As advocates, we are eager to develop strong messages to persuade the public that action must be taken to control tobacco use.

Indeed, we might be so eager to create such messages that we fail to stop and ask the question that will make our messages strategically effective. The question is not, "What do we want to say?" but, "What must we say to persuade our target audience to take the actions we recommend?"

For example, let us assume that one of your critical target audiences is the prime minister. You want this influential leader to support the enactment and enforcement of a law that will ban all smoking in public places—a national "clean indoor-air" law.

To make this possible, you need the prime minister to believe in your "core messages."

Core Messages Speak to the Broad Public Interest
In this case, your core message is threefold:

• Passive smoking is a serious health hazard.
• Passive smoking is a public health hazard that requires responsive public health laws and regulations.
• Clear health benefits will be achieved at reasonable or low cost.

But delivering your core message will usually not be enough. You will also need to develop "tailored messages."

Create Tailored Messages

Tailored messages address the self-interests and special concerns of your target audience.

Perhaps, for example, the prime minister and the cabinet are impressed by your core health message but do not feel they need to take action. They are now targets for messages tailored to their own self-interest and concerns. For instance, they may need to hear that important political constituents, such as labor unions, support workplace smoking bans—or at least do not oppose these bans.

The prime minister, the finance minister, and the commerce minister may also need to hear that restrictions on smoking in public places, including restaurants, will not cause economic harm to businesses and will not create a sudden drop in tax revenues.

The prime minister would also probably be impressed to learn that reliable polls show that enacting and enforcing smoking bans in public places would be politically popular moves—not only with the general public, but with voters. (This assumes you have such poll information available. But even if not, a respected political observer close to the prime minister could offer an informed opinion that these measures are politically popular.)

In most low-income countries, there is little or no information on the national smoking situation and the damage it is doing to both health and the economy. For example, if cabinet members ask the finance or agriculture minister, "How much does tobacco contribute to the economy in taxes and jobs?" they will hear exact figures. But if they ask the health minister, "How many deaths does tobacco cause in our nation?" they will get no answer.

Yussuf Saloojee, executive Director of the National Council Against Smoking, South Africa, as well as Strategic Leader of Tobacco Control, UICC, was talking about tailored messages when he said: "The clearest antidote to lack of political support is to provide politicians and society with convincing answers to the question—what interventions work and at what social and economic cost? If clear health benefits can be realized at a reasonable cost, most politicians will support health legislation."

Here is another example. Suppose you know that your government is eager to become a member of the European Union. The tailored message the finance minister may most need to hear is: Clean indoor-air laws will bring this country into line with other EU countries. Or say you are aware that your prime minister is eager to be seen as a progressive leader on the international stage. That person might respond to the tailored message that comprehensive tobacco control legislation is something that progressive countries do, as well as what the authoritative World Health Organization recommends in its Framework Convention on Tobacco Control.

There is a danger, of course, in always assuming the worst in politicians. Most political leaders harbor conflicting values and impulses. While they almost all want to sustain their power and status, many also want to do what is best for their country. One of the most successful tobacco control advocates in Europe, Dr. Witold Zatonski, has discovered what works best in Poland: Appeals to lawmakers' pride in promoting public health proved a more effective tactic than direct attacks on the greed and political corruption of the transnational tobacco companies and the politicians who take their money.

The more political intelligence you gather about the concerns and motives of key decision makers, the more effectively you can tailor the messages they need to hear to support your advocacy objectives.

Tailor Messages to Specific Public Policies

Our target audience needs to hear different tailored messages for different public policies. Suppose advocates are trying to persuade key decision makers to support comprehensive advertising bans. Their tailored messages need to address the individual interests and concerns raised by advertising bans.

You can advance any policy effectively with some quick and fairly simple research. For example, research in Bangladesh found:

• High levels of support for ad bans, smoke-free places, and tobacco tax increases
• High exposure of children to tobacco ads (which shows the need for a total ad ban)
• Ignorance of specific diseases and problems caused by tobacco, with nonsmokers showing more knowledge of them than smokers (which shows the need for bigger, clearer, more specific warnings on tobacco packs).

