Ex post outcome impact evaluation on ex-smokers campaign : final report – annex B : evaluation evidence.
Date: 2016-02-08
Institutions: Directorate-General for Health and Food Safety
Subjects: case study, health policy, public awareness campaign, public health, smoking, tobacco

Ex post outcome impact 
evaluation  
on Ex-smokers campaign 

Final Report – Annex B:  
Evaluation evidence 

Written by 

December 2015 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
December 2015 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ex post outcome impact 
evaluation  
on Ex-smokers campaign 

Final Report – Annex B:  
Evaluation evidence 

December 2015 

3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PREPARED BY: 

Andrea Kobilsky, Melanie Kitchener and Karolina Wrona 
Coffey International Development 
109 Baker Street, London, W1U 6RP, United Kingdom 

and 

Economisti Associati srl 
Via Rialto, 9, 40124 Bologna, Italy  

and 

CEMKA S.A.S 
Boulevard du Maréchal Joffre, 92340 Bourg-La-Reine, France  

and  

Lihero Instituto Universario Carlo Cattaneo (LIUC) 
Corso Matteotti, 22 Castellanza (Varese), Italy 

and 

IBF International Consulting S.A. 
Avenue Louise 209A - 1050 Brussels, Belgium 

Specific contract No 17.030100/14/687339 implementing Framework Contract No SANCO/2012/02/11-Lot 1 

December 2015 

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LEGAL NOTICE 

This document has been prepared for the European Commission however it reflects the views only of the 
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Luxembourg: Publications Office of the European Union, 2015 

ISBN 978-92-79-54972-4 
doi: 10.2875/268229 

© European Union, 2015 

Reproduction is authorised provided the source is acknowledged. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Table of Contents 

1.  DESK-BASED RESEARCH OF CAMPAIGN MONITORING DATA ............................13 

1.1.  Introduction to the campaign’s Key Performance Indicators .........................13 

1.2.  First KPI: campaign reach ........................................................................14 

1.3.  Second KPI: impact, awareness and call to action .......................................19 

1.4.  Third KPI: on-line word of mouth ..............................................................25 

1.5.  Fourth KPI: registration and conversion .....................................................34 

2.  ON-LINE SURVEY WITH NATIONAL STAKEHOLDERS AND PARTNERS .................42 

2.1.  Introduction ...........................................................................................42 

2.2.  Profile of respondents ..............................................................................42 

2.3.  Levels of campaign awareness ..................................................................43 

2.4.  Effectiveness of campaign tools and channels .............................................44 

2.5.  Effectiveness of campaign messages .........................................................48 

2.6.  The campaign in perspective ....................................................................49 

2.7.  Campaign outcomes and impacts ..............................................................49 

2.8.  Perceived main strengths and weaknesses and future recommendations .......51 

2.9.  Examples of successful communication tools and activities in the Member 

States ...................................................................................................53 

2.10. 

On-Line Survey Questionnaire for Stakeholders (EN) .............................56 

3. 

IN-DEPTH INTERVIEWS WITH NATIONAL STAKEHOLDERS AND PARTNERS ........64 

3.1.  Introduction ...........................................................................................64 

3.2.  Main features of the campaign – perceived strengths and areas for 

improvement .........................................................................................65 

3.3.  National contexts ....................................................................................67 

3.4.  Campaign design ....................................................................................68 

3.5.  Campaign implementation and results .......................................................70 

3.6.  Recommendations for future initiatives ......................................................75 

3.7.  Interview Guide for National Stakeholders .................................................77 

3.8.  Interview Guide for Campaign Ambassadors ..............................................79 

4.  ON-LINE PANEL SURVEY WITH SMOKERS AND EX-SMOKERS IN 6 COUNTRIES ...81 

4.1.  Introduction ...........................................................................................81 

4.2.  Smoking habits ......................................................................................82 

4.3.  Quit attempts and experiences .................................................................85 

4.4.  Recall of “Ex-smokers are Unstoppable” campaign ......................................94 

4.5.  iCoach ...................................................................................................97 

4.6.  Future intentions to quit smoking ........................................................... 101 

4.7.  Internet use and access ......................................................................... 102 

4.8.  Composition of the sample ..................................................................... 106 

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4.9.  On-Line Panel Survey Questionnaire (EN) ................................................ 108 

5.  FOCUS GROUPS WITH SMOKERS AND EX-SMOKERS ..................................... 117 

5.1.  Findings for Austria ............................................................................... 117 

5.2.  Findings for Bulgaria ............................................................................. 123 

5.3.  Findings for Germany ............................................................................ 127 

5.4.  Findings for Greece ............................................................................... 131 

5.5.  Findings for Lithuania ............................................................................ 138 

5.6.  Findings for Spain ................................................................................. 145 

5.7.  Focus Group Discussion Guide with Smokers (EN) ..................................... 154 

5.8.  Focus Group Discussion Guide with Ex-Smokers (EN) ................................ 157 

6.  PHONE INTERVIEWS WITH iCOACH USERS .................................................. 160 

6.1.  Introduction ......................................................................................... 160 

6.2.  Public health information campaigns ....................................................... 160 

6.3.  “Ex-smokers are Unstoppable” campaign ................................................. 161 

6.4.  Quit attempts ....................................................................................... 163 

6.5.  Quit aids .............................................................................................. 164 

6.6.  Experiences using iCoach ....................................................................... 165 

6.7.  Ideas for future messages  and actions against smoking ............................ 165 

6.8.  Interview Guide for iCoach Users (Smokers) (EN) ..................................... 167 

6.9.  Interview Guide for iCoach Users (Ex-Smokers) (EN) ................................ 169 

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Annex B: Evaluation evidence 

List of figures 

Figure 1: Smokers 25-34 (in mill) targeted vs reached ..........................................15 
Figure 2: Share of campaign channels (in %s) .....................................................15 

Figure 3: Number of articles targeted versus generated ........................................17 

Figure 4: Media coverage by media type (in %s) ..................................................17 

Figure 5: Top-performer countries in nr of articles ................................................17 

Figure 6: Bottom-performer countries in nr of articles ...........................................18 

Figure 7: Penetration of top 4 campaign messages (%s) .......................................19 

Figure 8: Message penetration by media type (%s) ..............................................19 

Figure 9: Smokers: campaign executions will encourage me to stop smoking (%s) ...20 

Figure  10:  Non-smokers:  campaign  executions  will  encourage  smokers  to  stop 
smoking (%s) ..................................................................................................21 

Figure 11: To what extent do you agree / disagree that the campaign is trying to say  
that “stopping smoking is a great achievement”? (Totally agree + agree - %s) ........21 

 Figure 12: Campaign call to action (CtA) (%s) ....................................................23 

Figure 13: CtA - All respondents vs smokers (%s) ................................................23 

Figure 14: Outcoming WoM per regions (%s) .......................................................24 

Figure 15: Outcoming WoM – smokers vs non-smokers (%s) .................................24 

Figure 16: Incoming WoM per regions (%s) .........................................................25 

Figure 17: Incoming WoM – smokers vs non-smokers (%s) ...................................25 

Figure 18: Evolution of page views (in %s) ..........................................................28 

Figure 19: Evolution of traffic sources (in %s) ......................................................28 

Figure 20: Evolution of Unique Active FB Users.....................................................33 

Figure 21: Evolution of FB fans and interactions ...................................................33 

Figure 22: iCoach registrations as a percentage of the number of smokers per country 
(in %s) ...........................................................................................................39 

Figure 23: Type of organisation of respondents (in numbers) .................................43 

Figure 24: Country in which respondents’ organisations operate (in numbers) ..........43 

Figure 25: Campaign  awareness (in %s) ............................................................44 

Figure 26: Participation in campaign activities (in %s) ..........................................44 

Figure 27: Knowledge about the campaign (in %s) ...............................................44 

Figure 28: Effectiveness of tools and channels (avg ranking) .................................45 

Figure 29: Awareness of tools and channels (in %s) .............................................45 

Figure 30: Effectiveness of campaign messages (avg ranking) ...............................48 

Figure 31: Agreement with campaign statements (in percentages) .........................49 

Figure 32: Agreement with campaign outcomes (in percentages) ...........................50 

Figure 33: Agreement with campaign longer-term impacts (in percentages) ............51 

Figure 34: Rauchfrei!  homepage ........................................................................53 

Figure 35: Smoking status of respondents (in percentages) ...................................82 

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Figure 36: Current smokers by sub-groups (in percentages) ..................................83 

Figure 37: How old were you when you started smoking? (in percentages) ..............83 

Figure  38:  Average  number  of  cigarettes,  cigars,  pipes  smoke/d  per  day  (in 
percentages) ....................................................................................................84 

Figure 39: Light smokers ( ˂10 cigarettes p/day (in %s) .......................................85 

Figure 40: Heavy smokers (+20 cigarettes p/day (in %s) ......................................85 

Figure 41: Attempts to quit smoking (in percentages) ...........................................86 

Figure 42: Current smokers who tried to quit by sub-groups (in percentages) ..........86 

Figure 43: How long did you stop smoking in your most recent attempt to quit? (in %)
 ......................................................................................................................87 

Figure  44:  Smokers  who  stopped  for  less  than  a  week  vs  smokers  who  stopped  for 
more than six months (in %s) ............................................................................87 

Figure  45:  Which  services  or  products  have  you  tried  to  help  you  stop  smoking?  (in 
%s, multiple responses) ....................................................................................88 

Figure 46: Which reasons led you to stop smoking or to think about stopping? (in %s, 
multiple responses) ..........................................................................................90 

Figure  47:  Main  benefits  experienced  after  quitting  smoking  (in  %s,  multiple 
responses) .......................................................................................................92 

Figure 48: Challenges experienced after quitting smoking (in %s, multiple responses)
 ......................................................................................................................93 

Figure 49: Spontaneous campaign recall (in %s) ..................................................95 

Figure 50: People who spontaneously recall the campaign (in %) ...........................95 

Figure 51: Aided campaign recall by sub-groups ...................................................96 

Figure 52: Aided campaign recall by sub-groups ...................................................96 

Figure  53:  Where  did  you  see,  read  or  hear  any  part  of  this  campaign?  (in  %s, 
multiple responses) ..........................................................................................97 

Figure 54: Spontaneous iCoach recall (in %s) ......................................................97 

Figure 55: Spontaneous iCoach recall by sub-groups .............................................98 

Figure 56: Combined iCoach recall by sub-groups .................................................98 

Figure 57: Have you visited iCoach? (in %s) ........................................................99 

Figure 58: Visited iCoach more than once by sub-groups (in %s) ...........................99 

Figure 59: Have you subscribed to iCoach? (in %s)...............................................99 

Figure 60: Visitors who subscribed to iCoach by sub-groups (in %s) ..................... 100 

Figure 61: To what extent has iCoach helped you to stop smoking? (in %s) ........... 100 

Figure 62: Likeliness to subscribe to iCoach (in %s) ............................................ 101 

Figure 63: Very + fairly likely to subscribe (in %s) ............................................. 101 

Figure 64: Intention to stop smoking next year (in %s) ....................................... 102 

Figure 65: Definitely + probably intend (in %s) .................................................. 102 

Figure 66: Frequency of internet use (in %s) ..................................................... 103 

Figure 67: Internet use several times a day (in %s) ........................................... 103 

Figure 68: Access to the internet: for how long? (in %s) ..................................... 103 

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Annex B: Evaluation evidence 

Figure 69: Those with access for +6 years (in %s) ............................................. 104 

Figure 70: Main sources of access (in %s, multiple resp.) .................................... 104 

Figure 71: Main sources of access (in %s, multiple resp.) .................................... 105 

Figure 72: In which ways have you used the internet in the last three months? (in %s, 
multiple resp.) ............................................................................................... 105 

Figure  73:  The  three  top  reasons  for  using  the  internet  in  the  last  3  months  (in %s, 
multiple resp.) ............................................................................................... 106 

Figure 74: Gender of respondents (in %s) ......................................................... 106 

Figure 75: Age of respondents (in %s) .............................................................. 106 

Figure 76: Level of education of respondents (in %s) .......................................... 107 

Figure 77: Working status of respondents (in %s) .............................................. 107 

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Annex B: Evaluation evidence 

List of tables 

Table 1: Overview of campaign’s KPIs .................................................................13 
Table 2: Overview of campaign’s total reach through paid advertising – targets versus 
results for Years 1 to 3 ......................................................................................14 

Table  3:  Overview  of  campaign’s  media  coverage  generation  –  targets  versus  results 
for Ys 1 to 3 .....................................................................................................16 

Table  4:  Overview  of  campaign’s  key  messages  penetration  –  targets  versus  results 
for Years 1 to 3 ................................................................................................18 

Table 5: Impact of campaign executions – targets versus results for Years 1 to 3 .....20 

Table 6: Campaign awareness – targets versus results for Year 3 ...........................21 

Table 7: Campaign call to action – targets versus results for Years 1 to 3 ................22 

Table 8: Overview of campaign’s website statistics – targets versus results for Years 1 
to 3 ................................................................................................................26 

Table 9: Campaign number of visits to website – per country per year ....................27 

Table 10: Overview of campaign’s temporary website statistics ..............................29 

Table 11: Impact of campaign executions – targets versus results for Years 1 to 3 ...29 

Table 12: Facebook pages Unique Active Users – per country per year ....................30 

Table 13: Facebook fans – per country per year ...................................................31 

Table 14: Facebook interactions (likes, comments, shares) – per country per year ...32 

Table 15: On-line media campaign ......................................................................34 

Table 16: Overview of registrations to iCoach– targets versus results for Years 1 to 3
 ......................................................................................................................35 

Table 17: Number of visits to iCoach website – per country per year .......................36 

Table 18: Number of registrations to iCoach – per country per year ........................37 

Table 19: Number of registrations to iCoach as a percentage of the number of smokers 
per country ......................................................................................................38 

Table  20:  Estimation  of  the  number  of  smokers  quitting  based  on  number  of  log-ins 
amongst non-responding registered users ...........................................................40 

Table  21:  Estimation  of  the  number  of  smokers  quitting  based  on  number  of  log-ins 
amongst non-responding registered users ...........................................................41 

Table 22: Overview of stakeholders interviewed (per country and per group) ...........64 

Table 23: Key themes and types of questions in the on-line panel survey ................81 

Table 24: How old were you when you started smoking? .......................................84 

Table 25: Which services or products have you tried using to help you stop smoking? 
(by sub-groups) ...............................................................................................89 

Table 26: Which reasons led you to stop smoking or to think about stopping? (by sub-
groups) ...........................................................................................................91 

Table  27:  What  have  been  the  main  benefits  that  you  experienced  after  quitting 
smoking? (by sub-groups) .................................................................................93 

Table 28: Which, if any, of the following have you experienced after quitting smoking? 
(by sub-groups) ...............................................................................................94 

Table 29: Austrian participants’ responses to different quit messages ................... 119 

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Annex B: Evaluation evidence 

Table 30: Bulgarian participants’ responses to different quit messages .................. 124 

Table 31: German participants’ responses to different quit messages .................... 128 

Table 32: Greek participants’ responses different types of messages ..................... 132 

Table 33: Greek participants’ responses to different quit messages ....................... 133 

Table 34: Participants’ responses to different quit messages ................................ 140 

Table 35: Spanish participants’ responses different types of messages .................. 147 

Table 36: Spanish participants’ responses to different quit messages .................... 149 

Table 37: Overview of stakeholders interviewed (per country) ............................. 160 

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Final Report 
Annex B: Evaluation evidence 

1. 

DESK-BASED RESEARCH OF CAMPAIGN MONITORING DATA 

1.1. 

Introduction to the campaign’s Key Performance Indicators 

The  Ex-smokers  campaign  set  out  to  achieve  four  Key  Performance  Indicators  (KPIs) 
during the second and third years of the campaign. 

The KPIs were agreed with the Commission at the outset of each campaign year and 
were  then  assessed  against  the  campaign  monitoring  data  collected  in  the  Annual 
Analytical Reports presented at the end of each campaign year. 

The table below features an overview of the main KPIs and parameters set: 

Table 1: Overview of campaign’s KPIs  

KPIs 

Parameters 

Explanation 

Total reach 

Engagements of the 
reached audience 
(introduced in Year 3) 
Media coverage 
generation 
Key message 
penetration 

  Total number of 25-34 year old smokers 
reached across the EU 27 Member States 
through paid advertising 

  Total engagement number of the target 

audience reached by the campaign  

  Total number of individual news articles 

generated across the EU 27 Member States  
  Total percentage of media coverage generated 

to incorporate 3 of the 5 key campaign 
messages 

Impact  (Years 1 and 2) 

  Percentage of smokers who said the campaign 

executions would encourage them to stop 
smoking (GfK post-tests) 

  Percentage of ex-smokers who said the 

campaign executions would encourage smokers 
to stop smoking (GfK post-tests) 

Awareness  (Y3) 

  Agreement with “stopping smoking is a great 

achievement” 

Call to action 
Likes 

  Average call to action of all campaign executions 
  # likes to the Unstoppable Facebook pages/1000 

fans 

Comments 

  # comments to the Unstoppable Facebook 

pages/1000 fans 

Shares 

  # shares to the Unstoppable Facebook 

pages/1000 fans 

iCoach registrations 

  Total number of registrations on iCoach 

Reach 

Impact and 
call to action 

On-line word 
of mouth 

Registration 
and 
conversion 

The  following  sections  provide  the  evaluation’s  analysis  of  the  different  KPIs  set  and 
the campaign’s results in each of the key areas. 

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Final Report 
Annex B: Evaluation evidence 

1.2. 

First KPI: campaign reach 

The main focus of the campaign was to reach smokers aged 25 to 34 in the EU, which 
amounted to about 27.9 million people across the EU 27 Member States. A selection of 
14  priority  countries  was  made1,  with  a  view  to  prioritising  the  target  audience  of 
young adult smokers in those countries. 

The  first  parameter  set  to  measure  campaign  reach  was  total  reach  through  paid 
advertising.  As  reflected  in  Table  2  and  Figures  1  and  2  below,  the  campaign 
exceeded the initial targets set for Years 2 and 3 (no initial target was set for Year 1). 
The  targets  for  the  second  and  third  year  of  the  campaign  were  calculated  based  on 
the  results  obtained  for  the  first  year  and  taking  into  account  the  decreased  annual 
media budgets (40% media cut from Y1 to Y2 and an additional 8% media cut from Y2 
to Y3).  

Table 2: Overview of campaign’s total reach through paid advertising – targets versus results for 
Years 1 to 3 

Year 

Y1 

Initial 
target 
N/A 

19,354,142 

Results / reach 

Comments 

Y2 

11,612,
500 

13,656,819 (World No 
Tobacco Day - WNTD) 
11,478,431 (Xmas) 
9,861,670 (Sep cont.) 

Y3 

9,774,8
19 

12,623,481 (Quit Smoking 
with Barça - QSWB) 
9,104,546 (Day of the Ex-
Smoker - DOES) 

  69% of target audience reached in Y1 
  On-line was main channel: reached 15 

million people 

  TV reached 5.9 million people 
  Print reached 3.6 million people 
  Media budget cut from Y1 to Y2: 40% 
  Goal exceeded for Y2 (WNTD) 
  WNTD: 48.9% of target reached versus 

41.6% planned 

  Xmas: 41.1% of target reached 
  Sept (continuity campaign): 35% of target 

reached 

  Mobile + on-line main channels (significant 

differences with print, TV and other 
channels) 

  Media budget cut from Y2 to Y3: 8% 
  Goal exceeded for Y3 (QSWB campaign) 
  QSWB: 45.2% of target reached versus 

38% planned 

  DOES: 32.6% of target reached 
  Mobile + on-line main channels  

(significant differences with print and TV) 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

The campaign reached 19.3 smokers in the target age group during its first year. For 
the second and third years, it was difficult to estimate an aggregate number of people 
reached as monitoring data are available for the different initiatives undertaken and it 
is  likely  that  the  activities  would  have  reached  the  same  /  similar  audiences.  The 
activities around World No Tobacco Day in Year 2 and those around the Quit Smoking 
with Barça initiative in Year 3 were judged to be highly successful in reaching smokers 

1  The  campaign  priority  countries  were  Germany,  Spain,  France,  Poland,  United  Kingdom,  Italy,  Romania, 
Greece, Netherlands, Bulgaria, Hungary, Czech Republic, Portugal and Austria. 

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Annex B: Evaluation evidence 

in the target age group. Digital channels (mobile and on-line) were the main channels 
used  by  the  campaign,  representing  a  60%  share  of  paid  media  in  Year  1,  and 
increasing  to  more  than  80%  in  Years  2  and  3.  TV,  which  amounted  to  24%  of  the 
campaign’s total paid advertising reach in Year 1, decreased significantly in the second 
and  third  years  to  less  than  2%.  Print  channels  maintained  relatively  similar  levels 
throughout  the  campaign,  always  below  a  20%  share  in  comparison  to  the  other 
channels used.  

Figure 1: Smokers 25-34 (in mill) targeted vs reached         

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Figure 2: Share of campaign channels (in %s) 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

The  second  parameter  under  campaign  reach  (introduced  only  in  the  third  year  to 
capture  more  accurately  the  response  to  the  DOES  campaign)  aimed  to  capture  the 
engagement  of  the  target  audience  that  was  reached  by  the  campaign.  The 
target  that  was  set  at  the  outset  of  Y3  (following  benchmarks)  was  a  total 
engagement number of 0.1% of the reached target audience. 

According to campaign registers, the  DOES campaign achieved a 0.24% engagement 
rate, representing 2.4  million engagements in the form  of tweets, video views, clicks 
to the ex-smokers’ site, mobile engagements, mentions to the campaign, etc. 

The third parameter was linked to media coverage generation which was meant to 
complement  the  reach  of  paid  media  analysed  above.  As  reflected  in  Table  14  and 
Figures  6  and  7  below,  the  campaign  significantly  exceeded  the  initial  targets  set  for 
Years 2 and 3 (no initial target was set for Year 1). The targets for Years 2 and 3 were 
set slightly above (10% increase) to the result obtained for Year 1.  

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Annex B: Evaluation evidence 

From  the  campaign  monitoring  data  reviewed  by  the  evaluation,  it is  not  clear  which 
criteria  were  used  to  set  these  targets.  On  the  other  hand,  both  targets  appear  to 
have been quite conservative. Even though the overall annual budgets for the second 
and third years of the campaign were 40% lower than the budget for the initial year, 
the  portions  of  the  budget  assigned  to  media  relations,  stakeholders  engagement, 
partnership events and specific initiatives, tended to be more balanced from one year 
to  the  other.  Timings  were  also  considerably  longer  for  Years  2  and  3,  which  should 
have  been  a  factor  to  take  into  account  when  proposing  the  targets  for  number  of 
articles generated. 

Table 3: Overview of campaign’s media coverage generation – targets versus results for Ys 1 to 3 

Year 

Y1 

Initial 
target 
N/A 

Results 

860 articles 
generated 

1,600 articles 
generated 

Y2 

950 articles 
generated 
(10% 
increase 
from Y1) 

Y3 

950 articles 
generated 
(= as Y2) 

3,075 articles 
generated 

Comments 

  Combined total of 356,826,614 impressions 
  From Sep 2011 onwards2 majority of coverage 
generated through on-line (60.7%) and print 
(24.7%) media 

  Top five countries in terms of media clippings: 

Slovakia, Slovenia, Italy Spain, Poland 

  Results for Y2 represent 168% of initial target 
  Combined total of 1,653,980,207impressions 
  Majority of coverage generated through on-

line (76%) and print (16%) media 

  Top five countries to generate the most media 
clippings: Germany, Italy, Bulgaria, Poland, 
Spain 

  Results for Y3 more than  triplicated initial 

target 

  Combined total  of 2,806,447,542 impressions 
  Majority of coverage generated through online 

(86%) and print (9%) media 

  Top five countries to generate the most media 
clippings: Spain, Romania, Germany, Bulgaria, 
UK 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

The  Ex-smokers  campaign  generated  a  total  of  5,535  articles  in  the  media.  The 
number of articles produced in the second year of the campaign almost duplicated the 
number  of  articles  generated  in  Year  1,  and  a  similar  increase  was  registered  from 
Year  2  to  Year  3.  In  a  similar  line,  it’s  interesting  to  note  that  the  number  of 
impressions  in  Year  2  were  more  than  four  times  higher  than  the  number  of 
impressions for Year 1. In the last year of the campaign, impressions – which were 1.7 
times higher in Year 3 than they had been in Year 2 – grew at a similar rate than the 
number of articles. Overall, the number of articles published increased 3.6 times and 
the number of impressions grew 7.9 times between Years 1 and 3 of the campaign. 

On-line and social media were the main channels covering the campaign, registering a 
steady increase of their share from almost 70% in the first year, to 86% in the third 
year.  Conversely,  campaign  articles  in  print  channels  recorded  a  gradual  decrease 
from  25%  in  Year  1  to  9%  in  Year  3.  Campaign  coverage  in  TV  and  radio  was 
significantly lower, with an average 2.5% for TV and 2.4% for radio. 

2 Data not available for the soft campaign launch 

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Figure 3: Number of articles targeted versus generated             

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Figure 4: Media coverage by media type (in %s) 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

As  reflected  in  Figure  5  below,  Spain  (435),  Germany  (375),  Bulgaria  (328),  Italy 
(317)  and  Poland  (274)  were  the  five  countries  that  generated  the  most  press 
clippings  during  the  campaign.  The  in-country  variations  from  year  to  year  can  be 
attributed to specific initiatives taking place, such as the QSWB in the third year or the 
Berlin Marathon in the first year.  

As  shown  in  Figure  6,  the  bottom  performer  countries  in  terms  of  number  of  articles 
published  were  Ireland  (22),  Denmark  (37),  Luxembourg  (39),  Sweden  (45)  and 
Finland (54). In line with other evaluation findings, the Ex-smokers campaign was less 
successful  in  the  Nordic  countries.  Low  coverage  in  small  countries  like  Luxembourg 
and  Malta  can  be  explained  by  the  lesser  number  of  publications  /  media  outlets  in 
those countries in comparison to larger Member States.  

Figure 5: Top-performer countries in nr of articles    

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3)               

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Figure 6: Bottom-performer countries in nr of articles 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

The  fourth  and  final  parameter  established  to  measure  campaign  reach  was  key 
messages  penetration.  The  objective  of  the  campaign  was  to  incorporate  key 
messages  through  the  media  coverage  generated.  As  can  be  seen  in  Table  4  below, 
the campaign significantly exceeded the initial targets set for Years 2 and 3 (no initial 
target  was  set  for  Year  1).  However,  the  targets  set  for  Years  2  and  3  were 
considerably  lower  than  the  result  obtained  for  Year  1.  The  four  main  messages 
monitored  by  the  campaign  were  the  “Ex-smokers  are  Unstoppable”,  the  “European 
Commission” brand, “iCoach”, and the “Ex-smokers.eu website”.  

Table 4: Overview of campaign’s key messages penetration – targets versus results for Years 1 to 3 

   Year 
Y1 

Initial target 
N/A 

Results 
  Ex-smokers are Unstoppable included in 

Y2 

Y3 

50% of all media coverage 
generated to incorporate 3 of 
the 5 key campaign messages 

83% of messages 

  European Commission included in 82% 

of messages 

  iCoach included in 69% of messages 
  Ex-smokers are Unstoppable included in 

92% of messages 

  European Commission included in 92% 

of messages 

  iCoach included in 68% of messages 
  ex-smokers.eu website included in 76% 

of messages 

50% of all media coverage 
generated to incorporate 3 of 
the 5 key campaign messages 

  Ex-smokers are Unstoppable included in 

92% of messages 

  European Commission included in 91% 

of messages 

  iCoach included in 83% of messages 
  ex-smokers.eu website included in 40% 

of messages 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

As reflected in Figure 7, the Ex-smokers and European Commission messages showed 
very  similar  results.  Both  messages  were  included  in  slightly  more  than  80%  of 
articles  in  the  first  year  of  the  campaign,  and  consolidated  further  in  Years  2  and  3, 
with more than 9 in every 10 articles incorporating these messages. iCoach messages, 
which were incorporated in nearly 70% of all campaign-related articles in the first two 
years  of  the  campaign,  registered  an  increase  in  the  final  year  to  83%  of  articles 

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Annex B: Evaluation evidence 

making  reference  to  the  platform.  Conversely,  the  ex-smokers  website  recorded  an 
important decline, from 76% of campaign articles that made reference to the website 
on the second year to 40% who mentioned it in the third year.  

Figure 8, which compares message penetration by media type, shows that all four key 
messages registered a very similar coverage with a clear preponderance of on-line and 
social  media  channels  over  print,  TV  and  radio.  Messages  relating  to  iCoach  and  the 
ex-smokers.eu  website  were  slightly  more  represented  on-line  than  the  Ex-smokers 
are Unstoppable and European Commission messages, which received more mentions 
on print and TV channels.   

Figure 7: Penetration of top 4 campaign messages (%s)           

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Figure 8: Message penetration by media type (%s) 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

1.3. 

  Second KPI: impact, awareness and call to action 

The second KPI focused on the  effects that the campaign had on the target audience 
that it reached. In other words, it aimed to analyse the relevance of the campaign and 
its key messages and to assess if the campaign had encouraged people to take action. 

The  first  parameter  was  campaign  impact  and  its  evolution  was  monitored  by  two 
variables  on  the  campaign  annual  post-test  measurements  carried  out  by  GfK, 
namely: 

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  Percentage of smokers surveyed who thought that the campaign executions they 

had been exposed to would encourage them to stop smoking; and 

  Percentage of non-smokers surveyed who thought the campaign executions they 

had been exposed to would encourage smokers to stop smoking. 

As reflected in Table 5, campaign targets for this parameter were only set for Year 2, 
even  though  the  results  were  also  available  for  Year  3.  According  to  the  Annual 
Analytical Report for Year 3, it was decided to introduce a new parameter in the final 
campaign  year  (awareness)  because  the  final  campaign  momentum  was  intended  to 
increase awareness as opposed to driving registrations to iCoach.  

The  table,  which  presents  the  average  results  for  the  different  campaign  executions 
tested  (TV  ads,  banners,  print),  shows  that  the  campaign  reached  the  target  set 
amongst smokers and that it slightly exceeded the target amongst non-smokers. Non-
smokers  were  in  average  more  positive  than  smokers  that  the  different  campaign 
executions would encourage smokers to stop smoking.    

Table 5: Impact of campaign executions – targets versus results for Years 1 to 3 

  Parameter 

Year 

Target   Results 

% of smokers who thought that campaign executions would 
encourage them to stop smoking 

% of non-smokers who thought that campaign executions 
would encourage smokers to stop smoking 

Y1 

Y2 

Y3 

Y1 
Y2 

Y3 

N/A 

28% 

  28% 

28% 

 N/A 

 N/A 

    N/A 

    29% 

 29% 

    32% 

 N/A 

    N/A 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

When analysed the evolution of the impact of the different campaign executions (see 
Figures  9  and  10),  we  found  significant  differences  between  the  perceived  impact  of 
TV  ads  and  the  impact  of  banners  and  print  executions.  Smokers  and  non-smokers 
were more likely to think that the campaign TV ads would encourage smokers to quit 
smoking  than  the  campaign  banners  or  the  print  executions.  The  figures  below  also 
reveal that the evolution of the perceived impact of the different campaign executions 
tended to decrease during the campaign (with the exception of banners and print from 
Year 1 to Year 2). 

Figure 9: Smokers: campaign executions will encourage me to stop smoking (%s)         

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

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Figure 10: Non-smokers: campaign executions will encourage smokers to stop smoking (%s) 

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

In  terms  of  impact  across  sub-groups,  the  campaign  executions  had  a  stronger 
positive  effect  in  the  Southern  European  Member  States,  but  also  amongst  men, 
people  in  the  younger  age  group  (18-34),  smokers  who  planned  to  stop,  and  those 
who  had  recognised  the  campaign.  Respondents  in  the  Northern  European  countries 
were  the  least  impacted  by  the  campaign,  though  there  was  an  upward  trend 
registered in these countries in the second and third campaign years.   

The second parameter, campaign awareness, was introduced in the final year of the 
campaign and intended to measure the extent to which the target audiences took out 
the  central  message  behind  the  Day  of  the  Ex-smoker  (DOES)  campaign  (“stopping 
smoking 
is  a  great  achievement”)  when  being  exposed  to  the  campaign 
advertisements.  The  result  obtained  in  the  campaign  post-measurement  (76%)  was 
slightly below the initial target set (77%).  

Table 6: Campaign awareness – targets versus results for Year 3 

Parameter 

Year 

Target   Results 

% of respondents (smokers and non-smokers) who agreed 
with the statement “stopping smoking is a great 
achievement” 

Y1 
Y2 

Y3 

 N/A 

 N/A 

 N/A 

 N/A 

 77% 

     76% 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

When  analysed  across  sub-groups  (Figure  11)  message  awareness  was  above  the 
average  amongst  respondents  in  Southern  (84%)  and  Eastern  Europe  (78%), 
amongst smokers (77%) and non-smokers (77%), amongst smokers  who planned to 
stop (80%) and amongst heavy Internet users (78%). 

Figure  11:  To  what  extent  do  you  agree  /  disagree  that  the  campaign  is  trying  to  say  
that “stopping smoking is a great achievement”? (Totally agree + agree - %s) 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

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The  third  parameter  was  campaign  call  to  action.  It  was  intended  to  measure  the 
extent to which the campaign executions (TV ads, banners, print) triggered people to 
take  action,  including  talking  about  the  execution  /  campaign  with  other  people, 
recommending it to someone, going to the campaign’s website,  considering stopping 
smoking  or  clicking  on the  banner.  Targets  were  set  individually  for  each  action,  and 
as an average for the combined actions.  

As reflected in Table 7, respondents were most likely to talk about the campaign with 
other  people  after  being  exposed  to  the  different  executions.  Second,  smokers  were 
most inclined to consider stopping smoking. Third, the campaign executions triggered 
people to recommend the campaign to others. Fourth, respondents were led to go to 
the  campaign’s  website.  Respondents  were  least  likely  to  click  on  the  banner  (after 
viewing the campaign banners).      

The  word  of  mouth  targets  (talking  about  the  campaign  with  other  people  / 
recommending  it  to  someone)  were  achieved  or  exceeded  for  Years  2  and  3.  The 
smoking cessation target (considering stopping smoking) was exceeded for Year 2 but 
was  not  achieved  for  Year  3  (probably  because  the  objective  of  the  third  year  was 
awareness  as  opposed  to  conversion).  The  targets  linked  to  personally  digging  for 
further campaign information (going to the website / clicking on the banner) were the 
least effective, with the majority of targets not achieved (with the exception of ‘going 
to the website’ in Year 2). 

Overall, the average ‘call to action’ for all executions was exceeded in Year 2 but was 
not  achieved  in  Year  3.  However,  it  evolved  from  20%  in  Year  1  to  23%  for  Years  2 
and 3.  

Table 7: Campaign call to action – targets versus results for Years 1 to 3 

  Parameter 

Year 

Target   Results 

I talked about it with other people 

I recommended it to someone 

I went to the website  

I considered stopping smoking  

I clicked on the banner  

Average ‘call to action’ on all parameters 

Y1 

Y2 

Y3 

Y1 

Y2 

Y3 

Y1 

Y2 

Y3 

Y1 
Y2 

Y3 

Y1 
Y2 

Y3 

Y1 

Y2 

Y3 

 N/A 

24% 

  24% 

30% 

 35% 
 N/A 

35% 
   19% 

19% 

    23% 

19% 
 N/A 

    23% 
   13% 

 13% 

   18% 

 21% 

   15% 

 N/A 

   28% 

 28% 

   31% 

 30% 

   25% 

 N/A 

   15% 

 15% 

   12% 

 18% 

   17% 

 N/A 

   20% 

 17% 

   23% 

 26% 

   23% 

 Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

Figure  12  below  presents  the  evolution  of  the  different  call  to  action  parameters 
measured by the campaign. The percentage of people who talked about the campaign 
with  others  registered  a  steady  increase  from  Years  1  to  3.  In  a  similar  line,  the 

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Annex B: Evaluation evidence 

proportion of people who recommended the campaign also increased from one year to 
the  other.  The  percentage  of  people  who  considered  stopping  smoking  as  a  result  of 
exposure to the different executions increased in the second year, but then decreased 
substantially in the final campaign year   

Figure 13, which features the average call to action for all survey respondents versus 
the  average  call  to  action  for  smokers,  shows  that  smokers  were  more  inclined  than 
ex-smokers  or  non-smokers  to  take  action  after  being  exposed  to  the  campaign. 
Similar  trends  were  observed  for  respondents  from  Southern  European  countries, 
smokers who planned to stop smoking and heavy internet users.  

Figure 12: Campaign call to action (CtA) (%s)       

 Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3)              

 Figure 13: CtA - All respondents vs smokers (%s) 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

Even  though  not  included  as  a  KPI,  the  GfK  post-tests  also  asked  respondents  who 
were  aware  of  the  campaign  whether  they  had  talked  more  generally  about  it  with 
others (outcoming word of mouth), if they had heard about the campaign from others 
(incoming  word  of  mouth)  and  whether  conversations  about  the  campaign  had  been 
positive or negative.  

As reflected in Figures  14 and 15 below, an average  of slightly more than 4 in every 
10  respondents  who  were  aware  of  the  campaign  talked  about  it  with  others  (with  a 
peak of 47% registered in Year 2). Outcoming word of mouth about the campaign was 
higher amongst survey respondents in Southern Europe, followed by Eastern European 
countries in second place, and Western European countries third. Word of mouth was 

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Annex B: Evaluation evidence 

lowest  amongst  respondents  in  Northern  Europe,  it  should  be  noted  results  for 
respondents in this region registered a gradual increase from Year 1 to Year 3. 

In  a  similar  line  smokers  who  planned  to  stop  were  most  likely  to  speak  about  the 
campaign than smokers who did not plan to stop. Ex-smokers were the least likely to 
speak about the campaign with others, even less than non-smokers. 

Figure 14: Outcoming WoM per regions (%s)                         

 Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

Figure 15: Outcoming WoM – smokers vs non-smokers (%s) 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 1, 2 and 3) 

Incoming  word  of  mouth  amongst  those  who  were  aware  of  the  campaign  registered 
lower levels than outcoming word of mouth (see  Figures 16 and 17). Respondents in 
Southern  Europe  were  most  likely  to  have  heard  of  the  campaign  from  others, 
followed  closely  by  Western  Europeans  and  by  Eastern  Europeans  in  third  place. 
Incoming word of mouth was less frequent in Northern Europe, though once again the 
evolution from Year 2 to Year 3 was positive. 

When  analysed  by  smoking  status  of  respondents,  smokers  who  did  not  plan  to  stop 
were  the  most  likely  to  have  heard  from  others  of  the  campaign,  followed  closely  by 
smokers  who  planned  to  stop.  Ex-smokers  were  the  least  likely  to  have  heard  about 
the Ex-smokers campaign. 

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Figure 16: Incoming WoM per regions (%s)                            

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 2 and 3) 

 Figure 17: Incoming WoM – smokers vs non-smokers (%s) 

Source: Campaign Annual Analytical Reports and GfK post-test reports (Years 2 and 3) 

1.4. 

Third KPI: on-line word of mouth 

The  third  KPI  focused  on  the  campaign’s  on-line  performance,  aiming  to  capture  the 
way people talked about the campaign, shared it with each other on social media and 
the degree to which the campaign’s on-line activity encouraged people to sign-up for 
iCoach.  

The  first  parameter  was  linked  to  the  activity  registered  around  the  campaign’s 
website  www.exsmokers.eu.  As  confirmed  in  the  campaign’s  annual  reports,  the 
website  was  conceived  as  an  institutional  tool  to  inform  organisations  about  the 
campaign and the iCoach, as well as to enable the creation of synergies with national 
stakeholders. 

Table  8  below  features  the  aggregated  annual  numbers  of  unique  visitors3  and  of 
visits4 to the campaign’s website. The number of unique visitors to the website in the 

3 As defined in the campaign annual reports, unique visitors represent the number of unduplicated (counted 
only once) visitors to the website over the course of a specified time period.  

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third  year  of  the  campaign  was  more  than  seven  times  higher  than  the  number  of 
visits  registered  in  the  first  year,  with  a  significant  increase  from  Year  2  to  Year  3 
(which exceeded by far the target that was set).  

Table 8: Overview of campaign’s website statistics – targets versus results for Years 1 to 3 

 Year 

Y1 

Initial 
target 
N/A 

Results 

Comments 

-  82,517 Unique 
Visitors 
-  96,090 Visits 

  Estonia, France, Sweden,  Poland and Belgium: 

top five EU-MS in number of visits in Y1 

  Visits also comparatively high for non-EU MS 
  Lowest number of visits in Y1: Lithuania, Malta, 

Cyprus, Luxembourg and Germany   

Y2 

N/A 

-  170,922 Unique 
Visitors 
-  204,705 Visits 

  Results for Y2 more than doubled results for Y1 
  Number of visits highest in non-EU MS 
  Germany, Italy, Belgium, Spain and Portugal: top 

five EU-MS in number of visits in Y2 

  Lowest number of visits in Y2: Luxembourg, 

Malta, Latvia, Ireland and Denmark  

Y3 

341,844 
Unique 
Visitors 
(double 
the 
results 
for Y2) 

-  639,333 Unique 
Visitors 
-  775,693 Visits 

  Results for Y3 more than  triplicated results for Y2 
  Number of visits highest in non-EU MS 
  UK, Spain, Germany, France and Italy: top five 

EU-MS in number of visits in Y3 

  Lowest number of visits in Y3: Luxembourg, 

Malta, Cyprus, Estonia and Latvia 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Table 9 overleaf details the number of visits to the website per country per year and 
calculates the visits as a percentage  of the total. In the final column, we provide the 
net  increase  or  decrease  in  the  number  of  visits  per  country  from  Y1  to  Y3.  Overall, 
the UK, Germany, Italy, Spain and Greece were the five EU countries with the highest 
increase in the number of visits during the campaign. The UK in particular registered a 
significant increase in the number of visits from Y2 to Y3, whereas the increase for the 
other  countries  was  more  gradual.  Non-EU  Member  States  registered  the  highest 
number of visits in the second and third years of the campaign. It’s interesting to note 
that  the  substantial  growth  of  visits  from  Year  2  to  Year  3  was  strongly 
concentrated in the UK and non EU-Member States, which together represented 
41% of the total number of visits for Year 3.  

At the other end of the spectrum, Estonia (which kicked-off with an important number 
of visits in Y1) registered a net decrease of visits of -5.8 at the end of the campaign. 
Sweden,  Ireland,  Luxembourg  and  Slovenia  recorded  the  lowest  increases  in  the 
number of visits. 

4  As  per  the  campaign  annual  reports, visits  represent  the  number of  times visitors  have  been  to  the  site 
(unique sessions initiated by all visitors). If a user is inactive on the site for 30 minutes or more, any future 
activity  will  be  attributed  to a  new session.  Users  who  leave  the  site  and  return  within  30  minutes  will be 
counted as part of the original session. 

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Table 9: Campaign number of visits to website – per country per year 

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

    Country 

Y1 

Austria 
Belgium 

Bulgaria 

Cyprus 

Czech Republic 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

United Kingdom 

Visits 

1,982 

5,256 

1,299 

707 

3,566 

1,135 

% of 
total 

2.3% 

6.2% 

1.5% 

0.8% 

4.2% 

1.3% 

13,860 

16.2% 

Y2 

Visits 

5,418 

14,156 

10,137 

2,753 

10,230 

2,005 

2,578 

2,563 

2,318 

8,788 

746 

1,342 

4,755 

3,623 

804 

1,024 

383 

599 

429 

4,718 

5,873 

2,605 

2,040 

1,411 

1,233 

2,037 

5,935 

1,024 

2.7% 

10.3% 

10,830 

0.9% 

1.6% 

5.6% 

4.2% 

0.9% 

1.2% 

0.4% 

0.7% 

0.5% 

5.5% 

6.9% 

3.0% 

2.4% 

1.7% 

1.4% 

2.4% 

6.9% 

1.2% 

6.9% 

15,166 

7,449 

7,324 

1,586 

14,808 

1,530 

2,894 

790 

1,299 

4,810 

11,149 

11,949 

11,410 

5,188 

2,632 

13,859 

3,495 

10,140 

16,557 

% of 
total 

2.6% 

6.9% 

5.0% 

1.3% 

5.0% 

1.0% 

1.3% 

1.3% 

5.3% 

7.4% 

3.6% 

3.6% 

0.8% 

7.2% 

0.7% 

1.4% 

0.4% 

0.6% 

2.3% 

5.4% 

5.8% 

5.6% 

2.5% 

1.3% 

6.8% 

1.7% 

5.0% 

8.1% 

Y3 

Visits 

9,183 

29,014 

6,635 

2,213 

13,041 

5,497 

2,404 

6,214 

45,281 

59,490 

23,815 

14,275 

5,972 

44,364 

2,843 

3,864 

1,449 

1,611 

17,303 

27,438 

26,030 

16,306 

5,952 

3,114 

73,817 

8,206 

% of 
total 

1.2% 

3.7% 

0.9% 

0.3% 

1.7% 

0.7% 

0.3% 

0.8% 

5.8% 

7.7% 

3.1% 

1.8% 

0.8% 

5.7% 

0.4% 

0.5% 

0.2% 

0.2% 

2.2% 

3.5% 

3.4% 

2.1% 

0.8% 

0.4% 

9.5% 

1.0% 

Increase/ 
Decrease 
from Y1 to 
Y3 

+4.7 

+5.5 

+5.1 

+3.1 

+3.7 

+4.8 

- 5.8 

+2.7 

+5.1 

+79.7 

+17.7 

+3.0 

+1.6 

+55.2 

+2.8 

+10.1 

+2.4 

+3.8 

+3.7 

+4.7 

+10.0 

+8.0 

+4.2 

+2.5 

+36.2 

+1.4 

150,647 

19.4% 

+147.1 

169,715 

21.9% 

+28.7 

Non-EU MS 

TOTALS 

5,921 
85,4135 

100.0%  204,705  100.0% 

775,693 

100.0% 

+8.1 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

As  reflected  in  Figure  18  below,  which  shows  the  evolution  of  page  views  as  a 
percentage of the total page views, the ‘Home’ and ‘About’ pages registered a gradual 
increase from Y1 to Y2 which was more accentuated from Y2 to Y3. iCoach registered 
an average of 50,000 page views per year (with a slight increase in Y2 but otherwise 
stable). However, when analysed in comparative terms, the proportion of iCoach page 
views  registered  a  decline  from  48%  of  total  page  views  in  Y1  to  11%  of  total  page 
views in Y3.  

Figure  19  features  the  evolution  of  traffic  sources  to  the  website  as  a  percentage  of 
total visits. Direct traffic, which was the main traffic source to the website in the first 
year  of  the  campaign,  registered  a  downward  trend  in  the  second  and  third  years. 
Traffic via referring sites recorded a peak in the second year, and then declined again 
in the final year. Search sites represented 26% of the total traffic to the website in the 

5 There seems to be a discrepancy in the Annual Analytical Report for Year 1, as the number of visits to the 
website for Year 1 is 96,090, but the sum of visits per country adds to 85,413. We have taken this second 
number  as  valid  with  a  view  to  calculating  the  number  of  visits  per  country  as  percentages  of  the  total 
number of visits. 

December, 2015 

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Annex B: Evaluation evidence 

first  two  years  of  the  campaign,  and  declined  to  8%  in  the  last  year.  Paid  searches 
(cost  per  click  and  paid  banners)  represented  52%  of  the  traffic  sources  in  the  third 
and final year of the campaign. 

