate in tobacco control activities. In fact, 

many of Florida’s original ads are believed to 

have helped the viewing audience become 

more media literate by exposing the role of ad 

agencies and marketing groups in creating 

positive images of tobacco. 

Media literacy often leads to media advocacy 

efforts. In many cases, once youth are sensitized to deceptive marketing messages and 

practices, they’re eager to work to counter 

those messages. At the community level, many 

community advocates use media literacy techniques to educate the public about the influence of tobacco ads in convenience stores and 

at sporting events. 

Media literacy is also an effective tool for 

educating legislators and health policy decision 

makers. Because it’s based on educational theories and addresses issues beyond tobacco 

control, media literacy can be viewed as a less 

charged critique of industry practices. It can be 

a useful way to educate policy makers about 

why the tobacco control movement needs 

effective policies for youth marketing, youth 

access, and clean indoor air. 

It may be difficult to convey the direct impact 

a well-crafted media literacy program can have 

on youth. The best way to convince your state 

tobacco control advocates of the power of 

media literacy is to invite them to attend a 

media literacy session or to conduct a session 

designed especially for them. 

Implementing a Media Literacy 

Program 

Once you decide that media literacy supports 

your counter-marketing program’s goals, you 

can begin your search for the right strategies 

and activities. Many media literacy programs 

and curricula are available; do some research 

to find the ones that will work best with your 

program. (See Programs and Resources section 

at the end of this chapter.) Here are the general 

steps for implementing your program: 

■	 	 Talk to other state tobacco control 
 

program staff about how media literacy 
 

fits into their counter-marketing pro­
 

grams. Many states have used locally 
 

developed and tested programs and 
 

teaching tools. Ask them about their 
 

experiences with media literacy programs 
 

and experts. 
 

■	 	 Develop a strategy for media literacy in 
 

your counter-marketing plan. Apply 
 

strategies that work with your target 
 

audiences. Media literacy is an obvious 
 

match for youth prevention programs. If 
 

your focus is on industry manipulation, 
 

you can use media literacy strategies 
 

with adults to deconstruct the tobacco 
 

industry’s public relations ads and youth 
 

smoking prevention messages. Make 
 

sure that you have the resources, staff, 
 

and time to invest in media literacy as a 
 

program strategy. In addition, you’ll 
 
286 Chapter 11: Media Literacy 

need to find one or more experts who 

can implement media literacy programs 

in your state. (See the Resources list at 

the end of this chapter.) 

■	 	 Learn about media literacy programs 

and resources. The Centers for Disease 

Control and Prevention’s Office on 

Smoking and Health, the American 

Academy of Pediatrics, the National 

Education Association’s Health 

Information Network, and the Center 

for Substance Abuse Prevention jointly 

developed MediaSharp: Analyzing 

Tobacco and Alcohol Messages, a tool kit 

for educators, youth group leaders, 

pediatricians, and others who work with 

youth ages 11 through 14. The kit 

includes worksheets, suggested activities, references and resources, and a 

video module to use across the learning 

modules. In addition, several Web sites 

offer information about media literacy 

organizations and resources for media 

literacy. Experts around the country also 

can help you design a state program. 

(See the Resources list at the end of this 

chapter.) 

■	 	 Track who is using the program and 

how it is working in different settings. 

Once you’ve chosen a program and 

implemented it, be sure to evaluate your 

efforts. Evaluation will enable you to 

identify and correct any problems with 

the program. 

Here are several tips from media literacy 

experts for launching your effort: 

■	 	 Include links to media literacy Web 

sites on your state tobacco control site. 

These links will make media literacy tools 

readily available for teachers, health 

educators, and others who may be interested in working on tobacco control. 

■	 	 Visit state and local departments of 

education, health, or alcohol and other 

drug services. 

– 	 	Learn about your state’s education 

standards on media literacy. 

– 	 	Determine the department’s interest 

in tobacco media literacy and find 

out who is addressing the issue. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 287 

– 	 	Make tobacco media literacy 

resources and materials available to 

the department. 

– 	 	Work with the department to create 

professional development opportunities in media literacy. 

– 	 	Provide access to teaching tools and 

resources, and offer to train teachers, 

health educators, or other staff. 

– 	 	Introduce media literacy programs 

and teaching tools at state and local 

health and education conferences. 

– 	 	Find state media literacy experts to 

speak to students, parents, or teachers or at teacher training programs. 

– 	 	Train people to present media literacy programs at schools and other 

youth gatherings. 

■	 	 Identify youth organizations, religious 

groups, community hospitals, pediatricians, and other community groups 

open to addressing the issue of media 

literacy with their members. If your 

counter-marketing program addresses 

youth prevention, this can be an important addition to your media efforts. 

– 	 	Present information on media 

literacy to the organization leaders. 

– 	 	Determine whether they’re interested in offering media literacy 

programs. 

– 	 	Make resources and teaching tools 
 

available. 
 

– 	 	Offer to train staff from the organiza­
 

tions or offer to provide staff to con­
 

duct the programs for them. 
 

– 	 	Encourage organizations to publish 
 

or display artwork, ads, or other 
 

media literacy products developed 
 

by youth. 
 

■	 	 Approach local commercial and public 

television stations, education writers at 

newspapers, and cable stations with 

distance-learning access channels. 

– 	 	Offer experts to talk about the con­
 

cepts behind media literacy. 
 

– 	 	Showcase classes or organizations 
 

that are involving youth in media 
 

literacy programs. 
 

– 	 	Broadcast ads or other media mes­
 

sages developed by young people. 
 

– 	 	Develop a distance-learning program 
 

on media literacy for a cable channel. 
 

– 	 	Propose media literacy articles for 
 

newspapers with youth pages. 
 

■	 	 Involve parents. Help parents learn 

about media literacy programs so that 

they can reinforce and sustain media 

literacy at home. Inform them about 

school or community programs through 

parent resource groups such as the 

Parent Teacher Association. 
288 Chapter 11: Media Literacy 

Evaluating Your Efforts 

Evaluating your media literacy efforts will help 

you report to stakeholders and will give you 

valuable insights on improving your approach. 

Fine-tuning your approach using evaluation 

results can help you increase the public’s ability to analyze tobacco advertising, its motivation to counter the tobacco industry’s goals, 

and its involvement in the counter-marketing 

program. Some smokers may tell you that 

what they learn in media literacy justifies their 

addiction (i.e., they’re victims of industry 

manipulation). If this happens, don’t think that 

your program is having an adverse effect; 

instead, consider this argument a “teachable 

moment.” You may need to present additional 

information to these individuals, including 

information on health effects and cessation 

services. 

Evaluation will help you answer these types of 

questions: 

■	 	 How is the funding for media literacy 

being used? 

■	 	 Was your media literacy program implemented the way it was designed? 

■	 	 Was the audience attentive and engaged 

throughout? 

■	 	 Were there significant changes in the 

audience’s awareness, attitudes, perceptions, intentions, and behaviors? 

■	 	 How can you use the evaluation results 

to adjust your media literacy efforts and 

be more successful? 

How To Evaluate Your Media 

Literacy Efforts 

You may want to review Chapter 5: Evaluating 

the Success of Your Counter-Marketing 

Program, which addresses evaluation in depth. 

Base your approach to evaluation on how the 

results will be used and by whom. Once you 

have determined how the evaluation results 

will be used, you can develop the most effective questions, plan a strategy for getting 

answers, and then provide the information to 

those who need it in a format that they can 

use. Involve the intended users and allow them 

to provide input from the start about the 

type(s) of information that they need from the 

evaluation. 

To help manage the implementation of your 

media literacy efforts—and to respond to 

inquiries from your stakeholders—you must 

monitor and track your activities. As discussed 

in Chapter 5, you’ll need to complete or obtain 

logs and other documentation tools regularly 

to track the activities linked to your plan’s goals 

and objectives. For example, if one objective is 

to teach a certain number of targeted youth 

about specific content areas and skills within a 

given time frame, a log can allow you to document how many youth were reached, what 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 289 

areas and skills were addressed during each 

session, and when the instruction took place. 

Most importantly, you’ll want to assess outcomes to determine the effectiveness of 

your media literacy efforts. This assessment 

involves measuring the impact on program 

participants, including changes in: 

■	 	 Awareness of the role of the media 

■	 	 Attitudes toward and perceptions of the 

tobacco industry, its advertising, and the 

harm both perpetuate 

■	 	 Critical viewing skills 

■	 	 Ability to develop their own countermarketing messages 

■	 	 Intentions to talk with others about 

what they have learned 

If you conduct an outcome evaluation, use the 

strongest design possible. A pretest and 

posttest measurement that uses a comparison 

or a control group that didn’t receive the media 

literacy education is preferable. A participant 

survey is one important way to measure outcomes. You may also want to review items 

from other surveys that evaluated the outcomes of similar programs and to involve one 

or more experts in the survey development 

and data analysis. 

Using Evaluation Results for 

Decision Making 

The results of your outcome evaluation may 

show that some outcomes were achieved and 

others weren’t. To understand these results, 

check your monitoring and tracking data to see 

whether your media literacy activities were 

implemented according to plan. If the activities 

and content linked to certain outcomes weren’t 

taught appropriately or at all, you and your 

instructors will need to pay closer attention to 

program design and implementation. 

If your monitoring and tracking data show that 

your activities were implemented as planned, it 

may be helpful to conduct interviews or focus 

groups with members of your target audience 

to understand why certain outcomes weren’t 

achieved. If the focus group is designed and 

conducted effectively, these qualitative findings 

may help identify and correct problems with 

your media literacy efforts, such as low credibility of instructors, inappropriate learning 

techniques, program content that doesn’t resonate with the audience, or lack of time to 

practice relevant skills. By evaluating your 

efforts regularly, you’ll learn more about how to 

best engage your target audience, how to 

increase their knowledge, and how to motivate 

them to get involved in the tobacco countermarketing program. Then you’ll be able to 

make adjustments so that each round of media 

literacy efforts becomes more successful. 
290 Chapter 11: Media Literacy 

Points To Remember 

■	 	 Make sure that media literacy fits into your overall counter-marketing strategy. 

■	 	 Learn about media literacy programs and resources. Talk to program staff from 

states conducting media literacy efforts. 

■	 	 Identify which media literacy programs and resources match your audience and 

strategy. 

■	 	 Determine which organizations can help you implement a media literacy program. 

Offer them tools and training. 

■	 	 Track who is using the program and how it’s working. 

Resources 

Health Education 

Centers for Disease Control and Prevention. Guidelines for school health programs to prevent 

tobacco use and addiction. Morbidity and Mortality Weekly Report Recommendation Report 

1994;43(RR-2):1–18. 

Shelov S, Baron M, Beard L, Hogan M, et al. Children, adolescents and advertising. Pediatrics 

1995;95:295–7. 

U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A 

Report of the Surgeon General. Atlanta, GA: USDHHS, Public Health Service, Centers for Disease 

Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 

Office on Smoking and Health; 1994. Reprinted with corrections, July 1994. 

Programs and Resources 

■	 	 MediaSharp is an interactive, multimedia program designed to help young people critically 

assess how the media normalize, glamorize, and create role models for unhealthy lifestyles 

and behaviors. It focuses on analyzing tobacco and alcohol messages delivered through 

entertainment, news, and marketing. The MediaSharp kit includes a video, a leader’s guide, 

handouts, exercises, and an extensive list of media literacy resources; it can be ordered free 

from the Centers for Disease Control and Prevention/Office on Smoking and Health Web 

site (http://www.cdc.gov/tobacco). 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 291 

■	 	 Smoke Screeners is an educational program that helps young people learn media literacy skills 
 

by improving their ability to critically analyze messages about tobacco use in movies and on 
 

television. The program includes a moderator’s guide and video, and it can be used in a class­
 

room or in a youth group setting. Created as part of the youth initiative of the Massachusetts 
 

Department of Public Health’s antismoking campaign, this program is now a national effort. 
 

Smoke Screeners is free and can be ordered from the Centers for Disease Control and 
 

Prevention/Office on Smoking and Health Web site (http://www.cdc.gov/tobacco). 
 

■	 	 The Center for Media Literacy (http://www.medialit.org) is the leading organization for 
 

media literacy in the United States. The center has an extensive catalogue of recommended 
 

books, videos, and curriculum resources. 
 

■	 	 The Alliance for a Media Literate America (http://www.nmec.org) is a professional develop­
 

ment collaboration that organizes and hosts the annual National Media Education 
 

Conference for teachers, administrators, and community leaders. 
 

■	 	 South Carolina Educational Television’s Media Literacy Program Web site 
 

(http://www.med.sc.edu/medialit) provides numerous teaching tools for tobacco media 
 

literacy. 
 

■	 	 The New Mexico Media Literacy Project (http://www.aa.edu), sponsored by the Albuquerque 
 

Academy, offers a wealth of information for teaching media literacy skills to youth. 
 

■	 	 Hip Hop! Influence Within Youth Popular Culture: A Catalyst for Reaching America’s Youth 
 

with Substance Abuse Messages is a report by Dr. Thandi Hicks-Harper that can help readers 
 

to understand hip hop in a prevention context (http://www.hiphop4kids.com). 
 

Research Literature 

American Academy of Pediatrics. Media education. Pediatrics 1999;104:341–3. 

Brunner C, Talley W. The New Media Literacy Handbook: An Educator’s Guide to Bringing New 

Media into the Classroom. New York, NY: Anchor Books/Doubleday, 1999. 

Hobbs R. Literacy in the information age. In: Flood J, Lapp D, Brice Heath S, eds. Handbook of 

Research on Teaching Literacy Through the Communicative and Visual Arts. International Reading 

Association. New York, NY: Macmillan, 1998. pp. 7–14. 

Hobbs R. Media literacy in Massachusetts. In: Hart A, ed., Teaching the Media: International 

Perspectives. Mahwah, NJ: Lawrence Erlbaum Associates, 1998. pp. 127–440. 

Hobbs R. The seven great debates in the media literacy movement. Journal of Communication 

1998;48(2):9–29. 
292 Chapter 11: Media Literacy 

Hobbs R. Classroom strategies for exploring realism and authenticity in media messages. Reading
 


Online (International Reading Association) 2001;4(9). Available at:
 


http://www.readingonline.org/newliteracies/lit_index.asp?HREF=hobbs/index.html. 
 


Accessed June 20, 2003.
 


Hobbs R. Improving reading comprehension by using media literacy activities. Voices from the
 


Middle (National Council of Teachers of English) 2001;8(4):44–50. 
 


Hobbs R, Frost R. Instructional practices in media literacy education and their impact on 
 


students’ learning. New Jersey Journal of Communication 1999;6(2):123–48.
 


Krueger E, Christel MT. Seeing and Believing: How to Teach Media Literacy in the English
 


Classroom. Portsmouth, NH: Boynton/Cook Publishers, 2001.
 


Kubey R, Baker F. Has media literacy found a curricular foothold? Education Week 1999;19(9):56.
 


Available at: www.edweek.org/ew/newstory.cfm?slug=09ubey2.h19. For current links to all 50
 


states, see http://www.med.sc.edu:1081/statelit.html. Accessed June 20, 2003. 
 


Project Look Sharp. 12 Basic Principles for Incorporating Media Literacy into Any Curriculum. 

Ithaca, NY: Ithaca College, 1999. 

Silverblatt A. Media Literacy: Keys to Interpreting Media Messages, 2nd ed. Westport, CT: Praeger, 

2001. 

Silverblatt A, Ferry J, Finan B. Approaches to Media Literacy: A Handbook. Armonk, NY: M.E. 

Sharpe, 1999. 

Tyner K. Literacy in a Digital World: Teaching and Learning in the Age of Information. Mahwah, NJ: 

Lawrence Erlbaum Associates, 1998. 

Teaching and Learning Resources 

American Cancer Society. National Health Education Standards: Achieving Health Literacy. Atlanta, GA: 

American Cancer Society, 1995. 

DeGaetano G, Bander K. Screen Smarts: A Family Guide to Media Literacy. New York, NY: Houghton 

Mifflin,1996. 

Hobbs R. To your health. Cable in the Classroom 1995;Oct:12–13. 

Hobbs R. Know TV: Changing What, Why and How You Watch. Bethesda, MD: Discovery 

Communications, 1996. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 293 

Hobbs R. Start early to help children combat alcohol-saturated TV. American Academy of 

Pediatrics News 1998;14(3):20–1. 

Hobbs R. Media Literacy. New York, NY: Newsweek Education, 2000. 

Johnson LL. Media, Education and Change. New York, NY: Peter Lang Publishing, 2001. 

Manzo KK. Schools begin to infuse media literacy into the 3 R’s. Education Week 2000;Dec:6–7. 

Available at: http://www.edweek.org/ew/ewstory.cfm?slug=14media.h20&. Accessed July 3, 2002. 

Thoman E. Skills & strategies for media education. Educational Leadership 1999;56(5):50. 

Walsh B. Understanding Media Literacy. Center for Media Literacy, 2000. 

Zollo P. Wise Up to Teens: Insights Into Marketing and Advertising to Teenagers. Ithaca, NY: New 

Strategist Publications, 1995. 

Videos 

Centers for Disease Control and Prevention, Office on Smoking and Health; Massachusetts 

Department of Public Health. Smoke Screeners. 1999. To order, call 1-800-CDC-1311. 

DeBenedittis P. Rebelling Against Tobacco Ads. 2000. Available at: http://www.medialiteracy.net/ 

purchase. 

Hobbs R. Tuning In to Media: Literacy for the Information Age. 1994. Available at: 

http://gpn.unl.edu/cml/product_.index_alph.aspMangan M. Corporate Deceit: Big Tobacco’s 

Target (CD-ROM). 2001. Available at: http://www.medialiteracy.net/purchase 

National Institute for Media & The Family. Smoke & Mirrors. 1999. Available at: 

http://www.mediafamily.org/store/tools.shtml 

New Mexico Media Literacy Project. Just Do Media Literacy (companion teacher guide included). 

1997. Available at: http://www.nmmlp.org/products.htm 

New Mexico Media Literacy Project. Media Literacy for Health (CD-ROM, K–12 curriculum). 2001. 

Available at: http://www.nmmlp.org/products.htm 

Substance Abuse and Mental Health Services Administration, Center for Substance Abuse 

Prevention; Centers for Disease Control and Prevention, Office on Smoking and Health; American 

Academy of Pediatrics; National Education Association Health Information Network. MediaSharp: 

Analyzing Tobacco and Alcohol Messages. 1998. Available at: http://www.cdc.gov/tobacco/ 

mediashrp.htm. 
294 Chapter 11: Media Literacy 

Web Sites and Internet Resources 

Alliance for a Media Literate America: http://www.nmec.org. 
 


American Academy of Pediatrics, Understanding the Impact of Media on Children and Teens:
 


http://www.aap.org/family/mediaimpact.htm.
 


Center for Media Literacy: http://www.medialit.org. 
 


Countering the Influence of Alcohol and Tobacco Advertising: 

http://www.drugs.indiana.edu/prevention/advert.html. 
 


Deconstructing Media Messages: http://www.etr.org/recapp/practice/youthskills200106.htm. 
 


Media Education Foundation: http://www.mediaed.org/
 


Media Literacy Clearinghouse: http://www.med.sc.edu/medialit.
 


Media Literacy for Prevention, Critical Thinking and Self-Esteem (Web site of media literacy expert 
 


Dr. Peter DeBenedittis): http://www.medialiteracy.net. 
 


Media Literacy Review, Media Literacy Online Project, College of Education, University of Oregon:
 


http://interact.uoregon.edu/medialit/mlr/home/index.html. 
 


Media Literacy and Substance Abuse Virtual Library:
 


http://www.health.org/features/medlit/library.htm. 
 


New Mexico Media Literacy Project: http://www.nmmlp.org. 
 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Chapter 11: Media Literacy 295 

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296 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 297 

Resources and Tools
 


Federal Government Agencies 

Agency for Healthcare Research and Quality (AHRQ) 

The Agency for Healthcare Research and Quality (AHRQ), a part of the U.S. Department of Health and Human 

Services, is the lead agency charged with supporting research designed to improve the quality of health care, to 

reduce its cost, to improve patient safety, to decrease medical errors, and to broaden access to essential services. 

The agency provides materials on smoking cessation for health professionals and consumers. 

AHRQ Publications Clearinghouse 

P.O. Box 8547 

Silver Spring, MD 20907-8547 

800-358-9295 

www.ahrq.gov 

Centers for Disease Control and Prevention’s Office on Smoking and Health (CDC/OSH) 

The Centers for Disease Control and Prevention (CDC) is the lead federal agency for protecting the health and 

safety of all U.S. citizens at home and abroad, for providing credible information to enhance health decisions, 

and for promoting health through strong partnerships. CDC develops and implements disease prevention and 

control, environmental health, and health promotion and education activities to improve the public’s health. 

The Office on Smoking and Health (OSH) is a division of the National Center for Chronic Disease Prevention 

and Health Promotion (NCCDPHP), one of the centers within the CDC. OSH is responsible for leading and 

coordinating strategic efforts to prevent tobacco use among youth, to promote smoking cessation, and to protect nonsmokers from secondhand tobacco smoke. OSH’s Web site, the Tobacco Information and Prevention 

Source (TIPS), provides a range of materials on tobacco control and prevention. 

Office on Smoking and Health 

National Center for Chronic Disease Prevention and Health Promotion 

Centers for Disease Control and Prevention 

4770 Buford Highway NE, MS K-50 

Atlanta, GA 30341-3717 

800-CDC-1311 (toll free) / 770-488-5705 (phone) 

tobaccoinfo@cdc.gov (e-mail) 

www.cdc.gov/tobacco 
298 Resources and Tools 

Centers for Disease Control and Prevention’s Office on Smoking and Health 

National Networks 

To help eliminate tobacco-related disparities among priority populations, the Office on Smoking and Health 

(OSH) has established national networks to plan, initiate, coordinate, and evaluate tobacco control activities. 

The networks include the following: 

■	 	 Northwest Portland Area Indian Health Board (NPAIHB)
 


www.npaihb.org
 


■	 	 Association of Asian Pacific Community Health Organizations (AAPCHO)
 


www.aapcho.org
 


■	 	 The National Association of Lesbian, Gay, Bisexual and Transgender Community Centers (NALGBTCC) 

www.lgbtcenters.org 

■	 	 The National Alliance for Hispanic Health
 


www.hispanichealth.org
 


■	 	 National Latino Council on Alcohol and Tobacco Prevention
 


www.nlcatp.org
 


■	 	 The BACCHUS and GAMMA Peer Education Network
 


www.bacchusgamma.org
 


■	 	 Health Education Council
 


www.healthedcouncil.org
 


■	 	 Employee and Family Resources, Inc.
 


www.efr.org
 


Centers for Disease Control and Prevention’s Office on Smoking and Health Tribal 

Support Centers 

The Office on Smoking and Health (OSH) has established tribal support centers to develop or improve tobacco-related regional resource networks and outreach to tribes. The centers provide and support training and 

technical assistance, data collection, materials development, partnership building, and programs. The centers 

include the following: 

■	 	 Aberdeen Area Tribal Chairmen Health Board (AATCHB)
 


www.aatchb.org
 

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Resources and Tools 299 

■	 	 Alaska Native Health Board (ANHB)
 


www.anhb.org
 


■	 	 California Rural Indian Health Board (CRIHB)
 


www.crihb.org
 


■	 	 Intertribal Council of Arizona (ITCA)
 


www.itcaonline.com
 


■	 	 Inter-Tribal Council of Michigan, Inc.
 


www.itcmi.org
 


■	 	 Muscogee Creek Nation of Oklahoma
 


www.ocevnet.org/creek/index.html
 


■	 	 Northwest Portland Area Indian Health Board (NPAIHB)
 


www.npaihb.org
 


Center for Substance Abuse Prevention (CSAP) National Clearinghouse on Alcohol and 

Drug Information 

The Center for Substance Abuse Prevention (CSAP) provides national leadership in the development of 

policies, programs, and services to prevent the onset of illicit drug use, to prevent underage alcohol and 

tobacco use, and to reduce the negative consequences of using substances. CSAP is one of three centers in the 

Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. Department of Health and 

Human Services. CSAP funds the National Clearinghouse on Alcohol and Drug Information, which disseminates materials for professionals and the public on alcohol, tobacco, and other drugs. Information is available 

in various forms, including videos, fact sheets, posters, and pamphlets. 

Center for Substance Abuse Prevention 

National Clearinghouse on Alcohol and Drug Information 

P.O. Box 2345 

Rockville, MD 20847-2345 

800-SAY-NO-TO (toll-free) / 301-468-6433 (fax) 

www.samhsa.gov/centers/clearinghouse/clearinghouses.html 

www.health.org 
300 Resources and Tools 

Environmental Protection Agency (EPA) 

The Environmental Protection Agency (EPA) serves as the federal lead agency on environmental issues. Its 

Indoor Air Quality Information Clearinghouse offers publications and information on the harmful effects of 

secondhand smoke and indoor air pollution. 

Environmental Protection Agency 

Indoor Air Quality Information Clearinghouse 

P.O. Box 37133 

Washington, DC 20013-7133 

800-438-4318 (toll-free) / 703-356-5386 (fax) 

iaqinfo@aol.com (e-mail) 

www.epa.gov/iaq 

Federal Trade Commission (FTC) 

The Federal Trade Commission (FTC) is the U.S. government’s main authority on trade issues. It provides 

publications and information related to trade policies and tobacco advertising, including health warning labels, 

and produces a report that contains data on the tar, nicotine, and carbon monoxide in domestic cigarettes. 

Federal Trade Commission 

Consumer Response 

600 Pennsylvania Avenue NW 

Washington, DC 20580 

202-326-2222 (phone) / 202-326-3090 (tobacco-related questions) 

www.ftc.gov 

Food and Drug Administration (FDA) 

The Food and Drug Administration (FDA) responds to consumer requests for information and publications 

and provides information about regulations restricting the sale and distribution of cigarettes and smokeless 

tobacco to protect children and adolescents. 

Food and Drug Administration 

5600 Fishers Lane 

Rockville, MD 20857 

888-INFO-FDA (toll-free) 

www.fda.gov 
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Resources and Tools 301 

Indian Health Service (IHS) 

The Indian Health Service (IHS) provides a comprehensive health services delivery system for American 

Indians and Alaska Natives, with the opportunity for maximum tribal involvement in developing and 

managing programs to meet their health needs. The IHS facilitates and assists in coordinating health 

planning and in obtaining and using health resources available through federal, state, and local programs. 

Indian Health Service 

Public Affairs Staff 

801 Thompson Avenue, Suite 400 

Rockville, MD 20852-1627 

301-443-3593(phone) 

www.ihs.gov 

National Cancer Institute (NCI) 

The National Cancer Institute (NCI) supports research on counter-marketing and other tobacco control 

interventions and produces publications on smoking. It also provides telephone counseling services for 

smoking cessation. Programs and materials are available to health professionals and the public. 

National Cancer Institute 

Office of Cancer Communications 

6116 Executive Boulevard, Suite 3036A, MSC-8322 

Bethesda, MD 20892-8322 

800-4-CANCER (toll-free) 

www.nci.nih.gov 

www.smokefree.gov (for smoking cessation information and tools) 

National Center for Health Statistics (NCHS) 

The CDC's National Center for Health Statistics (NCHS) answers requests for catalogs, electronic data products, and single copies of publications, such as Advance Data reports and Monthly Vital Statistics reports. 

Ordering information is available for publications and electronic products sold through the Government 

Printing Office and the National Technical Information Service. Specific statistical data collected by the NCHS 

are also available. 

National Center for Health Statistics 

Division of Data Services 

3311 Toledo Road 

Hyattsville, MD 20782 

301-458-4636 (phone) 

www.cdc.gov/nchs 
302 Resources and Tools 

National Heart, Lung, and Blood Institute (NHLBI) 

The National Heart, Lung, and Blood Institute (NHLBI) provides information and materials on risk factors for 

cardiovascular disease. It disseminates public education materials and programmatic and scientific information. 

National Heart, Lung, and Blood Institute 

Health Information Center 

P.O. Box 30105 

Bethesda, MD 20824-0105 

301-592-8573 (phone) / 301-592-8563 (fax) 

www.nhlbi.nih.gov 

National Institute on Drug Abuse (NIDA) 

The National Institute on Drug Abuse (NIDA) provides information on nicotine addiction, its health hazards, 

and its treatment. It fulfills requests for catalogs and publications. It also publishes NIDA Notes, which covers 

topics such as nicotine addiction and smokeless tobacco use. The institute’s Web site has news releases and 

links to other resources. 

National Institute on Drug Abuse 

6001 Executive Boulevard, Room 5213 

Bethesda, MD 20892-9561 

301-443-1124 (phone) / 301-443-7397 (fax) 

www.drugabuse.gov 

National Institute for Occupational Safety and Health (NIOSH) 

The National Institute for Occupational Safety and Health (NIOSH) provides information on chemical and 

physical hazards in the workplace, training courses, publications, and the health hazard evaluation program. 

It distributes a subject-indexed catalog of its materials. NIOSH also maintains an automated database on 

occupational safety and health, and its library is open to the public. 

National Institute for Occupational Safety and Health 

Information Retrieval and Analysis Team 

4676 Columbia Parkway, MSC-13 

Cincinnati, OH 45226 

800-35-NIOSH (toll-free) / 513-533-8573 (publications fax) 

www.cdc.gov/niosh/homepage.html 
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Resources and Tools 303 

National Technical Information Service (NTIS) 

The National Technical Information Service (NTIS) offers a variety of information, including reports by U.S. 

government research and development agencies, databases produced by federal agencies, and descriptions of 

ongoing research sponsored by the U.S. government. NTIS has absorbed the National Audiovisual Center 

(NAC) and offers materials previously available from the NAC. 

National Technical Information Service 

5285 Port Royal Road 

Springfield, VA 22161 

800-553-6847 (toll free) / 703-605-6000 (regular and rush services) / 703-605-6900 (fax) 

www.ntis.gov 

Occupational Safety and Health Administration (OSHA) 

The Occupational Safety and Health Administration (OSHA) develops and promulgates occupational safety 

and health standards, develops and issues regulations, conducts investigations and inspections to determine 

the status of compliance with safety and health standards and regulations, and issues citations and proposes 

penalties for noncompliance with safety and health standards and regulations. 

Occupational Safety and Health Administration 

U.S. Department of Labor 

200 Constitution Avenue, NW 

Washington, DC 20210 

800-321-OSHA (toll-free) 

www.osha.gov 

Substance Abuse and Mental Health Services Administration (SAMHSA) 

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the federal agency charged 

with improving the quality and availability of prevention, treatment, and rehabilitative services to reduce the 

health and social costs of substance abuse and mental illnesses. SAMHSA funds a number of projects, including information clearinghouses and data collection efforts, to monitor the prevalence of substance use and 

mental health issues. 