For ideas of specific research projects for different policy measures, see PATH Canada's Guide to Low-Cost Research for Advocacy. The guide covers general tobacco control law and policy, as well as research on the benefits of banning ads and misleading terms on packs, supporting stronger pack warnings, increasing taxes, reducing tobacco use among the poor, and opposing industry-sponsored campaigns to prevent youth smoking.

Another PATH Canada guide, Tobacco Control Law, discusses various legal measures and their rationales, examples from other countries, and recommendations.

The International Tobacco Evidence Network (ITEN) maintains "a formal network of economists, epidemiologists, social scientists and other tobacco control experts able to provide rapid, policy-relevant research on country-level, regional or international tobacco control issues." http://www.tobaccoevidence.net/

Comprehensive Advertising Bans

To gain support for comprehensive advertising bans, we will send messages such as:

• Advertising restraints will not harm the economy. The advertising industries in countries with advertising bans have not suffered significant losses of jobs or been bankrupted.
• The proposed advertising bans are constitutional under the laws of this country. They place a justifiable restraint on freedom of commercial speech because no civilized society permits profit to be made by marketing disease and death.
• Advertising restrictions and bans have proved effective in keeping fewer young people from starting to smoke.
• Tobacco companies have a long and sordid history of lying to the public and to decision makers about these very issues—ammunition when spokespersons for the industry argue against these facts.

Clean Indoor Air

If your clean-indoor-air objective is, for example, smoke-free workplaces, your messages need to include:

• Less time lost by workers who get sick from tobacco smoke and cannot work brings economic benefits to employers.
• Eliminating the time wasted by employees on workplace smoking breaks brings employers economic benefit, especially since there is evidence that smoke-free offices cause many smokers to quit altogether, resulting in healthier, more reliable workers.
• Employers benefit from lower costs of ventilation and cleaning.
• Employers gain approval and support from nonsmoking workers.
• Employers can usually count on little opposition from workers who smoke.

Tobacco Taxes

If your policy objective is to increase tobacco taxes, advocates need to persuade finance and commerce ministers that:

• Cigarette tax increases invariably raise tax revenues.
• Such tax increases do not necessarily increase smuggling.

Vary the Message and Target Audience as Your Advocacy Campaign Progresses

At different stages in an advocacy campaign, you need to tailor your messages to different target audiences.

For example, you may need to overcome the idea, held for many years even in developed countries, that women were thought to be at less risk than men for tobacco-caused diseases. An excellent example of a message that addresses this issue is simply: "Women who smoke like men, die like men."

Or you may need to direct your message to the general public, whose ignorance or skepticism about the hazards of passive smoking is even greater than its lack of understanding of all the hazards of direct smoking. In many countries, people believe that direct smoking is a serious health hazard, but not that "passive smoking" is a serious health risk. The message for them is: "Science proves that those who breathe other people's tobacco smoke get sick and die like smokers."

Even the best-educated public officials may not see smoking as a public health issue, especially where tobacco use is important in a society's cultural history. Even if they understand that smoking is harmful, they may believe the solution lies, not in government regulation, but in individual "free choice"—just as the tobacco industry has always argued.

Indeed, the more educated a public is to the risks of smoking, the greater the chance that some public officials believe smoking has become "an informed choice," and no further government action needs to be taken.

Public officials need to hear this message: Tobacco use is not just a serious health problem, but a public health problem and so demands government action. Therefore, tobacco control advocates must make sure that public officials also hear three complementary and reinforcing messages:

• Most smokers become addicted to tobacco when they are too young to make "informed choices" that will affect their health and life.
• By the time most smokers are old enough to make informed choices, they are addicted to cigarettes. Cigarettes are addictive in a similar way to heroin or cocaine—and no one doubts that heroin or cocaine traffic calls for government action.
• Cigarette smoking is a "communicated" disease, in the words of the World Health Organization. Tobacco companies communicate through their advertising the romance and the social benefits of smoking. People the world over see regulating advertising abuse as a government responsibility.