Figure 18: Evolution of page views (in %s)                                  

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Figure 19: Evolution of traffic sources (in %s) 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

The  second  parameter  was  linked  to  the  temporary  campaign  websites  launched 
as part of the campaign. Three temporary campaign websites were launched in Years 
2  and  3,  including  XMAS  2011,  Quit  Smoking  with  Barça  and  the  Day  of  the  Ex-
smoker.  

The  Christmas  Campaign  website,  launched  in  December  2011,  proposed  to  give  the 
iCoach  as  a  Christmas  present  to  loved  ones.  Ninety-one  percent  of  unique  visitors 
were givers (people who aimed to send the iCoach gift), and the remaining 9% were 
receivers (those who received the gift). Half of those who received the gift opened it, 
and 37% visited iCoach pages.  

The  Quitsmokingwithbarca.eu  was 
the 
announcement  of  the  partnership  with  FC  Barcelona.  The  campaign  took  place  in 
December 2012 and February 2013, which corresponds to the two peaks registered in 
terms of visits to the website. The same KPI was set than for the campaign’s website 
(to reach 341,844 unique visitors), and was greatly exceeded. 

in  September  2012  with 

launched 

The  campaign’s  website  was  modified in  September  2013  to  host  the  Day  of  the  Ex-
smoker  event.  The  DOES  website  registered  579,179  unique  visitors,  thus  exceeding 
the  target  of  341,844  set.  The  campaign  allowed  people  to  congratulate  ex-smokers 

December, 2015 

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Annex B: Evaluation evidence 

friends  by  Facebook  or  Twitter.  Less  than  1%  of  unique  visitors  to  the  website  used 
the Facebook and Twitter applications.  

Table 10: Overview of campaign’s temporary website statistics 

 Website 

Duration 

Becomeunstoppable.eu (XMAS 2011) 
Quitsmokingwithbarca.eu 

Dec 2011 to Jan 2012 
Sep 2012 to Oct 2013 

Day of the Ex-smoker 

Sep 2013 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Unique 
Visitors 
222,316 
584,241 

579,179 

Visits 

234,633 
664,469 

686,055 

The  third  parameter  for  on-line  activity  was  related  to  the  Unstoppable  Facebook 
pages.  The  main  goal  of  the  Facebook  pages  was  to  engage  smokers  and  motivate 
them to visit and sign-up for iCoach. A second goal was to build a community of ex-
smokers that could share their stories and motivate and support new quitters.  

The  main  targets  set  for  Years  2  and  3  were  aimed  at  retaining  /  engaging  fans 
(measured  via  the  numbers  of  likes,  comments  and  shares)  rather  than  at  recruiting 
new members. The main reason behind this is that the campaign did not have a paid 
media strategy to drive recruitment to the Facebook pages.  

As reflected in Table 11, with a relatively stable number of fans from one year to the 
other,  the  majority  of  the  engagement  targets  were  exceeded  in  Year  2  (with  the 
exception  of  number  of  comments  per  fans).  The  targets  for  the  third  year  were 
significantly exceeded, in particular the number of shares (nearly 7 times higher than 
the target) and the number of likes (more than 3 times higher than the target).  

Organic growth of the  Facebook pages was measured by the numbers of people who 
visited the pages (Unique Active Users). Again, the targets were  exceeded in Year 2, 
and substantially surpassed in the third and final year of the campaign.  

As  explained  in  the  Annual  Analytical  Report  submitted  in  Year  3,  the  numbers 
obtained in the final year were the result of the shift from a country-level decentralised 
strategy  to  a  new  centralised  Facebook  approach  that  was  adopted  to  ensure  a 
stronger alignment with campaign activities and consistency of campaign messages. 

Table 11: Impact of campaign executions – targets versus results for Years 1 to 3 

Parameter 

Year 

Target 

Results 

Fans6 

Per 1,000 
fans 

Success 
rate 

Likes 

Comments 

Shares 

Organic 

reach 

Y1 
Y2 

Y3 

Y1 
Y2 

Y3 

Y1 
Y2 

Y3 

Y1 
Y2 

N/A 

77,377 

75 likes per 1,000 fans 

6,910 

78,776 

87.72 

105 likes per 1,000 fans 

29,373 

81,051 

362.40 

N/A 

77,377 

35 comments per 1,000 fans 

1,747 

78,776 

22.18 

49 comments per 1,000 fans 

5,559 

81,051 

68.58 

N/A 

77,377 

8 shares per 1,000 fans 

11 shares per 1,000 fans 

1,512 

5,879 

78,776 

19.19 

81,051 

72.53 

N/A 

350,000 Unique Active Users7 

873,310 

N/A 

N/A 

117% 

345% 

63% 

140% 

240% 

659% 

250% 

N/A 

N/A 

N/A 

Y3 

49,000 Unique Active Users 

9,751,852  N/A 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

66  Fans  are  users  that  have  “liked”  the  Unstoppable  pages.  This  means  they  connect  to  Unstoppable  and 
receive the news feed on their own profiles.  
7  Unique  Active  Users  are  the  number  of  people  who  have  interacted  with  or  viewed  the  Page  or  its  posts,  including 
interactions from fans and non-fans. 

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Annex B: Evaluation evidence 

Table  12  below  details  the  number  of  Unique  Active  Users  to  the  campaign’s 
Facebook  pages  per  country  per  year  and  calculates  the  Unique  Active  Users  as  a 
percentage of the total. In the final column, we provide the net increase or decrease in 
the number of Unique Active Users per country from Y1 to Y3.  

The number of Unique Active Users to the campaign’s Facebook pages was 8.5 times 
higher  in  Year  3  than  in  Year  1,  with  a  moderate  rise  in  Year  2  and  a  significant 
upsurge  in  the  final  year  of  the  campaign.  Facebook  traffic  was  also  substantially 
higher  than  traffic  on  the  website  throughout  the  campaign.  The  number  of  Unique 
Active Users in Facebook was 14 times higher than the number of visits to the website 
in  the  first  year  of  the  campaign.  The  difference  contracted  in  the  second  year  with 
Facebook  users  8  times  higher  than  website  visits,  and  then  again  increased  in  the 
final year with Facebook users 13 times higher than website visits.  

Germany, Poland, Italy, Austria and the UK were the five EU countries with the highest 
increase  in  the  number  of  Unique  Active  Facebook  users  during  the  campaign.  In 
general,  the  majority  of  Member  States  maintained  a  relatively  similar  proportion  of 
Unique  Active  Users  from  year  to  year  (see  columns  reflecting  %  of  total  for  each 
year).  Germany  and  Italy  were  the  two  countries  that  registered  a  stronger  increase 
from  Year  2  to  Year  3.  Conversely,  Malta,  Estonia,  Slovakia,  Denmark  and  Slovenia 
registered the lowest increases in the number of Unique Active Facebook Users during 
the campaign.  

Table 12: Facebook pages Unique Active Users – per country per year 

    Country 

Y1 

Y2 

Y3 

% of 
total 

1.3% 

3.4% 

4.5% 

1.8% 

3.9% 

1.7% 

1.4% 

1.9% 

7.9% 

6.4% 

3.7% 

3.5% 

1.9% 

8.0% 

0.7% 

2.3% 

0.5% 

1.0% 

2.2% 

4.8% 

3.3% 

7.0% 

5.4% 

2.1% 

8.7% 

2.5% 

Unique 
Active 
Users 

14,761 

46,475 

110,640 

16,468 

72,438 

22,654 

19,400 

33,733 

99,355 

84,110 

47,690 

64,235 

63,134 

103,419 

17,499 

65,171 

8,033 

16,118 

22,570 

84,138 

73,313 

136,613 

57,776 

43,805 

128,970 

35,021 

% of 
total 

0.9% 

2.8% 

6.7% 

1.0% 

4.4% 

1.4% 

1.2% 

2.1% 

6.1% 

5.1% 

2.9% 

3.9% 

3.8% 

6.3% 

1.1% 

4.0% 

0.5% 

1.0% 

1.4% 

5.1% 

4.4% 

8.3% 

3.5% 

2.7% 

7.9% 

2.1% 

Unique 
Active 
Users 

14,865 

40,275 

52,209 

21,500 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Republic 

45,689 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

20,169 

16,657 

22,490 

91,956 

75,145 

43,564 

41,072 

22,650 

93,740 

8,082 

26,404 

6,186 

12,275 

26,118 

56,556 

39,091 

82,119 

63,547 

24,554 

102,328 

29,511 

December, 2015 

Unique 
Active 
Users 

176,170 

254,165 

304,655 

100,670 

429,592 

72,719 

56,295 

104,748 

920,241 

% of 
total 

1.8% 

2.6% 

3.1% 

1.0% 

4.3% 

0.7% 

0.6% 

1.1% 

9.2% 

1,193,680 

12.0% 

317,815 

354,081 

153,712 

3.2% 

3.5% 

1.5% 

Increase/ 
Decrease 
from Y1 
to Y3 

+11.9 

+6.3 

+5.8 

+4.7 

+9.4 

+3.6 

+3.4 

+4.7 

+10.0 

+15.9 

+7.3 

+8.6 

+6.8 

1,165,470 

11.7% 

+12.4 

74,613 

146,243 

32,720 

32,364 

177,955 

826,846 

295,415 

650,741 

223,362 

93,786 

624,803 

154,377 

0.7% 

1.5% 

0.3% 

0.3% 

1.8% 

8.3% 

3.0% 

6.5% 

2.2% 

0.9% 

6.3% 

1.5% 

+9.2 

+5.5 

+5.3 

+2.6 

+6.8 

+14.6 

+7.6 

+7.9 

+3.5 

+3.8 

+6.1 

+5.2 

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Annex B: Evaluation evidence 

    Country 

Y1 

Y2 

Unique 
Active 
Users 

% of 
total 

Unique 
Active 
Users 

% of 
total 

Y3 

Unique 
Active 
Users 

% of 
total 

Increase/ 
Decrease 
from Y1 
to Y3 

United 

Kingdom 

TOTALS 

91,948 

7.9% 

154,135 

9.4% 

1,022,904 

10.3% 

+11.1 

1,170.700  100.0%  1,641,674 

100.0% 

9,960,142  100.0% 

+8.5 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Table  13  details  the  number  of  Facebook  fans  per  country  per  year  and  calculates 
the fans as a percentage of the total. In the final column, we provide the net increase 
or decrease in the number of fans per country from Y1 to Y3.  

The  number  of  Facebook  fans  remained  stable  during  the  campaign  with  minor 
increases  from  one  year  to  another.  The  significant  increase  of  Unique  Active  Users 
registered in the final year of the campaign did not generate any major expansions in 
the number of Facebook fans. According to the campaign document on KPIs developed 
for the second year of the campaign, the main focus of the on-line / Facebook strategy 
was  on  retention,  but  not  on  recruitment  or  membership  volume.  In  the  absence  of 
paid media driving recruitment, it is understandable that the number of fans remained 
largely  unchanged  in  the  second  and  third  years  of  the  campaign  and  that  the 
objective  was  to  generate  stronger  participation  and  commitment  from  the  existing 
community (as evidenced by the KPIs set). 

When  analysed  the  number  of  Facebook  fans  per  country,  nearly  half  of  the  27 
Member States that participated in the campaign registered decreases in the number 
of  fans  from  Year  1  to  Year  3.  Fans  in  Cyprus,  Finland  and  Slovakia  decreased  the 
most, but also Lithuania, Malta, Sweden, France, Ireland, Slovenia, Denmark, Estonia 
and Hungary registered some losses.   

Net increases in the number of Facebook fans were registered for the remaining 15 EU 
Member  States,  with  Belgium,  Netherlands,  Greece  and  Luxembourg  showing  the 
highest increases. 

Table 13: Facebook fans – per country per year 

    Country 

Y1 

Fans 

728 

1,897 

3,450 

1,060 

2,848 

994 

928 

929 

5,086 

4,559 

3,945 

3,297 

2,781 

5,894 

702 

2,687 

366 

1,104 

% of 
total 

0.9% 

2.5% 

4.5% 

1.4% 

3.7% 

1.3% 

1.2% 

1.2% 

6.6% 

5.9% 

5.1% 

4.3% 

3.6% 

7.6% 

0.9% 

3.5% 

0.5% 

1.4% 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Republic 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Y2 

Fans 

754 

2,105 

3,573 

1,104 

2,790 

983 

911 

911 

5,076 

4,409 

3,933 

3,335 

2,805 

6,142 

729 

2,682 

401 

1,141 

% of 
total 

1.0% 

2.7% 

4.5% 

1.4% 

3.5% 

1.2% 

1.2% 

1.2% 

6.4% 

5.6% 

5.0% 

4.2% 

3.6% 

7.8% 

0.9% 

3.4% 

0.5% 

1.4% 

Y3 

Fans 

828 

2,488 

3,849 

924 

2,868 

993 

918 

820 

4,937 

4,735 

4,614 

3,278 

2,732 

6,535 

772 

2,476 

427 

1,027 

% of 
total 

1.0% 

3.1% 

4.7% 

1.1% 

3.5% 

1.2% 

1.1% 

1.0% 

6.0% 

5.8% 

5.7% 

4.0% 

3.4% 

8.1% 

1.0% 

3.1% 

0.5% 

1.3% 

Increase/ 
Decrease 
from Y1 to 
Y3 

+1.13 

+1.31 

+1.12 

(0.87) 

+1.01 

(0.99) 

(0.99) 

(0.88) 

(0.97) 

+1.04 

+1.17 

(0.99) 

(0.98) 

+1.12 

+1.10 

(0.92) 

+1.17 

(0.93) 

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Annex B: Evaluation evidence 

    Country 

Y1 

Fans 

832 

3,538 

4,130 

7,453 

3,913 

1,567 

5,299 

1,271 

6,119 

% of 
total 

1.1% 

4.6% 

5.3% 

9.6% 

5.1% 

2.0% 

6.8% 

1.6% 

7.9% 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

United Kingdom 

Y2 

Fans 

800 

3,504 

4,664 

7,577 

3,880 

1,582 

5,318 

1,213 

6,454 

% of 
total 

1.0% 

4.4% 

5.9% 

9.6% 

4.9% 

2.0% 

6.8% 

1.5% 

8.2% 

Y3 

Fans 

1,035 

3,685 

4,868 

8,039 

3,469 

1,536 

5,561 

1,233 

6,404 

% of 
total 

1.3% 

4.5% 

6.0% 

9.9% 

4.3% 

1.9% 

6.9% 

1.5% 

7.9% 

TOTALS 

77,377 

78,776 

81,051 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Increase/ 
Decrease 
from Y1 to 
Y3 

+1.24 

+1.04 

+1.18 

+1.08 

(0.89) 

(0.98) 

+1.05 

(0.97) 

+1.05 

+1.05 

Table  14  details  the  total  number  of  Facebook  interactions  including  likes, 
comments and shares per country per year and calculates the different interactions in 
each country as a percentage of the number of fans.  

Even  though  not  reflected  the  annual  evolution  of  the  number  of  interactions,  the 
number  of  likes  and  comments  on  the  campaign’s  Facebook  pages  registered  a 
decrease  from  Year  1  to  Year  2,  and  a  substantial  increase  in  the  final  year  of  the 
campaign. With the main focus of the on-line / Facebook strategy on participation and 
commitment from the existing community of fans, the table below shows how certain 
countries  reflected  a  higher  activity  of  fans  (Cyprus,  Czech  Republic,  Latvia  and 
Finland, but also Spain, Netherlands and Lithuania on specific fronts).  

Conversely, Ireland recorded lower levels of activity overall. Romania, Malta, Hungary 
and  Bulgaria  registered  low  proportions  of  likes.  Greece,  Luxembourg,  Portugal  and 
Romania  showed  low  proportions  of  comments,  and  Lithuania,  Poland,  Slovakia  and 
Slovenia recorded low proportions of shares. 

Table 14: Facebook interactions (likes, comments, shares) – per country per year 

    Country 

Likes 

Comments 

Shares 

Number 

As a % of 
fans 

Number 

As a % of 
fans 

Number 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Republic 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

853 

1,632 

1,919 

1,221 

3,956 

875 

653 

962 

2,700 

3,229 

2,633 

1,533 

1,225 

3,631 

1,347 

2,750 

274 

407 

103.0% 

65.6% 

49.9% 

132.1% 

137.9% 

88.1% 

71.1% 

117.3% 

54.7% 

68.2% 

57.1% 

46.8% 

44.8% 

55.6% 

174.5% 

111.1% 

64.2% 

39.6% 

128 

390 

529 

353 

1,560 

237 

138 

257 

670 

596 

323 

455 

233 

796 

199 

242 

37 

99 

15.5% 

15.7% 

13.7% 

38.2% 

54.4% 

23.9% 

15.0% 

31.3% 

13.6% 

12.6% 

7.0% 

13.9% 

8.5% 

12.2% 

25.8% 

9.8% 

8.7% 

9.6% 

98 

251 

242 

173 

426 

83 

84 

130 

303 

340 

334 

243 

163 

733 

118 

127 

30 

70 

As a % 
of fans 

11.8% 

10.1% 

6.3% 

18.7% 

14.9% 

8.4% 

9.2% 

14.1% 

6.1% 

7.2% 

7.2% 

7.4% 

6.0% 

11.2% 

15.3% 

5.1% 

7.0% 

6.8% 

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Annex B: Evaluation evidence 

    Country 

Likes 

Comments 

Shares 

Number 

As a % of 
fans 

Number 

As a % of 
fans 

Number 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

United Kingdom 

836 

2,384 

3,928 

3,935 

1,922 

956 

6,041 

1,051 

3,410 

80.8% 

64.7% 

80.7% 

48.9% 

55.4% 

62.2% 

108.6% 

85.2% 

53.2% 

367 

884 

453 

598 

490 

325 

1,389 

316 

1,114 

35.5% 

24.0% 

9.3% 

7.4% 

14.1% 

21.2% 

25.0% 

25.6% 

17.4% 

As a % 
of fans 

8.1% 

4.8% 

14.0% 

7.0% 

3.4% 

5.7% 

84 

178 

682 

561 

118 

87 

1,079 

19.4% 

82 

569 

6.7% 

8.9% 

TOTALS 

56,258 

69.4% 

13,369 

16.5% 

7,388 

9.1% 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Figures 20 and 21 below depict the evolution of Facebook statistics, including: 

  the  number  of  Unique  Active  Users  which  registered  an  impressive  jump  in  the 

final year of the campaign 

  the number of fans which remained very stable during the campaign with a slight 

upward tendency 

The  number  of  interactions,  including  likes,  comments  and  shares,  which  decreased 
from Year 1 to Year 2 and then increased again in the last year of the campaign. 

Figure 20: Evolution of Unique Active FB Users                     

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Figure 21: Evolution of FB fans and interactions 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

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Annex B: Evaluation evidence 

Even  though  not  an  explicit  parameter,  the  on-line  media  campaign  was  also 
monitored  in  the  annual  reports  and  focussed  on  the  following  key  initiatives  during 
the campaign: 

  Year  1:  the  soft  launch  of  the  campaign  in  June  2011,  the  Rankin  recruitment 
for  the  Rankin  photo-shoot  of  campaign  ambassadors  (from  end  July  to  early 
August), and the hard launch of the campaign in September 2011 

  Year  2:  the  Christmas  Campaign,  World  No  Tobacco  Day  and  Back  To  Work  

Campaign 

  Year  3:  Quit  Smoking  with  Barça  (Phases  1  and  2),  and  the  Day  of  the  Ex-

smoker campaign 

Table  15  below  features  an  overview  of  the  different  on-line  media  initiatives 
implemented, including the total number of impressions and clicks generated by each, 
the Click through Rate (CTR)8 percentages, the number of registrations to iCoach that 
resulted  from  the  initiatives  that  were  intended  to  generate  conversions  (as  opposed 
to only raising awareness), the total expenditure and the Cost per Registration (CPR).  

Average  CTRs  were  significantly  higher  in  the  final  year  of  the  campaign.  The  QSWB 
initiatives  (Phases  1  and  2)  produced  the  highest  CTRs  (2.82%  and  0.91% 
respectively),  followed  by  the  DOES  campaign  (0.56%).  At  the  other  end,  the  soft 
launch of the campaign, the Rankin recruitment and the Back to Work Campaign were 
the least successful in terms of CTRs.   

   Table 15: On-line media campaign 

Year 

 Campaign 

Spend (€) 

Impressions 

Clicks 

CTR 

Year 

Soft launch  

1 

Rankin  

Hard launch 

TOTAL Y1 

N/A 

N/A 

N/A 

393,857,940 

223,773 

0.06% 

243,003,445 

120,068 

0.05% 

1,557,323,007 

2,351,942 

0.15% 

N/A 

2,194,184,392  2,695,783 

0.09% 

Year 

Christmas  

406,237.00 

563,313,373 

874,464 

0.16% 

2 

WNTD 

1,275,009.00 

1,060,640,707 

1,553,179 

0.15% 

Back to Work  

374,979.00 

1,433,761,315 

1,196,686 

0.08% 

TOTAL Y2 

2,056,225.00 

3,057,715,395  3,624,329 

0.13% 

Year 

QSWB (Phase 1) 

483,607.70 

412,397,168 

1,475,297 

2.82% 

3 

QSWB (Phase 2) 

627,745.27 

1,591,892,119 

1,431,615 

0.91% 

DOES 

1,122,817.19 

322,017,555 

588,260 

0.56% 

TOTAL Y3 

2,234,170.16 

2,326,306,842  3,495,172 

1.43% 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Regis 
trations 

CPR 
(€)9 

N/A 

N/A 

N/A 

N/A 

43,615 

16,301 

28,421 

48,765 

N/A 

N/A 

N/A 

N/A 

N/A 

29.00 

23.00 

96.25 

97.56 

- 

1.5. 

  Fourth KPI: registration and conversion 

The fourth and last KPI was about  registering smokers and ex-smokers into the 
iCoach programme in order to achieve the main goal of the campaign, which was to 
help people to quit smoking. All of the campaign activities were conducted to generate 
traffic on the iCoach platform and to get people to sign-up to the programme.  

8 Click Through Rate (CTR): the number of clicks on an ad divided by the number of times the ad is shown 
(impressions), expressed as a percentage. 

9 Cost per Registration 

December, 2015 

   34 

 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
                                           
Table 16: Overview of registrations to iCoach– targets versus results for Years 1 to 3 

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

 Year 

Y1 

Initial 
target 
N/A 

145,491 people 
registered 

Results 

Comments 

  UK, Spain, Poland, Romania and Italy: the five 

countries with the highest number of registrations 
in Y1 

  Luxembourg, Finland, Denmark, Cyprus and 

Latvia: the five countries with the lowest number 
of registrations in Y1 

  Average conversion percentage (visitors to the 

website who registered to iCoach) was 9% 

  Conversion percentages were highest in 

Luxembourg, Malta, Latvia, Hungary and Lithuania 

  Conversion percentages were lowest in Sweden, 

France, Germany, Czech Republic and Netherlands 

  Goal exceeded for Y2, though total number of 

registrations decreased from Y1 to Y2 

  Campaigns and search were responsible for 61.5% 

of the traffic to the iCoach landing page 

  UK, Spain, Italy, Romania and France: the five 

countries with the highest number of registrations 
in Y2 

  Luxembourg, Malta, Cyprus, Finland and Denmark: 

the five countries with the lowest number of 
registrations in Y2 

Y2 

96,025 
people 
registered 

131,246 people 
registered 

Y3 

78,748 
people 
registered 

131,597 people 
registered 

  Goal exceeded for Y3. Total number of 

registrations remained stable from Y2 to Y3 

  Registrations through FC Barcelona represented 

55.7% of total registrations to iCoach in Y3 

  UK, Portugal, Belgium, Spain and Italy: the five 

countries with the highest number of registrations 
in Y3 

  Cyprus, Malta, Latvia, Slovenia and Finland: the 

five countries with the lowest number of 
registrations in Y3 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

Table  17  below  features  the  evolution  of  the  number  of  visits  to  the  iCoach  landing 
page per country per year and calculates the visits in each country as a percentage of 
the total. Overall, visits to the iCoach landing page registered a downward trend from 
Years  1  to  3,  with  a  more  pronounced  decline  in  the  final  year  of  the  campaign.  The 
decrease  can  be  attributed  to  the  launch  of  alternative  versions  of  the  application 
(mobile  and  FCB  iCoach),  and  the  fact  that  people  could  register  via  different  entry 
points and channels.  

Spain,  Belgium,  Portugal,  Italy  and  non-EU  Member  States  were  the  five  countries 
with  the  highest  proportion  of  visits  to  the  iCoach  website.  At  the  other  end, 
Luxembourg,  Latvia,  Cyprus,  Finland  and  Malta  registered  the  lowest  proportion  of 
visits to the iCoach landing pages. France, Germany and the UK registered important 
declines in the number of visits to the iCoach website from Year 1 to Year 3. 

December, 2015 

   35 

 
 
 
  
 
 
 
 
 
 
Table 17: Number of visits to iCoach website – per country per year 

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

    Country 

Y1 

Visits 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Republic 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

% of 
total 
1.1% 

3.7% 

4.2% 

0.7% 

5.4% 

1.4% 

0.6% 

1.1% 

10.6% 

9.0% 

3.5% 

2.3% 

1.6% 

8.5% 

0.5% 

1.2% 

0.2% 

0.4% 

4.5% 

5.0% 

2.4% 

4.5% 

2.2% 

0.7% 

18,196 

61,887 

69,954 

11,051 

89,344 

22,421 

9,844 

18,288 

174,570 

149,071 

57,724 

38,615 

26,362 

140,167 

7,528 

19,303 

2,715 

7,303 

74,691 

83,155 

40,234 

74,686 

36,944 

11,797 

35,742 

Y2 

Visits 

24,920 

104,907 

61,322 

7,888 

39,720 

15,877 

9,895 

12,924 

98,850 

% of 
total 
1.9% 

7.9% 

4.6% 

0.6% 

3.0% 

1.2% 

0.7% 

1.0% 

7.4% 

156,746 

11.8% 

41,831 

60,098 

26,141 

123,935 

6,002 

10,409 

2,434 

5,397 

45,750 

74,103 

51,619 

69,574 

34,941 

9,439 

3.2% 

4.5% 

2.0% 

9.3% 

0.5% 

0.8% 

0.2% 

0.4% 

3.4% 

5.6% 

3.9% 

5.2% 

2.6% 

0.7% 

9.5% 

2.4% 

5.5% 

1.9% 

Y3 

% of 
total 
1.4% 

10.5% 

3.1% 

0.3% 

3.1% 

0.7% 

0.6% 

0.5% 

5.5% 

5.3% 

2.9% 

3.5% 

0.9% 

7.9% 

0.3% 

0.6% 

0.3% 

0.5% 

4.5% 

3.9% 

10.4% 

4.8% 

1.2% 

1.0% 

Visits 

8,719 

63,460 

18,820 

1,718 

18,981 

4,391 

3,477 

3,305 

33,477 

32,273 

17,561 

21,290 

5,270 

47,641 

2,042 

3,717 

1,968 

2,837 

27,289 

23,689 

62,865 

29,198 

7,294 

5,986 

83,311 

13.8% 

5,008 

22,986 

46,184 

0.8% 

3.8% 

7.6% 

169,836 

10.3% 

126,589 

United Kingdom 

138,560 

Non-EU MS 

63,701 

2.2% 

8.4% 

3.9% 

32,516 

73,650 

N/A 

TOTALS 

1,653,68910 
Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

100%  1,327,477 

100% 

604,757 

100% 

Overall registrations to iCoach were highest in the first year of the campaign, and then 
stabilised at a lower level in the second and third years. The majority of registrations 
in the third year of the campaign (55.7%) were channelled through the FC Barcelona. 

10 We identified another discrepancy in the  Annual Analytical Report for Year 1, as the number of visits to 
the iCoach pages of the website for Year 1 is registered to be 1,327,477, but the sum of visits per country 
adds  to  1,653,689.  We  have  taken  this  second  number  as  valid  with  a  view  to  calculating  the  number  of 
visits per country as percentages of the total number of visits. 

December, 2015 

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Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Of  the  EU  Member  States,  the  UK  registered  the  highest  proportion  of  registrations. 
Spain, Portugal, Poland and Italy recorded more irregular registrations flows from one 
year  to  another,  though  the  proportion  of  registrations  in  these  countries  was  also 
comparatively  high.  Smaller  countries,  including  Cyprus,  Luxembourg  and  Malta,  and 
Northern  European  countries,  including  Denmark  and  Finland,  registered  the  lowest 
proportion of registrations to iCoach. 

Table 18: Number of registrations to iCoach – per country per year 

    Country 

Y1 

Y2 

Y3 

Registrations  % of 
total 
1.0% 

1,403 

Registrations  % of 
total 
1.0% 

1,329 

Registrations  % of 
total 
0.4% 

465 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Republic 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

4,184 

8,731 

1,365 

5,810 

2.9% 

6.0% 

0.9% 

4.0% 

1,325 

0.9% 

1,588 

1.1% 

1,281 

0.9% 

8,684 

7,662 

5,793 

6,903 

3,035 

6.0% 

5.3% 

4.0% 

4.7% 

2.1% 

6,903 

5,956 

5.3% 

4.5% 

527 

0.4% 

3,661 

856 

1,054 

654 

9,858 

5,856 

4,461 

5,186 

1,334 

2.8% 

0.7% 

0.8% 

0.5% 

7.5% 

4.5% 

3.4% 

4.0% 

1.0% 

5,695 

897 

145 

1,607 

441 

242 

218 

2,797 

2,950 

704 

939 

296 

11,075 

7.6% 

10,449 

8.0% 

3,443 

1,388 

3,293 

1.0% 

2.3% 

982 

0.7% 

1,410 

4,765 

1.0% 

3.3% 

12,783 

8.8% 

5,446 

3.7% 

11,730 

8.1% 

5,132 

1,628 

3.5% 

1.1% 

1,196 

1,111 

433 

470 

3,482 

6,097 

7,140 

9,719 

2,749 

881 

0.9% 

0.8% 

0.3% 

0.4% 

2.7% 

4.6% 

205 

331 

232 

119 

2,318 

1,776 

7.4% 

2.1% 

0.7% 

1,489 

536 

288 

13,131 

9.0% 

10,436 

8.0% 

4,862 

1,781 

1.2% 

1,570 

1.2% 

300 

4.3% 

0.7% 

0.1% 

1.2% 

0.3% 

0.2% 

0.2% 

2.1% 

2.2% 

0.5% 

0.7% 

0.2% 

2.6% 

0.2% 

0.3% 

0.2% 

0.1% 

1.8% 

1.3% 

1.1% 

0.4% 

0.2% 

3.7% 

0.2% 

5.4% 

12,941 

9.8% 

United Kingdom 

FC Barcelona 

13,183 

9.1% 

27,878 

21.2% 

12,089 

9.2% 

- 

- 

- 

- 

73,272 

55.7% 

TOTALS 

145,491 

100% 

131,246 

100% 

131,597 

100% 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

When  analysed  the  total  number  of  registrations  to  iCoach  as  a  percentage  of  the 
number  of  smokers  per  country,  we  see  that  (with  the  exception  of  Portugal)  the 
countries  that  registered  the  highest  proportions  of  subscribers  to  iCoach  were  those 

December, 2015 

   37 

 
 
 
  
 
 
Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

with  the  lowest  numbers  of  smokers,  including  Malta,  Luxembourg,  Cyprus  and 
Estonia.  Portugal,  which  ranked  third  in  the  list,  registered  an  important  number  of 
subscribers to iCoach relative to the number of smokers. On the other hand, Germany, 
Austria,  France,  Finland,  Italy  and  Poland  recorded  the  lowest  proportions  of 
subscribers in relation to the total number of smokers.  Table 19 and Figure 22 below 
register the numbers and percentages. 

Table  19:  Number  of  registrations  to  iCoach  as  a  percentage  of  the  number  of  smokers  per 
country 

Country 

Smokers  per 
country 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Republic 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

United Kingdom 

TOTALS 

2,365,932 

2,455,579 

2,330,074 

198,148 

2,614,242 

1,187,041 

294,939 

1,121,900 

14,837,023 

18,410,704 

3,873,088 

2,729,124 

1,016,182 

12,507,173 

692,320 

827,012 

113,885 

95,544 

3,299,694 

10,831,290 

2,076,726 

5,470,423 

1,059,108 

492,614 

12,931,987 

1,020,579 

13,927,609 

Total iCoach 
registrations 
3,127 

16,270 

15,459 

2,024 

10,891 

2,570 

2,840 

2,113 

20,986 

16,295 

10,855 

12,908 

4,616 

24,608 

2,759 

4,680 

1,617 

1,980 

10,205 

20,461 

24,536 

22,789 

8,271 

2,750 

27,827 

3,598 

54,202 

145,491 

% of total 

0.13% 

0.66% 

0.66% 

1.02% 

0.42% 

0.22% 

0.96% 

0.19% 

0.14% 

0.09% 

0.28% 

0.47% 

0.45% 

0.20% 

0.40% 

0.57% 

1.42% 

2.07% 

0.31% 

0.20% 

1.18% 

0.42% 

0.78% 

0.56% 

0.22% 

0.35% 

0.39% 

100% 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

December, 2015 

   38 

 
 
 
  
 
 
 
 
 
                          
 
 
Figure 22: iCoach registrations as a percentage of the number of smokers per country (in %s) 

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Source: Campaign Annual Analytical Reports (Years 1, 2 and 3) 

In  order  to  assess  the  contribution  of  iCoach  in  terms  of  the  number  of  smokers 
helped  to  quit,  we  have  assessed  the  results  presented  in  the  iCoach  Sixth  Effect 
Report  of  October  2013  prepared  by  Brand  New  Health.  These  results  represent  the 
headline  figures  of  quit  rate  in  the  subsequent  follow  up  measurements  and  the 
estimate of smokers helped to quit (65,200) on which the cost-per smoker is derived.  

The  number  of  smokers  ceasing  smoking  following  registration is  defined  in  terms  of 
the  registered  population.  The  actual  outcome  is  only  known  for  a  proportion  of  this 
population, namely those who respond to the follow-up measurements. Therefore the 
number of smokers helped has to be extrapolated from available information.  

A direct approach would be to apply the proportion reporting quitting in the follow-up 
survey  to  the  non-responding  group.  This  is  equivalent  to  multiplying  the  entire 
registered  population  by  the  known  proportion  quitting.  This  approach  would  assume 
that  the  population  responding  to  the  follow-up  survey  is  similar  in  important  ways 
(that  influence  cessation)  to  that  who  do  not  respond.  This  is  not  the  approach 
adopted  by  BNH  for  calculating  overall  numbers  helped.  They  rightly  suggest  this 
requires  too  many  assumptions  about  similarity  between  responders  and  non-
responders on influential characteristics.  

important 
Where  there  are  known  differences  between  the  two  groups 
characteristics there may be a case for calculating the results for the non-responding 
group  in  a  way  that  adjusts  for  those  differences.  This  is  the  approach  adopted  by 
BNH.  They  identify  a  variable  which  is  associated  with  smoking  and  which  also  has 
different  profiles  in  responding  and  non-responding  populations.  This  variable  is  the 
number of times that the registered user has logged in to the system. They note that 
variation in this variable is associated in the responding sample with the likelihood of 
quitting success. It is also strongly associated with the likelihood of responding to the 
follow-up survey. 

in 

BNH do not assert that this is the only characteristic associated with quitting and with 
response, but they suggest it is the most important one. Based on this BNH apply the 
known  quit  rates  for  responders  with  different  levels  of  usage  (numbers  of  log-ins in 
banded  groups)  to  estimate  the  numbers  quitting  in  the  equivalent  group  (with  the 
same  banded  number  of  log-ins)  in  the  non-responding  registered  population.  This 
adjusts  for  potential  differences  in  the  two  groups  on  this  one  characteristic.  This 
calculation  is  supported  by  sharing  of  relevant  tabulations  (Table  20).  The  figure  is 
slightly rounded down in the report as noted in the table. 

December, 2015 

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Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

Table  20:  Estimation  of  the  number  of  smokers  quitting  based  on  number  of  log-ins  amongst 
non-responding registered users 

Intensity of logins 
category 

login cat 1 (1-2 logins) 

login cat 2 (3-5 logins) 

login cat 3 (6-10 logins) 

login cat 4  (11-20 logins) 

login cat 5 (21-50 logins) 

login cat 6 (51-max) 

TOTALS 

actual number of 
smokers at 
baseline who  
reported to have 
quit smoking at 1st 
follow-up 

actual quit-rate 
from smokers at 
baseline who 
completed the 
1st follow-up 

actual number 
of smokers at 
baseline who 
confirmed 
their 
registration11 

estimation of 
smokers at 
baseline who 
have quit at first 
follow-up based 
on previous 2 
rows12 

1,856 

2,527 

1,490 

987 

866 

314 

30.1% 

36.0% 

38.5% 

41.7% 

45.2% 

50.9% 

154,514 

32,655 

10,419 

5,125 

3,155 

756 

46,509 

11,756 

4,011 

2,137 

1,426 

385 

66,624 

The approach to adjusting the estimate using information about differences in profiles 
is  logical,  and  BNH  have  identified  a  variable  (number  of  log-ins),  which  is  clearly 
associated  with  the  cessation  outcome  and  response  to  the  follow-up.  Adjusting 
estimates for these differences appears sensible. The test of association cited by BNH 
(in  discussion  with  them)  is  a  nominal-by-nominal  association  and  they  propose  that 
this  test  suggests  that  number  of  logins  is  the  characteristic  that  is  most  strongly 
associated with cessation. Although they do not claim that this is the only association 
of significance, they do not propose any further adjustments to estimates on the basis 
of other characteristics.  

Logins  is  the  characteristic  most  clearly  associated  with  the  outcome  and  with 
responding  to  the  follow-up  survey  in  terms  of  a  nominal  relationship  of  those 
available. A nominal relationship is appropriate to consider for nominal variables or for 
ordinal  ones  with  a  non-linear  relationship  with  smoking.  Log-ins  may  well  have  the 
latter  characteristic  as  increasing  log-ins  may  reflect  increasing  commitment,  while 
very  high  numbers  of  log-ins  may  reflect  extreme  difficulties  quitting.  However, 
generally we would anticipate that most situations a confounding relationship would be 
linear  and  analysis  shared  by  BNH  suggests  there  are  other  characteristics  also 
linearly associated with the outcomes that are not adjusted for in the estimates. It is 
not  possible  to  say  on  the  evidence  available  whether  these  other  characteristics 
would  additionally  be  worth  adjusting  for.  It  may  be  that  adjusting  for  log-ins  alone 
removes  most  of  any  bias  that  might  arise  in  using  the  responding  sample  for 
estimates.  However,  this  may  not  be  the  case  and  it  might  be  that  some  bias  in  the 
estimate remains13.  

On  balance,  BNH  have  adopted  an  approach  to  adjusting  estimates  that  appears 
reasonable  if  the  intention  is  to  develop  a  broadly  indicative  quit  rate  for  the 
registered  population.  BNH  have  identified  a  method  for  creating  estimates  of  quit 

11 As highlighted by BNH, ‘confirmed smokers’ is a conservative way to calculate. For the calculations, BNH 
made the assumption that none of the not-confirmed have quit smoking, even though they have a few days 
access to iCoach after registration when not confirming their email. 
12  BNH  rounded  this  number  as  they  stated  that  they  could  only  calculate  a  (conservative)  estimation  but 
not pinpoint an exact number of smokers who had quit smoking. 
13  It  is  theoretically  possible  to  apply  a  multivariate  analysis  to  the  available  information  to  generate  a 
model of  likelihood  to  quit  with  a  number  of  the  associated  characteristics  as  predictors.  This  would  allow 
each individuals propensity to quit to be estimated and the the estimates for the non-responding sample to 
be  adjusted  according  to  this  “propensity  to  quit”.  However,  this  would  require  additional  analysis  and  it 
does  not  guarantee  that  the  estimates  derived  would  be  more  reliable,  since  there  may  still  be  other 
characteristics that are unmeasured which could bias the estimates. 

December, 2015 

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Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

rates  for  non-responding  registered  users  in  which these  are  adjusted  according  to a 
difference  between  responders  and  non-responders  in  one  known  characteristic  (log-
ins) that is associated with cessation. As discussed this may also adjust automatically 
for  the  differences  in  that  are  observed  in  other  variables  associated  with  cessation. 
However  it  should  be  noted  that  there  are  a  number  of  other  characteristics  that  do 
vary  markedly  between  responding  and  non-responding  samples  and  which  are 
associated  with  quitting14  and  given  that  this  is  the  case  some  caution  is  required 
about whether responders and non-responders will have behaved similarly in terms of 
cessation. 

Calculating quit rates 

Separately  from  estimating  the  numbers  of  smokers  helped,  BNH  have  presented 
estimates  of  quit  rates  that  are  not  based  on  adjustments 
important 
characteristics,  but  reflect  a  “raw”  quit  rate  among  those  responding  to  follow-up 
measurements at different stages. This gives a view not of numbers helped but of the 
evolution  of  the  programme  as  evidenced  by  those  responding  to  surveys.  Table  21, 
supplied  by  BNH,  clarifies  the  calculation  of  these  headline  proportions  from  the 
underlying data. 

for 

Table  21:  Estimation  of  the  number  of  smokers  quitting  based  on  number  of  log-ins  amongst 
non-responding registered users 

Number 

Definition 

Quit rate 3 months 

Where shown in 
report 

Base 

Active  users  who  responded  to  baseline  survey  and  reported 
they  were  smokers  at  that  time  and  also  responded  to  survey 
at 3 months 

Page  16,  first  paragraph 
(22,328) 

Quitters 

Number (within base population) reporting that they had quit at 
3 months 

Result 

Quit rate 3 months 

Quit rate 6  months 

Base 

Active  users  who  responded  to  baseline  survey  and  reported 
they  were  smokers  at  that  time  and  also  responded  to  survey 
at 6 months 

Quitters 

Number (within base population) reporting that they had quit at 
6 months 

Result 

Quit rate 6 months 

Quit rate 9  months 

Base 

Active  users  who  responded  to  baseline  survey  and  reported 
they  were  smokers  at  that  time  and  also  responded  to  survey 
at 9 months 

Quitters 

Number (within base population) reporting that they had quit at 
9 months 

Result 

Quit rate 9 months 

Quit rate 12  months 

Page 16, Table 7 (8,040) 

Page 16, Table 7 (36%) 

Page  19,  first  paragraph 
(7,095)  

Page 19, Table 11 (3,461) 

Page 19, Table 11 (49%) 

Page  20,  first  paragraph 
(3,135) 

Page 20, Table 13 (1,690) 

Page 20, Table 13 (54%) 

Base 

Active  users  who  responded  to  baseline  survey  and  reported 
they  were  smokers  at  that  time  and  also  responded  to  survey 
at 12 months 

Quitters 

Number (within base population) reporting that they had quit at 
12 months 

Result 

Quit rate 12 months 

Page  21,  first  paragraph 
(1,404) 

Page 21, Table 15 (834) 

Page 21, Table 15 (59%) 

14 Examples include: reported initial motivation to quit, perceived importance of quitting, and age. Gender 
also varies markedly by responding, but is not significantly associated with cessation. 

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2. 

ON-LINE SURVEY WITH NATIONAL STAKEHOLDERS AND 
PARTNERS 

2.1. 

Introduction 

In early January 2015, we launched an on-line survey questionnaire amongst national 
stakeholders  and  partners  who  took  part  in  the  Ex  smokers’  campaign.  The 
questionnaire  remained  on-line  for  a  period  of  8  weeks  (until  early  March)  and  was 
sent to 319 valid email addresses of stakeholders, which were updated / reconstructed 
with  support  from  the  Commission  and  from  national  campaign  correspondents  in 
each country.  

In total, 124 responses were collected and analysed, which represents an unusually 
high  response  rate  of  39%  for  these  types  of  survey  exercises.  The  success  of  the 
survey relied on personalised emails and follow-ups to each stakeholder in the list, as 
well  as  a  close  monitoring  and  tracking  of  email  addresses  to  make  sure  that  these 
were  up  to  date  given  the  period  of  time  elapsed  between  the  end  of  the  campaign 
and  the  evaluation.  In  addition,  we  attached  an  introductory  letter  signed  by  DG 
SANTE  to  each  stakeholder  explaining  the  purpose  of  the  evaluation  in  order  to 
reinforce the invitation and to increase buy-in. 

The objective of the survey questionnaire was two-fold:  

  On  the  one  hand,  it  aimed  to  collect  stakeholders’  levels  of  awareness  and 
participation  in  the  campaign,  as  well  as  their  views  on  the  campaign.  This 
included  questions  on  the  effectiveness  and  appropriateness  of  campaign 
actions,  channels  and  messages,  campaign  effects  on  target  audiences  and  on 
Member States, extent to which the campaign was perceived as an EU initiative, 
coherence  and  fit  between  different  campaign  elements,  and  ways  in  which  it 
interacted with national initiatives. 

  One  the  other  hand,  it  attempted  to  identify  information  initiatives  and 
campaigns  focussed  on  smoking  prevention  and  smoking  cessation  in  the 
Member States that have been effective in the fight against smoking, as well as 
plans for future activities. 

2.2. 

 Profile of respondents 

The  following  Figures  (23  and  24)  illustrate  the  profile  of  respondents  by  type  of 
organisation  and  by  country  in  which  the  organisations  operate.  As  can  be  seen  in 
Figure  3,  NGOs  /  Foundations  and  Communication  Agencies  were  the  stakeholder 
groups  most  represented  in  the  survey,  followed  closely  by  National  /  Local 
Authorities.  There  were  also 
from  Health  Organisations,  EC 
Representations,  Media,  Business  /  Industry,  University  /  Research  and  one  Patient 
Organisation. 

respondents 

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Figure 23: Type of organisation of respondents (in numbers) 

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Figure  24  reflects  a  higher  participation  in  the  survey  of  respondents  from  Romania 
and  Bulgaria,  followed  by  stakeholders  from  Czech  Republic,  Italy,  Poland,  Slovenia, 
Latvia, Portugal and Denmark. At the other end of the spectrum, responses have been 
low  for  Sweden,  Luxembourg  and  Estonia.  We  would  like  to  highlight  that  country 
differences  do  not  necessarily  reflect  higher  or  lower  response  rates.  There  were  a 
number of countries, including Luxembourg, France, Ireland, Malta, Spain and the UK, 
for which we had fewer valid email addresses, with less people contacted as a result. 

Figure 24: Country in which respondents’ organisations operate (in numbers) 

2.3. 

 Levels of campaign awareness 

The  vast  majority  of  survey  respondents  (88%)  were  familiar  with  the  Ex  smokers’ 
campaign  before  receiving  the  link  to  the  evaluation  survey.  A  lower  but  still 
significant  number  of  stakeholders  surveyed  (65%)  participated  in  specific  campaign 
activities (see Figures 25 and 26 overleaf). 

The  two  main  types  of  activities  mentioned  by  respondents  include  events 
(marathons, races, press conferences, seminars, festivals, activities around the World 

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No  Tobacco  Day,  Day  of  the  Ex-Smoker,  QSWB  initiative,  etc.)  and  campaign 
promotional  actions  (dissemination  of  material,  networking  with  stakeholders,  media 
relations,  writing  up  of  media  pieces,  promotion  via  social  media,  etc.).  A  few 
respondents  also  contributed  to  the  campaign  as  experts,  either  as  part  of  the 
campaign’s Advisory Committee or in an external role.  

Figure 25: Campaign  awareness (in %s) 

Figure  26:  Participation  in  campaign  activities 
(in %s) 

Yes

No

Don't Know

Yes

No

Don't Know

10 

2 

3 

32 

88 

65 

More than half of respondents considered that their knowledge about the Ex-smokers 
campaign  was  ‘well  advanced’  (34%)  or  ‘advanced’  (26%).  However,  a  substantial 
proportion  of  stakeholders  stated  that  they  had  a  ‘basic’  knowledge  about  the 
campaign (33%) and a smaller group went further to consider that their information of 
the  campaign  was  ‘very  basic’  (6%).  As  can  be  expected,  stakeholders  who  declared 
themselves  unfamiliar  with  the  campaign  skipped  many  of  the  subsequent  questions 
on campaign effectiveness and impact. 