Substance Abuse and Mental Health Services Administration 

5600 Fishers Lane 

Rockville, MD 20857 

info@samhsa.gov (e-mail) 

www.samhsa.gov 
304 Resources and Tools 

U.S. Department of Agriculture (USDA) 

The Department of Agriculture (USDA) provides information on tobacco price support programs and other 

tobacco-related agricultural issues. 

U.S. Department of Agriculture 

Tobacco Division 

Stop 0514 (for Express Mail, use Room 5750) 

1400 Independence Avenue SW 

Washington, DC 20250-0514 

202-720-4318 (phone) / 202-690-2298 (fax) 

www.usda.gov 

U.S. Department of Health and Human Services (USDHHS): Office of Minority Health’s 

Initiative To Eliminate Racial and Ethnic Disparities in Health 

This Department of Health and Human Services (USDHHS) initiative supports the goal of eliminating disparities in six areas of health status among U.S. racial and ethnic minority populations by 2010. The initiative’s Web 

site provides background on the initiative, news, a calendar of events, and links to publications and Web 

resources developed by USDHHS agencies to support the initiative. 

Office of Minority Health 

Tower Building, Suite 600 

1101 Wootton Parkway 

Rockville, MD 20852 

301-443-9923 (phone) / 301-443-8280 (fax) 

raceandhealth@osophs.dhhs.gov (e-mail) 

www.raceandhealth.hhs.gov 

U.S. Department of the Treasury: Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) 

The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) is a law enforcement organization within the 

Treasury Department that provides general information on current tax rates and tax revenues pertaining to tobacco. 

U.S. Department of the Treasury 

Bureau of Alcohol, Tobacco, Firearms and Explosives 

Regulations Division–Office of Alcohol and Tobacco 

650 Massachusetts Avenue NW, Room 5000 

Washington, DC 20226 

202-927-8210 (phone) 

www.atf.treas.gov 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 305 

Volunteer and Professional Organizations 

Action on Smoking and Health (ASH) 

Action on Smoking and Health (ASH) produces materials on a variety of smoking and health topics, with an 

emphasis on legal action to protect nonsmokers’ health. 

Action on Smoking and Health 

2013 H Street NW 

Washington, DC 20006 

202-659-4310 (phone) / 202-833-3921 (fax) 

www.ash.org 

The Advocacy Institute 

The Advocacy Institute works to counter the influence of the tobacco industry and provides strategic 

consulting and advocacy support on policy issues related to tobacco control. 

The Advocacy Institute 

1629 K Street NW, Suite 200 

Washington, DC 20006-1629 

202-777-7575 (phone) / 202-777-7577 (fax) 

www.advocacy.org/tobacco.htm 

American Cancer Society (ACS) 

The American Cancer Society (ACS) provides smoking education, prevention, and cessation programs and 

distributes pamphlets, posters, and exhibits on smoking. Check your telephone book for the ACS chapter in 

your area or contact the national office below for more information. 

American Cancer Society 

1599 Clifton Road NE 

Atlanta, GA 30329 

800-ACS-2345 (toll-free) 

www.cancer.org 
306 Resources and Tools 

American Council on Science and Health 

The American Council on Science and Health provides scientific evaluations on tobacco-related topics. 

American Council on Science and Health 

1995 Broadway, Second Floor 

New York, NY 10023-5860 

212-362-7044 (phone) / 212-362-4919 (fax) 

www.acsh.org/tobacco/index.html 

American Dental Association (ADA) 

The dentists’ association’s Web site contains American Dental Association (ADA) letters, which address these 

topics: excise taxes on tobacco products, tobacco settlement legislation, reduction of tobacco use, smokeless 

tobacco, the Warning Label Act, and advocacy. 

American Dental Association 

211 East Chicago Avenue 

Chicago, IL 60611 

312-440-2500 (phone) / 312-440-7494 (fax) 

www.ada.org 

American Dental Education Association (ADEA) 

The American Dental Education Association (ADEA) (formerly the American Dental Schools Association) 

offers a Tobacco-Free Initiatives Special Interest Group, an informal affiliation of dental and allied dental 

faculty interested in the promotion of tobacco cessation activities in dental education. The group represents 

ADEA interests in collaborative projects of the National Cancer Institute and the American Cancer Society. 

The group offers programs that help participants discuss, design, implement, and evaluate tobacco cessation 

programs in dental settings. 

American Dental Education Association 

1625 Massachusetts Avenue NW, Suite 600 

Washington, DC 20036-2212 

202-667-9433 (phone) / 202-667-0642 (fax) 

www.adea.org 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 307 

American Heart Association 

The American Heart Association promotes smoking intervention programs at schools, workplaces, and health 

care sites. Check your phone book for an association chapter in your area or contact the national office below 

for further information. 

American Heart Association 

National Center 

7272 Greenville Avenue 

Dallas, TX 75231 

800-AHA-USA-1 (toll-free) 

www.americanheart.org 

American Legacy Foundation 

The American Legacy Foundation was established to reduce tobacco use in the United States as outlined in 

the Master Settlement Agreement. Its Web site provides information about the antitobacco movement and 

ways that the Master Settlement Agreement’s funding is being used. There are also updates about public education efforts, including the national “truth” campaign, and stories that people share about their personal 

struggles with tobacco. 

American Legacy Foundation 

1001 G Street NW, Suite 800 

Washington, DC 20001 

202-454-5555 (phone) / 202-454-5599 (fax) 

www.americanlegacy.org 

American Lung Association (ALA) 

The American Lung Association (ALA) conducts programs addressing smoking cessation, prevention, and 

protection of nonsmokers’ health and provides a variety of educational materials for the public and health 

professionals. Check your telephone book for an association chapter in your area or contact the national 

office below for further information. 

American Lung Association 

61 Broadway, Sixth Floor 

New York, NY 10006 

212-315-8700 (phone) / 800-LUNG-USA (toll-free) 

www.lungusa.org 
308 Resources and Tools 

American Medical Association (AMA) 

The Web site of the American Medical Association (AMA) offers articles from the Journal of the American 

Medical Association, American Medical News, Archives of Internal Medicine, and other publications on 

tobacco-related issues. Some articles require a subscription or an association membership to view. 

American Medical Association 

515 North State Street 

Chicago, IL 60610 

312-464-5000 (phone) / 312-464-4184 (fax) 

www.ama-assn.org 

American Medical Association/SmokeLess States 

SmokeLess States is the largest non-government-funded national effort in tobacco prevention and control. 

The 30 grantees concentrate their efforts in three general areas: 1) promoting public awareness of the dangers 

of tobacco use, 2) educating the public about policy options related to tobacco, and 3) enhancing local prevention and treatment programs. 

American Medical Association/SmokeLess States 

515 North State Street 

Chicago, IL 60610 

312-464-5000 (phone) / 312-464-4184 (fax) 

www.ama-assn.org/ama/pub/category/3229.html 

Americans for Nonsmokers’ Rights (ANR) 

Americans for Nonsmokers' Rights (ANR) provides information to organizations and individuals to help pass 

ordinances, to implement workplace regulations, and to develop smoking policies in the workplace. Its Web 

site features a section covering “Tobacco’s dirty tricks.” 

Americans for Nonsmokers’ Rights 

2530 San Pablo Avenue, Suite J 

Berkeley, CA 94702 

510-841-3032 (phone) / 510-841-3071 (fax) 

www.no-smoke.org 
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Resources and Tools 309 

Asian Pacific Partnerships for Empowerment and Leadership (APPEAL) 

Asian Pacific Partnerships for Empowerment and Leadership (APPEAL) works to prevent tobacco use among 

the Asian American and Pacific Islander community through five priority areas: network development, capacity building, education, advocacy, and leadership development. 

APPEAL c/o AAPCHO (Association of Asian Pacific Community Health Organizations) 

439 23rd Street 

Oakland, CA 94612 

510-272-9536 (phone) / 510-272-0817 (fax) 

www.appealforcommunities.org 

Association of State and Territorial Health Officials (ASTHO) 

The Association of State and Territorial Health Officials (ASTHO) is the national nonprofit organization 

representing state and U.S. territorial public health agencies. The association has a Tobacco Control Program 

that develops and promotes policies that enhance the health agencies’ ability to address tobacco use 

prevention and control. ASTHO offers information on the tobacco settlement, state tobacco settlement 

updates, newsletters, reprints from ASTHO reports, and resource links. 

Association of State and Territorial Health Officials 

1275 K Street NW, Suite 800 

Washington, DC 20005-4006 

202-371-9090 (phone) / 202-371-9797 (fax) 

www.astho.org 

BACCHUS and GAMMA Peer Education Network 

The BACCHUS and GAMMA Peer Education Network is an international association of college- and universitybased peer education programs dedicated to alcohol abuse prevention and related student health and safety 

issues (including tobacco use). 

The BACCHUS and GAMMA Peer Education Network 

P.O. Box 100430 

Denver, CO 80250-0430 

303-871-0901 (phone) / 303-871-0907 (fax) 

admin@bacchusgamma.org (e-mail) 

www.bacchusgamma.org 
310 Resources and Tools 

Campaign for Tobacco-Free Kids 

The Campaign for Tobacco-Free Kids is one of the nation’s largest nongovernmental initiatives ever launched 

to protect children from tobacco addiction and exposure to secondhand smoke. 

Campaign for Tobacco-Free Kids 

1400 I Street NW, Suite 1200 

Washington, DC 20005 

202-296-5469 (phone) / 202-296-5427 (fax) 

info@tobaccofreekids.org (e-mail) 

www.tobaccofreekids.org 

Center for Media Literacy 

The Center for Media Literacy is the leading organization for media literacy in the United States. It has an 

extensive catalog of recommended books, videos, and curriculum resources. 

Center for Media Literacy 

3101 Ocean Park Boulevard, Suite 200 

Santa Monica, CA 90405 

310-581-0260 (phone) / 310-581-0270 (fax) 

cml@medialit.org (e-mail) 

www.medialit.org 

Center for Social Gerontology: Tobacco & Adult Minorities 

The Center for Social Gerontology’s Web site provides information on tobacco use and its effects on old and 

young adults from communities of color. Because people in communities of color have been specifically targeted by the tobacco industry, this site has information on lawsuits and legislative action against the tobacco 

industry and information related to the recent state tobacco settlements. 

Tobacco & Adult Minorities 

The Center for Social Gerontology 

2307 Shelby Avenue 

Ann Arbor, MI 48103 

734-665-1126 (phone) / 734-665-2071 (fax) 

tcsg@tcsg.org (e-mail) 

www.tcsg.org/tobacco/minorities/minorities.htm 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 311 

Chronic Disease Directors: Association of State and Territorial Chronic Disease 

Program Directors 

The Chronic Disease Directors (CDD) represents the chronic disease interests of the state and territorial health 

agencies and the District of Columbia. (Tobacco use is a common risk factor that contributes to one or more 

chronic diseases.) State health agencies play a major role in educating the public about risks and choices, and 

in creating better access to preventive and diagnostic health services. 

Association of State and Territorial Chronic Disease Program Directors 

Chronic Disease Directors 

8201 Greensboro Drive, Suite 300 

McLean, VA 22102 

703-610-9033 (phone) / 703-610-9005 (fax) 

info@chronicdisease.org (e-mail) 

www.chronicdisease.org 

Doctors Ought to Care (DOC) 

Doctors Ought to Care (DOC) mobilizes doctors and health organizations to speak out against tobacco and to 

publicize its effects. DOC provides school curricula, smoking intervention information, and tobacco counteradvertising for use in clinics, classrooms, and communities. 

Doctors Ought to Care 

5615 Kirby Drive, Suite 440 

Houston, TX 77005 

713-528-1487 (phone) / 713-528-2146 (fax) 

www.bcm.tmc.edu/doc 

The Foundation for a Smokefree America 

Created by Patrick Reynolds, grandson of tobacco company founder R.J. Reynolds, the foundation is a nonprofit organization that educates people of all ages about smoking and tobacco use. The foundation’s Web site 

provides antitobacco messages to youth and adults, antismoking videos, live talks, ads, photos, and art. 

The Foundation for a Smokefree America 

P.O. Box 492028 

Los Angeles, CA 90049-8028 

800-541-7741 (toll-free) / 310-471-4270 (phone) / 310-471-0335 (fax) 

www.tobaccofree.org 
312 Resources and Tools 

Global Partnerships for Tobacco Control: Essential Action 

The Global Partnerships for Tobacco Control’s Essential Action program helps to support and strengthen 

international tobacco control activities at the grassroots level. The program pairs groups in the United States 

and Canada with groups in Asia, Africa, Latin America, Central and Eastern Europe, and the former Soviet 

Union and helps them initiate meaningful shared activities. 

Global Partnerships for Tobacco Control 

P.O. Box 19405 

Washington, DC 20036 

202-387-8030 (phone) / 202-234-5176 (fax) 

tobacco@essential.org (e-mail) 

www.essentialaction.org/tobacco 

Healthy People 2010 

Healthy People 2010 is the federal blueprint for public health for the next 7 years. The set of health objectives 

can be used by individuals, states, communities, professional organizations, and others in developing programs to improve health. Healthy People 2010’s two main goals are: 1) to help individuals of all ages increase 

their life expectancy and improve their quality of life, and 2) to eliminate health disparities among different 

segments of the population. Each of the 28 focus-area chapters contains a concise goal statement that frames 

the overall purpose of the focus area. 

www.health.gov/healthypeople/About/goals.htm 

Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual, and Transgender 

(LGBT) Health 

Published by the Gay and Lesbian Medical Association, this document is a comprehensive look at the Lesbian, 

Gay, Bisexual, and Transgender (LGBT) community and is intended for health care consumers, providers, 

researchers, educators, government agencies, schools, clinics, advocates, and health professionals in all settings. The document focuses on about 120 objectives and 12 focus areas from Healthy People 2010. 

www.glma.org/policy/hp2010/index.html 

Join Together Online (JTO) 

Join Together Online (JTO) is a national Web resource for communities fighting substance abuse. JTO offers 

tobacco facts, the latest news on tobacco, and links to tobacco control resources. The site also has a Tobacco 

Information Packet, a technical assistance packet that includes a list of national organizations, publications, 

community stories, and community leaders with expertise in tobacco. 
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Resources and Tools 313 

Join Together Online 

One Appleton Street, Fourth Floor 

Boston, MA 02116-5223 

617-437-1500 (phone) / 617-437-9394 (fax) 

info@jointogether.org (e-mail) 

www.jointogether.org/sa 

Media Literacy for Prevention, Critical Thinking, Self Esteem 

Media Literacy for Prevention, Critical Thinking, Self Esteem provides a Web site that presents the work of Dr. 

Peter DeBenedittis and provides articles and tools for teaching media literacy. 

www.medialiteracy.net 

National Alliance for Hispanic Health 

The National Alliance for Hispanic Health is the oldest and largest network of health and human service 

providers, serving more than 10 million Hispanic consumers throughout the United States. The alliance’s 

Hispanic youth tobacco policy and leadership initiative, Nuestras Voces, is an effort to give a policy voice to 

Hispanic youth in the tobacco control movement. Nuestras Voces brings together Hispanic community-based 

organizations in five sites to implement local action plans against the strategic marketing of tobacco products 

to Hispanic youth. 

National Alliance for Hispanic Health 

1501 16th Street NW 

Washington, DC 20036 

202-387-5000 (phone) / 202-797-4353 (fax) 

alliance@hispanichealth.org (e-mail) 

www.hispanichealth.org 

National Association of Attorneys General (NAAG) 

The National Association of Attorneys General (NAAG) promotes coordination, cooperation, and communication among U.S. attorneys general. NAAG’s Web site offers information on the Master Settlement Agreement, 

including the full text of the agreement, information on state and industry participants, and other information 

on tobacco settlement issues. 

National Association of Attorneys General 

750 First Street NE, Suite 1100 

Washington, DC 20002 

202-326-6000 (phone) / 202-408-7014 (fax) 

www.naag.org 
314 Resources and Tools 

National Association of County and City Health Officials (NACCHO) 

The National Association of County and City Health Officials (NACCHO) provides education, information, 

research, and technical assistance to local health departments and facilitates partnerships among local, state, 

and federal agencies to promote and strengthen public health. NACCHO’s Tobacco Prevention and Control 

Project aims to strengthen local health departments’ ability to engage in tobacco use prevention and control. 

NACCHO’s Web site offers a number of tobacco control resources and links, including “Program and Funding 

Guidelines for Comprehensive Local Tobacco Control Programs.” 

National Association of County and City Health Officials 

1100 17th Street NW, Second Floor 

Washington, DC 20036 

202-783-5550 (phone) / 202-783-1583 (fax) 

www.naccho.org 

National Association of Lesbian and Gay Addiction Professionals (NALGAP) 

The National Association of Lesbian and Gay Addiction Professionals (NALGAP) works to prevent and treat 

alcoholism, substance abuse, and other addictions in the lesbian, gay, bisexual, and transgender (LGBT) 

communities. NALGAP’s mission is to confront prejudice in the delivery of services to LGBT people and to 

advocate for LGBT-affirming programs and services. NALGAP provides information, training, networking, 

advocacy, and support for addiction professionals, individuals in recovery, and others concerned about LGBT 

health. 

National Association of Lesbian and Gay Addiction Professionals 

901 North Washington Street, Suite 600 

Alexandria, VA 22314 

703-465-0539 (phone) / 703-741-6989 (fax) 

www.nalgap.org 

National Association of Lesbian, Gay, Bisexual, and Transgender Community Centers 

(NALGBTCC) 

The National Association of Lesbian, Gay, Bisexual, and Transgender Community Centers (NALGBTCC) works 

to sustain and empower its 107 member community centers in 36 states, while encouraging the creation of 

new centers. The association supports a CDC Tobacco Prevention and Control Initiative. 

www.lgbtcenters.org 
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Resources and Tools 315 

National Association of Local Boards of Health (NALBOH) 

The National Association of Local Boards of Health (NALBOH) is a nonprofit organization that represents the 

interests of local boards of health. NALBOH published a national survey of the legal authority for tobacco 

control of local boards of health and other local, state, and federal governmental agencies. NALBOH’s Web site 

provides tobacco control and prevention resources. 

National Association of Local Boards of Health 

1840 East Gypsy Lane 

Bowling Green, OH 43402 

419-353-7714 (phone) / 419-352-6278 (fax) 

nalboh@nalboh.org (e-mail) 

www.nalboh.org 

National Coalition for Women Against Tobacco 

The National Coalition for Women Against Tobacco, which was founded by the American Medical Women’s 

Association, aims to increase awareness of the dangers of tobacco use and exposure and to provide leadership 

in helping the global community of women and girls to lead tobacco-free lives. 

www.womenagainst.org 

National Governors Association (NGA) 

The Center for Best Practices of the National Governors Association (NGA) focuses on state innovations and 

best practices on a range of issues, including tobacco control. The NGA publishes an annual issue of briefs on 

the spending initiatives from tobacco settlement revenues, tracks spending decisions and legislation related to 

the Master Settlement Agreement, and provides information and technical assistance to states as they develop 

and reexamine spending decisions. The NGA Web site offers information on the tobacco settlement, including 

initiatives in each state. 

National Governors Association 

Hall of States 

444 North Capitol Street NW, Suite 267 

Washington, DC 20001-1512 

202-624-5300 (phone) / 202-624-5313 (fax) 

www.nga.org 
316 Resources and Tools 

National Indian Health Board (NIHB) 

The National Indian Health Board (NIHB) represents tribal governments that operate their own health care 

delivery systems or receive health care directly from the Indian Health Service (IHS). The NIHB conducts 

research, policy analysis, program assessment and development, national and regional meeting planning, 

project management, and training and technical assistance programs. These services are provided to tribes, 

area health boards, tribal organizations, federal agencies, and private foundations. The NIHB presents the tribal 

perspective while monitoring federal legislation and networking with other national health care organizations. 

National Indian Health Board 

101 Constitution Avenue, NW, Suite 8-B09 

Washington, DC 20001 

202-742-4262 (phone) / 202-742-4285 (fax) 

www.nihb.org 

National Indian Health Board 

Albuquerque Area Office, 2301 Renard Place SE, Suite 101 

Albuquerque, NM 87106 

505-764-0036 (phone) / 505-764-0466 (fax) 

National Latino Council on Alcohol and Tobacco Prevention (LCAT) 

The National Latino Council on Alcohol and Tobacco Prevention (LCAT) works to reduce the harm caused by 

alcohol and tobacco use in the Latino community, using research, policy analysis, education, training, and 

information dissemination. 

National Latino Council on Alcohol and Tobacco Prevention 

1875 Connecticut Avenue NW, Suite 732 

Washington, DC 20009 

202-265-8054 (phone) / 202-265-8056 (fax) 

lcat@nlcatp.org (e-mail) 

www.nlcatp.org 

National Latina/o Lesbian, Gay, Bisexual, and Transgender Organization 

The National Latina/o Lesbian, Gay, Bisexual, and Transgender Organization organizes Latina/o lesbian, gay, 

bisexual, and transgender (LGBT) communities on the local, regional, national, and international levels. The 

organization addresses the need to overcome social, health, and political barriers faced because of sexual 

orientation, gender identity, and ethnic background. 

National Latina/o Lesbian, Gay, Bisexual, and Transgender Organization 

1420 K Street NW, Suite 200 

Washington, DC 20005 

202-408-5380 (phone) / 202-408-8478 (fax) 

www.llego.org 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 317 

National Network of Libraries of Medicine 

The National Network of Libraries of Medicine is responsible for eight regional medical libraries, each with a 

large geographic area. These regional libraries maintain information about local libraries that provide health 

information and database searches. 

National Network of Libraries of Medicine 

800-338-7657 (toll-free) 

National Oral Health Information Clearinghouse (NOHIC) 

The National Oral Health Information Clearinghouse (NOHIC), a service of the National Institutes of Health’s 

National Institute of Dental and Craniofacial Research, develops and distributes information and educational 

materials on special care topics. It maintains a bibliographic database on oral health information and materials and provides information services. Trained staff respond to specific interests and questions in the area of 

special care. 

National Oral Health Information Clearinghouse 

ATTN: SH 

1 NOHIC Way 

Bethesda, MD 20892-3500 

301-402-7364 (phone) / 301-907-8830 (fax) 

nohic@nidcr.nih.gov (e-mail) 

www.nohic.nidcr.nih.gov 

Office of Minority Health Resource Center 

The Office of Minority Health Resource Center responds to information requests from health professionals 

and consumers on minority health issues and locates sources of technical assistance. It also provides referrals 

to relevant organizations and distributes materials. Spanish-speaking operators are available. 

Office of Minority Health Resource Center 

P.O. Box 37337 

Washington, DC 20013-7337 

800-444-6472 (toll-free) / 301-251-2160 (fax) 

www.omhrc.gov 
318 Resources and Tools 

The Onyx Group 

The Onyx Group is a consulting firm that provides marketing communications, qualitative research, strategic 

planning, diversity services, program development, and training, with particular emphasis on tobacco control, 

health promotion, coalition building, youth services, and education. The firm develops culturally competent 

products and media for target markets, including communities of color, women, youth, older adults, and rural, 

urban, and other underserved populations. 

The Onyx Group 

P.O. Box 60 

Bala Cynwyd, PA 19004 

610-617-9971 (phone) / 610-617-9972 (fax) 

onyxcom1@aol.com (e-mail) 

www.onyx-group.com 

Oral Health America Foundation 

The Oral Health America Foundation develops resources for the improvement and promotion of the nation’s 

oral health. Its National Spit Tobacco Education Program (NSTEP) informs the public that the use of spit 

(smokeless) tobacco is not a safe alternative to smoking and can lead to oral cancer. The foundation offers 

literature on spit tobacco and information on cessation for health care professionals and the public. 

Oral Health America Foundation 

410 North Michigan Avenue, Suite 352 

Chicago, IL 60611-4211 

312-836-9900 (phone) / 312-836-9986 (fax) 

www.oralhealthamerica.org 

Robert Wood Johnson Foundation (RWJF) 

The Robert Wood Johnson Foundation (RWJF) works to improve the health and health care of all Americans. It 

concentrates on awarding grants in three areas: 1) ensuring that all Americans have access to basic health care at 

reasonable cost, 2) improving care and support for people with chronic health conditions, and 3) promoting health 

and preventing disease by reducing the harm caused by substance abuse, tobacco, alcohol, and illicit drugs. 

Robert Wood Johnson Foundation 

P.O. Box 2316 

Route 1 and College Road East 

Princeton, NJ 08543-2316 

888-631-9989 (toll-free)/ 609-627-6401 (fax) 

www.rwjf.org 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 319 

Society for Research on Nicotine and Tobacco (SRNT) 

The Society for Research on Nicotine and Tobacco (SRNT) sponsors scientific meetings and publications 

fostering the exchange of information on the biological, behavioral, social, and economic effects of nicotine. 

It supports scientific research on public health efforts for the prevention and treatment of tobacco use. SRNT 

provides the means by which various legislative, governmental, regulatory, and other public agencies and the 

drug industry can obtain expert advice and consultation on critical issues concerning tobacco use, nicotine 

dependence, and therapeutic uses of nicotine. The society’s publications include newsletters, Nicotine and 

Tobacco Research, and abstracts from its annual meetings. 

Society for Research on Nicotine and Tobacco 

7600 Terrace Avenue, Suite 203 

Middleton, WI 53562 

608-836-3787 (phone) / 608-831-5485 (fax) 

info@srnt.org (e-mail) 

www.srnt.org 

The Tobacco Control Resource Center, Inc., & The Tobacco Products Liability Project 

The Tobacco Products Liability Project, which was founded by doctors, academics, and lawyers, encourages 

and coordinates product liability suits against the tobacco industry, as well as legislative and regulatory initiatives to control the sale and use of tobacco as a public health strategy. The project provides legal assistance to 

states and municipalities attempting to pass tobacco control measures. 

The Tobacco Control Resource Center, Inc. 

Northeastern University School of Law 

400 Huntington Avenue 

Boston, MA 02115 

617-373-2026 (phone) / 617-373-3672 (fax) 

info@tplp.org (e-mail) 

www.tobacco.neu.edu 

Tobacco Industry Documents 

The CDC’s Web site includes a section that facilitates access to tobacco industry documents. It provides links 

to and descriptions of other Internet sites with tobacco industry documents, as well as search access to three 

tobacco industry indexes. 

www.cdc.gov/tobacco/industrydocs/index.htm 
320 Resources and Tools 

University of California, San Francisco, Tobacco Control Archives 

The Tobacco Control Archives is a central, organized source of tobacco-related information. Its purpose is to 

collect, preserve, and provide access to papers, unpublished documents, and electronic resources relevant to 

tobacco control issues, primarily in California. The University of California, San Francisco (UCSF), also houses 

the Legacy Tobacco Documents Library, a digital library of internal tobacco industry documents from tobacco 

company files and two additional collections from the Tobacco Control Archives. 

The Library and Center for Knowledge Management 

University of California, San Francisco 

tobacco-info@library.ucsf.edu (e-mail) 

www.library.ucsf.edu/tobacco 

www.legacy.library.ucsf.edu (Legacy Tobacco Documents Library) 

University of North Carolina, School of Public Health, Minority Health Project 

The Minority Health Project (MHP) is designed to improve the quality of available data on racial and ethnic 

populations, to increase the ability of minority health researchers to conduct statistical research and develop 

research proposals, and to foster a network of researchers in minority health. MHP conducts educational 

programs (including the Annual Summer Public Health Research Institute and Videoconference on Minority 

Health), provides information on research and sources of data on minority health, and maintains an extensive 

set of links to related Web sites. 

Minority Health Project 

Department of Maternal and Child Health 

UNC School of Public Health 

Campus Box 7445 

Chapel Hill, NC 27599-7445 

919-843-6934 (phone) / 919-966-6735 (fax) 

Minority_Health@unc.edu (e-mail) 

www.minority.unc.edu 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 321 

National Clearinghouses 

Media Campaign Resource Center (MCRC) 

The CDC’s Media Campaign Resource Center (MCRC) provides access to ads developed by a number of states 

and federal agencies as well as guidance and technical assistance on developing an ad campaign. 

Media Campaign Resource Center 

Office on Smoking and Health 

Centers for Disease Control and Prevention 

4770 Buford Highway NE, MS K-50 

Atlanta, GA 30341-3717 

770-488-5705, press 2 (phone) 

mcrc@cdc.gov (e-mail) 

www.cdc.gov/tobacco/mcrc 

National Health Information Center (NHIC) 

The National Health Information Center (NHIC) helps the public and health professionals find information on 

tobacco and other topics through an information and referral system and publications. It uses a database containing descriptions of health-related organizations to refer inquirers to the most appropriate resources. It also 

prepares and distributes publications and directories on health promotion and disease prevention topics. 

