Supplier name: Earnscliffe Strategy Group
Contract number: HT372-203701/001/CY
Contract value: $106,787.37 (including HST)
Award date: November 17, 2020
Delivery date: March 5, 2021
Registration number: POR 061-20
For more information on this report, please contact Health Canada at:
hc.cpab.por-rop.dgcap.sc@canada.ca
Ce rapport est aussi disponible en français.
Supplier name: Earnscliffe Strategy Group
March 2021
This public opinion research report presents the results of focus groups conducted by Earnscliffe Strategy Group on behalf of the Department of Health Canada. The qualitative research was conducted in February of 2021.
Cette publication est aussi disponible en français sous le titre : Recherche qualitative sur le renoncement au tabac chez les adultes – Rapport final
This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from the Department of Health Canada. For more information on this report, please contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca
Catalogue Number: H14-367/2021E-PDF
International Standard Book Number (ISBN): 978-0-660-39130-4
Related publications (registration number: POR 061-20)
H14-367/2021F-PDF (Final Report, French)
978-0-660-39131-1
© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2021
Earnscliffe Strategy Group (Earnscliffe) is pleased to present this report to Health Canada summarizing the results of the qualitative research on adult smoking cessation communication themes and concepts.
Though tobacco use has been decreasing, it continues to be the leading preventable cause of premature death in Canada. In order to reduce the staggering death and disease burden of tobacco use, as well as reduce the costs of tobacco use towards society, Health Canada continues to work towards its commitment to reduce tobacco use to less than 5% by 2035. Looking at 2019 CCHS data from Canada, Health Canada can attribute a third of all daily smoking to adults aged 50-64; adults 35-49 are the second largest group of those who smoke daily. Thus, Health Canada sought to better understand the platforms, types of messaging, tools and resources that would help facilitate these audience’s journey to quit smoking. Findings from the research will be used to create targeted messages for this audience, as well as support a more robust understanding of how Health Canada can support smoking cessation needs for the two largest demographic segments of those who smoke in Canada.
The specific objectives of the research were to understand from those in the targeted age ranges, the types of messaging that will resonate with them. More specifically, the focus groups explored reactions towards five creative themes and two possible advertisement approaches. The contract value for this project was $106,787.37 including HST.
To meet these objectives, Earnscliffe conducted a comprehensive wave of qualitative research involving a series of sixteen (16) online focus groups between February 16th and 22nd, 2021. The groups were conducted with residents (both urban and rural) of eight Canadian cities: Halifax, NS; Montreal, QC (in French); Ottawa and Toronto, ON; Winnipeg, MB; Saskatoon, SK; Calgary, AB; and, Vancouver, BC. The groups were conducted with 138 adults 40-49 and 50-64 who smoke regularly; defined as daily or almost daily use. The first focus group age range was selected to begin at 40 versus 35 years old in order to group participants in more similar stage of life categories. In addition, recent public opinion research we (Earnscliffe) conducted suggests that there are few broad differences between the 40-49 and 50-64 age ranges for this target audience. More focus group sessions were conducted for the 50-64 age range to account for a greater population of smokers in this age category. The groups with residents in Montreal were conducted in French; the others were conducted in English.
Consistent with the results of our past research with these target audiences, the findings across age group and location were remarkably consistent. Except where specifically identified, the findings represent the combined results regardless of audience, location or language (English and French).
It is important to note that qualitative research is a form of scientific, social, policy, and public opinion research. Focus group research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences, and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved, the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn and findings cannot reliably be generalized beyond their number.
The focus groups began with an initial warm-up discussion in which participants shared their views on smoking as well as their smoking behaviours.
Participants were asked to review different communications themes that could be used to encourage people to quit smoking. For each theme, two creative samples were shown to illustrate how that theme could be used in a communications campaign. The order in which the themes were presented in each group was randomized to reduce ordering effect.
While each theme generated a variety of specific reactions, there were two key overall takeaways worth noting:
The following highlights the overall reaction to each of the five different themes:
Participants were asked to review two draft creative concepts in storyboard format that are currently in development. Again, the order in which the concepts were presented in each group was rotated to reduce ordering effect. As these creative concepts were not the primary objective of the focus groups, the depth of discussions of each differed across each group dependent on the remaining time in each group.
Research Firm:
Earnscliffe Strategy Group Inc. (Earnscliffe)
Contract Number: HT372-203701/001/CY
Contract award date: November 17, 2020
I hereby certify as a Representative of Earnscliffe Strategy Group that the final deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Communications Policy of the Government of Canada and Procedures for Planning and Contracting Public Opinion Research. Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, standings with the electorate or ratings of the performance of a political party or its leaders.
Signed: Date:
March 5, 2021
Stephanie Constable
Principal, Earnscliffe
Earnscliffe Strategy Group (Earnscliffe) is pleased to present this report to Health Canada summarizing the results of the qualitative research on adult smoking cessation communication themes and concepts.
Though tobacco use has been decreasing, it continues to be the leading preventable cause of premature death in Canada. In order to reduce the staggering death and disease burden of tobacco use, as well as reduce the costs of tobacco use towards society, Health Canada continues to work towards its commitment to reduce tobacco use to less than 5% by 2035. Looking at 2019 CCHS data from Canada, Health Canada can attribute a third of all daily smoking to adults aged 50-64; adults 35-49 are the second largest group of those who smoke daily. Based on recent public opinion research we (Earnscliffe) conducted, 2019 Social Values and Psychographic Segmentation of Tobacco and Nicotine Users and Non-users, there are few broad differences between those between the age ranges of 40-49 and those 50-64. The target audience was further segmented to focus on those 40-49 ad 50-64 in order to group participants in more similar stage of life categories. More focus group sessions were conducted for the 50-64 age range to account for a greater population of smokers in this age category. Health Canada sought to better understand the types of messaging, platforms, tools and resources that would help facilitate this audience’s journey to quit smoking.
The overall objective of the research was to understand from those in the targeted age ranges the types of messaging that will resonate with them. More specifically, the focus groups explored reactions towards five creative themes and two possible advertisement approaches. The specific objectives of the research were to:
The research findings will be used to create targeted messages, as well as support a more robust understanding of how Health Canada can support smoking cessation needs for the two largest demographic segments of those who smoke in Canada.
