Very brief advice (VBA) is an evidence-based approach to increasing quit attempts. The purpose of VBA is to engage with people who smoke and get them to think about quitting. The aim is not to tell people how they should behave (quit smoking), but to guide them to the quit support that is available. VBA focuses on offering help by providing:
VBA is an opportunistic, non-intrusive and respectful approach which can be used by anyone, in any setting, including community settings. VBA is not smoking cessation therapy and does not require formal counselling skills or knowledge of the stages of behaviour change because:
In simple terms VBA is a short conversation lasting from 30 seconds to a couple of minutes during which you:
Because of the opportunistic non-clinical nature of VBA, anyone who has contact with people who smoke from Aboriginal and Torres Strait Islander communities should be able to provide this including:
According to a review of the evidence, brief simple advice about quitting smoking increases the likelihood that someone who smokes will successfully quit and remain smoke-free 12 months later.
VBA is a modification of the 5As (Ask, Advise, Assess, Assist, Arrange) approach to brief intervention which is often recommended for use in a clinical setting. You can read more about this clinical approach on the fact sheet: Key facts about behavioural support for smoking cessation.
Social media and social networking tools such as Facebook, Instagram, TikTok, YouTube, Snapchat and Twitter are increasingly being used to help tackle smoking and vaping, particularly with youth. One of the advantages of these platforms is that they are accessible, low cost and familiar to young people. Research suggests that Aboriginal and Torres Strait Islander people use social media at higher rates than non-Indigenous Australians. Social media is popular even in remote communities, where access to the internet can be limited. This makes social media a valuable communication tool for healthcare services. Social media can be a cost effective way to announce events, increasing their visibility and encouraging community engagement.
Social media can also be used to share health promotion messages as part of a social marketing campaign. Social media platforms like Facebook, and traditional mass media channels like TV and radio are all good ways to deliver a message to an audience. However, social media platforms go one step further, encouraging a response from the audience. Social media posts can promote discussions about smoking and vaping, allow people to share their own stories about quitting, and increase audience engagement with the message. Messages will also be amplified (increase their reach) when users share posts with their wider social network.
As a social networking service, platforms like Facebook also provide a unique opportunity to engage with the community and build support for smoke and vape free messages. A recent study on using Facebook to reduce smoking among Aboriginal and Torres Strait Islander people found that there was potential for health services to incorporate a strategy of using paid local social media ‘champions’ or ‘ambassadors’ to disseminate tobacco control messages on Facebook through community networks. It also found that:
The NBPU TIS have produced a Key facts about social media factsheet and infographic that provide key information for TIS workers about using social media to communicate messages about smoking.
Social media factsheet
Social media infographic
Claudine Thornton’s social media training
A bespoke online social media training course has been developed for the TIS workforce by Claudine Thornton Creative. You will learn about marketing terminology and consumer behaviour tactics. Understanding how marketers use emotion over logic in promoting cigarettes, means you can use the same tactics to persuade people to be smoke-free. The course focuses on how to use emotional availability to reverse engineer tobacco marketing. The course lasts around one and a half hours and comprises seven modules each split into 5-10 minute segments. So you can complete it in one go, or in short pieces. The course is free to access, simply open this link and then click the ‘Enroll for free’ button.
Menzies School of Health Research has produced a tips and tricks resource for people working in health promotion and tobacco control, Social media in health promotion and tobacco control: tips and tricks. An accompanying PowerPoint presentation, Can Facebook help Aboriginal and Torres Strait Islander people to quit smoking? is also available.
Mass media and social media campaigns use social marketing techniques to try and reduce the number of people who smoke and/or vape by changing attitudes, beliefs, and intentions about tobacco and/or vape use. Social marketing uses knowledge about the intended audience to develop targeted marketing messages. Campaigns promote being smoke and vape free as desirable and attainable. They do this by:
Social marketing campaigns use education to:
Effective social marketing campaigns include a clear call to action (CTA). The CTA prompts the audience to respond the campaign message, for example by committing never to vape, calling the Quitline or pledging to have a smoke and vape free home and car. Box 1 has more information about the CTA.
Box 1: What is a call to action?
