title: Raw and real: an innovative communication approach to smokeless tobacco control messaging in low and middle-income countries.
abstract: The evidence on the efficacy of tobacco control messages in low and middle-income country (LMIC) settings is limited but growing. Low message salience and disengagement, in the face of tobacco control messages, are possible barriers to self-efficacy and cessation-related behaviours of tobacco users. Although adaptations of existing pretested graphic and emotional appeals have been found to impact on behaviours, more personalised, culturally relevant and compelling appeals may more fully engage message receivers to elicit optimal behavioural responses. The objective of these case studies is to use lessons learnt from high-income country tobacco control communication programmes, and adapt practical approaches to provide cost-effective, culturally nuanced, graphic and personalised messages from tobacco victims to achieve the optimal behavioural impact for population-level communication campaigns in the resource-constrained settings of LMICs. The 'raw and real' messaging approach, which emanated from message pretesting in India, outlines creative and production processes for the production of tobacco victim testimonials, given the need to source patients, facing life-threatening conditions. This cost-efficient approach uses real tobacco victims, doctors and family members in a cinéma vérité style approach to achieve more personalised and culturally resonant messages. The methodological approach, used for the development of a number of patient testimonial messages initially in India, and later adapted for tobacco cessation, smoke-free and graphic health warning communication campaigns in other countries, is outlined. Findings from campaigns evaluated to date are encouraging as a result of the simple fact that true stories of local people's suffering are simply too difficult to ignore.
authors.affiliation: Vital Strategies, New York, New York, USA.
authors.forename: Tahir
authors.initials: T
authors.lastname: Turk
authors.affiliation: Tata Memorial Hospital, Head and Neck Cancer Ward, Mumbai, Maharashtra, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chaturvedi
authors.affiliation: Vital Strategies, New York, New York, USA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Murukutla
authors.affiliation: Vital Strategies, New York, New York, USA.
authors.forename: Vaishakhi
authors.initials: V
authors.lastname: Mallik
authors.affiliation: National Tobacco Control Programme, Ministry of Health and Family Welfare, Delhi, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Sinha
authors.affiliation: Vital Strategies, New York, New York, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Mullin
mesh_terms: D003142:Communication; D003906:Developing Countries; D006293:Health Promotion; D006801:Humans; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention / Q000379:methods*; D014030:Tobacco, Smokeless
keywords: Advertising and Promotion; Advocacy; Low/Middle income country; Media; Social marketing