Figure 27: Knowledge about the campaign (in %s) 

2.4. 

 Effectiveness of campaign tools and channels 

Survey  respondents  who  were  familiar  with  the  campaign  were  asked  to  rate  the 
effectiveness  of  a  series  of  campaign  tools  and  channels  on  a  scale  of  4  (“very 
effective”)  to  1  (“not  at  all  effective”),  and  were  then  asked  to  provide  reasons  for 
their answers. Figures 28 and 29 below feature the comparative ranking of tools and 
channels  from  the  most  effective  to  the  least  effective  and  in  terms  of  levels  of 
awareness. It is important to read these two variables (effectiveness and awareness) 

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together, as there are a few tools (e.g. PR &  stakeholder relations) that were judged 
very effective but evidenced low levels of awareness.  

Figure 28: Effectiveness of tools and channels (avg ranking)    

Figure 29: Awareness of tools and channels (in %s) 

Below we provide a more detailed analysis of each tool / channel. 

PR & stakeholder relations 

Levels  of  awareness  of  PR  &  stakeholder  relations  were  low  amongst  respondents: 
only  65%  of  those  who  answered  this  question  were  aware  of  this  particular  tool. 
Those familiar with the tool ranked it as the most effective in the list, with an average 
of  2.94  points  out  of  4.  Amongst  the  positive  aspects,  respondents  highlighted  that 
networking  with  NGOs  in  particular  increased  the  reach  of  the  campaign  as  civil 
society  organisations  offered  a  good  match,  local  professional  support  and  useful 
information, as well as the possibility to localise campaign tools. On the negative side, 
one  respondent commented that the campaign also met with organisations with rigid 
structures (namely governmental) that made it difficult to organise relatively straight-
forward tasks like sharing links. 

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iCoach application and on-line platform 

iCoach stands out as the tool that respondents were most aware of and amongst the 
top  ranked  in  terms  of  effectiveness  (2.92  average  points).  Key  strengths  associated 
with  iCoach  include  that  it  was  free  and  of  easy  access,  that  it  was  innovative, 
motivational  and  that  it  allowed  users  to  keep  track  of  progress,  as  well  as  popular 
amongst  the  campaign’s  target  audience  and  young  people  in  general.  Main 
drawbacks include that it was not sufficient per se as a tool to quit smoking (“I doubt 
that receiving daily messages may help people to give up smoking”), that the answers 
and  solutions  provided  were  standardised,  that  the  questionnaires  were  lengthy  and 
that the quality of local translations was not good. One respondent from a Danish NGO 
argued that they had better national digital health coaching applications. 

Social media (Facebook, Twitter, YouTube) 

Slightly more than eight in every ten respondents to the question (82%) were aware 
of the social media channels used by the campaign, and ranked these highly in terms 
of effectiveness (2.92 average points). On the positive side, stakeholders argued that 
social  media  channels  were  important  drivers  to  iCoach,  that  they  offered  the 
possibility  to  replicate  campaign  messages,  that  they  were  popular  tools  and  very 
appropriate  channels  to  communicate  with  the  target  audience,  that  they  provided  a 
chance for more interactive links between the  campaign and the target, and that the 
content  was  relevant  and  up-to-date.  On  the  negative  side,  respondents  considered 
that  the  content  in  social  media  could  have  been  better  adjusted  to  meet  country 
needs  and  that  it  would  have  been  useful  to  see  more  posting  and  special 
breakthroughs. 

Promotional material 

High  levels  of  awareness  of  the  campaign’s  promotional  material  were  registered 
amongst survey respondents, with more than nine in every ten stakeholders surveyed 
recalling  this  particular  tool.  Respondents  also  ranked  it  as  the  fourth  more  effective 
tool (2.89 average points). Amongst the key strengths of this tool, people highlighted 
that they were very useful at events and for further dissemination by NGOs and health 
professionals,  that  there  was  a  good  variety  of  material  and  that  it  was  attractive. 
Those more critical argued that promotional materials were just accessories, that they 
didn’t play a crucial role or cause any behavioural change in the target audience, and 
that they are only effective if combined with other activities. 

National / local events 

Three in every four respondents to this question (75%) recalled national / local events 
as part of the campaign. Stakeholders ranked it in fifth place in terms of effectiveness 
(2.81 average points) and highlighted that they reached lots of people and generated 
direct contacts, that the atmosphere was great, and that media interest was high as a 
result  of  their  local  focus.  A  few  respondents  considered  that  the  local  events  could 
have  been  more  visible  and  that  there  could  have  been  more  events  organised.  One 
stakeholder  underlined  that  sometimes  it  is  better  to  spend  funds  on  running 
initiatives than to create new ones. 

Campaign website 

The campaign website was, together with iCoach, the channel that respondents were 
most aware of. It was ranked in sixth place in terms of effectiveness, with an average 
of 2.79 points. What people most liked about the website is that it was well organised, 
provided  plenty  of  information,  its  content  was  provocative,  the  design  and  features 
were “young and cool”, that it featured downloadable materials and  that it supported 

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other campaign activities. Negative comments were fewer and focused on the lack of 
practical information about quitting and that it could have been more informative. 

Media relations 

Seventy-nine  percent  of  those  who  responded  the  survey  question  were  aware  of 
media relations, and ranked it number seven in terms of effectiveness (2.76 average 
points  out  of  4).  Stakeholder’s  comments  were  generally  more  critical  of  media 
relations,  in  particular  pointing  out  that  press  releases  lacked  in-country  perspective 
and that they were excessively long and full of EC quotes that made them unattractive 
to  the  media.  One  respondent  highlighted  that  local  originated  press  releases  would 
have been more effective and appealing to the media.  

QSWB iCoach application 

Nearly  seven  out  of  every  ten  respondents  (69%)  were  aware  of  the  QSWB  iCoach 
application  and  ranked  it  as  the  eighth  more  effective  tool,  with  an  average  of  2.7 
points. Stakeholders highlighted that it was inspiring and motivational with the football 
players as role models, and that it was a highly cost-effective tool as it generated a lot 
of good publicity. The main drawback is that it was not very effective or applicable in 
countries  where  Barça  is  less  popular  (e.g.  Czech  Republic  and  Latvia  stood  out  as 
examples). 

High level events 

High level events were recalled by slightly more than six out of every ten respondents 
(63%) and received 2.69 average points on the effectiveness scale. Stakeholders were 
particularly supportive of the activities organised around the World No Tobacco Day in 
particular  as  they  received  media  attention  and  had  chance  to  be  adapted  to  local 
settings.  Many  of  these  events  were  judged  to  be  inspiring  and  well  received  by  the 
target  audiences.  They  also  offered  the  opportunity  for  the  campaign  to  interact 
directly  with  its  target.  On  the  negative  side,  a  few  respondents  argued  that 
marathons  were  not  a  good  event  to  recruit  smokers  to  sign  up  for  iCoach  as  they 
tried  to  persuade  those  that  had  already  been  persuaded  to  quit  smoking 
(“marathonists / runners don’t usually smoke”).  

Audiovisual communications 

Levels  of  awareness  of  audiovisual  communications  were  low  amongst  respondents: 
only  65%  of  those  who  answered  this  question  were  aware  of  this  particular  tool. 
Ranked  in  the  lower  end  of  the  spectrum  in  terms  of  effectiveness  (2.54  average 
points), stakeholders argued that the budget for audiovisual communications was low 
and  that  these  tools  had  very  little  visibility  and  were  not  available  in  all  languages. 
On  the  positive  side,  respondents  considered  that  the  videos  were  creative  and 
attractive, and aligned with other campaign tools and material. 

Print ads in newspapers 

Sixty-eight  percent  of  respondents  who  answered  the  question  recalled  print  ads  in 
newspapers.  This  tool  ranked  low  in  terms  of  effectiveness  with  an  average  of  2.37 
points.  Main  points  made  against  the  print  ads  included  the  limited  budget  which 
affected  their  potential  impact  (“only  a  few  newspapers  were  used  for  a  very  short 
period of time”). Some respondents also commented that the lack of local media plans 
adapted to the different Member States decreased the  chances  of  success. According 
to  a  few  stakeholders,  a  more  appropriate  choice  of  media  could  have  been  made, 
including for example media outlets targeting smokers. Positive elements included real 
images  that  people  could  easily  relate  to,  and  the  fact  that  these  created  a  buzz  on 
Facebook. 

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Thematic campaigns 

Only  50%  of  respondents  who  answered  the  question  were  aware  of  the  thematic 
campaigns and they ranked as the least effective tool with an average of 2.28 points. 
These  sub-campaigns  passed  inadvertent  to  many  stakeholders  and  the  main 
criticisms were that they did not go viral, that the timing was inappropriate, and that 
they dispersed the attention of the focus of the campaign.  

2.5. 

Effectiveness of campaign messages 

Survey  respondents  were  asked  to  rate  the  how  effectively  were  the  different 
campaign  messages  delivered  on  a  scale  of  4  (“very  effective”)  to  1  (“not  at  all 
effective”).  Figure  30  below  presents  the  messages  according  to  their  average 
ranking,  ordered  from  the  most  effective  to  the  least  effective.  Survey  responses 
registered  high  levels  of  awareness  for  all  messages,  with  no  significant  differences 
observed.   

In  overall  terms,  stakeholders  made  a  more  positive  assessment  of  the  effectiveness 
of campaign messages than of the effectiveness of campaign channels and tools, with 
higher  averages  observed.  As  is  to  be  expected,  survey  respondents  were  more 
inclined  to  consider  the  campaign’s  positive  emotional  messages  focused  on  the 
advantages  of  becoming  an  ex-smoker  as  more  effective  than  those  messages  that 
involved a negative component.  

In view of respondents, the two messages most effectively delivered by the campaign 
were  the  message  on  the  many  advantages  of  stopping  smoking  and  the  message 
highlighting  that  ex-smokers  are  in  a  better  physical  and  mental  condition  (3.49 
average points each), followed closely by the message that ex-smokers have a better 
life  (3.41  average  points).  The  more  rational message  about  the  financial  benefits  of 
giving up smoking ranked as the fourth in terms of effective delivery with 3.14 points, 
followed  by  the  negative  message  about  how  smoking  is  dangerous  for  one’s  own 
health and the health of relatives (3.06 points). At the lower end of the spectrum, the 
least  effective  messages  in  view  of  respondents  were  that  if  you  can  stop  smoking, 
you can deal with many things in life (2.89 average points) and that stopping smoking 
is a very big challenge (2.83 points). 

Figure 30: Effectiveness of campaign messages (avg ranking) 

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2.6. 

The campaign in perspective 

Stakeholders  were  asked  to  rate  their  level  of  agreement  with  a  number  of  general 
statements  about  the  Ex-smokers  campaign.  We  used  a  scale  of  4  to  1,  with  4 
representing  those  who  agreed  “to  a  great  extent”  with  the  statement  and  1 
representing  those  who  did  “not  agree  at  all”.  Figure  31  below  presents  the 
statements according to their ranking.  

In  overall  terms,  there  was  consensus  amongst  respondents  consulted  that  the 
campaign’s  main  benefits  were  its  innovative  positive  concept  and  its  originality  in 
comparison to other anti-smoking campaigns. The three statements that respondents 
most  agreed  with  were  that  the  campaign  talked  about  stopping  smoking  in  a  new 
way  (83%),  that  it  was  original  compared  to  other  campaigns  (79%),  and  that  it 
showed  that  smokers  have  a  high  chance  of  quitting  if  they  receive  guidance  and 
coaching  (78%).  At  a  second  level,  slightly  more  than  two  thirds  of  respondents 
(67%) agreed that target audiences perceived the campaign as an EU initiative. Sixty 
per  cent  of  those  surveyed  agreed  that  the  Ex-smokers  campaign  was  better  from 
other  prevention  campaigns  and  that  it  was  a  useful  complement  to  national  efforts. 
Respondents  showed  split  views  over  the  last  two  statements:  51%  agreed  that  the 
campaign  contributed  to  an  improved  image  of  the  EU  and  a  lower  42%  considered 
that the campaign had a lasting effect at national level.  

Figure 31: Agreement with campaign statements (in percentages) 

“The Ex-smokers are Unstoppable campaign...” 

2.7. 

Campaign outcomes and impacts 

This section should be read with the caveat that many respondents –particularly those 
who  were  not  actively  involved  in  the  campaign–  found  it  hard  to  comment  on  the 
campaign’s outcomes and longer-term impacts.  

We first asked respondents to give their views on the extent to which the Ex-smokers 
campaign  achieved  a  number  of  outcomes.  Figure  32  below  presents  the  levels  of 
agreement  and  disagreement  with  each  statement,  as  well  as  the  percentages  for 
those who did not have an opinion.  

Respondents  were  most  in  agreement  with  the  statement  that  the  Ex-smokers 
campaign  reinforced  awareness  of  the  dangers  of  tobacco  (60%).  The  majority  of 
stakeholders  surveyed  also  acknowledged  that  the  campaign  encouraged  smokers  to 

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stop smoking (54%) and that it attracted the attention of the media in their respective 
countries (51%). Fewer respondents –though still a high number– considered that the 
campaign  reached  a  significant  number  of  people  in  their  country  (48%)  or  that  it 
encouraged  people  to  talk  with  friends  and  family  about  the  dangers  of  smoking 
(47%). Slightly more than in every four respondents (28%) felt entitled to agree that 
the campaign had increased visits to local cessation services in the Member States.  

Overall, as evidenced in the figure below, a significant number of respondents did not 
have a shaped opinion on many the campaign outcomes. Respondents were clearer on 
whether the campaign had attracted the attention of the media or not, but many did 
not have sufficient evidence to ascertain if the campaign had increased visits to local 
cessation services or if it had encouraged people to talk about the dangers  of smoking 
or to stop smoking. 

Figure 32: Agreement with campaign outcomes (in percentages) 

                         “The Ex-smokers are Unstoppable campaign...” 

We  also  questioned  respondents  about  their  views  on  the  expected  longer-term 
impacts  of  the  Ex-smokers  campaign,  in  particular  the  extent  to  which  the  campaign 
can help to achieve a number of impacts in the future. 

As  reflected  in  Figure  33  overleaf,  60%  of  respondents  who  answered  this  question 
agreed  that  the  Ex-smokers  campaign  could  help  to  encourage  smokers  to  remain 
abstinent  after  they  quit  smoking  and  to  contribute  to  the  broader  goal  of  a  smoke-
free  Europe.  A  slightly  lower  number  of  stakeholders  (58%)  considered  that  the 
campaign  could  contribute  to  an  increase  in  the  number  of  healthy  life  years  of  the 
targeted  population.  Fewer  respondents  (42%)  were  inclined  to  agree  that  the 
campaign could contribute to decreased costs for EU public healthcare systems. 

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Figure 33: Agreement with campaign longer-term impacts (in percentages) 

                         “The Ex-smokers are Unstoppable campaign can help to...” 

2.8. 

Perceived main strengths and weaknesses and future recommendations 

We  asked  respondents  to  express  their  views  on  the  campaign’s  main  strengths  and 
drawbacks  and  to  provide  suggestions  on  ways  in  which  the  EU  could  (better) 
communicate  with  target  audiences  on  issues  related  to  smoking  prevention  and 
smoking  cessation.  The  responses  were  open-text,  which  allowed  us  to  complement 
the previous responses with qualitative data.  

Perceived strengths of the campaign 

Survey respondents judged the concept of the campaign and its key messages in 
a  very  positive  light.  People  considered  that  the  campaign  was  original,  fresh,  young 
and attractive, that it offered a new way to tackle the  challenge of quitting smoking, 
with messages that were motivating and that touched a chord on smokers. 

Stakeholders  were  also  highly  appreciative  of  iCoach  and  the  on-line  channels 
used.  In  particular,  one  respondent  defined  iCoach  as  a  “new,  modern  and 
unconventional  method  that  gives  freedom  to  use  it  whenever  users  find  it  more 
convenient”.  Participants  considered  iCoach  as  a  practical,  well-designed,  interactive 
platform  of  easy  access  for  users,  and  were  especially  positive  about  the  mobile 
application.    Respondents  also  valued  the  on-line  channels  used  by  the  campaign,  in 
particular Facebook. Several people thought they fit well with the campaign target and 
were a good point of entry to iCoach. 

Other  campaign  strengths  enumerated  by  respondents  include  the  EU-wide 
coverage  (“broad  message,  local  delivery”).  A  few  participants  highlighted  that  the 
campaign reflected the EU’s concern and commitment towards the issue, which helped 
to boost the EU’s image. The fact that the EU funded the campaign was also attractive 
for NGOs and public health organisations working on smoking prevention and smoking 
cessation  at  local  levels,  as  the  EU  is  perceived  as  a  prestigious  institution  to  work 
with. 

A  few  stakeholders  mentioned  the  attractiveness  and  coherence  of  the  campaign’s 
design and visuals, and there were some who referred to the local events and the 
campaign materials disseminated.   

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Perceived campaign drawbacks 

In view of many survey respondents, the main drawback of the Ex-smokers campaign 
was  the  lack  of  clear  links  and  interaction  with  civil  society,  government  and  public 
health organisations in each country. Stakeholders highlighted that stronger campaign 
connections  with  those  actively  working  in  this  field  would  have  increased  the 
visibility, impact and sustainability of the campaign. A few respondents questioned the 
selection of PR Agencies as local partners, instead of exploring partnerships with public 
health or civil society players: 

  “The campaign should not have been implemented through local PR Agencies, but 
in close liaison with public health organisations.” (EC Representation, Slovenia) 

Related  to  the  point  above,  stakeholders  argued  that  the  Ex-smokers  campaign  was 
not sufficiently prominent in the national and local media. Respondents related the low 
visibility  to  the  lack  of  tailored  campaign  messages,  local  spokespersons  and  local 
famous  personalities  endorsing  the  campaign15.  A  few  also  mentioned  the  limited 
budget available to organise local events and to advertise in traditional media.  

Another drawback highlighted by respondents was the centralised campaign structure 
that  resulted  in  a  slow  decision-making  process  with  little  room  for  PR  Agencies  to 
propose  alternative  approaches.  Stakeholders  also  criticised  the  long  and  not 
sufficiently  appealing  press  releases.  Many  would  have  liked  to  see  the  campaign 
continue  for  a  longer  period  or  would  have  liked  to  hear  about  the  campaign 
outcomes: 

  “The  campaign  suddenly  stopped  without  any  continuity.”  (National  /  local 

authority, Portugal) 

  “There  was  a  lack  of  momentum  after  the  campaign  came  to  an  end”  (EC 

Representation, Latvia) 

One  participant  argued  that  use  of  black  in  campaign  visuals  was  perceived  to  be 
contradictory as it suggested that ex-smokers were mourning for cigarettes, and that 
it contrasted with the positive messages disseminated. 

Suggestions for future improved EU communication 

Survey  respondents  suggested  that  the  EU  could  better  communicate  with  target 
audiences about smoking prevention and smoking cessation via the following: 

  Closer  communication  and  cooperation  (from  planning  to  implementation)  with 
tobacco-control  stakeholders  in  the  Member  States,  including  government,  civil 
society and public health organisations 

  Co-funding of initiatives at national and local levels through EU grants 

  Targeting younger age groups (to prevent them from starting smoking) 

  Involving celebrities and popular personalities in the Member States as campaign 

ambassadors 

  Finding more creative strategies to engage with journalists / media organisations 

through events, press trips, and other activities 

  Helping  health  professionals  and  teachers  via  capacity-building  strategies  to 
work  on  this  topic,  including  training  materials,  training  seminars,  informative 
tools, experience exchanges. 

15 In countries where the campaign engaged with local referents, this worked very well. 

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2.9. 

Examples of successful communication tools and activities in the Member 
States 

Stakeholders  provided  some  examples  of  communication  tools  and  activities 
implemented in the Member States. These are of course not representative of the full 
range of on-going initiatives at national and local levels, but provide some evidence of 
ways in which governments, civil society organisations and public health professionals 
address this challenge in different countries. In general, many activities are organised 
around specific days, in particular the World No Tobacco Day on May 31st every year.  

Activities in Cyprus organised and implemented by the Cyprus Non-Smokers’ 
League 

The  Cyprus  Non-Smokers’  League  works  in  partnership  with  Cypriot  national 
authorities in the fight against smoking. The organisation’s main activity is the set-up 
of  non-smokers’  committees  in  different  districts  around  the  country,  as  well  as  in  a 
great  number  of  communities  and  municipalities.  They  also  communicate  through 
public  and  private  radio  stations,  TV,  and  newspapers,  and  disseminate  information 
via leafleats and on-line channels. Their communication is mainly targeted at younger 
audiences  in  schools  and  universities,  local  communities  and  clubs.  They  are  also 
active  in  demanding  the  implementation  of  stricter  laws  and  measures  to  combat 
smoking amoung younger people. 

Rauchfrei! campaign in Germany 

Rauchfrei!  (http://www.rauchfrei-info.de/) 
is  a  smoking  cessation  programme 
designed  and  implemented  by  the  German  Federal  Centre  for  Health  Education.  The 
campaign  features  an  information  portal  with  an  on-line  tool  and  a  personalised  hot 
line  which  has  attracted  nearly  76  000  participants.  It  also  provides  a  savings 
calculator  and  an  E-mail  coach.  Main  strengths  of  the  campaign  have  been  the 
stakeholder  relations  it  developed,  its  strong  presence  at  events  and  the  fact  that  it 
has reached a broad target audience. On the downside, stakeholders consulted argue 
that the campaign was not very innovative in terms of its content. 

Figure 34: Rauchfrei!  homepage 

Initiatives in Denmark 

The  “Every  cigarette  is  doing  you  damage”  campaign  was  implemented  at  national 
level  in  Denmark  in  2009/10  using  the  Australian  concept.  It  targeted  middle-aged 
smokers with low education levels via TV and radio spots, a website and promotional 
material.  In  view  of  the  Danish  Cancer  Society,  50%  of  all  smokers  in  Denmark 
recalled the campaign, and the initiative stimulated 10% of smokers to quit smoking. 
At the time of the campaign, the number of phone calls to the national Quit line was 7 

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times  higher  than  the  average  rate  of  calls  and  it  generated  a  vivid  debate  around 
smoking and campaigns. 

“Stoplinien”  is  a  public  funded  Danish  website  (www.stoplinien.dk)  implemented  by 
the Danish Health Protection Agency. In addition to the website, the initiative includes 
a  toll  free  number  to  support  people  in  their  efforts  to  stop  smoking.  It  has  been 
operating for more than 15 years now, since 1999. 

“Smoke-free class” competition in the Flemish region of Belgium  

Partners from all over Europe who are engaged in Smokefree Class (SFC) Competition 
collaborate  in  the  Smokefree  Class  Network.  The  Institute  of  Therapy  and  Health 
Research (IFT-Nord, Kiel Germany) is in charge of the coordination of this network. In 
2009,  the  SFC-Network  was  funded  by  an  operating  grant  of  the  European  Union  in 
the framework of the Health Programme.  

SFC is a competition targeted at school pupils aged between 11 and 14. In Flanders, 
the 
activity 
voluntary 
(http://www.rookvrijeklassen.be/).  

programme 

carried 

class 

and 

out 

as 

is 

a 

Pupils  sign  a  class  contract  promising  not  to  smoke  during  the  competition.  The 
responsibility for the control of smoking lies mainly with the pupils themselves: pupils 
monitor  their  smoking  status  and  submit  regular  reports.  Classes  that  refrain  from 
smoking  get  to  participate  in  a  national  competition  where  they  can  win  different 
prizes.  Studies  are  available  measuring  the  effectiveness  of  the  approach  under  real 
classroom conditions (see http://www.smokefreeclass.info/impact_sfc.htm) 

Initiatives organised by the Italian League against Cancer in Italy 

The Italian League against Cancer (LILT) has been active around the National Week of 
Cancer Prevention every spring, and around the World No Tobacco Day (every 31st of 
May). LILT works  on preventive actions, as well as training and supervision of health 
professionals and volunteers, and participates in research projects. They manage local 
services  for  tobacco  cessation  (LILT  Smoke  Centres)  and  a  national  quit  line  “SOS 
LILT”.  The  organisation  communicates  on  its  website  (www.lilt.it)  and  via  social 
networks.  They  offer  tailored  individual  courses  and  smoking  cessation  groups  in 
schools, companies and institutions. They are active disseminators of information and 
have organised events focussed on tobacco control. 

“No  Smoking  Weeks”  organised  by  the  Spanish  Society  of  Family  and 
Community Medicine (SEMFYC) in Spain 

This  initiative  has  been  running  since  2000  with  support  from  SEMFYC,  the  Spanish 
Ministry  of  Health  and  the  Departments  of  Health  of  the  Autonomous  Communities. 
NSW  is  a  community  prevention  and  intervention  campaign  aimed  at  healthcare 
initiative’s  website 
professionals,  doctors  and  nurses,  and  the  public.  The 
(http://www.semanasinhumo.es)  is  updated  every  year,  together  with  the  campaign 
material (including posters, leaflets for patients and for health professionals, protocol 
sheets and a brief guide to support health centres in their efforts to help people to quit 
smoking).  The  main  activities  organised  each  year  include  information  tables,  talks 
and  debates  with  the  general  public,  workshops  in  schools  and  educational 
institutions,  competitions  in  schools  and  clinical  sessions  amongst  others.  Press 
conferences and press packs are also available for the media.  

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An  award  is  given  every  year  during  NSW  to  a  Spanish  figure  in  recognition  of  their 
work  to  promote  smoke-free  environments,  or  because  they  have  quit  smoking  or 
have contributed towards spreading the message on the benefits of giving up. 

Smoking  cessation  workshops  organised  by  pharmacies  of  Ljubljana  in 
Slovenia  

Pharmacies  in  the  municipality  of  Ljubljana,  in  Slovenia,  have  been  promoting  and 
organising workshops amongst smokers who want to quit smoking. Between 8 and 10 
people  are  invited  to  attend  10  regularly  weekly  sessions  led  by  pharmacists  where 
people share their personal stories. This is a small-scale initiative, but still valid as an 
example of activities organised by public health professionals at local level. 

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2.10.  On-Line Survey Questionnaire for Stakeholders (EN) 

The  European  Commission  (Directorate-General  for  Health  and  Consumers  –  DG  SANCO)  has 
commissioned Coffey International Development to undertake an “Ex post evaluation on the 
‘Ex-smokers are Unstoppable’ campaign” which ran for three years, from June 2011 to the 
end of 2013 and targeted smokers aged 25 to 34. 

The  evaluation’s  main  objective  is  to  assess  the  impact  of  the  different  campaign  actions 
and to use the results of the evaluation as a basis for further improving future communications 
of DG SANCO.   

With this on-line questionnaire,  targeted at  national authorities and campaign partners  in 
the Member States, we would like to ask you to contribute to this evaluation study, and thereby 
help  shape  future  EU  communication  focussed  on  smoking  prevention  and  smoking  cessation. 
The concrete aim of the questionnaire is two-fold: 

1.  Your views on the campaign: collect your opinions on the relevance of the Ex-
smokers campaign and the effectiveness of the different campaign actions and 
channels, as well as the effects that the campaign had on Member States and ways in 
which it interacted with national initiatives. 

2.  Examples of communication initiatives in the Member States: to identify 

information initiatives and campaigns focussed on smoking prevention and smoking 
cessation in the Member States, we would like to ask you to send us information on a 
few selected initiatives that you consider have been effective in the fight against 
smoking. 

We would like to emphasise that we will treat the responses confidentially and only aggregated 
results will be reported in the study. Moreover, all of the information received in the context of 
this evaluation shall be used only for the purpose it was requested.  

Finally,  any  personal  data  collected  in  this  evaluation  and  brought  to  the  attention  of 
Commission  services  will  be  treated  in  accordance  with  Regulation  (EC)  No  45/2001  of  the 
European  Parliament  and  the  Council  on  the  protection  of  individuals  with  regard  to  the 
processing of personal data by the Community institutions and bodies.  

The questionnaire should take around 20 to 30 minutes to complete.  

If  possible,  please  provide  your  answers  to  in  English.  If  this  is  not  convenient,  we  can  also 
accept responses in French, German, Polish or Spanish. 

Please feel free to contact a member of the evaluation team in case you require any assistance 
or clarification. 

Thank you very much in advance for your valuable feedback and support.  

Andrea Kobilsky 

E-mail: Andrea_Kobilsky@coffey.com 

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A. Introduction 

1. Which of the following best describes your organisation? 

  National / local / regional authority  

  NGO, foundation 

  Communication Agency  

  University / Research Institute   

  Patient association 

  Health professional organisation 

  Other (please specify………………..) 

  Don’t know / No answer 

2. What country does your organisation operate in (more than one if applicable)? 

  Austria   

  Belgium   

  Bulgaria 

  Croatia   

  Cyprus    

  Czech Rep 

  Denmark 

  Estonia 

  Finland 

  France 

  Germany 

  Greece 

  Hungary 

  Ireland 

  Italy 

  Latvia 

  Lithuania 

  Luxembourg 

  Malta 

  Spain 

  Netherlands 

  Poland 

  Portugal 

  Romania 

  Slovakia 

  Slovenia 

  EU-wide  

  Sweden 

  UK 

  DK/NA 

  Outside of the EU  
(please specify):  

B.  Your  level  of  awareness  and  knowledge  of  the  EU-wide  ‘Ex-smokers  are 

Unstoppable’ campaign   

The Ex-smokers’ campaign was launched by the European Commission in 2011 with the aim of 
encouraging smoking cessation across the EU. The campaign, which ran for 2.5 years in the EU-
27  MS,  targeted  male  and  female  smokers  between  the  ages  of  25  to  34  with  the  positive 
message of “ex-smokers are unstoppable”.  

3. Before receiving this survey questionnaire, were you aware of the ‘Ex-smokers are 
Unstoppable’ campaign which took place across the EU between 2011 and 2013? 

  Yes 

  No (go to Q. 13) 

  Don’t know / No answer  

 4. Did you participate in any of the campaign’s activities? 

  Yes  

  No (go to Q. 6) 

  Don’t know / No answer (go to Q.6) 

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5. If yes, could you specify which activities, the year when they took place, and what 

was your role in those activities? 

Activity you participated in 

Year when the 
activity took 
place 

Your role in the activity 

6. Thinking in retrospective about the campaign, how would you judge your 

knowledge about the ‘Ex-smokers are Unstoppable’ campaign? 

  Very basic  

(I heard there was a campaign but I was not familiar with its activities) 

  Basic  

(I knew about the campaign,  and I was roughly familiar with its activities) 

  Advanced  

(I was familiar with the campaign and its activities) 

  Well Advanced  

(I was very familiar with the campaign and its activities) 

  Don’t know / No answer 

C. Campaign communication tools, channels and messages 

The  effectiveness  of  a  communication  campaign  measures  the  extent  to  which  the 
communication tools were successful in delivering key messages to the target audiences.  

7. In your opinion, how would you rate the effectiveness of the following campaign 

tools and channels?  

Please  rate  on  a  scale  of  4  to  1,  where  4  means  “very  effective”  and  1  means  “not  at  all 
effective” and provide reasons for your answers in the second column.  

Main reasons for 
(lack of) 
effectiveness 

I was not aware of 
this tool 

Rank on a scale 
of 4 to 1 

4=very 
effective 

1= not at all 
effective 

iCoach digital health coaching  
application and on-line platform 

(becomeunstoppable.eu / 
stopsmokingcoach.eu) 

Quit smoking with Barça iCoach 
application 

(Quitsmokingwithbarca.eu) 

Campaign website 
www.exsmokers.eu  

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Main reasons for 
(lack of) 
effectiveness 

I was not aware of 
this tool 

Rank on a scale 
of 4 to 1 

4=very 
effective 

1= not at all 
effective 

Social media  

(Facebook, Twitter, YouTube) 

Print advertising in newspapers 

Audiovisual communication  

(TV commercials ‘Pregnant’ and 
‘Marathon’, Ambassadors’ movies, 
interviews with Commissioner, 
marathon’s videos, Christmas  video) 

Thematic sub-campaigns 

(Back to work campaign, New Year’s 
resolutions campaign) 

PR & stakeholder relations  

(Meetings with NGOs, 27 campaign 
Ambassadors) 

Media relations 

(Press releases, media coverage and  
engagement) 

Promotional  material  

(Gadgets, shirts, leaflets, call-to-
action cards, posters, foldable 
stands, pup-up stands, roll-up 
banners) 

High level events  

(Berlin / Poznan / Venice/ Dublin / 
Athens marathons, Bad Gasestein 
Health Forum, World No Tobacco 
Day, Quit Smoking with Barça, 20km 
of Brussels) 

National / local events  

(81 in-country partnership events) 

Other  
(please specify…………………………) 

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8. To what extent do you think that the Ex-smokers campaign effectively delivered 

each of the following messages to the target audiences? 

Messages 

To a 
great 
extent 

To 
some 
extent 

To a 
small 
extent 

Not at 
all 

Don’t 
know 

There are many advantages when you 
stop smoking 

Smoking is dangerous for your health 
and for the health of your relatives 

One can also have financial benefits 
when one stops smoking 

Stopping smoking is a very big 
challenge 

Ex-smokers are in a better physical 
and mental condition 

Ex-smokers have a better life 

If you can stop smoking, you can deal 
with many things in life 

9. To what extent do you agree with the following statements about the Ex-smokers 

To a 
great 
extent 

To 
some 
extent 

To a 
small 
extent 

Not at 
all 

Don’t 
know 

campaign? 

The Ex-smokers campaign… 

Was original compared to other 
prevention campaigns around smoking 

Showed that smokers have a high 
chance of quitting if they receive 
guidance and coaching 

Talked  about stopping smoking in a 
new way 

Was better from other prevention 
campaigns around smoking 

Was clearly perceived by target 
audiences as an EU initiative 

Contributed to an improved image of 
the EU 

Was a useful complement to smoking 
prevention  and cessation efforts at 
national level 

Has had a  lasting effect at national 
level, even one year after it came to an 
end 

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10. To what extent do you think that the Ex-smokers campaign achieved the following 

To a 
great 
extent 

To 
some 
extent 

To a 
small 
extent 

Not at all 

Don’t 
know 

outcomes? 

Outcomes 

Reached a significant number of 
people in your country 

Attracted the attention and interest 
of  the media  in your country 

Increased visits to local cessation 
services in your country 

Encouraged smokers to stop  
Smoking 

Reinforced awareness of the 
dangers of tobacco 

Encouraged people to talk with 
friends and family about the 
dangers of smoking 

11. And to what extent do you think that the Ex-smokers campaign can help in the 

longer term to achieve the following impacts? 

Outcomes 

To a 
great 
extent 

To some 
extent 

To a 
small 
extent 

Not at 
all 

Don’t 
know 

Encourage smokers to remain 
abstinent after they quit smoking 

Contribute to a smoke-free Europe 

Contribute to an increase in the 
number of healthy life years of the 
targeted population 

Contribute to decreased costs for EU 
public healthcare systems 

12. Please summarise, in your own words, the main strengths of the EU ‘Ex-smokers 

are Unstoppable’ campaign, as well as the main drawbacks and challenges faced.  

Main  strengths  of  the  Ex-smokers  are 
Unstoppable campaign 

Main  drawbacks  and  challenges  of  the  Ex-
smokers are Unstoppable campaign 

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13. Do you have any suggestions on ways in which the European Union could (better) 
communicate with target audiences on issues related to smoking prevention and 
smoking cessation? 

E. Examples of successful communication tools and activities in the Member States 

14. Could you please provide us with examples of successful communication tools and 
activities aimed at smoking prevention and cessation in the Member States?  

Please complete up to three fiches / examples of initiatives that have been implemented in the 
last three years. 

Characteristics 

Name/title of communication tool or 
activity 

Specific type of communication 
(e.g. conference, radio spot, leaflet, 
website, etc.) 

Short description 

(i.e. main content, design features, 
proceedings) 

Main target audience(s) 

(General public? Specific stakeholder 
group? Demographic characteristics? ) 

Assessment 

Results 

(If available, briefly describe 
monitoring / evaluation mechanisms 
and main results) 

Success factors 

(Please list the main factors why you 
consider this tool / activity was 
successful or effective) 

Novelty 

(Was this tool / activity / campaign 
innovative in any way? Why?) 

Lessons learned 

(What have you learned for future 
communication activities? What could 
be improved?) 

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15. Are you aware of any future communication initiatives in your country aimed at 

smoking prevention and cessation?  

  Yes (please provide a short description of the initiative ………………………………………….)  

  No  

  Don’t know / No answer  

Thank you very much for taking the time to fill in this questionnaire.  

Your support to this evaluation is much appreciated! 

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3. 

IN-DEPTH INTERVIEWS WITH NATIONAL STAKEHOLDERS 
AND PARTNERS 

3.1. 

Introduction 

This  section  presents  the  findings  of  the  telephone  interview  programme  with 
stakeholders  and  partners  in  the  Member  States.  Initially  foreseen  as  an  element  of 
the  case  studies,  we  proposed  to  broaden  the  scope  of  countries  in  the  interview 
sample from the  six case  study countries  to include stakeholders from other Member 
States.  The  main  reason  behind  this  change  is  that  we  lacked  sufficient  relevant  / 
informed contacts to speak with in some of the case study countries. 

At  the  time  of  submitting  the  report,  we  have  conducted  59  out  of  the  60 interviews 
planned  and  have  one  final  interview  to  carry  out.  The  following  table  provides  an 
overview of the number and type of stakeholders interviewed in each country. 

Table 22: Overview of stakeholders interviewed (per country and per group) 

EU 
Member 
States 

Austria 

Belgium 

Bulgaria 

Cyprus 

Czech Rep 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Netherlands 

Malta 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

UK 

TOTAL 

Types of stakeholders 

TOTAL 

NCs 

PHPs  NGOs  Media 

EC 
Reps 

Govts  Companies  CAs 

IOs 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

2 

1 

9 

1 

1 

1 

1 

1 

1 

1 

1 

1 

1 

2 

1 

1 

2 

1 

1 

1 

1 

1 

2 

1 

1 

1 

1 

1 

1 

1 

1 

1 

16 

9 

8 

12 

2 

5 

2 

4 

2 

3 

3 

4 

1 

2 

2 

- 

2 

1 

4 

10 

1 

- 

2 

- 

7 

- 

1 

3 

2 

2 

2 

1 

1 

6 

- 

- 
60 

NCs: National Correspondents / PHP: Public Health Professionals / CAs: Campaign Ambassadors 
/ IOs: International Organisations 

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The interviews served the dual objective  of  gathering information that will help us to 
evaluate  the  interaction  of  the  Ex-smokers  campaign  with  the  national  level  and  to 
complement / contrast the (self-reported) evidence on the impact of the campaign on 
the target group that will be collected via the on-line panel surveys and focus groups. 

We  used  semi-structured  guides  to  cover  all  relevant  points.  However,  we  conducted 
the  discussions  with  relative  flexibility  to  give  interviewees  the  chance  to  raise  any 
issues  that  were  not  initially  in  the  interview  guide.  Interviewees  lasted  between  30 
and 45 minutes.  

Key topics discussed included: 

  Relevance of the campaign and its objectives to the specific MS 

  Public health approaches and anti-smoking initiatives in the MS 

  Campaigns’ effectiveness, targeting and visibility in the MS 

  Perceived short-term and mid-term effects on smokers in the MS 

  Strengths and weaknesses of the campaign 

  Image of the EC as campaign owner 

  Campaign’s media interest / coverage 

  Synergies/linkages  of  the  campaign  with  national  campaigns  and/or  smoking 

cessation structures 

  Sustainability and EU added value of the campaign in the MS 

(For campaign ambassadors) 

  Personal experiences as iCoach users  

(For ambassadors and partners) 

  Personal experiences as national ambassadors / partners 

  Problems  or  challenges  encountered  in  partnering  with  /  supporting  the  EC's 

campaign 

The sub-sections below present the key findings from the interviews. 

3.2. 

 Main features of the campaign – perceived strengths and areas for 
improvement 

In view of stakeholders interviewed, the main strengths of the Ex-smokers campaign 
can be synthesised as follows: 

  Strategic  positive  concept  and  messages:  the  positive  approach  and  key 
messages  were  appealing  to  the  target  audience  as  they  were  fresh  and 
innovative, different from the traditional negative messages around smoking and 
its harmful effects. This positive angle was particularly effective in countries with 
former communist regimes (Hungary, Bulgaria, Slovenia), where people are less 
receptive  to  threatening  messages  that  aim  to  tell  them  what  to  do  /  not  do. 
Conversely,  the  concept  was  less  innovative  in  the  Nordic  countries  (Finland, 
Denmark),  where  there  is  a  long-standing  anti-tobacco  tradition  with  active 
governmental and civil society communication on this topic. 

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  EU  quality  seal:  the  EU  brand  is  said  to  have  generated  strong  expectation  in 
countries  with  low  levels  of  government  communication  in  this  field  (Spain, 
Bulgaria).  Danish  and  Italian 
the  benefits  of 
implementing  a  pan-European  campaign,  and  the  possibility  to  collect  and 
disseminate comparative information across many different countries. 

interviewees  highlighted 

  Social  media  channels:  the  interactive,  two-way  flow  of  social  media  channels 
was  considered  highly  appropriate  to  reach  the  campaign’s  age  group  (25-34) 
and  to  cover  the  topic  of  smoking  cessation.  Smokers  and  ex-smokers  could 
share  their  experiences  with  others  fomenting  a  sense  of  “community”  on  the 
Internet. On-line channels were also an effective point of entrance to iCoach. 

  iCoach: the iCoach platform was unanimously considered by interviewees as an 
innovative  tool  that  differentiated  the  Ex-smokers  campaign  from  other 
initiatives.  In  particular,  iCoach  was  better  received  in  countries  that  had  not 
developed this type of tool at national level. The added value of the platform in 
these  cases  was  significantly  higher  than  in  countries  that  had  developed  and 
implemented similar tools (Nordic countries). 

  Partnership  with  Barcelona  FC:  in  view  of  stakeholders  interviewed,  the  ‘Quit 
Smoking  with  Barça’  initiative  was  highly  innovative  and  had  a  strong  impact  in 
Spanish media in particular, and in other countries to a lesser extent. The media 
coverage  and  involvement  of  renowned  Barça  football  players  significantly 
increased  visits  to  the  campaign’s  website  and  Facebook  pages,  as  well  as  visits 
and subscriptions to iCoach. When consulted about the partnership with Barcelona 
FC, the majority of national correspondents whom we spoke with highlighted that 
this  initiative  was  inspiring  for  organising  local  sports  events  in  their  countries. 
Many made attempts and would have liked to implement similar partnerships with 
recognised  football  teams  in  their  countries  but  there  was  a  strategic  decision 
taken at central level not to emulate this initiative. 

Interviewees  were  also  requested  to  reflect  on  main  challenges  and  areas  for 
improvement of the campaign. These are developed below: 

  Lack  of  strong  links  with  governments  /  civil  society  organisations:  in  view  of 
public  health  professionals,  NGOs  and  government  representatives  consulted, 
the  Ex-smokers  campaign  was  not  complementary  or  linked  to  national 
initiatives  and  structures.  The  shared  view  is  that  if  the  campaign  had  involved 
national  stakeholders  –both  during  its  inception  and  its  implementation–  the 
potential  reach,  impact  and  its  sustainability  would  have  been  much  stronger. 
Those interviewed argued that their organisations were not consulted about the 
campaign, and would have welcomed a more active role from the outset: 

o 

o 

o 

“It  looked  like  a  private  campaign,  there  were  no  links  with  the  public 
sector.” (NGO representative, Italy) 

“It  was  a  classical  paid  campaign,  with  lots  of  money  available  for 
advertising  but  no  relationship  with  the  organisations  working  in  the 
field  of  smoking  prevention  and  smoking  cessation.”  (International 
Organisation representative, Germany) 

“The  campaign  in  our  country  was  restricted  to  the  use  of  one 
advertising firm but there was no cooperation with medical and scientific 
societies, like the Respiratory Society or the Cardiological Society. As  a 
result it was not promoted in a scientifically correct way.” (Public health 
professional, Greece) 

o 

“There  was  no  connection  between  the  Ex-smokers  campaign  and 
national  initiatives,  it  looked  like  it  was  hanging  in  the  air,  it  lacked 

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reference  points  at  national 
Lithuania) 

level.”  (Public  health  professional, 

From  the  point  of  view  of  some  national  correspondents  consulted  (Slovakia, 
Czech  Republic,  Finland),  it  was  difficult  for  their  PR  agencies  to  engage  with 
stakeholders and to get them on board. On the one hand, government and civil 
society stakeholders were cautious about supporting PR activities organised by 
advertising  agencies.  In  view  of  an  Italian  NGO,  it  took  them  some  time  to 
figure  out  that  the  agency  that  had  contacted  them  was  supporting  a  public 
campaign and that it did not have any links with the tobacco industry. On the 
other  hand,  there  were  some  NGOs  and  media  organisations  that  asked  for 
funds in exchange of cooperation or dissemination of the campaign.  

  Lack of accredited spokespersons in the Member States: national correspondents 
agreed that it was difficult to react to media requests in their countries as there 
were no authorised spokespersons at local level that could speak on behalf of the 
campaign.  Media  requests  were  elevated  to  the  central  level,  which  difficulted 
that  Commission 
timely 
Representations,  which  were  not  actively  involved  in  the  majority  of  Member 
States, could have played this role speaking on behalf of the Commission in each 
country.  

interviewees  pointed  out 

responses.  Some 

  Lack  of 

flexible 

implementation  structures: 

the  majority  of  national 
correspondents  highlighted  that  the  internal  structures  of  the  campaign  did  not 
give  room  for  flexibility  and  that  it  was  difficult  to  manage  media  relations 
locally. In particular, national correspondents argued that they were not allowed 
to  tailor  the  press  releases  that  were  drafted  centrally  and  that  approval  from 
headquarters was requested for every initiative. All of this hindered the internal 
communication  process  and  impacted  on  the  campaign’s  capacity  to  react  to 
media and stakeholders in a timely way. 

3.3. 

  National contexts 

In  view  of  those  consulted,  there  have  not  been  many  communication  initiatives  on 
smoking  prevention  and  smoking  cessation  implemented  at  national  level  in  recent 
years.  National  and/or  local  anti-smoking  initiatives  have  been  usually  organised  by 
NGOs or public health organisations around specific dates, like the World No Tobacco 
Day  or  New  Years’  Eve.  In  this  framework,  interviewees  valued  EU  large-scale 
campaigns like Ex-smokers or its predecessor HELP. Stakeholders also recognised that 
Ireland and the UK have been leading innovative communication initiatives in the fight 
against  tobacco,  and  shared  a  few  examples  of  articulated  national  campaigns  in 
Germany and Denmark: 

  Germany: 

‘Rauchfrei!’ 

(http://www.rauchfrei-info.de/).  Smoking  cessation 
programme  targeted  at  the  general  public  and  implemented  by  the  German 
public  health  authority.  The  initiative  features  a  website  with  and  on-line 
application and a personal hotline, as well as community and media activities. It 
has  reached  nearly  76,000  participants  and  has  developed  solid  stakeholder 
relations and a strong presence at events. The approach and key messages  are 
traditional, but the campaign has been effective. 

  Denmark:  ‘Every  Cigarette  is  Doing  You  Damage’.  Smoking  cessation  campaign 
adapted / tailored from Australia to Denmark. Targeted at middle-aged men with 
low  education  levels,  the  campaign  included  TV  and  radio  spots,  a  website, 
posters,  etc.  During  the  campaign,  the  number  of  phone  calls  to  the  national 
Danish quit-line was 7 times higher than the average. 

