Behaviour Change

PROPAGANDA FOR CHANGE is a project created by the students of Behaviour Change (ps359) and Professor Thomas Hills @thomhills at the Psychology Department of the University of Warwick. This work was supported by funding from Warwick's Institute for Advanced Teaching and Learning.

Monday, December 5, 2016

The Act of Smoking

Above is an example of a persuasive advertisement on smoking. What I understand from the ad is that the cigarette is a metaphor for a family member’s life, and by continuing to smoke, the smoker is slowly damaging his/her family’s life. I personally feel that this ad is quite powerful as it clearly takes the pleasure out of smoking and it also shows the damaging effects. This ad is just one out of many more persuasive advertisements out there, calling out on the dangers of smoking. The question is, do these ads really work? Have they helped in combating the act of smoking within the population?

Recent news has shown that in England, the number of smokers have declined to its lowest level, with only one out of six adults smoking (Campbell, 2016). This was also followed with a decline in the sales of cigarettes. However, there is still an astounding amount of 7.2 million adults in England who still smoke, where around 200 people die prematurely every day as a result of breathing problems, heart attacks, and strokes, all caused by smoking. So, although smoking prevalence has dropped two-thirds in 50 years, there are still 7.2 million smokers out there to worry about. Apart from unhealthy diet, it was found that smoking is still the biggest cause of over 78,000 deaths per year in England. While in the US, cigarette smoking accounts for more than 480,000 deaths every year (Centers for Disease Control and Prevention, 2016). This is worrying as this is something that can easily be prevented. So, before we can further decrease the prevalence of smoking, we need to fully understand why there are still so many people out there smoking their life away.

Of course, there are many reasons as to why one smokes. This post describes one of them and Gladwell (2002) explains it well in his debut book, called The Tipping Point: How Little Things Can Make a Big Difference. He conducted a study by giving several hundred people in their late twenties and early thirties a questionnaire, asking them to describe their earliest experiences with cigarettes. Here is an example of an answer that was given in the book:

“The first person who I remember smoking was a girl named Pam P. I met her when we were both in the 10th grade. We rode the school bus together in Great Neck, L.I., and I remember thinking she was the coolest because she lived in an apartment. (Great Neck didn't have many apartments.) Pam seemed so much older than her 15 years. We used to sit in the back of the bus and blow smoke out the window. She taught me how to inhale, how to tie a man-tailored shirt at the waist to look cool, and how to wear lipstick. She had a leather jacket. Her father was rarely home.”

Other examples given were very much similar to the one stated above. As Gladwell (2002) stated, most of the experiences described had one thing in common: sophistication. There was always one person described in the experiences that was impulsive, indifference to the opinion of others, always taking chances, sensation seeking – essentially an extrovert, someone considered cool. And these extroverts are drawn to expressing their rebellion through a cigarette. A quote from the book explained this quite nicely, “They weren’t cool because they smoked, they smoked because they were cool.” This is important to understand as all this while, smoking was never the problem, it was never cool. Smokers themselves, are cool. Then from here, can we only tackle the problem of smoking. Instead of focusing on the dangers of smoking, diverge the attention on the smokers instead.

In the book, a research was done where smokers were asked to guess how many years of life smoking from the age of twenty-one onwards, would be taken away from them. Most of them guessed nine years, when the real answer is around six years. This points to how most smokers overestimate the risks of smoking, showing that they do know and understand that smoking causes more harm than good. Having parents warn their children against the dangers of smoking does not seem to work as well. In fact, this has been found to make them want to try out smoking even more. From 1993 to 1997, the number of college students who smoke increased from 22.3% to 28.5%, while from 1991 to 1997, the number of high school students who smoke rose to 32%. Teen smoking in the United States have also increased to 73% since 1988. No public health programmes or any persuasive advertisements have been found to be effective in combating smoking (Gladwell, 2002). So, if educating on the dangers of smoking does not seem to work, and even the smokers themselves are aware of the effects of smoking, what then should be done?

This is where it gets interesting, as research has found an association between depression and smoking. Steuber and Danner (2006) found that adolescents who used to smoke or are currently smoking were more likely to experience depression, with regular smokers showing the highest level of depression. A longitudinal study conducted by Fergusson, Goodwin, & Horwood (2003) found that adolescents who met the criteria for major depression had rates of daily cigarette intake between 1.70 to 2.19 times higher than those who did not have major depression. These associations were replicated throughout their adolescence years and into young adulthood. Kendler et. al (1993) found similar results, where regular smokers had higher rates of major depression than non-smokers, and heavy regular smokers had higher rates of major depression than light regular smokers. Even after controlling either alcohol dependence or anxiety disorders, the association between smoking and major depression only reduced slightly.

While these findings do not suggest that smoking leads to depression, they are consistent with the notion that there is an association between smoking and depression (Steuber & Danner, 2006). So, although we may not know whether it is a causal relationship, but seeing as we do know that there is an association, it would definitely help with trying to decrease the act of smoking within the population. This would then suggest that there is a possibility that public health programmes aimed at reducing major depression may have an impact on reducing cigarette smoking, or conversely, public health programmes that help with ceasing smoking could also have indirect effects on helping to reduce major depression (Fergusson, Goodwin, & Horwood, 2003). However, more research needs to be done to fully understand the relationship between smoking and depression.

To conclude, persuasive advertisements on the effects of smoking may not work very well, as there are still millions of people out there still smoking and they understand how it could heavily affect their health, but unfortunately, still continue to do so. Based on the findings above, one of the things we can look into is focusing on the smokers themselves instead of only highlighting the dangers of smoking.

Campbell, D. (2016, September 20). Number of smokers in England drops to all-time low. The Guardian. Retrieved from

Current cigarette smoking among adults in the United States. Centers for Disease Control and Prevention. Retrieved from   
Fergusson, D. M., Goodwin, R. D., & Horwood, L. J. (2003). Major depression and cigarette smoking: results of a 21-year longitudinal study. Psychological medicine, 33(08), 1357-1367.

Gladwell, M. (2002). The tipping point: How little things can make a big difference. Little, Brown.

Kendler, K. S., Neale, M. C., MacLean, C. J., Heath, A. C., Eaves, L. J., & Kessler, R. C. (1993). Smoking and major depression: a causal analysis. Archives of general psychiatry, 50(1), 36-43.

Steuber, T. L., & Danner, F. (2006). Adolescent smoking and depression: which comes first?. Addictive behaviors, 31(1), 133-136.

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