To meet these objectives, Earnscliffe conducted a comprehensive wave of qualitative research involving a series of sixteen (16) online focus groups between February 16th and 22nd, 2021. The groups were conducted with residents (both urban and rural) of eight Canadian cities: Halifax, NS; Montreal, QC (in French); Ottawa and Toronto, ON; Winnipeg, MB; Saskatoon, SK; Calgary, AB; and, Vancouver, BC. The groups were conducted with adults 40-49 and 50-64 who smoke regularly; defined as daily or almost daily use. The groups with residents in Montreal were conducted in French; the others were conducted in English. Focus group participants received an honorarium of $100 as a token of appreciation for their time.
Appended to this report are the screener, discussion guide, materials used and methodology report.
This report is divided into three sections: views about smoking and smoking behaviours; reactions to communications themes; and, reactions to creative concepts.
It is important to note that qualitative research is a form of scientific, social, policy, and public opinion research. Focus group research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences, and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved, the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn, and findings cannot reliably be generalized beyond their number.
Consistent with the results of our past research with these target audiences, the findings across age group and location were remarkably consistent. Except where specifically identified, the findings represent the combined results regardless of audience, location or language (English and French). Quotations used throughout the report were selected on the basis of bringing the analysis to life and providing unique verbatim commentary from participants across the various locations.
Please refer to Appendix A: Methodology Report for a glossary of terms used throughout the report.
The focus groups began with an initial warm-up discussion in which participants shared their views on smoking as well as their smoking behaviours.
Asked to discuss what smoking means to them, and why they smoke, perhaps not surprisingly, the reasons were not the same for all. Having said that, there were several patterns of responses that seemed to lead to the conclusion that most derive a certain level of enjoyment from smoking. For some, there was a lot of pleasure derived from smoking; and, no intention to reduce or quit. Others spoke of the perceived benefits related to easing tension and stress; and, needing a break, most commonly from either work or from children, or other stressful situations. Some looked at it differently and explained that they currently smoke because of the addiction or routine (the ritual hand-to-mouth feeling came up spontaneously), as well as the routine of having a cigarette with a morning coffee, or before/after a meal. Worth noting, a few, more often than not women, also mentioned smoking as a weight suppressant, and a few others mentioned smoking (more often) while socializing and/or drinking alcohol.
“What I really like about smoking the most, was that it gave me a break. When you smoke, you are not thinking about everything else. It’s almost like a meditation. You just take that time and you have that smoke.” Vancouver, Adults 40-49
"I think I use it as an escape, to get a few quiet minutes off to myself when I'm a bit aggravated or stressed. It gives me an excuse to leave the room go outside and cool off.” Saskatoon, Adults 50-64
“J’ai arrêté avec le patch la première fois. J’ai arrêté aussi avec le medicament, Champix pendant un ans quoique j’aie repris 40 livres. À ce point là, j’ai recommencé à fumer.” / "I stopped with the patch the first time. I also stopped with the drug, Champix for a year even though I gained 40 pounds. At that point, I started smoking again." Montreal, Adults 40-49
The vast majority have been smoking for many decades – anywhere from 20-40 years. Most indicated having succumbed to peer pressure as a teenager; mostly because of the perception that smoking was cool. They explained that, at the time, smoking was everywhere and it was portrayed in the media as cool (and still is in some ways).
Current consumption levels seemed to vary depending on personal choice and lifestyle. There were some who spoke of taking steps to reduce the number of cigarettes they smoke by reducing the number of daily cigarettes, smoking every other day, or only on weekends. Others were comfortable with the number of cigarettes they currently smoke and were not actively trying to reduce in any way; they seemed to smoke between a half a pack to a full pack a day.
There was universal understanding that smoking is bad for one’s health, and that one should not smoke. Indeed, many participants mentioned feelings of guilt and intentions to quit at some point. Interestingly, the vast majority have tried to quit at least once in the past, most have tried several times, while a handful of participants (across all groups) have never tried and have no desire to try. Most of those who have tried or quit successfully in the past indicated having tried to quit at least a couple of times, while others have tried for what seems like “hundreds of times.” Those who have quit in the past indicated having quit for a number of weeks, months or up to a year; a handful of participants said they had quit for as long as 10 years.
Those who had tried or quit successfully in the past indicated they did so due to pregnancy, upcoming surgery, a desire to be more active (due to sport) or lead a ‘healthier’ lifestyle.
When probed, participants suggested that they took up smoking again typically as a result of stressful moments in their lives (i.e., a bad breakup or work stress) and/or being in social settings or around friends who smoke and the offer of a cigarette. Also worth noting, those who had reduced the number of cigarettes they smoke to their desired number, did not feel the perceived health risks outweighed the perceived comfort/enjoyment they derived from smoking those few cigarettes.
“I don’t want to say it’s a team event, but it always feels like that. It’s that camaraderie aspect of it that I enjoy.” Calgary, Adults 40-49
“It still has a hold on me. I can go 10 years without smoking, and then be out with buddies and if someone is having a smoke I want to have one. I go to my mother’s house and she smokes and I will take one. I have children as well. They don’t know I smoke, and I certainly wouldn’t want them to know. But it still has a hold on me. ” Vancouver, Adults 40-49
“J’ai jamais essayé d’arrêter de fumer. J’ai rarement des problèmes de santé. Je n’ai même pas de rhume. Je fais du sport et ça va bien. Je fume sept cigarettes par jour, pas si pire.” / “I have never tried to quit smoking. I rarely have health problems. I don’t even have a cold. I do sports and I’m fine. I smoke seven cigarettes a day, not so bad.” Montreal, Adults 40-49
“I’d like to say ‘Ya, that light bulb is going to click and I’m not going to want to be a smoker’ but you know I’m 50 and that hasn’t happened yet.” Vancouver, Adults 40-49
“When I heard after 18 years that she [my friend] still actually craved it, I just thought, ‘Oh, for god's sake!’ I mean, I can be horribly cranky to begin with. No bloody way.” Saskatoon, Adults 50-64
In terms of tools and resources used to try and help in their attempts to quit, most participants had throughout the years tried a few different methods, including: cold turkey, nicotine reduction tools such as nicotine gum or patches, and medication. Some had tried alternative approaches such as hypnosis, laser therapy, acupuncture, and a handful had tried vaping.
