Social gradients in responsiveness to messages on children's tobacco smoke exposure

Abstract

BACKGROUND: Health communication campaigns aimed to diminish morbidity and mortality caused by smoking are expected to impact a complicated causal pathway starting from attracting the attention of the target audience, increasing knowledge, changing behaviors, and finishing with a lower risk of death at the end. The purpose of this pilot study was to conduct a formative evaluation of the posters covering issues related to tobacco smoke exposure of small children and to explore who are those people who pay more attention to the posters.
METHODS: Observation was conducted in the underground carriages in Kazan city, Russian Federation, where posters were placed on the walls. Registered characteristics of passengers included whether the passenger was looking at the poster (outcome); gender, age, clothing of the passenger, whether a passenger is accompanied by somebody else and communicates with this person, whether a passenger holds gadgets, books or newspapers, whether a passenger looks at the screen of the monitor in the carriage. Some of the posters were also discussed in interviews.
RESULTS: The proportion of those who paid attention to the poster was on average 19%, ranging from 13% to 25%. The only variable associated with the outcome was passenger's clothing considered as a proxy for SES collapsed into three categories: (1) poorly dressed, (2) commonly dressed, (3) well-dressed. All the posters where this association was found were covering prenatal and little children's secondhand smoke exposure.
CONCLUSIONS: This pilot study has generated a hypothesis, which can be used and tested in further social marketing campaigns. Lower SES passengers were paying more attention to the posters than those better off. If mothers of small children who live in families of low SES with smoking fathers or grandfathers are the primary target group for addressing this problem, metro could be the proper place for such campaigns.