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Debates around legislation on smoking in public places have been taking place across 
EU  countries  in  recent  years,  with  Ireland  and  Italy  becoming  pioneers  in  approving 
and implementing this piece of legislation, and other countries following with more or 
less  controversy.  Stakeholders  in  some  countries  (Spain,  Hungary,  Slovenia  and 
Slovakia) recalled heated public debates around this measure, and recognised positive 
results  after  its  implementation.  Interviewees  in  other  countries  (Czech  Republic, 
Austria and Germany) highlighted the significant lobbying resources of their respective 
tobacco industries, with advertising and promotion budgets that are extremely difficult 
to counterbalance.   

Nordic  countries  (Denmark,  Finland  and  Sweden)  provide  interesting  role  models  to 
follow,  with  strong  links  between  national  /  local  authorities  and  civil  society 
organisations  and  with communication initiatives  implemented  at  local level  targeting 
specific  sub-groups  (young  people,  lower  socio-economic  groups)  and  geographical 
areas.  

Current  and  future  discussions  will  pivot  around  the  transposition  of  the  EU  Tobacco 
Products  Directive  laying  down  rules  on  the  manufacture,  presentation  and  sale  of 
tobacco and related products. The debates around plain cigarette packaging and prices 
of  cigarettes will also stand out in the coming years, with strong opposition from the 
tobacco industry. 

Stakeholders also shared a few examples of future communication initiatives in some 
Member States: 

  In  Italy,  several  smoking  prevention  actions  are  foreseen  for  2015  targeting 
young  people,  in  the  framework  of  the  national  programme  “Gaining  Health” 
and on the tenth anniversary of the Italian anti-smoking legislation. Initiatives 
will  be  aimed  at  preventing  smoke  initiation  amongst  youth  and  at  promoting 
cessation amongst all smokers, especially pregnant and breast-feeding women. 

  In  Portugal,  the  national  Health  Directorate  is  currently  launching  a  national 
campaign  on  TV,  radio,  press  and  on-line  channels  to  highlight  the  risks  of 
passive smoking in homes and cars. The main message of the campaign is that 
“When  someone  smokes,  everybody  smokes”,  and  the  objective  is  to  protect 
children from passive exposure to cigarettes.  

3.4. 

 Campaign design 

Campaign concept and key messages 

As highlighted in other sections of the report, stakeholders were highly appreciative of 
the  campaign’s  positive  concept  and  key  messages.  Many  interviewees  felt  that  the 
Ex-smokers  campaign  approach  was  complementary  to  the  negative  messaging  and 
images that tend to surface more often, and which can be effective. 

  “The  images  and  warnings  on  cigarette  packs  have  helped  to  inform  people. 
But  positive  messages  are  important  to  build  trust  and  motivation  amongst 
smokers.” (Local authority representative, Spain)  

  “Negative  messages  also  touch  a  cord  on  people,  so  a  combination  with 

positive messages is desirable.” (Private sector representative, Lithuania) 

Stakeholders agreed that it was a motivating approach for young people who are tired 
of  so  many  messages  against  drugs,  alcohol  and  tobacco  and  their  harmful 
consequences.  The  campaign  was  fresh  because  it  identified  and  exploited  an 
attractive twist that was missing at national level in many EU countries. 

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  “Positive messages give a perspective, a state of living smokers would like to be 
in the future. They move away from addressing people as smokers all the time.” 
(NGO, Germany) 

  “I like the idea that people can quit smoking, that many people have achieved it, 

that there is support to do so.” (Local authority representative, Spain)  

The  fear  factor  was  more  likely  to  be  ineffective  in  countries  with  former  communist 
regimes, as it reminded people of past times.  

  “If you start telling people what to do / not to do, Bulgarians will react negatively 
questioning why they are receiving orders.” (National correspondent, Bulgaria) 

However, negative messages could also deter young smokers who do not usually feel 
affected by the long-term harmful effects of smoking. 

Campaign slogan 

The majority of national correspondents consulted by the evaluation felt that the “Ex-
smokers  are  Unstoppable”  slogan  was  not  well  translated  in  their  native  languages. 
Some  countries  (Italy,  Austria,  Bulgaria,  Cyprus,  Germany)  preferred  to  use  the 
English  version  as  they  considered  that  it  was  ‘catchier’  and  that  young  audiences 
would not have problems in understanding it. 

In Spain, the slogan led to some confusion as it was translated “Los Ex Fumadores no 
Abandonan”  (Ex-smokers  don’t  quit),  which  could  also  be  interpreted  to  mean  the 
opposite.  

In  Austria  and  Germany,  one  stakeholder  explained  that  ‘Ex-smoker’  is  a  male 
expression  that  does  not  have  a  feminine  counterpart,  so  the  slogan  was  gender 
biased and the English version was used instead. 

Lithuania, Finland and Slovenia also experienced difficulties when using the campaign 
slogan in their native language versions.  

One stakeholder in Czech Republic highlighted that they experienced some issues with 
the graphic design of the slogan, as it gave the impression that it read “Smokers are 
stoppable”. 

National  correspondents  in  Romania,  Hungary  and  Denmark  were  satisfied  with  how 
the slogan was translated to their native languages. 

Target audiences 

Overall,  stakeholders  seemed  to  agree  that  the  age  group  selected  (25  to  34)  was 
very appropriate for a campaign focussed on smoking cessation. 

  “When  you  are  25  you  are  still  invincible,  nothing  can  hurt  you.  You  are  not 
prepared to stop smoking. A lot of people decide to quit when they start having 
kids.” (National correspondent, Denmark) 

  “People in their early twenties are not thinking about quitting.” (NGO, Italy) 

The  on-line  approach  and  channels  used  were  also  considered  relevant  for  engaging 
with young people. 

  “Facebook and social media are essential tools nowadays, and they are the right 

way to communicate with this group.” (National correspondent, Denmark) 

Stakeholders  would  have  favoured  targeting  a  broader  age  group,  in  particular 
teenagers  and  younger  audiences  at  school  and  University.  Interviewees  in  many 
countries  (in  particular  new  Member  States  like  Hungary,  Romania  and  Bulgaria) 

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agreed  that  people  are  starting  to  smoke  at  younger  ages,  hence  there  is  a  need  to 
design education and prevention campaigns amongst these age groups. 

  “In  Romania,  teenagers  start  smoking  very  young.  There  is  scope  to  organise 
partnerships with student organisations and initiatives in Universities.” (National 
correspondent, Romania) 

  “In  Bulgaria,  over  the  past  10  to  15  years,  people  have  started  to  smoke  at 
earlier  ages.  If  the  EU  were  to  launch  future  initiatives,  we  would  advise  to 
target teenagers from 14 years old onwards.” (National correspondent, Bulgaria) 

Stakeholders  in  countries  with  advanced  anti-smoking  policies  (Finland,  Denmark) 
were  inclined  to  target  people  in  older  age  groups  as  they  thought  that  the  iCoach 
application  is  effective  for  smokers  irrespective  of  their  age.  One  Finnish  interviewee 
also mentioned that the number of young people smoking in Finland is decreasing.   

  “The target audience of the campaign was good, but the question is how strictly 
we  should  stick  to  this  particular  age  group.  The  application  was  useful  for 
people of every age group.” (National correspondent, Finland)  

A few respondents considered that iCoach was more fit for relatively educated people, 
as  evidenced  by  the  success  amongst  young  professionals  and  employees  in  private 
companies.  People  with  lower  education  levels  completed  who  were  approached  at 
events were less interested in the tool.  

3.5. 

 Campaign implementation and results 

Campaign management structure 

The  majority  of  stakeholders  interviewed  agreed  that  the  Ex-smokers  campaign 
followed a highly centralised structure that did not give much room for tailoring to the 
local contexts. The lack of local spokespersons or decision-makers, the requirement to 
consult every decision / initiative / media request with headquarters (with the delays 
that  this  brought  about),  the  condition  not  to  adapt  press  releases  to  the  different 
Member  States,  were  considered  to  have  hindered  the  opportunities  to  generate 
broader media coverage and wider impact in the target audiences: 

  “Press  releases  were  written  for  the  whole  of  Europe,  we  couldn’t  adapt  them 

properly to our needs.” (National correspondent, Germany) 

  “Those  allowed  to  speak  on  behalf  of  the  campaign  were  people  from  Brussels 
not  based  in  our  country.  If  we  had  an  opportunity  for  an  interview,  we  really 
couldn’t do it.” (National correspondent, Bulgaria) 

  “We would have needed a national speaker to speak on behalf of the campaign, 

but we never had one.” (National correspondent, Italy) 

  “Each  country  involved  should  have  been  allocated  more  time  and  a  higher 
budget to plan initiatives at national level.” (Public health professional, Lithuania) 

National correspondents recognised that they had more flexibility when designing and 
organising  local  events,  as  well  as  when  interacting  with  the  campaign’s  target 
audiences via the local on-line channels (Facebook, Twitter, etc.). This was positive in 
that it offered them the possibility to better target the campaign to their countries, but 
the success of local initiatives was strongly linked to the work carried out by and the 
networks  built  by  the  local  PR  Agencies.  Those  Agencies  that  managed  to  work  in 
tandem  with  civil  society  organisations  and  public  health  professionals,  or  that 
appealed  to  the  media  and  to  private  sector  organisations,  achieved  better  results  in 
their countries than National correspondents who were less active, less connected with 
local stakeholders, or less creative to get through with the message.    

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Cooperation with local stakeholders 

Overall,  stakeholders  seemed  to  agree  that  the  Ex-smokers  campaign  could  have 
achieved  better  results  if it  had  developed  firmer  partnerships  and  had  worked  more 
aligned  with  local  stakeholders.  In  fact,  the  more  connected  the  campaign  was  with 
relevant  actors  in  the  Member  States,  the  more  successful  it  was  in achieving  media 
coverage and in reaching the target audience. 

NGOs  and  public  health  organisations  were  the  most  open  to  cooperate  with  the 
campaign  by  distributing  campaign  material,  co-organising  events,  recommending 
iCoach,  etc.  The  Ex-smokers  campaign  gave  them  visibility  and  prestige,  and  helped 
to reinforce the work they usually do. There were a few cases reported (Italy, Finland) 
where  NGOs  were  reluctant  to  collaborate  with  the  campaign  because  they  were 
distrustful  of  the  local  PR  Agencies  that  approached  them.  In  general,  there  were 
many  NGOs  and  public  health  organisations  interviewed  that  regretted  not  having 
participated  at  an  earlier  stage  when  the  campaign  was  under  construction,  and  not 
having had a chance to exercise a more active role throughout the implementation of 
the campaign: 

  “We  would  have  loved  to  participate,  but  unfortunately  we  found  out  too  late 

about the campaign.” (Public health professional, Spain)  

  “We were informed about the campaign and we helped to disseminate campaign 
material,  but  we  would  have  been  open  to  play  a  more  active  role.”  (NGO, 
Denmark) 

Governments  were  less  willing  to  work  in  tandem  with  campaign  structures  and  less 
flexible to disseminate information. There were some interesting and fruitful links with 
companies in a number of countries, but this element was not widespread. In fact, the 
HR toolkit distributed to large companies in 15 countries and to Commission DGs, EU 
Institutions and Agencies was less successful than expected. 

Campaign tools, channels and initiatives 

iCoach 

The  majority  of  stakeholders  interviewed  considered  that  iCoach  was  the  most 
effective  campaign  tool.  It  was  thought  to  be  innovative,  aligned  with  the  increasing 
use of technology in other areas, attractive to present to the media, and appropriate 
for the audience group that was being targeted by the campaign. It was also defined 
positively  as  an  example  of  a  ‘final  campaign  product’  that  ensured  continuity  and 
sustainability in the aftermath of the campaign: 

  “I  like  the  fact  that  iCoach  is  a  concrete  product,  a  tangible  legacy  of  the 
campaign.  It  is  not  common  to  see  campaigns  like  Ex-smokers  create  these 
types of tools.” (Public health professional, Greece) 

Public  health  experts  were  the  most  prudent,  considering  this  type  of  tool  as  one 
amongst  many  stimuli  that  smokers  and  ex-smokers  can  use  in  their  efforts  to  quit 
smoking and to remain abstinent. In particular, a few experts relativised its potential 
with  specific  sub-groups  like  heavy  smokers,  who  are  likely  to  need  to  combine  this 
type  of  tool  with  medical  treatment.  There  were  also  some  concerns  on  the 
measurement of  outcomes, especially the method used to  calculate if and how many 
people managed to quit as a result of using the application. 

Stakeholders  in  some  countries  (Denmark,  Germany)  confirmed  the  existence  of 
similar  national  applications  running  in  parallel  to  iCoach,  which  somehow  hindered 
the  dissemination  and  publicity  of  the  EU  platform  as  it  competed  against  their  own 
applications. Conversely, iCoach was highly valued in countries that had not developed 
this type of tool.  

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for 
Interviewees  highlighted  a  number  of  elements  where  they  saw  room 
improvement,  including  the  length  of  the  initial  sign-up  questionnaire  (“people  were 
discouraged  to  complete  the  questionnaire  and  stopped  using  iCoach”),  the 
requirement to sign up as user to make use  of the platform, its complexity for  some 
people  (“it  would  have  been  good  to  have  two  variants  of  iCoach,  an  easier  version 
and  a  complex  one  for  different  types  of  users”),  and  the  fact  that  it  was 
depersonalised and that people could not contact an actual person. A few stakeholders 
also  agreed  that  the iCoach  mobile  application  was  launched  too  late,  and  that users 
had been requesting it for a long time. 

On-line channels (Facebook, website, Twitter) 

Overall,  stakeholders  were  positive  about  the  role  played  by  on-line  channels  in  the 
campaign.  Interviewees  in  smaller  countries  or  new  Member  States  (Malta,  Hungary, 
Romania,  Bulgaria)  were  particularly  approving  of  Facebook  as  they  thought  that  it 
worked very well as a point of entry to iCoach and amongst young adults targeted by 
the  campaign.  Stakeholders  in  bigger  countries  highlighted  that  the  campaign  should 
have  had  a  stronger  focus  on  mainstream  media,  and  that  on-line  channels  –even 
though good and necessary– were not sufficient per se to generate broader awareness 
of the campaign.  

Social media channels in general were well-suited for the campaign’s topic of quitting 
smoking,  as  their interactive  nature  created  a  sense  of  community  amongst  smokers 
and  ex-smokers  who  had  succeeded  in  stopping  smoking.  People  were  not  just 
recipients  of  key  campaign  messages  but  they  were  able  to  respond  to  these 
messages and to share their experiences with others. 

In  view  of  national  correspondents,  Facebook  provided  them  the  opportunity  to 
generate their own tailored content, in line with overall campaign messages, but more 
aligned and/or linked to national contexts. They valued the flexibility of this channel as 
they  felt  more  restricted  by  the  campaign  headquarters  when  it  came  to  media 
relations.  

Quit Smoking with Barça (QSWB) 

Nearly  all  interviewees  were  aware  of  the  QSWB  initiative  that  took  place  in  the 
second  year  of  the  campaign.  In  general,  stakeholders  considered  that  the  initiative 
generated  strong  media  interest,  particularly  in  Spain  and  in  countries  with  a  long-
standing  football  tradition.  National  correspondents  expressed  some  frustration  that 
they  were  not  granted  authorisation  from  the  campaign’s  headquarters  to  explore 
similar partnerships in their countries, as they believed that the potential impact would 
have been significant.  

  “I am not really sure this worked in France. People know FC Barça but why not 
do  it  with  the  PSG?  Why  not  have  a  host  of  stars  or  a  European  team?  E.g. 
French  sailor,  Spanish  footballer,  British  tennis  player,  German  racing  driver 
etc...?” (NGO, France) 

Events 

In a similar line as with on-line channels, local events allowed national correspondents 
to work fairly independent from headquarters and to tailor  them to the local realities. 
In  general,  stakeholders  highlighted  that,  given  the  budget  available  for  this  type  of 
events,  it  was  more  effective  to  support  events  organised  at  local  level  (stands  at 
marathons,  sport  exhibitions,  conferences,  promotional  activities,  press  conferences, 
in-company events, etc.) than to design and implement exclusive events. 

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  “The  central  hub  gave  us  the  opportunity  to  adapt  the  local  events  to  the  local 

specificities, which was very important.” (National correspondent, Bulgaria) 

One  of  the  main  drawbacks  of  supporting  events  organised  by  others  is  that  it  was 
difficult  to  maintain  a  clear  line  that  people  would  recognise  as  distinctive  of  the  Ex-
smokers campaign.  

A few stakeholders criticised the focus on sport events as a way to sign up people for 
iCoach.  They  argued  that  even  if  sport  is  naturally  associated  with  healthy life-styles 
(including  quitting  smoking),  they  did  not  succeed  in  contacting  many  smokers  in 
marathons and sport events because those who take part are usually non-smokers or 
ex-smokers.  

  “We could have contacted more smokers if we had organised events in shopping 
malls,  Universities,  rather  than  supporting  marathons  or  sport  competitions.” 
(National correspondent, Hungary) 

Events  worked  better  when  they  received  media  coverage,  when  they  had  support 
from  local  celebrities,  and  when  they  were  targeted  at  the  local  audiences.  Activities 
developed  at  European  level  were  attractive  in  theory  but  were  not  necessarily 
relevant for the different countries as they were far off the local realities.  

One-off  activities,  like  the  day  of  the  Ex-smoker  in  the  final  year  of  the  campaign, 
were attractive for stakeholders but there were some who argued that there needs to 
be continuity from year to year to achieve real impact, e.g. the World No Tobacco Day 
on 31 May. 

Promotional material 

Stakeholders were divided over the campaign’s promotional material. On the positive 
side, they highlighted that give-aways were nice to attract people, and that NGOs and 
public  health  professionals  used  the  material  as  incentives  or  support  for  their 
audiences. 

  “All NGOs we were in touch with were interested in receiving campaign material 

- everybody was asking us about it.” (National correspondent, Italy) 

  “We  used  the  campaign  material  to  inform  our  members,  a  network  of  230 
hospitals, and our partners. We sent them the link to the campaign website and 
distributed the material we had.” (Public health organisation, Germany) 

On the negative side, some interviewees considered that the promotional material was 
not  tailored  to  the  local  market,  that  some  of  the  information  was  very  general,  and 
they suggested editing the material in the future. A few stakeholders alleged that the 
distribution method to NGOs and public health organisations was not effective as “they 
don’t usually work putting posters on the wall”. 

Media relations 

In view of the majority of national correspondents consulted by the evaluation, media 
relations were one of the most challenging elements of the Ex-smokers campaign. The 
main factors that hindered media interest and coverage included the lack of flexibility 
to  localise  press  releases,  the  lack  of  campaign  spokespersons  at  national  level,  the 
lack  of  strong  links  with  local  stakeholders  focussed  on  smoking  prevention  and 
cessation,  and  the lack  of  paid  media.  A  few  respondents  also  mentioned  that it  was 
difficult  to  keep  the  attention  of  the  media  during  the  three  years  that  lasted  the 
campaign as the messages tended to repeat. 

  “The  press  releases  were  too  bureaucratic  –  they  didn’t  try  to  identify  an  issue 

what we could sell to the media.” (National correspondent, Slovenia) 

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Despite the constraints highlighted by national correspondents, many  also mentioned 
that  the  challenge  was  to  find  creative  opportunities  to  capture  the  attention  of  the 
media,  including  involving  local  celebrities,  adequately  timing  the  local  events, 
tailoring  (to  the  extent  possible)  the  campaign  messages,  and  following-up  closely. 
The  partnership  with  Barcelona  Football  Club  in  Spain  was  extremely  successful  in 
achieving media coverage, and  encouraged national correspondents across  Europe to 
identify potential high-impact opportunities in their countries. 

  “General  EU-level  data  was  not  attractive  for  journalists,  so  we  tried  to  include 

as much local information as possible.” (National correspondent, Hungary) 

  “We  had  a  proactive  relation  with  journalists.  We  provided  information  to  them 

before, during and after the events.” (National correspondent, Bulgaria)  

Media  interest  was  weaker  in  countries  with  established  anti-tobacco  communication 
initiatives  (Finland,  Denmark),  and  conversely  stronger  in  countries  that  lacked  local 
action on this topic. 

  “Media  were  not  really  interested.  Anti-smoking  initiatives  have  been  out  there 
for  years,  they  are  not  new.  There  are  many  NGOs  working  together  that  are 
looking out for media coverage all the time.” (National correspondent, Finland) 

Journalists  interviewed  (mainly  in  Greece,  but  also  in  Bulgaria  and  in  Germany) 
argued  that  the  Ex-smokers  campaign  could  have  been  more  prominent  on 
mainstream media, in particular on TV. In general, they agreed that the message was 
attractive but that it did not manage to stand out. Greek journalists felt it was a lost 
opportunity for the EU given the low priority that national governments in Greece have 
assigned to this topic. Bulgarian journalists emphasised the cohesiveness between the 
Ex-smokers  campaign and a national plan on tobacco prevention that was running in 
parallel at that time.  

Campaign ambassadors 

In  view  of  national  correspondents  consulted,  the  experience  with  campaign 
ambassadors  was  not  as  useful  as  they  would  have  liked  to.  In  some  countries,  the 
selected ambassadors were more active at the beginning but with time they lacked a 
specific  role  (Austria,  Denmark,  Hungary).  In  others,  they  interacted  very  little  with 
the  campaign  from  beginning  to  end,  either  because  it  was  difficult  to  find  a  role  for 
them  (Romania,  Lithuania),  because  they  moved  countries  (Bulgaria),  because  they 
were not interested (Slovenia), or because they did not feel comfortable speaking with 
the media (Finland). 

Our experience with ambassadors in the framework of the evaluation was in line with 
national  correspondents’  views.  Only  4  out  of  the  27  ambassadors  that  we  contacted 
for  an  interview  agreed  to  speak  to  us.    All  of  them  confirmed  having  been  initially 
engaged  with  the  campaign  when  they  heard  about  the  competition  and  the  photo-
shoot  with  Rankin  in  London,  but  none  seemed  to  be  committed  to  the  campaign  as 
such. They agreed that the trip to London was a great personal experience, but when 
they returned to their countries they felt excluded by the campaign’s organisation and 
as  a  consequence  experienced  varying  degrees  of  frustration.  None  seemed  to  be 
strong  supporters  of  iCoach,  and  in  general  agreed  that  the  main  reasons  why  they 
quit  smoking  were  will-power  or  personal  experiences.  However,  if  they  had  been 
given  the  opportunity  they  would  have  enjoyed  a  stronger  involvement  in  the 
campaign. 

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Views on campaign results 

Stakeholders  found  it  very  difficult  to  elaborate  on  campaign  results,  as  they  lacked 
information  to  do  so,  but  also  because  they  agreed  that  it  is  difficult  to  isolate  the 
effects of a given campaign in the broader framework of other relevant factors such as 
national campaigns, anti-tobacco laws, price of cigarettes, etc.  

  “The wider context of smoking initiatives means changes cannot be attributed to 

this campaign alone.” (NGO, France) 

However, the majority felt that the campaign could have achieved more if it had built 
closer  links  with  national  stakeholders,  if  it  had  had  more  exposure  on  mainstream 
media, or if it had been more tailored to the different countries. 

In  general,  respondents  seemed  to  agree  that  the  campaign  had  more  added  value 
and broader visibility in countries with low levels of government activity in this field.    

3.6. 

 Recommendations for future initiatives 

At  the  end  of  each  interview,  we  asked  stakeholders  if  they  had  any  suggestions  on 
how  communication  and  campaigns  targeted  at  smokers  and  ex-smokers  could  be 
improved. We grouped the recommendations under the following main headings. 

Closer collaboration with public health stakeholders in each country  

Stakeholders  insisted  on  the  need  to  involve  national  and  civil  society  stakeholders 
from  the  very  outset  of  the  campaign,  during  the  design  phase  and  prior  to  local 
implementation.  In  view  of  respondents,  if  national  stakeholders  are  ‘involved’  as 
opposed  to  ‘informed’  ,  the  potential  for  complementing  efforts  and  for  reaching  the 
target  audience  can  be  significantly  higher.  One  way  to  do  this  is  through  umbrella 
organisations  in  Brussels,  many  of  which  represent  national  organisations  but  also 
have the European perspective.  

  “We are usually not contacted before but after when all is set. We would like to 

be part of the development of the campaign.” (NGO, Denmark) 

Target public health professionals  

Respondents emphasised the importance of disseminating key messages and tools to 
the target audience indirectly through public health professionals. If the campaign and 
specific  tools  like  iCoach  are  recommended  by  health  professionals  in  clinics  and 
health  care  centres,  the  impact  can  be  huge.  Creating  synergies  with  those 
responsible  for  smoking  prevention  and  control  in  the  different  countries  and  local 
communities would multiply the reach of any initiative and anchor it more strongly in 
national and local contexts. 

More flexibility for adapting messages to each country  

National  correspondents  in  particular  suggested  that  future  initiatives  should  attempt 
to  find  some  room  to  adapt  press  releases,  events  and  media  relations  to  local 
settings  with  a  view  to  reaching  the  target  audience  more  effectively.  This  also 
included  having  local  spokespersons  (EC  Representations,  local  leaders)  who  could 
speak on behalf of the  campaign, and local stories to be presented as testimonies. A 
few national correspondents highlighted that the media budget could have been more 
focussed on specialised media outlets focussed on sport and healthy lifestyles. 

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Focus on younger people  

Even  though  respondents  thought  that  the  25-34  target  was  appropriate  for  the  Ex-
smokers  campaign,  many  expressed  a  sense  of  urgency  in  relation  to  educating  and 
preventing younger generations including teenagers and people in their early twenties. 

Sustainability  

Whilst  respondents  recognised  that  the  length  of  the  Ex-smokers  campaign  was  a 
positive  feature,  many  also  argued  that  there  is  a  lack  of  continuity  between  EU 
campaigns. Some interviewees felt that EU campaigns lack a starting and an end point 
in  order  to  know  how  effective  they  were  and  to  keep  an  interest  around  the 
campaign. The shared  view is that every new  campaign needs to start all over again 
instead  of  capitalising  on  previous  efforts.  Keeping  iCoach  on-going,  building  closer 
links  with  public  health  stakeholders,  co-financing  grants  for  local  campaigns, 
supporting  tobacco  cessation  structures  and  networks  in  the  Member  States,  are 
different  ways  in  which  the  campaign  can  consolidate  its  results  and  keep  the 
momentum. 

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3.7. 

Interview Guide for National Stakeholders 

Ex post outcome impact evaluation on Ex-smokers campaign 

Interview guide for campaign partners 

Interviewee/s name/s 

Organisation 

Interviewer name 

Date 

Introduction / Your involvement as campaign partner 

  Could  you  briefly  introduce  yourself  and  your  background  /  the  organisation  that  you 

work for? 

  Could you describe your involvement / contribution to the Ex-smokers campaign? 

  How did you become a campaign partner in your country? Could you tell us about your 

experience as campaign partner?  

  How much contact did you have with the campaign organisers and with other campaign 

partners? 

 

In  which  ways  did  you  and  other  partners  contribute  to  the  success  of  the  campaign? 
Did you face any drawbacks or challenges in the process? 

Campaign’s relevance  

The three main objectives of the Ex-smokers campaign were to: (1) Encourage citizens to 
stop  smoking  and  help  them  quit;  (2)  Raise  awareness  of  the  dangers  of  tobacco;  and  (3) 
Contribute to the EC’s long-term objective of a smoke free Europe.  

  To what extent did the campaign meet the three key objectives in this country? Were there 
any particular campaign activities in this country that were more or less effective to reach the 
objectives?  Is  there  a  need  to  review  or  update  these  objectives  thinking  about  future 
potential actions? 

  Could  you  describe  the  public  health  approach  and  main  initiatives  undertaken  in  your 
Member  State  to  combat  smoking?  To  what  extent  has  the  government  been  an  active 
communicator  in  this  field?  Have  there  been  any  national  initiatives  or  campaigns 
implemented  on  smoking  prevention  or  smoking  cessation  in  recent  years?  Are  there  any 
initiatives from civil society stakeholders? 

  What  would  you  say  were  the  main  features  of  the  EU  Ex-smokers  campaign  in  this 
country?  In  your  view,  what  are  the  reasons  for  the  campaign’s  relative  success  or  lack  of 
success? Would you have done anything differently?   

  Do  you  think  that  the  campaign  approach  was  appropriately  tailored  to  this  country?  In 
which  ways  was  the  Ex-smokers  campaign  complementary  to  national  initiatives  and 
campaigns in your Member State?  

  And  in  which  ways  was  the  Ex-smokers  campaign  complementary  to  national  smoking 

cessation structures and services in this country? 

  Were there any synergies and challenges encountered when partnering with the EU on this 

campaign? 

  To what extent did the Ex-smokers campaign generate interest from local media, and what 

were the reasons (behind media’s interest or lack of interest)? 

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  In  terms  of  results,  what  were  the  main  achievements  of  the  Ex-smokers  campaign,  and 
what  were  the  main  drawbacks  or  challenges?  In  what  ways  was  this  campaign  different  / 
innovative from other campaigns targeted at smokers? 

  Are  there  any  lessons  to  be  learned  from  examples  of  other  similar  anti-smoking 

campaigns implemented in this country or elsewhere?  

Campaign’s effectiveness, targeting and visibility 

  Were target audiences in this country receptive to the Ex-smokers campaign? In light of the 
results, should there be any changes to target group segmentation in order to optimise reach 
of future campaigns? 

  Were the key campaign messages received and understood? Did they create some form of 
change  on  smokers’  attitudes  and  behaviours?  Are  there  any  gaps  in  the  content  of  the 
campaign  messages?  Are  the  messages  sustainable,  and  does  their  impact  last  beyond  the 
campaign? 

  Was the  EU’s  image  sufficiently prominent in  the  campaign?  To what extent  did the target 
audiences  associate  the  campaign  as  an  EU  initiative?  To  what  extent  did  the  campaign 
contribute  to  an  improved  EU  image  among  target  audiences?  Were  there  any  particular 
actions that were more or less effective to reinforce the positive image?  

Campaign’s acceptability, accessibility and coherence 

  What  was  the  contribution  of  the  different  campaign  tools  and  activities  to  the  overall 
objectives  of  the  campaign  (Interviewer  prompt:  campaign  website,  Facebook  Page,  iCoach 
application, events, videos, etc.)? Which campaign tools and activities have proved the most 
successful, and which have not worked as expected? Which was the most effective in bringing 
people to iCoach? 

  To  what  extent  is  it  possible  to  say  that  the  campaign  in  this  country  contributed  to  the 

following outcomes: 

o 

Increasing visits to local cessation services 

o  Changing  smokers’  behaviour  (increasing  smoking  cessation  attempts  and 

contributing to smoking cessation) 

o 

Increasing the number of talks about the dangers of smoking 

o  Modifying health beliefs and attitudes in the target audiences 

o  Generating media interest and coverage on the topic 

o 

Increasing the  number of quality life-years of the targeted population 

  Are there any statistics / studies / reports supporting the above assumptions? 

  Are  there  any  other  short  or  long  term  effects  in  your  country  as  a  result  of  the 

campaign?  

 

Is there scope to propose new tools or channels to communicate more effectively to the 
target audiences in future activities? With a reduced budget, what would you recommend to 
focus on in the future? 

Sustainability and EU Added Value 

  What is the effect of the Ex-smokers campaign in your country 12 months after the end 

of the activity? 

  What are the key lessons to be learned from the Ex-smokers campaign? Do you have any 
suggestions  on  how  communication  and  campaigns  targeted  at  smokers  and  ex-smokers 
could be further improved and if so, how and why? 

Many thanks for your support to this evaluation! 

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3.8. 

Interview Guide for Campaign Ambassadors 

Ex post outcome impact evaluation on Ex-smokers campaign 

Interview guide for national ambassadors 

Interviewee/s name/s 

Organisation 

Interviewer name 

Date 

Introduction / Your involvement in the campaign 

  Could you briefly introduce yourself and your background? 

  Could you describe your involvement / contribution to the Ex-smokers campaign? 

Your personal experience with iCoach 

  How did you first become aware of the Ex-smokers campaign and the iCoach application? 

  How did you take the decision to sign up for iCoach and what was your personal experience 

throughout the process?  

  How long did it take you to quit smoking? Do you remain abstinent since then? 

  Was  iCoach  the  key  driver  /  factor  that  helped  you  to  quit  smoking,  or  did  you  have  any 

additional support? (In which case) What type of additional support did you receive? 

  What changed in your life since you became an ex-smoker? 

  As an iCoach user, what would you say are the key strengths of the application? And do you 

see any aspects that could be improved? 

Your experience as campaign Ambassador 

  How did you become a campaign Ambassador in your country? Could you tell us about your 

experience as campaign Ambassador?  

  What feedback did you receive from other iCoach users – did they share similar experiences 

as yours? Did you collect any particularly challenging or positive experiences? 

  What  role  did  you  play  as  campaign  Ambassador  in  your  country?  How  much  contact  did 

you have with the campaign organisers? 

 

In  which  ways  did  you  and  other  national  ambassadors  contribute  to  the  success  of  the 
campaign? Did you face any drawbacks or challenges? 

Campaign’s relevance  

The three main objectives of the Ex-smokers campaign were to: (1) Encourage citizens to 
stop  smoking  and  help  them  quit;  (2)  Raise  awareness  of  the  dangers  of  tobacco;  and  (3) 
Contribute to the EC’s long-term objective of a smoke free Europe.  

 

To what extent did the campaign meet the three key objectives in this country? Were there 
any particular campaign activities in  this country that were more or less effective to reach 
the objectives?  Is there a need to  review  or update these  objectives thinking about future 
potential actions? 

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  Have  there  been  any  national  initiatives  or  campaigns  implemented  on  smoking 
prevention or smoking cessation in recent years? To what extent has the government been 
an  active  communicator  in  this  field?  Are  there  any  initiatives  from  civil  society 
stakeholders? 

  What  would  you  say  were  the  main  features  of  the  EU  Ex-smokers  campaign  in  this 
country?  In your view, what are the reasons for  the campaign’s  relative success or lack of 
success? Would you have done anything differently?   

  Do you think that  the campaign approach  was  appropriately tailored  to this country?  In 
which  ways  was  the  Ex-smokers  campaign  complementary  to  national  initiatives  and 
campaigns in your Member State?  

  And  in  which  ways  was  the  Ex-smokers  campaign  complementary  to  national  smoking 

cessation structures and services in this country? 

 

 

To  what  extent  did  the  Ex-smokers  campaign  generate  interest  from  local  media,  and 
what were the reasons (behind media’s interest or lack of interest)? 

In terms of results, what were the main achievements of the Ex-smokers campaign, and 
what were the main drawbacks or challenges? In your view, what ways was this campaign 
different / innovative from other campaigns targeted at smokers? 

  Are  there  any  lessons  to  be  learned  from  examples  of  other  similar  anti-smoking 

campaigns implemented in this country or elsewhere?  

Campaign’s effectiveness, targeting and visibility 

  Were  target audiences  in this country receptive to  the  Ex-smokers campaign?  In  light  of 
the results, should there be any changes to target group segmentation in order to optimise 
reach of future campaigns? 

  Were the key  campaign  messages  received and  understood?  Did  they  create  some  form 
of change on smokers’  attitudes and behaviours?  Are  there any  gaps  in  the content of  the 
campaign messages? Are the messages sustainable, and does their impact last beyond the 
campaign? 

  Was the EU’s image sufficiently prominent in the campaign? To what extent did the target 
audiences  associate  the  campaign  as  an  EU  initiative?  To  what  extent  did  the  campaign 
contribute  to  an  improved  EU  image  among  target  audiences?  Were  there  any  particular 
actions that were more or less effective to reinforce the positive image?  

Sustainability and EU Added Value 

  What  would  you  say  is  the  effect  of  the  Ex-smokers  campaign  in  your  country  12 

months after the end of the activity? 

  What are the key lessons to be learned from the Ex-smokers campaign? Do you have any 
suggestions  on  how  communication  and  campaigns  targeted  at  smokers  and  ex-smokers 
could be further improved and if so, how and why? 

Many thanks for your support to this evaluation! 

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4. 

ON-LINE PANEL SURVEY WITH SMOKERS AND EX-SMOKERS 
IN 6 COUNTRIES 

4.1. 

 Introduction 

In  conjunction  with  Ipsos  MORI,  we  carried  out  on-line  panel  surveys  with  current 
smokers and ex-smokers aged 25 to 34 in the six case study countries. The Ipsos on-
line  team  conducted  fieldwork  for  the  survey  between  13  and  18  February  2015  via 
the  Ipsos  On-line  Panel.  Data  are  based  on  500  interviews  per  country  in  Austria, 
Bulgaria,  Germany,  Greece,  Lithuania  and  Spain  (3002  interviews  in  total).  The 
following sections outline the results from the on-line survey. 

Sample design and recruitment 

Members of the panels consisted of individuals who volunteered to take part in market 
research  surveys  and  whom  Ipsos  contact  solely  for  market  research  purposes.  We 
selected  a  sample  from  the  panel  corresponding  to  the  desired  profile  of  participants 
(i.e.  smokers  and  ex-smokers  between  25  and  34  years  old),  and  collected  five 
hundred  responses  in  each  country.  Outcomes  are  correlated  in  terms  of  significance 
for  the  total  target  population  because  samples  were  stratified  to  reflect  the  national 
population.  

Survey objectives and questionnaire 

In the absence of a baseline assessment before the Ex-smokers campaign, the on-line 
panel  survey  intends  to  provide  a  baseline  with  which  to  plan  future  actions.  The 
results  of  the  on-line  panel  survey  will  also  allow  comparing  /  contrasting  the  results 
of the general smoking population in the selected countries with those of iCoach users. 
The  evaluation  will  attempt  to  assess  how  representative  iCoach  users  are  of  the 
population targeted by the campaign. 

The  survey  included  questions  on  smoking  habits  of  respondents,  quit  attempts  and 
resources, as well as a number of general questions on campaign and message recall. 
The  table  below  presents  the  main  themes  and  types  of  questions  covered  in  the 
questionnaire in more detail. Coffey  elaborated the questionnaire together with Ipsos 
and submitted it to DG SANTE for approval. Once approved, we translated the survey 
to  Bulgarian,  German,  Greek,  Lithuanian  and  Spanish  for  implementation  in  each 
country.   

Table 23: Key themes and types of questions in the on-line panel survey 

Themes 

Smoking habits 

Quit attempts 

Types of questions 

  Smoking status of respondents 
  Age when respondents started smoking 
  Average number of cigarettes respondents smoke/d per day 

  Intentions or attempts to quit smoking 
  Success in quitting smoking 
  Sources of help amongst quitters (including nicotine replacement 

medications, professional help, telephone or on-line quit lines, on-line 
and/or mobile applications such as iCoach, etc) 

  Factors that led people to attempt to quit smoking or to think about 

quitting 

  Benefits and challenges of quitting smoking 

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Themes 

Communication  
recall and liking 

Demographics 

Ex post outcome impact evaluation on Ex-smokers campaign 
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Annex B: Evaluation evidence 

Types of questions 

  Recall of the Ex-smokers campaign (spontaneous and aided) 
  iCoach awareness (spontaneous and aided) 
  iCoach usage and effectiveness as a support tool 
  Likeliness of using iCoach in the future 
  Likeliness of quitting smoking in the future 

  Gender 
  Age 
  Work status 
  Country / region of residence 
  Level of education 
  Internet access and use 

4.2. 

Smoking habits 

Respondents’ smoking status 

The  majority  of  respondents  surveyed  currently  smoke.16  Six  in  ten  (59%)  of 
the  participants  surveyed  are  current  smokers.  The  remainder  are  ex-smokers,  with 
three in ten (29%) having quit smoking more than 12 months ago and just over one 
in ten (12%) having quit less than 12 months ago.  

Figure 35: Smoking status of respondents (in percentages) 

BASE: All respondents (N=3002) 

By  sub-group,  current  smokers  in  the  sample  are  more  numerous  in  Bulgaria  (63%) 
and less numerous in Spain (54%). Males in our sample are more likely to be current 
smokers  (63%  versus  56%  of  females).  Conversely,  females  are  more  likely  to  have 
stopped smoking more than 12 months ago (32% versus 25% of males). Participants 
with  lower  education  levels  completed  are  more  likely  to  be  current  smokers  than 
those with post-secondary or tertiary studies. 

16 It should be noted that participants who had never smoked before were excluded from participating in the 
survey. The initial screening survey question only selected participants who were current or ex-smokers. 

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Figure 36: Current smokers by sub-groups (in percentages) 

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Annex B: Evaluation evidence 

BASE: All respondents (N=3002) 

Age when respondents started smoking 

In general, survey respondents started smoking when they were very young. 
The  vast  majority  of  participants  (91%)  started  smoking  before  the  age  of  25,  with 
more  than  half  (59%)  having  started  before  they  turned  18,  and  a  quarter  (24%) 
having started earlier at the age of 15 or under.  

Figure 37: How old were you when you started smoking? (in percentages) 

BASE: All respondents (N=3002) 

When  disaggregated  the  results  per  sub-groups  (see  the  Table  overleaf),  it  is 
interesting  to  note  that  participants  in  Austria  and  Germany  are  more  likely  to  have 
started smoking at the age of 15 or younger (35% and 30% respectively, versus 24% 
overall).  Similarly,  heavier  smokers  (who  smoke/d  more  than  30  cigarettes  per  day) 
and respondents with lower education levels are more likely to have started  smoking 
at an earlier stage. We did not observe any significant differences for other variables 
such as gender or working status of respondents.  

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Table 24: How old were you when you started smoking?  

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Annex B: Evaluation evidence 

Average number of cigarettes, cigars, pipes smoke/d per day 

The  majority  of  survey  respondents  smoke,  or  used  to  smoke,  less  than  a 
pack of cigarettes per day. Three quarters of respondents (75%) smoke, or used to 
smoke,  an  average  of  1-19  cigarettes17  per  day,  with  12%  smoking  between  20  and 
29 cigarettes and just 2% smoking 30 or more per day.  

Figure 38: Average number of cigarettes, cigars, pipes smoke/d per day (in percentages) 

                                          BASE: All respondents (N=3002) 

Participants in Lithuania and Spain are more likely to smoke, or to have smoked, less 
than  10  cigarettes  per  day  (59%  and  56%  respectively,  versus  50%  overall). 
Similarly,  women,  younger  people  (aged  25  –  29);  those  who  started  smoking  at  a 
later age and respondents with higher levels of education completed are more likely to 
be, or to have been, lighter smokers. 

At  the  other  end,  respondents  in  Germany  and  Greece  are  more  likely  to  be,  or  to 
have been, heavier smokers, with 18% smoking 20 or more per day compared to the 
overall  average  of  14%.  Male  respondents,  those  who  started  smoking  at  a  younger 
age  and  participants  with  lower  levels  of  education  are  more  likely  to  be,  or  to  have 
been, heavier smokers. 

17 Includes cigarettes, cigars or pipes 

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TotalTotalATBGDEGRLTESMaleFemSmokerEx-smoker 1 - 910-2930+WorkingNot workingSecondaryPost secondary Tertiary %%%%%%%%%%%%%%%%%%%All respondents3002500500500501501500132616761775122715001408762322588728413180115 or under24%35%23%30%18%13%22%24%24%23%25%18%29%41%24%24%32%30%19%16-1735%36%42%29%30%38%38%35%36%35%35%33%38%37%35%34%38%35%35%18-2432%20%30%19%45%43%31%31%32%31%33%38%25%18%31%34%23%23%37%25-296%5%3%12%5%4%6%6%5%7%4%7%4%4%6%4%4%6%6%30-342%4%0%8%1%0%3%3%2%3%2%2%3%0%3%2%3%4%2%Don’t know1%0%1%1%0%1%0%1%0%1%1%1%0%0%0%1%0%1%1%Prefer not to say0%0%0%0%1%1%0%1%0%0%0%1%0%0%0%1%0%0%1%CountryGenderType of smokerNr of daily cigarettes EducationWorking status 
 
 
  
 
 
 
 
 
 
 
 
 
                                           
Ex post outcome impact evaluation on Ex-smokers campaign 
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Annex B: Evaluation evidence 

Figure 39: Light smokers ( ˂10 cigarettes p/day (in %s)    

BASE: All respondents (N=3002) 

Figure 40: Heavy smokers (+20 cigarettes p/day (in %s) 

BASE: All respondents (N=3002) 

4.3. 

 Quit attempts and experiences 

Attempts to quit smoking 

Smokers  who  attempted  to  quit  smoking  more  than  double  smokers  who 
never  tried  to  quit.  More  than  two  thirds  of  current  smokers  (69%)  have  tried  to 
give up smoking previously, with around a third (32%) who tried to give up smoking 
in the last 12 months and 37% who attempted to quit more than one year ago. Three 
in ten current smokers (29%) never tried to give up smoking.  

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Annex B: Evaluation evidence 

Figure 41: Attempts to quit smoking (in percentages) 

BASE: Current smokers (n=1775) 

Respondents  in  Lithuania  are  more  likely  to  have  attempted  to  quit  smoking  in  the 
past  (77%  versus  69%  overall).  Quit  attempts  also  experienced  higher  registers  in 
Bulgaria  and  Spain  (73%  in  both  cases).  In  contrast,  a  higher  number  of  German 
participants  (41%)  have  never  tried  to  give  up  smoking.  Heavy  smokers  and 
participants  who  started  smoking  at  younger  ages  are  also  more  likely  than  the 
average to have tried to give up smoking. 

Figure 42: Current smokers who tried to quit by sub-groups (in percentages) 

BASE: Current smokers (n=1775) 

Few  smokers  in  the  sample  have  remained  abstinent  for  long  when  they 
attempted  to  quit  smoking.  On  the  most  recent  occasion  that  they  tried  to  stop 
using tobacco, almost half of current smokers (47%) managed to stop for between 24 
hours and one month. A quarter of current smokers (26%) were able to stop between 
1 and 4 months. One in five current smokers (19%) stopped for more than 6 months.  

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Figure 43: How long did you stop smoking in your most recent attempt to quit? (in %) 

Ex post outcome impact evaluation on Ex-smokers campaign 
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Annex B: Evaluation evidence 

BASE: Current smokers who have tried to quit smoking (n=1226) 

When  disaggregated  by  sub-groups,  recent  quit  attempts  have  been  in  average  less 
successful  in  Germany  and  amongst  those  aged  25  to  29.  Smokers  in  Bulgaria, 
Lithuania and women are more likely to have achieved more sustained efforts to quit.   

Figure 44: Smokers who stopped for less than a week vs smokers who stopped for more than six 
months (in %s) 

BASE: Current smokers who have tried to quit smoking (n=1226) 

Services and products tried to stop smoking 

A high  number of current  smokers in the sample  have not tried any services 
or  products  in  their  efforts  to  quit  smoking.  One  in  five  current  smokers  who 
have  tried  to  quit  smoking  has  used  nicotine  replacement  products18  or  electronic 
cigarettes19  (both  21%).  A  similar  proportion  (18%)  used  self-help  literature. 
Respondents  were  less  likely  to  use  other  types  or  services  and  products,  including 
help  from  their  doctors  or  other  health  professionals  or  other  relevant  medication 
(both 6%) and natural or alternative therapy (4%). Stop  smoking services, including 
clinics / counselling, telephone helplines and stop smoking applications, were the least 
used by participants in their efforts to quit or stop smoking services such as clinics. It 

18 Products like nicotine gum, patch or inhaler 
19 Including smokeless cigarettes 

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Annex B: Evaluation evidence 

is  worth  noting  that  42%  of  current  smokers  who  have  tried  to  quit  smoking  used 
none of the listed methods, perhaps relying on willpower alone.  