While not asked in every group (due to time limitations), for information about which approaches to use, many indicated that they have consulted with a nurse, doctor or pharmacist in the past while some mentioned having turned to family and friends, particularly those who had quit in the past. Worth noting, there was also a sense that family and friends could help hold them accountable in future quit attempts.
“Si je voulais m’arrêter, j'irais utiliser une vape. J'en ai même acheté une, mais je n'ai pas encore réussi. J'ai reçu cette recommandation d'amis qui ont arrêté de fumer de cette façon.” / “If I wanted to stop, I would go and use a vape. I even bought one but I haven’t succeeded yet. It was recommended to me from friends who quit smoking this way.” Montreal, Adults 40-49
“For me, a really good source is your pharmacist. They always take the time to not just give you what's out there, what choices you have, but they'll give you the side effects. They'll give you a little bit more detail than what is on like a 30-second commercial.” Vancouver, Adults 50-64
“I suppose a good resource would be my husband because he doesn’t smoke and he is fairly healthy. He knows that I can’t give this up and he hates it, so if I really wanted to finally decide to quit, I would make him hold me accountable.” Vancouver, Adults 40-49
Participants were asked to review five different communications themes that could be used to encourage people to quit smoking. For each theme, two creative samples were shown to illustrate how that theme could be used in a communications campaign. The order in which the themes were presented in each group was randomized to reduce ordering effect.
Participants were presented with five communication themes, in randomized order, that could be used to encourage people to quit smoking. To bring each theme to life, participants were provided with a description of each theme (outlined below) and shown two creative samples of advertisements (please refer to the Appendix) that have been used in the past, including some used in other jurisdictions, to illustrate how that theme would be used in a communications campaign. Participants were asked to focus on the theme rather than the specific examples provided.
The themes included:
Description: Content features health impacts of continuing to smoke and positive impacts of quitting as well as motivational messages.
Description: Content educates around the effectiveness of tools and supports. (Using quit supports will improve your chances of success.)
Description: Content features descriptions of the health consequences of smoking, often featuring images of the shocking results.
Description: Content features real life testimonials from former smokers.
Description: Content typically involves social media and active participation is asked of the audience.
For each theme, participants were asked a series of questions to gauge their overall reactions and the likelihood they would be motivated to contemplate quitting smoking. For the purposes of reporting, except where specifically identified, the findings for each theme focus on the theme rather than on the specific creative samples shown. Again, please refer to the Appendix for the specific creative samples shown for each theme.
While each theme generated a variety of specific reactions (outlined below), there were three key overall takeaways worth noting:
The following summarizes participants’ preferences when asked which theme resonated most and would be most effective at motivating them to contemplate quitting smoking.
The following summarizes the overall reaction to each of the five different themes. They are presented in the order of how often they were selected as most resonant and motivating (as outlined above).
Description: Content educates around the effectiveness of tools and supports. (Using quit supports will improve your chances of success.)
This theme was well received by virtually all participants. It was clear and easy to understand and participants welcomed information about the supports they could use/rely on if they made a quit attempt.
More than any other theme, perhaps, some participants also felt that this theme met them where they were at (in the evolution of their smoking use). Bear in mind, these groups consisted of individuals who have been smoking for decades, who have tried, using different tools and with varying degrees of success, to quit on multiple occasions in the past. The majority were interested in learning more about the different tools and supports available to them and the understanding that there were many options they could try was comforting especially for those aged 50-64 who felt hopeful there was a tool that could help them. Moreover, the notion of combining multiple tools and/or supports and of the statistical rates of success of each was appreciated as both credible and helpful information.
However, despite the interest in the information, many did not think this theme would be all that effective at motivating them to think about quitting smoking. It seemed to be more appropriate and of interest to those who were ready to quit, or in the process of trying to quit.
“I think for me, it was a big reminder in terms of how many option there are out there to quit. It really made me feel like a wakeup call in terms of willpower is not going to work. It made me feel supported in a way; that there are many options to quit smoking.” Calgary, Adults 40-49
“I think this one is great actually. It kind of gets your attention. All the different avenues you can take to try and quit. A lot of those on there, I didn’t even know existed. You look at something like that and you go ‘Well, if there is another option that you can take, it might be worth giving it a try’.” Calgary, Adults 50-64
“Possibly consider things I haven't tried before. Like I mentioned, I kind of resort to going cold turkey. And I can see that that's the least effective method out of all of these. So this just raises a bit of awareness about what else I can possibly try; combinations of different things that might lead to better success.” Ottawa, Adults 40-49
“Je prendrai peut-être le temps de le lire, mais il s'adresse sans aucun doute à des personnes qui sont absolument prêtes à arrêter, mais je le regarderais.” / “I might take the time to read it, but it is definitely for people who are absolutely ready to quit, but I would watch it.” Montreal, Adults 40-49
Description: Content features descriptions of the health consequences of smoking, often featuring images of the shocking results.
Theme C received mixed reviews, though overall opinions of this theme tended to be negative. Participants found it repetitive, unhelpful, discomforting, and much of the same they have been exposed to over the years. In fact, many claimed to be immune to these types of messages and to have the feeling that this type of messaging would be better suited to educate youth about the harmful health consequences (before they start smoking).
Having said all this, there were some participants who felt that they needed to see jarring images to convey the sense of urgency to quit smoking. This approach was particularly well received by participants in Halifax who felt they needed something more hard hitting to get their attention. These participants found the creative samples particularly memorable, especially the video. Another source of praise for this theme was the credibility, though for many that was offset by weaknesses in connecting with them in a manner that respects their intelligence and in terms of informing them.
“I personally know that it's going to be hazardous eventually; and, still, it's addictive. So this is not effective for me.” Toronto, Adults 40-49
“I find myself numb to these. It's been so long that they've been putting this on cigarette packs, and you just don't pay any attention to it whatsoever. So I understand. I know smoking is bad for me. And this picture isn't telling me anything that I didn't already know.” Calgary, Adults 40-49
“Quand j'ai l'impression d'être manipulé, j'éteins mon interrupteur et je ne regarde plus.” / “When I feel like I’m being manipulated, I turn off my switch and don’t watch any more.” Montreal, Adults 40-49
Description: Content features real life testimonials from former smokers.