National Health Information Center 

P.O. Box 1133 

Washington, DC 20013-1133 

800-336-4797 (toll-free) / 301-565-4167 (phone) / 301-984-4256 (fax) 

www.health.gov/nhic 

www.healthfinder.gov 

National Women’s Health Information Center 

The National Women’s Health Information Center is supported by the Office on Women’s Health (which is a 

part of the U.S. Department of Health and Human Services). Its Web site offers a variety of resources and 

information tailored for women. 

www.4women.org 
322 Resources and Tools 

State Campaigns and Clearinghouses 

Arizona 

Tobacco Education and Prevention Program (TEPP) 

www.tepp.org 

Arizona Tobacco Information Network Clearinghouse 

www.tepp.org/atin/clearinghouses/index.htm 

California 

For A Voice 

www.foravoice.com 

California Department of Health Services, Tobacco Control Section 

www.dhs.cahwnet.gov/tobacco/index.htm 

California Tobacco Education Media Campaign (TEMC) 

www.dhs.ca.gov/tobacco/html/media.htm 

Tobacco Education Clearinghouse of California (TECC) 

P.O. Box 1830
 


Santa Cruz, CA 95061-1830
 


800-258-9090, ext. 234 (toll-free) / 831-438-3618 (fax)
 


www.etr.org/TECC
 


Delaware 

Delaware Tobacco Prevention and Control Program 

www.state.de.us/dhss/dph/impact.htm 

Florida 

Florida Online Tobacco Education Resources 

www9.myflorida.com/tobacco/index.html 

Florida Tobacco Control Clearinghouse 

www.ftcc.fsu.edu 

Students Working Against Tobacco 

http://swatonline.proboards20.com/ 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 323 

Tools and Tactics for Fighting Big Tobacco 

www.ftcc.fsu.edu/teensite/main-page.cfm 

Truth 

www.wholetruth.com 

Georgia 

UNITE Georgia 

www.unitegeorgia.com 

Georgia Alliance for Tobacco Prevention 

www.gatobaccoprevention.org 

Illinois 

Reality Illinois 

www.realityillinois.com 

Indiana 

Indiana Tobacco Prevention and Cessation Program 

www.in.gov/itpc/statePartners.asp 

White Lies 

www.whitelies.tv 

Iowa 

Iowa Division of Tobacco Use Prevention and Control 

www.idph.state.ia.us/tobacco 

Kansas 

Kansas Department of Health and Environment, Tobacco Use Prevention Program 

www.kdhe.state.ks.us/tobacco 

Tobacco Free Kansas Coalition 

www.tobaccofreekansas.org 

TASK 

www.kstask.org 
324 Resources and Tools 

Kentucky 

Kentucky Action 

www.kyaction.com 

Kentucky Health Action for Kids 

www.khik.org/thecampaign.htm 

Louisiana 

Louisiana Tobacco Prevention Program 

www.dhh.state.la.us/OPH/chrondis/Tobacco/Tobacco.htm 

Maryland 

Smokefree Maryland Coalition 

www.smokefreemd.org/initiative 

Smoking Stops Here 

www.SmokingStopsHere.com 

Massachusetts 

Get Outraged 

www.getoutraged.com 

Massachusetts Tobacco Control Program 

www.state.ma.us/dph/mtcp/home.htm 

Massachusetts Tobacco Media Education Campaign 

www.state.ma.us/dph/mtcp/media.htm 

Massachusetts Tobacco Education Clearinghouse 

www.jsi.com/health/mtec/home.htm (Tobacco Education Materials Catalog) 

Trytostop.org 

www.trytostop.org 

Minnesota 

Minnesota Partnership for Action Against Tobacco 

www.mpaat.org 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 325 

Minnesota Department of Health, Tobacco Prevention and Control Program 

www.health.state.mn.us/divs/fh/assist/tpc.html 

Minnesota Youth Tobacco Prevention Initiative 

www.mntobacco.net 

Target Market 

www.tmvoice.com 

Mississippi 

Question It 

www.questionit.com 

Partnership for a Healthy Mississippi 

www.healthy-miss.org 

Missouri 

Missouri Comprehensive Tobacco Use Prevention Program 

www.dhss.state.mo.us/MTCPUpdate 

Montana 

Tobacco Media Campaign: Montana Tobacco Use Prevention Program (MTUPP) 

www.dphhs.state.mt.us/hpsd/pubheal/disease/tobacco/media.htm 

New Jersey 

Reaching Everyone by Exposing Lies (REBEL) 

www.njrebel.com 

New Mexico 

New Mexico Tobacco Use Prevention and Control (TUPAC) Program 

www.health.state.nm.us/TheStink/pop_up.html 

New York 

New York City Department of Health and Mental Hygiene, Tobacco Control Program 

www.ci.nyc.ny.us/html/doh/html/smoke/smoke.html 

New York State Smoker’s Quitsite 

www.nysmokefree.com 
326 Resources and Tools 

North Carolina 

North Carolina Tobacco Prevention and Control Branch 

www.communityhealth.dhhs.state.nc.us/tobacco.htm 

Ohio 

Stand 

www.standonline.org 

Oklahoma 

Students Working Against Tobacco 

www.okswat.com 

Oregon 

Oregon Tobacco Prevention and Education 

www.dhs.state.or.us/publichealth/tobacco/index.cfm 

Oregon Tobacco Quitline 

www.oregonquitline.org 

Pennsylvania 

Coalition for a Tobacco Free Pennsylvania 

www.tobaccofreepa.org 

Texas 

Duck Texas 

www.ducktexas.com 

Utah 

Tobacco Free Utah 

www.tobaccofreeutah.org 

Virginia 

ydoyouthink 

www.ydoyouthink.com 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 327 

Washington 

Unfiltered TV 

www.unfilteredtv.com 

Washington State’s Unfiltered: Online Reality Show 

www.outrageavenue.com 

Washington State Tobacco Prevention and Control Program 

www.doh.wa.gov/Tobacco 

Wisconsin 

Had Enough? 

www.hadenoughwisconsin.com 

Tobacco Control Resource Center for Wisconsin 

1552 University Avenue 

Madison, WI 53726 

800-248-9244 (toll-free)/ 608-262-6346 (fax) 

tcrcw@tobwis.org (e-mail) 

www.tobwis.org 

Electronic Mailing Lists 

Entertainment Media List 

The entertainment media list provides information, sharing, and event updates on the depiction of tobacco in 

film, TV, and music. To join, send an e-mail message to Melissa Havard at mcaplan@cdc.gov. 

GLOBALink: The International Tobacco Control Network 

GLOBALink: The International Tobacco Control Network, which is sponsored by the Europe Against Cancer 

Programme, supports the international tobacco community. It provides news bulletins, electronic conferences, access to tobacco control documents, reports, and e-mail service from more than 1,500 tobacco 

control professionals and advocates from more than 100 countries. 

www.GLOBALink.org 
328 Resources and Tools 

Media Network 

The Media Network joins media specialists from tobacco control programs in states and national organizations on monthly conference calls to share information about current media topics and to learn about tobacco 

counter-marketing from a variety of experts and guest speakers. Between calls, Media Network members 

receive electronic newsletters. 

To join, send an e-mail message to Diane Beistle at DBeistle@cdc.gov. 

SmokeScreen Action Network 

This network provides a forum for antitobacco discussion locally and nationally. You may subscribe to the lists 

of your choice or start your own e-mail list (see below). 

www.smokescreen.org 

SmokeScreen E-Mail Lists 

agingtob-talk@smokescreen.org 

This list provides a private discussion among 135 participants about all topics related to tobacco and aging. 

www.agingtob-talk@smokescreen.org 

anr-announce@smokescreen.org 

This public announcement list distributes announcements from Americans for Nonsmokers’ Rights (ANR). 

It focuses on activities that support local clean indoor air ordinances and oppose preemption bills. The list 

is useful for exposing front groups. 

www.anr-announce@smokescreen.org 

atmc-talk@smokescreen.org 

This list supports the Addressing Tobacco in Managed Care (ATMC) project, supported by the University of 

Wisconsin and the American Association of Health Plans, funded by the Robert Wood Johnson Foundation. 

The Health Alliance Plans in Detroit and the Prudential Center for Health Care Research in Atlanta partner 

with the American Association of Health Plans, to form the National Technical Assistance Office for ATMC. 

www.atmc-talk@smokescreen.org 

bg-announce@smokescreen.org 

This private announcement list serves 3,839 participants. It keeps subscribers aware of federal developments, helps move the news, follows hot topics, supports creative interaction, and is useful in support of 

media advocacy activities. 

www.bg-announce@smokescreen.org 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Resources and Tools 329 

doc-alert@smokescreen.org 

Serving 648 subscribers, this forum provides a once-a-day mailing that reports on important finds from the 

39 million formerly secret tobacco industry documents. 

www.doc-alert@smokescreen.org 

docdata-talk@smokescreen.org 

This small, highly focused public discussion list is devoted to technical issues surrounding the organization 

and categorization of tobacco industry documents. 

www.docdata-talk@smokescreen.org 

doc-talk@smokescreen.org 

This counterpart private discussion list engages 72 participants in active conversation about documents 

available online. 

www.doc-talk@smokescreen.org 

ets-talk@smokescreen.org 

This forum, founded by the ANR, serves 167 participants with announcements, news, and developments 

surrounding secondhand smoke. 

www.ets-talk@smokescreen.org 

localets-talk@smokescreen.org 

Created by ANR, this discussion list focuses on secondhand smoke issues, particularly local ordinance activity. 

www.localets-talk@smokescreen.org 

media-alert@smokescreen.org 

This list notifies members of the media of late-breaking tobacco news and events. 

www.media-alert@smokescreen.org 

StanGlantz-L@smokescreen.org 

Serving 1,494 participants, this list takes on a public announcement format. Stan Glantz, a professor of 

medicine at the University of California at San Francisco, uses this forum to instigate action (e.g., getting 

the voluntary associations in Florida to take a public stand against legislation to protect the tobacco 

industry from the Engle jury) and then announces the development to the public. 

www.StanGlantz-L@smokescreen.org 

talc-announcement@smokescreen.org 

This private discussion list serves 199 participants with announcements from the Technical Assistance 

Legal Center, which provides free technical assistance to California communities seeking to restrict tobacco 

advertising and promotions, limit tobacco sales, or divest their pension funds from tobacco stocks. 

www.talc-announcement@smokescreen.org 
330 Resources and Tools 

tp-talk@smokescreen.org 

This private list is rich in policy strategy and is helpful for litigation support. Expert witnesses can access 

this forum before their testimonies, ask for help on esoteric topics, or get answers to specific questions. The 

Tobacco Products Liability Project is active and helpful on this list. 

www.tp-talk@smokescreen.org 

News Services 

PR Newswire 

This Web site’s search engine lets you track tobacco companies’ press releases. 

http://biz.yahoo.com/prnews 

Tobacco Documents Online 

This collection of tobacco industry documents is searchable and constantly growing in capacity and capability. 

www.tobaccodocuments.org 

Tobacco.org 

This Web site provides daily quotes on tobacco (pro and con), customizable news, and everything that you 

need to keep on top of the tobacco conglomerates. Its news database contains summaries of every article 

concerning tobacco published in four national papers: USA Today, Wall Street Journal, Washington Post, and 

New York Times. 

www.tobacco.org 

Tobaccoresolution.com 

This Web site contains links to the tobacco companies’ online collections of industry documents made 

available as a result of litigation. 

www.tobaccoresolution.com 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Glossary 331 

Glossary
 


Advertising threshold. The level of message exposure that is required to make an impact with your target audience. 

Appeal. A message quality that can be tailored to one’s target audience(s). This term refers to the motivation 

within the target audience that a message strives to encourage or ignite (e.g., appeal to the love of family, 

appeal to the desire to be accepted by peer group). 

Attitudes. An individual’s predispositions toward an issue, object, person, or group, which influence his or her 

response to be either positive or negative, favorable or unfavorable. 

Audience. The number of people or households that are potentially exposed to a counter-marketing tactic 

(e.g., radio ad, grassroots event, newspaper article) or other intervention. 

Audience profile. A formal description of the characteristics of the people who make up a target audience. Some 

typical characteristics useful in describing audiences include media habits (e.g., newspaper and magazine readership, television [TV] viewership, radio listenership, and Internet use), family size, residential location, education, income, lifestyle preferences, leisure activities, religious and political beliefs, level of acculturation, ethnicity, 

ancestral heritage, consumer purchases, and psychographics. An audience profile can help you to develop more 

effective media messages and interventions based on an improved understanding of the audience. 

Audience segment(s). A group of people who share a set of common characteristics. On the basis of these similarities, one can develop program elements and communications activities that are likely to be successful with 

most members of the segment. 

Audience segmentation. The process of dividing up or grouping a large target audience into smaller groups 

based on common characteristics related to behaviors or predictors of behavior. Audience segmentation will 

help you to target media messages and key strategies more precisely. 

Barriers (or audience barriers). Hindrances to desired change. These may be factors external or internal to 

audience members themselves (e.g., lack of information about health effects of tobacco use, the belief that fate 

causes illness and one cannot alter fate, lack of access to cessation services). 

Baseline study. The collection and analysis of data regarding the target audience or environment before an 

intervention. Generally, baseline data are collected to provide a point of comparison to the data collected 

during the intervention and at its conclusion. 

Bonus weight/time. Additional advertising space or time given as a “bonus” by the media outlets for buying ad time. 

Central location intercept interviews. A method for pretesting messages and materials. It involves “intercepting” 

potential intended audience members at a high-traffic location (such as a shopping mall), asking them a few 
332 Glossary

questions to see if they fit the intended audience’s characteristics, sometimes showing them a message or materials, 

and administering a questionnaire of predominantly closed-ended questions. Because respondents form a convenience sample, the results cannot be projected to the population. Also called mall intercept interviews. 

Channels (also called vehicles). The routes or methods used to reach a target audience (e.g., mass media 

channels include TV, radio, newspapers, and magazines; interpersonal channels include parents and health 

professionals; organizational channels include faith-based organizations; community channels include community events, such as health fairs and sporting events). 

Closed-ended questions. Questions worded to provide respondents with a set number of possible response 

choices (e.g., multiple-choice, yes/no, scales). 

Communication check (or “comm check”). In advertising, a type of pretest to measure whether the messages 

and impressions played back by the audience after viewing the ad (the overall “take away”) are as intended. 

Communications plan (sometimes called media campaign plan). A written strategy document that details 

the framework and establishes the foundation for your communications activities. A communications or 

media campaign plan serves as a guide to help achieve the program goals by delineating choices made about 

factors such as audiences, messages, and media vehicles. 

Community channel. A communications channel in which messages are disseminated at the community 

level (e.g., library, supermarket, house of worship, municipal swimming pool). 

Concept testing. The process of 1) learning about the target audience’s responses to possible concepts on 

which you might base your message, and 2) assessing which of the concepts is most persuasive and has the 

greatest likelihood of changing attitudes and behaviors. This process usually requires qualitative research such 

as focus groups. 

Control group. A group that is randomly selected and matched to the target population according to characteristics identified in the study to permit a comparison between the changes for those who receive the intervention and those who do not. 

Convenience samples. Samples of respondents in research studies who are typical of the target audience and 

who are easily accessible. No attempt is made to collect a probability sample, and convenience samples are 

not statistically representative of the entire population being studied. Therefore, findings from studies using 

convenience samples cannot be generalized. 

Copy. The written text in print materials (e.g., ads, newspaper articles, books) or the spoken words in radio or TV 

(e.g., ads). This term is also used more broadly to signify a whole ad or body of ads. For example, someone might 

make reference to needing to develop new copy for the following year’s campaign. 

Copy strategy. A short and simple statement that outlines your specific communications approach for an 

ad or a campaign (e.g., the message to be conveyed, the intended outcome, the benefit offered to the target 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Glossary 333 

audience in exchange for making the desired change, and the character or tone of the advertising). The copy 

strategy guides the advertising agency as they develop new advertising or other materials. 

Counter-advertising (or tobacco counter-advertising). Any advertising efforts aimed at countering the 

tobacco industry advertising and other protobacco influences. Counter-advertising seeks to counter these 

protobacco messages and influences with persuasive prohealth, antitobacco messages. These can take many 

forms, including TV, radio, billboards, print ads, outdoor and transit advertising, and cinema advertising. 

Counter-marketing (or tobacco counter-marketing). Marketing and communications efforts aimed at countering the marketing efforts (including but not limited to advertising) of the tobacco industry and other protobacco influences. Counter-marketing can include efforts such as media advocacy, media relations, in-school 

curriculum programs, sponsorships, and promotions, as well as counter-advertising through paid media 

channels, such as TV, radio, billboards, the Internet, and print media. 

Creative. This word is typically used as a noun in the advertising industry and has two meanings: 1) the advertising agency staff (artists and writers) who create advertising ideas and concepts are called “creatives,” and 2) 

the body of work that the creatives produce is called “the creative” and is always used in singular form. 

Creative brief. A document that guides the agency’s creative team in developing concepts, messages, and 

materials. It includes elements such as the goal and main messages of the communications piece(s), the 

actions you want the target audience to take and barriers to those actions, the demographic and psychographic characteristics of the audience, and other key insights about the audience that should be considered 

when developing the communications piece(s). 

Cultural competence. An organizational and philosophical commitment to, and actions based on, recognizing the cultural differences and similarities within, among, and between groups, including their history, culture, context, geography, and other factors. 

Cultural diversity. The range of differences in race, ethnicity, religion, or nationality among various groups 

within a community, state, region, or nation. 

Culturally appropriate. Demonstration of sensitivity to cultural similarities and differences, and effective use 

of cultural symbols and language to communicate messages. 

Culture. The shared values, traditions, norms, customs, arts, history, folklore, and institutions of a group of 

people who are unified by race, ethnicity, language, nationality, or religion. 

Demographics. Data, such as gender, age, ethnicity, income, or education, which can be collected from a target audience and which can be useful for defining the target audience and understanding how to communicate more effectively with them. 

Earned media (also called free media or news making). Coverage of your story without paying for media 

placements. Examples include letters to the editor, op-eds, coverage of press conferences, appearances on talk 
334 Glossary

shows or local news programs, and on-air or print interviews. Such coverage is called “earned media” because 

you have to develop materials (e.g., news releases, press kits), work with reporters (e.g., by holding press conferences, proactively contacting reporters), and expend resources to get it; however, you do not pay for the 

placement of the messages in the stories. 

Executions (or creative executions). Different creative approaches for communicating the same message 

strategy, usually involving variations in copy, tone, casting, setting, wardrobe, music, etc. Typically each ad 

campaign will develop, and perhaps use, several different executions, with each execution being a unique way 

to communicate the same main message. 

Editorial. Articles expressing opinions that appear on the editorial page of a newspaper or magazine, separate 

from the news stories. They are usually not signed by an individual because they are seen as representing the 

official position of the publication. 

Flight. The period of time over which a set of ads is broadcast. For example, media campaign managers typically 

buy media in “flights” of 3 to 6 weeks. They may go off the air for several weeks, then return for additional flights. 

Focus groups. A qualitative research method in which a skilled moderator, using a discussion guide of openended questions, facilitates a 1- to 2-hour discussion among 5 to 10 participants who are encouraged to talk 

freely and spontaneously. The discussion guide is developed on the basis of the goals of the research and on 

what information about the participants is sought. As new topics related to the material emerge, the moderator asks additional questions to learn more. Focus groups are often used during the planning and development stages to identify previously unknown issues or concerns, or to explore reactions to potential actions, 

benefits, concepts, or communications materials. 

Formative evaluation. Evaluation research conducted during program development. May be used to pretest 

concepts, messages, and materials, and to pilot test interventions and programs. 

Formative research. Research conducted during the development of a program to help decide on and describe the 

target audience, understand the factors that influence their behavior, and determine the best ways to reach them. It 

looks at behaviors, attitudes, and practices of target groups; involves exploring behavioral determinants; and uses 

primarily qualitative methods to collect and analyze data. Formative research may be used to complement existing 

epidemiologic and behavioral data to assist in program planning and design. 

Framing. The process of developing a particular perspective on a news story to maximize its news value and to 

ensure that it is presented in a way that supports your policy goals. News coverage can provide visibility, credibility, and legitimacy to the issue being covered, and can help set public and policy agendas. 

■	 	 Framing for access—Shaping a story to attract journalists’ attention and to interest the media in 
 


covering the story.
 


■	 	 Framing for content—Shaping a story to ensure that the content supports your point of view and 
 


your policy goals.
 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Glossary 335 

Frequency. Used in advertising to describe the average number of times an audience is exposed to a specific 

media message over a certain period of time (usually 4 weeks). 

Gatekeeper. An organization or individual you must work with before you can reach a target population (e.g., 

a schoolteacher) or accomplish a task (e.g., a TV public service director). Gatekeepers may be leaders in the 

community or have access to and knowledge about a group of people you are trying to reach. 

Goal. The overall health improvement or other significant advance that a program, organization, or agency 

strives to create. 

Health behavior. An action performed by an individual that can negatively or positively affect his or her health 

(e.g., smoking, exercising). 

Health communication. The study and use of communications strategies to inform and influence individual 

and community decisions related to health. 

Impact evaluation (also called outcome evaluation and summative evaluation). The systematic collection 

of information to assess the impact of a program and to measure the extent to which a program has accomplished its stated goals and objectives. This information can be used to make conclusions about the merit 

or worth of a program, and to make recommendations about future program direction or improvement. 

In-depth individual interview. A qualitative research method that involves a one-on-one discussion during 

which a trained interviewer guides an individual through a discussion about selected topics, allowing the 

respondent to talk freely and spontaneously. The structure and interviewing style are less rigid than in quantitative, interviewer-administered surveys. This technique is often used during the planning and development 

stages to identify previously unknown issues or concerns, or to explore reactions to potential actions, benefits, 

or concepts, or communications materials. 

Indicator. A specific, observable, and measurable characteristic or change that shows the progress a program 

is making toward achieving a specified outcome. For example, the “number of days that you smoked during 

the past 30 days” is an indicator of smoking behavior. Researchers often use several indicators to represent a 

complex concept such as behavior. 

Intermediaries. Organizations, such as professional, industrial, civic, social, and fraternal groups, that act 

as channels for distributing program messages and materials to members of the desired target audience. 

Interpersonal channel. A communications channel that involves the dissemination of messages through 

one-on-one communication (e.g., mentor to student, friend to friend, pharmacist to customer). 

Language. Includes form and pattern of speech. It may be spoken or written, and it is used by residents or 

descendants of a particular area, region, or nation or by a large group of people. Language can be formal or 

informal and includes dialect, idiomatic speech, and slang. 
336 Glossary

Local media. Media whose coverage and circulation are confined to, or concentrated in, markets that are 

smaller than a state. Usually, they offer different sets of rates to national and local advertisers. 

Logic model. A systematic and visual way to present the perceived relationships among the resources you 

have to operate the program, the activities you plan to do, and the changes or results you hope to achieve. 

Marketing. The process of planning and executing the conception, promotion, and distribution of ideas, 

goods, and services to create exchanges that satisfy consumers. 

Media. Channels for disseminating your message and materials. Mass media include TV, radio, newspapers, 

magazines, billboards, public transportation, direct mailings, Web sites, and others. 

Media advisory. A submission to media outlets that provides basic information (who, what, when, where, why) 

about an upcoming event with opportunities for interviews and/or photographs. Advisories are usually not 

more than one page. 

Media advocacy. The strategic use of media and community advocacy to advance social or policy change. 

Media advocacy can reframe issues; shape public discussion; or build support for a policy, point of view, or 

environmental change. Instead of using vehicles to send messages to the community, media advocacy works 

with the community to create messages to help change the environment within which the community lives. 

Media alert. A short (two- to three-paragraph) announcement to the media alerting them to new information 

or a new development on an issue. It provides the “who, what, when, where, and how” and generally little 

other information. 

Media campaign plan. See communications plan. 

Media kit (also called press kit, press packet, or information kit). A packet (usually a folder) that includes 

items explaining a program or health issue to the media. It contains a lead or main press release and related 

elements (e.g., brochures, fact sheets, contact information, and camera-ready photographs or images) that tell 

a complete story to the press. 

Media literacy. The ability to analyze, evaluate, and produce media in various forms. It involves the examination of the techniques, technologies, and institutions that are involved in media production, the ability to 

deconstruct and critically analyze media messages to identify the sponsor’s motives, and the recognition of the 

role that audiences play in taking meaning from those messages. It also involves the ability of individuals to 

construct or compose media messages representing their (the intended audience’s) point of view. 

Media placement plan (or media buy plan or media plan). The specific schedule of paid placements that 

have been negotiated for an ad or set of ads. The media placement plan details the times and programs during which TV and radio ads will be aired, the locations and sizes of billboards that will be placed, the magazines, issues, and specific placements into which print ads will be placed, etc. The media placement plan also 

contains a summary of target audience reach and frequency, typically per 4-week period. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Glossary 337 

Media relations. Establishing a positive working relationship between individuals in your organization and 

members of the news media to increase the likelihood that your issue will be covered favorably, thus helping 

to advance your program goals. Media relations includes getting to know individual reporters (including the 

scope of their work and their interest areas); serving as a reliable, proactive provider of credible information 

about the issue; and being timely and responsive to their requests for interviews, additional contacts, and 

other resources. 

Media tracking. The monitoring of radio, TV, and print media over a specified period of time for a specific 

topic or message. Data gathered can be analyzed for content, slant (positive or negative), location of placement, or trends in the amount of coverage. 

Medium. Any media class used to convey a message to the public, such as TV, radio, the Internet, billboards, 

cable TV, newspapers, neighborhood publications, magazines, comic books, billboards, posters, music, and 

point-of-purchase displays. 

Moderator’s guide. A set of questions, probes, and discussion points used by a focus group moderator to help 

him or her facilitate the group. A guide can also contain reminders of which questions are most important to 

the research to help the moderator use the discussion time effectively. 

Objectives. Quantifiable statements describing the intended program achievements necessary to reach a program goal. Objectives should be specific, measurable, achievable, relevant, and time-bound. 

Op-Ed (Opinion Editorial). A letter, statement, article, or short essay submitted to a newspaper editor by a reader 

or a representative of an organization. Op-eds usually express a strong opinion or point of view about an issue, 

and are backed by well-researched and documented facts. They appear on the page opposite the editorial page. 

Open-ended questions. Questions worded to allow an individual to respond freely in his or her own words, in 

contrast to closed-ended or fixed-choice questions. 

Organizational channel. A communications channel in which messages are disseminated at the organizational level (e.g., corporate newsletters, cafeteria bulletin boards). 

Outcome evaluation. See impact evaluation. 

Over recruiting. Recruiting more respondents than required to compensate for expected “no shows.” 

Paid media (also called paid advertising). The placement of messages through advertising on TV, radio, print, 

outdoor media, the Internet, etc. Because you are paying for these placements, you can control the exact 

placement and content of the messages, making them very useful in targeting specific audience segments. 

However, paid advertising can be very expensive, making it difficult to use effectively with a small budget. 

Partners. Individuals or organizations/agencies that contribute to the efforts initiated by a leader or a head 

organization/agency. Partners can have a variety of roles (e.g., contribute research data, share evaluation 

experience, help spread the health message). 
338 Glossary

Piggybacking. Relating your story to other breaking events in the media as a way of gaining access to the media. 

Pilot testing. Implementing and evaluating the program in a limited area for a limited amount of time to make 

program adjustments based on the pilot experience. 

Pitch letter. A brief, targeted letter or e-mail message that tries to convince a journalist to cover your story by 

outlining the information that you have to share and why it is valuable. Pitches can also be made by telephone. 

Pretesting. A type of formative evaluation that involves assessing the target audience’s reactions to your messages, materials, or both before they are finalized. This will help you determine if your messages and materials 

are likely to achieve the intended effect. 

Primary target audience(s) (or primary audience(s)). The group(s) of individuals you determine are most 

important for your communications effort to reach and influence. The primary audience is a portion of a 

larger population selected because influencing that group will contribute most to achieving your campaign’s 

objectives. You may also choose secondary audiences, but your greatest emphasis will be on achieving your 

objectives through communication with the primary target audience. 

Probe. An interviewer technique that is used primarily in qualitative research (e.g., focus groups, individual 

in-depth interviews) to solicit additional information about a question or issue. Probes should be neutral (e.g., 

“What else can you tell me about _____?”) rather than directive (“Do you think the pamphlet was suggesting 

that you take a particular step, such as changing your diet?”). 

Process evaluation. The systematic collection of information to document and assess how well a program is 

being implemented. Process evaluation includes assessments such as whether materials are being distributed 

to the right people and in what quantities, whether and to what extent program activities are occurring, 

whether and how frequently the audience is being exposed to your ads, and other measures of how and how 

well the program is being implemented. This information can help you determine whether the original program is being implemented as designed and can be used to improve the delivery and efficiency of the program. 

Program evaluation. The systematic collection of information about a program’s activities and outcomes for 

the purpose of making judgments about the program, improving program effectiveness, and informing decisions about future program development. 

Psychographics. A set of variables that describes an individual in terms of his or her overall approach to life, 

including personality traits, values, beliefs, preferences, habits, and behaviors. Psychographics are not usually 

related to health-specific issues, but more commonly to characteristics such as consumer- or purchase-specific 

behaviors, beliefs, and values. 

Psychosocial factors. Variables that describe an individual in terms of preferences and characteristics, such as 

attitudes, beliefs, values, perceived norms, self-efficacy, and intentions. In many theories of behavior, psychosocial factors are assumed to be the determinants of behaviors or the factors that influence whether a behavior 

is performed. 
Glossary 339 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Public relations. Using various communications channels, such as earned media, paid advertising, media 

relations, Web sites, speakers’ bureaus, and/or brochures, to help the public understand your organization, 

its programs, and its products and services, as well as to build a positive image of them in the community. 

Public service announcement (PSA). A form of advertising that can be delivered via TV or radio and that is 

aired free of charge by the media. There is limited control over when or how often a PSA airs, making it difficult 

to effectively reach specific target audiences. 

Qualitative research. Research that focuses on in-depth audience insights and information as opposed to collecting numerical measures. Qualitative research is useful for exploring reactions; collecting information about 

feelings, impressions, and motivations; and uncovering additional ideas, issues, or concerns. Results from 

qualitative research cannot be generalized to the whole target audience because the participants don’t constitute 

a representative random sample, samples are relatively small, and not all participants are asked precisely the 

same questions. Focus groups and in-depth individual interviews are common types of qualitative research. 

Quantitative research. Research designed to count and measure knowledge, attitudes, beliefs, and behaviors 

by asking a large number of people identical (and predominantly closed-ended) questions. Quantitative 

research yields numerical data that can be analyzed statistically. If the respondents are a representative 

random sample, quantitative data can be used to make statements about the intended audience as a whole. 

Quantitative research is useful for measuring the extent to which knowledge, attitudes, or behaviors are 

prevalent in an audience. Surveys are a common type of quantitative research. 

Random sample. A sample of respondents in which every member of the target population has an equal 

chance of being included in the sample. 

Rating points. Used in media buys to measure the exposure of the audience to an ad. Target rating points 

(TRPs) and gross rating points (GRPs) are the two main types of rating points. TRPs are obtained by multiplying the percentage of the target audience potentially reached (“reach”) by the number of times that this percentage will potentially see the message (“frequency”). GRPs are a similar measure of exposure, but among the 

whole population, rather than just the specific target audience. Often the two terms (TRPs and GRPs) will be 

used interchangeably to mean exposure among the selected target audience. Rating points are usually, but not 

necessarily, expressed in 4-week figures. For example, an agency may recommend buying 1,200 rating points 

over 3 months, which means an average of 400 points per 4-week period. 

Reach. Used in advertising to describe the percentage of the total target audience exposed to a specific media 

message during a specific period (usually 4 weeks). 

Recall. The extent to which respondents remember seeing or hearing a message shown in a competitive media 

environment. It usually centers on the main idea or the awareness of an ad. 

Schedule/flow chart. A list or graphic of the media placements that have been bought and when they are 

going to air or appear. 
340 Glossary

Screener. An instrument containing short-answer questions used in the recruitment process for research 

methods such as focus groups and central location intercept interviews. Interviewees’ answers to the questions determine who is eligible to participate in the research. 

