In response to above-national-average smoking rates, the Ohio Tobacco Use Prevention and Control Foundation (TUPCF) needed an integrated advertising, interactive, public relations and grassroots communications campaign that would effectively reach across the culturally- and socio-economically-diverse state. Branded “stand,” the youth-to-youth campaign is aimed at one, over-arching goal: to change the cultural acceptance of tobacco use in Ohio. In 2004, stand accepted the challenge of evolving awareness into a movement that would live on as a part of youth culture.

Primary research, including statewide focus groups of junior high and high school youth, provided a baseline quantitative and qualitative understanding of youth attitudes toward tobacco use, current levels of education and awareness about the dangers of tobacco use and social initiation patterns for youth tobacco use between the ages of 11 and 17. With this information, the stand campaign in 2002 and 2003 focused on awareness and brand-building across the state.

Against those objectives, stand achieved impressive results. By the end of 2003, the campaign had 93 percent awareness among Ohio youth of the campaign’s core anti-tobacco message.

Aside from youth smoking rates among the highest in the country, research also revealed a cultural acceptance of tobacco use among Ohio youth. In 2004, the program’s goals grew beyond awareness-building to the major strategic thrust of the stand campaign: to seed a youth-led movement that would wipe out cultural acceptance and create tobacco abhorrence.

The campaign needed to progress beyond education and awareness to empowerment and activism. This meant creating cultural and attitudinal change among Ohio teens and a self-sustaining movement. A second round of youth focus groups indicated the need for an increase in “edgier,” harder-hitting and localized activism opportunities if the program was to become a sustainable grassroots movement among Ohio teens.

One objective was growth of the stand campaign beyond awareness and brand-building toward the creation of an autonomous, sustainable, statewide grassroots movement; measured growth of youth involvement through increases in awareness, education, empowerment and activism; positive influence among local and national decision-makers involved in setting perceptions of tobacco use among teens; reduction in youth tobacco use.

Another was to saturate the field of vision of Ohio youth with tobacco counter-marketing campaign messages that reach youth where they live, learn and play; create “edgy” activism initiatives with more localized ways for youth to get involved and stand up against tobacco; build the stand brand as the emblem of youth empowerment among anti-tobacco activists throughout multiple communication channels, ensuring blanketed and consistent messaging.

Local events, as well as year-long activities, helped cultivate an increasing number of youth activists across Ohio. During each local event, stand youth recruited new members for local stand Teams. Events included: booth at Ohio First Lady’s Smart & Sober Kick-Off (a program modeled after stand), “stand Day” at the Ohio State Fair, including a booth at the entry gates; a monthly youth e-newsletter; individual stand Team pages on stand’s youth website; stand Speakers’ Bureau, featuring stand youth speakers to generate interest and recruitment; stand gear to incentivize Team recruitment and retention; ongoing media relations served to support the stand movement throughout the year.

Stand youth first began their anti-glamorization efforts in the spring of 2003 with a statewide youth petition drive and delivery of 8,000 of those petitions to MTV studios in New York City. Empowered by the attention from MTV and by the advertising that showcased this effort, youth continued to collect petitions and spread awareness about the effects of tobacco glamorization. Ohio stand youth participated in the National Day of Action in March 2004, a day designed to raise national awareness of the issue, via a stand at the movies event and press conference.

Parallel support of this effort included documentation of activism on video (some by trained stand youth) resulting in TV spots which ran through the spring and culminated in the premiere of a documentary that captured the initiative from beginning to end. Year-long media relations and dedicated anti-glamorization Web pages at standonline.org also served to support the initiative. To date, Ohio stand teens have collected 51,000 petition signatures.

Encouraged by the momentum building across Ohio, stand youth wanted to do their part to support a growing clean indoor air movement. They created the “Not-So-Picture-Perfect Photo Tour,” which included photos taken by youth from around the state that demonstrated the impact of secondhand smoke on young Ohioans. The Tour made 29 stops across the state, reaching thousands of youth and adults. Empowered to affect change, stand youth also testified in front of their city council members in Columbus, Dayton and Toledo via written and demonstrative testimony.

The youth used effective attention-getting tactics to deliver their message to local decision-makers, such as presenting smoke-ridden T-shirts from a smoky bowling alley and wearing shirts with “No Smoking Section” across the front. stand youth were instrumental in the effort behind successful ballot initiatives that made the city of Columbus and six surrounding suburbs smoke-free. These efforts were supported via two clean indoor air TV spots that featured stand teens, one of which showcased youth in “No Smoking Section” T-shirts. Dedicated Web pages at standonline.org also served to support the initiative.

In April 2004, an amendment to the state budget was proposed that threatened funding for the stand campaign. Outraged by this, more than 100 stand youth rallied together to march to the Statehouse with tape over their mouths and signs that read “don’t silence stand” and “don’t take our voice.” stand youth then testified in support of stand funding, citing key benefits of advertising to allow their message to be heard in all corners of the state and the projected lives and money saved as a result of their efforts. The hard work paid off as the amendment was withdrawn prior to vote, funding was preserved and an additional payment made to the Foundation from tobacco Master Settlement Agreement (MSA) funds.

In 2004, the stand grassroots movement grew by 247 percent with an increase in stand Teams from nine to 64 across Ohio. In addition, 28,050 new youth registrants joined local stand Teams via the Web site, more than double that of the previous year. Grassroots events allowed for more than 891,935 total acts of activism in support of stand’s mission.

Unaided campaign awareness among the target increased to 63.7 percent (up from 28.8 percent the previous year). Among the same target, aided awareness grew to 93 percent (up from 86 percent last year). TV and radio ads reached 95 percent of Ohio youth, 45 times through the year for total ad impressions of more than 51.1 million. Campaign effectiveness is reflected in the 93 percent of Ohio youth who believe stand empowers youth to proactively spread anti-tobacco messages and offer their points of view on the negative effects of tobacco use.

Blanket news media coverage of the campaign occurred in 90 percent of all major Ohio media markets, resulting in 41.8 million gross news media impressions, an increase of 76 percent from the previous year. Among the approximately 12 million Ohioans spread across the 88-county state, this equates to more than three news stories per person. TUPCF and stand have educated more than 1,300 community and thought leaders on tobacco control efforts in Ohio.

A statewide study of Ohio youth conducted by the Ohio Department of Health reported a 45 percent decrease in youth tobacco use over the past four years and a 25 percent decrease in adult tobacco use over the four years. In addition, confirmed unaided awareness of the stand initiative among Ohio youth grew from 38 percent in 2003 to nearly 64 percent in 2004. In December 2004, the Centers for Disease Control and Prevention (CDC) reported that Ohio had slipped out of the top ten states for highest adult smoking rates, from fourth to 11.