Figure 45: Which services or products have you tried to help you stop smoking? (in %s, multiple 
responses) 

BASE: Current smokers who have tried to quit smoking (n=1226) 

In Spain, smokers were significantly more likely to try to stop smoking using different 
services  or  products,  in  particular  nicotine  replacement  products,  electronic  or 
smokeless  cigarettes  and  help  from  healthcare  professionals20.  Likewise,  Lithuanian 
smokers were more likely to have used self-help literature as aids to quit smoking and 
Greek respondents were more likely not to have used any type of support.  

Males  were  more  likely  than  females  to  use  nicotine  replacement  products  (26% 
versus  17%).  In  general,  those  participants  who  recognised  at  least  one  element  of 
the  “Ex-smokers  are  Unstoppable”  campaign  were  more  likely  to  have  used  each  of 
the methods listed.   

20 Includes doctors, pharmacists and other healthcare professionals 

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Annex B: Evaluation evidence 

Table  25:  Which  services  or  products  have  you  tried  using  to  help  you  stop  smoking?  (by  sub-
groups) 

Reasons why participants stopped smoking or thought about stopping 

Health concerns  and  the price of tobacco products are the two main reasons 
that  have  led  smokers  to  try  to  stop  smoking.  More  than  half  (56%)  of  current 
smokers who have previously tried to quit smoking did so because of concerns about 
their  health,  with  the  next  most  popular  reasons  being  the  price  of  tobacco  products 
(42%)  and  pressure  from  their  family  or  friends  (29%).  Other  reasons,  including 
different  types  of  smoking  restrictions,  warning  labels  on  tobacco  packs,  concerns 
about  the  health  of  others  or  about  social  disapproval,  support  services  and 
communication  campaigns,  are  less  likely  to  have  exerted  a  definitive  influence  on 
smokers.    

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TotalTotalATBGDEGRLTESMaleFemale25-2930-34 15-17 18-34 Less than 1 - 910-2930+Any campaign recallNo campaign recall%%%%%%%%%%%%%%%%%%Base: All current smokers who have tried to quit smoking 122619423217619423020056765959263476645754964728235991Nicotine replacement product 21%21%19%23%17%17%32%26%17%19%23%20%24%14%27%25%34%18%Electronic / smokeless cigarettes 21%9%30%14%25%18%30%24%19%19%24%21%21%15%27%25%30%19%Self-help literature18%16%8%17%5%35%22%18%17%16%19%18%17%15%20%7%22%16%Help from healthcare professional6%4%4%6%6%2%18%7%6%7%6%5%8%5%8%7%16%4%Other relevant medication 6%3%10%4%3%5%8%7%4%6%6%6%5%3%8%7%11%4%Natural or alternative therapy 4%5%1%5%4%1%9%5%3%4%4%3%5%3%5%0%10%2%Stop smoking services (clinics, counselling sessions)3%4%2%3%4%0%7%5%1%3%4%3%4%1%5%4%9%2%Telephone stop smoking helpline1%3%0%1%3%0%2%2%1%2%1%1%2%1%1%7%6%0%Stop smoking application on my mobile phone1%3%0%2%1%1%1%2%1%1%1%1%1%1%2%0%0%1%Stop smoking application online0%1%0%0%1%1%0%0%0%0%1%0%1%1%0%4%1%0%None of these42%49%43%48%54%33%26%38%45%44%40%41%42%53%32%29%21%47%Ex smokers campaign recall CountryGenderAgeAge started smokingNumber of cigarettes/cigars/pipes smoked per day 
 
 
  
 
 
 
 
 
Ex post outcome impact evaluation on Ex-smokers campaign 
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Annex B: Evaluation evidence 

Figure  46: Which  reasons led  you to stop  smoking  or  to think about  stopping?  (in %s, multiple 
responses) 

BASE: Current smokers who have tried to quit smoking (n=1226) 

When analysed by countries (see Table 26 overleaf), health concerns were a stronger 
influence on Lithuanian smokers, whereas the price of tobacco products is more likely 
to  have  led  smokers  in  Germany  and  Bulgaria  to  stop  smoking  or  to  think  about 
stopping.  Spanish  smokers  are  more  likely  to  have  been  impacted  than  others  by 
requests from family and friends, concerns about the effects of their smoking on non-
smokers, and by professional support and communication stimuli. Austrian smokers in 
turn are less likely to have been influenced by any of the factors listed.  

When disaggregated the results by other  variables, men are more likely than women 
to have been influenced to stop smoking by factors like the price of tobacco products 
or requests from their family / friends.  

Respondents  who  smoke/d  30  cigarettes  or  more  per  day  were  more  likely  to  be 
influenced  by  warning  labels  on  tobacco  packs  than  participants  who  smoke/d  less 
cigarettes.  People  smoking  between  10  and  29  cigarettes  per  day  were  more 
influenced by the price of tobacco products.  

Those  participants  who  recognised  at  least  one  element  of  the  campaign  were  more 
likely  to  cite  each  of  the  reasons  listed.    In  addition,  these  participants  were  more 
likely  to  cite  a  “stop  smoking”  application  on their  mobile  phone  or  on-line  (both  6% 
versus 1% overall).   

No  significant  differences  are  observed  by  age  of  respondents  or  by  age  when 
participants started smoking. 

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Table 26: Which reasons led you to stop smoking or to think about stopping? (by sub-groups) 

Ex post outcome impact evaluation on Ex-smokers campaign 
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Annex B: Evaluation evidence 

Main benefits experienced after quitting smoking 

Those who quit smoking principally felt good about themselves after quitting. 
Many also benefitted from having fresher breath and smelling cleaner. One of 
the main benefits ex-smokers experienced after quitting smoking is feeling good about 
themselves  (66%).  Other  significant  benefits  experienced  include  having  fresher 
breath  (63%)  and  smelling  cleaner  (62%).  Slightly  more  than  half  of  ex-smokers 
(53%) also recognise having more money as a benefit, followed closely by 49% who 
can  breathe  more  easily,  44%  who  feel  they  could  set  a  good  example  on  others 
(including  children),  41%  who  consider  they  have  more  energy,  and  39%  who 
highlight that food and drink taste and smell better. Fewer respondents mention that 
their  cough  and  wheezing  problems  improved  (32%)  or  that  their  skin  looks  better 
(30%) after quitting smoking.    

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TotalTotalATBGDEGRLTESMaleFemale25-2930-34 15-17 18-34 Less than 1 - 910-2930+Any campaign recallNo campaign recall%%%%%%%%%%%%%%%%%%Base: All current smokers who have tried to quit smoking 122619423217619423020056765959263476645754964728235991Concerns about my health56%44%56%55%58%63%57%56%55%57%55%58%53%57%55%50%59%55%Price of tobacco products42%35%50%51%38%40%38%45%40%42%42%44%39%34%50%29%43%42%Requests from family/ partner/ friends 29%23%27%19%30%35%35%31%26%29%28%29%29%28%30%7%35%27%Concerns about the effects on non-smokers11%4%14%7%13%12%17%12%11%12%11%10%13%13%11%0%16%10%Smoking restrictions in public places 9%5%16%11%7%3%10%9%9%9%9%9%9%7%11%4%13%8%Healthcare professional advised me to stop smoking8%7%7%10%9%3%14%8%8%7%9%8%9%8%9%4%15%7%Society doesn’t approve of smoking7%4%6%6%3%11%12%9%5%7%7%7%7%6%8%4%11%6%Smoking restrictions where I work7%4%12%8%8%3%8%8%6%7%7%7%7%4%10%0%12%6%Warning labels on tobacco packages6%5%4%7%7%4%7%7%4%6%5%6%5%6%5%11%11%4%Because of a communication campaign3%2%4%1%2%2%8%4%2%3%3%3%4%3%3%4%7%2%Medication was available at no or low cost2%1%2%2%3%2%4%3%2%2%2%2%2%2%2%4%6%1%Support was available through a telephone or online helpline1%0%1%3%1%0%4%2%1%2%1%1%1%1%2%0%6%0%Support was available through a stop smoking app on my mobile phone1%1%2%1%0%0%4%2%1%2%1%1%2%1%2%0%6%0%Support was available through an online stop smoking application1%1%1%2%2%0%2%2%0%2%1%1%1%1%1%4%6%0%None of these13%25%12%11%14%13%2%9%16%13%12%14%11%15%11%25%5%15%Don’t know / Can’t remember1%4%0%1%0%0%0%1%1%1%1%1%1%1%1%4%1%1%CountryGenderAgeAge started smokingNumber of cigarettes/cigars/pipes smoked per dayCampaign recall  
 
 
  
 
 
 
 
Figure 47: Main benefits experienced after quitting smoking (in %s, multiple responses) 

Ex post outcome impact evaluation on Ex-smokers campaign 
Final Report 
Annex B: Evaluation evidence 

BASE: All ex-smokers (n=1227) 

In  Spain,  feeling  good  about  themselves  is  a  main  benefit  for  over  three-quarters 
(77%)  of  ex-smokers.  In  Bulgaria,  a  fresher  breath  and  breathing  more  easily  are 
more  likely  to  be  judged  as  important  benefits  after  quitting  smoking  than  in  other 
countries.  German  ex-smokers  are  more  inclined  than  others  to  prioritise  monetary 
benefits.  Lithuanian  participants  on  the  other  hand  are  more  likely  to  assign  more 
significance to setting a good example for others, such as children.  

Female  ex-smokers  are  more  likely  than  male  ex-smokers  to  say  their  skin  looking 
better is one  of the main benefits they experienced after quitting smoking (34% and 
23%  respectively,  compared  to  30%  overall).  Male  ex-smokers  are  more  likely  to 
report  that  they  feel  good  about  themselves  (71%  versus  63%  of  females).  Older 
respondents  (those  aged  30-34)  are  more  likely  to  highlight  benefits  related  to 
breathing  more  easily  and  to  coughing  and  wheezing  problems  improved.  Similarly, 
ex-smokers  who  started  smoking  between  the  ages  of  15  -  17  and  respondents  who 
used  to  smoke  more  than  10  cigarettes  per  day  are  more  likely  to  have  experienced 
more  benefits  after  quitting  than  those  who  started  smoking  at  latter  ages  or  those 
who used to smoke fewer cigarettes. 

See Table 27 overleaf for a comparative overview amongst sub-groups. 

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Table  27:  What  have  been  the  main  benefits  that  you  experienced  after  quitting  smoking?  (by 
sub-groups) 

Perceived challenges after stopping smoking 

Eating more and gaining weight are the two main challenges experienced by 
those who quit smoking. After quitting, ex-smokers and current smokers who have 
tried  to  quit  in  the  last  12  months  are  most  likely  to  report  that  they  started  eating 
more (34%), that they gained weight (32%), that they missed the taste of cigarettes 
(31%)  and  that  they  felt  more  irritable  (30%).  Slightly  fewer  respondents  consider 
that  they  felt  uncomfortable  around  smokers  (27%)  or  that  they  felt  less  able  to 
concentrate  (13%).  A  large  group  of  respondents  in  this  group  (18%)  did  not 
experience any of the challenges listed after stopping smoking. 

Figure 48: Challenges experienced after quitting smoking (in %s, multiple responses) 

BASE: All ex-smokers or current smokers who have tried to quit in the last 12 months (n=1791) 

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TotalTotalATBGDEGRLTESMaleFemale25-29 30-3415-17 18-34 Less than 1 - 910-2930+%%%%%%%%%%%%%%%%Base: All ex smokers122720718419521220022948574255667173847466151937I feel good about myself66%69%54%66%63%66%77%71%63%65%67%68%63%62%71%70%My breath is fresher63%64%74%55%61%68%59%64%63%63%64%67%59%59%70%68%I smell cleaner62%59%66%62%67%59%59%62%62%63%61%66%56%56%69%65%I have more money53%47%52%62%50%48%59%55%52%55%52%55%51%48%59%70%Breathe more easily49%52%65%48%52%36%45%55%46%45%53%54%43%40%59%81%Setting a good example for others (children)44%47%53%37%38%56%33%41%46%44%43%47%40%40%49%46%I have more energy41%39%48%36%43%46%36%50%35%40%41%42%39%36%47%51%Food and drink tastes and smells much better.39%45%35%41%35%34%43%44%36%36%41%43%33%30%49%59%Cough and wheezing problems improved32%36%23%30%32%33%35%37%28%30%33%36%26%22%42%59%My skin looks better30%24%37%32%30%28%28%23%34%31%29%30%29%27%33%24%Other4%4%3%4%3%3%6%4%4%4%4%5%2%4%3%3%None of these2%0%0%4%3%5%2%2%3%2%3%1%3%4%1%3%Don’t know1%2%2%2%1%1%0%1%1%2%1%1%2%2%1%0%CountryGenderAgeAge started smokingNumber of cigarettes/cigars/pipes smoked per day 
 
 
  
 
 
 
 
 
Ex post outcome impact evaluation on Ex-smokers campaign 
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As reflected in the table below, respondents in Bulgaria are more likely than others to 
have started eating more as a result of quitting smoking (40%). Current smokers and 
ex-smokers  in  Lithuania  are  more  inclined  to  have  missed  the  taste  of  cigarettes 
(40%) or to have felt more irritable (34%). Participants in Spain, on the other hand, 
are  more  likely  to  have  felt  uncomfortable  around  smokers  (30%)  and  less  able  to 
concentrate (17%).   

Current  smokers  are  more  likely  to  report  that  they  felt  more  irritable  (50%  versus 
30%  overall),  that  they  started  eating  more  (43%  versus  34%  overall),  that  they 
missed the taste of cigarettes (39% versus 31% overall) and that they felt less able to 
concentrate (21% versus 13% overall)  

Older  participants  aged  30-34  are  more  likely  to  report  that  they  gained  weight 
(35%).  Younger  respondents  on  the  other  hand  are  more  inclined  to  have  felt  more 
irritable (34%) and less able to concentrate (15%). 

Respondents  smoking  30  or  more  cigarettes  per  day  are  significantly  more  likely  to 
have  experienced  many  of  the  challenges  listed,  including  eating  more,  gaining 
weight,  missing  the  taste  of  cigarettes  and  feeling  uncomfortable  around  smokers. 
Participants  smoking  between  10  and  29  cigarettes  per  day  are  more  inclined  than 
others to have felt more irritable and less able to concentrate. 

Table 28: Which, if any, of the following have you experienced after quitting smoking? (by sub-
groups) 

4.4. 

Recall of “Ex-smokers are Unstoppable” campaign 

Spontaneous and aided campaign recall 

Spontaneous  Ex-smokers’  campaign 
low  amongst  survey 
respondents  more  than  one  year  after  it  ended.  Less  than  one  in  ten  (7%) 
participants  could  spontaneously  recall  the  campaign  slogan21.  In  Greece  (11%)  and 
Spain (10%), participants were more likely to say they had seen the campaign, whilst 

recall 

is 

21 “Ex-smokers are unstoppable” and “If you stop it, nothing is stopping you” in Greece 

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TotalTotalATBGDEGRLTESMaleFemaleSmokerEx-smoker 25-29 30-34 15-17 18-34 Less than 1 - 910-2930+%%%%%%%%%%%%%%%%%%Base: All ex smokers or smokers who have tried to quit in the last 12 months179129226627030631634175610355641227853938107969693580046I started eating more34%30%40%29%32%37%33%35%33%43%29%33%34%36%31%27%41%52%I gained weight32%32%30%35%29%29%35%33%31%28%34%28%35%34%29%24%40%52%I missed the taste of cigarettes31%25%29%24%32%40%31%32%30%39%27%32%29%32%29%25%36%43%I felt more irritable30%27%29%29%32%34%30%32%29%50%21%34%28%32%29%22%40%39%I felt uncomfortable around smokers27%29%24%23%24%29%30%26%27%24%28%27%26%28%25%27%26%30%I felt less able to concentrate13%14%9%15%8%13%17%15%11%21%9%15%10%14%11%10%16%11%Other3%3%2%3%3%3%3%3%3%4%3%3%3%3%3%3%3%2%None of these18%18%19%21%20%18%15%16%20%6%24%18%19%17%20%25%11%4%Don’t know / Can’t remember3%3%3%5%2%3%1%2%3%1%4%3%3%3%3%3%2%2%CountryGenderType of smokerAgeAge started smokingNumber of cigarettes/cigars/pipes smoked per day 
 
 
  
 
 
 
 
 
                                           
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those in Austria, Germany and Lithuania are the least likely (5% respectively). Males 
were  more  likely  to  spontaneously  recognise  the  campaign  (9%  versus  6%  of 
females),  as  were  current  smokers  (8%),  participants  who  started  smoking  after 
turning 18 (9%), and those who smoke/smoked 30 or more cigarettes per day (13%). 
Other  notable  groups  include  current  smokers  who  have  previously  tried  to  quit 
smoking  (10%),  those  with  any  iCoach  recall  (31%)  and  those  with  any  combined 
campaign recall (39%)22. 

Figure 49: Spontaneous campaign recall (in %s)          

BASE: All respondents (N=3002) 

Figure 50: People who spontaneously recall the campaign (in %) 

BASE: All respondents (N=3002) 

Aided  Ex-smokers’  campaign  recall  is  slightly  higher  amongst  survey 
respondents.  When  shown  the  “Ex-smokers  are  Unstoppable”  logo,  campaign  recall 
increases  to  almost  one  in  ten  (9%)  participants.  Once  again,  participants  in  Greece 
and  Spain  are  more  likely  to  recall  the  campaign  (13%  and  11%  respectively), 
dropping  to  4%  for  German  participants  and  6%  for  Austrian  respondents.  Male 
respondents  are  more  likely  to  recall  the  campaign  than  female  participants  (10% 
compared  to  7%).  In  a  similar  line,  participants  aged  25  -  29  years  are  more  likely 
than those aged 30 - 34 years to recall seeing the campaign (10% compared to 8%). 
Those  who  started  smoking  after  turning  18  and  respondents  who  smoke/d  30  or 
more cigarettes per day are more inclined to recall the campaign when exposed to the 

22 Any recall at Q8/Q9/Q11/Q11a/Q11b/Q11c 

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logo (10% and 13% recall respectively). Those with any recall of the iCoach platform 
(38%) are significantly more likely to have seen or heard about the campaign. 

Figure 51: Aided campaign recall by sub-groups 

BASE: All respondents (N=3002) 

Figure 52: Aided campaign recall by sub-groups 

 BASE: All respondents (N=3002) 

Of  those  who  recall  seeing  the  campaign  logo,  more  than  half  (57%),  remember 
seeing  it  on-line,  usually  on  a  website  (23%)  or  on  a  Facebook  page  (22%).  Some 
respondents  also  mention  YouTube  (8%)  or  Twitter  (4%).  Overall  on-line  recall  is 
stronger  in  Bulgaria  and  Lithuania,  where  almost  two-thirds  (64%  and  62% 
respectively) recall seeing the campaign on-line.  

TV  (including  advertising,  news  or  current  affairs  and  TV  programmes)  is  the  second 
most  cited  channel  by  28%  of  respondents  who  recall  the  campaign.  Newspapers, 
radio and magazine channels come next with 17% and 16% of responses respectively. 
German  respondents  are  more  likely  to  have  seen  or  heard  about  the  campaign  in 
traditional media, including TV, radio, newspapers and magazines.  

Survey  respondents  also  saw,  heard  or  read  about  the  campaign  in  brochures  / 
leaflets or via word of mouth (13% both), through a doctor or healthcare professional 
or a local area health service (11% both). 

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Figure  53:  Where  did  you  see,  read  or  hear  any  part  of  this  campaign?  (in  %s,  multiple 
responses) 

BASE: All those with spontaneous or prompted recall of the Ex-smokers are unstoppable campaign (n=325) 

4.5. 

 iCoach 

Spontaneous and aided iCoach recall  

Spontaneous iCoach recall is slightly higher than overall campaign recall. One 
in  ten  (10%)  participants  has  heard  of  the  iCoach  platform,  with  awareness  levels 
highest  in  Bulgaria  and  Spain  (both  14%)  and lowest  in  Germany  and  Lithuania  (6% 
both).  By  sub-group,  males  are  more  likely  than  females  to  have  heard  of  iCoach 
(12%  versus  9%).  Levels  of  recall  are  also  more  notable  amongst  participants  who 
quit smoking less than 12 months ago (15%) and amongst respondents who smoke/d 
more than 30 cigarettes in average per day (16%). 

Figure 54: Spontaneous iCoach recall (in %s)      

BASE: All respondents (N=3002) 

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Figure 55: Spontaneous iCoach recall by sub-groups 

 BASE: All respondents (N=3002) 

When  prompted  with  iCoach  visuals  (images  of  the  dashboard,  savings 
calculator and tips) the levels of iCoach recall remain similar as in the initial 
unaided  question.  We  calculated  the  combined  iCoach  recall,  which  includes  any 
recognition of the application or of the three images. Just over one in ten participants 
(13%)  recall  any  element  of  the  iCoach  platform,  with  levels  highest  in  Bulgaria  and 
Spain  (both  19%).  Recognition  levels  are  also  higher  for  those  who  smoke/d  more 
than 30 cigarettes per day (21%) and ex-smokers who quit less than 12 months ago 
(19%). 

Figure 56: Combined iCoach recall by sub-groups 

BASE: All respondents (N=3002) 

Visits / subscriptions to iCoach (amongst those who recall the application) 

Overall, 7% of respondents in the sample have  visited  iCoach  either  once or 
more than once. One in five participants (21%) who could recall the iCoach platform 
(n=401) have visited iCoach more than once. In Spain, this increases to one in three 
(31%)  participants.  Conversely,  in  Austria  almost  six  in  ten  (59%)  participants  who 
could recall the iCoach platform have never visited iCoach (versus 38% overall). Male 
participants are more likely to have visited iCoach more than once (25% versus 17% 
for female participants).  In a similar line, ex-smokers who quit smoking less than 12 
months ago, and participants who smoke/d more than 30 cigarettes per day are more 
likely to have visited the application more often. 

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Figure 57: Have you visited iCoach? (in %s)         

BASE: All those with spontaneous or prompted recall of the iCoach platform (n=401) 

Figure 58: Visited iCoach more than once by sub-groups (in %s) 

 BASE: All those with spontaneous or prompted recall of the iCoach platform (n=401) 

Overall, 3% of respondents in the sample have subscribed to iCoach. Of those 
who have visited iCoach (n=227), four in ten (40%) participants have subscribed to it. 
This  increases  to  50%  amongst  German  respondents,  46%  of  current  smokers  who 
have  visited  iCoach  and  50%  of  participants  who  smoke/d  between  10  and  29 
cigarettes per day. Conversely, subscription rates amongst visitors are lower amongst 
Greek  respondents  (25%),  amongst  ex-smokers  who  quit  more  than  12  months  ago 
(27%) and amongst respondents who smoke/d less than 10 cigarettes per day (26%).  

Figure 59: Have you subscribed to iCoach? (in %s)     

BASE: All those who have visited iCoach (n=227) 

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Figure 60: Visitors who subscribed to iCoach by sub-groups (in %s)          

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BASE: All those who have visited iCoach (n=227) 

Perceived effectiveness of iCoach (amongst those who subscribed to iCoach) 

The  majority  of  subscribers  to  iCoach  considered  that  the  tool  supported 
them  to  stop  smoking.  One  in  five  iCoach  subscribers23  (19%)  say  that  iCoach 
helped  them  to  stop  smoking  a  great  deal,  whilst  four  in  ten  (37%)  say  it  helped 
somewhat.  However,  nearly  one  in  five  (19%)  participants  consider  that  it  helped 
them a little, and almost one quarter (24%) say that it did not help at all.  

Figure 61: To what extent has iCoach helped you to stop smoking? (in %s) 

BASE: All those who have subscribed to iCoach (n=90) 

Likeliness of using iCoach in the future 

Survey  respondents  were  divided  over  the  likeliness  of  using  iCoach  in  the 
future,  with  current  smokers  more  likely  to  do  so.  Of  those  who  have  not 
subscribed to iCoach, over three in ten participants (36%) say that they are very,  or 
fairly  likely  to  do  so  over  the  next  12  months.  Specifically,  one  in  ten  participants 
(12%) are very likely to subscribe. In contrast, more than half of respondents (57%) 
are not very likely or not likely at all to subscribe to iCoach (see Figure 40 overleaf).  

As  reflected  in  Figure  62,  participants  in  Greece  and  Bulgaria  are  the  most  likely  to 
subscribe  to  iCoach  in  the  future  (49%  and  47%  of  people  who  are  very,  or  fairly 

23 Base size of 90 participants 

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likely  to  subscribe  respectively).  Respondents  in  Germany  and  Austria  are  the  least 
likely  to  subscribe  to  the  application.  Current  smokers  (48%)  and  respondents  who 
smoke/d between 10 and 29 cigarettes per day (42%) are more inclined to subscribe 
to iCoach than others.   

Figure 62: Likeliness to subscribe to iCoach (in %s)        

BASE: All those who have not subscribed to iCoach (n=2912) 

Figure 63: Very + fairly likely to subscribe (in %s) 

BASE: All those who have not subscribed to iCoach (n=2912) 

4.6. 

Future intentions to quit smoking 

The  majority  of  smokers  in  the  survey  sample  have  intentions  to  quit 
smoking  in  the  next  12  months.  More  than  six  in  ten  current  smokers  (65%) 
intend to stop smoking in the next 12 months, with nearly one in five (19%) definitely 
intending to stop. In Lithuania, this increases to almost one in three (28%) smokers. 
In contrast, in Germany slightly more than one in ten (13%) smokers definitely intend 
to  quit  smoking  in  the  next  12  months,  versus  19%  of  participants  overall.  Current 
smokers  who  tried  to  quit  before  are  significantly  more  likely  to  intend  to  quit  than 
those  who did not try to quit in the past (76% versus 37%). Similarly, smokers who 
recall the Ex-smokers campaign are more likely to have intentions to quit in the near 
future than those who do not recall the campaign (76% versus 62%). 

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Figure 64: Intention to stop smoking next year (in %s)     

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BASE: All current smokers (n=1775) 

Figure 65: Definitely + probably intend (in %s)    

  BASE: All current smokers (n=1775) 

4.7. 

Internet use and access 

Frequency of use 
The  vast  majority  of  participants  (89%)  use  the  internet  several  times  a  day.24 
Respondents  in  Lithuania  are  more  frequent  internet  users,  and  conversely  German 
participants are less likely than others to use the internet several times a day. Women 
are more likely than men to use the internet more frequently. 

24 It is worth noting that the survey was conducted via an on-line methodology, meaning that the results for 
these questions are unlikely to be representative of the general population in each country. 

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BASE: All respondents (N=3002) 

Figure 67: Internet use several times a day (in %s)     

BASE: All respondents (N=3002) 

Internet access 

Eighty-one  percent  of  those  who  have  access  to  the  internet,  have  had  access  for 
more than 6 years now. Lithuanian and Bulgarian respondents were  more likely than 
respondents  in  other  countries  to  have  had  access  for  longer  (91%  and  88% 
respectively, versus 81% for the overall sample).  

Figure 68: Access to the internet: for how long? (in %s)     

BASE: All those with internet access (N=3000) 

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Figure 69: Those with access for +6 years (in %s)     

BASE: All those with internet access (N=3000) 

Nearly all (94%) participants access the internet via a personal computer or laptop at 
home. Slightly more than 7 in every 10 respondents access the internet via a mobile 
terminal  (e.g.  mobile  telephone,  PDA,  Palm,  Blackberry,  tablet).  Half  of  participants 
(51%)  access  the  internet  via  a  personal  computer  or  laptop  at  work,  university  or 
school. Fewer (20%) access via public places like internet cafes or libraries, or via TV 
sets (12%) or game consoles (9%). 

When analysed by sub-groups, it is interesting to note that the stronger variations are 
amongst those who access the internet via mobile devices. Respondents in Austria are 
more  likely  than  respondents  in  other  countries  to  access  the  internet  via  a  mobile 
terminal (83% versus 73% for the overall sample). Conversely, participants in Greece 
(59%)  are  significantly  less  likely  to  use  their  mobile  devices  for  accessing  the 
internet.  Younger  respondents  are  more  likely  than  those  in  the  older  age  group  to 
access the internet via their mobiles. 

Figure 70: Main sources of access (in %s, multiple resp.)  

BASE: All those with internet access (N=3000) 

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BASE: All those with internet access (N=3000) 

Internet uses 

The  main  reason  participants  used  the  internet  in  the  last  three  months  was  for 
sending and receiving emails (87%). Three in every four respondents (75%) used it to 
visit  social  networking  sites  like  Facebook  or  Twitter  or  to  take  part  in  blogs  and 
forums.  In  third  place,  participants  used  the  internet  to  visit  sites  for  information  on 
hobbies  and  personal  interests  (71%),  or  for  information  on  products/services  they 
are  thinking  of  buying  (71%).  Buying  products  or  services  on-line  (68%),  checking 
bank account data and other financial information (68%), reading newspapers on-line 
(57%) were also widely popular. 

Figure 72: In which ways have you used the internet in the last three months? (in %s, multiple 
resp.) 

BASE: All those with internet access (N=3000) 

When  analysed  the  top  three  reasons  by  sub-groups,  Spanish  respondents,  male 
participants and younger people were less likely to have used the internet for sending 
and  receiving  emails.  More  interestingly,  Lithuanian  respondents  and  female 
participants  stood  out  as  those  with  a  higher  social  media  activity  in  recent  months. 
German  participants  were  less  likely  to  have  visited  social  networking  sites,  blogs  or 
forums. 

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Figure  73:  The  three  top  reasons  for  using  the  internet  in  the  last  3  months  (in  %s,  multiple 
resp.) 

BASE: All those with internet access (N=3000) 

4.8. 

Composition of the sample 

Gender and age of respondents 

Overall, the sample consisted of 44% males and 56% females. In terms of age, there 
is  a  relatively  even  split  between  those  aged  25  –  29  years  and  those  aged  30  –  34 
years (48% and 52% respectively). The mean age is 30 years. 

Figure 74: Gender of respondents (in %s)                           

Figure 75: Age of respondents (in %s)             

56 

52 

Male

Female

44 

25 - 29
years

30 - 34
years

48 

BASE: All respondents (N=3002) 

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Level of education and working status of respondents 

Sixty percent of respondents in the sample have completed either the first or second 
stage  of  tertiary  education.  Approximately  one  third  of  respondents  (32%)  have 
completed  upper  or  post-secondary  studies.  Less  than  one  in  ten  respondents  (8%) 
have completed primary or lower secondary levels. 

Around six in ten participants (61%) are employed full-time, whilst one in ten (10%) 
are  unemployed.  This  figure  is  significantly  higher  for  Greece,  where  a  quarter  of 
participants are unemployed (24%). 

Figure 76: Level of education of respondents (in %s)        

BASE: All respondents (N=3002) 

Figure 77: Working status of respondents (in %s)             

BASE: All respondents (N=3002) 

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4.9.  On-Line Panel Survey Questionnaire (EN) 

INTRODUCTION 

This  survey  is  about  your  views  on  smoking  and  quitting  smoking.  The  main  objective  of  the 
survey is to investigate smoking behavior and habits and quit attempts. We would also like to 
show you some campaign materials. The questionnaire is for both smokers and ex-smokers. It 
should take about 10 minutes to complete this survey. 

SCREENING QUESTIONS 

First of all, a few questions about you. 

Aim: determine respondent’s smoking status (current or ex-smoker?) 

ASK ALL 
SA (=Single Answer) 

S1.  Which one of the following best applies to you? Please select one option only. 

1.  I currently smoke cigarettes, cigars or pipes (no matter how often) 
2.  I used to smoke cigarettes, cigars or pipes but I have stopped more than 12 months 

ago 

3.  I used to smoke cigarettes, cigars or pipes but I have stopped less than 12 months ago 
4.  I have never smoked cigarettes, cigars or pipes 
5.  Don’t know 
6.  Prefer not to say  

IF CODE 4, 5 OR 6 THANK AND CLOSE INTERVIEW 

Aim: collect respondent’s age, for use in analysis 

ASK ALL 
SA  

S2.  How old are you? Please select one option only. 

1.  18-24 
2.  25-34 
3.  35-44 
4.  45-54 
5.  55-64 
6.  65+ 
7.  Prefer not to say 

IF CODES 1 OR 3-7, THANK AND CLOSE INTERVIEW 

Aim: collect age when respondent first started smoking regularly, for use in analysis 

ASK ALL 
SA  
S3. How old were you when you started to smoke cigarettes, cigars or pipes 
regularly? By regularly we mean at least once a week. Please select one option only. 

1.  15 or under 
2.  16-17 
3.  18-24 
4.  25-29 

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5.  30-34 
6.  Don’t know  
7.  Prefer not to say  

Aim: collect information on work status, for use in analysis 

ASK ALL 
SA 
S4. Which of the following statements best describes your current employment 
situation? Please select one option only. 

1.  Work full-time 
2.  Work part-time 
3.  Self-employed   
4.  Unemployed  
5.  Full-time student 
6.  Homemaker 
7.  Retired  
8.  Other 

IF CODE 7 THANK AND CLOSE INTERVIEW 

QUESTIONNAIRE 

Aim: measure regularity of smoking, for use in analysis 

ASK ALL 
SA 

Q1. On average, how many cigarettes, cigars or pipes would you say you [IF CODE 1 AT 
S1:  smoke  OR  CODE  2  OR  3  AT  S1  =  used  to  smoke]  a  day?  Please  select  one  option 
only. 

1.  Less than one a day 
2.  1-9 
3.  10-19 
4.  20-29 
5.  30 or more 
6.  Don’t know 

Aim: understand whether current smokers have tried to quit smoking previously 

ASK CURRENT SMOKERS (THOSE CODING 1 AT S1). IF CODES 2-3 AT S1 THEN PLEASE SKIP 
TO INSTRUCTION BEFORE Q6. 
SA 

Q2. Have you ever tried to give up smoking? Please select one option only. 

1.  Yes, in the last 12 months 
2.  Yes, more than a year ago 
3.  No, never 
4.  Don’t know / No answer 

Aim: understand whether current smokers have tried to quit smoking previously 

ASK ALL EXCEPT THOSE WHO HAVE NEVER TRIED TO QUIT SMOKING OR DON’T KNOW (THOSE 
CODING 3 OR 4 AT Q2)  

SA (= Single Answer) 

Q3.Thinking about the most recent occasion you tried to stop using tobacco, how long 
did you stop for?  Please select one option only. 

1.  Less than 24 hours 

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2.  More than 24 hours but less than a week 
3.  More than a week but less than a month 
4.  Between 1 and 3 months 
5.  Between 4 and 6 months 
6.  More than 6 months 

Aim: understand whether current smokers have tried to quit smoking previously 

ASK ALL EXCEPT THOSE WHO HAVE NEVER TRIED TO QUIT SMOKING OR DON’T KNOW (THOSE 
CODING 3 OR 4 AT Q2) 

MA 

Q4. Which services or products have you tried using to help you stop smoking? Please 
select all that apply to you. 

1.  Nicotine replacement product (like nicotine gum, patch or inhaler)  
2.  Other relevant medication (with or without doctor's prescription)  
3.  Help from my doctor, pharmacist or other health professional  
4.  Stop smoking services such as clinics, counselling sessions or groups 
5.  Telephone stop smoking helpline  
6.  Stop smoking application available on-line (please write in ………………………………………….)  
7.  Stop smoking application on my mobile phone (please write in ……………………………….……) 
8.  Natural or alternative therapy such as acupuncture or hypnotherapy 
9.  Electronic cigarettes or smokeless cigarettes 
10. Self-help literature 
11. Other (please write in ………………………………………….) 
12. None of these  
13. Don’t know / can’t remember  

Aim: understand reasons for stopping smoking/ trying to stop smoking 

ASK ALL EXCEPT THOSE WHO HAVE NEVER TRIED TO QUIT SMOKING OR DON’T KNOW (THOSE 
CODING 3 OR 4 AT Q2) 

MA 

Q5.  Which  of  the  following  are  reasons  why  you  stopped  smoking  or  thought  about 
stopping? Please select all that apply to you. 

1.  I was concerned about my health 
2.  I was concerned about the effects of me smoking on non-smokers 
3.  My family/ partner/ friends wanted me to stop 
4.  Society doesn’t approve of smoking 
5.  The price of tobacco products 
6.  Smoking restrictions where I work 
7.  Smoking restrictions in public places like bars and restaurants 
8.  Because of a communication campaign 
9.  Because support was available through a telephone or on-line helpline  
10. Because support was available through an on-line stop smoking application  
11. Because support was available through a stop smoking application on my mobile phone  
12. My doctor, pharmacist or other health professional advised me to stop smoking 
13. Stop smoking medication was available at no cost, or low cost 
14. Warning labels on tobacco packages 
15. None of these  
16. Don’t know / Can’t remember 

Aim: understand perceived benefits of stopping smoking 

ASK EX-SMOKERS (THOSE CODING 2 OR 3 AT S1) 

MA 

Q6.  What  have  been  the  main  benefits  that  you  experienced  after  quitting  smoking? 
Please select all that apply. 

1.  I could breathe more easily 

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2.  I have more energy 
3.  My skin looks better 
4.  Cough and wheezing problems improved 
5.  My breath is fresher 
6.  I smell cleaner 
7.  Food and drink tastes and smells much better 
8.  I have more money 
9.  I feel good about myself 
10. I feel that I am setting a good example for other people, such as children 
11. Other  
12. None of these 
13. Don’t know  

Aim: understand perceived challenges after stopping smoking 

ASK  EX-SMOKERS (THOSE CODING 2 OR 3 AT S1) OR CURRENT SMOKERS  WHO HAVE TRIED 
TO QUIT IN THE LAST 12 MONTHS [THOSE CODING (1 AT Q2 AND 1 AT S1)] 

MA 

Q7.  Which,  if  any,  of  the  following  have  you  experienced  after  quitting  smoking? 
Please select all that apply. 

1.  I started eating more 
2.  I gained weight 
3.  I felt more irritable 
4.  I felt less able to concentrate 
5.  I felt uncomfortable around smokers 
6.  I missed the taste of cigarettes 
7.  Other 
8.  None of these  
9.  Don’t know / Can’t remember  

Aim: measure recall of Ex-smokers are unstoppable campaign 

ASK ALL 

SA 

Q8.  Have  you  seen  a  communication  campaign  with  the  slogan  ‘Ex-smokers  are 
unstoppable’ in the last three years? Please select one option only. 

1.  Yes 
2.  No  
3.  Don’t know / Can’t remember  

Aim: measure recall of Ex-smokers are unstoppable campaign 

ASK ALL. DISPLAY ENGLISH LOGO FOR ALL COUNTRIES 

SA 

Q9.  This  is  the  logo  of  the  ‘Ex-smokers  are  unstoppable’  campaign  –  please  tell  me 
whether you recall seeing the campaign’s logo or not? Please select one option only. 

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1.  Yes 
2.  No  
3.  Don’t know / Can’t remember 

Aim: measure recall of Ex-smokers are unstoppable campaign 

ASK THOSE CODING 1 AT Q8 or Q9 

Q10.  Where  did  you  see,  read  or  hear  any  part  of  this  communication  campaign? 
Please select all that apply. 

ASK THOSE RECALLING EX-SMOKERS CAMPAIGN (THOSE CODING 1 AT Q8 or Q9) 

MA 

1.  TV advertising 
2.  TV news / current affairs 
3.  Television program 
4.  Radio advertising 
5.  Radio news 
6.  Radio programme 
7.  Magazine article 
8.  Magazine advertising 
9.  Newspaper article 
10. Newspaper advertising 
11. Brochure / booklet 
12. Website 
13. Facebook page 
14. YouTube channel 
15. Twitter 
16. Sporting event  
17. Word of mouth 
18. Local area health service 
19. Doctor / General practitioner 
20. Other  
21. Don’t know / Can’t remember 

Aim: measure awareness of iCoach  

ASK ALL 

SA 

iCoach  

Q11.  Have  you  heard  of  iCoach?  This  is  a  digital  health  coach  platform  that  helps 
smokers quit at their own pace either immediately or in the near future. Please select 
one option only. 

1.  Yes 
2.  No  
3.  Don’t know / Can’t remember 

Q11a/b/c.  Here  are  some  images  for  the  iCoach  platform  –  please  tell  me  whether 
you recall seeing this platform or not? IMAGES TO BE INCLUDED. PLEASE SHOW 3 IMAGES 
PER  COUNTRY  ON  SEPARATE  SCREENS,  WITH  SEPARATE  YES,  NO,  AND  DON’T  KNOW/CAN’T 
REMEMBER CODES BELOW EACH IMAGE Please select one option for each image 

1.  Yes 
2.  No  
3.  Don’t know / Can’t remember 

Aim: measure usage of iCoach  

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ASK ALL CODING 1 AT Q11 OR Q11a/b/c 

SA 

Q12. Have you visited iCoach? Please select one option only. 

1.  Yes, more than once 
2.  Yes, only once 
3.  No, never  
4.  Don’t know / Can’t remember 

Aim: measure usage of iCoach  

ASK ALL CODING 1 OR 2 AT Q12 

SA 

Q13. Have you subscribed to iCoach? Please select one option only. 

1.  Yes 
2.  No 
3.  Don’t know / No answer  

Aim: measure views on extent to which iCoach has helped support them to stop 
smoking  

ASK ALL CODING 1 AT Q13 

SA 

Q14. To what extent has iCoach helped you to stop smoking? Please select one option 
only. 

1.  A great deal 
2.  Somewhat 
3.  A little 
4.  Not at all 
5.  Don’t know  

Aim: measure likeliness of using iCoach in the future  

ASK ALL APART FROM THOSE WHO HAVE ALREADY SUBCRIBED TO ICOACH (CODE 1 AT Q13). 

SA  
The iCoach is a digital health coach platform, which provides users with personalised 
assistance in their efforts to stop smoking. The advice for each user is based on his or 
her smoking profile, as assessed by a smoking questionnaire filled out at registration. 
The  iCoach  reaches  smokers  who  are  still  ambivalent  about  stopping  and  smokers 
who have no intentions to quit. Ex-smokers can also sign up. 

Q15.  How  likely,  if  at  all,  are  you  to  subscribe  to    iCoach  in  the  next  12  months? 
Please select one option only. 

1. Very likely 

2. Fairly likely 

3. Not very likely 

4. Not at all likely 

5. Don’t know 

Aim: measure likeliness of quitting smoking in the future  

ASK CURRENT SMOKERS (THOSE CODING 1 AT S1) 
SA 

Q16. Do you intend to stop smoking in the next 12 months?  Please  select one option 
only. 

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1.  Definitely  
2.  Probably  
3.  Probably not 
4.  Definitely not 
5.  Don’t know 

DEMOGRAPHICS 

Finally, a few questions about you. 

ASK ALL 
SA  

D1.  Are you? Please select one option only. 

1.  Male 
2.  Female 

ASK ALL 
SA 

D2.  In which region are you located? Please select one option only. 

[DROPDOWN LIST SPECIFIC TO EACH COUNTRY] 

[USE IIS REGION MODULE] 

ASK ALL 
SA  

D3.    What  is  the  highest  level  of  education  you  have  achieved?  Please  select  one 
option only. 

[DROPDOWN LIST SPECIFIC TO EACH COUNTRY] 

1.  Not completed primary education 
2.  Primary or first stage of basic 
3.  Lower secondary or second stage of basic 
4.  Upper secondary 
5.  Post secondary, non tertiary 
6.  First stage of tertiary 
7.  Second stage of tertiary 

D4. Which  of  these  best  describes  your  use  of  the  internet?  Please  include  all  use  of 
the internet, including sending and receiving emails. Please select one option only. 

ASK ALL 
SA  

1.       Several times a day 

2.       Around once a day 

3.       4 or 5 times a week 

4.       2 or 3 times a week 

5.       Around once a week 

6.       2 or 3 times a month 

7.       Around once a month 

8.       Less than around once a month 

9.       Never but I have access 

10.    Never but I do not have access 

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D5.  And  for  how  long  have  you  had  access  to  the  internet?  Please  select  one  option 
only. 
ASK ALL EXCEPT THOSE WHO DO NOT HAVE ACCESS TO THE INTERNET (THOSE CODING 9 OR 
10 AT D4) 

SA 

1.       Less than 3 months 

2.       Between 3 and 6 months 

3.       Between 6 and 12 months 

4.       Between 1 and 2 years 

5.       Between 2 and 3 years 

6.       Between 3 and 4 years 

7.       Between 4 and 5 years 

8.       Between 5 and 6 years 

9.       More than 6 years 

10.    Don't know   

D6. And how do you access the internet? Please include all the ways you ever access 
the internet. 

ASK ALL EXCEPT THOSE WHO DO NOT HAVE ACCESS TO THE INTERNET (THOSE CODING 9 OR 
10 AT D4) 

MA 

1.       Via personal computer or laptop at HOME 

2.       Via personal computer or laptop at WORK/UNIVERSITY/SCHOOL 

3.       Via convenient public place of access - e.g. Internet Cafe, Library etc. 

4.       Via mobile terminal (e.g. mobile telephone, PDA, Palm, Blackberry, tablet) 

5.       Via TV set (through digital cable) 

6.       Via games console e.g. Nintendo Wii, Sony PSP, PSP 2, PSP 3, Xbox 360) 

D7. In which of these ways have you used the Internet in the last three months? 

You can mention as many or as few as you wish. 

ASK ALL EXCEPT THOSE WHO DO NOT HAVE ACCESS TO THE INTERNET (THOSE CODING 10 AT 
D4) 

MA 

1.       For sending / receiving emails 

2.       To visit sites for information on hobbies and personal interests 

3.       To visit sites for information on products/ services I am thinking of buying 

4.       To buy products/ services on-line (not groceries) 

5.       Grocery shopping on-line 

6.       To check on my bank account and other financial holdings 

7.       Play video games on-line (e.g. simple (casual) games or multi-player games versus other 

players)/ not for money gaming 

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8.       Download/stream music 

9.       Download/stream movies 

10.     On-line Dating 

11.       Voice  Over IP (used the internet to  make  voice  and/or video calls using a VOIP service 

such as Skype or similar) 

12.     To visit social networking sites (such as Facebook or Twitter), or to look at or/and to take 

part in discussion forums or blogs 

13.    On-line gaming / playing for money (e.g. poker, bingo) 

14.    Download /stream TV programmes / clips  

15.    To look for a job/ search job (recruitment) sites 

16.    Completing on-line surveys 

17.    Read newspapers on-line 

18.    For something else 

19.    Don't know 

D8 

And  finally,  our  partners  at  Coffey  ,  who  have  commissioned  this  survey,  may 
wish to contact you to ask you to take part in similar research in future. Coffey is 
a  professional  services  consultancy,  established  in  1959,  with  expertise  in 
international  development  and  project  management.  They  also  provide  high 
quality  and  independent  evaluations  to  the  European  Commission  on  a  broad 
range of policy areas. Would you be happy for us to keep a record of your name, 
address and telephone number to let you know about future research?  

Yes  -  I  am  happy  for  Coffey  to 
contact me about taking part in 
further research 

1 

INTERVIEWER: PLEASE TAKE 
CONTACT DETAILS 
(NAME/ADDRESS/E-MAIL/TELEPHONE 
NUMBER) 

No - I do not wish to participate 
in further research 

2 

THANK AND END 

Please  make  sure  you  enter  correct  and  complete  information  in  order  to  participate 
to further research: 

1.  First Name: 
2.  Last Name: 
3.  Address: 
4.  Email: 
5.  Telephone number: 

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5. 

FOCUS GROUPS WITH SMOKERS AND EX-SMOKERS 

5.1. 

Findings for Austria  

The Austrian on-line focus groups took place on 16 March 2015 (ex-smokers) and 17 
March  2015  (current  smokers).  Each  group  lasted  just  over  one  hour.  The  five  ex-
smokers (three women and two men) and five smokers (two women and three men) 
were recruited from across Austria and were aged between 27 and 32. 

