The Drug Education Forum have made the following comments on the draft guidance from NICE on preventing the uptake of smoking by children.

Recommendation 1:

“be informed by research that identifies and understands the target audiences”

“include advertisements that elicit an emotional reaction (for example, fear)”

The Drug Education Forum is well aware of young people’s often stated claim that they would find harder messages around drugs (including tobacco) would have a deterrent effect on their use. However, there is no evidence, we are aware of, for campaigns carried out in this way leading to changes in children’s behaviour.

There does seem to be some evidence (see Boomerang Ads from Drug and Alcohol Findings 2005) that harder messages can have the unintended consequence of making drugs more attractive to some young people.

The Drug Education Forum does not believe that fear is the most effective reaction to be trying to achieve with public health campaigns aimed at children. To support this view we would cite the findings in the review of effectiveness carried out to inform this guidance, which says:

“A UK-based (++)6 qualitative study found that social norms messages were more effective than fear messages at encouraging more committed smokers to consider their smoking behaviours and reinforcing awareness of the dangers of smoking in less committed smokers.” [page 6]

NICE will also want to make it clear that where campaigns are targeted at children and young people they need to be in line with the Advertising Standards Authority guidance. We would particularly point to CAP Code clauses 9.1 and 9.2 (Fear and distress) and 47.2 (Children), and CAP (Broadcast) TV Advertising Standards Code rules 7.3.6 (Children – Distress).

contribute to changing society’s attitude towards tobacco use so that smoking is not considered the norm by any group’

We endorse this as a critical challenge for the outcome of the guidance; as peer and family norms are powerful influences on children and young people.