Spotlight on SKY Girls

Social Marketing for Tobacco Prevention

The SKY Girls tobacco prevention campaign, launched in 2014, was initially established to stop teenage girls in sub-Saharan Africa from taking up smoking. Social marketing was identified as a promising strategy for combatting tobacco uptake in this context, for several reasons:

Supportive wider environment

Governments and other stakeholders in sub-Saharan Africa are already taking steps to implement tobacco control measures. In Botswana, where SKY Girls was launched in 2014, the Government ratified the WHO Framework Convention on Tobacco Control in 2005. This sets out a range of provisions, including tobacco taxation, limits on sales to minors and restrictions on tobacco advertising and sponsorship. In this environment, a social marketing campaign to strip the aspirational value out of smoking was a valuable complement to the measures already being introduced.

Education is not enough

Most existing preventative activity directed at young people focusses primarily on the communication of the negative health impacts of smoking. This meets an important need, but it alone does not adequately address the multiple reasons why young people start smoking – many of which are complex, and socially embedded, and very much in the here and now, rather than in what seems like the long-term future. Social marketing helps to plug this gap, by addressing the core motivators that lead a teenager to smoke in the moment.

Prevention rather than cure

Stopping young people from starting to smoke has many clear personal, social and financial advantages over trying to help them quit once they’ve started. Those who try smoking are likely to become adult smokers. And social marketing is one of the primary means to achieve prevention goals, particularly in a teenage audience.

Spotlight on SKY Girls

Selecting our audience in Botswana

SKY Girls launched in Botswana in 2014. The decision to launch a social marketing programme aimed at teenage girls in this country was informed by many of the factors discussed in Social Marketing.

The Issue

In 2013, the latest WHO data suggested a worrying trend. Whilst overall youth tobacco rates were below those of adults, the rate of cigarette use amongst female youth aged 13-15 (10.9%) was higher than among women aged 15 or more (WHO Report on the Global Tobacco Epidemic, 2013). In addition, the number of girls aged 13-15 who reported smoking appeared to have rapidly increased, from 2.6% in 2002 to 10.9% in 2008: a quadrupling of the rate in just six years. The large gap between teenage and adult smoking rates combined with the rapid increase in teenage smoking rates indicated that without preventative measures, overall female smoking rates in Botswana were likely to grow significantly in the coming years: an epidemic in the making.

There was also broader evidence that tobacco companies were targeting young women in order to create new audiences for tobacco products. The World Health Organisation’s report ‘Gender, women and the tobacco epidemic’ argued that: “in countries where the rate of tobacco use (and particularly cigarette smoking) by women and girls is still relatively low, programs are needed to prevent increased uptake and future premature deaths and disabilities.” And the Guidelines for the Implementation of the WHO Framework for Convention on Tobacco Control also recommended that “Special attention should be paid to those most affected by marketing and rising tobacco use, such as young people, particularly young women, who are targeted as ‘replacement smokers’” (Guidelines for Article 12, Action Point 27).

The Intervention

As well as a clear need, there was also evidence that teenage girls in Botswana would be particularly suitable for a tobacco-related social marketing programme. There is little media content in the country aimed specifically at girls, and the media that does exist is rarely locally-made. At the same time, teenagers have relatively little to fill their time, making them a captive audience. Combined together, this suggested teenagers would be highly receptive to social marketing content that directly reflected their reality, and likely to engage with it in a sustained way. In addition, teenagers are at a stage in their lives when habits and identity are likely to be in flux: they are transitioning to new schools, meeting new peers and are often keen to fit in. This makes them more likely to be influenced by the pressure to smoke than other demographics, but also provides a ‘timely moment’ for a social marketing intervention to solidify healthy habits and choices.

Practical factors

Practical factors also played a role in the decision to target this audience. Policy-makers in Botswana had been working on developing a new FCTC-compliant law, which was ultimately passed in 2021. The SKY programme therefore worked in tandem with the development of this law to shift social norms relating to tobacco and provide a supportive environment for policy change.

Spotlight on SKY Girls

Understanding our Audience in Botswana

In October 2013, social marketing consultancy Good Business and research agency 2CV undertook primary research in Botswana to understand the potential levers for smoking prevention among girls aged 13-15.

The research was designed to explore the role of smoking in the context of girls’ everyday lives and provide key insights into attitudes and experiences of smoking. It consisted of a series of workshops, ethnographies and in-depth interviews in Gaborone and Francistown, covering girls from a range of demographics, and including those who had both tried and not tried smoking. Girls were recruited in friendship groups or pairs in order to make them feel relaxed and confident, and discussions were facilitated using a range of creative tools – including twists on board games, image association and imaginative exercises. With some girls, researchers also undertook ethnographic visits to their communities in order to get a better picture of their everyday lives.

2CV also ran interviews with other influential figures for the girls, including older brothers, mothers, a youth worker and a school guidance counsellor. These figures were able to shed light on the wider context of girls’ lives, and identify influences on girls that they may not have recognised themselves.

The insights gained from these groups were essential in the development of the SKY Girls Botswana programme, as well as future SKY programmes.

Insights from research:

Social inclusion is a priority for adolescent girls, and a marker of ‘teen health’

  • Desire to ‘belong’ can prompt imitation of peer/role-model behaviours

Girls perceive a number of social rewards to smoking

  • Sense of ‘belonging’, means to maintain friendships and impress others
  • Many girls try smoking in social settings (parties, in peer groups at school), where peer pressure is high and cigarettes are available

Environmental factors including exposure at a young age, and lack of entertainment for young people create a receptive market

Whilst girls understand the risks associated with smoking, they choose to prioritise short term gains over long term dangers

Lack of open conversations within the home and school, means girls are not having meaningful conversations about ways to avoid smoking and peer pressure

The research identified a range of levers that could inform smoking prevention approaches with this audience:

  • Considering social rewards
  • Informing and educating
  • Providing support