While reactions were mixed, testimonials were viewed by most as powerful, and effective at making a personal connection. The testimonial theme is one that participants have seen executed many times and, in several groups, there was a participant or two citing an example (e.g., Barb Tarbox) that stayed with them well beyond exposure to the campaign. Participants indicated these can be emotional and powerful, but as with the hard-hitting theme, cynicism around the authenticity, repetitiveness and overexposure were often cited by the many participants who claimed this type of advertising has little effect on them now.
Nevertheless, in most groups there were participants who felt this theme worked particularly well. This theme was particularly well-received by participants in Toronto, Saskatoon and Winnipeg.
One key aspect that all agreed is vital is authenticity. There was a sense advertising campaigns commonly used actors or stock photos to manipulate viewers and readers. As a result, for any advertising using this theme, participants indicated that effectiveness will be non-existent if there is any doubt about the sincerity – even as they accept that the messages are credible. Participants no longer need to be told that smoking is harmful. That is accepted as fact. However, testimonials about what emotional pain and loss is at risk and better yet, stories of success and examples of the improvements in quality of life were messages participants felt could resonate, if done well.
Worth noting, as with the hard-hitting theme, there was some evidence that there is a significant drop-off in effectiveness when shifting from video to static.
“You’re actually seeing someone open up with this particular style of advertisement. That would be very effective because it takes people to a certain state in their feelings about smoking to a pinnacle whereby they think, ‘Oh boy, I have to make a decision.’ That’s more effective than most other forms of communication, for me.” Toronto, Adults 50-64
“Personally, I'm tired of all of the doom and gloom around smoking. You know, people come up to you and they comment on how you smell or if you have a cough. It’s like, ‘Oh it’s so bad’. But when you come to this one with the lady and the benefits that say things that are positive about what happened with her after she quit, that speaks more to me than the doom and gloom.” Saskatoon, Adults 50-64
“I think it's really effective. It's always, you know, because when you get into testimonials, there's always somebody that you're gonna relate to.” Halifax, Adults 40-49
“The video one hits a little harder. It's definitely got more impact, again, probably wouldn't make me quit. Just because it is so difficult to quit. With the poster, I kind of chuckle because the first thing that came to my mind when it said food tastes better, and this is as a woman, I'd be like, ‘Oh, great, I'm going to get fat.’” Toronto, Adults 40-49
Description: Content features health impacts of continuing to smoke and positive impacts of quitting as well as motivational messages.
Overall reactions to this theme were generally mixed. At first glance, most participants felt it was along the lines of much of what they have seen before. Some interpreted the messages as negative, and when probed realized that the messages were actually positive but were quick to judge based on past communications materials. Those who took the time to read the information provided in the creative samples felt that the messages were helpful and could be effective.
By far what participants liked most about this theme was the positive tone, which many appreciated compared to some of the other themes. Participants felt the messages citing the health benefits related to smoking cessation were credible and aspirational.
Those who did not like this theme felt that it had been done before, and would not capture their attention. Some felt that it was meant more as a preventative ad for younger people than a motivational ad encouraging an avid smoker to quit.
“Je suis pas mal prêt à arrêter de fumer là, donc pour moi, j’ai aimé ce thème. Sur le côté positif, je l’ai trouvé encouragent.” / “I’m pretty much ready to quit smoking right now, so for me, I liked this theme. On the positive side, I found it encouraging.” Montreal, Adults 40-49
“I think it's their gentle reminder of the things that we already know. And it's, it's just a very gentle campaign; like this is, you know, all ‘look at how wonderful life can be’. I think for a lot of the hardcore smokers, they're going to need something a little more graphic and a little more impactful.” Winnipeg, Adults 50-64
“I guess I’m immune to it. In my case, my mother- and father-in-law both died of smoking related cancer. So you know, I’ve been through it, I’ve seen it, and that didn’t make me quit. So this is the more positive aspects. It may not hit you the first time. You might need to see it ten times, but it will gradually sink in.” Toronto, Adults 50-64
“This is almost for non-smokers thinking about smoking, or for the younger generation moreso than for someone who has been smoking a long time, because we all know this.” Saskatoon, Adults 50-64
Description: Content typically involves social media and active participation is asked of the audience.
The majority of participants did not feel this theme was either appealing, motivating, or credible. Many indicated being only light users of social media, especially those 50-64, saying there was little chance they would see something like this, notice it, let alone respond to the call to action in any way. The few who liked this theme tended to be more regular users of social media in the 50-64 age group because they liked the sense of community and support it inferred.
Having said that, most expressed an apprehension or reluctance to draw any attention to the fact they smoke publicly in this way. The idea of doing something to publicize their smoking was particularly uncomfortable due to the stigma attached to their tobacco use and due to the fear of failure to quit smoking.
One constructive criticism offered was that the more closed the engagement (i.e., limitations on who could see their post), the more likely they would be to engage. More commonly, participants were able to appreciate that it may be helpful to see the stories, examples and encouragement of those who are attempting to reduce their smoking or quit altogether.
“Moi je trouve ça mignon comme façon de faire participer les gens. C’est une bonne idée. J’aime plutôt le fait que les médias sociaux soient utilisés pour faire participer les gens.” / “I think it’s a cute way to get people involved. It’s a good idea. I rather like the fact that social media is used to get people to participate.”Montreal, Adults 50-64
“I'm not, you know, a huge social media person, I'd scroll past this. It didn't reach me; didn't jump out at me. And I would find it more annoying and would deliberately go out of my way to avoid it. I just couldn't fathom how taking a picture of myself and saying ‘Quitting smoking will make me free’ would motivate me to quit smoking.” Halifax, Adults 40-49
Participants were presented with two draft advertising concepts currently being developed. For each, participants were asked a series of questions to gauge their overall reactions and the likelihood each concept could motivate them to contemplate quitting smoking. The order in which each concept was presented was randomized in each group. Please refer to the Appendix for examples of each.
Participants really liked the positive tone and message of encouragement that this concept implied. They also appreciated the bright colours, the interesting/appealing activities, and the fact the people in the ads were people like them (i.e., similar age). It was applauded for managing to convey a smoking cessation message without the irritating and constant finger-wagging about their tobacco use. Several pointed out that this helps them by recommending constructive and realistic activities to replace their smoking, with some saying, “I can do these things.”
