Up in smoke: Anatomy of a statewide campaign

June 5, 2013

The findings of a large health populations survey about Oregon surprised many health policy experts around the country in May.

While looking at the general health outcomes over a five-year period, researchers compared objective health measurements among those covered by the Oregon Medicaid program versus uninsured Oregonians. And they did not see any discernible differences in overall health status.

The Oregon Medicaid Experiment’s findings also may have considerable influence over what we think we know and can predict about consumer behavior.

You can infer that insurance does not equal access, and that access does not equal health improvement or better outcomes for a defined population.

It’s a lesson that PR professionals have learned in the past: Outputs do not equal outcomes.

Thinking differently

In health care policy and communications, we can see how market dynamics define patients’ broadening use of social media. Dubbed “Patients 2.0,” people are engaging online to share information and make important health care and household decisions. As communicators, we have to think in new ways about the necessary platforms available for this new Patient 2.0.

The changes in health care policy and practice at all possible levels — national to hyperlocal — are impacting Patient 2.0. This person must go out into the open market to evaluate and purchase health coverage as well as general goods and services, to which they now have more access.

Launching a broad-scale campaign

In these days of declining budgets, stretched rsources and information overload, implementing a business advocacy campaign requires specific skills and discipline.

Look at the “Quitters are winners” 2010 campaign in Oregon. Building on the basic tenet of public relations — creating positive change — an opportunity arose to change the unhealthy behavior of tobacco use. Ending smoking and tobacco use not only saves lives, but also precludes millions of dollars in spending for businesses on employee sickness and loss of productivity, as well as for health care entities.

Cultivating advocates

The foundation of any grassroots advocacy campaign is to cultivate people who will help your cause. In this case, a key element was the first kindling to ignite the effort — a proposed piece of legislation requiring health insurers to cover at least $500 worth of benefits to help 544,000 Oregonians quit smoking. If successful, then Oregon would be the first state to have a law with such comprehensive benefits. But the law’s passage was only the first, small step.

The state now needed a broad-based statewide campaign to “pull through” the new law to inform consumers and the health care community. The goal was to drive them to action (quitting tobacco) or influencing others to do the same. Local and national health organizations, providers and public health experts formed a coalition around this opportunity.

Building strength and doing research

Health groups, health researchers, insurers, physician groups, patient advocates and PR pros also joined the coalition to launch the “Quitters are winners” campaign. This voluntary coalition first gathered several types of primary and secondary research to develop the communications goals and objectives.

During the legislative work, this coalition worked to educate policymakers with the voice of public health experts to create awareness of the legislation that aimed to curtail tobacco use.

As a coalition, we reviewed state reports to obtain current rates of smoking and tobacco use among various populations, which also helped us develop our motivation messages. We discovered the following about Oregonians:

  • 544,000, or 17 percent, use tobacco.
  • 80 percent who smoke want to quit.
  • 51 percent tried to quit this past year.
  • 45 percent say they plan to quit in the next 30 days.
  • The state “Quit Line” call volume showed 2,962 callers sought help in the seven months before the campaign began.

The team combed through a myriad of data sources to understand the breadth of the smoking and tobacco use addiction facing Oregonians, and to understand motivators for quitting to help us develop our messages and target audiences.

Pre-campaign surveys showed that 75 percent of consumers and 39 percent of providers were unaware of the potential new benefits of the law.

Moving to action

After reviewing the data and research, we defined two overarching goals, which were:

  1. Work with the coalition to pass the new law.
  2. Raise awareness so that once the law passed, tobacco users would seek help and ultimately, quit smoking.

We also knew that a means to our success would be to reach out to advocates for their feedback and recommendations. So we defined our tagline, “Quit. This time it’s covered,” with one clear message: “Quitters are winners in Oregon.”

The law passed, but we knew our work was just beginning.

To engage the advocates, we held a kick-off meeting for a focus group-type discussion to align strategies and messaging, crystallize the timeline and communications plan, and target messaging for the medical audience and underserved populations.

Finally, we selected and provided spokesperson training for a well-known physician, who had a background helping the U.S. Surgeon General’s office develop national tobacco cessation guidelines.

Integrating tactics

With diverse audiences, we knew that a fully integrated and coordinated campaign was crucial to “pull through,” or raise awareness that this new law was now a new health benefit that Oregonians have access. to. We developed fact sheets, template presentations and direct mailings for physicians; implemented one-on-one media briefings and pitches; and visited health fairs and events.

We worked to support, implement and place the following:

  • More than 40 articles, interviews and guest commentaries in the state and national media
  • A letter signed by our physician spokesperson that we sent to 9,000-plus Oregon physicians
  • The My Time To Quit website
  • A new online health service called Oregon Healthwire 
  • A Facebook page
  • A monthly newsletter, Health Access and Innovation News

Our strategy for earned media placement was to barnstorm Oregon’s community and daily newspapers and broadcast media, and utilize social media channels to reinforce the key messages. We were successful in pitching story leads as well as placing guest commentaries and op-eds.

We mostly used social media to attract those in the profile of Patient 2.0, who are exploring and gleaning from multiple communications channels.

Looking at the campaign’s success

After the law passed and we implemented the campaign, we conducted post-campaign research to quantify our success. Here’s what we learned:

  • Awareness of the benefit increased by 21 percent among consumers.
  • More physicians — an 18 percent increase from the start of the “Quitters are winners” campaign — knew about the law’s benefits and reported that more patients requested to utilize the benefits.
  • The volume of calls to the Oregon Quit Line grew 9 percent.
  • The advocates expanded their reach and invited insurers and others to join a new coalition called “Helping Benefit Oregon Smokers.”
  • Seven college and employer campuses implemented smoke-free workplace policies.
  • Seven states began work to put a similar tobacco coverage law into practice.

We found that consumers used the social media channels a great deal. And many used them to encourage family or friends to find out more information about quitting smoking.


Dianne Danowski Smith, APR, Fellow PRSA
Dianne Danowski Smith, APR, Fellow PRSA, is vice president of Publix Northwest PR + PA, an affiliate of Todd Myers Communications, Inc., a regional multi-disciplinary firm dedicated to innovative communications and market development. Follow her on Twitter: @DiannePublixPR.


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