Technical Paper 2:
Tobacco Control in Australia: making smoking history
3.5.7 Highly disadvantaged neighbourhoods
- Overview and summary of action proposed
- Summary of proposed measures
- 1 - Introduction: the big picture
2 - Progress in meeting National Tobacco Strategy objectives: trends and concerns
3 - Progress in Australia on recommended policies and programs- 3.1 - Regulate
- 3.2 - Public education: Increase promotion of Quit and smoke-free messages
- 3.3 - Improve services and treatment for smokers
- 3.4 - Better support families and educators
- 3.5 - Tailor messages and services for highly disadvantaged groups
- 3.6 - Address causes of disadvantage
- 3.7 - Improve focus in research, monitoring and evaluation
- 4 - What next, what first and for what cost?
- Major sources used in this document
- References
- Addendum for October 2008 to June 2009
A major study recently published highlights the social diffusion process that has been at work in the wholesale rejection of smoking among the best educated sections of the population in the US.[435] Sophisticated network analysis of data from the 12,000 people taking part over a 32-year period in the Framingham study reveals both the shifting position of smokers in society over that period and the dynamics of quitting. In 1971 smokers were indistinguishable from non-smokers in terms of integration in their social networks. Three decades later, smokers were at the periphery of these networks, mainly aligned only with other smokers.[436] Also interesting is the observation that smokers tended to quit in clusters rather than by gradual attrition.[27]
While television advertising remains the most cost-effective way of promoting interest among disadvantaged as well as more affluent smokers, the very high concentration of smokers within particularly disadvantaged neighbourhoods provides the opportunity for the highly localised advertising of services and treatments. This could be done for public housing estates and areas serviced by particular shopping centres, rather than merely to postcode or local government areas.
Figure 23: Proportion of persons aged 18+ who smoke regularly, Australia, 2004–2005, by Social and Economic Index of Disadvantage – aggregated to the level of census district rather than merely SLA or local government areas
Source: ABS National Health Survey 2004–2005[437]
Quit Victoria is currently exploring billboard, transit, mobile and other outdoor advertising of the Quitline within highly disadvantaged suburbs. This might help to increase usage of the Quitline by people in those areas. It could also be used to promote local courses and other projects that could be established at a local level. Given the lower awareness of stop-smoking treatments among low-income smokers, pharmaceutical companies could also be encouraged to invest in this sort of targeted promotion.
Quit and Win competitions have not been very successful in the past in encouraging long-term changes in smoking behaviour;[438] however, these competitions have involved relatively small payments, many of which were available only for a ‘winner’ rather than for all participants. Incentive payments in development projects overseas and in other areas of public administration in Australia (for example, the maternity payments ‘baby bonus’, favourable tax treatment for certain forms of investment, welfare payments contingent on school attendance, purchase of water tanks) suggest that substantial cash payments might help highly disadvantaged smokers to maintain the necessary resolve to get through the difficulties and discomfort of quitting.
Idea for consideration
Fund a pilot campaign including outdoor advertising and other initiatives to boost the use of cessation products and services in disadvantaged areas.
Trial payment for performance for patients (P4P4P) schemes in highly disadvantaged communities