Secondary target audience(s) (or secondary audience(s)). Group(s) of individuals in addition to the primary 

audience(s) that your communications efforts seek to reach and influence. Secondary audiences may be a 

subset of the primary audience (e.g., adult Hispanic/Latino smokers, if adult smokers are the primary audience); groups that may help reach or influence the primary audience (e.g., parents or teachers, if youth aged 

12-17 years old is the primary audience); or other groups that are important for reaching your objectives (e.g., 

policy makers, if changes in policies and individual behavior are both necessary). 

Self-administered questionnaires. Questionnaires that are filled out by respondents. These can be distributed 

by mail, handed out in person, or programmed into a computer. 

Setting. A location or an environment where the target audience can be reached with a communications effort. 

For example, a grocery store is a setting where audience members can be reached with educational pamphlets. 

Social marketing. The application and adaptation of commercial marketing concepts and techniques to the 

analysis, planning, implementation, and evaluation of programs designed to bring about behavior change of 

target audiences to improve the welfare of individuals or their society. Social marketing emphasizes thorough 

market research to identify and understand the intended audience and what is preventing them from adopting a certain health behavior and to then develop, monitor, and constantly adjust a program to stimulate 

appropriate behavior change. Social marketing programs can address any or all of the traditional marketing 

mix variables—product, price, place, or promotion. 

Stakeholders. Individuals or organizations that are invested in the program and its outcomes. They include 

those involved in the campaign’s operation (e.g., managers, staff, funders, partners), those served or affected 

by the program (e.g., advocacy groups, target group members), and those in a position to make decisions 

about program efforts. 

Storyboard. Illustrations and accompanying scripts that represent ideas for scenes for a TV ad. 

Strategy. The overall approach that a program takes. Effective strategies contribute toward achieving program 

goals and objectives. Strategies should be based on knowledge about effective counter-marketing; the target 

audience’s needs and characteristics; and the program’s capabilities, timelines, and resources. 

Strategy statement. A written document delineating the important choices you have made that will help 

achieve the campaign’s objectives. The strategy statement should include the target audience profile, the 

action audience members should take, how they will benefit (from their perspective, not necessarily from a 

public health perspective), and how you can reach them. This document provides the direction and consistency for all program messages and materials for this audience and is broader than a creative brief, which is used 

for the development of individual materials. 
Glossary 341 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Style. A message quality that can be tailored to one’s target audience(s). This is a general term that refers to issues 

such as presenting cartoon figures versus detailed graphs or using embellished text versus short or concise text. 

Summative evaluation. See impact evaluation. 

Surveillance. The ongoing, systematic collection, analysis, and interpretation of data essential to planning, 

implementation, and evaluation of public health programs. For example, this would include assessing at 

regular time intervals target audience beliefs, attitudes, and behaviors related to tobacco use. Surveillance 

efforts can also track health outcomes over time. 

Tailoring. The adaptation of program components to best fit the relevant needs and characteristics of the 

target population. 

Talking points. Prepared notes used by a speaker to guide his or her presentation. Often used in preparing for 

interviews or other interaction with the news media. 

Target audience (target population). The group of people the program intends to involve and affect in some way. 

The target audience shares common characteristics that help guide decisions about program development. 

Theater-style pretesting. A research method in which a large group (usually 50 to 300 people) is gathered in a 

theater-style setting to view and respond to audiovisual materials such as TV ads. Ads are typically shown 

embedded in a set of other audiovisuals (programming, other ads, or both) to replicate a more natural viewing 

environment and to help determine memorability of test materials when shown among other materials. 

Tobacco counter-advertising. See counter-advertising. 

Tobacco counter-marketing. See counter-marketing. 

Tone. A message quality that can be tailored to one’s target audience(s). This term refers to the manner in 

which a message is expressed (e.g., an authoritative tone, an alarming tone, a friendly tone). 

Variable. A characteristic of an object of measurement that can take on a range of values (e.g., height, test 

scores, gender). 
342 
Appendices 343 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 2.1: Counter-Marketing Planning Worksheet
 


This worksheet should be used as a guide. Don’t worry about filling in each item in this exact order. Developing 

a counter-marketing plan is an iterative process; you’ll revise and improve on each step as your campaign progresses. The most important thing is that you think through each step and that every activity moves you closer to 

your goal. Before you complete this worksheet, it would be helpful to review Chapter 2: Planning Your CounterMarketing Program and other relevant information in this manual. The Counter-Marketing Planning Worksheet 

Guidelines on the following pages provide a quick reference to use in completing the worksheet. 

Tobacco Control Goal: 

Problem Statement and Background: 

Target Audience(s): 

Counter-Marketing Program Objective(s): 

Strategy Statement: 

Activities and Channels: 

Opportunities for Collaboration: 

Evaluation Plan: 

Tasks and Timeline: 

Budget and Resources: 
344 Appendices 

Counter-Marketing Planning Worksheet Guidelines 

Tobacco Control Goal 

•	 	 Base your goal(s) on research, the state’s assessment, or both. 

•	 	 Complete a separate Counter-Marketing Planning Worksheet for each goal, because you need a 

separate plan for each goal you’re addressing. Make sure overlapping areas are consistent and 

complementary. 

Problem Statement and Background 

•	 	 Describe the problem you’re addressing. Specify the group(s) affected, how it is affected, and the 

severity of the problem. Give supporting epidemiologic data from current research and scientific 

literature. 

•	 	 Identify who might be able to positively influence this situation or the affected group(s). 

•	 	 Explain why your agency is addressing the problem. 

•	 	 Assess and list your program’s strengths, weaknesses, opportunities, and threats (SWOTs); its assets 

and resources; links to or influence with the target audience(s); current activities; and gaps and 

barriers to achieving the needed change. 

•	 	 Review relevant theories and models. 

Target Audience(s) 

•	 	 Define the group(s) you want to reach, the desired results, and how you’ll measure those results. 

•	 	 Select target audience(s). Decide which audience segments represent the highest priority for reaching your goal. Consider which audience segments are affected disproportionately by tobacco-related 

health problem(s), which segments can be most easily reached and influenced, and which are large 

enough to justify intervention. 

•	 	 Describe each group you plan to reach with your campaign. Detail any knowledge you have about 

how each group is affected, as well as gaps in knowledge to be addressed through market research 

or other research. Include demographics, cultural and lifestyle characteristics, media preferences 

(channels, message appeals, activities, and types of involvement in the issue), and other traits that 

will help you understand how best to reach each group, as well as related feelings, attitudes, knowledge, and behaviors. 

•	 	 Determine which secondary audience(s) can influence the behavior of your primary audience(s). 
Appendices 345 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Counter-Marketing Program Objective(s) 

•	 	 Set objectives that reflect the desired results of counter-marketing efforts within the given time frame 

and resources, and within the context of a comprehensive tobacco control program. 

•	 	 Write objectives that are SMART (specific, measurable, achievable, relevant, and time-bound). 

Strategy Statement 

•	 	 To develop a strategy is usually an iterative process; as you learn more about one element, other 

elements may need to be adjusted. 

•	 	 Write a strategy statement for each target audience that includes: 

– Description of the target audience 

– Description of the action you want the audience to take as a result of exposure to 


your program, as specified in the objectives 


– List of obstacles to taking the action 

– Description of audience’s perceived benefit of taking the action 

– Explanation of why the benefit, and the audience’s ability to attain it, will be 
 


credible and meaningful to the audience
 


– List of potential channels and activities that will reach audience members 

– Description of image, tone, look, and feel of messages and materials most likely to reach the target 

audience 

Activities and Channels 

•	 	 Assess the current media environment related to your goal, and decide which counter-marketing 

approach(es) to use, such as advertising, public relations, media advocacy, grassroots marketing, 

and media literacy training. 

•	 	 Determine for each target audience which approaches (or combination of approaches) best address 

the problem and your program objectives. 

•	 	 Ask what is the best way to reach each target audience. Select channels and activities that fit your 

target, budget, time constraints, and resources. Consider the attributes and limitations of each type 

of channel. 
346 Appendices 

Opportunities for Collaboration 

•	 	 Determine whether you want to recruit partners for collaboration, and consider how many partners 

would be optimal. 

•	 	 Identify organizations that have similar goals and are willing to work with you. 

•	 	 Be strategic in selecting organizations as partners. Consider which community-based organizations 

and businesses may help you achieve your goal by providing: 

– Access to a target audience 

– Enhanced credibility for your message or program, if the target audience considers the organization to be a trusted source 

– Additional resources, either financial or in-kind 

– Added expertise 

– Cosponsorship of events 

•	 	 Consider the requirements for collaboration with each partner, including time for additional approvals, 

minor or major changes in the program to match each partner’s needs and priorities, and how these 

requirements fit with the direction and procedures of your organization. 

Evaluation Plan 

•	 	 Develop plans for formative research and evaluation, process evaluation, and outcome evaluation. 

•	 	 Base the design of your evaluation plan on the objectives of the counter-marketing program. 

Determine the most important questions for the evaluation, the information you’ll need now and in 

the future, how you’ll gather the information, and how you’ll analyze it to determine whether you’ve 

met your objectives. 

•	 	 Identify evaluation experts, either internal or external to your agency, who will work with you 

throughout the design and implementation of your program to develop plans for the various types 

of evaluation. 

•	 	 Perform formative research (research on the target audience before you develop the countermarketing campaign) to help you gain valuable insights that will guide the development of your 

message and materials, as well as the channels of delivery. 

•	 	 Conduct formative evaluation (research conducted during the development of your program to 

pretest and pilot test your interventions, messages, and programs) to determine (1) whether the 
Appendices 347 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

materials you are developing effectively communicate what you intended, and (2) how the target 

audience will be influenced by your materials. 

•	 	 Perform process evaluation to determine whether your program was implemented as planned. It can 

answer questions such as: 

– Did partners contribute as expected? Why or why not? 

– Did you have the right amount of resources? 

– Did you schedule enough time for campaign development and implementation? 

– Was your issue covered by the news media your target audience sees or reads? 

– Was your issue covered by the media in the way you had hoped? Was your approach to framing 

the messages reflected in the media coverage? 

– Have you become a source for journalists covering this issue? 

•	 	 Conduct outcome evaluation to help you answer the following important questions: 

– Did your counter-marketing program achieve the outcomes you expected? 

– Did you build awareness of the ads you ran? Of the program elements? 

– Did the audience recall the campaign’s main messages? 

– Did the audience increase its knowledge as desired/intended? 

– Did the audience change beliefs and attitudes as desired? 

– Did the audience change its behaviors? 

– What did the target audience think of your campaign? Did members become involved in 

the program? 

– Did a policy (e.g., clean indoor air ordinance or tax increase) change as desired? 

Tasks and Timeline 

•	 	 List all activities that need to occur before, during, and after implementation of your counter-


marketing program. 


•	 	 Identify major milestones, such as launch and start dates for specific activities. 
348 Appendices 

•	 	 Include smaller tasks to be accomplished from the time you write the plan until the time you intend 

to complete the program evaluation. By building these tasks into the timeline, you’ll be more likely to 

remember to assign the work and stay on schedule. 

•	 	 Review and update your task list and timeline regularly. It is a flexible management tool that can help 

you track your progress. 

Budget and Resources 

•	 	 List all anticipated expenses, including staff time and other resources. 

•	 	 Include all budget and resources available (staff, in-kind, internal, and external). 

•	 	 Assess the financial and human resources available to help you anticipate funding needs, thoroughly 

plan your campaign to fit your budget, and make optimal use of all available resources. 

•	 	 Recall that if your plan calls for efforts to lobby for a particular bill, you’ll need to use funding not 

provided by the Centers for Disease Control and Prevention. 
Appendices 349 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 3.1: Sample Recruitment Screener for 
 


Intercept Interviews on Smoking Cessation
 


(Interviewer instructions are in italics.) 

Good morning/afternoon, my name is ______, from _____Market Research Firm, an independent market 

research agency. Today, we’re conducting a survey in this area among people between 25 and 49 years old. Do 

you fit into that age group? 

Yes ❑ (Continue.)
 


No ❑ (Thank and terminate interview.)
 


1. First, can I ask, do you or does anyone in your family work in any of the following areas? (Show card A with 

the following items written on it.) 

Market research ❑ 1
 


Advertising or Marketing ❑ 2
 


Media ❑ 3
 


Public relations ❑ 4
 


Auto industry ❑ 5
 


Manufacture/distribution ❑ 6
 


of tobacco products 

(If answer is “yes” for any of these areas, except auto industry, thank and terminate interview. If answer is "no" for 

any of these areas, continue.) 

2. Do you currently smoke cigarettes? 

Yes ❑ 1 (Continue.)
 


No ❑ 2 (Thank and terminate interview.)
 


3. Since you started smoking, would you say you have smoked more than 100 cigarettes? 

Yes ❑ 1 (Continue.)
 


No ❑ 2 (Thank and terminate interview.)
 

350 Appendices 

4. Please tell me how much you agree with the following statement: 

“I want to stop smoking within the next 6 months.” 

(Show card B with the statements below written on it.) 

Strongly agree ❑ 1 (Continue.) 

Slightly agree ❑ 2 (Continue.) 

Neither agree nor disagree ❑ 3 (Thank and terminate interview.) 

Slightly disagree ❑ 4 (Thank and terminate interview.) 

Strongly disagree ❑ 5 (Thank and terminate interview.) 

5. Could you spare some time to come into the hall to answer some further questions? 

(If respondents need reading glasses, check whether they have their glasses with them.) 

Yes ❑ 1 (Continue.)
 


No ❑ 2 (Thank and terminate interview.)
 


(Check quotas to see whether the client has requested that there be minimum numbers of participants 

with certain demographics.) 

6. Do you have a telephone at home or work or a cell phone where you can be reached? 

Yes ❑ 1 (Continue.)
 


No ❑ 2 (Conduct 20-minute interview.)
 


7. Would you be available to take part in a further short telephone interview within the next 3 or 4 days? 

Yes ❑ 1 (Conduct 10-minute interview.) 

No ❑ 2 (Conduct 20-minute interview.) 
Appendices 351 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 3.2: Sample Recruitment Screener for 

Individual Interviews To Test Advertisements and Ad Concepts 

(Instructions for interviewer are in italics.) 

Client: ______________________________________ 

Hello. My name is _________________, and I’m calling on behalf of _________________ (market research company) in ____________ (city). We’re conducting a very brief public opinion survey. If you complete the study 

and meet the appropriate criteria, you’ll be invited to participate in a discussion about advertising in 

______________ (location) on _________ (date). May we ask you a few questions? 

(Don’t ask but do record gender. Attempt to recruit 50% males and 50% females.) 

____ Male ____ Female 

1. Do you or anyone in your household work for any of the following types of companies: marketing, market 

ing research, public relations, advertising, or a tobacco company or any of its affiliates? 

____ Yes (Thank and terminate interview.) 

____ No (Continue interview.) 

2. In which of the following age groups are you? (Attempt to achieve a good mix of ages.) 

____ Younger than 25 years old (Thank and terminate interview.)
 


____ 25–30 years old
 


____ 31–39 years old
 


____ 40–50 years old
 


____ Older than 50 years old (Thank and terminate interview.)
 


3. Have you participated in a market research discussion group of any kind in the last 3 months? 

____ Yes (Thank and terminate the interview.)
 


____ No (Continue.)
 

352 Appendices 

4. So that we can be sure that all backgrounds are represented in our study, please tell me your race or ethnic 

background. Are you .... ? 

____ Caucasian/white
 


____ African American/black
 


____ Hispanic/Latino
 


____ Asian 
 


____ Other
 


(Recruit two or three individuals per minority group.) 

5. Have you smoked more than 100 cigarettes in your life? 

____ Yes (Continue.)
 


____ No (Thank and terminate the interview.)
 


6. Do you currently smoke? 

____ Yes (Continue.)
 


____ No (Thank and terminate the interview.)
 


7. Do you plan to quit smoking in the next 3 months? 

____ Yes (Continue.)
 


____ No (Thank and terminate the interview.)
 


We are holding a discussion on _________ (date) at _____________ (location). Light refreshments will be served, 

and you’ll receive $40 (regular interviews) or $60 (floaters). (Floaters are individuals who will be recruited for a 

longer period of time and will be interviewed if someone scheduled for a regular slot does not show up.) 

The topics for the focus group will be advertising and smoking. 

Will you be able to join us? 

____ Yes (Continue.)
 


____No (Thank and terminate the interview.)
 


Great. Now I just need to record some information, so we can mail you a confirmation letter and directions. 

We’ll call you the day before to confirm your attendance. 

(Fill out all information on the next page.) 
Appendices 353 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Recruitment Interview Summary 
 

45-minute interview 

$40 for regular times; $60 for floaters (Floaters are individuals who will be recruited for a longer period of time 

and might be interviewed if someone scheduled for a regular slot does not show up. Recruiter will ask people 

their availability and assign them to a specific time slot. Individuals who are available for longer periods of time 

are typically assigned as floaters.) 

(Circle time for which participant is available and scheduled.) 

Regular times: 1:00 p.m., 1:45 p.m., 2:30 p.m., 3:15 p.m., 4:00 p.m., 4:45 p.m., 5:30 p.m., 6:15 p.m., 7:00 p.m., 

7:45 p.m., 8:30 p.m.
 


Floater times: 1:45–3:15 p.m., 4:00–5:30 p.m., 7:00–8:30 p.m.
 


Name __________________________________________Date of birth ________________
 


Address ____________________________________________________________________
 


City ______________________________________ State______________ ZIP __________
 


Telephone numbers:
 


Home __________________________________________
 


Work __________________________________________
 


Cell ____________________________________________
 


Fax number ____________________________________
 


(Ask and record responses to the following questions after the screening interview is completed:) 

When you come to the discussion, please bring a driver’s license or other picture identification with your birth 

date for registration. 

If you have any questions or need to reschedule your interview time, you may call ___________ (market 

research company) at (xxx-xxx-xxxx). 

Someone from _________________ (market research company) will call you the day before the discussion in 

order to confirm and remind you of the time. 

First name and initial of last name of phone interviewer _____________________________ 
354 Appendices 

Appendix 3.3: Moderator’s Guide for Focus Groups With Smokers 

(Instructions for interviewer are in italics.) 

Objectives for Focus Groups 

This discussion guide was developed to achieve several objectives: 

1. To identify potential benefits and barriers for calling a “quitline” or visiting a quitting Web site. 

2. To determine which logo design most clearly conveys the purpose of the quitline and which logo elements 

will be most effective in getting smokers to call the quitline, to visit the Web site, or both. 

3. To determine which TV and radio spots are most likely to move the target audience to take action by calling 

the quitline, visiting the Web site, or both. 

Focus Group Discussion
 


Moderator’s Guide
 


1. Warm-up, Explanations, and Introductions 

Introduction and purpose 

Welcome. My name is ______, and I’ll be facilitating our discussion tonight. 

Thanks for joining us. We do appreciate the fact that you’re taking time from your 

day to provide us with your opinions. 

What we are doing tonight is called a focus group. It’s a way for us to get your opinions, much like a survey, but it’s done as a group discussion rather than a lot of 

yes/no questions. 

There are no right or wrong answers, and it’s important that I hear what everyone 

thinks. All of your comments––both positive and negative––are important, so please 

speak up, even if you disagree with someone else. 
Appendices 355 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Procedure 

Our discussion tonight will be videotaped and audiotaped so I don’t lose any of 

your comments. We’ll use the tapes to write a report summarizing what was said. 

The report won’t identify any of you by name. 

Behind me is a one-way mirror. Some people who are interested in what you have 

to say will be sitting behind the glass on and off during our discussion. They aren’t 

in the same room with us, because they can be distracting. 

This is a group discussion, so please don’t wait for me to call on you, but please 

speak one at a time, so the recorder can pick up everything. It’s also helpful if we 

give everyone in the group a chance to voice an opinion. 

We do have many topics to discuss in a very limited amount of time, so at times I 

may change the subject or move on, to keep us on schedule. I’ll try to come back to 

earlier points at the end of our session if there’s time. 

Self-introductions 

Let’s do a quick round of introductions. Just tell us your first name and your 

occupation. 

2. General Information Discussion 

Overview of discussion 

Tonight, we’re going to talk a bit about smoking. Everyone here smokes, at least 

some of the time. All of you have said you want to quit. I’d like to start by asking 

about that. 

Can you tell me what good things might happen if you quit? 

(Probe for potential benefits.) 

I know most people here think it would be a good idea to stop smoking, but even 

things we want to do sometimes have a downside. Can you tell me what bad things 

might happen if you quit? 

(Probe for unwanted consequences of quitting [e.g., more difficulty fitting in socially].) 
356 Appendices 

What makes it hard to quit? 

(Probe for barriers.) 

Who do you think would approve if you stopped smoking?
 


Who might disapprove?
 


When you think about quitting, whose opinion do you respect? 
 


(Probe for trusted sources.) 

Has anyone ever heard about a hotline or resource number to help you stop smok­
 


ing? What have you heard? Has anyone ever called this type of number?
 


For those of you who haven’t called, why not?
 


For those of you who have called, how did it work for you?
 


If there were a hotline like this available where you live, would you use it? Why or
 


why not?
 


What would make it easier to use the number?
 


What makes it hard to use a hotline like that?
 


Has anyone ever visited a Web site to help you quit smoking or to find out more
 


about it? 
 


(Use follow-up questions similar to the previous five questions.) 

Where would you expect to see or hear information about a hotline or Web site 

designed to help people quit smoking? 

What would be the best way to hear about such a hotline or Web site? Why? 

3. Test of Television and Radio Ads 

Overview of TV testing 

We’d like to show you several TV commercials on this subject. I’m going to begin by 

showing you a set of three commercials. I’m most interested in whether any of 

these ads might move you to call—or at least think about calling—a smoking cessation line, or visit a quitting Web site. 

To record your individual opinions, we’ve provided you with a reaction sheet. 

Please mark your opinions individually either during the spots or immediately after 
Appendices 357 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

you see them. We’ll collect the sheets after we’ve completed this exercise. 

(Distribute sheets, cue VCR, and run first set of spots.) 

I’m now going to give you a moment to fill out your handouts. Then we’re going to 

watch another set of three commercials. 

(Allow time [a few minutes maximum] for individual responses to be completed.) 

Now we’re going to watch another set of three commercials. Once again, I’m most 

interested in whether any of these ads might move you to call—or at least think 

about calling—a smoking cessation line. 

(Distribute sheets, cue VCR, and run second set of spots.) 

Discussion of TV ads 

Please take a moment to record your thoughts and pass your sheets to the front.
 


Now I’d like to hear your feedback.
 


Which spots would be the most likely to catch your attention? Why?
 


Which spots did you like the best? Why?
 


Was there anything in any of the spots that upset you?
 


(Probe for reasons and implications.) 

Overview of radio testing 

I’d like to have you listen to several radio spots about smoking health, smoking 

cessation, or both. Each of the radio spots is 60 seconds long, and we’ll be playing a 

total of six spots for you to review. As with the TV ads, we’re most interested in hearing your feedback as to which spot or spots do the best job of motivating you to call 

the quitline or visit the quitting Web site. 

Again, we’d like you to record your individual opinions on the sheet we’re distributing and then we’ll have a group discussion once the tape is finished playing. 

(Distribute sheets, cue tape, and run compilation tape.) 
358 Appendices 

Discussion of radio ads 

Please take a minute to record your individual thoughts on the radio spots, and 

pass the sheets to the front. Now I’d like to hear your feedback as to which spot or 

spots would make you call the quitline or visit the Web site. 

(Probe as to why and why not.) 

4. Testing of Logos 

Overview of logo testing 

We’d also like to get your opinions on several logo designs that are being considered. The final logo will appear on materials related to the quitline, for instance, at 

the end of a TV spot, on an outdoor billboard, or on a poster or handout in a physician’s office. 

Please keep in mind that we want your feedback on which logo or logos most clearly convey what the quitline is about. As we did with the TV and radio ads, we’ll be 

handing out a sheet to each of you. Please record your opinions, and pass your 

sheets to the front. Then we’ll discuss your thoughts as a group. 

Logo presentation and discussion 

(Distribute sheets, present four logos, and pass around logos, display, or both for participants to review. Collect sheets.) 

Which logo or logos did you like the most? 

Why? 

Which logo or logos did you like the least? 

Why? 

5. Wrap-up 

Thank you very much for participating tonight. I’m going to see if my colleagues 

have anything else they’d like to ask. 
Appendices 359 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

(Check with staff behind the mirror if time allows.) 

Thanks for sharing your opinions and your time with us tonight. This session has 

been extremely helpful. As you walk out, a staff member will hand you reimbursement for your time tonight. She’ll also ask you to sign a form acknowledging your 

receipt of the compensation for this evening 

Thanks again and have a good night. 
360 Appendices 

Appendix 3.4: Sample Moderator’s Guide for
 


Focus Groups To Test Advertisements With Youth
 


(Instructions for moderator are in italics.) 

1. Welcome and Ground Rules (5 minutes) 

■	 	 There are no right or wrong answers. Give honest opinions. You’re not here to decide what’s good or bad. 

■	 	 Everything said in the room will be confidential—only the people working on this project will know 

what you said, not other people in your life, such as your parents or teachers. 

■	 	 We are videotaping and audiotaping all of the discussions that we are doing simply so that I don’t have 

to take a lot of notes during this session. In addition, there may be some people interested in observing 

the discussion and they are seated behind that window so that they don’t disturb our discussion. 

2. Introductions and Warm-up (5 minutes) 

■	 	 Give name, age, and grade in school. 

■	 	 What are your favorite commercials, and why? 

(Write on a flip chart. This is just an icebreaker to get respondents to think about advertising.) 

3. Tobacco Knowledge (10 minutes) 

(Explain that the purpose of this research is to better understand teens and their attitudes toward and use of 

tobacco. Assure respondents that they won’t be judged in any way.) 

■	 	 What are some of the reasons people begin to smoke cigarettes? (Write on a flip chart.) 

■	 	 What are some of the reasons people continue to smoke cigarettes? (Write on a flip chart.) 

■	 	 What are some of the reasons, if any, people shouldn’t use tobacco? What else? What else? (Write on a 

flip chart.) 

■	 	 Where did you learn about this? (Probe for any awareness of specific advertising, media vehicles [e.g., TV, 

radio, magazines, billboards, Internet], or local antitobacco programs.) 
Appendices 361 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

■	 	 For community and school programs: What sort of programs have you heard of or participated in at 


school or in your town? 


■	 	 For advertising: Which of the specific ads do you remember? (Ask to describe in detail.) 

—What do you think they’re trying to get across in these commercials? 

—What do you think are the purposes of these commercials? 

4. Exposure to Ads (45 minutes) 

(Show the ads one at a time. Rotate the order of the ads for each new group to avoid first-position bias. After 

showing each ad, ask respondents to write the main message on notepads that they have been given, and how 

much the ad makes them “stop and think about not using tobacco.” Use a scale of 1 to 10. Explain that 1 means 

the ad doesn’t make them stop and think much about not using tobacco and 10 means it really does make them 

stop and think about not using tobacco. Carefully explain that we’re not as much interested in which ads are 

their favorites, but which ones are most likely to make them stop and think. Then for each ad ask the following 

questions before showing the next ad.) 

■	 	 What do you think was the most important thing they’re trying to tell you in this commercial? (Poll the 


respondents and lead a brief discussion.) 


■	 	 What rating did you give this ad on the “stop and think” scale, and why? (Ask respondents to explain their 


ratings.) 


■	 	 Who do you think made this commercial? 

(After they have discussed each ad, ask respondents as a group to decide where each ad should be placed on a 

wall scale. The wall scale is simply numbers from 1 to 10 written on individual pieces of paper attached to the 

wall in order. It gives participants a visual way to consider each ad and compare among the ads. Explain that 1 

means the ad doesn’t make them stop and think much about not using tobacco and 10 means it really does 

make them stop and think about not using tobacco. Write the name of each ad on an index card and attach each 

card to the wall scale in a place the respondents think is appropriate.) 

5. Wall Scale Reassessment (10 minutes) 

(After all of the index cards have been placed on the wall scale, ask respondents to reevaluate their placement of 

the ads on the wall scale, now that they’ve seen all the ads in comparison to each other. Make any necessary 

changes to the order of the ads on the wall scale. Probe for reasons behind changes.) 
362 Appendices 

6. Final Selection Among Ads (10 minutes) 

Of all these ads, which do you think would most get people your age to seriously consider not using tobacco? 

(Ask respondents to write the answer on their notepads, and then lead the group in a discussion.) 

7. Advice and Suggestions (5 minutes) 

Thinking about all the things we’ve discussed today, what are the three pieces of advice you would give to the 

people who create ads to encourage people your age not to use tobacco? (Ask respondents to write their 

answers on their notepads. Then lead a group discussion.) 

(Thank respondents, collect notepads from respondents, and conclude the session. Respondents will go the front 

desk to receive their incentives.) 
Appendices 363 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 3.5: Sample Self-Administered Form To Test Fact Sheets 

Pretest Questions 

As you probably are aware, [name of sponsoring organization] has recently launched its tobacco control program. One component of [sponsoring organization]’s campaign is the distribution of fact sheets that convey 

important information about issues related to tobacco use. It’s crucial that we test these fact sheets in order to 

ensure that we are communicating our key messages effectively. 

We appreciate your willingness to share your reactions to the attached fact sheet by reading it and answering a 

few questions. We don’t ask your name, and all information you provide will remain confidential. 

Because only a few individuals are being asked to help judge this material, your response is particularly valuable. 

Before you begin, please check the appropriate answers to these four questions. 

1. How much would you say you know about the [sponsoring organization]’s tobacco control program? 

Nothing ____ A little ____ Some ____ A lot ____ 

2. Is there anything you want to know about the program? 

Yes______ No_______ If yes, please specify. 

[Note: More questions about knowledge can be added here.] 

3a. Are you currently and actively involved in tobacco control and prevention? 

Yes______ No________ 

3b. Are any of your family members currently and actively involved in tobacco control and prevention? 

Yes______ No________ 

4. Are you a member of any group concerned about tobacco control and prevention? 

Yes______ No________ 

[Note: Insert page with fact sheet.] 

Please turn the page and read the fact sheet. 
364 Appendices 

Post-test Questions 

Now that you’ve finished reading the fact sheet, please answer the following questions. You may refer to the 

fact sheet as you consider your response. 

1. In your own words, what would you say is the purpose of the [sponsoring organization]’s 

tobacco control program? 

[Note: Additional questions about knowledge can be added here.] 

2. How much of the information in the fact sheet was new to you? 

Most ______ Some ______ None_______ 

3. Do you have questions about the [sponsoring organization]’s tobacco control program that weren’t 

answered in the fact sheet?
 


