Prepared for Health Canada
Supplier Name: Phoenix SPI
Contract Number: CW2236506
Award Date: 2022-07-25
Contract Value: $87,693.65 (including applicable taxes)
Delivery Date: 2022-11-30
Registration Number: POR #018-22
For more information on this report, please contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca
Ce rapport est aussi disponible en français.
Evaluation of Public Education Tool and Resources for the Tobacco Cessation Program
Final Report
Prepared for Health Canada
Supplier name: Phoenix Strategic Perspectives Inc.
November 2022
This public opinion research report presents the results of 11 online focus groups conducted with Canadian adults, aged 35 to 64 years, who said they smoke cigarettes daily. Three sessions were conducted with those living in Ontario, two sessions with those living in Quebec (conducted in French), two sessions with those living in a Prairie province (Manitoba, Saskatchewan, and Alberta), two sessions with those living in Atlantic Canada (Newfoundland, Nova Scotia, Prince Edward Island, and New Brunswick), and one session each with those living in British Columbia and Northern Canada (Yukon Territory, Northwest Territories, and Nunavut). The research was conducted September 7 through 14, 2022.
This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at:
HC.cpab.por-rop.dgcap.SC@canada.ca or at:
Communications and Public Affairs Branch
Health Canada
200 Eglantine Driveway, Jeanne Mance Building
AL 1915C, Tunney's Pasture
Ottawa, Ontario K1A 0K9
Catalogue number:
H14-420/2022E-PDF
International Standard Book Number (ISBN):
ISBN 978-0-660-46025-3
Related publications (registration number: POR 018-22):
Catalogue number (Final report, French) H14-420/2022F-PDF
ISBN 978-0-660-46026-0
© His Majesty the King in Right of Canada, as represented by the Minister of Health, 2022.
Cette publication est aussi disponible en français sous le titre :Évaluation d'outils et de ressources de sensibilisation pour le Programme de renoncement au tabac
Health Canada commissioned Phoenix Strategic Perspectives (Phoenix SPI) to conduct qualitative public opinion research (POR) with Canadians aged 35 to 64 who smoke cigarettes daily to validate a series of tobacco cessation communication products.
The leading preventable cause of premature death in Canada continues to be tobacco. Each year, approximately 48,000 Canadians die from a tobacco-related disease. While tobacco use has decreased, a significant number of Canadians still use tobacco. The Government of Canada announced a target of less than 5% tobacco use by 2035 to reduce the death and disease burden of tobacco use. Public education and tobacco cessation communications products support efforts to reach this target.
The purpose of this qualitative research was to validate new tobacco cessation communication products for the upcoming marketing campaign. The objectives were to: 1) explore reactions to the communication products to identify potentially encouraging and/or stigmatizing elements; 2) determine if the call to action in the products is effective; and 3) assess whether viewing the products result in any immediate gains in knowledge or changes in personal intentions for cessation.
To meet the objectives, 11 virtual focus groups were conducted with Canadian adults (aged 35 to 64) who indicated they smoke daily. Three sessions were conducted with those living in Ontario, two sessions with those living in Quebec (conducted in French), two sessions with those living in a Prairie province (Manitoba, Saskatchewan, and Alberta), two sessions with those living in Atlantic Canada (Newfoundland, Nova Scotia, Prince Edward Island, and New Brunswick), and one session each with those living in British Columbia and Northern Canada (Yukon Territory, Northwest Territories, and Nunavut). Participants received an honorarium of $125. The fieldwork took place between September 7 and 14, 2022.
Participants are aware of smoking cessation tools and supports and most frequently identified NRTs and "cold turkey" as tools they have tried during a quit attempt.
Overall reaction to the two ads participants were shown tended to be divided between positive and neutral/indifferent reactions. Specifically, many participants reacted positively to the ads, slightly more were neutral or indifferent, and a few reacted in an overall critical or negative way.
Nearly half the participants said that these ads encouraged or motivated them to find out more about quit tools/supports and encouraged or motivated them to combine quit tools/supports.
Overall, most participants reacted positively to the two resource videos. Reactions that were not positive were more likely to be neutral/indifferent than negative, with some participants attributing their indifference or neutrality to not being ready or willing to quit smoking.
After reviewing the ads and resource videos, a majority of participants said that their views on supports or tools used to quit smoking had changed since the beginning of the session.
A few themes emerged in a recurring fashion as part of participants' positive assessments of the communications materials presented to them.
Three aspects of the ads and the videos tended to resonate positively with participants. This includes positive messaging, new information, and data/statistics/evidence.
Positive messaging was more likely to be identified as something participants liked in relation to the ads, but it was also something many reacted to positively to in the resource videos. Examples of positive messaging included the overall tone of the ads and videos (which was described as 'positive', 'motivating', 'personable', 'encouraging', 'non-judgmental'), the focus on success and overcoming challenges, and the focus on self-empowerment/helping people who smoke help themselves.
The impact of what participants referred to as positive messaging was evident in two ways. First, the reason most often given to explain why the resource videos encourage participants to find out more about the best ways to quit smoking as well as use some of the referenced quit tools and/or combine them was that combining approaches can improve one's chances of quitting. Second, the reason identified most often to explain why the ads motivate participants to combine quit tools/supports was also the idea that combining approaches can be successful or improve one's chances of success in quitting smoking.
The inclusion of new information was also a feature of the communications materials that elicited positive reactions from many participants. This included the idea of using a quit plan, reference to specific resources participants were not aware of before, such as Cytisine (a natural health product), and the idea that combining options can increase the likelihood of success. The impression that communications materials provide new information was identified as a reason why the materials grab participants' attention, why the materials are considered relevant/useful, and why the materials motivate them to learn more about resources. Conversely, one of the main reasons participants reacted neutrally or indifferently to the materials and were not interested in learning more about them was the impression that they do not provide any new information.
Finally, positive reaction to the inclusion of data/statistics/evidence was most obvious in relation to 'What's the best way to quit smoking?'. One of the main reasons explaining positive overall reactions to this resource video was the inclusion of evidence (e.g., combining methods can almost double or triple one's chances of quitting smoking). Some also described as new and/or useful/relevant to them the information that combining certain methods can almost double or triple one's chances of quitting smoking.
The results from the virtual focus groups cannot be quantified or generalized to the full population of Canadians between the ages of 35 and 64 who smoke cigarettes on a daily basis (i.e., they are not statistically projectable), but they do offer detailed opinions about the issues explored through this research. As such, the results will be used by Health Canada to inform the development of tobacco cessation communication products and to identify potential topics of interest for future research.
