Stories of tobacco victims deliver a powerful impact in low and middle income countries

News Hour:

A paper on the impact of tobacco victim testimonials, authored by Vital Strategies’ public health communication experts, has been published in leading peer-review journal “Tobacco Control.” The paper, entitled “Raw and real: an innovative communication approach to smokeless tobacco control messaging in low and middle-income countries” evaluates Vital Strategies’ use of victim testimonials in countries including India, Senegal, Indonesia, and Bangladesh.

Lead author, Tahir Turk, Senior Advisor – Policy, Advocacy and Communication, Vital Strategies, said: “These campaigns simply wouldn’t be possible without the bravery of the victims who have agreed to feature, nor without the support and cooperation of their families and the medical facilities, doctors and authorities involved. It is critical that each campaign is respectful to the victim and their family, without shying away from the reality. These victims are the most authentic voices to demonstrate how tobacco tears lives apart. They cannot be ignored.

Sandra Mullin, Senior Vice President, Policy, Advocacy and Communication, Vital Strategies and co-author of the paper said: “This paper is a vital contribution to building the evidence base around anti-tobacco communication campaigns. On a global basis, we have found that certain graphic, hard hitting tobacco control campaigns and messages are equally successful when adopted across high, middle and low income countries. However, this paper confirms that there is also a strong case for developing and implementing more personalised, culturally relevant and emotionally compelling campaigns to engage tobacco users and policy makers in low and middle income countries. This is particularly important in changing attitudes towards products like smokeless tobacco, which are more prevalent in specific communities and countries.”


“We also acknowledge the governments that have agreed to run these hard-hitting campaigns in order to improve public health. They can be reassured that this approach delivers results while also proving highly cost effective, especially in resource-constrained settings. We strongly encourage the adoption of the “Raw and Real” approach in tobacco control communication campaigns and further assume it could prove equally successful in addressing other preventable causes of disease and premature death.”


This is a pared-down, documentary-style approach to communicating the harms of tobacco. It features real tobacco victims, their doctors and their families, relating their own experiences and emotions, while showing harrowing images of tobacco-related disease. Victims are featured in hospital or at home. Unfortunately, several of the victims featured in these campaigns never had the opportunity to see the impact of their story on others. That is made clear in the PSA, where appropriate.

In India, there have been five such testimonial campaigns. “Mukesh” had recall rates of over 80 percent. It helped to support a national ban on Gutka, a prevalent form of smokeless tobacco in India, and the adoption of or increases in tobacco taxes on smokeless tobacco products across 17 of 35 States and Territories, many for the first time. The youth and family responsibilities of“Sunita” resonated powerfully across India, drawing attention to the problem of smokeless tobacco use among young women. It also helped to support the adoption of large graphic warnings on tobacco packaging.

In Senegal, the story of “Idrissa” resulted in a near-600% increase in calls to the national quitline.

The stories of “Ike” and “Robbie” in Indonesia prompted millions of quit attempts.

The “People Behind The Packs” campaign in Bangladesh featured the stories of four tobacco victims to support the implementation of graphic health warnings. In pre-testing, over 90 percent of respondents agreed the PSAs made them feel “motivated to quit smoking” and “increased my confidence to quit smoking.”

Mridha Shihab Mahmud

Mridha Shihab Mahmud is a writer, content editor and photojournalist. He works as a staff reporter at News Hour. He is also involved in humanitarian works through a trust called Safety Assistance For Emergencies (SAFE). Mridha also works as film director. His passion is photography. He is the chief respondent person in Mymensingh Film & Photography Society. Besides professional attachment, he loves graphics designing, painting, digital art and social networking.
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