“I liked it, actually. I mean, it's positive. I guess it's welcoming and friendly. Like it's not overbearing, or in your face, trying to shove it down your throat type thing.” Calgary, Adults 50-64
“I like this. It's a little more uplifting. It's not putting you down. It's not making you seem like you're a second class citizen because you do smoke. You know, that's one thing I do not like about some of the other ones.” Halifax, Adults 50-64
A few alternative messages were tested throughout, and, in every case, there tended to be consensus around the preferred options:
Participants typically offered negative comments or indicated disinterest in the The Smoke from Cigarettes concept. They were less able to identify with this concept, felt it was neither very memorable nor attention grabbing, and unlike the hard hitting theme, it failed to shock. One comment often offered was “I’ve been smoking for 25-30 years; this is exactly the kind of advertising I’ve learned to ignore.” Further, a few commented that the bright visuals at the end of the ad seemed incongruous with the rest of concept, although some appreciated that it ended on a positive note.
“L’image et le message ne sont pas percutants autant que les images sur les paquets de cigarettes. L’utilisation du mot ‘peut’…? Il ‘peut’ mais ne signifie pas ‘va’. C’est comme ça que je le vois.” / “The image and the message are not as powerful as the images on cigarette packs. The use of the word ‘may’…? It ‘may’ but it does not mean ‘will’. That’s how I see it.” Montreal, Adults 50-64
“That first frame actually makes me want to light up. I hate to say it, but the first thing I thought when I saw that was, ‘That looks good to me’, which is unfortunate.” Vancouver, Adults 40-49
“I know the smoke from cigarettes can make it harder for me to breathe. I mean, I know it makes me look and feel a lot older than I really am. And I know it's going to increase my risk of disease and premature death. So I mean, this is not telling me something that I don’t already know. It's not shocking at all.” Halifax, Adults 40-49
The purpose of this research was to help Health Canada understand the kinds of thematic communications approaches that resonate in two specific age groups (40-49 and 50-64), including reactions to two draft creative concepts encouraging those who smoke to consider quitting. The groups demonstrated that regardless of age or location, there is clearly no single thematic that is likely to suit all; this held true as well when viewing the draft creative concepts although, there was broad appreciation of Health Canada’s “It’s Never Too Late” concept.
When exploring different approaches to communicating, qualitative research often produces the conclusion that there is no “one-size-fits-all” communications solution and that was particularly evident in this case. The research demonstrated that most participants were able to indicate there was at least one theme that worked better for them than all the others. The theme that was more broadly promising was, Tools and resources are effective, because it clearly helped participants understand the relative effectiveness of different approaches to quit smoking. Most indicated there was welcome new information contained in the examples tested, suggesting there remains some ability to steer more people to attempting – or more likely, re-attempting – to quit. Many felt that the hard hitting health consequences theme could still shock them in a way that mattered, while others claimed to be immune to it. Some felt that the emotional and personal connection they made with the subjects of the testimonial theme were particularly motivational. Likewise, some appreciated the positive quality of highlighting health benefits as an outcome of quitting smoking. Several could get behind the idea of engagement, while others indicated they did not relish the thought of publicly acknowledging their tobacco use in this way.
Despite the diverse reactions to the themes tested, discussions elicited learnings that apply to any theme related to communicating on smoking cessation with these target groups. Perhaps most importantly, participants rather consistently expressed a desire to be communicated with respect for their knowledge/intelligence.
Similarly, one of the most common preferences expressed was for positive messages that encourage, rather than negative messages that discourage. In this vein, it was not surprising that the reaction to one of Health Canada’s draft creative concepts triggered positive reactions by most participants across all the groups. Those who liked it lauded it for its positive look and feel, it’s encouragement to do things that were realistic, and because it seemed to speak to them specifically.
In summary, the qualitative research suggests that among people in these ages who smoke, approaches that are respectful, meet people where they are in their lives, encourage them to make what is likely another attempt at quitting and provide them with something they consider to be positive support (e.g., tools, resources, support) are the ones they claim are more likely to stimulate reaction and action.
To meet these objectives, Earnscliffe conducted a comprehensive wave of qualitative research involving a series of sixteen (16) online focus groups between February 16th and 22nd. The groups were conducted with residents of eight Canadian cities: Halifax, NS; Montreal, QC (in French); Ottawa and Toronto, ON; Winnipeg, MB; Saskatoon, SK; Calgary, AB; and, Vancouver, BC. The groups were conducted with adults age 40-49 and 50-64 who smoke regularly (defined as daily or almost daily use). The groups with residents in Montreal were conducted in French; the others were conducted in English.
In each city, the groups were approximately 90 minutes in length and conducted with adults age 50-64, and adults age 40-49. The group with residents of Montreal were conducted in French; the others were conducted in English.
| City | Audience | Moderator | Participants | Date/Time |
|---|---|---|---|---|
| Halifax, NS | Adults 40-49 | Stephanie Constable | 7 | Tuesday, February 16, 4:00 pm (EST) |
| Toronto, ON | Adults 40-49 | Stephanie Constable | 10 | Tuesday, February 16, 5:45 pm (EST) |
| Calgary, AB | Adults 40-49 | Stephanie Constable | 6 | Tuesday, February 16, 7:30 pm (EST) |
| Montreal, QC | Adults 40-49 | Stephanie Constable | 9 | Wednesday, February 17, 5:00 pm (EST) |
| Montreal, QC | Adults 40-49 | Stephanie Constable | 9 | Wednesday, February 17, 6:45 pm (EST) |
| Vancouver, BC | Adults 40-49 | Stephanie Constable | 10 | Wednesday, February 17, 8:30 pm (EST) |
| Halifax, NS | Adults 50-64 | Doug Anderson | 9 | Wednesday, February 17, 4:00 pm (EST) |
| Ottawa, ON | Adults 40-49 | Doug Anderson | 10 | Wednesday, February 17, 5:45 pm (EST) |
| Calgary, AB | Adults 50-64 | Doug Anderson | 12 | Wednesday, February 17, 7:30 pm (EST) |
| Montreal, QC | Adults 50-64 | Stephanie Constable | 8 | Thursday February 18, 5:00 pm (EST) |
| Montreal, QC | Adults 50-64 | Stephanie Constable | 6 | Thursday February 18, 6:45 pm (EST) |
| Vancouver, BC | Adults 50-64 | Stephanie Constable | 8 | Thursday February 18, 8:30 pm (EST) |
| Ottawa, ON | Adults 50-64 | Doug Anderson | 9 | Thursday February 18, 5:00 pm (EST) |
| Winnipeg, MB | Adults 50-64 | Doug Anderson | 8 | Thursday February 18, 6:45 pm (EST) |
| Toronto, ON | Adults 50-64 | Doug Anderson | 9 | Monday, February 22, 5:00 pm (EST) |
| Saskatoon, SK | Adults 50-64 | Doug Anderson | 8 | Monday, February 22, 6:45 pm (EST) |
Participants were recruited using a screening questionnaire (included in Appendix C).