The contract value was $87,693.65 (including applicable taxes).
I hereby certify as a Senior Officer of Phoenix Strategic Perspectives that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Communications Policy of the Government of Canada and Procedures for Planning and Contracting Public Opinion Research. Specifically, the deliverables do not contain any reference to electoral voting intentions, political party preferences, standings with the electorate, or ratings of the performance of a political party or its leader.
Alethea Woods
President
Phoenix Strategic Perspectives Inc.
The leading preventable cause of premature death in Canada continues to be tobacco. Each year, approximately 48,000 Canadians die from a tobacco-related disease. While tobacco use has decreased, a significant number of Canadians still use tobacco. According to recent data (2021 Canadian Community Health Survey [CCHS]), approximately one in 10 Canadians use tobacco and six in 10 people who smoke daily are between the ages of 35 and 64 years.[3]
The Government of Canada announced a target of less than 5% tobacco use by 2035 to reduce the death and disease burden of tobacco use. Reaching this target can be expected to save millions of lives and billions of dollars. Public education and tobacco cessation communications products support efforts to reach this target. The 2022-23 marketing campaign contained a few novel and nuanced approaches. Health Canada, therefore, commissioned public opinion research (POR) to validate these new products for the upcoming marketing campaign. The target audience for this research is Canadians aged 35 to 64 years who smoke daily.
The products tested included the following:
The objectives for this research were as follows: 1) to explore reactions to the communication products to identify potentially encouraging and/or stigmatizing elements (e.g., messaging, imagery, etc.); 2) to determine if the call to action in the products is effective (i.e., will the target audience respond to the call to action, why/why not); and 3) to assess whether viewing the products result in any immediate gains in knowledge or changes in personal intentions for cessation.
Research results will be used by Health Canada to better understand how the overall campaign might be received by the target audiences—specifically, whether the campaign is clear, informative, helpful, and non-stigmatizing in its current format.
To meet the objectives, a set of 11 virtual focus groups were conducted with Canadian adults (aged 35 to 64) who currently smoke daily. Three sessions were conducted with those living in Ontario, two sessions with those living in Quebec (conducted in French), two sessions with those living in the Prairie provinces (Manitoba, Saskatchewan, and Alberta), two sessions with those living in Atlantic Canada (Newfoundland, Nova Scotia, Prince Edward Island, and New Brunswick), and one session each with those living in British Columbia and Northern Canada (Yukon Territory, Northwest Territories, and Nunavut). All groups included a mix of participants by age (within the recruitment parameters), gender, education, ethnicity, income, length of time smoking cigarettes, living arrangement (with family, with roommates, on own), and community size (centres of under 100,000 people and centres of 100,000 or more). All participants received an honorarium of $125. The fieldwork took place between September 7 and 14, 2022.
This section presents findings related to participants' smoking habits and cessation attempts.
Most participants have been smoking for over a decade
The length of time that participants have been smoking varied considerably, ranging from two to three years to almost 50 years. The largest single proportion, close to half, indicated that they have been smoking for over 20 years, with most of the rest saying they have been smoking somewhere between 11 and 20 years. In contrast, just a few participants indicated that they have been smoking for 10 years or less.[4]
Most participants smoke over five cigarettes per day
Most participants said they smoke over five cigarettes a day. Approximately one-third smoke between six and 10 cigarettes a day, and a similar proportion smoke between 11 and 20 cigarettes a day. The remaining participants were more likely to smoke five cigarettes or less a day (only a few said they smoke over 20 cigarettes a day). A few participants volunteered that the number of cigarettes they smoke per day can vary and sometimes depends on circumstances (e.g., the number of cigarettes smoked increasing on weekends/when not at work, when stressed).
Almost all participants have tried to quit smoking, and most have tried more than once
Almost all participants said that they have tried to quit smoking, and most reported trying to do so on more than one occasion. The largest single proportion, over one-third, indicated that they have tried to quit anywhere between two and five times, with most of the rest saying they have tried to quit more than five times. In addition, a few participants did not provide a number but specified that they have tried to quit many times. Few said they have tried to quit only once.
Routine and stress – most frequently identified challenges in trying to quit smoking
A number of challenges to quitting smoking were identified by participants, but the frequency with which they were identified varied. Two challenges to quitting were identified most often, each one by many participants. These included:
Challenges to quitting identified less often, but still with some frequency (i.e., mentioned by some participants) included living with someone who smokes, such as a spouse or partner, and lacking motivation to quit because smoking is enjoyable.
Infrequently mentioned main challenges (i.e., identified by no more than a few participants) included the following:
None of the following were identified as challenges to quitting by participants: the cost of quitting, the consequences of quitting (e.g., fear of weight gain), or uncertainty regarding types of quit aids/what approach to take or how to use quit aids.
Participants collectively aware of a variety of smoking cessation tools and supports
Participants had no difficulty identifying smoking cessation tools and supports available to someone wanting to quit smoking cigarettes. The most frequently mentioned tools, identified by many participants, were nicotine replacement therapies (NRTs), including gums, patches, lozenges, inhalers, and sprays, as well as prescribed medications, including Chantix, Bupropion and Zyban[5]. Smaller numbers (some participants) identified vaping, and hypnosis as smoking cessation tools and supports. A host of other tools and supports were identified by individuals or no more than a few participants. These included the following:
NRTs and cold turkey approach used most frequently by participants in smoking cessation efforts
As noted above, almost all participants said that they have tried to quit smoking. The most frequently identified ways for doing this (each identified by many participants) were the use of NRTs (including gums, patches, lozenges, and sprays) and the cold turkey method.[6] Two other ways identified less frequently, but by some research participants, were prescription medication(s) and vaping. All other ways tried by participants were identified by no more than a few participants and included the following:
Participants offered a variety of reasons for using tools/approaches
Participants were asked why they took the approach(es) they used when trying to quit smoking. Reasons provided included the following, none of which was provided by more than a few participants:
Feedback regarding the perceived effectiveness of tools/approaches was mixed
Perhaps not surprisingly, feedback on the tools and approaches that worked best or were most effective was varied and sometimes mixed—that is, what worked with one participant did not work with another. The only approach identified as successful or effective with any regularity (i.e., by some participants) was the cold turkey approach.[7]Among participants who described this approach as effective were a few women who noted that the only time(s) they were successful in quitting smoking for an extended period was during pregnancy.