A call to action (CTA) encourages people to do something after you have provided them with health information. It should be easy to remember, compelling and appealing. An effective CTA will:
Campaign messages can be shared using:
A 2021 publication from the Mayi Kuwayu study showed that education provided by the TIS program has changed awareness and understanding of the impact of smoking on long term health in Aboriginal and Torres Strait Islander adults. We know that negative attitudes towards smoking are an important precursor to smoking behaviour change. Anti-smoking attitudes are more likely to lead to quit attempts, and to successful long term smoke free living.
There is evidence that social marketing campaigns can help prevent smoking from starting, encourage people to stop smoking, and prevent relapse among recent quitters by reminding them about why they chose to stop smoking. However one of the biggest effects is in relation to promoting access to cessation support services such as Quitline, counselling and other health professionals. Developing capacity to support people who are ready to quit – by taking the systems approach described under Planning Guidance, is therefore essential if programs are to be sustainable.
Social marketing campaigns also prevent uptake of vaping, encourage cessation and prevent relapse. Because the main audience for anti-vaping campaigns is youth, emerging evidence supports the use of social media to deliver these messages.
A campaign’s impact is influenced by:
Don’t Make Smokes Your Story campaign ad
The relevance of the message has been found to be important for audience engagement. The context, characters and role models used in advertising or community activities must seem believable, if people who smoke are to connect to them. When a campaign does not relate to how people see themselves, they find it hard to become interested in the content. While there is some evidence that mass media campaigns do influence attitudes and beliefs of Aboriginal people and Torres Strait Islander people regarding smoking, more specific local messages tailored for Aboriginal and Torres Strait Islander people seem to be most effective. Evidence from the Talking About The Smokes project also supports the importance of using targeted advertising.
The Australian Government’s Don’t Make Smokes Your Story campaign is a good example of how advertising and community-based activities can work together to encourage behaviour change among Aboriginal and Torres Strait Islander people who smoke. You can adapt and use these materials and resources for your own activities.
In 2024, the Australian Government launched a new national campaign ‘Give Up For Good’. The campaign includes four separate but complementary advertising streams to raise awareness of the health harms of smoking and vaping and encourage Australians to seek support from newly expanded quit support services.
The campaigns will run across television, digital video and audio, social media, gaming, radio, cinema and out-of-home channels like billboards, shopping centres and bus shelters. Box 2 gives more information on the four campaign streams.
Box 2: ‘Give Up For Good’ campaign streams
Why are we still doing this? – young people who vape
This advertising stream seeks to disrupt and counter the high exposure of e-cigarette advertising aimed at young people aged 14 to 24, focusing on the social benefits of quitting together, to increase young people’s confidence in their ability to quit and empower them to take control of their physical and mental health. It shows a clear arc to addiction through demonstrations of nicotine dependency and isolation. It features messaging about how vaping can quickly progress from the early ‘casual’ stage of using vapes, to becoming addictive and causing people to lose enjoyment from their social activities and connections.
Dedicated resources have also been developed for parents and carers, and others who support young people’s efforts to quit. This includes a conversation guide, fact sheet and frequently asked questions.
You can view the campaign materials at health.gov.au/Vaping
Vaping. Are you really choosing anymore? – adults who vape
The creeping nature and emotional impact of nicotine addiction, has the potential to motivate people to question their vaping habits. This creative stream demonstrates the path to addiction and prompts the audience to question whether they are really in control of their vaping. It shows that quit support services can help people reduce their reliance on or addiction to nicotine, regardless of whether they smoke or vape.
You can view the campaign materials at health.gov.au/GiveUpForGood
Choose your hard – adults who smoke
This smoking-specific stream of creative illustrates that whilst quitting is hard, the devastating long-term consequences of smoking are much harder. The creative seeks to drive quit attempts and prevent uptake and product switching, whilst connecting people with evidence-based cessation tools to support them.
Keep at quitting – First Nations adults who smoke
The campaign includes materials to engage with First Nations communities and motivate, empower, and encourage quit attempts. Materials will be supported by a strong community education and engagement strategy.
You can view the campaign materials at health.gov.au/GiveUpForGood.
Reducing second-hand and third-hand smoke is an important aim. This is because second-hand and third-hand smoke can be very harmful. The evidence also shows that if smoking is seen as ‘normal’ at a community level, young people are more likely to start smoking, and people who currently smoke will find it harder to quit. Increasing the extent to which a community is smoke-free is associated with less smoking and more success in quitting. A 2021 publication from the Mayi Kuwayu study showed that areas of Australia where the TIS program is present, compared to non-TIS areas, have a significantly lower prevalence of smoking inside households.