Yes_______ No________ 
 


If yes, please list:________________________________ 

4. Was there anything you particularly liked about the fact sheet? 

Yes_______ No_______ 

If yes, what?________________________________ 

5. Was there anything you particularly disliked or found confusing about the fact sheet? 

Yes______ No_________ 

If yes, what?________________________________ 

6. This fact sheet is most appropriate for (check all that apply): 

General Public______ 

College Graduates______ 

Health Professionals______ 

Policy Makers _____ 

Educators ______ 

Youth ________ 

Specific Populations (please list) _________
 


Other (please list) ___________
 

__________________________________________________________________________________________________ 

__________________________________________________________________________________________________ 

__________________________________________________________________________________________________ 

__________________________________________________________________________________________________ 

Appendices 365 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

7. Would you recommend the fact sheet to a friend or family member? 

Yes_______ No_______ 

Why or why not? 

8. The following phrases describe the fact sheet. Please circle the one choice on each line that most closely 

reflects your opinion. 

a. Very interesting Somewhat interesting Not at all interesting 

b. Very informative Somewhat informative Not informative 

c. Very accurate Partially accurate Inaccurate 

d. Very clear Somewhat clear Confusing 

e. Very useful Somewhat useful Not useful 

f. Unbiased Biased toward the tobacco industry Biased toward smoker 

g. Easy to read Understandable Hard to understand 

h. Complete Somewhat complete Incomplete 

9. Would you like to say anything else about the fact sheet? Please comment: 

Thank you very much for your help in reviewing this fact sheet. 

Please return this sheet by _____________ (date) to: 

[name] 

[fax #] 

[e-mail] 

If you have any questions, please contact: 

[name] 

[phone #] 

[e-mail] 
366 Appendices 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

Appendix 3.6: Sample Intercept Interview Questionnaire
 


Respondent number: ____________________________ 

(Instructions for interviewer are in italics.) 

Good morning/afternoon. My name is _____________. Thank you for agreeing to take part in this research. I 

am now going to show you a short video recording. When it has finished, I will ask you some questions about 

what you have just seen. 

(Play video of all five ads.) 

1. Thinking of the video you’ve just seen overall, which advertisement did you like the most? 

Ad A ❑ 1 

Ad B ❑ 2 

Ad C ❑ 3 

Ad D ❑ 4 

Ad E ❑ 5 

None ❑ 6 

1a. And why do you say that? 
___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

Appendices 367 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

2. And thinking of the video you’ve just seen overall, which ad did you like the least? 

Ad A ❑ 1 

Ad B ❑ 2 

Ad C ❑ 3 

Ad D ❑ 4 

Ad E ❑ 5 

None ❑ 6 

2a. And why do you say that? 

(Show only test ad again.) 

3. Now thinking specifically about this ad, could you tell me what you think the main message of this ad is? 

4. Again for this ad, could you tell me what you think its other messages are? Anything else? 
368 Appendices 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

5. What is there that you like about this advertisement? And what else? Is there anything else at all you like 

about this advertisement? 

6. What is there that you dislike about this advertisement? And what else? Is there anything else at all you dislike 

about this advertisement? 

7. I’m going to read out a number of statements about the advertisement that you just viewed. For each statement 

I’d like to know to what extent you agree or disagree with it, using the scale on this card. 

(Show card A on with scale responses.) 

Strongly Slightly Neither Slightly Strongly Don’t 

Agree Agree Agree nor Disagree Disagree Know 

Disagree 

a) This advertisement has a 

convincing message ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6 

b) This is an attentiongrabbing advertisement ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6 

c) The message of this 

advertisement is unclear ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6 
Appendices 369 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Strongly 

Agree 

Slightly 

Agree 

Neither 

Agree nor 

Disagree
 


Slightly 

Disagree 

Strongly 

Disagree 

Don’t
 


Know
 


d) This advertisement is 
 


similar to other stop smoking 
 


advertisements ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6
 


e) This advertisement has a
 


persuasive message ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6
 


f) This advertisement is
 


boring ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6
 


8. Can you tell me your overall opinion of this advertisement? (Read options.)
 


Excellent ❑ 1
 


Very Good ❑ 2
 


Good ❑ 3
 


Fair ❑ 4
 


Poor ❑ 5
 


9. If the ad provided a toll-free phone number, do you think you would call that number?
 


Yes ❑ 1
 


No ❑ 2
 


10. Overall, would this advertisement persuade you to try to quit smoking? 

Yes ❑ 1 (Ask question 11, then go to question 13.) 

No ❑ 2 (Ask question 11, then go to question 12.) 
370 Appendices 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

11. Why do you say that? 

12. (Only ask this question if respondent answered “no” to question 10.) What would you change about the 

advertisement to make it more persuasive for you to quit smoking? 

13. Have you ever tried to stop smoking before? 

Yes ❑ 1 (Go to question 14.) 

No ❑ 2 (Go to demographics questions.) 

14. How long ago did you last try to stop smoking? 

Within last 3 months ❑ 1 

Over 3 months to less than 6 months ❑ 2 

Over 6 months to less than 1 year ❑ 3 

Over 1 year to less than 2 years ❑ 4 

Over 2 years to less than 3 years ❑ 5 

Over 3 years ago ❑ 6 

Don’t know / Can’t remember ❑ 7 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

________________________________________________________________________________________________ 

________________________________________________________________________________________________ 

________________________________________________________________________________________________ 

Appendices 371 

15.	 	 What was your main reason for trying to quit smoking on this previous occasion?
 


New Year’s resolution ❑ 1
 


Health reasons ❑ 2
 


Pregnancy ❑ 3
 


On medical advice ❑ 4
 


Wanted to improve fitness ❑ 5
 


To save money/couldn’t afford it ❑ 6
 


Request from friend/member of family ❑ 7
 


Thought I could kick the habit ❑ 8
 


Other (please specify)	 	 ❑ 9
 


Finally, these are questions for statistical purposes only. 

A. In which age group do you fit? 

(Show card B with age categories listed.) 

25–29 ❑
1
 


30–34 ❑
2
 


35–39 ❑
3
 


40–44 ❑
4
 


45–49 ❑
5
 

372 Appendices 

B. How many people are there in your household, including yourself and children?
 

Two 
 ❑ 2
 

Three 
 ❑ 3
 

Four 
 ❑ 4
 

Five 
 ❑ 5
 

Six 
 ❑ 6
 

Seven and above 
 ❑ 7
 

One 
 ❑ 1
 

C. How many children under age 16 live in your household?
 

Two 
 ❑ 3
 

Three 
 ❑ 4
 

Four 
 ❑ 5
 

Five 
 ❑ 6
 

Six 
 ❑ 7
 

Seven and above 
 ❑ 8
 

D. And what are their ages? 
 

3 to 5 years 
 ❑ 2
 

Under 3 years 
 ❑ 1
 

6 to 8 years 
 ❑ 3
 

9 to 11 years 
 ❑ 4
 

12 to 15 years 
 ❑ 5
 

None 
 ❑ 1 (Go to question ‘E’)
 

One 
 ❑ 2
 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 373 

E. What is your employment status? 
 

Employed full-time ❑ 1 
 

Employed part-time ❑ 2 
 

Self-employed ❑ 3 
 

Student ❑ 4 
 

Homemaker ❑ 5 
 

Not employed ❑ 6 
 

F. What is the highest level of education of the primary wage earner? 
 

Primary school/none ❑ 1 
 

Secondary school ❑ 2 
 

High school ❑ 3 
 

College graduate ❑ 4 
 

Postgraduate degree ❑ 5 
 

Thank you very much for taking part in the survey. 

(Give respondent incentive.) 
374 Appendices 

Appendix 5.1: Examples of Inputs, Activities, Outputs,
 


and Outcomes for Counter-Marketing Programs
 


Inputs Activities Outputs Short-Term 

Outcomes 

Intermediate 

Outcomes 

Long-Term 

Outcomes 

Advertising 

• Funds for paid 

media 

• Advertising 

contractor 

• Advertising 

specialist on 

staff 

• Conduct situational analysis 

to select audiences 

• Develop a 

media plan 

• Conduct formative research to 

understand 

audiences 

• Design new ads 

or select existing ads and 

pretest 

Target audience is 

exposed to countermarketing message 

via: 

• Spots aired on 

TV and radio 

• Posters placed 

in stores and on 

buses 

Target audience is 

aware of ads, 

recalls specific 

messages, and has 

a positive reaction 

to the ads 

Target audience 

has changed attitudes, beliefs, 

behavioral intentions or intermediate behaviors. For 

example: 

• More parents 

believe secondhand smoke is 

harmful 

• More adults join 

smoking cessation programs 

Target audience 

has changed 

behavior. For 

example: 

• Fewer youth 

start smoking 

• Cessation rates 

are higher 

• Prevalence of 

tobacco use is 

reduced 

Public Relations (PR) 

• PR specialist on 

staff 

• PR contractor 

• Health department spokespeople 

• Identify stakeholders 

• Develop overall 

plan 

• Generate story 

ideas and articles 

• Plan and conduct 

press conferences 

• Contact media 

outlets 

• Develop and distribute newsletter 

• Provide 

spokesperson 

training to health 

department staff 

Target audiences 

are exposed to 

message via: 

• Scheduled press 

conferences 

• Articles in newspapers 

• Coverage on TV 

news 

• Distribution of 

newsletter 

Target population 

is aware of and 

understands message of stories 

Target population 

has changed attitudes, beliefs, 

behavioral intentions, and intermediate behaviors. 

For example: 

• More adults join 

cessation programs 

• More smokers 

believe the 

tobacco companies engineer 

cigarettes to 

make them more 

addictive 

Target population 

has changed 

behavior. For 

example: 

• Cessation rates 

are higher 

• Prevalence of 

tobacco use is 

reduced 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 375 

Appendix 5.1: Examples of Inputs, Activities, Outputs,
 


and Outcomes for Counter-Marketing Programs (cont.)
 


Inputs Activities Outputs Short-Term 

Outcomes 

Intermediate 

Outcomes 

Long-Term 

Outcomes 

Media Advocacy 

• Marketing staff 

time 

• Grants to 

communitybased 

organizations 

• Funds for 

community 

coalitions 

• Establish local 

and regional 

coalitions to 

work on 

adapting policies 

for smokefree 

environments 

• Develop plan for 

advocacy work 

• Develop news 

releases, stories, 

and strategy for 

pitching from 

policy perspective 

• Conduct meetings with policy 

makers to educate them about 

hazardous effects 

of secondhand 

smoke exposure 

and benefits of 

smoke-free 

policies 

• Provide 

spokesperson 

training to community members 

Policy makers and 

restaurant and 

business owners 

are exposed to 

messages (e.g., 

hazards of 

secondhand 

smoke and the 

role of smokefree 

policies in reducing exposure) via: 

• News releases 

• Stories 

• Meetings 

Policy makers and 

restaurant and 

business owners 

become more 

aware of the hazardous effects of 

secondhand smoke 

exposure 

Policy makers and 

restaurant and 

business owners 

change their attitudes, beliefs, and 

intermediate 

behaviors about 

smokefree policies: 

• More policy makers and restaurant 

and business 

owners believe 

that secondhand 

smoke kills 

• More restaurant 

owners believe 

business would 

not be hurt as a 

result of clean 

indoor air 

policy. 

• Restaurant owners voluntarily 

adopt smokefree 

policies 

• Policy makers 

enact smokefree 

policies 

Exposure to 

secondhand 

smoke is reduced 

Continues 
376 Appendices 

Appendix 5.1: Examples of Inputs, Activities, Outputs,
 


and Outcomes for Counter-Marketing Programs (cont.)
 


Inputs Activities Outputs Short-Term 

Outcomes 

Intermediate 

Outcomes 

Long-Term 

Outcomes 

Grassroots Marketing 

• Marketing staff 

time 

• Funds for 

contests, 

events, and 

activities 

• Existing and 

available 

materials 

• Identify whom to 

involve at low, 

medium, and 

high levels of 

engagement 

• Prepare brief to 

keep participants 

on strategy 

• Create means of 

communication 

(e.g., Web site or 

e-mail distribution 

list) for advocates 

• Build partnerships 

with key organizations 

• Organize college 

youth to collect 

data on advertising in stores 

Targeted partners 

are exposed 

through credible 

interpersonal 

channels: 

• On-campus 

distribution of 

leaflets giving 

study results 

• Youth who attend 

concerts sponsored by tobacco 

industry are 

exposed to “truth” 

campaign’s “Truth 

Truck” 

• Local physicians 

receive related 

messages via 

professional 

group’s newsletter 

Exposed youth and 

physicians have 

increased awareness of tobaccorelated issues 

• Youth have 

improved attitudes, 

beliefs, and intermediate 

behaviors (e.g., 

engaged youth 

convey message 

about industry’s 

deceptive practices to others) 

• Physicians talk to 

smokers about 

quitting and refer 

them to cessation 

programs 

• More smokers 

join cessation 

programs 

Target population 

has changed 

behavior. For 

example: 

• Fewer youth 

start smoking 

• Rates of successful smoking 

cessation are 

higher 

• Prevalence of 

smoking is 

reduced 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 377 

Inputs Activities Outputs Short-Term 

Outcomes 

Intermediate 

Outcomes 

Long-Term 

Outcomes 

Media Literacy 

• Marketing staff • Agree to hold • Middle school Program partici­ Program partici­ • Fewer youth start 

time workshops and and high school pants become pants develop criti­ smoking 

• Grant funding 

for workshops 

• Existing 

and available 

materials 

• Hold workshops 

and presentations 

at sites other than 

schools 

• Offer curricula in 

schools 

deliver curricula youth participate 

in media literacy 

curriculum 

• Youth groups 

participate in 

workshops and 

presentations 

aware of the role of 

media and the 

importance of 

managing and 

interpreting that 

role 

cal viewing skills 

and ability to produce tobacco control messages 

through different 

forms of media. For 

example: 

• Prevalence of 

smoking is 

reduced 

• Adults are 

exposed to video 

presentation on 

secrets of tobacco 

advertising 

• Persons who 

received messages of media 

literacy program 

produce tobacco 

control messages 

• Curriculum is using different 

implemented forms of media 

according to 

design • Persons who 

received messages of media 

literacy program 

become involved 

in tobacco control campaign 

Appendix 5.1: Examples of Inputs, Activities, Outputs,
 


and Outcomes for Counter-Marketing Programs (cont.)
 

378 Appendices 

Appendix 5.2: Key Data Collection Tools and Methods
 


Method Description Evaluation Uses and Other Consideration 

Media tracking 

and content 

analysis 

Systematic monitoring of 

the various media 

channels (e.g., print, 

radio, TV, outdoor) to 

identify ads, editorials, 

and articles relevant to 

the campaign and to 

assess messages in these 

ads, editorials, and 

articles (often with use of 

a professional tracking 

service) 

• Can be used to monitor media efforts, both earned 

and paid, to assess quantity and quality of messages 

• Can be combined with data on the reach of various 

channels to estimate potential exposure of audience, 

overall and by demographics 

• Content analysis can be used to determine what 

messages are disseminated to the target audience, if 

those messages are on strategy, and if the messages 

have changed since the campaign began 

• Can be used to track changes in messages to 

determine whether they are on target and consistent 

with the marketing plan 

• Can be used to modify the media plan 

Tracking 

requests for 

information 

Systematic recording of 

the number and type of 

people who request 

information (e.g., call the 

quitline, visit the Web site) 

• Can be used to assess the effectiveness of countermarketing efforts that list the Web site or quitline as a 

source of additional information 

• Can be used to track simple counts of number of 

requests over time, to show correlation with countermarketing efforts 

• Requires more effort to determine the characteristics 

of the population reached 

Logs of events 

and activities 

Completion of a form by 

the organizer of an event 

or activity, to describe the 

type of activity, where the 

activity happened, the 

number of participants, 

the type of participants, 

and comments about the 

event 

• Can be used for rapid tracking of program activities 

and outputs (e.g., workshops, press conferences, summits, and community forums) for process evaluation 

• Can be easily entered into database, to produce 

summaries of activities over time and by type 

• Can only provide estimates of the number of participants reached and general categorization of those 

participants (e.g., log sheets for press events may show 

TV reporters vs. print reporters) 

• Counting of participants facilitated by sign-up sheet 

• Can used to determine whether program 

implementation is following plan 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 379 

Appendix 5.2: Key Data Collection Tools and Methods (cont.) 
 

Method Description Evaluation Uses and Other Consideration 

Review of 

existing data 

and records 

Structured analysis of 

information being collected for other purposes, 

usually on a regular basis 

• Is an inexpensive source of data 

• Data produced may not be relevant 

• Requires thought and knowledge of local systems to 

locate relevant data 

Focus group 

discussions 

Qualitative method in 

which a skilled moderator 

uses an interview guide 

with open-ended 

questions to facilitate a 

1- to 2-hour discussion 

among 5 to 10 

participants 

• Is more useful for formative evaluation than for process 

or outcome evaluation 

• Can be used diagnostically in conjunction with 

quantitative data to understand results 

• Can facilitate interaction among group members that 

elicits in-depth responses 

• Provides richer data about meanings and reactions 

than closed-ended questions 

• Can be observed, recorded, or both, to facilitate 

analysis 

• Requires a skilled moderator who understands how to 

manage the group process, so necessary information is 

collected 

• Can result in domination of discussion by vocal 

individuals 

• Results in findings that can’t be generalized and may be 

biased by the unique characteristics of participants 

Document 

analysis 

Systematic assessment of 

the content of documents 

• Can be useful if the program is expected to result in 

changes in documents such as local ordinances 

• Can be used to determine whether ordinances and 

policies have shifted in the desired direction 

In-depth 

individual 

interviews 

Qualitative data collection 

with a semistructured 

interview guide in which a 

limited number of 

respondents are asked 

questions (often 

open-ended) by a skilled 

interviewer 

• Can be used to assess reactions to specific countermarketing efforts 

• Is particularly useful to assess reactions of specific 

individuals (e.g., stakeholders, members of the press, 

station managers, and heads of key organizations) 

• Can be used to modify the program 

• Can use observation or recording of information to 

facilitate analysis 

• Requires a skilled interviewer who is knowledgeable 

about the reason for the interview and how the 

responses might be used to improve the program 

Continues 
380 Appendices 

Appendix 5.2: Key Data Collection Tools and Methods (cont.)
 


Method Description Evaluation Uses and Other Consideration 

Participant 

feedback survey 

Survey administered to 

participants in a countermarketing event, to 

obtain feedback about the 

event 

• Can be used as a simple method to describe the size 

and characteristics of the population reached by an 

event 

• Can be used to assess the reaction of the target 

population to the event 

• Provides insight into approaches to improve the 

content of and recruitment for the event 

• Is more useful for process evaluation than for outcome 

evaluation 

Populationbased survey 

Survey of a population 

that follows strict sampling rules, so findings are 

representative of that 

population; administered 

by interviewer or selfadministered 

• Is likely to be used in some form to evaluate 

advertising efforts 

• Can indicate the percentage of the state population 

reached by counter-marketing efforts 

• Can be used to determine whether persons aware of 

the advertising or other counter-marketing efforts 

have improved beliefs, attitudes, and behaviors 

• Can be repeated at regular intervals to track changes 

Random digit 

dialing (RDD) 

Population-based survey 

using special telephonedialing procedures to 

reach a probability sample of the state population; computer-assisted 

telephone interviewing is 

a common type of RDD 

• Provides efficient, cost-effective means of generating 

a probability sample that can be generalized to the 

target population 

• Must use special sampling procedures to obtain 

sufficient samples of some populations (e.g., youth, 

ethnic/racial minority groups, and smokers) 

• See population-based survey in this table 

Observation Observation of persons in 

public settings or observation of physical settings, 

with minimal observer 

interaction 

• In some cases, can be used to directly assess program 

implementation and behavior and reactions of target 

audience 

• Can also be used to determine the quantity and 

content of tobacco advertising, counter-advertising 

and promotion in physical settings 

• Is labor intensive and requires visits to the sites of the 

program and skilled observers trained to use tested 

protocols 

• May result in bias, if behaviors are influenced by the 

presence of the observer 

• May result in questioning of the ethics of observing 

people without their consent 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 381 

Appendix 5.3: Key Variables and Sample Items To Consider 
 


Including in Survey of Target Population
 


Category Variable Sample Item 

Awareness Unaided Describe anything you recall from recent advertising against 

smoking that you have seen. 

Aided Have you recently seen an antismoking ad that shows two 

young men in a van who drive up to an office building and talk 

to a uniformed guard? 

Confirmed 

awareness 

Can you provide more detailed information about what 

occurred in the ad? 

Unaided 

awareness of 

campaign or 

slogan 

Are you aware of any antismoking campaigns now taking place 

in this state? 

What is the theme or slogan of this campaign? 

Recall Recall of ad What happens in the ad? (List of closed-ended ad descriptions is 

not read, but is included for the interviewer to code responses) 

Recall of message What do you think the main message of the ad is? (List of 

closed-ended ad messages is not read, but is included for the 

interviewer to code responses) 

Reactions Diagnostic 

measures 

For each of the following statements, please tell me how much 

you agree or disagree with the statement. Do you strongly agree, 

agree, neither agree nor disagree, disagree, or strongly disagree? 

The ad was memorable. 

I liked the ad. 

The ad was believable. 

The ad was relevant to me. 

I talked with my friends about the ad. 

Open-ended 

measures 

What specifically did you like about the ad? 

What did you dislike about the ad? 

What, if anything, was confusing about the ad? 

Who, if anyone, would be offended by the ad? 

Reaction to 

workshops and 

events 

What specifically did you like about the workshop? 

What did you dislike about the workshop? 

Would you recommend the workshop to a friend? Continues 
382 Appendices 

Appendix 5.3: Key Variables and Sample Items To Consider 
 


Including in Survey of Target Population (cont.)
 


Category Variable Sample Item 

Attitudes Attitude toward 

trying cigarettes 

Trying just a few cigarettes won’t hurt anyone. 

(For all items the following response scale can be used: strongly 

agree, agree, disagree, strongly disagree, or no opinion.) 

Attitude toward 

smoking 

Young people who smoke are usually “cooler” than those who 

don’t. 

Attitude toward 

quitting 

I can quit smoking any time I choose. 

Support for bans Smoking in the workplace should be banned. 

Beliefs Beliefs about 

consequences of 

smoking 

For each of the following statements, please tell me how much 

you agree or disagree with the statement. Do you strongly agree, 

agree, neither agree nor disagree, disagree, or strongly disagree? 

My smoking in the next 3 months will help me fit in. 

My smoking in the next 3 months is harmful to my health. 

My smoking in the next 3 months will make my breath smell bad. 

Smoking has nothing to do with whether a person is cool. 

Smoking causes heart disease . . . lung cancer . . . 

blocked arteries. 

Beliefs about the 

tobacco industry 

For each of the following statements, please tell me how much 

you agree or disagree with the statement. Do you strongly agree, 

agree, neither agree nor disagree, disagree, or strongly disagree? 

Tobacco companies try to get young people to smoke because 

older people quit smoking or die. 

Tobacco companies use advertising to fool young people. 

If people my age knew we were being used by tobacco companies just to make money, we would never start smoking. 

Most people my age don’t believe all the bad things we hear 

about tobacco companies. 

Beliefs about 

secondhand 

smoke 

For each of the following statements, please tell me how much 

you agree or disagree with the statement. Do you strongly agree, 

agree, neither agree nor disagree, disagree, or strongly disagree? 

Secondhand smoke causes lung cancer. 

Secondhand smoke is an extremely important public health

issue. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 383 

Appendix 5.3: Key Variables and Sample Items To Consider 
 


Including in Survey of Target Population (cont.)
 


Category Variable Sample Item 

Normative 

beliefs 

Perceptions of 

friends’ use 

How many of your close friends do you think smoke? 

Does your best friend smoke? 

Perception of 

others’ use of 

cigarettes 

How many sixth graders at this school do you think smoke 

cigarettes? 

Normative belief 

from friends 

Do you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statement? 

My close friends think it’s OK for me to smoke. 

Normative belief 

from parents 

Do you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statement? 

My parents think it’s OK for me to smoke. 

General 

normative belief 

Do you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statement? 

Most people who are important to me think it’s OK for me to 

smoke. 

Self-efficacy Confidence to 

refuse an offer 

How easy or hard would it be for you to say “no” to the offer of a 

cigarette when you are at a party with friends? ...when you are 

at a close friend’s house and their parents are not at home? 

Would you say it would be very easy, easy, neither easy nor hard, 

hard, or very hard? 

Confidence to 

quit smoking 

How easy or hard would it be for you to quit smoking in the 

next 30 days? Would you say it would be very easy, easy, neither 

easy nor hard, hard, or very hard? 

Intention Intention to try Do you think that you’ll try a cigarette in the next 30 days? 

Intention to 

refuse an offer 

How likely is it that you’ll refuse a cigarette the next time you’re 

offered one? Would you say it’s very likely, likely, neither likely 

nor unlikely, unlikely, or very unlikely? 

Intention to quit 

smoking 

Are you planning to quit smoking in the next 30 days? 

How many times in the past 30 days have you thought about 

quitting smoking? 

Intention to avoid 

secondhand 

smoke 

Would you eat at restaurants more often, as often, or less often 

if smoking were banned? 

Continues 
384 Appendices 

Appendix 5.3: Key Variables and Sample Items To Consider 
 


Including in Survey of Target Population (cont.)
 


Category Variable Sample Item 

Susceptibility Susceptibility How many of your four best friends smoke cigarettes? 

(If the responses is 1 or more, respondent can be categorized as 

“susceptible”; if the response is “none,” respondent can be categorized as “nonsusceptible”) 

Behavior Initiation of 

smoking 

cigarettes 

Have you ever tried cigarette smoking, even one or two puffs? 

(If response is “no,” respondent can be categorized as “nonsmoker”) 

Initiation of using 

smokeless 

tobacco 

Have you ever used chewing tobacco, snuff, or dip, such as 

Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or 

Copenhagen? 

(If response is “no,” respondent can be categorized as “non-user 

of smokeless tobacco”) 

Initiation of cigar 

smoking 

Have you ever tried smoking cigars, cigarillos, or little cigars, 

even one or two puffs? 

(If response is “no,” respondent can be categorized as “nonsmoker”) 

Never smoked, 

current smoker, 

or former smoker 

Have you ever tried cigarette smoking, even one or two puffs? 

(If response is “no,” respondent can be categorized as “nonsmoker”) 

Do you smoke cigarettes every day, some days, or not at all? (If 

response is “every day” or “some days,” respondent can be 

categorized as “current smoker”) 

During the past 30 days, on how many days did you smoke 

cigarettes? (If response is 1 or more days, respondent can be 

categorized as “current smoker”) 

Have you smoked at least 100 cigarettes in your lifetime? 

(If response is “yes,” ask next question) 

Do you smoke cigarettes every day, some days, or not at all? 

(If response is “not at all,” respondent can be categorized as 

“former smoker”) 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 385 

Appendix 5.3: Key Variables and Sample Items To Consider 
 


Including in Survey of Target Population (cont.)
 


Category Variable Sample Item 

Behavior (cont.) No use, 

situational use, or 

established use 

During the past 30 days, on the days you smoked, how many 

cigarettes did you smoke per day? 

(If response is “none,” respondent can be categorized as “no 

use”) 

During the past 30 days, on how many days did you smoke cigarettes? 

During the past 30 days, on the days you smoked, how many 

cigarettes did you smoke per day? 

(If response to first question is 6 days or fewer, and response to 

second question is 4 cigarettes per day or fewer, respondent can 

be categorized as “situational smoker”) 

During the past 30 days, on how many days did you smoke 

cigarettes? 

During the past 30 days, on the days you smoked, how many 

cigarettes did you smoke per day? 

(If response to first question is 6 or more days, and response to 

second question is 5 or more cigarettes per day, respondent 

can categorized as “established smoker”) 

Smoking 

cessation 

During the past 12 months, did you ever seriously try to quit 

smoking cigarettes? 

How many times, if any, have you tried to quit smoking? 

When you last tried to quit, how long did you stay off cigarettes? 

Actions to avoid 

secondhand 

smoke 

Have you asked an acquaintance not to smoke around you or 

others in the past 30 days? 

Have you asked a stranger not to smoke around you or others 

in the past 30 days? 

Have you avoided a smoky place in the past 30 days? 

Have you gone to a smokefree club in the past 30 days? 

If you went to a smokefree club, was part of your decision 

based on knowing that it was smokefree? 
386 Appendices 

Appendix 6.1: Key Elements of a Request for Proposals (RFP) 

for a Media Campaign 

Requests for Proposals (RFPs) vary significantly among states and organizations. They range in length from 

less than 10 pages to over a hundred pages. They also vary in terms of the elements included. The following is a 

list of potential elements to include in an RFP. It is not meant to be a recommendation for the structure or content of your RFP; rather, it is meant to help you in writing your RFP by providing information about elements 

other states have included and issues that have arisen. Your state or organization may not want to include 

in your RFP some of the elements listed below. Likewise, your state or organization may have additional 

requirements that are not addressed in this document. 

General Information/Introduction 

Background and Overview 

What is important to know about the current situation that explains why you are issuing an RFP at this time? 

Did you just acquire settlement dollars? Was a tobacco tax passed whose proceeds will be going to a tobacco 

control program? Will a broad tobacco control program be developed at this time, or just a media/PR 

campaign? 

Statement of Purpose/Goals/Objectives 

What are you trying to achieve through the media/PR campaign? This may include a statement of work for the 

media campaign. If you have selected target audiences for the campaign, include those as well. Be as clear and 

selective as possible. The more specific you are, the more focused proposals the bidding agencies can develop. 

If funds are limited, you may need to focus on one goal and one or two target audiences rather than diluting 

your efforts by trying to influence many audiences to change behaviors. 

Description of the Health Department or Program 

Share relevant information about current and past tobacco control programs and describe which organizations have been involved. Describe past or existing tobacco control efforts and media campaigns. Succinctly 

describe what media and public relations efforts have been implemented in the past and their results, if 

available. 

Description of Problem the Campaign Needs to Address 

Share research and data specific to the state, including any important regional, demographic, or other differences. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 387 

Budget or Funding Level 

Be specific about the time period for the budget, whether funds will be renewed after the first year, conditions 

for funding renewal, etc. If funding is uncertain, it is acceptable to include the existing conditions that have 

made the funding level uncertain. Also include the date when you expect to know the outcome. You may have 

the bidders prepare proposals at different funding levels. 

Contract Period 

You may want to check with your state health department’s contract office to determine the types of contracts 

available to your program. For example, you may be able to have a contract renewable for a certain number of 

years, contingent upon your approval rating of the agency. Note the beginning and end dates for the contract. 

Proposal Requirements 

Eligibility Criteria 

State who may apply for the contract. Optional requirements include the following: 

•	 	 Agency based in the state. Some state government policies require hiring only in-state contractors. 