Other approaches described as at least somewhat effective were identified by no more than a few individuals. These included vaping, prescription medication, NRTs (including the patch and gum), exercise/sports, and natural products. A few participants indicated that nothing they used was effective, while a few said that the approach they used was effective but also included negative side effects (e.g., nightmares, nausea, strep throat, rashes/itching).
Most participants said that they had not combined tools in their previous quit attempts, though many indicated that they have used different approaches in their smoking cessation efforts.
No consensus when it comes to using tools/supports in the future
As a follow-up to asking participants to identify the smoking cessation tools and supports that they have used, participants were asked which tools or supports they would be most likely to use if they decided to quit tomorrow. This was explored through an exercise in which participants were shown a list of potential tools or supports that someone could use to support their smoking cessation efforts and asked to select all the ones they would consider using. The list of tools and supports included the following:
There was no noticeable difference in preferences, with each tool or support being chosen by at least some participants. That being said, the options chosen most frequently were none or cold turkey approach (no tools or supports) and vaping. These were followed, in descending order of frequency, by counselling with a quit coach, nicotine gum/inhaler/lozenges, the nicotine patch and prescription medications, such as Varenicline or Bupropion, consulting their doctor or pharmacist, and taking Cytisine (a natural health product). 'Other' tools and supports volunteered by participants were laser treatment, acupuncture, hypnosis, injections, and sports.
Asked if they would use any of the tools or supports together, or in combination, during the same quit attempt, most participants said that they would not.
Mobile app top preference for information regarding smoking cessation
Participants were also asked to identify their preferred formats of information or supports to assist them in their smoking cessation efforts. This was also done via an exercise in which participants were shown a list of potential formats of information or support and asked to select all the ones they would prefer to use in their own quit efforts. The list included the following:
There were some noticeable differences in terms of participants' preferences.[8]The format identified most often, and the only one identified by a majority of participants, was a mobile app. Reasons given for preferring a mobile app had to do with its perceived convenience and accessibility. This included ease of use, and frequent use of one's phone/constantly having one's phone at hand. It was also suggested that an app could allow people who smoke to track their progress in their smoking cessation efforts (e.g., tracking the amount of money saved by not buying cigarettes).
Following a mobile app, participants expressed a preference for self-help guides, online short web videos, and a step-by-step questionnaire. Although not identified as frequently as the mobile app, each of these was identified by at least a third of participants. Some participants identified text message support services, a smoking telephone quit line, and online web text, while only a few identified a chat bot. Support groups were volunteered by some participants as another format for receiving information and support.
Only a couple of participants indicated that none of these options were appealing to them.
This section of the report presents participants' impressions of the first set of tobacco cessation materials developed by Health Canada[9]: two short video advertisements (15 seconds each) that would appear on social media, YouTube, news websites, and possibly in public places. The ads were shown to participants consecutively and discussed as a set. The order in which the ads were presented was rotated across groups.
Overall impressions divided between positive and neutral/indifferent reactions
Overall reaction to the ads tended to be divided between participants who reacted positively and participants whose reaction was neutral or indifferent. Specifically, many participants reacted positively to the ads, slightly more were neutral or indifferent, and a few reacted to the ads in an overall critical or negative way. A few participants who described their overall reaction as neutral or indifferent nonetheless identified aspects of the ads that they liked or reacted to positively.
Positive reactions to the ads were typically based on three things:
A few participants reacted positively to design features of the ads, including the overall presentation (which was described as attractive and crisp and clean), the music, the use of colour (including the colour combinations), and the pacing of the ads.
A few participants who reacted positively to the ads also volunteered that they preferred one version over the other version. Most of those who expressed a preference said they preferred Version 2 (I quit with a pharmacist advice…), based on the impression that the people in the ad look happier because of their prominent smiles. Version 1 (I quit with a quit coach…) was preferred because of the reference to quitting with a friend, described as a 'realistic' scenario.
Indifferent or neutral reactions to the ads were typically based on the following impressions:
Critical reactions to the ads were expressed by some participants[10], most often based on the impression that they are too fast/too short, resulting in an inability to register the information. Criticisms identified by no more than a few participants included the following:
In addition, a few reacted critically to things that elicited neutral or indifferent reactions from other participants, specifically the impression that the ads include no new information, are not personally relevant, and are boring/not attention-grabbing.
Most do not find ads attention-grabbing, mainly because they are too short/too fast
When asked specifically if these ads would grab their attention, most participants said no. The two reasons most often given to explain why were that the ads are too short/too fast and that they are too bland, i.e., there is nothing in the ads that jumps out or that would grab their attention. Other reasons were identified by no more than a few participants and included the following:
A few participants also observed that they do not tend to notice ads in general, and/or tend to skip ads when they are watching things online, occasionally adding that the shortness of these ads and/or the absence of speech makes them all the more likely to not notice them.
Participants who indicated that these ads would grab their attention provided the following reasons to explain why:
Asked if they would click on these ads to 'learn more', some said that they would.
The Target audience for the ads were usually identified as adults who smoke and those who want to quit
Asked who these ads are aimed at, participants most often identified people who smoke cigarettes who are ready to quit or interested in quitting and adults (as opposed to younger people who smoke). Among those who pointed to the latter as the target audience, estimates of the actual age group aimed at included those 35 and older, those 45 and older, those 50 and older, and 'older' people in general. Perceived target audiences other than these were identified by individuals or no more than a few participants and included the following:
Various quit options available and combining approaches – most frequently identified messages in ads
Participants had no difficulty identifying messaging communicated by these ads. Two ideas or messages communicated by the ads were most often identified by participants: one was the idea that there are a variety of ways to quit/different resources available, and the other was the idea of trying a combined approach/that a combined approach can help someone quit smoking.
Other messages detected in these ads were identified by no more than a few participants, and focused on or revolved around the following ideas:
There was widespread agreement that the ads communicate their message effectively, though a few participants felt that effectiveness of communication was impeded either by the shortness of the ads (i.e., they are too fast/too short to allow them to properly register the information), or by the absence of a voiceover which requires that they read the text.
Virtual unanimity that ads are credible and clear/easy to understand
There was a consensus that the ads are credible, and with the exception of the meaning of Cytisine (which a few participants said was not clear to them), there were no issues with the clarity of these ads.