The target audiences were adults age 40-49 and 50-64 who smoke regularly (defined as daily or almost daily use). The screener contained a series of standard screening questions to ensure participants qualified based on their ages and smoking behaviours. Additionally, we screened participants to ensure we aimed for a good mix of gender, household income, ethnicity, etc.
Quality Response and their selected suppliers reached out to members of their respective databases first via email and followed up with telephone calls to pre-qualify participants for speed and economies. All participants were contacted pre-group to confirm attendance.
For groups in the Ottawa/Toronto areas, Quality Response relied on their proprietary database of Canadians. For groups in other cities, Quality Response used selected suppliers who each have their own respective proprietary database of Canadians living in their local area. For groups in Halifax, Quality Response relied on the assistance of Metroline. For groups in Montreal, Quality Response relied on the assistance of MBA Recherche. For groups in Saskatoon/Winnipeg Quality Response relied on the assistance of Synchro. For groups in Calgary, Quality Response relied on the assistance of Qualitative Coordination. For groups in Vancouver, Quality Response relied on the assistance of Walmsley Research.
Quality Response’s database includes approximately 35,000 Canadians with profiling on a range of attributes including standard personal demographics, household composition, medical background, technology usage, financial services, health and wellness, business profiles, and other relevant criteria. Potential group participants are recruited to their database via mixed-mode: following a proprietary telephone survey, online, referral, social media and print advertising. Initial contact is often made via email or online pre-screening for speed and economies, followed up by personal telephone recruitment and pre-group attendance confirmation.
Metroline’s database varies. Their Halifax database includes 5,300 Canadians. New participants are added to their database via referrals and online advertising. Metroline profiles their database based on a variety of characteristics including but not limited to: location; marital status; occupation; income; smoking behaviours; drinking behaviours etc.
MBA Recherche has a vast database of 35,000 Canadians across Quebec. They use Google ads, their website, telephone RDD lists, and referrals to recruit new participants. In addition to a variety of demographics, MBA Recherche’s profiling includes automobile types, substance use, and mobile phone attributes.
Synchro maintains a database of 3,000 to 3,500 Canadians. They depend on referrals and online advertisements to recruit new panelists. Panelists are profiled for a variety of demographics as well as: main financial institution; cell phone brand; and, vehicles owned, to name a few.
Qualitative Coordination’s database is approximately 5,500 Canadians. Qualitative Coordination uses referrals and online advertisements to find new participants. Their database is not profiled, and new registrants are only asked for their full name, email address, date of birth, and where they reside.
Walmsley Research’s database is comprised of approximately 5,500 Canadians. They rely on referrals and online advertisements to recruit to their database. In addition to a variety of demographics, their database is profiled for: age of children, occupation, spouse’s occupation, health issues, etc.
Given the accelerated timeline, two moderators were used to conduct the focus groups. Stephanie Constable led the first night of groups while Doug Anderson observed to ensure both were aware of the flow of the focus groups and involved in any conversation about potential changes to the discussion guide or flow of conversation for subsequent groups.
It is important to note that qualitative research is a form of scientific, social, policy, and public opinion research. Focus group research is not designed to help a group reach a consensus or to make decisions, but rather to elicit the full range of ideas, attitudes, experiences and opinions of a selected sample of participants on a defined topic. Because of the small numbers involved the participants cannot be expected to be thoroughly representative in a statistical sense of the larger population from which they are drawn and findings cannot reliably be generalized beyond their number.
Except where specifically identified, the findings represent the combined results regardless of audience, location or language (English and French). Quotations exhibited throughout the report are selected on the sole basis of bringing the report to life, and providing unique verbatim commentary from the participants across the various locations.
The following is a glossary of terms used throughout the report. These phrases are used when groups of participants share a specific point of view. Unless otherwise stated, it should not be taken to mean that the rest of participants disagreed with the point; rather others either did not comment or did not have a strong opinion on the question.
| Term | Definition |
|---|---|
| Few | Few is used when less than 10% of participants have responded with similar answers. |
| Several | Several is used when fewer than 20% of the participants responded with similar answers. |
| Some | Some is used when more than 20% but significantly fewer than 50% of participants with similar answers. |
| Many | Many is used when nearly 50% of participants responded with similar answers. |
| Majority/Plurality | Majority or plurality are used when more than 50% but fewer than 75% of the participants responded with similar answers. |
| Most | Most is used when more than 75% of the participants responded with similar answers. |
| Vast majority | Vast majority is used when nearly all participants responded with similar answers, but several had differing views. |
| Unanimous/Almost all | Unanimous or almost all are used when all participants gave similar answers or when the vast majority of participants gave similar answers and the remaining few declined to comment on the issue in question. |
Moderator introduces herself/himself and her/his role: role of moderator is to ask questions, make sure everyone has a chance to express themselves, keep track of the time, be objective/no special interest.
Moderator will ask participants to introduce themselves.
Given the topic of our discussion today, I would like to ask each of you to introduce yourselves by your first name only, and to also share how long you have been smoking and how frequently you smoke (i.e., how many cigarettes you smoke in a day or week).
I would like to start with a fairly general question.
MODERATOR TO PROBE FOR SPECIFIC SOURCES
This next part of our discussion we are going to review different communication themes that could be used to encourage people to quit smoking in an advertising campaign. In total, we will be looking at five different themes.