•	 	 Submissions only by agencies with certain experience. For example, you may want to hire an agency 

with experience in one or more of the following areas: marketing, public relations, marketing 

research, specific ethnic group marketing, youth marketing and public education, direct marketing, 

new media (e.g., Internet), sports and entertainment marketing and merchandising, media buying 

and planning, creative development and production, grassroots organizing, crisis management, or 

special events. 

•	 	 Annual billings within a specific range. The rationale for including this is that you might not want to 

hire an agency that is so small that you’re concerned about it’s capability to handle your account or 

so large that you’re concerned that your account won’t be so important to them. 

•	 	 Lead agency may partner with other agencies that have needed experience. For example, lead agencies without ethnic marketing experience may still be considered as long as their proposals specify 

which ethnic marketers they would partner with. 

Proposal Content and Format Requirements 

•	 	 Formatting, such as white 8 1/2" x 11" paper, page numbering, limitations on number of pages, 

required appendices. Providing such requirements may not only make the proposals easier to read 

but may also help avoid the tendency of advertising and PR agencies to “out-glitz” each other by 

using the most creative, original formats for their proposals. 
388 Appendices 

•	 	 Inclusion of specific elements and organization into specific content sections. For example, required 

elements might include a standard cover sheet with signature, table of contents, proposal narrative, 

narrative responses to questionnaire, proposed budget in standard format, work plan or action plan, 

nondiscrimination compliance statement, drug-free workplace certificate, etc. 

•	 	 Examples of desired formats for proposal pages or appendices. 

Potential or Perceived Conflict of Interest 

All applicants should be required to provide a statement of disclosure regarding potential or perceived conflict 

of interest due to connection with the tobacco industry, and you should provide the standard format for this 

statement. Potential or perceived conflict of interest could include affiliation or contractual relationships, 

direct or indirect, with tobacco companies, owners, affiliates, subsidiaries, holding companies, or companies 

involved in any way in the production, processing, distribution, promotion, sale, or use of tobacco. You may 

choose to state in the RFP any of the following: 

•	 	 Only agencies with no such affiliation within some time frame (e.g., the past five years) are allowed 

to apply. 

•	 	 Any tobacco company affiliation disqualifies an agency from competing for the contract. 

•	 	 An agency must divest itself of such affiliation prior to bidding and must submit with its bid written 

documentation of such divestment. 

•	 	 Such affiliation doesn’t necessarily disqualify agencies, but disclosure of real or apparent conflict of 

interest is required in the proposal. 

In addition, you may require a written statement that the selected agency will not accept such relationships 

during the term of contract with the health department. 

Applicant Questionnaire 

You may ask each applicant to answer questions regarding the agency, including areas such as the following: 

•	 	 Agency mission and philosophy 

•	 	 List of key agency staff and agency offices 

•	 	 Description of departments and staff positions within the agency 

•	 	 Organizational chart 

•	 	 Names of other agencies, subcontractors, and consultants to be included in submission 

•	 	 Number years in business 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 389 

•	 	 Annual billings 

•	 	 Experience with government, nonprofit, or health-related accounts 

•	 	 Antidiscrimination policy 

•	 	 Past pro bono work and contacts for references 

•	 	 List of top accounts (typically based on billings) and contacts for references 

•	 	 Examples of accounts that demonstrate the agency’s experience in changing behavior on social or 

public health issue (including key results) 

•	 	 Information about how the agency uses research in developing, executing, and 
 


evaluating campaigns
 


You may ask for a narrative about how the agency plans to provide the required services. This may include 

more specific information about the particular agency staff who will be working on this account (e.g., titles, 

functions, education, experience, accounts handled at current agency, accounts handled at previous employer, 

level of responsibility). You may also ask about discounts, bonuses, or pro bono work the agency will offer. 

Compensation 

You may ask bidding agencies to recommend how they should be compensated for their work on the campaign. 

This will help you understand how they typically charge clients and may highlight to you some innovative 

approaches to compensation. In addition, you may ask for a proposal for a performance-based contract or the 

agency position on performance-based contracts. A performance-based contract makes the agency more 

accountable for bottom line outcomes of campaign; one caveat is to make sure that your expectations are realistic regarding what the potential outcomes will be. Remember that the compensation proposal is only a starting 

point for contract negotiations. You may choose another compensation arrangement when you negotiate the 

final contract with the selected agency. 

Examples of Work 

You may ask for examples of creative executions, especially those most relevant to the current proposal, such 

as materials targeted toward teens if the proposal is for a youth antitobacco campaign, materials targeted 

toward Hispanics/Latinos if the proposal includes a Hispanic/Latinos component, etc. Examples of materials 

would normally be submitted in one or more of the following forms: videotape with TV and radio ads, photos 

of outdoor ads, copies of print ads, examples of brochures or other educational materials, and hard copies of 

Web pages. You may also ask for other materials or information related to the individual campaigns (e.g., campaign results, summaries of research, target audience development, campaign strategy from one completed 

campaign, PR plan, samples of press materials, media plan, event plan). 
390 Appendices 

Ideas for Addressing Your Campaign’s Goals 

Requesting the bidding agencies’ ideas about approaches to your campaign will help you gauge the level of 

strategic and creative thinking that they can bring to your program. The description of the agency’s proposed 

approach to addressing your campaign’s goals might include information on their understanding of the problem; strategic thinking about how to address the problem; identification of target populations(s); campaign 

strategies and action plans; description of media buying plans and strategy; PR strategy, including media coverage, promotional events, and integration with local programs and target population(s); links to existing 

tobacco control efforts; how research and evaluation would be conducted; general estimate of how funds 

would be allocated; use of existing resources and materials (e.g., CDC’s Media Campaign Resource Center, 

state clearinghouses); and input from external experts. 

It is not recommended that you ask the bidding agencies to develop and present new creative ideas or specific 

advertising executions. Creative development is very time-consuming and can only be done well when agencies have full knowledge about the issue and are fully immersed in the campaign development. If you do 

request or allow for new creative ideas to be presented, you will want to include a statement that the health 

department has ownership of ideas or adaptations of ideas contained in any proposal submitted, as well as the 

right to copyright them. 

Proposal Preparation and Submission 

Schedule/Timeline 

Provide information about bidder’s conference and any other pertinent dates. 

Application Deadlines 

Include date/time of deadlines for letter of intent (confirming intent to submit full proposal) and complete 

proposal package. 

Key Contact Information at Health Department 

Provide contact information for key health department staff that may be contacted regarding the RFP process. 

Include instructions for how to submit questions. 

Instructions for How To Submit Application 

Include date and time that application is due, address where applications should be sent, and whether faxed 

applications will be accepted. List the number of copies of the application required. Typically, agencies are 

asked to submit multiple copies so that the health department does not have to make copies of the proposals 

for the reviewers. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 391 

Instructions for How To Withdraw Application 

Provide information about how an agency can withdraw an application after it has been submitted. 

Reasons for Disqualification 

Possible reasons for disqualifying an application include the following: 

• Incomplete or late submission 

• Failure to meet requirements regarding lack of tobacco industry affiliation 

• Attempts to influence a member of review panel during the review process 

• Submitting application with false, inaccurate, or misleading statements 

• Unwillingness or inability to fully comply with proposed contract provisions 

Proposal Review/Evaluation/Selection 

Criteria for Evaluation of Proposal 

Proposals may be evaluated based on factors relating to the agency and staff (agency background, agency 

capabilities and experience, agency personnel, capabilities and experience of subcontractors), materials submitted (samples of work, strategic plan for campaign, proposed media strategies and plans, proposed budget 

and timeline), or quality of the proposal (clarity, creativity, innovation, quality, balance). You may choose to 

include in the RFP a point structure identifying the maximum number of points each section of the proposal 

can be awarded. You may choose to require oral presentations by some or all applicants. 

Information Regarding Review of Proposals 

List the stages of review process, whether the review sessions will be open sessions or closed to the public. 

Award Notification and Contract Negotiation 

Provide information about how (e.g., e-mail, fax) and approximately when applicants will be notified about 

results. You may choose to not send the final notification stating that an applicant has not been selected until 

after a contract is signed with the agency that is selected during the review process. If you are not able to agree 

on contract terms with the selected agency, then you may begin negotiating with the second choice. 
392 Appendices 

Other Rules/Information/Disclaimers 

Your state may choose to include some, none, or all of these stipulations: 

•	 	 The health department reserves the right to negotiate and clarify before entering into contract. 

•	 	 The health department reserves the right to amend the RFP prior to the proposal submission 

date. Applicants who have submitted a letter of intent by the required date shall be notified of 

amendments and will be afforded an opportunity to revise their proposal to accommodate the 

RFP amendment. 

•	 	 In the event that the health department is unable to execute a contract with the agency selected, 

the health department reserves the right to continue evaluations of other agencies and select 

another agency. 

•	 	 The RFP does not constitute commitment by the health department to award a contract. 

•	 	 Deliverables and other materials provided by contractor to the health department become the 

property of the health department. 

•	 	 A schedule of regular meetings between the agency and the health department will be required. 

•	 	 Reasons for termination of contract may be listed in the RFP. 

•	 	 The health department reserves the right to remove or replace subcontractors. 

•	 	 The health department assumes no responsibility or liability for costs incurred by bidders prior to 

contract award. 

•	 	 Confidentiality policies vary by state law. Some state health departments will not release information 

to bidders or anyone else regarding the content of any of the applications during the RFP process (or 

at any time). Other states require an open review process, proposals becoming public information at 

the end of review process, or both. 

•	 	 Some states have subcontracting policies or requirements. 

•	 	 Some states have affirmative action requirements. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 393 

Optional/Possible Appendices 

Your state may choose to include some, none, or all of these appendices. 

•	 	 Applicant Information Sheet. This might include information such as agency name and address, tax 

identification number, name of main contact at agency, and signed affirmation that statements 

contained in application package are true and complete. 

•	 	 Checklist for Responding to RFP. This would clarify what key elements must be included in proposal. 

•	 	 Proposal Evaluation Instrument or Evaluation Summary Sheet. This is the evaluation form used by 

reviewers to assess proposals. 

•	 	 Standard contracts agreements/forms. Some states have specific language required in all contract 

agreements or forms used in all contracts. 

•	 	 State contract terms and conditions (e.g., taxes, warranties, payments, indemnity, liability, insurance, 

termination, records maintenance, severability). 

•	 	 Signature Verification Form. This would serve as notarized proof that the individual signing is 

authorized to execute contracts on behalf of bidder or contractor. 

•	 	 Consultant/contractor submissions form/contractor data and certification form (might include 

information such as contractor name and address, tax identification number or social security 

number, contact information, and resume or statement of qualifications of key personnel). 

•	 	 Reference Review Form 

•	 	 Sample health department tobacco control program budget 

•	 	 Conflict of Interest Statement/Statement of Disclosure of Tobacco Industry Affiliation/Statement 

of Assurance 

•	 	 Certificate of Independent Price Determination. With this form, the bidder certifies that the prices 

in the proposal have been arrived at independently without consultation, communication, or 

agreement with any other bidder, and that the prices in the proposal have not been and will not be 

disclosed by the bidder, directly or indirectly, to any other bidder before bid opening or contract 

award unless otherwise required by law. 

•	 	 Outline of proposal format 

•	 	 Outline of line item project budget form 

•	 	 Errata, amendments, addenda 

•	 	 Instructions for oral presentations 

•	 	 Q&As 
394 Appendices 

Appendix 6.2: Questions and Answers on RFPs 
 

Issues Related to RFP Process 

1.	 How much time should the RFP process take? How much time should be allowed for 

each step in the process? 

Each state has different rules and schedules for the RFP (Request for Proposals) process, based on variables 

such as state restrictions and the state funding cycle. Thus, there is no golden rule, but there are some general 

considerations. The key is to allow sufficient time in each step to accomplish the work required, while not 

delaying unnecessarily the hiring of an agency. The entire process generally takes from six weeks to three 

months, but much more time can be required if contract negotiations are difficult or if a bidding agency contests the award decision. 

Here’s a general outline of the steps involved and the approximate time needed for each step: 

•	 	 Release of RFP. The RFP should be released as soon as possible, so an agency can be hired in a 

timely manner. 

•	 	 Deadline for Submission of Proposals. In general, four to six weeks is sufficient time for the agencies 

to put together proposals. 

•	 	 Bidders’ Conference. The bidders’ conference is a meeting held so possible applicants can obtain 

information they need to respond to the RFP. Enough time should be allowed to publicize the RFP and 

disseminate the information about this meeting to the potential bidders. The bidders’ conference 

should be held about midway in the four- to six-week period between the release of the RFP and the 

proposal deadline. This schedule gives agencies sufficient time after the bidders’ conference to determine whether they are still interested in submitting a proposal and, if so, to develop the proposal. 

•	 	 Technical Review of Proposals. The technical review is conducted to ensure that the agencies making proposals meet the criteria specified in the RFP and don’t need to be disqualified for any reason. 

This review should take place immediately after the proposals are due. Completion of the technical 

review by the appropriate state staff generally requires one to three days, depending on the number 

of proposals and the complexity of the technical requirements. 

•	 	 Review of Written Proposals. The process for review of written proposals determines the amount of 

time needed to complete this review. To ensure that all reviewers are able to attend, the dates for the 

review of written proposals should be set well in advance. 

If the review committee reads proposals in a room together, the review of written proposals can 

begin immediately after the technical review and usually lasts one to four days. The amount of time 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 395 

necessary to read, discuss, and score the proposals depends on the number of proposals and the 

length of the proposals. 

If the proposals are sent to the review committee to read before the committee convenes, the time 

required is approximately one to two weeks, including one to two days to discuss and score the proposals at the meeting. 

•	 	 Oral Presentations. Agencies that remain in the process after the technical review and the review of 

written proposals are given an opportunity to make oral presentations. At least two weeks should be 

allowed for preparation of these presentations. These presentations might include a review of creative products from previous campaigns. 

•	 	 Final Selection of an Agency. The final selection of the winning agency may be made after the oral 

presentations, on the basis of the scores calculated by the review committee. Some states require 

final approval by a state health department or a state contract officer. This requirement can add 

several days to the RFP process. 

•	 	 Signing of the Contract. The time elapsing before the contract is signed can vary from one week to 

more than one month, depending on factors that include the following: 

– How much specific information about requirements (e.g., compensation and scope of work) is 

laid out in the RFP 

– How much negotiation with the winning agency is necessary 

– Whether the decision is contested by one of the agencies that isn’t selected 

– How many levels of approval are necessary before a contract is made final. 

It’s advisable to wait to notify agencies that they haven’t been selected for further consideration until a final 

contract is signed and not contested. This approach allows you to consider the second or third choices in case 

a problem occurs with the top choice among the agencies. 

2. Should a bidders’ conference be held? 

Benefits of a bidders’ conference include the following: 

•	 	 Answers to questions can be provided at one time to all the potential applicants present. 

•	 	 A transcript of the conference or a summary of the answers can be put online. 

•	 	 The program manager sees the people and agencies that may be bidding and can estimate how 

many agencies will bid on the contract. 
396 Appendices 

The greatest potential negative is the time and energy involved in setting up such a conference. You’ll want the 

key health department staff involved in the RFP and the contracting process to be present, so scheduling a 

time when all are available may be difficult. In addition, you might not have all the answers to questions posed 

to you at the bidders’ conference and you’ll then have to follow up later. This problem can be avoided by asking that all questions be submitted in writing in advance. Then you can provide answers in person at the bidders, conference since you will have had time to prepare answers to questions submitted. 

An alternative to a bidders’ conference is to have all questions submitted in writing and provide answers 

online. You can announce the Web address in the RFP and make it clear that bidders can access the Web site to 

find updates and corrections to the RFP and answers to submitted questions. 

3. How should information be disseminated to potential bidders? 

Most states put the full RFP, along with information such as edits and updates to the RFP and answers to the 

bidders’ questions, on the contracts section of the state health department Web site. When there is a high level 

of publicity around spending of funds for the state tobacco control program, many agencies interested in this 

work will be aware that an RFP is being released. Some states send a copy of the RFP to all top agencies in the 

state, along with a cover letter inviting them to apply. In addition, there may be publications in the state that 

advertise government contracts. If your contract will be large enough and you want to attract agencies from 

outside the state, you might consider placing an ad in advertising industry publications such as Advertising 

Age, Ad Week, or Brand Week. 

4. Should health department staff perform site visits to the agencies that are bidding? 

Site visits allow you to see the work space and sense the tone of the environment in which the agency staff 

work, and these visits may help you to better understand the technical capabilities of the agency staff. Some 

states and organizations have found site visits to be very beneficial, but the vast majority of states don’t perform site visits, and they’re probably not necessary unless extenuating circumstances exist. 

5. How should the written proposals be scored? 

Methods for scoring the written proposals are different in each state. Some score sheets include a number of 

categories that correspond to the sections of the RFP. Other score sheets include sections addressing elements 

such as agency experience and knowledge, technical capability, previous creative, expertise in market research, 

experience with media campaigns targeting a particular population, and budget management. Most states set 

the criteria for scoring of the proposals. In some states, however, the reviewers are given the opportunity to 

provide input, and the final decisions on criteria for scoring rest with the health department. 

6. How should the process for review of written proposals be managed? 

There are several options for managing the process for review of written proposals, and states manage this 

process in different ways. Some states have reviewers read the proposals in advance; others have reviewers 

read the proposals together. Some states allow reviewers to share scores; others explicitly prohibit sharing of 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 397 

scores. Some states allow reviewers to change their scores after seeing all of the presentations; others do not 

allow such changes. You may have some flexibility in making these decisions, but some of the decisions will be 

mandated by state policy. Here are some methods states use to manage the review of written proposals, along 

with related benefits and drawbacks for each method: 

• Reviewers read proposals before meeting to discuss the proposals. 

–	 Benefits. If reviewers read the proposals before meeting, the discussion moves more quickly. 

Reviewers can read the proposals on their own schedule. They may be able to pay more attention 

to the details when they read alone than when they read in a group. 

– Drawbacks. Reviewers may forget the specifics of the proposals between the time they read them 

and the time of the meeting where the group scoring is done. Also, a large volume of proposals 

must be shipped or hand delivered to each reviewer. Reviewers must then bring the materials 

with them to the review session. In addition, some reviewers may not take the time to review the 

proposals before the review session. If there are a lot of proposals, review committee members 

may not have the time to thoroughly read each proposal. In that case, you can assign, in advance, 

one review committee member to report on each proposal to the group and have someone else 

be a second reporter, to add anything the first reporter missed. These two individuals would be 

responsible for reading the proposal most thoroughly, although others will read it, too. 

• Reviewers read the proposals when they come together in one room. 

–	 Benefits. If the proposals are read at a meeting, they don’t have to be shipped to reviewers in 

advance and brought back by the reviewers. Control and confidentiality of proposals are assured. 

Also, the information is fresh in the minds of the reviewers when they do the scoring. 

– Drawbacks. Reading in a group can be very distracting and tiring. Different reviewers read at different speeds, and the time devoted to each proposal may not be sufficient for adequate review. In 

addition, reading in a group takes longer than if reviewers come together after reading the proposals. It may be difficult for some review committee members to set aside such a large block of 

time from their busy schedules to participate in the reviews. 

• Reviewers are allowed to share scores with the committee. 

– Benefits. One benefit of sharing scores is that it allows a reviewer to gauge his or her scoring 

against the scoring by other members of the review committee. The committee can assess 

whether the scoring method is consistent among all the reviewers and can make appropriate 

adjustments for equitable scoring, if necessary. 

– Drawbacks. One potential drawback of sharing scores is that one reviewer with strong opinions 

may influence others on the review committee. 
398 Appendices 

• Reviewers are not allowed to share scores with the committee. 

– Benefits. A prohibition against sharing scores may ensure that reviewers are not influenced by 

scores of other reviewers. This approach may be more objective than the sharing of scores, and 

may be mandated by state contract policy. 

– Drawbacks. The main drawback of a prohibition against sharing scores is that different reviewers 

may use different methods to score proposals, and the review committee is not able to assess if 

scoring is inconsistent. 

• Reviewers are allowed to change scores after reading, discussing, and scoring all the proposals. 

– Benefits. Regardless of whether scores are shared with the rest of the review committee, it’s helpful for reviewers to be able change their scores after reviewing all the proposals. This is especially 

true for a reviewer who has never participated in an RFP review. After reading all the proposals, a 

reviewer has a better sense of the range of responses and can go back and view the first few proposals with a better perspective of what is good and bad in each of the proposals. 

– Drawbacks. Some reviewers may be unduly influenced by other committee members. Changing 

scores may add time to the process. In addition, changing scores may be prohibited by state contract policy. 

• Review committee meets in person. 

–	 Benefits. The importance of selecting a contractor probably justifies the requirement for a meeting of the review committee. For most states, the media campaign contract involves a large 

amount of money and a significant portion of the budget for the tobacco control program. The 

discussion and interpersonal interaction are critical to the decision-making process. 

– Drawbacks. A meeting of the review committee requires that reviewers travel to a central location, which may involve time and travel expenses. 

When there is no other alternative, one or more reviewers may participate in the review of written proposals 

by telephone. This option is rarely used and is not recommended, because of the value of having all the 

reviewers interact in person. 

7. Should the bidding agencies be required to make oral presentations? 

Oral presentations are very useful and should be required. They help to identify differences among the agencies that score well in the review of written proposals. Also, they often allow a better understanding of aspects 

of the agencies that don’t always come across in a written proposal. These aspects include factors such as work 

flow and procedures, creativity and style, and technical capabilities. 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 399 

8. Who should make the oral presentations for an agency? 

If possible, you should require that the individuals who will be your day-to-day contacts make part or all of the 

oral presentation. You can ask that specific people be part of the presentation team (e.g., the financial person, 

the primary client contact, and the creative lead). The oral presentation is an opportunity for you to meet the 

individuals who will work on the account and to determine whether you have “chemistry” with them. You 

want to avoid being “wowed” by the agency head(s) or other trained presenters, only to find that you’ll be 

working with lower-level staff once the agency is selected and contracted. 

You can also specify a minimum and/or maximum number of people to participate in the oral presentation. 

Usually agencies will want to include more people, so providing a minimum is not usually an issue. Some 

states limit the number of agency staff making the presentation within a range of five to 10. Other states don’t 

limit the number. You may choose to require that only the staff making the presentation be allowed to attend 

this RFP session, or you may allow additional agency staff to be present to answer questions. 

In general, you want enough agency staff present to give you a clear picture of what the agency has to offer, but 

not too many whose presence is unnecessary. Depending on the site for the oral presentations, space may be a 

limiting factor. 

9. How many agencies should be invited to make oral presentations? 

Ideally, you’ll want to invite a minimum of three qualified agencies to make oral presentations, to ensure that 

the review committee has an adequate number of agencies to review. In some cases, states have invited only 

two agencies to give oral presentations, because only two were qualified to move past the review of written 

proposals. 

Also, you should set a maximum number of agencies to make presentations. It’s not advisable to allow all the 

bidding agencies to give oral presentations, for several reasons: 

•	 	 Depending on how the scoring is configured (i.e., how many points are assigned in each phase of the 

review and whether the scores from each phase are cumulative), it’s usually not possible for an 

agency with a relatively low score after the review of written proposals to be a top scorer after the 

oral presentations. 

•	 	 Reviewers will find it difficult to listen to too many presentations, especially if they know that some 

of the agencies have no chance of winning the contract. 

•	 	 Preparation of an oral presentation requires an investment of time, money, and energy, so it’s not 

fair to ask agencies that have no chance of winning the contract to put this level of effort into the 

oral presentation. 

•	 	 Because you want to select an agency that does well in both written and oral communications, it’s 

beneficial to eliminate agencies that don’t submit a strong written proposal, even if they might be 

able to perform well in an oral presentation. 
400 Appendices 

•	 If the written proposal is of low quality, you may not want to give the impression to the agency that 

you think their work was good enough to merit the invitation for an oral presentation. 

10. How should the oral presentations be scored? 

As with the scoring of the written proposals, the methods for scoring oral presentations are different in each 

state. In many states, reviewers are allowed to provide a combination of number scores and written comments. In other states, reviewers can provide only a number score, but the score sheets leave space for reviewers to make notes that help them to determine their scores. Depending on the laws and policies of the state, 

the score sheets may become public record. Reviewers should be notified of this policy in advance, so they are 

aware that anything they write will be accessible to the agencies and anyone else interested in examining the 

score sheets. 

You’ll need to determine how many points to allocate for each phase of the review. Another important decision you must make is whether the final selection should be based on a total score from all phases of review or 

whether the score in each phase is used only to determine which proposals move forward to the next phase. 

Some states assign points during the technical review; others don’t score that phase but do eliminate proposals that don’t qualify. In other states, the scores for the written proposals determine which agencies are invited 

to give an oral presentation, and the scores for the oral presentation determine which agency is offered the 

contract. In still other states, the total score from all phases of the review process (technical review, review of 

written proposals, review of oral presentations, and review of creative) is the only factor used to award the contract. This strategy allows one phase of the review to be given more weight by assignment of more points to 

that phase. However, this option should be exercised with caution. If you choose to give more weight to the 

review of written proposals by assigning more points to it than are assigned to the oral presentations, be aware 

that if the written proposals have a wide range of scores, the reviewers of the oral presentations may not be 

able to influence the final outcome, because they have fewer points to assign. This outcome eliminates the 

benefit of having additional input for decision making, based on the review of the oral presentations. 

Some states don’t allow the review committee to make the final decision; instead, the committee is asked to 

make a recommendation. Then the health department makes the final decision. The reviewers’ qualitative 

comments can be helpful to the health department staff in their final determination, particularly when the 

scores are close. 

11. How should the review process for the oral presentations be managed? 

As with the process for review of the written proposals, there are several options for managing the process for 

review of oral presentations, and states manage this process differently. The comments in response to question 

6 about sharing scores and changing scores are also relevant here. 
Appendices 401 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

You should schedule enough time for each agency to set up (at least 15 minutes) and to make the presentation 

(one to two hours). Additional time is required for reviewers to ask questions of the agency (30 to 60 minutes) 

and then to discuss and score each presentation (30 to 45 minutes). Time is also needed for activities such as 

breaks and meals. You’ll need to provide a private and quiet room where the reviewers can talk while the next 

agency has access to the presentation room to set up for the oral presentation. 

12. What kinds of questions should agencies be given in advance of oral presentations, 

and which questions should be surprises? 

Providing each agency the same set of questions, either in advance or during the oral presentation, gives the 

reviewers some common ground for assessment and comparison of the agencies. Questions given to agencies 

in advance should call for responses that require planning, data gathering, alignment with agency management, or other time-consuming preparation. Surprise questions should require strategic thinking (specific 

choices or recommendations) related to the proposal. You should be able to ask the agency “why...?” in relation to any part of its proposal, because presumably everything in the proposal was developed with use of 

good strategic thinking. Some questions are appropriate either in advance or during the presentation; for 

example, “What potential media crises do you foresee on this account, and how would you respond?” 

To demonstrate levels of creative and strategic thinking, some states ask agencies to perform tasks such as 

putting together initial creative ideas or developing a proposed media placement schedule. You shouldn’t ask 

agencies to develop near-final ad executions as part of their written proposals or oral presentations. In addition to the time, cost, and energy required, such a task sets an agency in a particular direction without providing the necessary baseline data and input from the state staff. 

13. What is the ideal composition of a review committee? 

Many states have specific restrictions or policies that help to determine the makeup of the review committee. 

Such restrictions include requiring that all or a majority of the review panel live in the state or prohibiting state 

tobacco control staff from being on the panel. You need enough reviewers that the committee represents a 

range of backgrounds and expertise but not so many that the process becomes cumbersome. One member 

should have experience working with minority and diverse populations. 

Many states invite people who manage tobacco counter-marketing contracts in other states to serve on the 

review committee, because they’ve been through the RFP process and often can offer helpful insights from 

experience. You can ask people in other agencies within your state government that have large advertising or 

marketing contracts (e.g., the lottery, tourism, or agriculture). Also, you may want to include one or two people 

from national organizations who have worked with other states on their counter-marketing efforts and can 

offer a national perspective. For example, representatives from the Health Communications Branch of the 

CDC’s Office on Smoking and Health, the American Cancer Society, the Campaign for Tobacco-Free Kids, and 

other national organizations have served on review panels in a number of states. In addition, it’s helpful to 
402 Appendices 

have people on the committee who have experience working in advertising or marketing, either for an agency 

or as a client. Most people with such backgrounds have an in-depth understanding of how to develop a 

marketing plan and advertising campaign and how to select an agency. They are also likely to be able to see 

through the glitz of the written and oral presentations. 

14. Should the same committee review the written proposals and the oral presentations? 

Sometimes state regulations and policies determine whether the same panel must review the written proposals and the oral presentations. Some states require use of the same panel for both reviews; others have no such 

requirement. One benefit of having the same group for both reviews is that the reviewers can follow up during 

the oral presentations with specific questions about the written proposals. One benefit of having different 

groups for both phases is that a new person added to the panel for the oral presentations comes into the process 

with a fresh perspective and can assess the presentations without being influenced by the written proposals. 

Criteria To Aid in Selecting an Agency 

1. What are some of the issues with hiring an agency based in another state or city? 

Some states must select suppliers and contractors that are within the state, because government rules and 

policies require doing so or because if they don’t, they’ll be seen as giving business to other states and not supporting the local economy. In addition, if an agency from a state or city other than the location of the health 

department offices is selected, communications will be more difficult, because face-to-face interactions will be 

less frequent. Problems could result, because the state and the agency should be partners in most aspects of 

the campaign planning, execution, and evaluation; thus, the better the communication and interaction are, 

the more productive the work relationship can be. Nevertheless, it’s important that every state considers the 

best candidates available. Effective marketing and advertising are not easy to achieve, and a local firm should 

not be selected at the cost of compromising the quality of the work. States should “cast the net” as broadly as 

possible and then choose the best candidate on the basis of specified criteria. The criteria used to select the 

agency should always be clear and supportable in case they are later challenged by individuals or organizations outside of the selection process. 

2. What skills, experiences, and capabilities should be required of the ad agency? Of the 

public relations agency? 

The ad agency chosen should have experience in planning, implementing, and evaluating comprehensive ad 

campaigns. Agency staff should be familiar with the marketing mix (product, placement, packaging, price, 

promotion, and politics), so they understand the importance of each element and the interrelatedness of 

all the elements. They should have strengths in the areas of creativity and strategic thinking (i.e., making 

important choices about the direction of the communications plan). The work they produce should clearly 

show a balance between keeping a strong strategic focus and developing products that are insightful, interesting, and deliver an impact. The ad agency should have the following functions in house: (1) account services, 
403 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

(2) creative, (3) media planning and buying, and (4) research. In-house planning is optional, but more and 

more agencies offer this service, which is a cross between research and strategic planning. If the agency doesn’t 

do media buying or research in-house, agency staff may have sufficient experience with the function and a 

strong relationship with a subcontractor to provide these services through a subcontract. 