Nearly half said they are encouraged to find out more about quit tools/supports and combine them
Nearly half the participants said that these ads encouraged or motivated them to find out more about quit tools/supports and encouraged or motivated them to combine quit tools/supports.
a. Finding out more about quit tools/supports
The reason identified most often to explain the motivation to find out more about quit tools/supports was curiosity generated by the newness of information in the ads, particularly the idea of combining approaches. This was identified by many participants, and examples of new information included the information that tools can be combined, the reference to Cytisine, the idea of a quit coach, and support groups. Other reasons motivating participants to find out more about quit tools/supports were identified by individuals or no more than a few participants and included the following:
Those who said they are not motivated to find out more about quit tools/supports most often explained that they are not interested in quitting smoking. Other reasons participants are not motivated to find out more about quit tools/supports were identified by individuals or no more than a few participants and included the following:
b. Combining quit tools/supports
The reason identified most often to explain the motivation to combine quit tools/supports was the idea that combining approaches can be successful or improve one's chances of success in quitting smoking. Other reasons motivating participants to combine quit tools/supports were identified by individuals or no more than a few participants and included the following:
As was the case when it came to finding out more about quit tools/supports, those who said they are not motivated to combine quit tools/supports most often explained that they are not interested in quitting smoking. Other reasons were identified by individuals or no more than a few participants and included the following:
Many suggestions to improve the ads were offered, but there was no consensus
A variety of suggestions were offered to improve these ads, but all were mentioned by no more than a few participants. These included the following:
This section of the report presents participants' reactions to and impressions of two resource videos designed to provide information on quitting smoking. One video provides information about a quit plan and the other provides information about smoking cessation resources. Participants were informed that these videos would appear on YouTube and on a new Health Canada website. They were also informed (and reminded when appropriate during the discussion) that these were not advertisements but resources that people could interact with, e.g., they could access, view, pause, and rewatch them. The videos were shown to participants and discussed one at a time. As was the case with the ads, the order of presentation of videos was rotated across groups.
Overall, reactions to the two resource videos tended to be positive, and reactions that were not positive were more likely to be neutral/indifferent than negative. Specifically, a majority of participants indicated the following:
While a majority of participants reacted positively to both videos, some expressed preferences for one or the other. Specifically, in four groups, reaction to the quit plan video was more positive than reaction to the resources video while in three groups reaction to the resources video was more positive than the reaction to the quit plan video. In four of the groups, reaction to both videos was equally positive (i.e., one was not preferred over the other).
Overall impressions of the resource video tend to be positive
Most participants' overall reaction 'Your quit plan' tended to be positive and reactions that were not positive were more likely to be neutral/indifferent than negative. Positive reactions to the video were based on a number of things, but most often focussed on the following:
A host of other aspects of the video also elicited positive reactions, albeit from smaller numbers of participants. Specifically, some participants ascribed their positive reactions to the following:
Neutral or indifferent reactions to the quit plan resource video were based on the following:
Few participants reacted critically to the video in general.[11]Critical reaction to the video was ascribed to the following aspects of the video, none of which were identified by more than a few participants:
Majority describe 'Your quit plan' as effective in keeping their attention
More than half of the participants described 'Your quit plan' as effective in terms of keeping their attention in the sense that they would watch it from start to finish. Those who said that the video was not effective in this regard identified the following types of reasons to explain why:
Inability to relate to the narrator.'
Variations on the idea of a quit plan – most frequently identified message in this video
Participants had no difficulty identifying messages communicated by 'Your quit plan'. This most often included variations on the idea of a quit plan, such as the following: there's a road map/steps to take to help; have or make a quit plan; and a plan will improve the likelihood of success in quitting smoking. Other messaging identified in this video were identified by individuals or no more than a few participants and included the following:
Near unanimity that 'Your quit plan' is credible and clear/easy to understand
There was a virtual consensus that 'Your quit plan' is credible, as well as clear and easy to understand. While a few participants re-iterated that they would not use a quit plan or that they have tried this unsuccessfully, they did not call into question the credibility of the video, or the information provided.
The idea of making a plan was most often identified as new and relevant/useful information
More than half of the research participants said that they learned something from 'Your quit plan' or found information that is useful/relevant to them. When identifying what they learned or what was relevant to them, participants most often pointed to the idea of using a quit plan (identified by many participants). Additional information described as new and/or useful/relevant was identified by no more than a few participants and included the following:
A few participants said that, although they learned nothing new from 'Your quit plan', it is a good refresher/reminder about what to think about when trying to quit smoking.
Participants who described the information in 'Your quit plan' as not useful or relevant to them most often explained that they are not ready/willing to quit smoking.[13]Other reasons identified infrequently included the following:
Majority encouraged to find out more about making a quit plan and using one
A majority of participants said 'Your quit plan' encouraged or motivated them to find out more about making a quit plan as well as to use one.
a. Finding out more about making a quit plan
The reason identified most often to explain the motivation to find out more about a quit plan was never having considered this before/the newness of the information. Other reasons participants were motivated to find out more about a quit plan were identified by no more than a few participants and included the following:
Participants who said they were not motivated by 'Your quit plan' to find out more about a quit plan tended to reiterate reasons given when explaining why the information in the video is not useful or relevant to them. Once again, the most frequently given reason was not being ready/willing to quit smoking, with the following being identified infrequently:
b. Using a quit plan
Reasons provided by participants to explain why they are motivated to use a quit plan tended to echo reasons given for being motivated to find out more about a quit plan. The reason identified most often was never having considered using a quit plan. Other reasons were identified by no more than a few participants and included the following:
In a similar way, reasons provided by participants to explain why they are not motivated to use a quit plan tended to echo reasons for not being motivated to find out more about one. The most frequently given reason was not being ready/willing to quit smoking, with the following being identified infrequently:
Various suggestions to improve 'Your quit plan' were offered, but there was no consensus
A variety of suggestions were made to improve this video, but all were mentioned by no more than a few participants only. These included the following:
Overall impressions of resource video tend to be positive
As was the case for 'Your quit plan', most participants' overall reaction to 'What's the best way to quit smoking?' tended to be positive, with reactions that were not positive more likely to be neutral/indifferent than negative. Positive reactions to 'What's the best way to quit smoking?' tended to focus on the following:
A host of other aspects of 'What's the best way to quit smoking?' also elicited positive reactions, although each item in the list below was mentioned by no more than a few participants. These included the following:
Neutral or indifferent reactions to 'What's the best way to quit smoking?' tended to be based on not being ready/willing to quit smoking, the impression that the video provides no new information, and being provided with a number of options without any real guidance/direction (e.g., which tools can and cannot be combined).
No more than a few participants offered critical reaction to 'What's the best way to quit smoking?', including:
Majority describe 'What's the best way to quit smoking?' as effective in keeping their attention
More than half the research participants described 'What's the best way to quit smoking?' as effective in terms of keeping their attention in the sense that they would watch it from start to finish. Those who said that 'What's the best way to quit smoking?' was not effective in this regard identified the following to explain why:
Combining approaches and the number of options available – most frequently identified messages in 'What's the best way to quit smoking?'