For each theme, I will show you a series of creative samples, including a video and or posters and other creatives that are examples of how that theme has been or is being considered for use in a communications campaign. You will see that the approach taken to deliver the message varies; each with their own tone and style. These have been selected deliberately because we would like to understand what you think of the different themes, particularly as it relates to the tone, style, impact and feel. It is important for you to know that the advertisement may have been used before, perhaps in other jurisdictions, but what I want you to focus on, is the theme/approach/tone of the ad, and not the ads themselves. For example – don’t focus on the production value of the video or the exact wording used. If the ad mentions something not available in Canada that isn’t important as we’re trying understand what you think of the approach/ tone and not the specifics featured in the ads.
MODERATOR TO ROTATE ORDER OF EACH THEME. FOR EACH THEME, MODERATOR TO READ THE THEME DESCRIPTION, PLAY A VIDEO AD AND SHOW OTHER TOOLS (POSTERS, ETC.).
Description: Content features health impacts of continuing to smoke and positive impacts of quitting as well as motivational messages.
Description: Content educates around the effectiveness of tools and supports. (Using Quit supports will improve your chances of success.)
Description: Content features descriptions of the health consequences of smoking, often featuring images of the shocking results.
Description: Content features real life testimonials from former smokers.
Description: Content typically involves social media and active participation is asked of the audience.
Moderator to probe for each theme:
*SPECIFIC ADDITIONAL PROBES FOR THEME E:
WRAP-UP QUESTIONS AFTER ALL THEMES HAVE BEEN PRESENTED
[MODERATOR TO DISPLAY ON SCREEN THE THEMES AND DESCRIPTIONS (ABOVE)]
We would now like to show you some draft concepts that are currently being developed. As these are still in the draft stage, we will be presenting them in storyboard format. As you review these concepts, I want you to use your imagination to imagine them as fully executed/produced video advertisements.
Unlike the previous exercise where you were asked to consider the theme, with these concepts, we would appreciate more specific and detailed feedback.
[MODERATOR TO PROBE FOR EACH CONCEPT]:
MODERATOR TO CHECK IN THE BACK ROOM AND PROBE ON ANY ADDITIONAL AREAS OF INTEREST.
[IF TIME PERMITS] Resources
[IF TIME PERMITS] Communications Needs
Description: Content features health impacts of continuing to smoke and positive impacts of quitting as well as motivational messages.
Coughing is your lungs warning you it’s time to quit.
When you quit smoking:
Within the first few months, you’ll cough and wheeze less and you’ll be short of breath less often.
In the first 5 years, respiratory problems like bronchitis and pneumonia will decrease significantly.
You can quit and breathe easier!
Health Canada
Green box with text inside
Quitting smoking: Provincial and territorial services
1-866-366-3667
Health Canada
Description: Content educates around the effectiveness of tools and supports. (Using Quit supports will improve your chances of success.)
Blue box with text inside.
Visual depicting the most effective methods to the least effective.
Give yourself the best chance to quit
Description: Content features descriptions of the health consequences of smoking, often featuring images of the shocking results.
Example 1: Public Health England, Mutations 20s UK TV.Read.mp4. Reproduced with the permission of Public Health England (including its successors in title)
Smokefree ‘Health Harms’ 2019 TV ad – Mutations
Tobacco breaks hearts
Choose health, not tobacco
31 May: World No Tobacco Day #NoTobacco
Logos of #beat NCDs Together Let’s Beat Tobacco, World Heart Federation, WHO Framework Convention on Tobacco Control Secretariat (FCTC), World Health Organization
Description: Content features real life testimonials from former smokers.
Example 1: Centers for Disease Control and Prevention (CDC), CDC: Tips From Former Smokers – Michael P.’s “COPD and Smoking” Tips Commercial. Reproduced with the permission of the Centers for Disease Control and Prevention
CDC: Tips From Former Smokers - Michael P.’s “COPD and Smoking” Tips Commercial
“I quit to save money, but most of the positive.”
“Food tastes better and my sense of smell is back. I have a lot more energy and I am a lot more productive.” – Jennifer Smoked for 20 years. Quit at age 36.
Cigarettes are highly addictive.
A blue box at the bottom with text.
Quitting smoking: Provincial and territorial services
1-866-3667
Health Canada
Description: Content typically involves social media and active participation is asked of the audience.
Example 1: World Health Organization, What should take your breath away? Never tobacco – show us what takes your breath away Reproduced with permission of the World Health Organization.
What are you doing to keep busy and healthy whilst practicing social distancing? Post a story and let us know by tagging @healthycdns and use the #socialdistancingclub
Blue box with the text It’s Never Too Late
Close-up image of an older man wordworking with the text To Learn a New Skill
Image of a woman wearing mask and gloves packing a donation box with the text To Volunteer in Your Community.
Image of a woman lifting a weight with the text To Get Active
Close up image of hands breaking a cigarette in half with the text To Quit Smoking
Blue box with the text Quitting is possible.
Green box with the text Getting help improves your chances of quitting.
Green box with the text Find tools and resources at Canada.ca/quit-smoking
Black box with the Canada Wordmark.
Black box with a burning cigarette with the text The smoke from cigarettes
Black box with a woman holding her chest and the text Can make it harder to breathe
Black box with a man seeing his reflection with the text Makes you look and feel
Black box with a man seeing his reflection looking older with grey hair and more wrinkles with the text Makes you look and feel older than you are
Black box with a heart monitor moving to a flat line with the text Increases your risk of disease and premature death
Image of blue sky with some faint clouds and green grass with the text Getting support can double your chances of quitting
Muted image of a blue ski and green grass with the text Access tools and resources Canada.ca/Quit-Smoking
White box with the Canada Wordmark.
TUESDAY, FEBRUARY 16, 2021
WEDNESDAY, FEBRUARY 17, 2021
WEDNESDAY, FEBRUARY 17, 2021
THURSDAY, FEBRUARY 18, 2021
THURSDAY, FEBRUARY 18, 2021
MONDAY, FEBRUARY 22, 2021
Respondent’s name:
Hello, my name is _______________ and I’m calling on behalf of Earnscliffe, a national public opinion research firm. We are organizing a series of discussion groups on issues of importance to Canadians, on behalf of the Government of Canada. We are looking for people who would be willing to participate in an online discussion group. Participants will receive an honorarium for their participation. May I continue?