Relevant activities include the following:
To be successful, smoke-free policies need community participation – not just consultation – in their development. Policies that have local ownership and commitment are more likely to be followed. There is also evidence that introducing smoke-free policies in the workplace can lead to increased support for smoke-free spaces in other areas such as smoke-free homes and cars. Successful smoke-free workplace policies also result in more workers wanting to quit.
‘Keep our place a smoke-free space’ is a resource package developed to support the implementation of smoke-free workplace policies. ‘Keep our place a smoke-free space’ was a collaboration between NBPU TIS, the Office of the Registrar of Indigenous Corporations (ORIC) and TIS teams from WA, Qld, SA and NT. You can view the poster presentation about the project that was presented at the Lowitja Institute International Indigenous Health and Wellbeing Conference 2023 here.
Resources include:
Smoke-free workplace wallchart
Workshop resources
An information leaflet promoting the initiative to Aboriginal and Torres Strait Islander organisations is available here. TIS teams can download this leaflet and personalise with their contact details before sharing with local businesses.
Combining locally owned smoke-free policies with access to quit support services increases the success of these policies. Working in an environment with a smoke free policy can also encourage individuals to quit.
Second-hand and third-hand smoke is a health risk factor, particularly for children. Children are at greater risk for a number of reasons, including their size, faster breathing rates and less developed respiratory and immune systems. Second-hand smoke is associated with a number of childhood illnesses including:
Second-hand smoke is also believed to contribute to the risk of sudden infant death syndrome (SIDS).
Less well known, but probably just as harmful is third-hand smoke. Third-hand smoke is the tobacco smoke toxins from second-hand smoke that get into people who smoke’s hair and clothes and build up on surfaces and dust in areas where people smoke. Evidence shows that these toxins stay in homes and cars for a long time after the cigarette has been extinguished, even several months later. They may even become more toxic over time.
Bullinah Aboriginal Health Service’s Solid Mob ‘Our home is a smoke free zone’ campaign
Third-hand smoke is an emerging area of research and we don’t yet understand all the health hazards. However, children (especially infants), are more vulnerable to third-hand smoke toxins. This is because infants crawl over contaminated floors and mouth contaminated surfaces like furniture and toys. We also know that infants consume up to a quarter of a gram of dust every day. That’s twice as much as adults.
There is good evidence that having a smoke-free home and car improves children’s health. There is also some evidence that keeping the home smoke-free helps to prevent uptake of smoking by young people. There are therefore many good reasons to support people to have smoke-free homes and cars.
A 2018 review found that intensive counselling methods or motivational interviewing with parents to be most effective for reducing children’s tobacco smoke exposure in the home. There is some indication that school-based education, intensive home visits, brief education provided to parents in clinics (including scheduled children’s health checks) and culturally sensitive health promotion brochures may also help reduce second-hand smoke in the home and car.
Menzies School of Health Research has developed Healthy starts: reducing the health effects of smoking around Indigenous babies and children, a resource to support health providers when discussing second-hand tobacco smoke with families, and to encourage families to have smoke-free homes.
Griffith AMS hosting a smoke-free community event
Any opportunity to reduce second-hand smoke is a good investment because there is no safe level of exposure to second-hand smoke, and smoke-free events both denormalise smoking and encourage people to think about quitting. The Talking About The Smokes (TATS) study found that support for smoke-free festivals and events is strong in Aboriginal and Torres Strait Islander communities, particularly among those who don’t smoke:
Pledging to be smoke-free demonstrates an active commitment and motivation to change. Evidence shows that when someone makes a public declaration (pledge) they are more likely to follow through with that promise, both for themselves, but also because of what others might think of them if they don’t maintain their promise. We also know that people are more likely to stick with a commitment that has real value, purpose and meaning to them.
Smoke-free pledges are a good population health promotion tool because:
The Wellington Aboriginal Corporation Health Service Quit B Fit Team encouraging people to take a pledge to not smoke in their homes, cars and workplaces
You can find further information on smoke-free environments in the video and factsheet produced by NBPU TIS which can be downloaded here.