Participants had no difficulty identifying messaging communicated by this video. Two messages were identified most often (each by many participants). One was the idea that combining approaches can be successful/improve one's chances of quitting, and the other was that there are many tools/options for quitting smoking.
Messages identified by no more than a few participants included the following:
Near unanimity that 'What's the best way to quit smoking?' is credible and clear/easy to understand
There were no issues with the clarity of 'What's the best way to quit smoking?' and with one exception, no issues related to its credibility. Regarding the latter, a few participants did not like the reference to vaping given that it is not an approved smoking cessation technique. Without calling into question the credibility of the video, it was suggested that the reference to 'studies show …' is too general or vague. Similarly, without calling into question the clarity or ease of understanding of the video, it was suggested that the video contains a lot of information that would need to be reviewed in order to be properly processed or digested by viewers.
The idea of combining approaches most often identified as new and relevant/useful information
The majority of participants said that they learned something from 'What's the best way to quit smoking?' or found information that is useful and relevant to them. In explaining what they learned or what was relevant to them, participants most often pointed to the idea of combining approaches (identified by many participants).
Some participants identified specific information that they described as new and/or useful/relevant to them, including information about Varenicline, Bupropion, Cytisine/natural health products, and group counselling. Some also described as new and/or useful/relevant to them the information that combining certain methods can double or triple one's chances of quitting smoking.
Participants who described the information in 'What's the best way to quit smoking?' as not useful nor relevant to them most often explained that they are not ready to quit smoking.[14] Other reasons identified infrequently included the following:
Being provided with different options but without any real guidance (e.g., which tools can and cannot be combined).
Majority encouraged to find out more about the best ways to quit and use/combine tools/supports
More than half the research participants said that 'What's the best way to quit smoking?' encouraged or motivated them to find out more about the best ways to quit smoking as well as use (or at least investigate this as a possibility) some of the referenced quit tools and/or combine them.
a. Finding out more about best ways to quit
The reason identified most often (by many participants) to explain the motivation to find out more about the best ways to quit was that combining approaches is recommended and can improve one's chances of quitting. Some said they were motivated to find out more because of learning about resources they had not heard about before, such as Varenicline, Bupropion, Cytisine/natural health products, and group counselling.
Other reasons participants were motivated to find out more about ways to quit were identified by no more than a few participants and included the following:
Participants who said they were not motivated to find out more about ways to quit tended to reiterate reasons given when explaining why the information in the video is not useful or relevant to them. Once again, the most frequently given reason was not being ready to quit smoking, with the following being identified infrequently:
b. Using/combining resources/tools
Reasons provided by participants to explain why they are motivated to use some of the referenced quit tools/resources and/or combine them tended to be the same reasons given for being motivated to find out more about the best ways to quit. The reason identified most often was the idea that combining approaches can improve one's chances of quitting.
Other reasons were identified by no more than a few participants and included the following:
In a similar way, reasons provided by participants to explain why they are not motivated to use some of the referenced quit tools/resources and/or combine them tended to mirror the reasons for not being motivated to find out more about them. Once again, the most frequently given reason was not being ready to quit smoking, with the following being identified infrequently:
Some suggestions offered to improve 'What's the best way to quit smoking?'
A variety of suggestions were made to improve this video, but all were mentioned by no more than a few participants:
This brief section of the report presents participants' reactions to potential names/titles for the advertising campaign's webpage on Health Canada's website. Participants' preferences were solicited via an exercise in which they were shown the potential names/titles and asked to select the one they preferred. The four options were the following:
In response, participants were most likely to choose Tools for a smoke-free life. This was followed in by Quit with confidence, Your way to be smoke free, and Equipped to quit smoking. In addition to being the overall favourite, Tools for a smoke-free life was more likely to be chosen than any other option in nearly half of the groups. When probed about their reason for preferring Tools for a smoke-free life, participants tended to focus on the word 'tools' and the idea of 'fixing things' or 'problem-solving'.
This brief section reports on the extent to which participants' opinions towards/views on smoking cessation supports or tools changed because of the materials they were shown as part of the focus group.
Majority say their views on supports/tools have changed because of materials shown
After reviewing the materials, participants were asked if their opinions towards/views on supports or tools used to quit smoking changed since the beginning of the session. In response, more than half the participants (including at least a few in every group) said that their views had changed after having reviewed the materials. Such changes most often took the form of being more inclined to use/consider a quit plan and looking into combining various approaches (many adding that they did not know that doing so was safe and/or that they did not know that combining approaches could increase the likelihood of success).
Changes identified less frequently included the following:
Close to half say their views on the tools they would try have changed because of the materials
Participants were also asked if there were any changes in which tools they would try to support their quit efforts as a result of the materials they were shown. In response, close to half (at least a few participants in most groups) said that their views had changed in one way or another. Such changes most often took two forms (each one identified by many participants). One was being more likely to combine or consider combining approaches (e.g., natural/herbal options[15]+ quit coach, natural/herbal options + support groups). The other was being more inclined to use or consider using a quit plan.
Some participants said that they would consider the use of natural health products to help them in their smoking cessation efforts because of seeing the materials.
Other changes identified by only a few participants included looking into/inquiring about specific strategies (including Cytisine, Varenicline, Bupropion, quit coaches, and support groups), being more likely to consider NRTs, and consulting with a physician on smoking cessation strategies.
A few participants said that while there was no real change in what they would try to support their quit efforts, they feel better informed because of the materials they were shown.
