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A systematic scoping review of anti-smoking mass media campaign literature provided opportunity to explore how social normative theories and constructs are used to influence smoking cessation. Synthesis of findings was constrained by significant heterogeneity. Nevertheless, the results indicate that a broader conceptualization of social norm is worthy of further exploration. Perceptions of what others think and do contributed in multiple ways to the relationship between anti-smoking messaging and quitting outcomes. Furthermore, integrating research on social norms, social identity and communication may improve understanding of why quitting intentions are enhanced in some circumstances but reactance and counter-arguing responses corresponding to lower quitting intentions occur in others. Integrating a broader theoretical understanding of normative influences into campaign development and evaluation may prove useful in demonstrating the effectiveness of this approach in behaviour change campaigns.

Issue addressed: The LiveLighter® healthy weight and lifestyle social marketing campaign, developed in Western Australia, employs graphic advertising to communicate negative health effects of overweight and motivate behaviour change. This study extends prior evidence of the effectiveness of the LiveLighter® campaign by evaluating its implementation in a new jurisdiction. Methods: A controlled cohort design was employed in intervention (Vic) and comparison states (SA), with and without campaign exposure. Population surveys conducted at baseline (BL) (n = 1000 each state), had 75% retention at follow‐up (FU) (Vic: n = 715; SA: n = 787). Results: Total campaign awareness was moderate (61.5%). Exposed respondents indicated the campaign was "believable" (91.0%), made a strong argument for reducing weight (87.3%), made them "stop and think" (70.1%), motivated action to reach/stay a healthy weight (59.1%) and was "relevant" (55.6%). The proportion of respondents indicating "toxic fat build up" was a health consequence of overweight increased significantly from BL to FU in Vic and to a lesser extent in SA (Vic:55.7% vs 75.9%; SA:58.1% vs 62.6%, interaction P <.001). The proportion indicating cancer is a health consequence of overweight increased significantly from BL to FU in Vic, but not in SA (Vic:77.1% vs 83.4%; SA:77.8% vs 78.1%, interaction P <.05). Conclusions: This study extends the evidence base for the LiveLighter® campaign. Sustained campaign activity with clear behavioural recommendations is required to translate improved knowledge into behaviour change. So what: Evidence‐based mass media campaigns can positively impact health behaviours to address the unsustainable increasing burdens of unhealthy weight, dietary risk and inadequate physical activity. A National Obesity Campaign is needed and LiveLighter® is a ready‐made, relevant Australian resource. [ABSTRACT FROM AUTHOR]

Background: Emerging adulthood presents unique challenges to smoking cessation that are not well understood. During this phase, smoking identities can develop that become obstacles for quitting, particularly in social situations where smoking is accepted and expected. Using a social identity approach, this study explores how social relationships and normative group behaviours can be barriers to transitioning from a smoker to non-smoker identity. Method: Six focus groups of five participants (N = 30) were conducted with participants aged 18-25 years (57% male). Participants' smoking status was ascertained to construct six groups, two each of daily smokers, occasional (non-daily) smokers, and ex-smokers. Results: Salient in-group identities invoked out-group comparisons that could create barriers to change including feeling conflicted about becoming a "non-smoker", and maintenance of pro-smoking group norms. Three subthemes were identified: 1) Managing the division between smoker and non-smoker groups; 2) The isolation associated with navigating others' expectations about quitting when attempting to quit; and 3) Encountering normative in-group smoking-related behaviours when attempting to quit. Conclusions: The transition from smoker to non-smoker, when understood from a social identity approach, is not straightforward. Identifying as a smoker can invoke negative judgements from non-smokers while, conversely, attempting to quit may lead to perceived rejection among smokers. Further research is needed to explore whether perceptions of social risk can be reduced by increasing the salience of a transitional "quitter" identity that helps to reduce the perceived gap between "smoker" and "non-smoker". [ABSTRACT FROM AUTHOR]

Objective: To explore South Australian (SA) young adult smokers' and ex-smokers' perceptions of e-cigarettes as a possible tool for smoking cessation in a context where only e-cigarettes that do not contain nicotine are legally available. Design: Six focus groups: two groups of five participants each for daily smokers, occasional smokers (less than daily) and ex-smokers. Participants (N = 30, 57% male) were aged between 18 and 25 years; e-cigarette experience ranged from none (33%), experimental (47%) to using them as a cessation aid (20%). Topics discussed included smoking experiences, smoking cessation, and e-cigarette experiences, observations and perceptions. Transcripts of the discussions were analysed thematically. Results: Three overarching themes emerged: (1) E-cigarettes deemed unnecessary for quitting and lack appeal as a quitting aid; (2) Social unacceptability of e-cigarettes; and (3) Ambiguity in how e-cigarettes should be managed given the unknown risks and benefits. These views appeared to limit the desire to use e-cigarettes as a cessation aid. Nonetheless, participants preferred a 'wait and see' approach to regulation of e-cigarette availability, highlighting uncertainty about the evidence of harm. Conclusion: Perceptions of e-cigarettes may be shaped by the policy and social environment. Australia's maintained ban on nicotine-containing e-cigarettes signals potential harm, but unlike other Australian states, SA is yet to implement proposed non-nicotine e-cigarette regulations, which may create confusion about the risks and benefits of use. Further research is needed to identify how to convey information about e-cigarettes that does not undermine existing commitments to protecting the community from potential harm. [ABSTRACT FROM AUTHOR]