An initiative born out of COVID concerns encouraged quitting, use of cessation services and smoke-free policies. The campaign materials and resources are now available as part of World No Tobacco Day.
June 7, 2023 (New York)—The Eastern Mediterranean region can benefit from organized tobacco control efforts, as shown by the results of a single regional campaign that reached 50 million people across Egypt, Jordan, Iraq and Palestine in the summer and fall of 2022.
During the pandemic, many governments recognized the importance of protecting tobacco users from COVID-19 because of the increased risk of severe illness among smokers. In response to high tobacco rates—in Jordan, for instance, 65.3% of men are smokers—the United Against Tobacco and COVID initiative launched a regional initiative to create a strategic media campaign that called attention to the harms of smoking and encouraged quitting. United Against Tobacco and COVID is funded by the U.S. Centers for Disease Control (CDC) in partnership with the Eastern Mediterranean Public Health Network (EMPHNET) and Vital Strategies. The initiative website and brief launched with campaign materials available in English and in Arabic.
“Smoking remains the leading cause of preventable disease, disability and death worldwide,” said Indu Ahluwalia, MPH, PhD, Chief, Global Tobacco Control Branch, Office on Smoking and Health at CDC. “In addition to educating millions of people about the dangers of tobacco smoking and encouraging people to quit, the United Against Tobacco and COVID campaign also strengthened tobacco control efforts across the region. This campaign opened new possibilities for stronger evidence-based tobacco control policies that protect the health of millions.”
“This initiative highlighted the effectiveness of media campaigns and the need and resonance of tobacco control messaging in the region,” said Rebecca Perl, Vice President, Partnerships and Initiatives, Vital Strategies. “United Against Tobacco and COVID not only helped millions of tobacco users consider and access cessation services, it motivated policymakers to support smoke-free places and promoted an environment that is conducive to policy change. We are proud this work catalyzed action on tobacco control and is an important steppingstone in helping to protect the health of millions across the region.”
- The campaign reached an estimated 50 million smokers and nonsmokers across four countries through TV, digital media, radio and out-of-home advertising, such as billboards and posters.
- This estimate included approximately 29 million people in Egypt, 25 million in Iraq, 3 million in Jordan and more than 2.5 million in Palestine.
- Campaign process and post-campaign evaluation results demonstrated that many across Egypt, Iraq, Jordan and Palestine asked for support with quitting smoking. For example, in Jordan visits to cessation clinics almost doubled during the campaign with 865 visits before (March-May) compared to 1,392 throughout the campaign (July-August).
“In a region with limited exposure to tobacco control campaigns, even a single campaign can have multiple results, and this was shown in the evaluation findings—from encouraging a reduction in smoking prevalence to affecting policy and behavior change,” said Randa Saad, M.D, Technical Specialist, EMPHNET.
“Tobacco-related diseases have cut too many bright futures short,” said HRH Princess Dina Mired, Jordan, who was the keynote speaker at the campaign launch in Jordan. “As a longtime advocate for tobacco control, I am proud to see media campaigns in Jordan and the region at large to accelerate the adoption of proven, cost-effective strategies that reduce tobacco use and improve population health.”
In-Depth Country Findings:
- Approximately 36% of post-campaign evaluation survey respondents recalled the campaign three months after it ended; almost half of them were smokers.
- Most of the campaign-aware respondents saw the campaign on TV (52%) and social/digital media (37%).
- The campaign messages had the intended effect: 52% said the campaign provided them with new information and 72% agreed that it made them stop and think about the harms of smoking.
- Beyond the primary intentions of the campaign, the survey in Jordan found that the campaign fostered public support for smoke-free policies. More than 90% of those surveyed in Jordan supported smoke-free policies for schools, churches, mosques and hospitals. This support was higher among those who were campaign-aware than among those who were unaware.
- Participants expressed overwhelming support for smoke-free policies, with more than 84% of survey participants calling for smoke-free university buildings.
- The Ministry of Health aligned the opening of its smoking cessation clinics with the launch of the campaign and used the campaign platform to begin publicizing the clinics.
- The campaign also spurred Ramallah municipality to launch an effort to enforce a ban on tobacco sales to minors.
- Many people, including policymakers, called for comprehensive and more stringent tobacco regulations, including smoke-free policies.
- In September 2022, the Ministry of Health asked the United Against Tobacco and COVID partners to extend the campaign to the Arba’een religious pilgrimage for three more days. This extension enabled the United Iraqi Medical Society for Relief and Development to reach an estimated 600,000 to 700,000 pilgrims.
- The campaign reached 20.1 million through social media and 8.5 million through TV and radio.
- The Ministry of Health reported an increase in the number of calls to the ministry’s smoking cessation hotline during the campaign period.
- The campaign was launched under the leadership of the Ministry of Health, which oversaw material development, supported dissemination and included their logo.
Country partner organizations included The Cairo Association for Smoking Tuberculosis and Lung Diseases—Egypt, The Institute of Community and Public Health and The Media Development Center at Birzeit University, The Royal Health Awareness Society and The United Iraqi Medical Society for Relief and Development. In all four countries the ministries of health supported the campaign with funding, in-kind support or through campaign sponsorship.
Access the campaign brief.
Access the campaign website.
View the campaign video, ECHO, shown in Jordan, Palestine and Iraq.
Methodology: A mix of process and post-campaign evaluation methods were used to estimate campaign effects in the four countries. This included analysis of media reach estimated by media planning agencies, the number of news articles published about campaign launches, continuous monitoring of campaign performance by campaign managers, and outcome evaluation studies in Jordan (using quantitative methods) and Palestine (using primarily qualitative methods).
About Vital Strategies
Vital Strategies believes every person should be protected by an equitable and effective public health system. We partner with governments, communities and organizations around the world to reimagine public health so that health is supported in all the places we live, work and play. The result is millions of people living longer, healthier lives.
About GHD|EMPHNET: Working Together for Better Health
The Eastern Mediterranean Public Health Network (EMPHNET) is a regional network that focuses on strengthening public health systems in the Eastern Mediterranean Region (EMR) and beyond. EMPHNET works in partnership with ministries of health, non-government organizations, international agencies, private sector, and relevant institutions from the region and the globe to promote public health and applied epidemiology. To advance the work of EMPHNET, Global Health Development (GHD) was initiated to build coordination mechanisms with partners and collaborators. Together, GHD|EMPHNET is dedicated to serving the region by supporting efforts to promote public health policies, strategic planning, sustainable financing, resource mobilization, public health programs, and other related areas.