If a PR agency is to be selected, the staff of the PR agency should have experience in planning, implementing, 

and evaluating comprehensive PR campaigns. They must have in-depth experience interfacing with the media 

and should be able to show a track record of successful placements, for example, media coverage and stories 

that achieve high reach of target audiences, adequate frequency, exposure through major media outlets, and 

appropriate positioning of the issue and content covered. The staff should understand and show knowledge of 

the key tools for earned media (e.g., media kits, news conferences, editorial board meetings, press releases, 

and event planning). (See Chapter 8: Public Relations and Chapter 9: Media Advocacy for more information on 

these tools.) Ideally, they should understand and have experience working with ad agencies and other diverse 

partners. Also, if you’d like your agency to conduct media advocacy training sessions for your local coalitions, 

make sure that the agency staff have the necessary experience and that they understand the relationship 

between local coalitions and the state program. 

3. When should subcontractors be used? 

Subcontractors can be hired by the lead ad or PR agency when the agency doesn’t have the in-house expertise 

or resources to manage and execute a certain part of the contract. The lead agency shouldn’t subcontract 

major pieces of the campaign, but it may be difficult to find one agency that can meet all the needs detailed in 

the state’s RFP. By subcontracting, a strong lead agency can do what it does well and can manage the work of 

the subcontractors without executing the work themselves. Common examples are subcontractors who have 

expertise in communication with special populations, media-buying firms, PR agencies, and research firms, as 

long as they’re not conducting research to evaluate the effectiveness of the lead agency’s outputs. 

Subcontractors often report directly to the lead agency rather than the state health department, so their work 

is funneled through the lead agency. However, in some cases, it’s important to have the subcontractors interface directly with the state, so the state can more easily assess the expertise they bring, ask questions, and 

develop a positive working relationship with them. In addition, it may be beneficial to structure the contract so 

that, in the event you aren’t satisfied with the work, you’re able to replace the subcontractor without having to 

issue a new RFP. 

4. What size should the agency be? 

There’s no ideal size for an agency. The state must decide whether a large agency or a small agency better 

meets its needs. One advantage of small agencies is that you may be a large client to them, and if so, you’ll get 

plenty of their attention, including significant involvement from personnel in upper management, who are 

typically the most seasoned members of the agency. If you select a very large agency, the agency’s best people 

may not be assigned to your account, and personnel in upper management may not have time to spend on 

Appendices
404 Appendices 

your campaign. One advantage of large agencies is that they often have more internal resources. More of the 

important functions (e.g., account planning, media planning and buying, and research) are in-house, so 

they’re more directly available to you as the client. A large agency may also have a longer history and thus may 

have more experience in advertising and marketing. In addition, large agencies tend to be more stable, 

because they’re less vulnerable to economic upturns and downturns. Many states select an agency that has 

sufficient billings and internal infrastructure to do quality work but is small enough to consider the state’s 

account an important one. 

5. Is an agency’s connection with the tobacco industry acceptable? Should disclosure 

statements be required during the RFP process? 

The acceptability of hiring an agency that has connections with the tobacco industry is controversial. One 

view is that no links to the tobacco industry should be allowed, so even agencies owned by a company that 

does business with a tobacco company subsidiary should be prohibited from competing for a contract. The 

contention is that any links to the tobacco industry may compromise the quality of the agency’s work, because 

the agency will have a more important “master” to serve (i.e., management of the tobacco company). Another 

concern is that confidential tobacco control information that is shared with the agency could find its way into 

the hands of the tobacco industry. 

A different viewpoint is that if the links to the tobacco industry are weak (e.g., a subsidiary connection), the 

agency should be allowed to compete for a contract. The argument is that if the criteria are too restrictive, the 

health department or another lead state agency could rule out some of the best-qualified communication 

firms. Many of the top firms have some loose connection with the tobacco industry, because of the industry’s 

breadth of products and businesses. This view proposes that if the state sets high expectations for the agency 

(e.g., in a performance-based contract) and the agency performs well, the contract should continue. If the 

agency doesn’t perform well or if the state suspects that agency staff are not giving the campaign their best 

efforts, the contract should be terminated. 

Another consideration is how audiences will perceive your campaign if it’s known that the agency you chose 

has ties to the tobacco industry, however loose they may be. You may want to determine in advance whether 

your campaign messages will be credible to your audience and how your legislators may respond. 

Disclosure statements should be required of all agencies bidding for work on the state’s counter-marketing 

campaign, so RFP reviewers have knowledge of any affiliation with the tobacco industry and can assess it 

appropriately. In addition, it’s common practice to include in the contract with the ad agency a prohibition 

against accepting tobacco industry business while the agency is under the state contract. You must define 

what is meant by “accepting tobacco industry business.” 
Appendices 405 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

6. How heavily should experience with government programs be weighed? How important 

is experience with pro bono or public service programs or with campaigns related to 

health issues? 

The experience of an agency with government or public service programs should be considered in the RFP 

selection process. However, the most important strength that an ad or PR agency can bring to a contract is the 

ability to develop and execute effective communications. 

Experience working with the government is important because agencies must understand that the government 

doesn’t behave like most for-profit clients. State health departments are subject to many rules and administrative policies that must be followed. If an agency doesn’t understand the constraints the state has, it may have a 

slower start, may not take into account these constraints in terms of planning timelines, may not involve the 

necessary people in decisions, and may become very frustrated by a system that is unfamiliar to its staff. 

Pro bono experience may be considered important for at least two reasons, although neither of these reasons 

should make it a priority criterion for awarding a contract to an ad or PR agency. The first reason is philosophical. Pro bono experience may show the agency’s level of commitment to serving the community, not just profiting from it. The second reason is based on expertise. Pro bono work may give an agency experience working 

on issues relevant to tobacco control (e.g., youth drug use, gambling addiction, or referendum campaigns). 

Agency staff may gain perspective to help them better understand how to approach prevention of youth 

tobacco use, smoking cessation in adults, or reduction of exposure to secondhand smoke. 

Experience with a public service campaign may be important for the same reasons. In addition, if an agency 

has been able to secure free media placements for public service announcements, the staff may have expertise 

in getting the most media placements possible with limited or no funds. They may also have good relationships with media outlets and experience in acquiring bonus weight for media placement. 

Experience in a campaign related to health issues may give the agency insights into ways to approach the 

health issue of tobacco use. The task of influencing people to change behaviors related to tobacco use can be 

extremely challenging, and experiences addressing other types of behavior change to improve health may be 

applicable. In addition, such experience may make an agency more familiar with the workings of health 

organizations and government agencies that focus on health issues. 

Agencies bidding on a contract must do more than include in their proposals the names of campaigns they 

have worked on pro bono or with health organizations or government agencies. They should also be required 

to elaborate on how they developed and implemented the campaign(s), including the approaches they used; 

the insights they gleaned that helped them to create persuasive communications that had impact; the media 

vehicles used and why; and the results of the campaign(s). 
406 Appendices 

Other RFP Issues 

1. If an ad is produced by an agency, but the creative (the ad agency person whose job is to 

develop ideas for advertisements) who designed the ad leaves the agency and is hired by 

another agency, can the ad be used as an example of the former agency’s work, the work 

of the person who designed it, or both? 

There’s no clear answer to these questions. Agencies and agency personnel who produce creative materials 

will make individual decisions about which ads they’ll show as examples of their work. A good ad or ad campaign comes from both the individuals who create it and the whole agency. The individual Creatives will come 

up with the ideas, but the management always reviews the work and provides input to it. If an agency or an 

individual includes ads as examples in a proposal, you can ask questions about the ads to determine how 

involved they were in the development process and how much of their own thinking went into the ads. 

2. What are the advantages, disadvantages, and logistic considerations of using a 

performance-based contract for the agency? How should such a contract be structured? 

Performance-based contracts with agencies have been used by several states and by the American Legacy 

Foundation as a way to increase the accountability of the ad agencies, keep them focused on the bottom line 

of desired outcomes, and challenge them to achieve aggressive objectives. A performance-based contract can 

be developed in several ways. In the RFP, you can ask the prospective agencies how they would propose constructing the compensation package, including any performance-based elements. This request will heighten 

their awareness that you’re considering a performance-based contract, and it will give them an opportunity to 

share with you methods that have worked well with other clients. You should also ask some of the states and 

organizations that have used performance-based contracts for information, such as the wording they used 

and what changes they would make if they awarded a performance-based contract again. Typically, a compensation level is established for the work provided and the performance-based aspect allows the agency to earn 

additional compensation if the previously established objectives of the campaign are achieved. For example, 

the agency might be able to earn 5% more if the campaign achieves the objectives or perhaps 5% less if none 

of the objectives are achieved. 

The downside to performance-based contracts is that they don’t have the flexibility to take into account special circumstances. For example, the objectives may have been set too high in the face of a difficult political 

environment and lack of support from the legislature or the governor. On the other hand, the objectives may 

have been appropriate when the campaign started, but they didn’t take into account other tobacco control 

efforts that would help the campaign to accomplish its objectives, so their achievement became too easy. The 

use of absolute measures to gauge success, and thus compensation, doesn’t always take into account the 

volatility of the environment in which a campaign operates. 
Appendices 407 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

3. What questions should be asked to determine levels of expertise in media planning and 

media buying? 

Most state planners of media campaigns have limited expertise in the technical area of media planning and 

media buying. However, questions can be asked, either in the RFP or in an oral presentation, to determine an 

agency’s philosophy and level of expertise in media planning and media buying. Here are some of the issues to 

address in the questions: 

•	 Level of experience in securing bonus time for media placement and examples of success in securing 

media placement at low costs 

•	 Expertise in media buying in diverse media outlets (e.g., television, radio, outdoor, print, and the 

Internet) 

•	 Strategic thinking related to which media outlets, times of the day, and programs would be most 

appropriate for each of the campaign’s target audiences 

•	 The reach, frequency, and duration of media presence required to achieve the campaign’s awareness 

levels, and belief, knowledge, and attitude changes 

•	 Examples of clients for whom the agency has purchased media 

•	 Experience in selecting and buying media placements in all the state’s counties, not just in the big 

media markets 

The agencies submitting proposals should also clearly state whether they have the ability in-house to plan and 

buy media or whether they subcontract that work to outside experts. 

4. What are the advantages and disadvantages of creating a “brand”? Should bidding 

agencies be asked to provide their thinking on a brand for this campaign? 

Some states and organizations choose to develop a brand for their campaign; others choose not to develop a 

brand. This decision should be based on the campaign’s goals. If you think that having a recognizable label, 

identity, or badge to tie your campaign together and help your target audience develop an allegiance to your 

movement will help to achieve your goals, you should consider developing a brand. However, if you think your 

campaign’s ads should independently communicate strong messages and convey a sense of pervasiveness 

without being attached to an institution or organization, then a brand probably won’t serve you well. For 

example, if the goal is to reduce exposure to secondhand smoke, there may not be a strong reason to develop a 

brand, as long as the advertising messages are clear and compelling. However, if the goal is to reduce youth 

cigarette smoking by replacing that “badge” with another one, you may choose to develop a brand to associate 

with a nonsmoking lifestyle. As a result, youth may choose to wear attire with your brand, assuming that it’s 

cool, rather than choosing to pick up a cigarette when they’re with their peers. 
408 Appendices 

Developing a brand isn’t easy. A brand needs to be clear, recognizable, and meaningful and must have positive 

and desirable connotations among the target audience. It must represent something with which the target 

audience wants to associate or identify themselves.Those criteria are challenging to achieve. The downside is 

that if you don’t achieve one or more of these criteria, your effort may have no impact, or worse, your effort 

may backfire by causing the target audience to reject or make fun of your brand. It’s easy to see the attraction 

to brands like Nike, Coke, or Britney Spears, but it’s important to realize that for every brand that becomes cool 

or desirable, there are many, many more that are not considered cool or desirable at all. 

Depending upon your campaign goals, target audience(s), and budget, you may want to ask the bidding agencies to develop and present ideas for branding, including whether or not they think branding would help or 

hinder achievement of the campaign’s goals. 
Appendices 409 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 6.3: Elements of a Creative Brief
 

Purposes of a Creative Brief 

The creative brief includes key information gleaned from formative research and translates these research 

learnings into direction for the advertising agency creative staff (creatives) to develop communication 

materials. It serves as a link between the research and the creative process. The creative brief also helps 

bring everyone involved into alignment before development of materials begins. Once the individual(s) with 

responsibility for making the ultimate decision about creative materials has approved the creative brief, 

materials development can begin. 

Elements of a Creative Brief 

Below is a description of the most common elements included in a creative brief. There are many ways to 

design a creative brief, and different organizations and agencies will use formats that include some (or all) of 

these elements. 

Project Description and Background 

The specific assignment for the agency’s creatives. This section provides key background information and 

short-term tactical thinking to help bring the long-term strategy to life in the target audience’s current 

environment. The assignment might be a broad assignment such as the following: 

•	 Develop comprehensive introductory advertising for a new program designed to reduce exposure 

to secondhand smoke. 

•	 Develop a public education campaign designed to spur individual and community action to 

reduce young people’s access to tobacco products, especially by building support for local 

enforcement efforts. 

The assignment might also be as specific as the following: 

•	 Develop a new television advertising execution (sometimes called a “pool-out”) for a campaign 

in progress. 

•	 Create ads for billboards to supplement existing TV and print ads. 

Description of the Target Audience 

Identification of the target audience you want to reach. Examples of target audiences include the following: 

•	 Restaurant owners who smoke 

•	 11- to 15-year-old nonsmokers 

•	 African-American adult male smokers 
410 Appendices 

• Family members of smokers 

• Policy makers 

Target Audience Insights 

Descriptive details about the target audience. This should include specific information about demographics, 

lifestyles, psychographics, and other characteristics of the target audience that help the creatives develop 

materials appropriate for this audience. Creative materials are most persuasive when based on one or more 

insights into target audience beliefs or practices related to the concept, product, attitude, or behavior being 

addressed. These target audience insights can be positive or negative. They are the foundation for building the 

content of communications materials. 

One example of a target audience belief that might influence the creation of advertising executions encouraging youth not to smoke is that youth are more afraid of living a life of pain and physical problems as a result of 

smoking than they are afraid of dying from smoking, because their perception of death is vague and abstract. 

Goal(s) 

What you want the target audience to do as a result of hearing, watching, reading, or experiencing the communication. Examples include the following: 

• Increase knowledge about tobacco industry marketing practices 

• Change attitudes about exposing other people to secondhand smoke 

• Support policies restricting smoking in public buildings 

• Enter a smoking cessation program 

Obstacles 

Beliefs, attitudes, values, behaviors, or environmental factors that prevent the target audience from adopting 

the desired attitude or behavior. The obstacles are what stand between the audience and the desired attitude 

or behavior. Examples include the following: 

• Lack of knowledge of the harmful effects of secondhand smoke 

• The belief that smoking is not harmful if one smokes only occasionally in social settings 

• Tobacco industry financial support of community organizations 

• Smokers’ belief that they must quit on their own without getting help 
Appendices 411 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Key Promise/Key Benefit(s) 

Statement of the key benefit(s) or reward(s) (including emotional benefits, if appropriate) that the audience 

will experience for adopting the desired attitudes or behavior. The key benefit is something that will make 

changing to the desired attitude or behavior worth it for the audience. Examples include the following: 

•	 Ability to live long enough to see one’s children grow up 

•	 Saving oneself from great pain and suffering caused by smoking-related disease/illness 

•	 Being a good parent by protecting one’s children from secondhand smoke 

Statements of Support or Reasons To Believe 

A statement of support, a reason to believe, or evidence that adopting the desired attitudes or behavior will 

result in gaining the key benefits. These statements should be compelling enough to overcome the obstacles. 

Examples include the following: 

•	 Sharing the fact that smokers who quit live an average of 15 years longer than smokers who continue 

smoking throughout their lives, and showing middle-aged and older nonsmokers enjoying life with 

their children and grandchildren 

•	 Showing a credible portrayal of someone who became ill from smoking and revealing how difficult 

that smoker’s life became 

•	 Persuasively communicating the fact that children in households where smoking occurs inhale the 

same poisons as the smoker 

Brand Character 

Description of the brand’s image or qualities designed to appeal to the target audience (e.g., nurturing and 

helpful, strong and powerful, credible and trustworthy, or rebellious and independent). Because many tobacco 

counter-marketing campaigns are not based on a brand, this section is often not included in a creative brief. 

Copy Strategy 

A short paragraph developed to succinctly summarize what the advertising needs to achieve, including who 

the advertising is directed to, what action is desired, the key benefit(s) of taking that action, the reason(s) to 

believe that benefit will be realized if the action is taken, and the brand character (if relevant). The format of a 

copy strategy might be something like, “The television ad will convince A (target audience) to do B (desired 

action) because they will believe that doing so will provide them with C (key benefit). The reason to believe 

will be D.” 
412 Appendices 

Tone 

The feeling that the materials will convey (e.g., authoritative; positive and encouraging; heart-wrenching; 

supportive). 

Media Channels/Vehicles 

Media vehicle(s) for which creative materials will be produced (e.g., TV spot, radio spot, newspaper ad, 

billboard, transit ad, Web site, brochure, educational video). 

Executional Considerations/Creative Considerations/Mandatories 

Specifics that the materials should or must contain. Examples include the following: 

•	 Materials may need to be easily adaptable for local or national use; therefore, references to names 

of specific towns or states should not be included. 

•	 Materials must not alienate adults even though teens are the primary audience, because adults will 

be exposed to the materials as well. 

•	 The TV advertising must include a five-second tag at the end with the quitline number. 
413 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 6.4: Creative Brief, Florida
 

Creative Brief 

This briefing document is intended to give direction and inspiration to creative. It is the beginning of 

the process, meant to initiate the dialogue that is an ongoing part of the development of the work. 

It is a guideline. 

Client 

Florida Dept. of Health 

Product 

“truth” TV campaign 

Date 

6/9/00 

Why are we advertising at all? 

(A brief outline of our client’s business situation and the problem/ 

opportunity this ad needs to 

address.) 

In an effort to keep the Florida Anti-Tobacco “truth” campaign fresh, 

we would like to produce 2-3 low-budget, teen TV spots before the 

end of the fiscal year (July 2000). Ultimately, the teens want to play 

an important part in delivering the “truth” message to their peers 

through our TV spots. 

What’s this advertising trying to 

do? 

(What can we realistically hope to 

accomplish by running this ad? Be 

clear, be realistic, and if there’s more 

than one objective—prioritize.) 

By telling teens how the tobacco industry is manipulating them, we 

hope to continue to reduce tobacco use throughout the state of 

Florida. We want to give teens the knowledge of how the tobacco 

industry is manipulating them by portraying smoking as glamorous 

and smokers as attractive and appealing. Teens need to make their 

own decisions about whether or not they want to smoke. They need 

to control their own lives. We want to de-legitimize the tobacco 

industry and de-glamorize smoking. 

Whom are we talking to? 

(Imagine you’re at a party and you 

run into someone from our target 

audience. Describe him or her.) 

(Whom are we not talking to?) 

Teen target audience (12-17 year old males and females). Teenagers 

aspire to be older, so if we want to reach these teens, we must target 

the 25 year olds. 

What do we know about our target audience that will help us? 

(What is the relationship between 

these people and our product? How 

does it fit into their lives, how would 

their lives be different without it? 

What kind of language do they use 

to describe our product?) 

Teens have the need to rebel, take risks, fit in/be liked, be independent, express themselves as individuals and feel respected. The major 

force behind these needs is for teens to feel in control of their lives, 

behaviors, their look, whom they choose to be friends with, and 

where they choose to hang out. Tapping into teens’ need to rebel, 

the campaign should continue to depict tobacco use as an addictive 

habit marketed by an adult institution. 

Continues 
414 Appendices 

Appendix 6.4: Creative Brief, Florida (cont.)
 

Client 

Florida Dept. of Health 

Product 

“truth” TV campaign 

Date 

6/9/00 

What’s the main thought we need 

to communicate here? 

(Thought, not thoughts. The one 

thing we want them to take away 

that will change their behavior. This 

is the phrase that matters. It should 

be concise yet meaningful. Think of 

it as a billboard for the creatives.) 

The tobacco industry uses deceitful, manipulative and dishonest 

practices to hook new users, sell more cigarettes, and make more 

money. We need to expose these lies and give teens the choice to 

make up their own minds about smoking. 

Why should they believe this? 

(What support do we have to show 

that the “main thought” matters? 

Relevant facts and information 

based on both the rational and the 

emotional are welcome here. Attach 

detail of this support if it will assist 

in creative development.) 

Tobacco companies have, for years, worked to target and manipulate teens into smoking. They see teens as potential life-long customers. To date, “truth” has worked to replace the role tobacco plays 

in the lives of these teens and fulfill their needs. 

What’s the best way of doing this? 

(Is it: a slice of life, soft sell, case histories, animated? Tonality? Give a 

few executional suggestions. With 

the emphasis on suggestions.) 

To compete with the tobacco industry advertising, we need ambitious, hard-hitting, in-your-face executions. We need to continue to 

portray teens as rebellious activists with a sense of humor who are 

willing to expose the hypocrisy of adult institutions. We can show 

that not using tobacco can be a more rebellious and cool act than 

using tobacco. 

Mandatories 

(Things that have to be seen or 

heard in the advertising. Not 

opinions, ideas, speculations or 

suggestions.) 

Develop scripts that include Florida teens in the spots (i.e., phone 

calls). 

The State has decided not to use the spots that were produced for 

the national Truth campaign (i.e., body bags, lie detector, etc.) 

because they do not want to run the risk of airing these spots and 

then having them pulled off the air. Additionally, the spots that feature teens going to the tobacco company offices also have legal 

implications (i.e., trespassing). 

Planning	 Approval Client 

Creative 
Appendices 415 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 6.5: Creative Brief, Centers for Disease Control and
 

Prevention and World Health Organization
 

STRATEGY PLATFORM 

CLIENT: World Health Organization and Centers for Disease Control and Prevention Project 

PROJECT: “How To Quit” TV—Revised 

DATE: 12/13/00 

BACKGROUND—what is the situation? 

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) with other 

health organizations are committed to tobacco use reduction; making it a priority over the next three years. 

The goal is to reduce the use of tobacco products, thereby reducing preventable disease and death. Globally, 

four million deaths a year are attributed to tobacco use. If tobacco use continues, unchecked, this death rate 

is projected to rise to 10 million deaths annually by 2030. By 2020, 70% of tobacco-related deaths would be in 

developing countries. Most of the future tobacco-related deaths over the next 50 years will be those of adult 

smokers smoking today; thus governments concerned about making health gains for their citizens can make 

a significant advance by encouraging and helping adult smokers to quit. 

As part of the commitment to tobacco use reduction, quit tools need to be provided to countries to assist in 

the fight against tobacco. As mentioned, WHO and CDC are working with other partners to develop a TV spot 

that educates smokers on “how to quit.” There are many tools to aid quit attempts and it often takes more than 

one attempt to succeed. 

Historically, public service announcements (or paid media TV spots) on tobacco have focused on the health 

risks of smoking—both for active and, more recently, passive smokers. While this remains important, in many 

countries the vast majority of smokers are now aware of these risks; stating that they want to quit and have 

tried to quit several times in the past. Unfortunately, however, the vast majority of smokers try to quit unaided, 

without any support (behavioral or pharmacological), despite the fact that such treatments are available and 

have been clinically proven to significantly increase success rates. Therefore, there is also a need to educate 

smokers that effective treatments do exist, that going it alone is the least successful way of quitting and to 

encourage them to seek out and use such treatments. 

COMPETITIVE FRAMEWORK—whom are we competing against? 

General Overview 

The tobacco companies continue to sell tobacco and their advertising hasn’t changed to include the health 

risks or addictiveness associated with cigarette smoking. Other than the mandated warning labels specific to 
416 Appendices 

each country (each country has their own tobacco regulations) and any other enforced mandates, the 

industry does not disclose information about the health consequences in any of their marketing. The 

industry continues to expand around the world, in developed and developing countries. 

Specific to Quit Attempts 

In the context of helping smokers to quit, the competitor is “Cold Turkey”—the least effective, but most 

commonly used means of quitting. 

OBJECTIVES—what are we trying to accomplish? 

•	 Overcome the perception that the best way to quit is to go it alone. 

•	 Get smokers to think about quitting with help; reinforce that quitting isn’t easy and it’s okay if success 

isn’t achieved the first time. 

TARGET—whom we want to connect with (include demographics and psychographics): 

Adult smokers 18–49 

Smokers’ thoughts/behavior on quitting are varied: 

•	 Some are in denial that they are addicted and that they can’t quit—they feel they can quit whenever 

they are ready to. 

•	 Some are ready to quit now but still may not realize they need help to succeed. 

•	 Others feel the only way to quit is cold turkey. They are not receptive to help because they feel they should 

do it alone. Even if they have tried to quit before and have failed, they still feel that it’s their own responsibility to quit. They want to be in control. Accepting help shows weakness and lack of control. 

CURRENT RESPONSE—what the consumer would say about the brand and/or offer before advertising: 

I know I need to quit; when I am ready I’ll do it on my own. 

DESIRED RESPONSE—what we want the consumer to say after the advertising:
 

I know quitting is hard and I do need help; getting help doesn’t diminish my accomplishment of quitting. 


KEY SELLING MESSAGE 

Don’t quit alone; seek out help to improve your chances of success. 

MOTIVATING SUPPORT POINTS—why should the consumer believe us? 

•	 Cigarette smoking is addictive and it’s hard to quit. Success doesn’t happen overnight. With help, 

it could be achieved sooner. Quit tools to consider: quitlines, pharmaceutical products, cessation 

programs, and web sites. 
Appendices 417 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

•	 Being in the right mindset is crucial (wanting to quit) and having the willpower is critical but getting 

help will significantly increase chances of success. 

•	 Smokers have a tendency to get discouraged if success isn’t immediate; they need to feel this isn’t 

a reflection on them as a person. They need to know it’s okay to attempt more than once before 

success is achieved. 

Additional support points should be specific to the tags for pharmaceutical products or quitline support. 

For countries that don’t have either of the above, their tags could contain a more emotional message, such 

as a point about how much your family cares about you and wants you to succeed in quitting—needs to be 

discussed further. 

TONE 

Understanding and Encouraging 

EXECUTIONAL CONSIDERATIONS—media/timing, unit sizes, budgets, other client directives 

•	 One :30 TV spot - :25/:05 split – 25 seconds dedicated to message and 5 seconds dedicated to call-toaction. Once in the creative process, the second split will more accurately be determined—the tag 

may need 10 seconds especially when the support points are clarified and confirmed. 

•	 Individual tags (the 5 or 10 seconds) highlighting quitlines, web sites, cessation programs, pharmaceutical products so people know what “quit tools” are available and where to find them. 

•	 Translations to be considered being executed by individual countries to ensure appropriate 

dialect/language. 

•	 The organization’s name to be included and will change by country. Each country will be responsible 

for inclusion when translations are done (need to discuss this portion further). 

•	 Due to countries not being identified at this point and the fact this spot needs to globally applicable, 

the creative concept may need to be more visual and less talent heavy. This will be determined once 

creative development begins. 

•	 Budget: (not confirmed) 

•	 Timing: Available the week of May 7, 2001 
418 Appendices 

Appendix 6.6: Creative Brief, Centers for Disease Control 

and Prevention 

CDC/OSH Parenting Project 

Creative Brief 3/24/00 

Target Audience: 

Less-involved parents with children ages 7 – 11 yrs. 

Secondary Audience: 

Less-involved parents with children ages 0 – 6 yrs. 

Less-involved parents with children ages 12 – 18 yrs. 

Key messages: 

You have time to spend with your kids. 

Here’s how (tactics). 

Promise: 

Increased parent/child interaction will help establish protective barriers against future drug and tobacco use. 

Better communication with your child. 

Call to Action: 

Talk/spend time with your child. 

Content: 

Activities and/or tactics that parents can do, with minimal effort or time, with their children. 

Model desired behavior: parent/child interaction and communication. 

Tone: 

Fun, Simple, Casual and Friendly 

Creative Considerations: 

Television Commercial 

Print • Newspaper: TV Guide Section 

• TV Guide Magazine, regional 

• Fast Food Tray liners 

• Work Posters 

Radio – drive time 

Testing: 

Concept tested in focus groups (2). 

Materials tested in 1-on-1’s and with states. 

Distribution: 

Via CDC - through state anti-tobacco programs. 
Appendices 419 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 7.1: Sample Advertising Comment Organizer 

Understand 

•	 Do you understand the layouts? What’s happening in the storyboards? In the print ad? In the 

outdoor ad? 

•	 Do you understand the ad agency’s recommendation, if one was made? 

Evaluate 

Think about these questions for each creative execution. 

•	 What is your overall reaction? Consider each entire ad. 

– Does it have stopping power? 

– Is it a fast read? 

– How would you react as a member of the target audience? 

– Is it relevant? 

•	 Is it on strategy? If the strategy is clear and decisive, this question can be answered promptly. 

•	 What is your reaction to the key executional elements of the ad? 

– Does it clearly communicate the key benefit? 

– Are the visuals and language provocative? 

– Is brand identification sufficient if that is a goal? 

– Is the setup or layout simple and clear? 

•	 Are there any more details that should be considered at this time? Distracting visuals? Controversial 

elements? Be especially selective with any comments in this area so that you focus only on important 

details. 

Communicate 

Now it’s time to organize your thoughts and communicate them to the agency clearly and positively. Test each 

comment in your mind to make certain it’s necessary and constructive. 
Give the agency your overall evaluation of the advertising and state whether you agree or disagree with its 

recommendation of which creative execution(s) to further develop. 

Then deliver your specific comments, making sure the agency knows how strongly you feel about each comment. State specifically what you like and why, as well as what you don’t like and why. Focus on important 

issues rather than feeling that you must address every detail. 

•	 Strategy issues, if any 

•	 Overall issues 

– Engagingness/stopping power (the ability to attract and keep audience attention) 

– Simplicity and clarity 

– Relevance 

– Convincingness 

•	 Issues with key executional elements 

•	 Comments about details (if they are important to the ad’s potential effectiveness) 

Overall Considerations 

•	 Remember, you’re not the target. The target audience doesn’t have your knowledge base or experience, so what may be obvious to you may not be obvious to them. 

•	 Don’t try to say too much. You may be tempted to put a lot of copy points in an ad. Don’t! Try to stick 

with communicating one main message. The more focused you are, the more likely that target audience members will take away the key point. Remember that you’re competing with all other advertisers for the audience’s attention. 