A  professional  moderator  led  both  focus  groups  and  the  participants  engaged  in  a 
healthy debate, responding to points raised by each other as well as to our questions. 
The discussions reflected the main objectives of the focus groups, which were to: 

  Generate  evidence  for  DG  SANTE  on  factors  that  influence  quitting  smoking  for 

future campaign targeting; 

  Better understand how ex-smokers views and feelings are evoked by information 

campaigns and messages on smoking prevention and smoking cessation; and 

  Analyse  recall  and  explore    what  the  ‘Ex  smokers’  are  unstoppable’  campaign, 
slogan and key messages make this group of ex-smokers feel / possible impacts, 
as well as experiences of the iCoach application. 

The  following  text  sets  out  the  main  findings  from  both  groups  comparing  and 
contrasting the views of the current smokers with those of the ex-smokers. 

Public health information campaigns 

The  discussion  kicked  off  with  participants  considering  information  campaigns  that 
encourage people to quit smoking. In the past year, none of the ex-smokers had seen, 
read, or heard any information campaigns or advertisements about quitting smoking. 
Amongst  the  smokers,  one  participant  had  seen  a  pharmacy  advertisement  for 
Nicorette,  while  another  referred  to  campaigns  she  had  seen  abroad.  While  none  of 
the  ex-smokers  was  able  to  think  of  any  public  health  campaigns  that  might  be 
particularly  effective  to  help  people  quit  smoking,  two  smokers  mentioned 
advertisements they had seen in free newspapers for their health insurance fund. 

We then asked both groups about which types of messages are most persuasive for 
people who want to quit smoking. The following points arose: 

  Spontaneously,  the  ex-smokers  mentioned  graphic  images  (‘smoker’s  leg’) 
depicting the negative health consequences of smoking and passive smoking. The 
majority  of  the  ex-smokers  thought  that  images  were  more  powerful  than 
words,  facts  or  figures.  Particularly  effective,  they  said,  were  images  depicting 
the  negative  health  consequences  of  smoking,  with  one  participant  suggesting  it 
would be good to show smokers how 20  years of smoking would impact on their 
personal appearance.  

  The smokers agreed that the most important messages were those centred on the 
harmful consequences smoking can have for one’s health. One smoker took issue 
with  this,  however.  He  made  the  point  that  while  everyone  knows  that  smoking 
can be bad for your health, the important message to get across is that the ability 
to  give  up  is  “all  in  your  head”.  Accordingly,  messages  should  focus  on  helping 
smokers overcome peer pressure and smoking’s association with particular social 
situations (e.g. a night out). 

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  The  ex-smokers  also  mentioned  the  importance  of  stressing  the  positive  side  of 
quitting,  including  having  “more  money  in  your  pocket”,  an  improved  level  of 
fitness,  an  avoidance  of  the  negative  health  consequences  and  fewer  wrinkles. 
One  ex-smoker  opined,  “you  must  want  it  for  yourself,  otherwise  it  won’t  work”. 
Almost  all  the  ex-smokers  thought  it  was  a  good  idea  to  focus  on  the 
experiences  of  ex-smokers  who  had  managed  to  quit.  “Only  those  who  have 
smoked can really empathise with smokers”, said one ex-smoker. “Someone who 
has never smoked doesn’t know what it is to stop”, said another.  

  The  ex-smokers  were  less  confident  that  messages  focussing  on  the 
manipulation  tactics  of  the  tobacco  industry  could  persuade  people  to 
quit. Several smokers pointed out that tobacco advertising is generally forbidden 
anyway. One ex-smoker suggested that while this kind of message might work to 
deter  people  from  starting,  it  would  not  persuade  smokers  who  are  already 
addicted  to  quit.  This  led  a  couple  of  ex-smokers  to  raise  the  importance  of 
educating  people  on  the  consequences  of  smoking  to  help  them  rethink  their 
choices.  

The  ex-smokers  agreed  that  they  had  looked  at  the  health  warnings  on  cigarette 
packs,  and  some  mentioned  having  seen  gruesome  images  of  diseased  lungs  on 
foreign  packets.  While  this  had  made  some  of  the  ex-smokers  reflect  very  briefly  on 
the  harmful  health  consequences  of  smoking,  the  general  feeling  amongst  the  ex-
smokers,  however,  was  one  of  scepticism  that  on-packet  warnings  would  persuade 
smokers  to  change  their  behaviour.  As  one  ex-smoker  pointed  out,  “every  smoker 
knows it’s bad for your health”, and even “disgusting” images would not have led her 
to think twice. It is interesting to note that this view, albeit expressed specifically with 
regard to on packet health warnings, seemed to contradict the view expressed by the 
majority of the ex-smokers earlier in the discussion that, in terms of messages aimed 
at persuading people to quit smoking, images were more powerful than words. 

Amongst the smokers, almost no one said they looked at these warnings. The general 
sentiment  echoed  the  views  of  the  ex-smokers  i.e.  the  images  might  be  disgusting, 
but most smokers know that smoking is bad for you and yet they continue. 

“Ex-smokers are Unstoppable” campaign 

Neither  the  ex-smokers  nor  the  smokers  said  they  had  noticed  the  campaign  logo 
and  slogan25  prior  to  their  involvement  with  this  study.  Asked  what  they  thought  of 
the  slogan,  the  ex-smokers  coalesced  around  the  idea  that  it  stood  for  stamina/ 
endurance and, secondarily, strength. The smokers were divided, with two suggesting 
that the slogan conjured up the idea of ‘decisiveness’ and ‘will power’, while the others 
said they did not understand what idea the slogan was trying to convey. Interestingly, 
participants  in  both  groups  considered  the  prominence  of  the  prefix  ‘Ex’,  which 
appeared  in  significantly  larger  font  size  than  the  other  words,  sent  out  a  negative 
message and distracted from the ‘unstoppable’ element of the message. 

Both  the  ex-smokers  and  the  smokers  were  then  shown  seven  messages  aimed  at 
persuading  smokers  to  quit  and  asked  which  they  considered  most  persuasive.  The 
results,  including  explanations  given  by  participants  to  explain  their  preferences,  are 
displayed in the table overleaf. 

25 Translated literally in Austria as ‘Ex-Raucher sind nicht aufzuhalten’ 

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Table 29: Austrian participants’ responses to different quit messages 

Message 

“There are many 
advantages when you stop 
smoking” 

“Smoking is dangerous for 
your health and for the 
health of your relatives” 

Number who liked each message         and comments made 

Ex-Smokers 

Smokers 

  Why?  

“This  would  be  good  if  you  also 
highlight the advantages” 

     Why?  

Why?  

  “Because it’s about death!”  

  “I noticed this when I stopped” 

  “It’s a good message as it links 

  “In principle, yes, although I 

live alone and am not harming 
anyone but myself” 

family with your bad conscience”. 

  “You can damage your family: not 
only through passive smoking, but 
also if you get sick, you can’t work, 
and that has consequences for 
them”. 

However: 

  “This message could be difficult as 

some people already avoid smoking 
near their family” 

  “’Family and friends’ would be better 

than ‘relatives’”  

“One can also have 
financial benefits when 
one stops smoking” 

“Stopping smoking is a 
very big challenge” 

    Why?  

   “For me this is the clearest 
reason to quit smoking” 

Why?  

  “It challenges me!” 

  “It’s only a challenge at the 

weekend!” 

“Ex-smokers are in a 
better physical and mental 
condition” 

Why?  

  “Smokers already have health 

problems” 

“Ex-smokers have a better 
life” 

Why?  

  “It’s based on envy, thus it’s 

motivating” 

“If you can stop smoking, 
you can deal with many 
things in life” 

     Why?  

  “Because you’ve done it and you can 

be an example” 

Amongst  the  ex-smokers,  the  most  popular  message  was  the  idea  that  “smoking  is 
dangerous for your health and for the health of your  relatives”. The smokers,  on the 
other hand took to the message that highlighted the “many advantages when you stop 
smoking”.  The  smokers  discussed  these  advantages,  listing  ‘better  quality  of  life’, 
‘feeling fitter’, ‘improved physical appearance’ (“no more yellow nails!”), an end to the 
cigarette  odour,  saving  money,  and  an  end  to  the  stress  associated  with  smoking 
(worrying when the next cigarette break will be). 

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Quit attempts 

Ex-smokers 

The  ex-smokers  then  discussed  the  process  they  had  gone  through  when  giving  up 
smoking. Asked what the ‘tipping point’ was that had led to their decision to give up 
smoking for good, the answers consisted of: 

  Having a non-smoking partner; 

  Costing a lot of money; 

  Having started as a teenager and always intending to quit; 

  Family planning/ becoming (unexpectedly) pregnant; and 

  Noticing that one was the only smoker on a course 

Three  of  the  ex-smokers  had  never  made  previous  attempts  to  quit.  The  other  two 
said  their  successful  attempt  was  motivated  by  their  changed  family  circumstances 
(family planning, becoming pregnant). Interestingly, beyond their family members and 
peers, only one of the ex-smokers credited external factors (the price of cigarettes) 
with any influence over their decision. 

According to the ex-smokers, the main benefits of quitting smoking were: 

  A return of their physical fitness; 

  A return of their sense of taste; 

  Saving money; 

  No more headaches after a night out; 

  “Not stinking anymore”; 

  Better skin, fewer spots; 

  Whiter teeth; and 

  “Noticing how disgusting it really is” 

A few participants mentioned that they were particularly pleased they had not given in 
(and started smoking again). A couple said they occasionally smoked (when stressed, 
or with alcohol) and one said he had taken the decision to no longer drink alcohol, in 
an  attempt  to  ensure  he  would  not  be  tempted  to  smoke  again.  Asked  which 
cigarette they found the most difficult to give up, most of the ex-smokers agreed 
that this was when they would go out, usually associated with drinking alcohol. 

Smokers 

Three of the five smokers had also tried to quit. Amongst the factors that had led 
them  to  try,  the  smokers  mentioned  work  (attending  an  office  seminar  on  quitting, 
making a bet with the boss), a desire to feel fitter, and simply having “had enough of 
cigarettes”.  External  factors,  such  as  a  smoking  ban  at  work  and  in  some  bars, 
seemed  to  have  led  a  few  participants  to  reduce  their  consumption  of  cigarettes,  or 
restrict their smoking to the weekend, rather than to quit. 

The smokers who had made quit attempts talked of the advantages of not smoking 
they had experienced. These included feeling more active and being able to participate 
in  sport  once  again,  and  having  a  renewed  healthy  appetite.  One  smoker  talked  of 
losing the feeling of stress associated with always checking she had cigarettes with her 
and  wondering  when  the  next  cigarette  break  would  come,  an  idea  that  some  of  the 
others smokers concurred with. 

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As  with  the  ex-smokers,  the  current  smokers  agreed  it  was  hardest  to  resist 
smoking when they were on a night out and drinking alcohol. Most agreed that 
the  atmosphere  in  smoke  free  bars  was  just  not  as  good  as  that  in  pubs  where  one 
could  smoke.  Interestingly,  however,  three  of  the  smokers  said  they  did  not  feel  the 
same need to  smoke when they were  on holiday abroad.  One  smoker suggested this 
was because “abroad, it’s normal that people don’t smoke”.  

Asked why they had  started  smoking again, the smokers primarily mentioned stress, 
either  specific,  traumatic  events,  or  generally  e.g.  at  work.  Other  factors  mentioned 
were  the  difficulty  of  withdrawing,  which  one  smoker  likened  to  the  distress 
experienced  when  splitting  up  with  a  partner,  and  the  difficulty  of  quitting  when 
everyone around him smoked. 

Quit aids 

Next the discussion turned to aids intended to help smokers quit. Perhaps surprisingly, 
none  of  the  ex-smokers  had  used  anything  beyond  their  own  ‘will  power’  when  they 
succeeded in quitting smoking.  

The  current  smokers  were  split  between  those  who  agreed  that  will  power  was  the 
only  real  answer,  and  those  who  considered  some  smoking  aids  (gum  and  e-
cigarettes)  could  be  helpful in  quitting.  E-cigarettes  divided  the  group,  with  some 
considering them a good means of breaking the habit gently.  One smoker described 
how  she  would  sometimes  ‘reward’  herself  with  an  e-cigarette.  She  also  explained 
that,  for  her,  smoking  was  primarily  a  social  thing,  and  that  by  ‘smoking’  an  e-
cigarette  with colleagues she was avoiding the temptation to  smoke tobacco instead. 
Presented with a list of different aids to help people quit, the majority of the smokers 
agreed that they would be open to the idea of using a smartphone app to try to break 
their habit. 

iCoach recall 

Neither  the  ex-smokers  nor  the  current  smokers  had  previously  heard  of 
iCoach. Only one participant was aware of an acquaintance who had used an app (to 
successful  ends),  although  she  could  not  be  sure  whether  this  had  been  iCoach.  The 
moderator  explained  that  iCoach  is  a  free  digital  health  coach  platform,  designed  to 
support users’ efforts to stop smoking by providing regular, tailored advice based on a 
user’s  ‘smoking  profile’.  One  ex-smoker  said  she  had  used  something  similar  to  help 
her overcome depression. 

Although  they  themselves  had  not  used  any  aids  to  quit,  the  ex-smokers  agreed 
that  iCoach  was  probably  a  good  idea,  reasoning  that individually  tailored  advice 
was  helpful  and  that  an  app  would  be  practical  and  simple.  “You’ll  never  go  a  day 
without  thinking  about  stopping,”  said  one  ex-smoker  with  approval.  A  couple  of 
participants  thought  iCoach  would  be  particularly  helpful  for  people  who  had  newly 
decided to quit. Setting goals was most useful during the first phase of quitting, they 
said.  Others  thought  iCoach  would  at  least  be  helpful  in  helping  smokers  curb  their 
habit, if not stop altogether.  

Amongst the smokers, most thought iCoach sounded good and agreed they would be 
willing to try it. Some hoped it would show how much their lungs had improved after a 
certain number of days without smoking, while others  suggested the  app could show 
how much money they had saved over a specified period. 

Some  of  ex-smokers  were  more  tentative  about  the  prospect  of  iCoach  working, 
saying  it  would  depend  on  the  kind  of  advice  dispensed,  while  one  ex-smoker 
suggested  that  ‘you  can  say  anything  to  an  addict’  without  success.  One  of  the 
smokers agreed  with this viewpoint, saying that, for him, the important thing was to 

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understand  the  psychology  behind  smoking  rather  than  simply  presenting  indicators 
with regard to improvement in lung capacity or money saved.  

Ideas for future messages and actions against smoking 

The  discussion  ended  with  both  groups  asked  to  imagine  they  had  been  tasked  with 
designing  an  information  campaign  to  encourage  people  to  quit  smoking.  “What 
would  be  the  key  messages  that  you  would  like  to  communicate?”  asked  the 
moderator.  The  ex-smokers’  responses  centred  on  the  damaging  health  effects  of 
smoking  (destroying  one’s  health,  ‘yellow  teeth  and  skin’,  mental illness),  alternative 
opportunities  for  spending  one’s  cash,  and  the  fact  that  one’s  quality  of  life  is  better 
after  quitting  (“smokers  will  admire  you  for  quitting  and  non-smokers  will  want  to 
hang out with you”). One participant suggested the motivational message “anyone can 
do  it!”,  while  another  was  more  blunt:  “People,  stop  with  the  nonsense  and  dedicate 
yourselves to more pleasant things in life!” 

The smokers agreed on the need to stress the personal benefits of quitting: “Your skin 
does not age as fast, you feel better physically and it saves money”, said one. Others 
mentioned  the  benefits  to  friends  and  family,  presumably  through  a  reduction  in 
passive smoking, and the importance of emphasising will power. 

Finally, both groups considered how governments and public health professionals can 
be  more  effective  in  encouraging  smoking  prevention  and  smoking  cessation 
initiatives. Suggestions put forward by the ex-smokers consisted of: 

  Extending smoking bans; 

  Banning advertisements for cigarettes; 

  Increasing prices for cigarettes; 

  Contacting  smokers  directly  through  surveys  to  find  out  why  they  still  smoke; 

and 

  Educating smokers with regard to smoking (starting with school children) 

The  point  with  regard  to  education  was  picked  up  by  most  of  the  ex-smokers  who 
agreed that not only children, but also their parents should be targeted by campaigns 
and possibly sent on courses to educate them on the dangers of smoking and how to 
prevent their children from starting. 

The current smokers echoed some of these suggestions, particularly the importance of 
educating school children. Perhaps surprisingly, some of the smokers were somewhat 
harsher in terms of the way they felt smokers should be treated, suggesting smokers 
should  have  to  make  larger  social  security  contributions  for  instance.  The  smokers 
were  also  more  critical  of  current  efforts  to  stop  smoking  in  Austria.  Most  of  the 
smokers  lamented  Austria’s  failure  to  introduce  a  real  smoking  ban  in  bars.  One 
participant  attributed  this  to  the  complaining  culture  in  Austria  (“If  we  had  groups  of 
people  standing  outside  bars  smoking,  there  would  be  complaints  from  the 
neighbours”) while another thought it was a question of insufficient enforcement (“In 
most  bars  there  is  a  smoking  ban,  yet  everyone  smokes.  All  they  do  is  hide  the  ash 
trays in case there’s an inspection”). 

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5.2. 

Findings for Bulgaria  

The  Bulgarian  on-line  focus  groups  took  place  on  23  March  2015  (current  smokers) 
and  24  March  2015  (ex-  smokers).  Each  group  lasted  just  over  one  hour.  The  five 
current  smokers  (three  women  and  two  men)  and  five  ex-smokers  (four  women  and 
one man) were recruited from across Bulgaria and were aged between 29 and 34. 

The following sub-sections present the main findings from the two groups, comparing 
and contrasting the views of the current smokers with those of the ex-smokers. 

Public health information campaigns 

We  first  asked  participants  if  they  recalled  recent  information  campaigns  that 
encourage people to quit smoking. In the past year, most of the ex-smokers had seen, 
read, or heard information campaigns or advertisements about quitting smoking. They 
indicated  newspapers  and  Facebook  as  primary  sources,  as  well  as  banners  on  the 
Internet. One participant recalled something related to the Ministry of Health. Another 
participant  mentioned  a  long  article  in  a  magazine  that  focussed  on  the  lungs.  Ex-
smokers generally recalled the content of the campaigns they had seen. Several could 
remember  a  campaign  called  “I  don’t  want  to  be  guilty”  (this  campaign  aimed  to 
reduce cases of lung cancer caused by smoking through raising awareness as opposed 
to “blaming and shaming”).  

Amongst  the  smokers,  everyone  mentioned  that  they  had  seen  campaigns,  but  were 
unable to elaborate further on the content when asked for more details. They recalled 
having  seen  such  campaigns  in  a  variety  of  media  –  newspapers,  billboards,  TV  and 
the Internet. Two recalled commercials for the anti-smoking pills Tabex. One recalled 
an advertisement for iCoach on a web pop-up page. No one could recall a particularly 
effective  or  memorable  campaign.  However,  they  mentioned  a  campaign  aimed  at 
school children – “Breathe freely”.  

We then asked both groups which types of messages are most persuasive for people 
who want to quit smoking. The following points arose: 

  The ex-smokers were unanimous that the most persuasive message was the one 
relating to statistical data and facts about the adverse effects of smoking. They 
thought  that  numbers  (of  cancer  cases,  deaths  etc)  have  a  significant  impact. 
They  mentioned  that,  unfortunately,  the  messages  relating  to  the  impact  of 
smoking on health are well known and have no considerable effect. However, the 
statistical  data  reinforces  the  legitimacy  on  those  claims.  Two  ex-smokers 
mentioned  the  messages  relating  to  manipulation  strategies  of  the  tobacco 
industry, but the other  participants felt that this could only discourage smokers 
from buying a certain brand of cigarettes, rather than quitting altogether.  

  The  smokers  found  that  messages  focussing  on  the  experiences  of  ex-smokers 
who managed to quit were most persuasive. Most of them did not agree with the 
idea  of  “manipulation”  as  they  all  thought  smoking  was  a  matter  of  personal 
choice. 

The ex-smokers were divided regarding the health warnings on tobacco/cigarette 
packs. Some felt affected by these warnings, while others never really paid attention 
to them.  Two women outlined that the health warnings are very effective with female 
smokers, as they bring to their attention health matters that can be adversely affected 
by their smoking habit, such as pregnancy and fertility. Others dismissed them as they 
felt such warnings become ubiquitous after time and lose their impact. 

The  smokers  dismissed  the  warnings  along  the  same  lines.  Several  referred  to  the 
warnings  as  annoying  and  ineffective.  Generally,  they  thought  that  graphic  images 
provoke  disgust  but  not  much  more.  Generally,  there  was  an  agreement  that  no 
warning would be so shocking that it would incite them to quit smoking. 

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“Ex-smokers are Unstoppable” campaign 

With  the  exception  of  one  smoker,  none  of  the  other  participants  (ex-smokers  and 
current  smokers)  had  ever  noticed  the  campaign  logo  and  slogan26  prior  to  their 
involvement with this study. Asked what they thought of the slogan, both groups were 
slightly confused as to the meaning, but this was partly due to the literal translation in 
Bulgarian that does not entirely reflect the original message.  

Participants in both groups thought that the slogan was ambiguous in the sense that it 
suggests ex-smokers are “wild” and “unrestrained”, or even that the need to smoke is 
so strong that they cannot stop themselves from smoking again. When told about the 
English  translation,  participants  in  both  groups  identified  themes  relating  to  ex-
smokers having more energy strength and being able to “take on the world”. The key 
conclusion was, however, that the translation was not entirely successful in Bulgaria.  

Participants also provided their views on the seven messages displayed below. 

Table 30: Bulgarian participants’ responses to different quit messages 

Message 

“There are many 
advantages when you 
stop smoking” 

“Smoking is dangerous 
for your health and for 
the health of your 
relatives” 

Number who liked each message         and comments made 

Ex-Smokers 

Smokers 

      Why?  

  “Financial, health” 

          Why?  

               Why?  

   “Adverse effects on health are the worst 

consequence.” 

  “The only time when I managed to 
quit was because I was worried 
about my small child.” 

  “Being responsible for someone else 

having health issues.” 

“One can also have 
financial benefits when 
one stops smoking” 

Why?  

Why?  

   “I stopped smoking for financial 

   “An expensive pleasure.” 

reasons.” 

  “Money was very important in my 

decision to quit smoking.” 

  “The financial consequences are 
stronger than the health ones.” 

  “This is the only reason for which I’d 

quit smoking.” 

“Stopping smoking is a 
very big challenge” 

Why?  

Why?  

  “It is something you are proud of.” 

  “It’s very difficult.” 

  “Everyone knows that smoking is bad– 

making quitting a challenge gives a boost 
to the attempt.” 

Why?  

  “When they quit smoking people start 

looking after themselves, get a 
membership in the gym.” 

      Why?  

  “Because it’s a triumph.” 

“Ex-smokers are in a 
better physical and 
mental condition” 

“Ex-smokers have a 
better life” 

“If you can stop 
smoking, you can deal 
with many things in 
life” 

26

 Translated literally in Bulgaria as “Екс-пушачите са неудържими” 

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Ex-smokers  thought  that  the  most  powerful  message  was  that  quitting  smoking  is  a 
challenge. They felt that it is very important to give weight to the effort. “Smoking is 
dangerous for your health and for the health of your relatives” was the message that 
smokers  preferred,  especially  in  relation  to  their  family  members,  not  themselves.  
Participants  in  both  groups  strongly  adhered  to  the  financial  benefits  of  giving  up 
smoking. 

Quit attempts 

Ex-smokers 

Key reasons that led ex-smokers to give up smoking for good included: 

  Costing a lot of money; 

  Ultimatum from non-smoking partner; 

  Starting a new job where colleagues are mainly non-smokers;  

  Having a family 

All of the ex-smokers succeeded in their quit attempt at the first try. According to the 
ex-smokers, the main benefits of quitting smoking were: 

  Improved physical fitness; 

  Saving money 

A few participants mentioned that their social circle made their quit attempt more 
difficult  and  they  had  to  distance  themselves  from  groups  where  people  smoked. 
Others were unaffected by people smoking around them. Asked which cigarette they 
found  the most  difficult  to  give  up,  most  of  the  ex-smokers  agreed  that  this  was 
when they would go out, usually associated with drinking alcohol or coffee. 

Smokers 

The five smokers had also tried to quit in the past. Amongst the factors that had led 
them  to  try,  the  smokers  mentioned  having  a  family  and  the  prohibitive  cost  of  the 
habit.  

The  smokers  pointed  out  that  the  main  benefits  from  quitting  would  be  mostly 
financial, but were also conscious about the health related implications.  

When  asked  about  their  relapse,  the  smokers  pointed  out  the  social  circle,  the 
overwhelming  thoughts  about  cigarettes  (“dreaming  of  smoking”)  and  children 
growing up as the reasons that pushed them to start again.  

Quit aids 

Next,  the  discussion  turned  to  aids  intended  to  help  smokers  quit.  The  ex-smokers 
stated that they had not used any means to assist their quit attempt. One pointed out 
that  she  had  an  electronic  cigarette  but  that  was  for  pleasure,  rather  than  to  help 
quitting. 

The current smokers thought that will power was the only thing that mattered in 
a  quit  attempt.  Some  had  tried  medication  (Tabex),  electronic  cigarettes  and 
nicotine  replacement  products,  but  the  group  was  not  convinced  that  they  had  any 
effect.  Many noted that psychological addiction is the hardest to overcome and that it 
should  be  dealt  with  first.  When  asked  if  they  were  keen  to  try  any  of  the  aids 
discussed, the currents smokers were in favour of trying herbs or natural remedies. In 

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any  case,  they  thought  it  should  not  be  an  expensive  product  (medication  was 
dismissed as too expensive). 

Participants  in  both  groups  were  suspicious  of  any  on-line  or  mobile  phone  apps  in 
support of quitting smoking. Smokers and ex-smokers agreed that quit aids can only 
be helpful if the person is motivated and ready to quit smoking. 

iCoach recall 

Most  of  the  smokers  and  one  ex-smoker  recalled  iCoach  from  the  internet. 
Whilst  they  were  not  entirely  convinced  it  could  help,  the  majority  of  participants  in 
both groups found the idea innovative and interesting and smokers stated they would 
be open to register because they found it interesting.  

Some  dismissed  the  idea  completely  as  a  waste  of  time.  A  few  also  highlighted  that 
apps  are  restricted  to  people  with  smart  phones  and  access  to  internet,  which  limits 
their broad use by the population.  

Ideas for future messages and actions against smoking 

The key conclusion from both groups is that any future campaigns in Bulgaria should 
target teenagers in secondary education, as this is when they start smoking.  

The  ex-smokers  thought  that  campaigns  should  emphasise  the  successful  quit 
attempts (“success stories”) of real people. They also thought that it would be great to 
feature  popular  celebrities  or  ex-smokers  testimonies.    The  idea  that  other  people’s 
quit attempts should serve as an example was very strong. 

The  ex-smokers  thought  that  campaigns  should  have  more  statistics  and  real  data 
about  the  harmful  effects  of  smoking.  Participants  in  the  two  groups  also  considered 
that finding a personal motivation to quit was essential. 

The majority of participants in both groups also thought that campaigns should focus 
on positive messages, as opposed to negative ones.  

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5.3. 

Findings for Germany  

The  German  on-line  focus  groups  with  smokers  and  ex-smokers  took  place  on  25 
March.  The  groups  consisted  of  eight  ex-smokers  (three  women  and  five  men)  and 
eight smokers (four women and four men). 

A  professional  moderator  led  both  focus  groups  and  the  participants  engaged  in  a 
healthy debate, responding to points raised by each other as well as to our questions.  

The  following  text  sets  out  the  main  findings  from  both  groups,  comparing  and 
contrasting the views of the current smokers with those of the ex-smokers. 

Public health information campaigns 

The  discussion  kicked  off  with  participants  considering  information  campaigns  that 
encourage people to quit smoking. In the past year, none of the ex-smokers had seen, 
read, or heard any information campaigns or advertisements about quitting smoking. 
Among  the  smokers,  few  had  much  recollection  of  public  health  campaigns  aimed  at 
helping people quit smoking, beyond a commercial for Nicorette which one participant 
had seen on TV. 

We then asked both groups about which types of messages are most persuasive for 
people who want to quit smoking. The following points arose: 

  The  ex-smokers  were  divided  by  messages  which  focussed  on  the  negative 
health  impact  of  smoking.  While  most  of  the  group  considered  these  messages 
were  important  and  that  it  was  necessary  to  ‘confront’  smokers  with  the  self-
inflicted  harm  which  smoking  represents,  others  were  less  convinced.  These 
sceptics considered that while health-focussed messages (and images) might put 
off  those  smokers  just  starting  out,  they  would  be  unlikely  to  deter  hard-bitten 
smokers with an established habit.   

  The  smokers  echoed  the  view  that  pointing  out  the  negative  health  impact  of 
smoking  would  be  persuasive.  One  smoker  suggested  that  specific  examples, 
e.g. telling the story of an individual who had suffered health consequences as a 
result of smoking, would be more effective than general warnings. 

  Among  both  smokers  and  ex-smokers,  opinion  was  divided  with  regard  to  anti-
smoking  messages  based  on  facts  and  figures.  Some  thought  this  would  be 
persuasive (creating a climate which raises awareness of smoking’s dangers and 
building  a  social  stigma  around  smoking),  while  others  thought  numbers  alone 
would be ‘too dry’. 

  Messages stressing the positive side of quitting were far more popular with both 
groups, particularly those messages which focussed on the positive experience of 
people who had managed to give up. Both smokers and ex-smokers considered 
these  messages  would  be  effective  as  they  were  ‘more  personal’  and  ‘tangible’ 
and  could  show  very  specific  benefits  (e.g.  showing  how  someone’s  skin  had 
improved as a result of quitting). One ex-smoker even suggested including short 
biographies of ex-smokers inside cigarette packets to encourage people to quit. 

  All  the  smokers  and  most  of  the  ex-smokers  were  less  than  confident  that 
messages  focussing  on  the  manipulation  tactics  of  the  tobacco  industry  could 
persuade people to quit. Participants pointed out that all advertising, regardless 
of  the  product  promoted,  is  intended  to  manipulate.  ‘Everyone  knows  this’  said 
one  participant,  and  the  general  feeling  was  that  messages  highlighting  the 
benefits  of  quitting  (as  well  as  the  harm  caused  by  smoking)  would  be  more 
‘personal’ and likely to persuade smokers to give up.  

  The  smokers  agreed  that  they  took  almost  no  notice  of  health  warnings  on 
cigarette packs.  While some  said that the first time they saw these messages 

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they  had  reflected  briefly  on  the  harmful  health  consequences  of  smoking,  the 
general  feeling  among  the  smokers  was  that  they  no  longer  even  noticed  the 
messages.  The  ex-smokers  found  these  health  warnings  ‘depressing’  but  also 
agreed that they had quickly stopped noticing them after they became a familiar 
feature on cigarette packets in Germany. 

“Ex-smokers are Unstoppable” campaign 

Neither  the  ex-smokers  nor  the  smokers  said  they  had  noticed  the  campaign  logo 
and  slogan27  prior  to  their  involvement  with  this  study.  Asked  what  they  thought  of 
the  slogan,  the  ex-smokers’  reactions  were  unanimously  negative.  ‘Why  would  this 
appeal  to  hardened  smokers?’,  asked  one,  while  another  thought  it  was  not  ‘catchy’ 
enough.  The  smokers  agreed  that  this  message  would  be  very  unlikely  to  convince 
anyone to quit. Interestingly, they said it seemed to be congratulating people who had 
managed to quit, rather than encouraging existing smokers to do so. 

We then discussed seven messages. The results are shown below.  

Table 31: German participants’ responses to different quit messages 

Message 

“There are many 
advantages when you stop 
smoking” 

“Smoking is dangerous for 
your health and for the 
health of your relatives” 

“One can also have 
financial benefits when 
one stops smoking” 

“Stopping smoking is a 
very big challenge” 

“Ex-smokers are in a 
better physical and mental 
condition” 

“Ex-smokers have a better 
life” 

“If you can stop smoking, 
you can deal with many 
things in life” 

Number who liked each message         and comments made 

Ex-Smokers 

Smokers 

  “The message is good because it’s true” 

 “ 
This  would  be  better  if  you  also  gave 
examples” 
  “Everyone knows this anyway” 

 However: 
  “Most smokers are not interested in their 
own health never mind that of others!” 
  “’Family’  or  ’children’  would  be  better 

than ‘relatives’”  

   “I noticed this when I stopped” 
  “Too general” 
  “Everyone knows this message!” 
  “I  always  make  an  effort  to  avoid 

smoking around non-smokers” 

  “You  can  always  spend  your  money  on 

something more sensible” 

  “Everyone  knows  this,  I  don’t  think  it 

would convince anyone to stop” 

  “This message is too boring” 
  “Everyone knows this” 

   “It challenges me!” 
  “This is better, it makes one curious” 
  “This  speaks  to  me  more  than  the 

other messages” 

  “This is good but the message should 
go  further  i.e:  ‘Others  have  quit,  you 
can too!’ 

  “This  isn’t  always  true.  I  know  fit 
smokers.  And  fitness  is  about  eating 
well, exercise etc. not just smoking” 

  “Too general” 
  ‘Define better!” 
  “I  find  the  opposite  is  true:  smokers 

are more relaxed, more social” 

  “This  is  strongly  persuasive.  Everyone 

wants to be fit!” 

  “What  smoker  would  admit  that  his  life 

his worse because of smoking?” 

  “This  is  the  most  positive  message  so 

  “This  is  good  because  it’s  about  you 

far, much better than the others” 

  “It’s a good message because it is hard 
to  give  up  smoking  and  once  you’ve 
done that everything will seem easier!” 
  “It’s  very  positive  to  think  that,  if  I  can 

overcome this, I can do anything” 

personally and your will power” 

  “This  is  the  best  message  because  it 
is  motivating,  and  there  is  nothing 
accusatory about it” 

  “It’s persuasive because it’s positive”. 

27 Translated literally in Germany as ‘Ex-Raucher sind nicht aufzuhalten’ 

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Among both the ex-smokers and the smokers, the most popular message was the idea 
that “If you can stop smoking, you can deal with many things in life”. This seemed to 
be because participants in both groups liked the positive tone  of the  message, which 
eschewed the ‘accusatory’ and ‘critical’ nature of messages telling smokers how much 
harm  they  are  inflicting  on  themselves.  Similarly,  a  number  of  participants  in  both 
groups liked the message promoting the “many advantages when you stop  smoking” 
because of its positive tone. Most of the other messages met with a negative reaction, 
as  they  were  either  ‘too  general’,  already  well  known  and  over-used  or  simply  too 
negative and not motivating. 

Quit attempts 

The  ex-smokers  then  discussed  the  process  they  had  gone  through  when  giving  up 
smoking. Asked what factors had led to their decision to give up smoking for good, the 
answers consisted of: 

  Growing  tired  of  the  negative  impact  of  smoking  (i.e.  personal  odour,  yellow 

teeth and skin, losing one’s sense of taste, breathlessness); 

  Wanting to save money; 

  Wanting to protect friends and family; 

  Becoming pregnant. 

Only of the ex-smokers said she had made previous attempts to quit (“Every year on 
New  Year’s  Eve!”).  Most  of  the  ex-smokers  said  their  successful  attempts  were 
motivated  by  a  desire  to  improve  their  health.  Several  of  the  ex-smokers  credited 
external factors (the rising price of cigarettes and the end of smoking in cafes) with 
some influence over their decision to quit. 

According to the ex-smokers, the main benefits of quitting smoking were: 

  A return of their physical fitness; 

  A return of their sense of taste; 

  Saving money; 

  “Having clothes which don’t stink of smoke”; 

  “Waking up without that horrible taste in your mouth”. 

Asked  which  cigarette  they  found  the most  difficult  to  give  up,  most  of  the  ex-
smokers  agreed  that  this  was  the  ‘after  dinner  cigarette’  or  smoking  when  going  out 
with friends, usually associated with drinking alcohol. 

Quit aids 

Next  the  discussion  turned  to  aids  intended  to  help  smokers  quit.  One  of  the  ex-
smokers  said  she  had  found  acupuncture  helpful,  while  another  mentioned  using  the 
Rauchfrei app on her smartphone which was ‘helpful’ on account of it allowing her to 
monitor her own progress.  

Half of the current smokers had made attempts to quit using quit aids. The group was 
split  between  those  who  agreed  that  will  power  was  the  only  real  answer,  and  those 
who  considered  some  smoking  aids  (gum  and  e-cigarettes)  could  be  helpful  in 
quitting.  The  group  agreed  that  the  role  of  will  power  was  preeminent  in  giving  up 
smoking. This led some of the smokers to include that apps would be the most helpful 
quit aid as they would show progress towards the goal of quitting and that this would 
reinforce a smoker’s motivation to break the habit.  

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iCoach recall 

Neither  the  ex-smokers  nor  the  current  smokers  had  previously  heard  of 
iCoach.  One  of  the  ex-smokers  had  previously  used  the  Rauchfrei  app  for  iPhone 
which  she  had  found  to  be  ‘very  helpful’.  The  moderator  explained  that  iCoach  is  a 
free digital health coach platform, designed to support users’  efforts to stop smoking 
by providing regular, tailored advice based on a user’s ‘smoking profile’.  

Although  they  themselves  had  not  used  any  aids  to  quit,  the  ex-smokers  agreed 
that  iCoach  was  probably  a  good  idea.  This  was  based:  firstly,  on  the  idea  that 
using  a  ‘coach’  is  a  tried  and  tested  means  of  supporting  someone  overcome  a 
challenge; secondly, on the idea that an app would be ever-present given the reliance 
and  attachment  people  today  place  on  their  phones.  The  theme  of  quitting  smoking 
would  thus  be  ever-present  in  smokers’  lives.  Amongst  the  smokers,  most  thought 
iCoach sounded appealing and agreed they would be willing to try it.  

Ideas for future messages and actions against smoking 

The  discussion  ended  with  both  groups  asked  to  imagine  they  had  been  tasked  with 
designing  an  information  campaign  to  encourage  people  to  quit  smoking.  “What 
would  be  the  key  messages  that  you  would  like  to  communicate?”  asked  the 
moderator.  The  ex-smokers’  responses  centred  on  the  damaging  health  effects  of 
smoking (to the smoker’s own health and that of friends and family) and stressed the 
importance of self-discipline.  

The  smokers  agreed  on  the  importance  of  stressing  the  personal  benefits  of  quitting 
and the need to highlight particular examples i.e. promoting the profiles of individuals 
who had quit. Most thought that continuing to stress positive messages (the benefits 
of giving up, the fact that quitting is possible and not a superhuman act) was key. 

Finally,  the  ex-smokers  considered  how  governments  and  public  health  professionals 
can  be  more  effective  in  encouraging  smoking  prevention  and  smoking 
cessation initiatives. The two suggestions put forward by the ex-smokers consisted 
of: 

  Banning  advertisements  for  cigarettes,  particularly  anything  linked  with  sport; 

and 

  Increasing prices for cigarettes. 

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5.4. 

Findings for Greece  

The two on-line groups with Greek smokers and ex-smokers took place on 18 March. 
The session with smokers lasted 1 hour and 15 minutes, and the discussion with ex-
smokers just  over one  hour.  The  six smokers  (three women and three men) and the 
seven ex-smokers (three women and four men) were from seven Greek cities (Athens, 
Thessaloniki,  Grevena,  Xanthi,  Kavala,  Lamia,  and  Patra).  Participants  were  aged 
between 25 and 34. 

The  following  text  sets  out  the  main  findings  from  the  two  groups,  comparing  and 
contrasting the views of the current smokers with those of the ex-smokers. 

Public health information campaigns 

When asked about their recollections of previous information campaigns and anti-
smoking messages, smokers recalled the following examples: 

  Leaflets distributed by the Municipality of Athens at the metro 

  Posters at school and at the Town Hall with information about the disadvantages 

of smoking and clinics for quitting 

  Radio  messages  providing  information  about  clinics  for  quitting  and  relevant 

medical professionals 

  Videos and articles of ex-smokers’ experiences  

  On-line advertisements and articles about the ‘Allen Carr’ method  

  Messages on cigarette packs 

Half  of  participant  smokers  were  doubtful  about  the  results  of  such  campaigns, 
and in  particular  about their  effectiveness  in influencing  smoking  habits.  One  smoker 
said that she was “entirely unaffected” by this type of initiatives and another smoker 
mentioned that she did not know anyone who quit smoking because of a campaign. A 
third  participant  suggested  that  campaigns  could  even  have  adverse  effects  on 
smokers.  There  were  others  in  the  group  who  thought  that  a  campaign  could  indeed 
provide  stimuli  or  that  it  could  be  thought  provoking,  even  at  an  unconscious  level 
that could later lead to quitting. Ultimately, smokers agreed that quitting smoking was 
a personal decision, often based on will power or personal experiences.  

Ex-smokers  had  a  rather  vague  recollection  of  the  existence  of  recent  or  previous 
campaigns  though  they  were  not  able  to  give  specific  examples.  Some  participants 
commented that communication initiatives were not enough to promote social change. 
A  few  argued  in  favour  of  radical  measures  in  the  fight  against  tobacco,  like  the 
shutting down of industries.  

Regarding  types  of  messages,  the  majority  of  participants  in  both  groups  favoured 
the  option  ‘messages  that  focus  on  the  experiences  of  ex-smokers  who  managed  to 
quit’.    Smokers  felt  that  these  types  of  messages  transmit  optimism,  courage, 
motivation  and  focus.  A  couple  of  smokers  supported  messages  focusing  on 
‘manipulation  tactics  of  the  tobacco  industry’,  and  a  few  supported  messages  on  the 
‘harmful  consequences  of  smoking’  because  they  were  powerful  to  trigger  debates 
around smoking.  

Ex-smokers favoured the messages focused on ‘facts and statistics’ and those focused 
on  the  ‘experiences  of  people  who  managed  to  quit’,  as  they  argued  that  hard  facts 
and  experiences  of  ex-smokers  were  real,  concrete,  credible,  and  effective  for 
conveying the message.  

The table overleaf illustrates preferences of participants in each group. 

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Table 32: Greek participants’ responses different types of messages 

Message 

Number who liked each message          

Ex-Smokers 

Smokers 

Messages warning about the 
harmful consequences of 
smoking  

Messages that provide facts and 
statistics on the harmful 
consequences of smoking 

Messages that focus on the 
experiences of ex-smokers who 
managed to quit  

Messages that focus on 
manipulation tactics of the 
tobacco industry 

With  the  exception  of  a  few  ex-smokers  who  admitted  feeling  a  big  guilty  when 
exposed to health warnings on tobacco packs, the majority of respondents in the 
two groups (smokers and ex-smokers) did not pay much attention to  the images and 
texts. As one ex-smoker pointed out, “the addiction is too strong to read messages”. 
Another ex-smoker mentioned that the unconscious influence of the warnings led her 
to  take  the  decision  to  quit.  Smokers  agreed  that  the  warnings  may  have  had  an 
impact  on  them  at  first  sight,  but  that  the  impact  diluted  after  a  while  and  they  felt 
unaffected by the warnings. 

“Ex-smokers are Unstoppable” campaign 

Half  of  participants  in  the  smokers’  group  had  noticed  the  Ex-smokers  campaign  on 
the internet, written media (magazine, newspaper) or at school. Conversely, only one 
ex-smoker recalled having seen the campaign at the metro.  

Asked  to  offer  their  opinion  on  the  campaign’s  logo  and  slogan,  four  out  of  six 
smokers  judged  it  positively.  Participants  liked  it  because  it  conveyed  power  and 
motivation.  They  also  considered  that  the  slogan  was  short,  that  it  caught  their 
attention, and that it was thought provoking. They preferred this message to negative 
messages  that  focus  on  diseases  and  harmful  consequences.  The  remaining  two 
smokers  thought  it  was  similar  to  other  messages  they  had  seen  in  the  past,  and 
therefore  the  Ex-smokers  message  did  not impress  them.  In  view  of  one  participant, 
smokers do not want to feel like campaigns are begging them to quit smoking or to be 
treated  like  sick  people.  Another  smoker  considered  that  the  word  ‘unstoppable’ 
seemed  “a  bit  funny  because  it  makes  me  picture  as  a  power  ranger  –  which  I  am 
not”.  

Ex-smokers were divided between those who thought the slogan was smart and that it 
conveyed  determination  and  reassurance  that  you  can  achieve  anything,  and  those 
who  were  less  enthusiastic  because  they  felt  that  it  was  not  strong  enough.    Ex-
smokers  also  discussed  the  graphic  design  of  the  logo.  Whilst  some  thought  that  the 
image of burning out the cigarette was a good illustration, one participant highlighted 
that the scissors would convey a more appropriate image, and another ex-smoker felt 
that the image was not obvious or understandable.   

We  then  discussed  with  participants  in  both  groups  seven  messages  aimed  at 
persuading  smokers  to  quit  and  asked  which  ones  they  considered  the  most 

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persuasive.  The  table  below  displays  participants’  preferences,  including  justifications 
for these preferences. 

There is not any one message in particular standing out in any of the two groups. The 
message  on  financial  benefits  was  relatively  more  prominent  than  the  other  options, 
pointing  out  to  the  current  political  and  economic  climate  in  Greece  marked  by  the 
financial  crisis.  Improvement  of  physical  and  mental  health  and  having  a  better  life 
followed were also popular across the two groups.  

Ex-smokers  commented  that  although  many  people  had  to  quit  because  of  the 
financial crisis, others  who would still smoke despite their financial difficulties  (“some 
people won’t buy bread, but they will buy tobacco”). Smokers preferred practical and 
realistic messages to sentimental and melodramatic ones.  

Table 33: Greek participants’ responses to different quit messages 

Message 

“There are many 
advantages when you 
stop smoking” 

“Smoking is dangerous 
for your health and for 
the health of your 
relatives” 

“One can also have 
financial benefits when 
one stops smoking” 

“Stopping smoking is a 
very big challenge” 

“Ex-smokers are in a 
better physical and 
mental condition” 

“Ex-smokers have a 
better life” 

“If you can stop 
smoking, you can deal 
with many things in life” 

Number who liked each message         and comments made 

Ex-Smokers 

Smokers 

      Why?  

 “Practical and considerable” 

  ‘It appeals to emotion… and 

smoking is already an emotional 
addiction‘ 

 ‘Unfortunately today the financial 

message is important…’ 

 ‘I know many people who quit 

because of the money…’ 

 ‘This challenges you to prove that 
you have the strength to quit…’ 

 ‘Financial benefits are more 

concrete…’ 

 ‘The physical condition is the best 
because health is above all…’ 

 ‘This is the truth…’ 

 ‘This is somewhat better 

because trying to appeal to the 
emotion does not work 
anymore… but [this] addresses 
the situation as an event…’ 

 ‘This would attract me… it is more 

general…’ 

 ‘A better life, that’s what I want if 
I quit smoking… and I believe 
that I will have it…’ 

 ‘I think this is quite motivational…’ 
 ‘It is motivating and it can be 

applied…’ 

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Quit attempts 

Ex-smokers 

When  consulted  about  the  ‘tipping  point’  that  led  to  their  decision  to  quit  smoking 
for good, ex-smokers highlighted the following: 

  Health concerns 

  Sports performance and stamina 

  Seeing no point in smoking 

  Loss of the sense of smell 

  Not enjoying being addicted to something 

  Being tired of thinking of smoking all the time 

Four  ex-smokers  had  never  made  previous  efforts  to  quit  smoking,  while  two  had 
attempted to quit smoking before at least once and started smoking again because of 
emotional overload and weakness of character in difficult times or getting carried away 
in  social  settings  when  combined  with  alcohol  or  coffee.  One  ex-smoker  admitted 
having  one  cigarette  very  rarely  when  she  is  not  emotionally  stable.  With  the 
exception of one participant, ex-smokers were not influenced by external factors like 
smoking bans at work or in public places, price of cigarettes and taxes.  

