Is it effective to improve advertisement literacy in teenagers?
Eldesta Nisa Nabila, Hamzah Pratama Megantara, Anshorulloh Abd Fath, Rabid Yahya Putradasa, Bernie Endyarni Medise, Devi Nurhaliza Atjo, Diandra Amandita D, Dina Clarissa
Fakultas Kedokteran Universitas Indonesia
Adolescents are a vital component in tobacco company’s market renewal. The truth is, teenagers are their major source of “replacement smokers”. Therefore, despite knowing that youths are susceptible to commercial messages due to their developmental vulnerability, tobacco companies keep targeting minors to secure their cash flow. Tobacco Industry uses diabolical marketing tactics to portray itself as a youth-friendly industry while glossing over the grotesque truths behind cigarette smoking. Their tactics to lure in young audiences range from selling stick cigarettes at pocket money prices and displaying in stores tobacco products at children’s eye level, to creating commercials that disseminate deceiving ideas of freedom, solidarity, and desired self-image. Another huge marketing ploy created by the tobacco industry is e-cigarette. Due to its attractive designs and wide range of flavours, many believe that e-cigarette is a harmless alternative to traditional smoking. Previous study showed that tobacco advertisement is not only a risk factor but rather one of the etiologies of smoking. Therefore, actions must be taken to reduce exposure of cigarette and e-cigarette advertisements on children and adolescents. However, recently, cigarette and e-cigarette advertisements have become more rampant in social media as a comprehensive law on online tobacco advertising and promotional activities has yet to be fully established. This loophole allows e-cigarette promotion to flourish in social media especially through subtle promotional approaches like influencer endorsement. Accordingly, integrating advertisement literacy in a smoking prevention program is crucial. However, studies showed that creating an impactful program for adolescents is quite challenging as this population is sensitive to social status and respect. Hence, to maximise the outcome of the intervention, we designed a smoking prevention program that harnesses youth’s desire for respect and social status. Besides, our program attempted to employ a strategy where teenagers were told that some adults , i.e. those from cigarette companies, were disrespecting them, with the hope that the students could channel the resulting emotions into desirable behavioural change. To our knowledge, this is the first anti-smoking advertisement literacy program for teenagers published in Indonesia.
The Smart Teens Project (TSTP) is a 4 week online anti-smoking program for teenagers. In the present study, 270 Indonesian high school students were recruited as control and 262 students were included in the intervention group. Assessment of student’s advertisement literacy was held during the third week of the program. Students in the control and in the intervention groups were asked to watch two kinds of advertisement videos: e-cigarette advertisement video and cigarette commercial video. The e-cigarette video displayed some guys and a girl wearing hijab doing some “cool” tricks with their vape while implying that vaping is a symbol of independence, creativity, and attractiveness. Meanwhile, the cigarette commercial showed a bunch of youths doing some adventurous acts. Another video of cigarette advertisement showed some activities that implied nationalism and patriotism. Students in the control group were asked to fill a questionnaire right after watching the e-cigarette and cigarette advertisement videos. Meanwhile, the intervention group was given a 90 minutes anti-smoking zoom interactive discussion and daily WhatsApp group discussion following a short video about cigarette advertisement for a week before completing the questionnaire. During the zoom interactive session, students in the treatment group were exposed to the unethical practices and the marketing strategies of tobacco industries. In essence, we revealed how tobacco companies exploit tobacco farmers in their business practice. We told them while there is a widespread notion that tobacco companies have helped tobacco farmer to thrive, the truth said otherwise. For example, although tobacco farming is considered one of the most labour-intensive crops and clearly not a profitable enterprise, tobacco companies keep pushing tobacco farmers to cultivate tobacco. Ironically, while it is the tobacco farmers who struggle the most, it is the owners of tobacco companies who reap most of the profit, thus making themselves even richer. We also showed how tobacco industry debilitated the economic growth in Indonesia by causing numerous preventable diseases which cost our country a huge amount of money. To harness the teenagers’ desire for status and respect, we showed the students how tobacco companies took advantage of children and adolescents. We told the students that tobacco companies see teenagers as a vulnerable group of consumers who has no capacity to differentiate facts from commercial messages. By making advertisements that captivate young audience’s attention, tobacco companies wished to get more teenagers to fall into their traps, thus ripping their money off of them and use it for the company’s benefit. In addition, the students in the treatment group were also told that the owners and the children of the tobacco companies themselves chose not to smoke cigarette as they are aware that cigarette and e-cigarette are harmful for their health.
After receiving zoom lecture and completing a week of WhatsApp group discussion regarding cigarette and e-cigarette advertisements, students in the intervention group were asked to complete a questionnaire. Cronbach alpha test has been used to validate the questionnaire in the present study. Our questionnaire explored students’ response and attitude towards cigarette advertisement which comprised 5 questions as follows: 1. Did you find cigarette/e-cigarette advertisements videos to be enticing? 2. Did the commercial videos raise your curiosity about smoking/vaping and did it tempt you to buy these products? 3. Did the cigarette/e-cigarette advert trigger you? 4. Do you think social media influencers are allowed to promote cigarettes/e-cigarette on their online platform? 5. Do you think cigarette/e-cigarette companies have the right to get permission to promote their products to children and teenagers?
Finally, we summed the scores of all the questions. To evaluate the efficacy of TSTP in improving students’ advertisement literacy, we compared the total score of the treatment group to that of the control group. Data were analyzed by using Mann-Whitney statistical test.
Cumulatively, compared to the control group, advertisement literacy scores of the treatment group were significantly higher in both smoking ( p = 0.000) and vaping ( p = 0.000). Significant differences were also seen in all components of the questionnaire. Students in the treatment group were less likely to say that cigarette and vape advertisements are interesting compared to students in the control group (p=0.016 for smoking, p=0.013 for vaping). The tendency to be tempted into buying cigarettes and vape were also lower in the intervention group than in the control group ( p= 0.000 for smoking, p= 0.000 for vaping). Subsequently, the amount of individuals who are enraged by cigarette/vape advertisements were considerably higher in the intervention group ( p=0.036 for smoking, p= 0.002 for vaping). In the treatment group, almost everyone disagreed with smoking and vaping portrayal by influencers on social media (p=0.000 for both smoking and vaping). Lastly, teenagers who received the advertisement literacy program were less likely to allow online promotion of underage smoking and vaping (p=0.000 for both )
Based on the above findings, TSTP proved to be effective in improving students’ literacy towards cigarette and e-cigarette advertisements. However, long term efficacy has yet to be examined. Future studies need to evaluate further implication of such a program on students’ advertisement literacy and the use of a more standardized questionnaire to assess advertisement literacy is needed. Besides, relationship between the scores of advertisement literacy and positive behavioural changes must as well be further examined.
Cigarette, e-cigarette, advertisement, commercials, advertisement literacy