Ads:
Version 1:
SCENE |
TEXT ELEMENTS |
|---|---|
010 |
You know why you want to quit smoking |
020 |
What about how? |
030  |
I quit with A quit coach Nicotine patches |
050  |
I quit with A friend Vaping |
060 |
Combine the right tools and support to improve your chances of success! |
070 |
Canada.ca/quit-smoking |
Version 2:
SCENE |
TEXT ELEMENTS |
010 |
You know why you want to quit smoking |
020 |
What about how? |
040  |
I quit with Pharmacist advice Medication |
050  |
I quit with A support group Cytisine |
060 |
Combine the right tools and support to improve your chances of success! |
070 |
Canada.ca/quit-smoking |
1: Your quit plan
Scene |
Spoken Elements |
On-Screen Action |
010 |
Branded intro. Title appears: Your quit plan |
|
020 |
If you're looking to quit smoking, making a quit plan can improve your chances. But what is a quit plan? Basically, it's a set of steps you can use to prepare your next quit attempt. A quit plan will help you think through challenges and how to overcome them. And if you've tried to quit before, you can use what you've learned in the past to help make this quit attempt successful. |
Open on host in front of light textured backdrop. They are standing, addressing the camera directly, and gesture with their hands to help make their point. Motion graphics and text elements appear in the space around them. What is a quit plan? 7 steps |
030 |
So how do you make one? Let's walk through some of the key steps together. First, list your reasons for wanting to quit smoking. Is it for your health? Your family? Being reminded of your reasons can help keep you motivated. |
Text element appears: 1. Clearly state your reasons for quitting Motion graphics build out depicting the process and making a clear statement. |
040 |
Also, think about any concerns you might have and how you can deal with them. Let's say, you're afraid it'll be hard. You could plan to ask someone you trust for support. Concerned about withdrawal symptoms? You might plan to call your doctor, or maybe the quitline. Next, identify your personal triggers. Is it stress? Seeing others smoke? Your coffee break? Understanding where and in what situations you smoke will help you prepare. |
Text element appears: Motion graphics build out depicting the process and worrying and then triggers. Text element appears: |
050 |
When a craving hits, it will be easier to resist if you have a strategy in place for what to do instead. Some people go for a walk, others might grab a healthy snack. Nicotine replacement therapy and other medications can help reduce the frequency and severity of cravings. |
Text element appears: Motion graphics build out depicting the process and responding to cravings. Nicotine replacement therapy can reduce cravings |
060 |
And, of course, you'll need to decide how you want to quit. Combining the right tools and support can give you the best chance of success. If you tried quitting before, what helped, what didn't? What could you do differently? Will you cut down over time or stop smoking all at once? Will you do it on your own or get support from friends, family or an app? Will you use approved quit aids such as prescription medication? Nicotine patches or gum? Connecting with a quit coach? |
Text element appears: Motion graphics build out depicting the process and cutting down vs cold turkey, then various quit aids. Text element appears: |
070 |
And finally, pick a date to quit. Give yourself enough time to prepare, but don't put it off. |
Text element appears: Motion graphics build out depicting the process and picking a date. |
080 |
Those are the basics of a quit plan. You can create your own or visit our quit plan tool to make your plan online. |
Motion graphics build out depicting writing down a plan or creating one online. |
090 |
Having a plan can help you resist cravings, overcome challenges and stay motivated. And remember, you can do this! |
The host wraps the story up. |
100 |
Text elements appear: Make your plan at Canada.ca/quit-smoking Branded extro and FIP elements. |
2: 'What's the best way to quit smoking?'
Scene |
Spoken Elements |
On-Screen Action |
010 |
Branded intro. Title appears: What's the best way to quit smoking? |
|
020 |
Nicotine gum, the patch, quitting cold turkey. These are just some of the ways that people quit smoking. Maybe you've tried some yourself? |
Open on host in front of light textured backdrop. They are standing, addressing the camera directly, and gesture with their hands to help make their point. Motion graphics and text elements appear in the space around them. |
030 |
But did you know that you can combine certain quit aids together? Studies suggest that the right combination of tools and support can almost triple your chances of quitting smoking! Could these methods be right for you? Let's take a look at what the evidence suggests could help… |
Text element appears: |
040 |
One winning strategy is combining nicotine replacement therapies (or NRTs). When you combine the patch, which is long-acting, with any short-acting NRT like nicotine gum, inhalers or lozenges, you can almost triple your chances of success! |
Motion graphics build out depicting the methods and combinations. Text elements appear: |
050 |
Equally effective is pairing prescription varenicline medication with expert advice or support – whether that's one-on-one or group counselling, calling a quit line, or talking to your healthcare provider. |
Motion graphics build out depicting the methods and combinations. Text elements appear: Varenicline medication + Counselling (One on One, Group Counselling, Call a quitline, Healthcare provider) |
060 |
Some methods can help a lot on their own. Choosing any one form of NRT – say the patch or nicotine gum – can almost double your chances. The same can be said for prescription bupropion medication and for counselling sessions, say with a Quit Coach. |
Motion graphics build out depicting the methods. Text elements appear: Some methods on their own almost double your chances |
070 |
Other newer methods, including getting support through text messages, and using the natural health product Cytisine, have also been shown to improve your chances. |
Motion graphics build out depicting the methods. Text elements appear: Other methods can improve your chances |
080 |
What about vaping? While vaping products have not been approved in Canada as a quit smoking aid at this point, some studies have found vaping nicotine can be more effective than NRT or counseling alone. If you're unable to quit smoking using approved methods, switching completely to vaping can significantly reduce your exposure to the toxic chemicals from tobacco smoke. |
Motion graphics build out depicting a vaping product. Text elements appear: Canadians are attempting to quit smoking by vaping |
090 |
While many people eventually succeed by quitting suddenly without assistance, you know: "cold turkey," - it can be rough and require multiple tries. Willpower is important but as we've seen, it doesn't have to be your only tool. |
Motion graphics build out depicting the methods. Text elements appear: The thing about cold turkey… |
100 |
The good news is that you have a lot of options -whether you try something again, try something new or try a combination of things. There's no wrong way to quit. The best way to quit smoking is the one that works for you! |
The host wraps the story up. |
110 |
Text elements appear: Learn more at Canada.ca/quit-smoking Branded extro and FIP elements. |
A set of 11 virtual focus groups was conducted with Canadians aged 35 to 64 who said they smoke cigarettes on a daily basis. Three groups were conducted with residents of Ontario, two groups respectively with residents of Quebec (French), the Atlantic region (Newfoundland, Nova Scotia, Prince Edward Island, and New Brunswick), and the Prairies (Manitoba, Saskatchewan, and Alberta), and one group respectively with residents of British Columbia and Northern Canada (Yukon Territory, Northwest Territories, and Nunavut).
Recruitment adhered to the Government of Canada's Standards for the Conduct of Government of Canada Public Opinion Research – Qualitative Research. Participants outside the of three Territories were recruited by telephone through CRC Research's opt-in database of 450,000 adults aged 18+ (CRC Research was responsible for recruitment as a subcontractor). Canadians living in the Territories were recruited by Elemental Data Collection (also responsible for recruitment) via random digit dialling (RDD). The same recruitment screener was used for populations. The identity of the client was revealed (i.e., the Government of Canada) during the recruitment interview.
When recruiting, individuals were offered the option to conduct the recruitment interview in English or French. All individuals recruited were fluent in the language in which the focus group was conducted. For the groups held with those residing in Quebec, the primary language of all recruited individuals was French and elsewhere it was English.