•	 Keep your production budget in mind, but remember that the quality of the final ad (production 

value) does matter. Don’t select an advertising execution you can’t afford to produce, or it will look 

“homemade” and may be viewed as inferior or unprofessional to the audience, compared with other 

broadcast, print, or outdoor ads. 

•	 Take a chance. Sometimes you need to take a leap of faith to create break-through advertising. Use 

your instincts. Everything you do won’t be perfect, but if you always err on the side of “being safe,” 

your work will likely reflect that attitude and ultimately won’t be as effective as it can be. 

420 Appendices 
Appendix 7.2: Sample Storyboard—“Carnival”


A locked off shot of a carnival target shooting game.Instead of the usual duck that goes back and forth,the target is a cigarette.

Into the frame, rubber-suction-tipped darts are beingshot at the cigarette. At first, the cigarette just moves back and forth like a duck target would. As some of the shots get closer the cigarette 

dodges out of the way. All the shots miss. 

Suddenly a huge rubber-tipped dart (the size of a plunger) fliesinto frame and not only hits the cigarette...

VO: Unless, of course... 

but rips it from its stand and pins it to the wall behind thegame.VO: you have help. 

ARTCARD: For help quitting, call XXX-XXXX. 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 421

Appendix 7.3: Sample Storyboard—“Drive” 

VISUAL: A man and woman are driving

down the road. Not giving it any thought, themale passenger lights a cigarette in the car. 

VISUAL: Female driver looks over at lit

cigarette, scowls slightly, and purposelyveers car off road... 

VISUAL: ... flies through a ditch... VISUAL: ... and heads straight towards a tree. 

VISUAL: Male passenger is petrified.

MAN: What are you doing!?WOMAN: (Calmly) You’re endangering mylife...just returning the favor. 

VISUAL: Car safely veers back onto road. ART CARD: Last year, 53,000 people died

from secondhand smoke. 

ART CARD: We all have a good reason to

quit. What’s yours? 

422 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.1: Sample Printed Campaign Newsletter 

Continues 

Appendices 423 
Appendix 8.1: Sample Printed Campaign Newsletter (cont.)


424 Appendices 
Appendix 8.1: Sample Printed Campaign Newsletter (cont.)


Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Continues 

Appendices 425 
Appendix 8.1: Sample Printed Campaign Newsletter (cont.)


426 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.2: Sample Online Newsletter 

Online Tobacco-Free News 

Current information for the Wisconsin Tobacco Control Program 

Issue #28 

March 7, 2002 

This update has been brought to you by the Tobacco Control Resource Center for Wisconsin (TCRCW). 

Funding is provided by the Wisconsin Tobacco Control Board. Submissions to Online Tobacco-Free News are 

welcome. E-mail Emi Narita at enarita@facstaff.wisc.edu. 

Table of Contents 

Save the Date: April 18 & 19, 2002. The Statewide Tobacco Control Conference in Madison, WI 

Theme: Taking Tobacco Control into the Future - Protecting the Investment 

1) Maternal Smoking and Low Birthweight Data by County 

2) FACT Introduces FACT Field Guru, Adult Advisory Panel 

3) Smoke in Workplace Divides White and Blue-Collar Employees 

4) The Burden of Tobacco in Wisconsin 

5) Show Us the Money: An Update on the States' Allocation of the Tobacco Settlement Dollars 

6) New Items from the Tobacco Control Resource Center 

7) Thomas T. Melvin Youth Program Will Launch a Campaign to Promote Media Literacy 

8) Evaluation Resource for Coalitions 

9) 2002 National Conference on Tobacco or Health

10) State Budget Update 

More information about these topics can be found at the TCRCW web site: http://www.tobwis.org 

Appendices 427 
1) Maternal Smoking and Low Birthweight Data by County 

The Wisconsin Department of Health and Family Services publishes local data on infants and pregnant 

women. The Infants and Pregnant Women Report - 2000 has information on the number of low birthweight 

babies to mothers who smoked during pregnancy. Data is available for individual counties, selected cities, 

the five public health regions, and the state as a whole. On the same web page, you'll find the 1999 Public 

Health Profiles with local data on natality (such as smoking status of mother), drug-related problems, 

injuries, and much more. http://www.dhfs.state.wi.us/localdata/infantspgwomn/START.HTM 

2) 	 FACT Introduces FACT Field Guru, Adult Advisory Panel 

Luke Witkowski is the new Field Guru for FACT, the youth movement to fight corporate tobacco. He will 

attend coalition meetings to discuss FACT and work directly with the FACT members on their activism 

efforts. He has already traveled to many areas of the state to talk about FACT and provide support - now he 

wants to come to your coalition. To reach Luke, call him at 715-344-8206. The Nixon group has put together 

a guide for coalitions: Providing Effective FACT Support, The Coalition's Role. It can be downloaded from 

the tobwis web site: http://www.tobwis.org/media/coalitionrole_FACT.pdf (PDF file) In addition, a FACT 

Adult Advisory Panel has been created to support coalitions in their work with FACT. The panel will be 

made up of two to three coalition members from each region and will serve as a liaison between local and 

statewide efforts. Find out more at: http://www.tobwis.org/people/index.php (Go to "youth projects.") 

3) 	 Smoke in Workplace Divides White and Blue-Collar Employees 

Wisconsin employees are divided into two fairly distinct groups: blue-collar employees, subjected to secondhand smoke, and white-collar employees, who have clean air in their workplace, according to a study 

released this week by the University of Wisconsin's Monitoring and Evaluation Program. The study found 

that 40 percent of the workplaces that are traditionally considered blue-collar, allow employees to be 

exposed to secondhand smoke. This is compared to 13 percent of white-collar workplaces. The full report 

will be released in two weeks. More information on the press release: 

http://www.tobwis.org/media/WorkplacePress3_4.pdf 

4) 	 The Burden of Tobacco in Wisconsin 

Over 2,600 people in Wisconsin died of lung cancer in 2000 with 81 percent of those deaths attributed to 

cigarette smoking. Nearly 16 percent of all deaths in Wisconsin were attributable to cigarette smoking. The 

Burden of Tobacco Report describes the health and economic impact of cigarette smoking in Wisconsin. 

The summary of the report and press release is available at: http://www.tobwis.org/ Summary report: 

http://www.tobwis.org/media/BurdenFacts2_02.pdf (PDF file, 686 KB). 

428 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

5) 	 Show Us the Money: An Update on the States' Allocation of the Tobacco Settlement Dollars 

The full Jan. 2002 report on the State Tobacco Settlement is online at: 

http://tobaccofreekids.org/reports/settlements/ -- and interestingly, shows that Wisconsin has dropped in 

"Rankings of States by Level of Funding for Tobacco Prevention" from 13 down to 20 in one year. It may 

drop even lower with the state taking away the settlement money, but we won't know how or when it will 

be reported. The report, entitled "Show Us the Money: An Update on the States' Allocation of the Tobacco 

Settlement Dollars," was released by the Campaign for Tobacco-Free Kids, American Heart Association, 

American Cancer Society and American Lung Association. 

6) 	 New Items from the Tobacco Control Resource Center 

The Spring/Summer 2000 Tobacco Free List will be available in late March and will be available on our web 

site at: http://www.tobwis.org/resources/ Our staff mentioned to coalition members that we will give away 

novelty items such as key chains, rulers, and bookmarks, free of cost. This announcement was premature, 

since our supply of these specialty items is very limited. We will bring you samples of these items when we 

do outreach and give you a listing of places where these items can be ordered. We are sorry for any inconvenience. Emi Narita will help you find materials that the Resource Center does not have. Call her at: 608­

262-7469. Look for these new items on the Free List: 

TOBP015 "Butts Are Gross" 

TOBP016 "Licking an Ashtray" 

TOBP017 "Butts Are Gross" (Spanish) 

TOB049 Mind Over Matter: The Brain's Response to Nicotine (brochure) 

7) 	 Thomas T. Melvin Youth Program Will Launch a Campaign to Promote Media Literacy 

In mid-March, the Thomas T. Melvin Youth Tobacco Prevention and Education Program will launch a 

youth-led TV program and radio campaign to teach people about media literacy. The program will be packaged into a video and a B-Free curriculum that will be sent to all Wisconsin middle schools, as well as to the 

coalitions, the Wisconsin Tobacco Control Board members, and the regional public health offices. The curriculum will help youth explore issues introduced by the video, such as peer pressure and media tricks. It 

also raises issues implied by the theme of freedom from tobacco, such as addiction. Check out the new BFree web site: http://www.be-free.org 

8) 	 Evaluation Resource for Coalitions 

The Monitoring and Evaluation Program (MEP) has published a resource titled "Collecting Evaluation 

Data: An Overview of Sources and Methods". MEP has more specific evaluation resources, but this is a 

good starting point for doing evaluation. It will help you answer questions like: who will use the information and how? What will they or we want to know? The publication can be found at: 

Appendices 429 
http://cf.uwex.edu/ces/pubs/pdf/G3658_4.PDF This document can be downloaded, and there are bound, 

hard copies at UW-Extension. Other evaluation materials: 

http://www.uwex.edu/ces/tobaccoeval/manual.htm 

9) 	 2002 National Conference on Tobacco or Health 

November 19-21, 2002 • Hilton San Francisco • Call for abstracts deadline: March 25, 2002 

Submit your abstract online at http://www.tobaccocontrolconference.org 

The 2002 National Conference is looking for abstracts of presentations and workshops that will provide 

current scientific and practical information on effective tobacco control strategies and developments. All 

abstracts must be submitted online. 

10) State Budget Update 

Joint Finance voted on the budget yesterday. Like the Governor's proposal, the Republican plan uses 

the money the state will get from the tobacco settlement to pay for shared revenue. The Republican 

plan would shift $214 million from the tobacco endowment to the state's general fund. McCallum's 

plan would have used all the endowment. News article: 

http://wisconsinstatejournal.com/local/21684.html Budget Adjustment paper: 

http://www.legis.state.wi.us/lfb/2001-03BudgetAdjustment/Papers/1250.pdf 

Smoke Free Wisconsin and other partners will sponsor a training on how to "Develop Long-Term 

Relationships With Policymakers." Trainings will be held in each region beginning in March. More details: 

http://www.tobwis.org/events/ 

End Issue #28 

Send to Friends and Colleagues 

We encourage you to pass along this issue on Online Tobacco-Free News to your colleagues. If you received 

this issue from someone you know, and you wish to have your own subscription, please send a message to 

Emi Narita at enarita@facstaff.wisc.edu. 

Suggested citation: 

The Online Tobacco-Free News was reprinted with permission from the Wisconsin Clearinghouse for 

Prevention Resources/Tobacco Control Resource Center for Wisconsin. Funding was provided by the 

Wisconsin Tobacco Control Board. 

430 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.3: Sample Editorial
 

USA Today Editorial 

February 13, 2002 

Triple Threat to Teen Smoking 

States are suddenly lining up to hit the tobacco industry where it hurts, and teen smokers where it just 

might help — right in the wallet. 

In recent months, five states have raised cigarette taxes significantly, four of them to $1 or more per 

pack. Now, 18 more states, from Connecticut to New Mexico, are considering tax hikes, too, according 

to the American Lung Association, which releases its state tobacco report today. 

Tax increases are one of the most promising ways to deter smoking, especially among price-sensitive 

teens. When Oregon raised its cigarette tax 60% to 78 cents per pack in 1997, consumption dropped 

20% in the next two years. Among eighth-graders, smoking plummeted 30% in 1999, according to the 

Centers for Disease Control and Prevention. 

Typically, smoking deterrence is not the lure when states hike cigarette taxes. This year, just as in 2001, 

most states are driven by budget deficits. Cigarette taxes are simply a politically convenient target. 

If states were serious about public health, they’d use at least some of the proceeds to deter this deadly 

habit. Few do, even though teens are most likely to avoid cigarettes when states use a triple strategy: 

making cigarettes less affordable, less alluring and less available. That requires combining high-priced 

cigarettes with anti-smoking-ad campaigns and local programs to enforce laws against selling tobacco 

to minors. 

The trifecta works. California and Massachusetts, which used it, have seen the most sustained reductions in tobacco use in the nation. 

When states hike taxes without spending money to help their citizens quit smoking, they’re simply taxing 

the addicts of today. Worse, they stop short of keeping teens from becoming the addicts of tomorrow. 

© Copyright 2002 USA TODAY, a division of Gannett Co. Inc. 

Appendices 431 
Appendix 8.4: Sample Letter to the Editor
 

Tuesday, April 2, 2002 

Comments on today’s editorial and letters can be sent to The Guardian at letters@chg.southam.ca 

We must do more to help smokers 

Editor: 

Smoking has been well-established as harmful, not only to those who engage in it, but also to the health of 

those around the smokers. Smoking has great costs, not only in dollars to purchase the cigarettes, but also to 

health-decreased lung capacity, increased risks of cancer, smaller birth weight of babies, and a long list of 

other detrimental health effects. Smokers’ homes and clothes require increased cleaning time and energy over 

those of non-smokers. Those who work, live or happen to be passing though environments where smoking is 

permitted are at risk from the smoke. Families and the health-care system bear any costs of this addiction. The 

P.E.I.* Home Economics Association respectfully urges the government of P.E.I. to enact legislation to make all 

public spaces on P.E.I. smoke-free. Studies show this should lower the overall consumption of cigarettes. The 

government of P.E.I. has established a ‘Quit-Smoking Line’ (1-888-818-6300) to help smokers find cessation 

programs. P.E.I. and Islanders could only benefit from fewer people smoking. We also need to put increased 

resources into helping people quit smoking discouraging youth from beginning to smoke. Islanders would find 

it difficult to find someone who was happy to have started smoking or who was sad to have quit. What can we, 

as Islanders, do to lower the numbers of people smoking? Increased taxes, fewer places where smoking is 

allowed, subsidized or free smoking cessation programs, and counselling for lifestyle changes? We obviously 

have to do more than we are doing now. 

Shari MacDonald 

President, P.E.I. Home Economics Association 

* Prince Edward Island, Canada 

432 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.5: Sample Op-Ed
 

Pioneer Planet 

Published: Thursday, September 27, 2001 

VIEWPOINT State teens reaching peers with anti-smoking message 

BY JAN K. MALCOLM 

Guest Columnist 

Last month, teens from Minnesota’s teen-led Target Market campaign released survey results telling us that 

young people across the state are hearing Target Market’s anti-tobacco industry message. As a result, teen 

behaviors and attitudes toward the industry and tobacco use are changing—for the first time in more than a 

decade. The news from Target Market is an exciting sign that, after just one year, the campaign is doing precisely what Minnesota's youth designed it to do—reduce the number of underage smokers. 

The changes in attitude highlighted in the survey are important precursors to long-term reductions in youth 

tobacco use. If the trend continues, as we hope it will, it will be a real success story for the Target Market campaign and the state’s broader Youth Tobacco Prevention Initiative. 

When legislators and Gov. Jesse Ventura created the tobacco prevention endowment in 1999, they gave the 

Minnesota Health Department an important charge to use the resources wisely to produce long-term health 

gains for Minnesota’s youth. The stakes are high—in lives we can save and in future health care costs we can avoid. 

Our department took a very different approach from prior tobacco prevention campaigns. This time we 

empowered Minnesota youth themselves to lead a marketing effort that could speak credibly to young people 

about tobacco. That credibility requires that teens deliver the message peer-to-peer in their own voice, which 

is not always a voice adults understand. 

The survey results tell us that in just one year, Target Market’s edgy campaign has already successfully reached 

Minnesota kids. Ninety-three percent of Minnesota teens are aware of Target Market’s central message about 

the tobacco industry’s manipulation of youth. That’s an awareness level most consumer brands would envy. 

About three-quarters of the youth surveyed did not want to be targets of the tobacco companies, and more 

than half say they now feel they have the power to fight back and resist tobacco company marketing. 

Appendices 433 
Does the campaign really work? Will it lead to a long-term decline in Minnesota’s rates of youth tobacco use? 

We think it will, as long as the effort can be sustained over time. The survey results are an important first indication that youth smoking rates in Minnesota are on the decline. Compared to a survey conducted before the 

Target Market campaign began, the number of committed non-smokers increased by 20 percent in the past 

year, and the number of teens who said they might try smoking someday decreased by 25 percent. After more 

than a decade of significantly increasing youth tobacco use rates (which have been about 4 percent higher 

than the national average), the survey suggests the trend is on its way downward. 

Changing the social climate around tobacco use is the primary purpose of the Minnesota Youth Tobacco 

Prevention Initiative of which Target Market is a part. 

The Target Market campaign is the most visible part of these efforts, but statewide grants and grants to community coalitions working to help young smokers quit, making sure kids cannot buy cigarettes and providing 

education in schools are vital parts of what the Centers for Disease Control and Prevention recommend for an 

effective and comprehensive tobacco control program. Each strategy plays an important role in reshaping and 

reinforcing the attitudes our kids have toward smoking. 

The survey results indicate a phenomenal success for Target Market and the entire initiative. It tells those 

involved in Target Market and those working statewide and on the community level that their efforts are 

paying off. Our work, however, is far from done. 

The tobacco industry continues to spend millions each year on marketing its products in Minnesota. To reach 

the goal the Legislature and governor set for us to decrease youth smoking rates by 30 percent by 2005, we will 

have to continue to be aggressive, innovative and responsive to the evidence of what works. 

While the public health community is still David to the Goliath tobacco industry, the results from Target 

Market are exciting indications that these efforts can succeed. However, to turn these results into a sustained 

trend and long-term decreases in youth tobacco use, we must maintain our commitment to Target Market and 

all of the innovative, statewide strategies and community-based approaches we’re taking to decrease the number of Minnesota kids who use tobacco. 

We have an unprecedented opportunity to reduce the human and economic consequences that tobacco use 

has on our youth and our communities. When we succeed, it will be one of the best public health investments 

we’ve ever made. 

Malcolm is Minnesota commissioner of health. Contact her by e-mail at commissioner@health.state.mn.us. 

434 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.6: Sample Spokesperson Profile Sheet
 


If you are interested in serving as a spokesperson for the [INSERT NAME OF PROGRAM], please complete the 

form below. 

The information will be shared with members of the [NAME OF PROGRAM] media subcommittee and [NAME 

OF PR FIRM] public relations firm. A special spokesperson kit containing key talking points, background information, a full press kit about [YOUR STATE]’s tobacco settlement – as well as public speaking guidelines – will 

be sent to each spokesperson when asked to speak. 

Name: _________________________________________________________________________________ 

First Middle Last 

Title: __________________________________________________________________________________ 

Organization: __________________________________________________________________________ 

Address: _______________________________________________________________________________ 

_______________________________________________________________________________ 

Telephone: Business: ______________________ Home: ___________________________________ 

Pager: ________________________ Cellular: __________________________________ 

Fax: _________________________ E-mail: ___________________________________________________ 

Gender: ❑ Male ❑ Female Year of birth: ______________________________ 

Ethnicity: ❑ African American 

❑ Asian American 

❑ Caucasian 

❑ Hispanic/Latino 

❑ Native American 

❑ Other _____________________________________ 

(please check one) 

❑ I can speak on behalf of my organization 

❑ I can speak as a private citizen 

(please check one) 

❑ I am available to speak to broadcast media or newspaper editorial boards. 


I will need ____ days lead time. 


❑ I have limited time to speak. Please call me to check my availability. 

❑ You can sign my name to a letter to the editor for a local newspaper. 

Appendices 435 
Spokesperson Profile (page 2) 

Topics that I can speak on: (check as many as apply) 

❑ Medical information about health risks associated with tobacco use 


____ general ____ pregnant women ____ smoking and children 


❑ Statistical data about tobacco use in [STATE] 

❑ Personal testimony about the impact of tobacco product use 

❑ Youth perspective about the impact of tobacco use 

❑ Minority communities and the impact of tobacco use 

❑ General information about tobacco settlement monies and the importance of prevention, cessation, 

and education programs 

__________________________________________________________________________ 

__________________________________________________________________________ 

Briefly describe your public speaking experience: 

Name(s) of your local community newspaper. Describe any relationship or experience that you 

have with the paper. 

1. ________________________________ 2. ____________________________________ 

3. ________________________________ 4. ____________________________________ 

TV/radio/news talk show in your area: Name of show: _______________________
 


Host: ____________________________ Phone: _______________________________
 


Name of your U.S. congressional delegate: ____________________District: ______ 

❑ know very well 

❑ know marginally 

❑ do not know 

Name of state senator:________________________________________District: ______
 


____________________________________________❑ know very well
 


❑ know marginally 

❑ do not know 

Name of state representative: ________________________________ District: ______ 

❑ know very well 

❑ know marginally 

❑ do not know 

If you have additional questions about this form, please call [NAME] at [PHONE NUMBER]. 

Please fax this form to [CONTACT NAME] at [FAX NUMBER] by [DATE]. 

436 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.7: Sample Pitch Letter
 


(Type pitch letters on your organization’s letterhead. Adapt to reflect local data before sending to a reporter. Use to 

introduce an idea, to make an interview offer, or as a cover sheet for additional information that accompanies 

the letter.) 

[DATE] 

Dear [NAME OF NEWS DIRECTOR or REPORTER], 

Every day, more than 2,000 of our American youth become regular tobacco smokers. Roughly 28 percent 

of U.S. high school students and nearly 13 percent of middle school students currently smoke. Right here in 

[INSERT LOCAL DATA and/or ANECDOTE HERE TO LOCALIZE THE ISSUE.] 

In an effort to prevent youth smoking in our community, [ORGANIZATION NAME] is launching a youth 

tobacco counter-marketing program. Our goal is to increase awareness about how the tobacco industry 

influences our youth, parents, and others who work with youth in [CITY OR COMMUNITY NAME], and how 

we can all work together to prevent that negative influence. 

[NAME], [ORGANIZATION] director, will be available for interviews on this issue, and we would like to 

schedule a time when he/she could talk with someone from [THEIR NEWS ORGANIZATION]. I will contact 

you in the next few days to make arrangements for the interview. 

If you have any questions, please call me at [PHONE]. I look forward to working with you. 

Sincerely, 

[YOUR NAME] 

[TITLE] 

For more help on crafting pitch letters, visit http://www.altonmiller.com/pitch.htm. 

Appendices 437 
Appendix 8.8: Sample News Release
 


FOR IMMEDIATE RELEASE 

POLL SHOWS ILLINOIS VOTERS SUPPORT TOBACCO PREVENTION SPENDING 

(Springfield, IL - November 17, 1999) Ninety-one percent of Illinoisans favor spending a portion of the 

settlement funds on programs that help children and teenagers stop smoking and prevent others from starting 

to smoke, says a poll released today by the Half for Tobacco Prevention campaign. Additionally, 79 percent 

support spending on programs to help adults quit smoking. 

“The people of Illinois want this money spent on tobacco prevention,” said Ronald Johnson, M.D., 

President-Elect of the Illinois Academy of Family Physicians. “An overwhelming majority of people see this 

tobacco settlement windfall for what it really is – a once-in-a-lifetime opportunity to undo the damage done 

by the tobacco industry over the last few decades.” 

The poll also revealed that nearly half of registered voters would be less likely to vote for a candidate who 

opposes programs that advocate tobacco control, smoking prevention and that help people stop smoking. 

Today’s announcement comes as part of “Operation Half the Pie,” a campaign designed to educate the public 

and key leaders on the importance of establishing a comprehensive tobacco control and prevention plan in 

Illinois. Another aspect of today’s event was the delivery of half of a pumpkin pie to every member of the 

General Assembly to illustrate what the campaign is asking for – half of the settlement “pie” put exclusively 

towards tobacco control and prevention. 

Why half? According to recommendations from the U.S. Centers for Disease Control and Prevention, that’s what 

is necessary in order to provide an effective tobacco control and prevention program in Illinois, including: 

• a media and public awareness campaign that will deglamorize tobacco use, especially among youth 

• strengthening and continuing to develop effective community-based programs 

• cessation services for those who want to stop smoking 

• 	a strong surveillance, evaluation and research component to ensure that funds are being put to the best 

use possible 

• 	a funds administration system so that the money is secure, accessible and free of the tobacco industry’s 

influence 

• enforcement of public policies that restrict the sales and marketing of tobacco products to youth 

438 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

“Another fact that this survey revealed is that more than half of the smokers in our state are either currently 

trying to quit smoking, or have tried in the past,” said Dr. Johnson. “But the state spends just 2.4 cents 

per person per year on tobacco control and prevention. Why should anyone be surprised to hear that nearly 

twenty thousand Illinoisans die each year because of smoking-related diseases? It’s time for the General 

Assembly to listen to the medical and public health community of this state, as well as the people, and use 

this money to make a real impact on tobacco use.” 

The poll was conducted October 26-28 by McKeon & Associates, asking Illinoisans statewide about their views 

on the state’s tobacco settlement and possible spending options for the funds. The sampling error is +/- 3.8 

percentage points. 

Backed by more than 65 public health organizations and physicians associations across the state, Half for 

Tobacco Prevention includes the American Heart Association, American Lung Association, American Cancer 

Society, Illinois State Medical Society, Illinois Academy of Family Physicians, Illinois Association of Public 

Health Administrators and the American Academy of Pediatrics, Illinois Chapter among its members. 

### 

To schedule an interview with a campaign member, please call Citigate Communications at 312-895-4715. 

Appendices 439 
Appendix 8.9: Sample Fact Sheet
 


440 Appendices 
Appendix 8.9: Sample Fact Sheet (cont.)
 


Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Continues 

Appendices 441 
Appendix 8.9: Sample Fact Sheet (cont.)


442 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.9: Sample Fact Sheet (cont.)
 

Continues 

Appendices 443 
Appendix 8.9: Sample Fact Sheet (cont.)
 


444 Appendices 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendix 8.10: Media Contact Record
 


Date of contact: __________________________________ Time: _________________________________________ 

Handled by: _______________________________________________________________________________________ 

Name of Contact/Editor/Reporter: ___________________________________________________________________ 

Title: ______________________________________________________________________________________________ 

Name of Publication/TV Station/Radio Station: ________________________________________________________ 

Address: ___________________________________________________________________________________________ 

Telephone Number(s): _______________________________ Fax Number(s): _______________________________ 

Circulation/Audience/Reach: ________________________________________________________________________ 

Deadline/Schedule: _________________________________________________________________________________ 

Purpose of call: _____________________________________________________________________________________ 

circle one: incoming call outgoing call 

Response provided over phone: ______________________________________________________________________ 

Mailed/faxed/e-mailed the following information: _____________________________________________________ 

Arranged interview with: ____________________________________________________________________________ 

Additional follow-up required: _______________________________________________________________________ 

Date story ran/will run: _____________________________________________________________________________ 

Other Comments/Miscellaneous Information: 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

___________________________________________________________________________________________________ 

Appendices 445 
Appendix 10.1: Georgia Burden of Tobacco Brochure
 

446 Appendices 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Continues 

Appendices 447 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


448 Appendices 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


Continues 

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 449 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


450 Appendices 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Continues 

Appendices 451 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


452 Appendices 
Appendix 10.1: Georgia Burden of Tobacco Brochure (cont.)


Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Appendices 453

454 Notes 
Designing and Implementing an Effective Tobacco Counter-Marketing Campaign 

Notes 455

Feedback Form


The Centers for Disease Control and Prevention would 

like to hear from you about your experience with 

Designing and Implementing an Effective Tobacco 

Counter-Marketing Campaign. 

To prepare future editions of this manual, we would appreciate any comments or suggestions. 


To share your opinions, please complete the tear-out card on the next page and drop it in the mail. 


If you prefer to send comments via e-mail, please send them to CampaignManualFeedback@cdc.gov.


To order additional copies of Designing and Implementing an Effective Tobacco Counter-Marketing


Campaign, please contact the CDC Media Campaign Resource Center at mcrc@cdc.gov 


or call 770-488-5705, press 2.


Thank you.


456 Feedback Form 
Feedback Form


Tear Along Perforation 

To share your comments or suggestions about Designing and Implementing an Effective Tobacco CounterMarketing Campaign, answer the questions on this form, carefully tear the form out of the manual, fold it in 

half, tape it closed, and drop it in the mail. Thank you! 

1.	 Overall, how useful did you find the manual? (Please check one.) 

❑ very useful ❑ somewhat useful ❑ not useful 

Why? ________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

2.	 Did you find the book to be: 

a. well organized? ❑ yes ❑ no 	 c. up to date? ❑ yes ❑ no 

b. easy to read? ❑ yes ❑ no 	 d. relevant to your work? ❑ yes ❑ no 

3.	 If you answered “no” in question 2, please explain. ______________________________________________________________ 

____________________________________________________________________________________________________________ 

4.	 Please mark which chapters of the manual you have read: 

❑	 Introduction ❑ Chapter 6: Managing and Implementing 


Your Counter-Marketing Program
 ❑	 Chapter 1: Overview 

❑	 Chapter 7: Advertising ❑	 Chapter 2: Planning Your Counter-


Marketing Program ❑ Chapter 8: Public Relations 


❑	 Chapter 3: Gaining and Using Target ❑ Chapter 9: Media Advocacy 


Audience Insights
 ❑	 Chapter 10: Grassroots Marketing 

❑	 Chapter 4: Reaching Specific Populations ❑	 Chapter 11: Media Literacy 

❑	 Chapter 5: Evaluation 

5.	 Which chapters, if any, did not meet you needs? Why? ____________________________________________________________ 

____________________________________________________________________________________________________________ 

6.	 How useful did you find the following sections in the back of the manual? 

Resources and Tools: ❑ very useful ❑ somewhat useful ❑ not useful ❑ didn’t review 

Glossary: ❑ very useful ❑ somewhat useful ❑ not useful ❑ didn’t review 

Appendices: ❑ very useful ❑ somewhat useful ❑ not useful ❑ didn’t review 

7.	

____________________________________________________________________________________________________________ 

What was most useful in the manual? Why? ____________________________________________________________________ 

8.	 What was least useful? Why? __________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

9.	 What best describes the scope of your work? (Check all that apply.) 

❑ local ❑ state ❑ national ❑ international ❑ non-U.S. 

10. What kind of organization do you work for? (Check all that apply.) 

❑ tobacco control program 	 ❑ university 

❑ market research firm 	 ❑ independent consultant 

❑ tobacco control coalition	 ❑ advertising/public relations firm 

❑ non-profit/voluntary organization/network ❑ other	 __________________________________________________ 

11. 

____________________________________________________________________________________________________________ 

What other resources or Web sites should be included in the manual? ____________________________________________ 

12. 

____________________________________________________________________________________________________________ 

How might this manual be improved? __________________________________________________________________________ 
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Centers for Disease Control and Prevention 

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