In  terms  of  the  main  benefits  of  quitting  smoking,  ex-smokers  named  the 
following: 

  Health improvement 

  Physical stamina 

  Improvement of finances 

  Not getting tired so easily 

  Fresher breath 

  Independence 

  Relaxation 

  No more spitting “black phlegm in the morning” 

In  view  of  ex-smokers,  the  cigarette  combined  with  coffee  or  alcohol  were  the  most 
difficult  to  quit.  People  also  mentioned  the  cigarette  after  eating,  the  cigarette  while 
waiting for the bus or the cigarette when feeling nervous.   

Smokers 

All  participant  smokers  had  made  previous  efforts  to  quit  smoking,  but  they 
remained  abstinent  for  less  than  a  year.  In  terms  of  influencing  factors  for  quitting, 
the smokers mentioned: 

  Health concerns 

  Financial reasons 

  Just wanting to quit 

  Smoking too much during the holidays 

  Not going out so much anymore 

  Destruction or aging of skin 

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  Being encouraged by partner 

All but one of the smokers said that they were not influenced by external factors. 

In  terms  of  benefits  of  quitting  smoking,  the  financial  one  was  the  most  popular, 
though respondents cited the following: 

  Improvement of finances 

  Physical stamina 

  Better atmosphere at work 

  Increase of energy 

  No need to look for a lighter all the time 

The  social  cigarette,  usually  associated  with  drinking  coffee  and/or  alcohol  was  the 
most  difficult  to  give  up  for  smokers.  Other  cigarettes  mentioned  included  the  one 
after eating and the one while playing cards.  

Asked about their reasons for starting smoking again, smokers highlighted: 

  Breaking up with a partner 

  Not feeling well psychologically 

  Missing the pleasure of smoking 

  Wanting to lose weight 

  Nothing in particular, just habit 

Asked  if  they  had  plans  to  give  up  smoking  in  the  future,  only  one  smoker 
responded that she definitely intended to quit smoking in 2015  for health and beauty 
reasons.  The  majority  of  participants  mentioned  that  they  would  like  to  quit  for 
various  reasons,  including  having  a  baby  or  experiencing  less  financial  constraints. 
Others  mentioned  that  they  needed  to  take  a  decision  when  they  felt  more 
determined. 

Quit aids 

None  of  the  ex-smokers  had  ever  used  any  aids  for  quitting  smoking,  and  there 
was consensus amongst all participants that the main elements that helped them quit 
smoking were their personal will and determination. Only one ex-smoker thought that 
quit  aids  could  potentially  be  beneficial  for  those  who  needed  help  for  quitting 
smoking. 

Current smokers were generally more negative than ex-smokers were in terms of aids 
for quitting smoking. Amongst smokers, two had tried electronic cigarettes before but 
one commented that it actually made him smoke more. Another participant had used 
a  Nicorette  product  but  said  that  it  was  “awful”.  One  smoker  referred  to  her  friends’ 
experiences  with  quit  aids  and  said  that  they  had  no  results.  Two  smokers  argued 
against  such  resources  because  they  considered  them  “pseudo-pharmaceutical 
products” and thought that they could be “worse than smoking”.  

In terms of services and products for helping people quit smoking, ex-smokers 
assumed that possibly the nicotine replacement products or other medication, and the 
professional health services could make a difference.  

Some  smokers  argued  that  none  of  these  services  or  products  would  be  effective, 
while others favoured professional health services or (one participant) a stop smoking 

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application available on mobile phones. Two smokers were not willing at all to try any 
of these products or services, and one in particular highlighted that they were “wasted 
money”.  Other  participant  smokers  were  open  to  considering  talking  to  medical 
professionals.  

iCoach recall 

None  of  the  ex-smokers  had  ever  heard  about  iCoach  before  taking  part  in  this 
research,  while  only  two  smokers  were  aware  of  the  platform.  At  least  half  of 
participants  in  the  group  of  smokers  were  willing  to  try  the  iCoach  platform.  One 
smoker  defined  herself  as  “the  kind  of  person  that  can  be  helped  by  such  apps”  and 
consequently expressed willingness to try it. Conversely, another smoker argued that 
the  app  sounded  like  “more  of  a  trend  than  a  substantive  tool  designed  by  doctors” 
and that he would not be willing to register for it.  

Most ex-smokers were unconvinced or ambivalent about the platform’s ability to help 
people  to  quit  smoking.  Some  ex-smokers  speculated  that  the  platform  might  work 
because people spent a lot of time on the internet or because it could be customised. 
Others thought that it all depends on the smoker and how much he or she will use it 
and  that  “getting  registered  is  one  thing,  but  using  it  is  another”.  Eventually  all  ex-
smokers agreed, as they had done previously in the discussion, that quitting smoking 
is a matter of personal will and that will power is the key ingredient to succeed. 

Smokers  seemed  equally  doubtful  regarding  iCoach’s  capacity  to  assist  people  with 
quitting  smoking.  Only  one  smoker  was  optimistic  stating  that  “some  people  are 
positively influenced if they have a reminder on their phone that can give them advice 
and encouragement”. Other smokers thought that it would work only if  “its approach 
is  scientific  enough,  which  can  be  hard  for  an  app”  or  if  the  user  “has  a  solid 
character”.  Other  smokers  simply  assumed  that  it  might  work  without  being  certain. 
One smoker liked that the app was free, so accessible for people to try it at least.  

None  of  the  ex-smokers  or  current  smokers  knew  any  friends,  colleagues  or 
relatives  who had previously used the  iCoach platform and as such, they could 
not comment on anyone’s experience.  

Ideas for future messages and actions against smoking 

In the final part of the sessions, we asked participants to describe the messages that 
they  would  like  to  communicate  if  they  were  to  design  a  campaign.  Ex-smokers 
focused  on  messages  about  health,  well-being  and  the  positive  effects  of  quitting  on 
various  domains  of  life,  like  family,  finances,  etc.  They  also  suggested  testimonies 
comparing  the  before  and  after  quitting  smoking.  Many  ex-smokers  agreed  that  it 
would be important to emphasise that smoking does not have much to offer to people, 
since  “smoking  does  not  belong  to  the  basic  needs  of  the  human  organism”  and  to 
underline  the  things  that  smoking  cannot  do,  such  as  “it  doesn’t  make  you  tougher, 
smarter  or  better”.  Additionally,  one  participant  suggested  that  the  issue  of  quitting 
smoking  could  be  formulated  as  a  personal  challenge  (“is  it  stronger  than  me?”)  to 
motivate people to stop. 

Smokers were more inclined to suggest messages with a focus on practical concerns, 
such  as  the  health  and  financial  benefits  of  quitting,  and  to  avoid  sentimental 
approaches  “so  that  people  can  identify  with  them”.  Some  smokers  proposed  their 
own  slogans,  such  as  “The  habit  of  smoking  repeats  itself.  Life  doesn’t”  (in  Greek:  Η 
συνήθεια του καπνίσματος επαναλαμβάνεται. Η ζωή όχι).  

Asked how governments and public health professionals could be more effective 
in  encouraging  smoking  prevention  and  smoking  cessation  initiatives,  ex-smokers 
emphasised  that  the  focus  should  be  on  the  younger  age  groups  and  the  institutions 
where people tend to start smoking, such as schools and the army. A few participants 

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suggested banning under aged people from buying cigarettes  or smoke products and 
installing effective control in tobacco selling shops.  

Ex-smokers asked for “more control” not only in selling and in buying cigarettes but in 
smoking  in  public  spaces,  because  “we  all  know  that  laws  in  Greece  are  made  to  be 
broken”.  Some  suggested  that  stricter  fines  should  be  applied.  At  least  three  ex-
smokers referred positively to the success of other countries such as Germany and the 
United Kingdom in banning smoking in public spaces and they criticised that in Greece 
“the only thing that changes is that they bring you a plastic cup, instead of an ashtray, 
so that it doesn’t show”.  

Ex-smokers  also  argued  that  the  government  should  give  incentives  to  health 
professionals and patients, like an extra bonus for every successful patient who quits 
smoking or extra credit in patients’ insurance.   

In contrast, smokers did not have many suggestions on this topic. They discussed how 
increasing the price of cigarettes could help. Someone also suggested that if the price 
of  cigarettes  went  down  people  would  stop  viewing  smoking  as  a luxury  product  and 
would be less inclined to smoke. 

At least four smokers expressed negative attitudes towards the government and said 
that  there  are  more  immediate  challenges  to  take  care  of  rather  than  tackling 
smoking. One smoker said the government should keep a low profile if launching anti-
smoking  campaigns  because  people  do  not  trust  governmental  messages  (“wherever 
there is the indication of the Ministry of Health it doesn’t make you feel that it is about 
your own benefit, but rather about the benefit of the insurance funds”).  

One smoker noted that doctors should be friendlier, while another said that politicians 
and  health  professionals  should  set  the  example  by  not  smoking  in  public.  Smokers 
did not mention the issue of smoking bans in public spaces or installing stricter control 
measures.  

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5.5. 

Findings for Lithuania  

The  two  on-line  focus  groups  with  Lithuanian  participants  took  place  on  31  March. 
Each  group  lasted  just  over  one  hour.  The  eight  ex-smokers  (five  women  and  three 
men)  and  eight  smokers  (six  women  and  two  men)  were  recruited  from  across 
Lithuania  and  were  aged  between  25  and  34.  The  following  text  sets  out  the  main 
findings  from  the  two  groups,  comparing  and  contrasting  the  views  of  the  current 
smokers with those of the ex-smokers. 

Public health information campaigns 

The  discussion  kicked  off  with  participants  considering  information  campaigns  that 
encourage people to quit smoking. Smokers reported having seen adverts on TV (e.g. 
“Nicorette”  and  other  patches).  Some  mentioned  self-help  literature  and  a  special 
stand at Akropolis (a large  shopping mall). One of the smokers argued that this kind 
of advertising was not effective.  

Both smokers and ex-smokers mentioned ‘disgusting’ graphic images (‘a smoker’s 
lungs’, ‘ill-developed foetuses’) depicting the negative health consequences of smoking 
and passive smoking. Participants in the two groups agreed that images  on cigarette 
packs  were  more  powerful  than  facts,  figures  or  words.  However,  they  also  agreed 
that images were only effective for a short while. According to one participant smoker, 
“they  work  for  a  moment  or  two  –  later,  one  forgets  them,  so  there  is  no  long-term 
effect.”  Ex-smokers  agreed  that  powerful  graphic  images  were  good  for  prevention 
purposes.   

In  general,  participants  in  both  groups  agreed  that  public  health  information 
campaigns  were  not  very  effective  to  help  smokers  quit  smoking.  The  majority 
considered  will  power  as  the  most  important  element  for  quitting  (“it’s  all  in  the 
smoker’s  head.  If  there  is  no  will  power  to  quit,  no  advertising  or  communication 
campaign  will  change  it”).  A  few  smokers  agreed  that  when  children  are  involved, 
messages tend to touch a cord on smokers. 

We  then  discussed  four  types  of  messages  with  participants  in  both  groups,  with  a 
view to exploring which are the most persuasive for people who want to quit smoking. 
The following points arose: 

  Unlike  the  majority  of  countries,  there  was  consensus  amongst  participants  in 
both groups that negative-type messages were the most effective. The majority 
of participants in both groups considered that the negative messages warning 
about the harmful consequences of smoking had to be included in anti-smoking 
campaigns.  Ex-smokers  were  less  convinced  of  the  effectiveness  of  negative 
messaging  because  they  thought  that  smokers  tended  not  to  read  them.  Visual 
negative images were considered more powerful than words. 

  Ex-smokers were divided over the effectiveness of informative messages that 
provide facts and statistics about the negative consequences of smoking. Whilst 
half  of  participants  agreed  that  statistics  were  effective  because  they  are 
evidence-based,  the  other  half  argued  that  numbers  were  impersonal  and 
removed  from  personal  experiences.  Smokers  were  in  their  majority  critical  of 
informative  messages;  they  agreed  that  figure  were  dry  and  not  sufficiently 
interesting to capture their attention.  

  Unlike the focus groups results in other countries, smokers were in their majority 
against  positive  messages  that  focus  on  the  experiences  of  ex-smokers  who 
managed  to  quit,  as  they  thought  that  the  experiences  of  ex-smokers  did  not 
affect them personally hence there would be no emotional connection with these 
stories and testimonies. Ex-smokers were highly supportive of positive messages 
as they found that personal experiences could be inspiring. 

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  The  majority  of  participants  in  both  groups  were  supportive  of  messages  that 
focus on manipulation tactics of the tobacco industry.  In general, smokers 
and  ex-smokers  agreed  that  manipulation  occurred  regularly  and  took  many 
different  shapes  (e.g.,  smoking  in  films,  product  placements,  etc.)  and  that  it 
had to be reported (“if people see that they are being manipulated, they will feel 
less  satisfaction  from  smoking”).  Those  who  were  against  these  types  of 
messages argued that manipulation is not exclusive of the tobacco industry and 
that  the  message  is  not  effective  for  people  to  encourage  people  to  quit 
smoking.     

“Ex-smokers are Unstoppable” campaign 

Neither  the  ex-smokers  nor  the  smokers  said  they  had  noticed  the  campaign  logo 
and  slogan28  prior  to  their  involvement  with  this  study.  Consulted  about  the  slogan, 
the smokers did not quite understand what ‘unstoppable’ (or, literally back translated 
‘invincible’)  meant.  They  were  also  sceptical  about  the  idea  of  an  ex-smoker,  (“there 
are no ex-smokers, only people who have not smoked for a long time and might start 
at any time”). 

None  of  the  ex-smokers  liked  the  logo  or  thought  it  was  effective.  Two  in  the  group 
misinterpreted  the  message  in  the  logo.  One  ex-smoker  added  that  when  people 
smoke, they are a part of the same social group. When they quit, they somehow loose 
the collective identity. It is hard to identify oneself with a group/club of ex-smokers. 

A  few  smokers  said  that  the  slogan  sounded  like  it  attempted  to  demean  those  who 
smoke. One smoker also argued that the logo was badly designed and ‘was begging to 
be vandalised’. The EX part could be easily painted over or erased and it would look as 
if  it  said  ‘Smokers  are  Unstoppable’.  Two  ex-smokers  also  said  that  initially  they 
thought that the slogan read ‘Smokers are Unstoppable’.  

Both the ex-smokers and the smokers discussed seven messages aimed at persuading 
smokers  to  quit.  The  results,  including  explanations  given  by  participants  to  explain 
their preferences, are displayed in the table overleaf. 

28 Translated literally in Lithuania as ‘Exrūkaliai nenugalimi’ 

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Table 34: Participants’ responses to different quit messages 

Message 

Number who liked each message         and comments made 

“There 
are  many 
advantages  when  you 
stop smoking” 

“Smoking  is  dangerous 
for  your  health  and  for 
the  health  of  your 
relatives” 

“One  can  also  have 
financial  benefits  when 
one stops smoking” 

Ex-Smokers 

Smokers 

3/8 participants consider that it 
would  be  better  to  say  ‘There 
are many advantages when you 
don’t  smoke’.  Or  perhaps  the 
message  ‘smoking  has  many 
disadvantages’  could  be  more 
useful? 

However  
 “What are those advantages 

exactly?” 

 “The message is too vague” 

  “Your actions can have a 

  “The family component can be 

negative effect on those you 
love” 

However: 
 “Not effective - has been over 

used” 

powerful” 

 “It is convincing for parents” 

  “It is the most convincing” 

 “The economic component is 

 “It’s the most effective message 
in times of economic hardship” 

“Stopping smoking  is a 
very big challenge” 

strong” 

“Ex-smokers  are  in  a 
better  physical  and 
mental condition” 

“Ex-smokers  have  a 
better life” 

can 

you 

stop 
“If 
smoking,  you  can  deal 
with  many  things  in 
life” 

  “I associate it to positive 
challenges like running 
marathons”  

  “I like that it makes reference 

to the efforts linked to quit 
smoking” 

  “I am 100% convinced by it” 

  “This message could motivate 

However: 
 “It’s not effective amongst 

smokers” 

me to quit smoking” 

  “It’s direct and real” 

 “Your life will be better 

without smoking” 

  “People don’t grasp the changes 
they will experience if they quit” 

  “You can run the bus, smell 

  “It sounds like a positive 

better, taste food, not 
smoking is awesome”   

challenge” 

 “You can achieve stability” 

Quit attempts 

Ex-smokers 

Ex-smokers mentioned a number of reasons why they quit smoking, including: 

  The  social  context  (“smoking  is  no  longer  cool”)  /  pressure  from  family  and 

friends 

  Changing conditions at the work place (smoking bans, less people smoking) 

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  Personal factors (fear of not being strong enough to quit) 

  Price of cigarettes 

  Health-related reasons 

When asked about the benefits, ex-smokers mentioned: 

  Improved complexion 

  Better smell 

  Financial benefits 

  Psychological well-being (feeling good about overcoming the challenge) 

  Regaining the sense of taste  

Interestingly, one respondent mentioned the negative social consequences of quitting 
smoking.  She  described  smoking  as  a  group  activity  that  sometimes  involved  the 
discussion  of  relevant  issues,  “when  one  does  not  smoke,  one  is  automatically 
excluded from that social activity.”  

Different  substitutes  that  participants  ex-smokers  used  to  quit  smoking  included 
snacks, chewing gum, coffee, chewing tobacco and alcohol.  

When  asked  what  makes  people  start  smoking  again,  the  majority  of  ex-smokers 
agreed that the social context was the main factor associated with relapse, and a few 
mentioned that that the availability of cigarettes everywhere (in shops, at counters, at 
service stations, etc.) also affected the quitting process.  

Asked  which cigarette  they found the most  difficult to give up, some  of the ex-
smokers  said  that  this  was  the  morning  one  with  the  coffee,  which  one  participant 
described  as  a  ritual.  Others  said  that  it  was  the  evening  cigarette  after  work.  A 
number  of  participants  agreed  that  the  hardest  cigarette  to  give  up  was  the  social 
cigarette with friends, and a couple of respondents said that they found it hard not to 
smoke when they were nervous or upset. 

Smokers 

The  majority  of  smokers  had  tried  to  quit  smoking.  A  couple  of  participants 
mentioned  a  book  that  had  helped  them  in  the  process  (‘An  Easy  Way  to  Quit 
Smoking’) and one confirmed having used e-cigarettes. Others said they had not used 
any  aids.  Asked  what  made  them  quit  smoking,  participants  mentioned  health 
reasons, family pressure, and self-determination. 

Amongst the main benefits of not smoking, participants mentioned the following: 

  Financial benefits 

  Physical fitness 

  Improved taste and smell 

  Improved breathing 

  More time available to do other important things 

The  most  difficult  cigarette  to  give  up  for  smokers  was  the  morning  one  with  coffee. 
Social cigarettes were also hard to abandon. One smoker said that holiday cigarettes 
and celebration cigarettes were the hardest to give up. 

The most commonly mentioned reason for resuming smoking was being in company of 
smokers.  A  couple  relapsed  because  they  wanted  to.  One  smoker  said  that  he  really 
enjoyed the act of smoking. 

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Quit aids 

The  majority  of  ex-smokers  had  never  used  any  aids  to  help  them  in  their  efforts  to 
quit  smoking.  One  participant  mentioned  nicotine  gums  (“they  were  hideous  and  not 
useful  at  all”)  and  acupuncture,  and  a  few  said  they  had  tried  regular  chewing  gums 
and  lollipops  (e.g.  Chupa  Chups).  Smokers  had  tried  different  things,  including 
nicotine gums, patches and medication (e.g. Champix), e-cigarettes, natural products 
and  self-help literature,  but  they  agreed  that  personal  willpower  was  more  important 
than any aid. 

We  then  asked  participants  in  both  groups  to  provide  their  views  on  the  following 
types of products and services: 

  Nicotine  replacement  products:  Ex-smokers  were  sceptical  of  nicotine 
replacement products, as they believed that the main factor for quitting was will 
power.  One  ex-smoker  mentioned  having  friends  who  had  used  these  types  of 
products but that they had not worked. Smokers were slightly more open to the 
idea  of  using  these  types  of  products,  but  there  were  also  some  comments 
around  the  potential  secondary  effects.  One  smoker  who  had  tried  taking  pills 
had to discontinue the medication as they made her feel nauseous. 

  Professional  health  services,  e.g.  advice  from  doctors,  clinics,  counselling 
sessions  or  groups:  Ex-smokers  were  highly  supportive  of  professional  health 
services to help smokers in their efforts to quit, as they agreed that people trust 
their  doctors  and  listen  to  their  advice.  However,  participants  in  both  groups 
believed  that  advice  from  doctors  would  be  more  effective  in  case  of  serious 
health problems where quitting smoking would be a decisive factor.    

  Electronic  cigarettes:  The  majority  of  ex-smokers  and  smokers  in  the 
Lithuanian  focus  groups  were  distrustful  of  the  effectiveness  of  electronic 
cigarettes as aids to quit smoking. In general, people believed that e-cigarettes 
generated  addiction  just  like  normal  cigarettes,  and  that  the  chemical 
components of e-cigarettes were unclear.   

  Telephone  ‘stop  smoking’  services:  The  majority  of  participants  in  both 
groups  were  wary  of  telephone  ‘stop  smoking’  services  as  they  thought  they 
were  impersonal.  A  few  highlighted  that  they  would  be  better  off  asking  for 
support from family or friends. A couple of ex-smokers expressed some support 
as  they  felt  that  conversation  and  communication  were  both  key  elements  to 
help people in their efforts to quit smoking. 

  Stop  smoking  application  available  online:  Participants  in  both  groups 
rejected  online  ‘stop  smoking’  applications  for  the  same  reasons  as  the 
telephone  services  in  both  groups.  However,  the  online  /  social  media  / 
application component was more appealing to many in both groups (see below). 

  Stop  smoking  application  available  on  mobile  phones:  Participants  were 
generally more receptive to ‘stop smoking’ mobile applications than to telephone 
or  online  variants  as  they  argued  that  they  were  innovative  and  motivating. 
However, several people were not sure how this type of application would work, 
and an ex-smoker highlighted that it was not suitable for older people who were 
not familiar with mobile applications.  

After  discussing  the  pros  and  cons  of  the  different  products  and  services,  we  asked 
participants  to  reflect  on  the  most  effective  aids  to  stop  smoking.  Ex-smokers 
agreed  that  counseling  sessions  and  groups  were  the  best  support  for  people  who 
wished to quit smoking, but many also believed that willpower was essential. A couple 
of ex-smokers preferred the mobile application over the other options.  

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Smokers’  preferences  were  divided  over  professional  help  and  follow-up,  medication, 
and  apps.  One  smoker  suggested  setting  up  a  programme  with  financial  benefits  for 
smokers  who  managed  to  quit.  Another  smoker  proposed  concrete  messages  about 
the  immediate  and  most  visible  benefits  of  quitting  smoking.  Participants  also 
highlighted that personalized help was important.  

iCoach recall 

Neither  the  ex-smokers  nor  the  current  smokers  had  previously  heard  of 
iCoach.  A  couple  of  ex-smokers  thought  it  was  an  application  related  to  a  sports 
brand. After explaining the details of iCoach in greater depth, we asked participants to 
share their views about the application. Both ex-smokers and smokers were interested 
in  the  potential  of  such  an  application,  and  would  be  open  to  try  it.  Smokers  in 
particular  agreed  that  the  application  had  to  be  flexible,  and  were  divided  over  the 
potential effectiveness of such an application, with some enthusiastic participants who 
agreed  it  could  be  of  help  for  people  who  are  motivated  to  quit.  Others  argued  that 
people  tend  to  lose  interest  with  this  type  of  applications  after  a  while,  so  it  is  not 
useful as a tool per se, if not supported by other elements. One participant ex-smoker 
mentioned  having  signed  up  for  other  applications  for  losing  weight  in  the  past  but 
that she lacked willpower to continue (“I’ve tried some applications to lose weight, at 
first you sign up, provide your information, follow-up, but with time you lose interest 
and you stop using them”). 

The  majority  of  smokers  were  open  to  the  possibility  of  signing  up  for  iCoach.  They 
agreed  that  it  could  be  an  interesting  experience,  that  the  fact  that  it  was  a  mobile 
application was practical in that they always carried it with them, and they liked that it 
had no cost. As with ex-smokers, a few participants in the smokers group stated that 
they could lose interest after a few days / weeks, and a couple mentioned that there 
were  other  factors  more  effective  to  quit  smoking,  including  willpower,  practising 
sports, or professional help. One smoker highlighted that he would be willing to try the 
application only if / when he made up his mind to quit smoking. 

None  of  the  participants  were  aware  of  any  relatives,  friends  or  colleagues  who  had 
signed  up  for  iCoach  and  who  had  used  it.  One  smoker  highlighted  that  she  knew 
some  friends  who  had  a  mobile  application  that  calculated  financial  savings  and 
provided tips for smokers who wanted to quit, but she did not provide the name of the 
app. 

When  asked  about  iCoach,  ex-smokers  all  said  that  they  had  not  heard  the  name 
before. Two of them thought that it had something to do with sports brands like ‘Nike’ 
or  ‘Adidas’.  1/8  smokers  said  that  they  had  not  heard  about  iCoach  before;  2/8  said 
that  they  had  heard  about  it  somewhere  but  did  not  remember  where;  the  other 
smokers did not reply. 

When they were told about iCoach, all ex-smokers were interested and said that they 
would like  to  try it  and  would  recommend  it  to  others.  Smokers  were  also interested 
and would like to try it but they would like the application to be flexible, meaning that 
it  should  not  send  information,  reminders  and  messages  like  ‘do  not  smoke,  do  not 
harm yourself’ all the time.  Both  smokers and  ex-smokers would like to see how the 
application works.  

Ideas for future messages and actions against smoking 

To  close  the  discussion,  we  asked  participants  in  both  groups  to  imagine  they  had 
been  tasked  with  designing  an  information  campaign  to  encourage  people  to  quit 
smoking,  and  to  suggest  key  messages  that  they  would  like  to  communicate  in  that 
hypothetical  situation.  Ex-smokers  focussed  on  positive  messages  about  the  benefits 

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of  quitting  smoking,  and  agreed  that  negative  messages  were  not  good  motivators. 
There  was  some  discussion  amongst  ex-smokers  on  how  to  attract  younger  people, 
and in general participants supported positive messages for this target too:  

  “If you want to quit, you can” 

  “It’s difficult, but it’s worth the try” 

  “Quitting is not easy, but you’re not alone” 

  “If you stop smoking, you win” 

Interestingly,  smokers  also  agreed  that  motivational  messages  were  the  most 
effective to encourage people to quit smoking. In general, the messages proposed by 
participant  smokers  pivoted  on  the  freedom  that  people  would  gain  if  they  stopped 
smoking. The main focus of the messages was on the quitting process as opposed to 
the benefits that would come next, and the idea that people could quit if they tried to. 
Examples of messages suggested included: 

  “You can do it” 

  “You will win freedom” 

  “Give yourself an opportunity” 

  “If you stop smoking, you win” 

One participant smoker highlighted that it was also important to draw attention to the 
financial  benefits  of  quitting  smoking,  and  to  provide  concrete  examples  of  savings. 
Another  smoker  argued  that  there  should  be  different  messages  and  campaigns 
developed  for  different  target  audiences  and  age  groups,  including  the  younger 
generations at school and young parents with small children. 

The  final  question  aimed  to  explore  ways  in  which  governments  and  public  health 
professionals could be more effective in encouraging smoking prevention and smoking 
cessation  initiatives.  There  was  consensus  amongst  ex-smokers  that  educating  the 
younger generations on the dangers of smoking and promoting healthy lifestyles were 
essential in the fight against tobacco. One ex-smoker suggested it would be important 
to link quitting smoking with sport, running and leading a healthy lifestyle (“If young 
people  see  healthy  as  a  trend,  they  will  follow  it”).  Participants  in  this  group  were 
against  increasing  the  price  of  cigarettes,  devising  taxes  or  tobacco,  or  developing 
measures banning smoking in public places.  

Smokers‘  views  were  more  heterogeneous  on  this  point.  Participants  in  this  group 
were  more  inclined  to  support  education  and  information  measures,  and  in  general 
considered  that  quitting  smoking  was  a  voluntary  act  and  that  smokers  were 
responsible for their decisions (“nobody threatened us with a gun to start smoking, it 
was our decision”). There were a few smokers who were open to further bans and to 
increasing prices. Suggestions put forward by participant smokers consisted of: 

  Including  more  information  (and  links  to  informative  websites  or  services)  on 

cigarette packs; 

  Information campaigns (ads on bus and metro stations and other public places); 

  Further banning smoking in public places, including in the street; 

  Increasing  prices  for  cigarettes  (though  this  suggestion  was  rejected  by  a  few 

participants); 

  Advancing on the generic packaging (no branding) 

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5.6. 

Findings for Spain  

The  on-line  focus  groups  with  Spanish  participants  took  place  on  19  March  (ex-
smokers) and 20 March (current smokers). The ex-smokers group lasted just over one 
hour, and the group with smokers extended to one hour and fifteen minutes. The eight 
ex-smokers (six women and two men) and nine smokers (four women and five men) 
were  recruited  from  across  Spain  and  were  aged  between  27  and  34.  The  following 
text sets out the main findings from both groups, comparing and contrasting the views 
of the current smokers with those of the ex-smokers. 

Public health information campaigns 

We  first  asked  participants  if  they  remembered  having  seen,  read  or  heard  any 
information  campaigns  or  ads  about  quitting  smoking in  the  past  year.  All  of  the  ex-
smokers recalled having seen something but the majority had only vague recollections 
about  the  content.  Ex-smokers  recalled  ads/information  about  the  following  topics, 
products or services: 

  Nicotine  replacement  products  (patches,  gum)  -  three  participants  specifically 

mentioned the Nicorette brand 

  Posters / information on health centres mainly related to quit smoking therapies 

  E-cigarettes 

  News about stronger images on tobacco packages  

Smokers  were  less  aware  of  recent  information  campaigns  or  ads  about  quitting 
smoking, with only four out of nine participants recalling something. Four participants 
made  reference  to  the  information  on  the  tobacco  packages,  with  one  of  them 
explicitly  mentioning  having  come  across  a  website  of  the  Spanish  Ministry  of  Health 
on the tobacco pack that offered help to quit smoking (“when I tried to access the link, 
the  website  no  longer  existed,  and  I  couldn’t  access  it  either  from  the  homepage  of 
the  Spanish  Ministry  of  Health”).  One  participant  recalled  a  mobile  application  for 
quitting  smoking  that  he  believed  was  called  ‘Quit’  and  another  application  that 
calculated  the  money  savings  that  smokers  would  benefit  from  if  they  stopped 
smoking. 
Participants  then  reflected  on  public  health  campaigns  (not  necessarily  recent)  that 
had  made  an  impact  on  them.  Both  ex-smokers  and  smokers  highlighted  that  the 
warnings  and  strong  images  on  tobacco  packages  made  an  impact  on  them  at  the 
outset, but that they got used to them after a while. The majority agreed that factors 
other than information campaigns –including the price of cigarettes, smoking bans on 
public places or at work, personal experiences– had been more effective instigators for 
quitting. As one participant smoker put it,  “information campaigns can be stimulating 
at first sight, but with time they become anecdotal evidence”. Another smoker argued 
that  anti-smoking  campaigns  should  be  out  there  permanently  to  generate  impacts, 
like campaigns on traffic accidents.  

Whilst ex-smokers had already recalled recent information campaigns or ads, smokers 
evoked the following ads / information campaigns / images: 

  TV ad “No to drugs” 

  Explicit  images  and  warnings  on  tobacco  packages  (effective  at  the  outset,  but 

participants got used to them) 

  “An  EU  ad  on  TV  about  somebody  who  tried  to  quit  smoking  and  couldn’t  and 

was offered help”. 

  News  article  about  passive  smokers  who  were  affected  by  their  families  and 

friends who smoked (“I was shocked when I read about it”) 

  An ad with a cigarette that was shaped like a gun 

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  Comparative pictures of lungs from smokers and non-smokers 

  “A YouTube video where they extracted the smoke from 500 cigarettes, passed it 

through water, and then boiled the water, and you could see the tar”. 

We  then  tested  four  types  of  messages  amongst  participants  in  both  groups,  with  a 
view to exploring which are the most persuasive for people who want to quit smoking. 
The following points arose: 

  The  majority  of  participants  in  both  groups  did  not  think  that  the  negative 
messages  warning  about  the  harmful  consequences  of  smoking  were  effective 
enough to motivate people in their efforts to quit smoking. In general, smokers 
and  ex-smokers  agreed  that  people  are  already  aware  of  the  damages 
associated  to  smoking,  that  many  smokers  underestimate  the  potential  effects 
on them, and that many others ignore these types of messages and images. As 
one ex-smoker shared with the group, “my father covers the images on tobacco 
packages with a paper and continues smoking”. In view of a smoker, “we already 
know  about  the  negative  effects  of  smoking,  so  even  if  they  tell  us  about 
thousands dying per year as a result of tobacco, we see it as something natural”. 
Those  who  did  support  these  types  of  messages  (three  ex-smokers  and  one 
smoker) think that they are an effective trigger to help people in their efforts to 
quit smoking. 

  Both smokers and ex-smokers agreed that informative messages that provide 
facts and statistics about the negative consequences of smoking were not strong 
enough  to  persuade  people  to  quit  smoking.  Some  participants  suggested  that 
informative  messages  are  even  less  effective  than  the  negative  messages  as 
statistics  tend  to  be  more  rational  but  they  lack  an  emotional  component.  In 
view  of  an  ex-smoker,  “as  long  as  numbers  and  statistics  do  not  affect  you 
personally,  they  are  not  useful  instigators  for  quitting  smoking”.  A  couple  of 
smokers  highlighted  that  the  over-exposure  to  information  and  statistics  on 
smoking has had an inverse effect on smokers as it has demystified the impacts. 

  Positive messages that focus on the experiences of ex-smokers who managed 
to  quit  were  the  preferred  option  for  smokers  and  ex-smokers.  Participants  in 
both  groups  agreed  that  positive  messages  are  effective  because  they  are 
authentic  and  credible  and  provide  examples  that  people  can  identify  with. 
According to an ex-smoker, “smokers feel affinity when they hear  about stories 
similar  to  theirs,  when  they  see  people  who  experienced  related  problems”.  In 
view of a smoker, “hearing from others what they went through to quit smoking, 
and the changes they experienced after quitting, can really help”. 

  Smokers were slightly more interested than ex-smokers were on messages that 
focus  on  manipulation  tactics  of  the  tobacco  industry,  though  in  general 
participants  tended  to  agree  that  these  types  of  messages  are  not  effective 
triggers for quitting smoking. Ex-smokers highlighted that it is not appropriate to 
portray  smokers  as  victims  because  they  know  how  harmful  cigarettes  are. 
Smokers  agreed  that  people  would  end  up  seeing  messages  that  focus  on 
manipulation  as  a  common  industry  feature,  “just  as  political  corruption  or 
poverty in the third  world”.  In view  of  one smoker, manipulation messages can 
have  the  opposite  effect,  as  “they  are  the  perfect  excuse  to  victimise  smokers 
and  encourage  them  to  continue  smoking”.  A  couple  of  participant  smokers 
mentioned that it would be interesting and effective for them to understand how 
cigarettes  are  manufactured,  and  to  have  information  on  the  origin  of  its 
components.   

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Table 35: Spanish participants’ responses different types of messages 

Message 

Number who liked each message          

Ex-Smokers 

Smokers 

Messages warning about the 
harmful consequences of 
smoking  

Messages that provide facts 
and statistics on the 
harmful consequences of 
smoking 

Messages that focus on the 
experiences of ex-smokers 
who managed to quit  

Messages that focus on 
manipulation tactics of the 
tobacco industry 

  “They are necessary. If you 
smoke you have to know 
about the consequences” 

  “They help you to become 

aware of the damages when 
you decide to quit” 

  “They are essential as 

triggers to help you quit” 

  “If others have managed to 

  “If you think positive, it’s 

quit, why not?” 

easier to quit” 

  “It’s reassuring to know that 

  “Knowing how others 

you are not the only one who  
finds it difficult to quit, and 
that others have succeeded” 

managed to quit can be 
inspiring and provide 
practical tips” 

  “It would be effective to 
have information on how 
cigarettes are 
manufactured” 

  “The majority of citizens are 
not aware of this process ” 

Participants in the two groups spontaneously recalled the health warnings and images 
on  cigarette  packs.  When  consulted  over  the  impact  that  these  warnings  and images 
had  exerted  on  their  smoking  habits,  both  ex-smokers  and  smokers  stated  that  the 
warnings  /  images  were  effective  when  they  first  came  out  (“crude  images,  real 
faces”),  but  people  got  used  to  them  and  they  were  seen  now  as  a  common  feature 
(“they  are  the  same  images,  they  haven’t  changed,  I  am  not  impressed  by  them 
anymore”).  Smokers  were  slightly  more  indifferent  to  the  images  /  warnings  (“I  am 
not  affected  by  the  images,  I  turn  round  the  pack  and    ignore  them”).  None  of  the 
participants  in  the  two  groups  recognised  having  quit  smoking  or  having  thought 
about quitting as a result of these warnings / images.  

“Ex-smokers are Unstoppable” campaign 

Except for three ex-smokers and one smoker, participants in both groups had not seen 
the  campaign  logo  and  slogan29  prior  to  their  involvement  with  this  study.  Those 
who recalled the logo and slogan had vague recollections about them, and highlighted 
having  come  across  the  campaign  on  TV  (“the  logo  and  people  telling  about  their 
experience,  but  I  don’t  remember  much”)  or  on  a  billboard  in  a  bus.  One  ex-smoker 
remembered the campaign slogan in English but not in Spanish.   

29 Translated literally in Spain as ‘Los Ex-fumadores no Abandonan’ 

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Ex-smokers were more receptive to the campaign’s logo (five ex-smokers versus only 
two smokers who said they liked the logo). A few participants in the ex-smokers group 
liked the “X” as it suggested a cigarette that was being put out. When consulted about 
what the phrase conveyed to them, the majority of ex-smokers felt that the slogan in 
Spanish  led  to  confusion  as  it  suggested  that  “ex-smokers  can’t  stop  smoking”,  “ex-
smokers can always relapse”, “it’s impossible to quit”.  

The  majority  of  smokers  agreed  that  the  logo  was  simple  and  not  sufficiently 
attractive or eye-catching for people who smoke (“it’s not the type of logo that I would 
recall”;  “I  don’t  think  I  would  notice  it  if  I  ran  past  it”).  Only  one  participant  smoker 
openly liked the logo because “it’s elegant, positive, and ex-smokers can identify with 
it”.  For  some  smokers,  the  slogan  in  Spanish  transmitted  strength,  confidence  and 
willpower  (“ex-smokers  resist”;  “ex-smokers  don’t  relapse  easily”;  “if  ex-smokers 
have  succeeded,  smokers  can  also  succeed”).  For  others,  it  was  misleading  as  it 
communicated that “ex-smokers relapse” or that “ex-smokers don’t abandon tobacco”. 
One  participant  smoker  argued  that  the  concept  was  clear,  but  that  it  was  more 
appropriate to help ex-smokers not to relapse than to help smokers in their efforts to 
quit. 

We  then  showed  participants  seven  messages  aimed  at  persuading  smokers  to  quit 
and  asked  which  they  considered  most  persuasive.  The  results  are  displayed  in  the 
bullets and table below. 

  “There are many advantages when you stop smoking”. This message was better 
received  amongst  smokers,  though  the  majority  of  participants  in  both  groups 
did  not  find it  convincing  enough  and  thought  it  was  very  general  and  obvious. 
Smokers who liked it agreed that each person could interpret it to mean different 
advantages (economic, health-related, etc.)  

  “Smoking  is  dangerous  for  your  health  and  for  the  health  of  your  relatives”. 
Smokers  were  more  supportive  of  this  message  as  they  argued  that  the  family 
component could sensitize those who smoke, in particular parents with kids. Ex-
smokers agreed that the message had lost its effectiveness after so much use. 

  “One  can  also  have  financial  benefits  when  one  stops  smoking”.  The  economic 
argument  had  more  weight  amongst  ex-smokers.  A  couple  of  ex-smokers 
suggested that the message could be more convincing if it included numbers and 
examples  of  alternative  things  that  people  could  spend  their  money  on  (“if  you 
quit  smoking  you  can  save  xx  money  and  use  the  savings  to  go  on  holidays”). 
Smokers felt that this message was not strong enough, and that people already 
knew that quitting smoking resulted in financial benefits. 

  “Stopping smoking is a very big challenge”. The majority of participants in both 
groups  agreed  that  this  message  could  discourage  people  from  attempting  to 
quit smoking as it made it sound very difficult (“if it’s such a big challenge, you 
may  not  succeed  in  quitting”;  “it  has  negative  connotations”;  “not  good  for 
people  with  low  self-confidence”).  Ex-smokers  suggested  variations  to  the 
message  to  make  it  more  appealing,  such  as  “quitting  smoking  is  your  biggest 
challenge” (to make it more personal); “quitting smoking is a big challenge, but 
you are not alone”; or “quitting smoking is the best challenge”.   

  “Ex-smokers are in a better physical and mental condition”. More than half of ex-
smokers agreed that this message was motivating and true for them, but a few 
participants highlighted that smokers were not receptive to it because they had 
not experienced the positive effects of quitting (“when you smoke you don’t see 
the  advantages”).  Smokers  were  in  effect  more  resistant  to  the  message  (“not 
credible”; “football players smoke”; “people who don’t smoke can be addicted to 
other things”).  

  “Ex-smokers  have  a  better  life”.  In  general,  participants  in  both  groups 
acknowledged that the message was generic, abstract and idyllic (“the message 

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is not concrete”; “I find it utopic”; “it loses credibility”; “I stopped smoking and I 
don’t notice that my life is much better than what it was  back  when I smoked”; 
“It’s very relative, there are many smokers who are happy as they are”) 

  “If you can stop smoking, you can deal with many things in life”. Participants in 
both groups felt inspired by this message as they thought it was more concrete 
and that it posed a positive challenge. Ex-smokers associated it with recovering 
specific  sensations  that  they  had  lost  as  smokers  (fresh  breathe,  better  skin, 
etc.)  Smokers  linked  it  to  general  perceptions,  like  recovering  emotional  and 
economic stability, or recuperating their freedom.  

Table 36: Spanish participants’ responses to different quit messages 

Message 

“There are many 
advantages when you 
stop smoking” 

Number who liked each message         and comments made 

Ex-Smokers 

Smokers 

Why?  

  “In particular economic 

advantages in times of crises” 
  “Each person links it to different 
advantages – economic, health, 
etc.” 

“Smoking is dangerous 
for your health and for 
the health of your 
relatives” 

Why?  

Why?  

  “Your actions can have a negative 

  “The family component can be 

effect on those you love” 

powerful” 

However: 
  “It is no longer effective - it has 

been used a lot” 

  “It is convincing for parents” 

“One can also have 
financial benefits when 
one stops smoking” 

Why?  

Why?  

  “It is the most convincing” 
  “The economic component has a 

   “It’s the most effective message 
in times of economic hardship” 

“Stopping smoking is a 
very big challenge” 

strong effect” 

Why?  

Why?  

“Ex-smokers are in a 
better physical and 
mental condition” 

“Ex-smokers have a 
better life” 

  “I associate it to positive challenges 

  “I like that it makes reference to 

like running marathons”  

the efforts linked to quit 
smoking” 

Why?  

Why?  

  “Perfect – I am 100% convinced  

  “This message could motivate 

by it” 
However: 
  “It’s not effective amongst smokers” 

me to quit smoking” 

Why?  

Why?  

  “It’s direct and real” 
  “Your life will be better without 

smoking” 

  “People don’t grasp the 

changes they will experience if 
they quit” 

“If you can stop 
smoking, you can deal 
with many things in life” 

Why?  

Why?  

  “You can run the bus, smell better, 

  “It sounds like a positive 

taste food, not smoking is 
awesome”   

challenge” 

  “You can achieve stability on 

various fronts” 

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Quit attempts 

Ex-smokers 

Asked what the ‘tipping point’ was that had led to their decision to give up smoking 
for good, ex-smokers mentioned the following reasons: 

  Costing a lot of money / financial difficulties; 

  A close friend / relative becoming ill; 

  Others around (friends) deciding to quit; 

  Health-related personal reasons; and 

  Smoking bans in public places (particularly for social smokers) 

Five of the ex-smokers had made previous attempts to quit in the past but had started 
smoking  again.  In  general,  they  recognised  that  they  had  found  it  difficult  to  quit 
when  others  were  still  smoking  around  them.  A  few  ex-smokers  agreed  that  the 
smoking bans in bars had been instrumental in their efforts to quit.  

According to the ex-smokers, the main benefits of quitting smoking were: 

  Better smell (skin, hair, clothes); 

  Breathing more easily; 

  Less coughing and wheezing; 

  A return of their physical fitness (“feeling great again when practising a sport”); 

  A return of their sense of taste; 

  Saving money; 

  Better skin 

Asked  which  cigarette  they  found  the most  difficult  to  give  up,  most  of  the  ex-
smokers  agreed  that  this  was  when  they  would  go  out,  usually  associated  with 
drinking alcohol. Many also mentioned the cigarette with coffee  or the cigarette after 
eating.  

Smokers 

Nearly  all  participant  smokers  had  also  tried  to  quit.  Amongst  the  factors  that 
had  led  them  to  try,  smokers  mentioned  not  feeling  well,  feeling  uncomfortable  at 
work  or  motivated  by  a  partner  or  friends  who  had  quit.  External  factors,  such  as 
smoking bans at work and in bars, and the price of cigarettes, were also influential for 
some  smokers.  However,  participants  were  inclined  to  think  that  willpower  and 
personal  examples  of  friends  or  relatives  who  managed  to  quit  were  stronger 
motivators than external factors.  

The  advantages  of  not  smoking  experienced  by  smokers  in  their  attempts  to  quit 
included  physical  improvements  (breathing  more  easily,  less  coughing,  physical 
fitness),  economic  benefits  and  renewed  self-esteem,  less  dependency  and  improved 
family  links.  The  ‘first  in  the  morning’  and  the  ‘late  night’  cigarettes  were  the  most 
difficult to give up for current smokers.  

Asked  why  they  had  started  smoking  again,  the  smokers  primarily  mentioned  stress 
(family or work-related) or anxiety. Other factors cited included relaxing on holidays, 
underestimating the power of smoking one cigarette with friends, and the difficulty of 
quitting when everyone around them smoked. Except for a couple of smokers who did 
not feel they had the need to quit, everyone in the group expressed the desire to stop 
smoking for good in the future.  

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Quit aids 

The  majority  of  ex-smokers  had  never  used  any  aids  to  help  them  in  their  efforts  to 
quit  smoking.  One  participant  mentioned  nicotine  gums  (“they  were  hideous  and  not 
useful  at  all”)  and  acupuncture,  and  a  few  said  they  had  tried  regular  chewing  gums 
and  lollipops  (e.g.  Chupa  Chups).  Smokers  had  tried  different  things,  including 
nicotine gums, patches and medication (e.g. Champix), e-cigarettes, natural products 
and  self-help literature,  but  they  agreed  that  personal  willpower  was  more  important 
than any aid. 

We  then  asked  participants  in  both  groups  to  provide  their  views  on  the  following 
types of products and services: 

  Nicotine  replacement  products:  Despite  not  having  used  any  aids,  ex-
smokers  were  distrustful  of  nicotine  replacement  products  like  gums  or  patches 
(“they  can  act  as  a  placebo,  but  personal  motivation  is  the  main  factor  for 
quitting”).  A  few  ex-smokers  mentioned  having  friends  who  had  used  these 
types  of  products  but  without  any  positive  results.  Smokers  were  slightly  more 
open  to  the  idea  of  using  these  types  of  products,  but  there  were  also  some 
concerns  around  them  linked  to  the  potential  secondary  effects.  One  smoker, 
who  shared  her  experience  with  Champix,  highlighted  that  she  had  to  suspend 
the  medication  because  she  did  not  feel  good  (dizziness,  vomits)  and  the 
medication did not have any effect. 