During the recruitment interview, potential participants were informed of their rights under the Privacy Act, Personal Information Protection and Electronic Documents Act and Access to Information Act. This included informing participants of the purpose of the research; that participation is completely voluntary; and that all information collected would be used for research purposes only. Verbal consent was also obtained from each participant prior to recording the virtual session.
These groups lasted 90 minutes and a total of 78 individuals participated in this research. All groups included a mix of participants by age (within the recruitment parameters), gender, education, ethnicity, income, length of time smoking cigarettes, living arrangement (with family, with roommates, on own), and community size (centres of under 100,000 people and centres of 100,000 or more people).
The fieldwork took place between September 7 and 14, 2022. All participants were paid an honorarium of $125 to thank them for taking part in the research.
Eligibility
INTRODUCTION:
Hello/Bonjour, my name is [INSERT]. I'm calling from Phoenix Strategic Perspectives, a Canadian public opinion research firm. Would you prefer to continue in English or French? / Préférez-vous continuer en français ou en anglais?
[RECRUITER NOTE: FOR ENGLISH GROUPS, IF PARTICIPANT WOULD PREFER TO CONTINUE IN FRENCH, PLEASE RESPOND WITH, "Malheureusement, nous recherchons des gens qui parlent anglais pour participer à ces groupes de discussion. Nous vous remercions de votre intérêt." FOR FRENCH GROUP, IF PARTICIPANT WOULD PREFER TO CONTINUE IN ENGLISH, PLEASE RESPOND WITH, "Unfortunately, we are looking for people who speak French to participate in this discussion group. We thank you for your interest."]
We're organizing a series of online discussion groups on behalf of the Government of Canada to explore issues of relevance to Canadians. Is there anyone in your household between the ages of 35 and 64? If so, may I speak with this individual?
INFORMATION:
The objective of these focus groups is to get feedback from Canadians on a number of communication products developed by the Government of Canada. Participation is completely voluntary and your decision to participate or not will not affect any dealings you may have with the Government of Canada. We are interested in your opinions and your experiences. No attempt will be made to sell you anything and at no point will you be asked to share personal information. The information collected will be used for research purposes only and handled according to the Privacy Act of Canada.* The format is an online discussion** with up to eight participants led by a research professional from Phoenix Strategic Perspectives. People who take part will receive a cash gift to thank them for their time. All opinions will remain anonymous and will be used for research purposes only in accordance with laws designed to protect your privacy.
May I continue?
NOTES TO RECRUITERS:
- *IF ASKED: The personal information you provide is governed in accordance with the Privacy Act and will not be linked with your name on any document including the consent form. In addition to protecting your personal information, the Privacy Act gives you the right to request access to and correction of your personal information. You also have the right to file a complaint with the Privacy Commissioner of Canada if you think your personal information has been handled improperly. The final report written by Phoenix SPI will be available to the public from Library and Archives Canada (http://www.bac-lac.gc.ca/).]
- **IF A POTENTIAL PARTICIPANT INDICATES THAT PARTICIPATING ONLINE IS NOT POSSIBLE FOR THEM (E.G., DUE TO LACK OF COMFORT, NO INTERNET ACCESS, NO COMPUTER, ETC.), SAY: Thank you for letting us know. You yourself do not need to have a computer and internet connection to participate. If you have a friend or family who could provide you with access to a computer, a high-speed Internet connection, and a Webcam for the online session, you would be able to participate. Would this be possible?
- IF AN INDIVIDUAL QUESTIONS THE VALIDITY OF THE RESEARCH, INVITE HIM/HER TO GO ONLINE TO CRIC RESEARCH VERIFICATION SERVICE AND ENTER PROJECT NUMBER: 20220801-PH954.
EN: https://www.canadianresearchinsightscouncil.ca/rvs/home/
FR: https://www.canadianresearchinsightscouncil.ca/rvs/home/?lang=fr
The focus group will take place online on the (INSERT DATE/TIME) and will last up to an hour and a half (1.5 hours).
[WHEN TERMINATING A CALL WITH SOMEONE, SAY: Thank you for your cooperation. We already have enough participants who have a similar profile to yours, so we are unable to invite you to participate.]
You qualify to participate in one of our virtual discussion groups. The discussion will be led by a researcher from the public opinion research firm, Phoenix SPI. The group will take place on [DAY OF WEEK], [DATE], at [TIME], and will last an hour and a half[1.5 hours]. You will receive an honorarium of $125 for your time.
INVITATION:
As we are only inviting a small number of people to attend, your participation is very important to us. If for some reason you are unable to attend, please call us so that we can get someone to replace you. You can reach us at [INSERT NUMBER] at our office. Please ask for [INSERT NAME].
May I have your email address so that we can also send you an email message with the information you will need about the FOCUS GROUP?
Yes: ENTER EMAIL ADDRESS:
Information regarding how to participate will be sent to you by email in the coming days. The email will come from Phoenix SPI and the address will be research@phoenixspi.ca. You will be asked to log into the online session 15 minutes prior to the start time. If you do not log in on time, you may not be able to participate and you will not receive an honorarium.
Someone will call you the day before to remind you about the session. So that we can call you to remind you about the focus group or contact you should there be any changes, can you please confirm your name and contact information for me?
First Name:
Last Name:
Daytime phone number:
Evening phone number:
Thank you very much for your assistance!
→ Introduce moderator/firm and welcome participants to the focus group.
TECHNICAL CHECK; CONFIRM SOUND AND VIDEO QUALITY.
→ Describe focus group.
→ Explanations
→ Any questions?
→ Roundtable introduction: Let's start with everyone introducing themselves, first name only, please.
Before I show you the materials, I'd like to ask you a few questions about yourselves.
What you have in common, and the reason you are here this evening, is that you all smoke cigarettes.
Probes (if needed): lack of support, no motivation, routine, friends who smoke, living with someone who smokes, cost of quitting, consequences of quitting (fear of weight gain, etc.), unsure of types of quit aids/what approach to take or how to use quit aids?
For those who have tried to quit,
Probe: cut down or stopped all cigarettes at once (i.e., cold turkey), relied on support from friends or family, made a quit plan, used resources/quit aids[17]or other tools/ supports
For everyone, I'm now going to ask you to complete some exercises.
