Thank you for vaping
Reflections on Big Tobacco and the long game of systems change
Image by CDC on Unsplash
For decades, tobacco use in Australia has been on a steady decline. This outcome has been attributed to the persistent, cross-sectoral actions levied against tobacco use, including well-funded social marketing campaigns, changes to government policy, stringent advertising regulations, and regular tobacco price hikes 1,2. Yet despite the ongoing efforts, the spectre of Big Tobacco has once again reared its ugly head – only this time it’s mango flavoured and shaped like a USB flash drive.
Over the past few years, vaping has exploded in popularity, particularly amongst adolescents and young people3. Vaping has become such an issue in schools that one senior college in Canberra recently installed sensors designed to alert teachers to the air anomalies caused by e-cigarettes and vapes4. The pivot to these ‘next generation products’ and their widespread popularity is testament to the persistent innovation of the tobacco industry and their efforts to influence public attitudes and behaviours towards smoking5.
Vaping has been marketed as healthier, cheaper and more socially acceptable than conventional cigarettes, and Big Tobacco has taken advantage of the radical shift in advertising brought about by the Internet, targeting ever-younger audiences through the digital offerings of trusted brands and social media influencers6,7. So, what does this tell us about the nature of change – not only how to instigate it, but perhaps more importantly, how to maintain it?
The meteoric rise in vaping can be attributed to a series of small, strategic, coordinated changes over time. A significant component of systems change relies on recognising that it is as much of a process as an end state. Foster-Fishman et al. emphasise the importance of ‘an ongoing and iterative approach to systems analysis and solution development’8. In other words, oppositional forces do not relent when a change is successfully implemented, so ongoing effort is required to make change ‘stick’.
One key component to maintaining systems change is the availability of human, social and economic resources in the change effort. Even if the key actors in a system are on board with the attitudes and values embodied by an initiative, without the necessary knowledge, skills or abilities required to implement the system changes, it’s unlikely that change efforts will succeed8.
Continuing to build capacity in a way that’s responsive to changes in the system more broadly can strengthen change efforts and encourage resilience and adaptive action amongst system actors. While the public health community gears up (yet again) to take on Big Tobacco, those of us working in the field of systems change have been delivered a sobering reminder of the importance of playing the long game!
References
Pierce JP, Macaskill P, Hill D. (1990). Long-term effectiveness of mass media led antismoking campaigns in Australia. American Journal of Public Health. 80(5):565–9.
Wakefield MA, Durkin S, Spittal MJ, Siahpush M, Scollo M, Simpson JA, et al. (2008) Impact of Tobacco Control Policies and Mass Media Campaigns on Monthly Adult Smoking Prevalence. American Journal of Public Health. 98(8):1443–50.
Lung Foundation Australia. Vaping and Young People for Educators. 2021. (Factsheet). Available from: <https://lungfoundation.com.au/wp-content/uploads/2021/07/Factsheet-Vaping-and-Young-People_For-Educators-Jul2021.pdf>, archived at <https://archive.ph/iaVPd>.
Lansdown S. (2022) Schools install vape detectors as experts warn of new generation of smokers. The Canberra Times. [Accessed Aug 2022]. Available from: <https://www.canberratimes.com.au/story/7866576/schools-install-vape-detectors-as-experts-warn-of-new-generation-of-smokers/>, archived at <https://archive.ph/c56zn>.
University of Bath. (2022). E-cigarettes. Tobacco Tactics. [Accessed Aug 22]. Available from: <https://tobaccotactics.org/wiki/e-cigarettes/>, archived at <https://archive.ph/ODUYl>.
Reuters. (2020). Juul bought ad space on kids’ websites, including Cartoon Network, lawsuit alleges. NBC News. [Accessed Aug 22]. Available from: <https://www.nbcnews.com/health/vaping/juul-bought-ad-space-kids-websites-including-cartoon-network-lawsuit-n1136086>, archived at <https://archive.ph/Y4w5h>.
Hancock A. (2019). Marlboro maker teams up with Vice for vaping push. Financial Times. 2019. Available from: <https://www.ft.com/content/9015a516-4b1d-11e9-8b7f-d49067e0f50d>, archived at <https://archive.ph/iUPoB>.
Foster-Fishman PG, Nowell B, Yang H. (2007). Putting the system back into systems change: a framework for understanding and changing organizational and community systems. American Journal of Community Psychology. 39(3–4):197–215.