  Professional  health  services,  e.g.  advice  from  doctors,  clinics,  counselling 
sessions or groups: The majority of participants in both groups were supportive 
of  professional  health  services  to  help  smokers  in  their  efforts  to  quit.  Even 
though they had not resorted to professional support in the past, many felt this 
could  be  an    effective  way  to  try  to  quit  smoking  (“sharing  experiences  can 
help”; “speaking with people who have managed to quit smoking”; “a collective / 
social strategy to stop smoking can help to achieve one’s objectives”) 

  Electronic cigarettes: There was consensus amongst ex-smokers and smokers 
that  electronic  cigarettes  were  not  good  as  a  strategy  to  quit  smoking.  Those 
who had tried them agreed they  were “disgusting” and not effective (“they had 
the same effect as taking a pencil to my mouth”). A few participants mentioned 
friends  who  had  used  them  and  were  “as  addicted  to  e-cigarettes  as  they  were 
to  regular  cigarettes”.  Smokers  were  particularly  distrustful  of  e-cigarettes  as 
they argued that they were harmful (“they are still cigarettes with nicotine”; “in 
the end it’s the same stuff with a different label”). 

  Telephone  ‘stop  smoking’  services:  The  majority  of  participants  in  both 
groups  were  not  supportive  of  telephone  ‘stop  smoking’  services  either  as  they 
thought  they  were  impersonal,  ineffective,  and  a  couple  even  considered  them 
as “a waste of public money”. A few participants were relatively open to the idea 
as  they  argued  that  it  could  be  an  interesting  channel  for  information  and 
consultation,  and  that  some  people  could  be  more  willing  to  speak  to  strangers 
about their problems. 

  Stop  smoking  application  available  online:  Participants  in  both  groups 
rejected  online  ‘stop  smoking’  applications  for  the  same  reasons  as  the 
telephone  services  in  both  groups.  However,  the  online  /  social  media  / 
application component was more appealing to many in both groups (see below). 

  Stop  smoking  application  available  on  mobile  phones:  Participants  were 
generally more receptive to ‘stop smoking’ mobile applications than to telephone 
or  online  variants  as  they  argued  that  they  could  use  them  anytime  and  a  few 
liked the social media component. Smokers mentioned a few examples that they 
thought  were  interesting  where  the  app  challenged  them  to  do  something  or 
where it calculated savings. However, several people highlighted that there were 
many applications available for use these days, and that downloading them was 

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not  guarantee  of  using  them  later.  One  ex-smoker  reasoned  that  a  mobile  app 
would work with younger people but not necessarily with older age groups.  

After  discussing  the  pros  and  cons  of  the  different  products  and  services,  we  asked 
participants  to  reflect  on  the  most  effective  aids  to  stop  smoking.  Ex-smokers 
agreed  that  counseling  sessions  and  groups  were  the  best  support  for  people  who 
wished to quit smoking, but many also believed that willpower was essential. A couple 
of ex-smokers preferred the mobile application over the other options.  

Smokers’  preferences  were  divided  over  professional  help  and  follow-up,  medication, 
and  apps.  One  smoker  suggested  setting  up  a  programme  with  financial  benefits  for 
smokers  who  managed  to  quit.  Another  smoker  proposed  concrete  messages  about 
the  immediate  and  most  visible  benefits  of  quitting  smoking.  Participants  also 
highlighted that personalized help was important.  

iCoach recall 

Neither  the  ex-smokers  nor  the  current  smokers  had  previously  heard  of 
iCoach.  Only  one  participant  smoker  mentioned  having  used  a  similar  app.  After 
explaining the details of iCoach in greater depth, we asked participants to share their 
views about the application. Ex-smokers were divided over the potential effectiveness 
of  such  an  application, with  some  enthusiastic  participants  who  agreed  it  could  be  of 
help  for  people  who  are  motivated  to  quit.  Others  argued  that  people  tend  to  lose 
interest with this type of applications after a while, so it is not useful as a tool per se, 
if  not  supported  by  other  elements.  One  participant  ex-smoker  mentioned  having 
signed  up  for  other  applications  for  losing  weight  in  the  past  but  that  she  lacked 
willpower to continue (“I’ve tried some applications to lose weight, at first you sign up, 
provide your information, follow-up, but with time you lose interest and you stop using 
them”). 

The  majority  of  smokers  were  open  to  the  possibility  of  signing  up  for  iCoach.  They 
agreed  that  it  could  be  an  interesting  experience,  that  the  fact  that  it  was  a  mobile 
application was practical in that they always carried it with them, and they liked that it 
had no cost. As with ex-smokers, a few participants in the smokers group stated that 
they could lose interest after a few days / weeks, and a couple mentioned that there 
were  other  factors  more  effective  to  quit  smoking,  including  willpower,  practising 
sports, or professional help. One smoker highlighted that he would be willing to try the 
application only if / when he made up his mind to quit smoking. 

None  of  the  participants  were  aware  of  any  relatives,  friends  or  colleagues  who  had 
signed  up  for  iCoach  and  who  had  used  it.  One  smoker  highlighted  that  she  knew 
some  friends  who  had  a  mobile  application  that  calculated  financial  savings  and 
provided tips for smokers who wanted to quit, but she did not provide the name of the 
app. 

Ideas for future messages and actions against smoking 

To  close  the  discussion,  we  asked  participants  in  both  groups  to  imagine  they  had 
been  tasked  with  designing  an  information  campaign  to  encourage  people  to  quit 
smoking,  and  to  suggest  key  messages  that  they  would  like  to  communicate  in  that 
hypothetical  situation.  Ex-smokers  focussed  on  positive  messages  about  the  benefits 
of  quitting  smoking,  and  agreed  that  negative  messages  were  not  good  motivators. 
There  was  some  discussion  amongst  ex-smokers  on  how  to  attract  younger  people, 
and in general participants supported positive messages for this target too. Examples 
of messages suggested included: 

  “If you want to quit, you can” 

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  “It’s difficult, but it’s worth the try” 

  “Quitting is not easy, but you’re not alone” 

  “If you stop smoking, you win” 

Interestingly,  smokers  also  agreed  that  motivational  messages  were  the  most 
effective to encourage people to quit smoking. In general, the messages proposed by 
participant  smokers  pivoted  on  the  freedom  that  people  would  gain  if  they  stopped 
smoking. The main focus of the messages was on the quitting process as opposed to 
the benefits that would come next, and the idea that people could quit if they tried to. 
Examples of messages suggested included: 

  “You can do it” 

  “You will win freedom” 

  “Give yourself an opportunity” 

  “If you stop smoking, you win” 

One participant smoker highlighted that it was also important to draw attention to the 
financial  benefits  of  quitting  smoking,  and  to  provide  concrete  examples  of  savings. 
Another  smoker  argued  that  there  should  be  different  messages  and  campaigns 
developed  for  different  target  audiences  and  age  groups,  including  the  younger 
generations at school and young parents with small children. 

The  final  question  aimed  to  explore  ways  in  which  governments  and  public  health 
professionals could be more effective in encouraging smoking prevention and smoking 
cessation  initiatives.  There  was  consensus  amongst  ex-smokers  that  educating  the 
younger generations on the dangers of smoking and promoting healthy lifestyles were 
essential in the fight against tobacco. One ex-smoker suggested it would be important 
to link quitting smoking with sport, running and leading a healthy lifestyle (“If young 
people  see  healthy  as  a  trend,  they  will  follow  it”).  Participants  in  this  group  were 
against  increasing  the  price  of  cigarettes,  devising  taxes  or  tobacco,  or  developing 
measures banning smoking in public places.  

Smokers‘  views  were  more  heterogeneous  on  this  point.  Participants  in  this  group 
were  more  inclined  to  support  education  and  information  measures,  and  in  general 
considered  that  quitting  smoking  was  a  voluntary  act  and  that  smokers  were 
responsible for their decisions (“nobody threatened us with a gun to start smoking, it 
was our decision”). There were a few smokers who were open to further bans and to 
increasing prices. Suggestions put forward by participant smokers consisted of: 

  Including  more  information  (and  links  to  informative  websites  or  services)  on 

cigarette packs; 

  Information campaigns (ads on bus and metro stations and other public places); 

  Further banning smoking in public places, including in the street; 

  Increasing  prices  for  cigarettes  (though  this  suggestion  was  rejected  by  a  few 

participants); 

  Advancing on the generic packaging (no branding). 

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5.7. 

Focus Group Discussion Guide with Smokers (EN) 

Ex post outcome impact evaluation on Ex-smokers campaign 

Discussion guide for online focus groups with smokers  

IN BLACK: FORMAL QUESTIONS THAT WE SHOULD UPLOAD BEFORE THE DISCUSSION 

IN BLUE: GUIDANCE FOR MODERATORS  

Main objectives of the focus groups with current smokers: 

  Generate evidence for DG SANTE on factors that influence quitting smoking for future 

campaign targeting 

  Better  understand  how  smokers  views  and  feelings  are  evoked  by  information 

campaigns and messages on smoking prevention and smoking cessation 

  Analyse recall and explore  what the ‘Ex smokers’ are unstopabble’ campaign, slogan 
and  key  messages  make  this  group  of  smokers  feel  /  possible  impacts,  as  well  as 
experiences of the iCoach application 

Background 

Thank you all for taking part in the research. 

My  name  is  xxx,  I  represent  Coffey  International  Development  and  we  are  conducting  an 
evaluation of the 'Ex-smokers are Unstoppable' campaign, which ran for three years, from June 
2011 to the end of 2013 and targeted smokers aged 25 to 34.  

The main objective of the focus group is to investigate your views and feelings on information 
campaigns  and  messages,  and  to  show  you  some  campaign  materials.  We  would  also  like  to 
discuss with you about your views on smoking and quitting smoking.  

Organisational issues 

Just a few organisational issues at the start: 

As anticipated, our discussion should last about 1 hour. 

The software is very easy to use. You will see the different topics and questions posted above in 
your screens. 

You  will  be  able  to  write  up  your  answers  and  comments  in  your  text-chat  windows,  which 
should encourage an active discussion amongst us all. 

The  discussion  will  be  recorded  for  analytical  purposes,  but  all  the  findings  will  be  made 
anonymous.  This means that particular opinions cannot be traced back to any individuals. We 
will use the data only for the purpose of this evaluation. 

We  would  like  to  stress  that  there  are  no  right  or  wrong  answers  –  we  are  just  interested  in 
finding out your views, opinions and experiences. 

Do you have any questions so far? 

Introduction of participants 

To  start  with  the  discussion,  could  each  of  you  please  tell  us  your  name,  age,  where  do  you 
come from, and what you do for a living? 

Public Health Information Campaigns 

First, I’d like to discuss information campaigns which encourage people to quit smoking. 

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-  In  the  past  year,  have  you  seen,  read,  or  heard  any  information  campaigns  or  ads  about 

quitting smoking?  

-  Can you remember what was it about and where you saw, read or heard about it? 

-  Can  you  think  of  any  public  health  campaigns  that  might  be  particularly  effective  to  help 

people quit smoking? 

-  As a smoker, which of the following  types of messages are most persuasive for people who 

want to quit smoking: 

  Messages warning about the harmful consequences of smoking  

  Messages that provide facts and statistics on the harmful consequences of smoking 

  Messages that focus on the experiences of ex-smokers who managed to quit  

  Messages that focus on manipulation tactics of the tobacco industry 

-  Do you ever pay attention to the health warnings on tobacco/cigarette packs?  

-  Do these warnings have an impact on how you feel about smoking? 

Ex-smokers are Unstoppable campaign 

-  Have you ever seen this slogan before?  (NOTE: Campaign logo  with slogan will appear 

on the screen) 

-  Do you remember where?  

-  What do you think of this slogan? What does it convey to you? 

-  I am now going to show you some messages on the screen. Can you tell me, which if any of 

these messages are most persuasive and why: 

 

 

 

 

 

 

 

“There are many advantages when you stop smoking” 

“Smoking is dangerous for your health and for the health of your relatives” 

“One can also have financial benefits when one stops smoking” 

“Stopping smoking is a very big challenge” 

“Ex-smokers are in a better physical and mental condition” 

“Ex-smokers have a better life” 

“If you can stop smoking, you can deal with many things in life” 

Quit attempts 

-  I would now like to ask if you’ve ever tried to give up smoking? 

-  Which factors encouraged you to try to give up smoking? 

-  Were there any external factors that influenced you, such as banning smoking at work or in 

public places, price of cigarettes, taxes? 

-  What were the main benefits of quitting smoking? 

-  Which cigarette did you find the most difficult to give up? 

-  What made you start smoking again? 

-  For those of you who haven’t tried to quit, do you have plans to give up smoking in the 

future? Why and when? 

Quit sources 

I’d now like to hear your views on aids to help you to quit smoking. 

-  Have you ever used anything to help you to quit smoking? 

-  If yes, what did you use? 

-  Did you find it effective? 

-  What do you think the following services and products are to help people quit smoking? 

  Nicotine replacement products or other medication 

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 

 

 

Professional health services, e.g. advice from doctors, clinics, counselling sessions or 
groups 

Electronic cigarettes 

Telephone stop smoking quit-lines 

  Stop smoking  application available online 

  Stop smoking application available on mobile phones 

-  Which do you think are the most useful products / services? 

-  Would you be willing to try any of the above services or products? Why / why not? 

iCoach recall 

In  this  last  part  of  the  discussion  we  would  like  to  ask  you  a  few  questions  about  iCoach,  a 
digital health coach platform that helps smokers quit at their own pace. 

-  Had you heard of iCoach before taking part in this research?  

The iCoach is a free digital health coach platform, which supports users’ efforts to stop smoking. 
Users  complete  a  registration  questionnaire  and  then  receive  regular  tailored  advice,  for 
example to their mobile phone / email, based on their ‘smoking profile’. 

-  What do you think of this type of tool? 

-  Would you be open to the idea of signing up? Why? 

-  Do you think that this type of tool can help people to quit smoking? Why? 

-  Do you know any relatives, friends or colleagues who have signed up for this type of tool, and 

what was their experience? 

Rounding off 

We are reaching the end of this discussion.  

- 

Before we finish, imagine you are tasked with designing an information campaign to 
encourage people to quit smoking. What would be the key messages that you would like to 
communicate? 

-  How can governments and public health professionals be more effective in encouraging  

smoking prevention and smoking cessation initiatives? 

- 

Is there anything else we haven’t covered that you feel is important? 

Thank you all for your very useful input! 

We have enjoyed the discussion, and we hope you had a good time also. 

Have a nice day and thank you on behalf of the Commission again – your views will 
help them to further improve their communication activities on smoking cessation and 
smoking prevention. 

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5.8. 

Focus Group Discussion Guide with Ex-Smokers (EN) 

Ex post outcome impact evaluation on Ex-smokers campaign 

Discussion guide for online focus groups with ex-smokers  

IN BLACK: FORMAL QUESTIONS THAT WE SHOULD UPLOAD BEFORE THE DISCUSSION 

IN BLUE: GUIDANCE FOR MODERATORS  

Main objectives of the focus groups with current smokers: 

  Generate evidence for DG SANTE on factors that influence quitting smoking for future 

campaign targeting 

  Better  understand  how  ex-smokers  views  and  feelings  are  evoked  by  information 

campaigns and messages on smoking prevention and smoking cessation 

  Analyse recall and explore  what the ‘Ex smokers’ are unstoppable’ campaign, slogan 
and key messages make this group of ex-smokers feel / possible impacts, as well as 
experiences of the iCoach application 

Background 

Thank you all for taking part in the research. 

My  name  is  xxx,  I  represent  Coffey  International  Development  and  we  are  conducting  an 
evaluation of the 'Ex-smokers are Unstoppable' campaign, which ran for three years, from June 
2011 to the end of 2013 and targeted smokers aged 25 to 34.  

The main objective of the focus group is to investigate your views and feelings on information 
campaigns  and  messages,  and  to  show  you  some  campaign  materials.  We  would  also  like  to 
discuss with you about your views on smoking and quitting smoking.  

Organisational issues 

Just a few organisational issues at the start: 

As anticipated, our discussion should last about 1 hour. 

The software is very easy to use. You will see the different topics and questions posted above in 
your screens. 

You  will  be  able  to  write  up  your  answers  and  comments  in  your  text-chat  windows,  which 
should encourage an active discussion amongst us all. 

The  discussion  will  be  recorded  for  analytical  purposes,  but  all  the  findings  will  be  made 
anonymous.  This means that particular opinions cannot be traced back to any individuals. We 
will use the data only for the purpose of this evaluation. 

We  would  like  to  stress  that  there  are  no  right  or  wrong  answers  –  we  are  just  interested  in 
finding out your views, opinions and experiences. 

Do you have any questions so far? 

Introduction of participants 

To  start  with  the  discussion,  could  each  of  you  please  tell  us  your  name,  age,  where  do  you 
come from, and what you do for a living? 

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Public Health Information Campaigns 

First, I’d like to discuss information campaigns which encourage people to quit smoking. 

-  In  the  past  year,  have  you  seen,  read,  or  heard  any  information  campaigns  or  ads  about 

quitting smoking?  

-  Can you remember what was it about and where you saw, read or heard about it? 

-  Can  you  think  of  any  public  health  campaigns  that  might  be  particularly  effective  to  help 

people quit smoking? 

-  As an ex-smoker, which of the following  types of  messages are  most  persuasive for people 

who want to quit smoking: 

  Messages warning about the harmful consequences of smoking  

  Messages that provide facts and statistics on the harmful consequences of smoking 

  Messages that focus on the experiences of ex-smokers who managed to quit  

  Messages that focus on manipulation tactics of the tobacco industry 

-  When you smoked, did you ever pay attention to the health warnings on tobacco/cigarette 

packs?  

-  Did these warnings have an impact on how you felt about smoking? 

Ex-smokers are Unstoppable campaign 

-  Have you ever seen this slogan before?  (NOTE: Campaign logo  with slogan will appear 

on the screen) 

-  Do you remember where?  

-  What do you think of this slogan? What does it convey to you? 

-  I am now going to show you some messages on the screen. Can you tell me, which if any of 

these messages are most persuasive and why: 

 

 

 

 

 

 

 

“There are many advantages when you stop smoking” 

“Smoking is dangerous for your health and for the health of your relatives” 

“One can also have financial benefits when one stops smoking” 

“Stopping smoking is a very big challenge” 

“Ex-smokers are in a better physical and mental condition” 

“Ex-smokers have a better life” 

“If you can stop smoking, you can deal with many things in life” 

Quit attempts 

I would now like to discuss with you about your process to give up smoking. 

-  What was the ‘tipping point’ that made you decide to give up smoking for good? 

-  Had you tried giving up smoking before? 

-  Were there any external factors that influenced you, such as banning smoking at work or in 

public places, price of cigarettes, taxes? 

-  What were the main benefits of quitting smoking? 

-  Which cigarette did you find the most difficult to give up? 

Quit sources 

I’d now like to hear your views on aids to quit smoking. 

-  Have you ever used anything to help you to quit smoking? 

-  If yes, what did you use? 

-  Did you find it effective? 

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-  What do you think of the following services and products to help people quit smoking? 

  Nicotine replacement products or other medication 

  Professional  health  services,  e.g.  advice  from  doctors,  clinics,  counselling  sessions  or 

groups 

Electronic cigarettes 

Telephone stop smoking quit-lines 

 

 

  Stop smoking  application available online 

  Stop smoking application available on mobile phones 

-  Which do you think are the most useful products / services? 

iCoach recall 

In  this  last  part  of  the  discussion  we  would  like  to  ask  you  a  few  questions  about  iCoach,  a 
digital health coach platform that helps smokers quit at their own pace. 

-  Had you heard of iCoach before taking part in this research?  

The iCoach is a free digital health coach platform, which supports users’ efforts to stop smoking. 
Users  complete  a  registration  questionnaire  and  then  receive  regular  tailored  advice,  for 
example to their mobile phone / email, based on their ‘smoking profile’. 

-  What do you think of this type of tool? 

-  Do you think that this type of tool can help people to quit smoking? Why? 

-  Do you know any relatives, friends or colleagues who have signed up for this type of tool, and 

what was their experience? 

Rounding off 

We are reaching the end of this discussion.  

- 

Before we finish, imagine you are tasked with designing an information campaign to 
encourage people to quit smoking. What would be the key messages that you would like to 
communicate? 

-  How can governments and public health professionals be more effective in encouraging  

smoking prevention and smoking cessation initiatives? 

- 

Is there anything else we haven’t covered that you feel is important? 

Thank you all for your very useful input! 

We have enjoyed the discussion, and we hope you had a good time also. 

Have a nice day and thank you on behalf of the Commission again – your views will 
help them to further improve their communication activities on smoking cessation and 
smoking prevention. 

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6. 

PHONE INTERVIEWS WITH iCOACH USERS  

6.1. 

Introduction 

This section sets out findings in relation to the 24 in-depth interviews carried out with 
iCoach  users  (smokers  and  ex-smokers)  from  a  sample  from  Austria,  Bulgaria, 
Germany,  Greece,  Lithuania  and  Spain.  The  interviews  took  place  during  the  months 
of  March  and  April  and  were  conducted  by  phone,  with  an  average  duration  of  30 
minutes. Native-speaking interviewers were engaged by the evaluation to conduct the 
discussions with iCoach subscribers in the different countries.  

The  table  below  features  the  number  of  interviews  conducted  in  each  country. 
Interviewees were recruited through a screener questionnaire in the revamped iCoach 
website. We also collected contact details of iCoach users who took part in the on-line 
panel  surveys  and  who  agreed  to  participate  in  further  research.30  Due  to  lack  of 
availability  of  sufficient  contact  details  in  some  countries  (Austria,  Germany  and 
Lithuania),  the  majority  of  the  interviews  were  conducted  with  iCoach  users  in 
Bulgaria, Greece and Spain. 

Table 37: Overview of stakeholders interviewed (per country) 

Member States 

Number of interviews 

Austria 

Bulgaria 

Germany 

Greece 

Lithuania 

Spain 

TOTAL 

1 

5 

2 

6 

1 

9 

24 

The  following  text  presents  the  results  of  the  interviews,  comparing  and 
contrasting the views of the current smokers with those of the ex-smokers as well as 
any  differences  between  countries.  It  reflects  the  views  of  those  interviewed  rather 
than the evaluators. The main objectives of the interviews were to compare / contrast 
the  views  of  iCoach  subscribers  with  those  of  the  general  audiences  targeted  by  the 
campaign  (smokers  and  ex-smokers  aged  25  to  34  in  the  selected  countries).  The 
evaluation also aimed to explore the experiences of iCoach users in greater depth.  

6.2. 

 Public health information campaigns 

The  evaluation  team  began  each  interview  by  asking  participants  to  consider  any 
information  campaigns  that  encourage  people  to  quit  smoking.  A  majority  of 
interviewees  recalled  having  seen  a  campaign  or  advert,  however  when  probed,  few 
could recall what or where they had seen the information. Warning labels on cigarette 
lesser  extent 
packs  were 
advertisements for nicotine replacement products and general anti-smoking messages 
in  public  or  on  television.  When  asked  for  details  about  the  campaigns,  interviewees 
had  trouble  to  recall  what  the  messages  were  in  detail  more  than  general  ‘anti-
smoking’ inferences and that smoking causes harmful health effects.   

in  this  context,  and 

frequently  mentioned 

in  a 

When  asked  about  which  types  of  messages  are  most  persuasive  for  people  who 
want to quit smoking, the following points emerged: 

30  With  the  exception  of  on-line  panel  survey  respondents  in  Lithuania  and  Germany,  who  were  not 
requested their contact details due to privacy disclosure rules in these countries.  

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  A few interviewees recalled especially graphic and disturbing anti-smoking videos 
they had seen with explicit images and information of the impacts of  prolonged 
smoking on the lungs and body.  

  A  couple  of  the  current  smokers  thought  that  focusing  exclusively  on  the 
negative  aspects  of  smoking  would  only  deter  people  from  starting  and  that  a 
greater  focus  on  the  benefits  of  quitting  should  be  emphasised  to  encourage 
current smokers. 

  Several  of  the  smokers  interviewed  struggled  with  identifying  a  specific  theme 
that  they  would  be  especially  receptive  to,  one  interviewee  mentioning  how  it 
had ‘all been done before’.  

Both ex-smokers and smokers alike were well aware of the warning labels on cigarette 
packets, though few believed that the warnings were  enough to  cause people to quit 
smoking or that they had contributed to help them quit. One interviewee from Greece 
noted that the warnings also differed between countries, with some countries labelling 
going beyond that  of mere health warnings, and using ‘shock tactics’ (disturbing and 
graphic  images).  This  had  captured  the  attention  of  the  interviewee  and  made  her 
reflect on her habits. The interviewee believed that this might be an effective way of 
warning  people,  especially  since  Greece  did  not  use  these  types  of  warnings  in  their 
tobacco labelling.   

Most interviewees agreed that the warnings had a small influencing effect compared to 
other  factors.    A  couple  of  interviewees  also  went  on  to  describe  how  they  would 
notice  the  warning  when  opening  the  packet,  but  given  time  and  exposure  smokers 
would  become  ‘desensitised’  to  even  the  most  graphic  warning  messages  and  ignore 
them.  

6.3. 

 “Ex-smokers are Unstoppable” campaign 

Only a small minority of interviewees admitted to having noticed the campaign logo 
and  slogan  prior  to  participating  in  the  study.  In  a  few  cases,  interviewees  thought 
the  slogan  sounded  familiar  but  were  unsure  if  they  had  seen  the  campaign  in 
question.  

Asked what they thought about the slogan, participants had mixed reactions to the 
wording  and  message.  A  minority  did  not  perceive  it  as  inspiring;  one  interviewee 
stated that it would have had little impact when he was a smoker since the message 
targeted  ex-smokers.  Particularly  among  Bulgarian  and  Spanish  interviewees,  the 
slogan  also  appeared  to  have  resulted  in  some  ambiguity  and  confusion  with  two 
interviewees  acknowledging  they  had  difficulties  in  understanding  what  the  slogan 
meant. To this point, one interviewee also touched  on the fact that the slogan might 
read different depending on what language it is expressed in.    

The  majority  did  not  express  any  doubts  about  the  meaning  of  the  slogan  and  were 
broadly  positive  towards  the  content,  describing  it  in  terms  of  ‘encouraging’, 
‘motivating’  and  ‘stimulating’.  Several  interviewees  also  stated  that  the  slogan 
conveyed  direction  and  momentum  (‘energy’),  and  liked  how  it  emphasised  the 
agency and will power of the intended audience. As one interviewee put it, “if you stop 
smoking, nothing stops you. I think it is a quite nice slogan.” 

All participants were then shown seven short slogans / messages aimed at persuading 
smokers  to  quit  and  asked  which  they  considered  most  persuasive.  The  list  below 
summarises the results from the interviews. 

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“There are many advantages when you stop smoking” 

Almost  all  interviewees,  smokers  and  non-smokers,  agreed  that  this  message  was 
vague and uninspiring. Not communicating anything new, interviewees read it more as 
an obvious factual statement rather than an inspirational slogan.  

“Smoking is dangerous for your health and for the health of your relatives” 

This message was the most popular amongst ex-smokers. Interviewees perceived this 
message as a more effective rhetoric device than the previous, especially in terms of 
bringing  in  an  emotional  component  by  referring  to  family  and  relatives.  A  couple  of 
interviewees  also  described  how  the  message  brought  to  mind  the  possible  harmful 
consequences for their children or partners.  

Amongst  those  who  did  not  like  this  message,  one  current  smoker  suggested  that  it 
had  become  a  ‘cliché’  and  the  common  use  and  oversaturation  of  these  types  of 
negative messages had made them loose some of their ‘power’.  

“One can also have financial benefits when one stops smoking” 

This  message  resonated  especially  among  Greek  and  Spanish  participants,  several 
interviewees  stating  how  this  would  be  a  very  effective  argument  in  the  current 
economic  climate.  One  smoker  described  how  she  ‘hated’  thinking  about  the  money 
that she spent on cigarettes. Some participants also requested more specificity, giving 
concrete examples of the financial benefits and give a unit of comparison, such as “‘if 
you  quit  smoking  one  cigarette  pack  a  day,  in  three  months  you  could  save  enough 
money to buy a bicycle”.   

“Stopping smoking is a very big challenge” 

Most  participants  acknowledged  that  this  could  be  an  effective  message  but  that  it 
addressed  certain  people  who  are  competitive  or  enjoy  challenges.  As  such, 
interviewees  agreed  that  it  lacked  general  appeal  but  could  be  effective  towards 
people who were motivated by a challenge and ‘proving’ themselves. 

“Ex-smokers are in a better physical and mental condition” 

Participants were broadly in favour of this message, stating that it connoted a positive 
outcome  and  that  it  was  an  obvious  result.  A  couple  of  the  ex-smokers  agreed  that 
this fit with their actual experience of quitting smoking. A few participants, mainly ex-
smokers, questioned if  it would work effectively as a slogan, stating that people who 
smoke  are  not  necessarily  concerned  with  the  issue  of  health  and  that  other  factors 
might be more motivating.  

“Ex-smokers have a better life”  

A majority of participants considered the concept too generic, hypothetical and lacking 
in substance. As one participant put it “when you smoke you don’t know what it’s like 
if you didn’t smoke, until you quit”.  

“If you can stop smoking, you can deal with many things in life”  

This  message  was  most  popular  amongst  smokers.  A  majority  of  participants 
positively  perceived  the  message  as  reinforcement  in  the  transition  to  stopping 
smoking.  As  one  ex-smoker  explained  “it  made  me  feel  successful”.  Several 

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participants  also  appreciated  the  motivational  content,  the  emphasis  on  quitting  as  a 
challenge  to  overcome.  As  one  smoker  stated,  “if  you  accomplish  that  [quitting 
smoking] you can accomplish many other things”.   

6.4. 

 Quit attempts 

Ex-smokers 

The  ex-smokers  discussed  the  process  they  had  gone  through  when  giving  up 
smoking. Asked what the ‘tipping point’ was that had led to their decision to give up 
smoking for good, the answers consisted of: 

  Health impact and life expectancy 

  Potential consequences on family and loved ones 

  Doctor’s advice, and 

  Removal of stressful ‘trigger’ situations from daily life 

A  few  of  the  ex-smokers  credited  external  factors  as  a  reason  for  quitting. 
Interviewees mentioned how the increased ‘stigmatisation’ of smokers had contributed 
to  their  decision,  such  as  the  banning  of  smoking  in  public  places  and  the  social 
pressure from friends and colleagues. As one German interviewee described it  “in my 
circle of friends only few smoke. At the office, not many smoke either and you have to 
go to a special room, which is unpleasant. It’s ugly [stigmatised].”  

According to the ex-smokers, the main benefits of quitting smoking centred on: 

  Improvement of health and physical fitness 

  Self-confidence and self-determination 

  Appreciation from family 

  Better smell 

  Less prone to sickness; and 

  Less stress in feeding the nicotine habit (e.g. not needing to smoke at work) 

Almost  all  of  the  ex-smokers  had  made  several  unsuccessful  attempts  to  quit 
previously  before  succeeding.  A  common  reason  expressed  for  relapse  among  ex-
smokers  was  that  of  stress,  participants  describing  how  they  used  cigarettes  to  cope 
with  emotionally  difficult  situations.  On  the  positive  side,  one  ex-smoker  described 
how having conquered the addiction had made her more confident in her abilities and 
that she felt more decisive and determined in her daily life as a result.  

Smokers 

Almost all smokers had made one or several serious tries to quit. The duration 
of  abstinence  from  smoking  varied  but  usually  limited  to  under  six  months  with  a 
majority of interviewees reported quitting for around one to three months.  

Among  the  factors  listed  that  had  contributed  to  their  attempts  to  stop  smoking, 
interviewees cited health as the main reason. Participants described health benefits in 
terms  of  improved  immune  systems,  respiratory  (breathing)  improvements,  general 
quality of life and wellbeing. Better health was also seen to impact positively on other 
associated benefits such as richer social and work life and better physical performance 
when doing sports.   

In  terms  of  external  factors,  several  participants,  in  particular  in  Greece  and  Spain, 
indicated the cost of cigarettes as an issue of weight. However, few believed that the 
prices  were  high  enough  to  cause  people  to  quit.  One  Greek  interviewee  noted  how 

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cigarette  prices  had  not  changed  substantially  with  only  marginal  cost  increases 
compared  to  other  countries.  If  there  were  not  an  economic  crisis  in  Greece,  the 
interviewee  argued,  few  people  would  have  taken  notice  of  the  increase  in  price. 
Several Greek interviewees also noted that the smoking ban in public places had not 
been  enforced  everywhere.  For  one  of  the  interviewees  this  had  only  resulted  in  a 
change  of  location  to  cafes  and  bars  that  did  not  enforce  the  smoking  ban.  Smokers 
from other countries were more aware of the banning of smoking in public. However, 
most  believed  it  did  not  result  in  people  quitting,  rather  than  in  a  reduction  of  use 
(especially in the workplace).  

According to the smokers interviewed, the main advantages of not smoking included: 

  Improved health 

  Improved sense of smell and taste 

  Increased energy levels (mood, appetite) 

  Better quality sleep 

  ‘Taste in the mouth when waking up in the morning’ 

  Increased disposable income; and 

  Sense of accomplishment of being free from the addiction 

Participants  described  broadly  two  different  social  contexts  that  acted  as  triggers  for 
relapse.  Firstly,  positive  social  contexts  such  as  parties  or  a  night  out,  often 
involving  the  consumption  of  alcohol  were  described  as  triggers  for  starting  smoking 
again.  Interviewees  strongly  associated  these  situations  with  ‘social’  smoking  and 
described  how  it  was  difficult  to  resist  the  temptation  of  smoking  in  these  types  of 
environments.  Secondly,  participants  noted  how  negative  social  contexts  such  as 
stressful events linked to work or personal relationships acted as ‘emotional’ triggers. 

A few interviewees referred to cigarettes as a form of stress management that helped 
to ‘even out’ or modulate stressful events. Additionally, one participant admitted that 
the reason for relapse was to control unwanted weight gain. There were no discernible 
patterns between countries in terms of main reasons for relapsing. 

In terms of plans of quitting in the future, all current smokers expressed plans to so. 
When  asked  why  they  did  not  do  so  today,  several  participants  reported  having 
adverse factors in their life that made quitting difficult, such as being under pressure 
at work.  

6.5. 

 Quit aids 

Next  the  discussion  turned  to  aids  intended  to  help  smokers  quit.  A  number  of  both 
ex-smokers and smokers alike had used a variety of quitting aids. Nicotine gums were 
the  most  commonly  cited  aid  with  e-cigarettes  coming  in  a  close  second.  Other 
methods  mentioned  included  self-help  books,  alternative  medicine  and  smoking 
cessation medication. In their own experience most interviewees did not find the aids 
they had tried to be very effective. 

A  couple  of  interviewees  believed  that  nicotine  gums  and  e-cigarettes  might  act  as  a 
temporary relief for the early physical withdrawal symptoms. However, several current 
smokers  were  wary  of  e-cigarettes  since  they  saw  it  as  sustaining  the  nicotine 
dependency  (though  less  harmful).  To  this  point,  most  interviewees  believed  the 
psychological  addiction  was  the  most  difficult  to  overcome  and  that  it  was  largely  a 
struggle of will power. As one interviewee described “I just feel that the nicotine is not 
the problem, it is more about the habit. […] I’m addicted to the habit”.  

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In terms of smoking aids that addressed the addiction on a more psychological level, 
several  participants  favoured  counselling  by  medical  professionals,  self-help  groups 
and online consultation including smartphone apps. 

6.6. 

 Experiences using iCoach 

A  vast  majority  of  the  participants  had  come  across  iCoach  through  browsing  the 
internet.  Participants  perceived  the  iCoach  as  a  largely  positive  experience,  most 
having signed up out of curiosity or in an attempt to quit. Several of the interviewees 
had difficulties in recalling details about the platform since considerable time (over two 
years  in  some  cases)  had  passed  since  they  last  used  it.  For  those  participants  who 
recalled specifics about iCoach, the positives included: 

  Reinforcing  and  motivating  daily  reminders  (such  as  your  life  expectancy  has 

increased) 

  The informational and explanatory articles about smoking 

  Being  able  to  customise  the  experience  (the  different  phases  in  the  quitting  

process and the possibility of changing status) 

In  terms  of  areas  of  improvement,  participants  struggled  to  suggest  specifics.  A 
majority had not used iCoach for some time, which made it difficult to provide useful 
feedback. Of those participants who suggested improvements, they included:  

  Tailored support towards specialised needs such as emotional and psychological 

support or referrals to these types of services 

  Increased content – a couple of users experienced the advice and tips as limited  

  Improved visual appeal – one user suggested using more colours 

  Avoiding the need for registration, which was considered demanding 

Almost all participants were happy to recommend iCoach with two participants stating 
that  they  had  done  so.  Several  current  smokers  expressed  how  recommending  it 
‘could not hurt’ and that it might be more useful for others than it had for them.  

Few  of  the  ex-smokers  saw  the  iCoach  as  a  key  driver  for  quitting,  with  a  majority 
seeing  it  as  more  of  a  complementary  aid.  Many  of  those  interviewed  confirmed 
having engaged with iCoach in the first weeks  after  registration, and gradually losing 
the  initial  attention  and  interest  on  the  application,  either  because  it  was  not 
personalised  enough,  because  people  were  just  not  used  to  follow-up  on  their 
applications,  or  because  it  ceased  to  be  a  novelty.  Only  one  ex-smoker  knew  any 
friends, colleagues or relatives who had previously used the iCoach platform. 
The  ex-smoker  had  successfully  used  iCoach  to  quit  smoking  and  had  become  an 
advocate, reporting how friends who used it had managed to quit as well.    

6.7. 

 Ideas for future messages  and actions against smoking 

In the final part of the session, we asked participants to describe the messages that 
they would like to communicate if they were designing an anti-smoking campaign. 
Among  ex-smokers  most  focused  on  messages  about  health,  well-being  and  how 
smoking can have harmful consequences on other people. Smokers suggested similar 
messages but also emphasised the financial factors, since “you shouldn’t waste money 
essentially  sponsoring  your  own  death“.  This  was  especially  underlined  by  Greek 
participants  who  argued  that  financial  arguments  would  be  especially  effective 
because of the economic crisis. Several ex-smokers also touched on the need to give 

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tangible  evidence  and  not  only  emphasise  the  negative  aspects  of  smoking  but  also 
the positive sides of quitting.  

One  smoker  described  how  the  issue  of  smoking  and  its  consequences  had  been 
discussed  at  length  before.  That  ‘we  have  heard  it  all  before’  and  that  to  reach 
smokers  there  was  a  need  to  use  unconventional  and  innovative  messages  that 
‘shakes  people  up’.  To  motivate  smokers  the  interviewee  also  argued  that  the 
messages needed to be simple and grounded in tangible situations that were easy to 
undestand. The effect of smoking on children was also raised as a powerful argument. 
Examples of suggestions and messages included:  

  “Do something good for yourself, stop smoking” 

  “Indicating that smoking limits one’s life” 

  “[t]hat  they  should  respect  their  life,  and  the  life  of  others,  and  that  smoking 

does not offer anything” 

  “[..] cigarettes cuts your life shorter, don’t waste this time on cigarettes” 

Finally,  interviewees  were  asked  to  consider  how  governments  and  public  health 
professionals  can  be  more  effective  in  encouraging  smoking  prevention  and  smoking 
cessation initiatives. Interviewees views were more heterogeneous on this point, with 
a number of different suggestions to how government and public health officials could 
become  more  effective  in  communicating  and  campaigning  against  smoking.  Most 
agreed  that  there  was  a  need  for  more  public  campaigning  and  education  on  the 
subject.  Several  German  and  Greek  interviewees  were  critical  to  governmental 
information campaigns, since ‘[…] I haven’t seen anything [campaigns], and if I have, 
it  hasn’t  stuck.”  To  this  point,  In  one  case,  a  Greek  ex-smoker  argued  that  the  anti-
smoking  outreach  activities  in  Greece  were  ten  to  twenty  years  behind  industry 
practices  (the  participant  worked  in  the  advertising  industry)  and  that  tobacco 
companies  were  influencing  the  government’s  anti-smoking  response.    Furthermore, 
he  stated  how  there  is  a  need  for  a  more  multi-level  holistic  approach  targeting 
families  making  use  of  a  combination  of  experts,  psychologists,  social  workers  and 
schools.  Suggestions put forward by the interviewees included: 

  Visually show the effects of smoking more prominently (‘shock tactics’) and give 

real-life examples of the results of smoking  

  Situated  communication,  using  everyday  examples  and  not  being  too  general 

when trying to convey the message 

  Increasing the resources and the visibility of anti-smoking campaigns  

  Focusing on the younger generation but also targeting smoking parents 

  Banning and enforcement of smoking in public places  

A  couple  of  the  Greek  participants  emphasised  the  point  of  focusing  campaigning 
efforts to the school context to counteract the image of smoking as something cool or 
‘magkia’31.  By  this  approach,  the  reasoning  went,  campaigns  could  reinforce  positive 
habits and attitudes around smoking at a point when children are extra vulnerable. 

31 Greek slang word, generally meaning ‘to be cool and tough’  

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6.8. 

Interview Guide for iCoach Users (Smokers) (EN) 

Ex post outcome impact evaluation on Ex-smokers campaign 

Interview guide for iCoach users (current smokers) 

Interviewee/s name/s 

Interviewer name 

Date 

Public health information campaigns 

-  In  the  past  year,  have  you  seen,  read,  or  heard  any  information  campaigns  or  ads  about 

quitting smoking?  

-  Can you remember what was it about and where you saw, read or heard about it? 

-  Can  you  think  of  any  public  health  campaigns  that  might  be  particularly  effective  to  help 

people quit smoking? 

-  Do you ever pay attention to the health warnings on tobacco/cigarette packs?  

-  Do these warnings have an impact on how you feel about smoking? 

Ex-smokers are Unstoppable campaign 

-  Have you ever heard of the campaign “Ex-smokers are Unstoppable” before participating in 

this research? 

-  Do you remember where?  

-  What do you think of this slogan? What does it convey to you? 

-  I am now going to read you some messages. Can you tell me what do you think of each:  

 

 

 

 

 

 

 

“There are many advantages when you stop smoking” 

“Smoking is dangerous for your health and for the health of your relatives” 

“One can also have financial benefits when one stops smoking” 

“Stopping smoking is a very big challenge” 

“Ex-smokers are in a better physical and mental condition” 

“Ex-smokers have a better life” 

“If you can stop smoking, you can deal with many things in life” 

-  Which if any of the above messages are most persuasive and why? 

Quit attempts 

-  Have you ever tried to give up smoking? 

(If yes) 

-  Which factors encouraged you to try to give up smoking? 

-  Were there any external factors that influenced you, such as banning smoking at work or in 

public places, price of cigarettes, taxes? 

-  What were the main benefits of quitting smoking? 

-  What made you start smoking again? 

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(If no) 

-  Do you have plans to give up smoking in the future? Why and when? 

Quit sources 

-  Have you ever used anything to help you to quit smoking? 

-  If yes, what did you use? 

-  Did you find it effective? 

-  What do you think of the following services and products to help people quit smoking? 

  Nicotine replacement products or other medication 

 

 

 

Professional  health  services,  e.g.  advice  from  doctors,  clinics,  counselling  sessions  or 
groups 

Electronic cigarettes 

Telephone stop smoking quit-lines 

  Stop smoking  application available online 

  Stop smoking application available on mobile phones 

-  Which do you think are the most useful products / services? 

Your personal experience with iCoach 

-  How did you first become aware of the iCoach application? 
-  How did you take the decision to sign up for iCoach and what was your personal experience 

throughout the process?  

-  Were there any aspects of iCoach that worked particularly well / were particularly effective? 
- 
-  Have you recommended or would you consider recommending iCoach? Why / why not? 

And are there any aspects that could be improved? 

Rounding up 

- 

Before we finish, imagine you are tasked with designing an information campaign to 
encourage people to quit smoking. What would be the key messages that you would like to 
communicate? 

-  Do  you  have  any  suggestions  on  how  communication  and  campaigns  targeted  at  smokers 

and ex-smokers could be further improved and if so, how and why? 

- 

Is there anything else we haven’t covered that you feel is important? 

Many thanks for your responses! 

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Annex B: Evaluation evidence 

6.9. 

Interview Guide for iCoach Users (Ex-Smokers) (EN) 

Ex post outcome impact evaluation on Ex-smokers campaign 

Interview guide for iCoach users (ex-smokers) 

Interviewee/s name/s 

Interviewer name 

Date 

Public health information campaigns 

-  In  the  past  year,  have  you  seen,  read,  or  heard  any  information  campaigns  or  ads  about 

quitting smoking?  

-  Can you remember what was it about and where you saw, read or heard about it? 

-  Can  you  think  of  any  public  health  campaigns  that  might  be  particularly  effective  to  help 

people quit smoking? 

-  When you smoked, did you ever pay attention to the health warnings on tobacco/cigarette 

packs?  

-  Did these warnings have an impact on how you felt about smoking? 

Ex-smokers are Unstoppable campaign 

-  Have you ever heard of the campaign “Ex-smokers are Unstoppable” before participating in 

this research? 

-  Do you remember where?  

-  What do you think of this slogan? What does it convey to you? 

-  I am now going to read you some messages. Can you tell me what do you think of each:  

 

 

 

 

 

 

 

“There are many advantages when you stop smoking” 

“Smoking is dangerous for your health and for the health of your relatives” 

“One can also have financial benefits when one stops smoking” 

“Stopping smoking is a very big challenge” 

“Ex-smokers are in a better physical and mental condition” 

“Ex-smokers have a better life” 

“If you can stop smoking, you can deal with many things in life” 

-  Which if any of the above messages are most persuasive and why? 

Quit attempts 

-  What was the ‘tipping point’ that made you decide to give up smoking for good? 

-  Had you tried giving up smoking before? 

-  Were there any external factors that influenced you, such as banning smoking at work or in 

public places, price of cigarettes, taxes? 

-  What changed in your life since you became an ex-smoker? 

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Annex B: Evaluation evidence 

Quit sources 

-  Have you ever used anything to help you to quit smoking? 

-  If yes, what did you use? 

-  Did you find it effective? 

-  What do you think of the following services and products to help people quit smoking? 

  Nicotine replacement products or other medication 

 

 

 

Professional  health  services,  e.g.  advice  from  doctors,  clinics,  counselling  sessions  or 
groups 

Electronic cigarettes 

Telephone stop smoking quit-lines 

  Stop smoking  application available online 

  Stop smoking application available on mobile phones 

-  Which do you think are the most useful products / services? 

Your personal experience with iCoach 

-  How did you first become aware of the iCoach application? 
-  How did you take the decision to sign up for iCoach and what was your personal experience 

throughout the process?  

-  How long did it take you to quit smoking? Do you remain abstinent since then? 
-  Was  iCoach  the  key  driver  /  factor  that  helped  you  to  quit  smoking,  or  did  you  have  any 

additional support? (In which case) What type of additional support did you receive? 

-  Were there any aspects of iCoach that worked particularly well / were particularly effective? 
- 
-  Have you recommended or would you consider recommending iCoach? Why / why not? 

And are there any aspects that could be improved? 

Rounding up 

- 

Before we finish, imagine you are tasked with designing an information campaign to 
encourage people to quit smoking. What would be the key messages that you would like to 
communicate? 

-  Do you have any suggestions on how communication and campaigns targeted at smokers 

and ex-smokers could be further improved and if so, how and why? 

- 

Is there anything else we haven’t covered that you feel is important? 

Many thanks for your responses! 

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