Exercise 1: [POST ON WHITEBOARD/SHARE] Here's a list of potential tools or supports that someone could use to support their smoking cessation efforts. If you were to decide to quit tomorrow, which would you most likely use to support your quit efforts and why? Please select all that you would consider using from the items listed on the screen. [REVIEW RESULTS AND NOTE ANY NOTICEABLE PREFERENCES. ASK FOR REASONS WHY TOP RANKED TOOLS ARE PREFFERED. ASK IF ANY WOULD BE INTENDED TO BE USED TOGETHER, IN COMBINATION DURING THE SAME ATTEMPT OR SIMPLY REFLECT SEPERATE, DESIRABLE OPTIONS]
Probe: Here are some tools and supports people currently use [POST ON WHITEBOARD/SHARE]
As I mentioned, this evening we'll be reviewing tobacco cessation communications products developed by Health Canada for an upcoming marketing campaign. Please keep in mind that the materials we will be asking you to review are not final and may change, in part because of the feedback we will receive from focus groups like this one.
1. ADVERTISEMENTS [15 minutes]
The first thing I'm going to show you are two short advertisements. The ads would appear on social media, YouTube, news websites and possibly in public places. I'm going to show them to you consecutively, one right after the other. Please keep your reactions to yourself until we've seen both versions. [ROTATE PRESENTATION ACROSS GROUPS]
2. RESOURCE VIDEOS [25 minutes]
I am now going to show you two resource videos designed to provide information on quitting smoking. These would appear on YouTube and on Health Canada's website (canada.ca/quit-smoking) We'll look at them one at time. Each one is just under three minutes long. Here's the first one. [ROTATE PRESENTATION ACROSS GROUPS]
Here's the second one [SHOW SECOND VIDEO AND REPEAT QUESTIONS 17-26]
3. CAMPAIGN LANDING PAGE TITLES [10 minutes]
The final thing I'm going to show you are potential titles for the advertising campaign's webpage on the Health Canada website. Imagine that if you saw one of the ads we showed earlier and clicked on it so that you would be taken to the home or landing page of a website. On the website, you would find links to information to help people to quit smoking, as well as the resource videos I just showed you. What we're looking for is your feedback on a potential title for the home or landing page of the website. There are four versions, which I'm going to present to you all at once. [PRESENT OPTIONS ON SCREEN]. I'd like you to read these titles on your own, in silence, and in a moment, I will ask you to identify the one you consider best suited to the homepage. Once everyone is finished, we'll discuss the titles as a group.
Titles:
ALLOW A MOMENT FOR PARTICIPANTS TO REVIEW THE TITLES THEN PROCEED WITH POLL.
I'm going to read each title and ask you about it if it was your favourite. READ LIST STARTING WITH THE TITLE MOST OFTEN IDENTIFIED AND ENDING WITH THE ONE LEAST OFTEN IDENTIFIED.
Now that you have seen these materials,
At the beginning of the session, I asked if you were to decide to quit tomorrow, which tools or support would you most likely use to support your quit efforts and why?
[IF TIME PERMITS] Here's another short exercise.
EXERCISE 2: [POST ON WHITEBOARD /SHARE] Now here's a list of potential formats of information or support to assist someone in their smoking cessation efforts. Again, I would like you to select the formats that you would prefer to use as supports in your own quit efforts. [REVIEW RESULTS AND NOTE ANY NOTICEABLE PREFERENCES. ASK FOR REASONS WHY TOP RANKED SOURCES ARE PREFFERED.]
SHOW CLOSING SLIDE:
Whatever you're going through, remember that you are not alone. Wellness Together Canada is here to support you:
https://www.wellnesstogether.ca/en-CA
And
You can quit. We can help.
1-866-366-3667
gosmokefree.gc.ca/quit
We've covered a lot tonight and I really appreciate you taking the time to share your opinions. The honorarium will be available via e-transfer or cheque; we'll contact you tomorrow to determine your preference. On behalf of Health Canada, I would like to thank you for your time and participation today.
You can all log out now. Have a great evening!
[1]This was the term used by participants. In this context, participants meant that they stopped smoking cigarettes all at once (for a period of time) without the use of any smoking cessation tools.
[2]Participants were presented with a list of potential tools or supports that someone could use to support their smoking cessation efforts. They were asked to identify the tools or supports they would consider using if they decided to quit tomorrow.
[3]Statistics Canada. Table 13-10-0096-01 Health characteristics, annual estimates. DOI: https://doi.org/10.25318/ 1310009601-eng
[4]Ranges have been used to facilitate reporting of feedback on how long participants have been smoking, the number of cigarettes smoked per day, and the number of quit attempts. Participants usually provided an absolute number in response to these questions (e.g., 'I have been smoking for 15 years'). Such a participant is described above as someone who has been smoking for 'somewhere between 11 and 20 years'.
[5]Both Buproprion, and the brand name, Zyban, were mentioned by participants.
[6]Cold turkey was one of the most frequently identified ways participants used to try to quit smoking, but it was infrequently identified as a possible tool or support available to someone who wants to quit smoking. The likely reason is that most participants do not think of 'going cold turkey' as a tool or support.
[7]Since all participants in this research smoke regularly, it goes without saying that no approaches were effective in the sense of helping participants give up smoking for good.
[8]Due to time constraints, this exercise was not completed in all focus groups.
[9]In advance of presenting the tobacco cessation communication products to be reviewed, participants were asked to keep in mind that the materials are not final products and that they might change in part as a result of their feedback.
[10]As reported above, few participants' overall reaction to the ads was critical or negative, though certain specific aspects or features elicited critical reaction from participants whose overall reaction was positive or neutral. Taking this critical feedback into account explains the use of the expression 'some' participants in this context.
[11]As was the case with the ads, few participants' overall reaction to the quit plan video was critical or negative, though certain specific aspects or features of the video elicited critical reaction from participants whose overall reaction was positive or neutral.
[12]When the video was described as too long and/or slow moving to hold their attention, participants were reminded that the video is a resource that they can access, pause, and rewatch. On a few occasions, this resulted in participants revising their estimate of it by saying that, as a resource, it is not too long (though they still might not watch it from beginning to end).
[13]This reason and the others echo reasons given to explain neutral/indifferent reactions to 'Your quit plan'.
[14]This reason and the others that follow echo reasons given to explain neutral/indifferent reactions to the video.
[15]Participants tended to use 'natural' and 'herbal' interchangeably, although 'natural' was mentioned more frequently than 'herbal'.
[16]This question was modified for recruitment of participants living in Northern Canada—specifically, those who work for a territorial government department or agency were eligible to participate in the study.
[17]Nicotine Replacement Therapies (patch, gum, inhalers), approved medications, or natural health products.