Participation is voluntary. We are interested in hearing your opinions; no attempt will be made to sell you anything or change your point of view. The format is a ‘round table’ discussion led by a research professional. All opinions expressed will remain anonymous and views will be grouped together to ensure no particular individual can be identified. But before we invite you to attend, we need to ask you a few questions to ensure that we get a good mix and variety of people. May I ask you a few questions?
READ TO ALL:“This call may be monitored or audiotaped for quality control and evaluation purposes.
ADDITIONAL CLARIFICATION IF NEEDED:
S1. Do you or any member of your household work for…
IF “YES” TO ANY OF THE ABOVE, THANK AND TERMINATE.
S2. DO NOT ASK– NOTE GENDER (ENSURE A GOOD MIX)
S3. Do you normally (at least half the year) reside in the [INSERT CITY] area?
S4. How would you describe the area in which you live?
PLEASE ENSURE 3 /10 RESPONDENTS IN EACH GROUP ARE FROM RURAL NEIGHBORING LOCATIONS
S5. Could you please tell me which of the following age categories you fall into? Are you...
(ENSURE A GOOD MIX)
S6. During the past 30 days, how often did you smoke cigarettes? Was it…
IF 1 (DAILY) OR 2 (OCCASIONAL) SMOKER. PLEASE ENSURE A GOOD MIX, 2/3 PER GROUP DAILY; 1/3 PER GROUP OCCASIONAL
S7. What is your current employment status?
S8. Which of the following categories best describes your total household income? That is, the total income of all persons in your household combined, before taxes [READ LIST]?
S9. What is the highest level of education that you have completed?
S10. To make sure that we speak to a diversity of people, could you tell me what is your ethnic background? DO NOT READ
ENSURE GOOD MIX OF ETHNICITY
This research will require participation in a video call online.
S11. Do you have access to a computer with high speed internet which will allow you to participate in an online discussion group?
S12. Does your computer have a camera that will allow you to be visible to the moderator and other participants as part of an online discussion group?
S13. Do you have a personal email address that is currently active and available to you?
S14. Have you participated in a discussion or focus group before? A discussion group brings together a few people in order to know their opinion about a given subject.
S15. When was the last time you attended a discussion or focus group?
S16. How many of these sessions have you attended in the last five years?
S17. And what was/were the main topic(s) of discussion in those groups?
IF RELATED TO TOBACCO, SMOKING, CIGARETTES, VAPING, NICOTINE, GOVERNMENT POLICY ON TOBACCO (INCLUDING SMOKING, CIGARETTES, VAPING, NICOTINE, ETC.), THANK AND TERMINATE
S18. Participants in discussion groups are asked to voice their opinions and thoughts. How comfortable are you in voicing your opinions in front of others? Are you… (READ LIST)
S19. Sometimes participants are asked to read text and/or review images during the discussion. Is there any reason why you could not participate?
S20. Based on your responses, it looks like you have the profile we are looking for. I would like to invite you to participate in a small group discussion, called an online focus group, we are conducting at [TIME], on [DATE].
As you may know, focus groups are used to gather information on a particular subject matter; in this case, the discussion will touch on your views related to smoking and cessation. The discussion will consist of 8 to 10 people and will be very informal.
It will last up to up to 90 minutes and you will receive $100.00 as a thank you for your time. Would you be willing to attend?
Now I have a few questions that relate to privacy, your personal information and the research process. We will need your consent on a few issues that enable us to conduct our research. As I run through these questions, please feel free to ask me any questions you would like clarified.
P1) First, we will be providing the session moderator with a list of respondents’ names and profiles (screener responses) so that they can sign you into the group. This information will not be shared with the Government of Canada department organizing this research. Do we have your permission to do this? I assure you it will be kept strictly confidential.
We need to provide the session moderator with the names and background of the people attending the focus group because only the individuals invited are allowed in the session and the moderator must have this information for verification purposes. Please be assured that this information will be kept strictly confidential. GO TO P1A
P1 a) Now that I’ve explained this, do I have your permission to provide your name and profile to the moderator?
P2) A recording of the group session will be produced for research purposes. The recordings will be used only by the research professional to assist in preparing a report on the research findings and will be destroyed once the report is completed.
Do you agree to be recorded for research purposes only?
It is necessary for the research process for us to record the session as the researcher needs this material to complete the report.
P2 a) Now that I’ve explained this, do I have your permission for recording?
P3) Employees from the Government of Canada may be online to observe the groups.
Do you agree to be observed by Government of Canada employees?
P3 a) It is standard qualitative procedure to invite clients, in this case, Government of Canada employees, to observe the groups online. They will be there simply to hear your opinions first hand although they may take their own notes and confer with the moderator on occasion to discuss whether there are any additional questions to ask the group.
Do you agree to be observed by Government of Canada employees?
INVITATION:
Wonderful, you qualify to participate in one of our discussion groups. As I mentioned earlier, the group discussion will take place [INSERT DATE AND TIME] for up to 90 minutes.
Can I confirm your email address so that we can send you the link to the online discussion group?
TUESDAY, FEBRUARY 16, 2021 - Honorarium: $100
WEDNESDAY, FEBRUARY 17, 2021 - Honorarium: $100
WEDNESDAY, FEBRUARY 17, 2021 - Honorarium: $100
THURSDAY, FEBRUARY 18, 2021 - Honorarium: $100
THURSDAY, FEBRUARY 18, 2021 - Honorarium: $100
MONDAY, FEBRUARY 22, 2021 - Honorarium: $100
We ask that you login a few minutes early to be sure you are able to connect and to test your sound (speaker and microphone). If you require glasses for reading, please make sure you have them handy as well.
As we are only inviting a small number of people, your participation is very important to us. If for some reason you are unable to attend, please call us so that we may get someone to replace you. You can reach us at [INSERT PHONE NUMBER] at our office. Please ask for [NAME]. Someone will call you in the days leading up to the discussion to remind you.
So that we can call you to remind you about the discussion group or contact you should there be any changes, can you please confirm your name and contact information for me?
First name
Last Name
Email
Daytime phone number
Evening phone number
If the respondent refuses to give his/her first or last name or phone number please assure them that this information will be kept strictly confidential in accordance with the privacy law and that it is used strictly to contact them to confirm their attendance and to inform them of any changes to the discussion group. If they still refuse THANK & TERMINATE.