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Newspaper coverage of tobacco control in New Zealand

Newspaper coverage of tobacco control in New Zealand of influence in modern society, and Objective: The New Zealand (NZ) government has proposed that the country be ‘Smokefree’ by Tmedia coverage can determine what 2025. This paper examines how NZ newspapers have portrayed tobacco control initiatives to we perceive as the norm, and what we view as achieve this goal. being ‘good’ , ‘bad’ , ‘important’ or ‘insignificant’ . The types of events and issues published in Method: We examined tobacco-related articles from NZ newspapers published between newspapers are those journalists and news 1 November 2011 and 31 October 2012, using a coding frame to capture smoking themes, editors have deemed for various reasons to portrayal of actions and degree of support expressed for various pro- and anti- tobacco control be newsworthy and, in a sense, the media objectives. can define reality in public discourse. As Results: A total of 537 separate articles were obtained from national and regional newspapers. one journalist noted, “if you don’t exist in Six themes appeared in more than 5% of the total articles: Smokefree 2025; smokefree areas; the media, to all intents and purposes, you pricing; tobacco industry; plain packaging; and cessation. Overall, articles on tobacco smoking don’t exist”. Consequently, the media may were three times more likely to emphasise actions consonant with tobacco control objectives have a powerful role in determining the rather than against them, and to report them with a positive rather than negative tone. effectiveness of public health policies such as Conclusions: NZ tobacco control advocates can take heart from the nature and extent of tobacco control policy through its influence coverage of tobacco control initiatives. Opportunities for further media advocacy are discussed. on individuals and policymakers. From a Key words: tobacco control, media, advocacy, smokefree, 2025 public health perspective, coverage can help inform the public of health issues and government actions to address those issues. Tobacco control initiatives such as the plain positively influence smokers’ perceptions of achieve this goal. These are outlined in packaging of cigarettes can be portrayed in the harms of tobacco and act as significant ‘Smokefree Aotearoa/New Zealand 2025 7 9 specific ways, and this can greatly influence prompts to quit. Logic’, and include: 1) protecting children their public perception and their palatability. from exposure to tobacco smoking and its Each year, about 5,000 people die in New promotion by supporting plain packaging, Previous Australian and US research Zealand (NZ) through smoking and 300 New health warnings on packs, and smokefree indicates that although coverage may vary Zealanders die from exposure to second-hand cars and communities; 2) reduction in considerably across a year, tobacco events smoke, and half of all long-term smokers 8 demand and supply achieved through are seen as newsworthy; reporting of them will die from a smoking-related disease. To policy changes such as increases in taxation is frequent with one article reported on reduce this toll, the NZ government made and further regulating and restricting the average every four days per newspaper; and a commitment in March 2011 to a goal of 9 sale of tobacco; and 3) support for smoking reporting is generally sympathetic to tobacco a Smokefree NZ by 2025. This goal aims 5,6 cessation both at the individual level control objectives. Studies have shown to have less than 5% of the population through supporting smokers with Quitline that enhancing media coverage of tobacco identifying as current smokers by 2025 and, and nicotine replacement therapy, and at control initiatives is one way of influencing to achieve this goal, 40,000 smokers need to a national level through promoting the their effectiveness, as it shapes the values successfully quit smoking annually leading up 9 Smokefree 2025 goal. held by the community. Furthermore, recent to 2025, assuming no new smokers start. Australian research suggests that news stories In this paper we examine the portrayal of A number of tobacco control initiatives about tobacco and its health effects can Smokefree 2025 tobacco control initiatives in have been identified as necessary to 1. Preventive and Social Medicine, Otago University, New Zealand Correspondence to: Professor Rob McGee, Preventive and Social Medicine, Otago University, Dunedin School of Medicine, Dunedin 9054, New Zealand; e-mail: rob.mcgee@otago.ac.nz Submitted: July 2013; Revision requested: August 2013; Accepted: January 2014 The authors have stated they have no conflict of interest. Aust NZ J Public Health. 2014; 38:265-9; doi: 10.1111/1753-6405.12216 2014 vol . 38 no . 3 Australian and New Zealand Journal of Public Health 265 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia McGee, Bang and Marsh the print media. As far as we are aware, there centres of Auckland, Hamilton, Wellington, with tobacco control objectives; for example, have been no published papers examining Christchurch and Dunedin, and the 15 daily an article about political support for plain how the print media is portraying the path papers with circulation figures of 10,000 or packaging would be coded as having a to a Smokefree NZ. While the portrayal more as well as the three weekly papers. positive impact. On the other hand, an article about the tobacco industry’s 2012 Agree/ of tobacco issues in the media has been Disagree campaign to counteract legislation addressed prior to Smokefree 2025, this Coding of articles for plain packaging (see: www.agreedisagree. has primarily involved tobacco imagery in Three tobacco-related keywords were co.nz) would be coded as having a negative the visual media. Newspapers here have used to search for relevant articles on the impact. Mixed impact was used for articles retained a steady readership even during newspaper databases: smoking, tobacco and that talked about, for example, both political a tough market. If anything, newspapers cigarettes. For the article to be eligible for support for plain packaging and the tobacco are perhaps even more accessible through inclusion, the main event or issue discussed industry’s actions to counter that support, or easy access to newspaper articles online. had to be tobacco related; this eliminated discussed events or initiatives that might have Smokefree 2025 is a national goal requiring articles that only briefly mentioned one or an uncertain effect on tobacco control. broad action on several fronts, and it is more keywords. Items retrieved included meaningful to examine how often and how The opinion dimension assessed the general news articles, editorials from the newspaper sympathetically this goal and associated impression that a reader of the article editors, opinion pieces submitted by other tobacco control initiatives have been would be left with. Was the article broadly writers, and letters to the editor. All were portrayed by the NZ media. supportive of, or hostile towards, tobacco coded using a system adapted from the 5,6 control objectives? This could be reflected Smith et al. (2005) framework. This coding At the same time, newspapers have the ability by either the views of people interviewed frame included three main sets of variables: to present the tobacco industry’s version of or mentioned in the news article, or the descriptors, content theme and tone. events and industry reaction to these policy explicit views of the writers in opinion pieces proposals. Smokefree initiatives will not only The article descriptors included the month or letters. For example, a positive opinion have an impact on industry profits in NZ, but of publication, type of article, name of code would be used for articles containing will serve as a model for other jurisdictions newspaper, and the number of appearances, expressions of support for plain packaging, or to follow suit, perhaps in much the same where the same article was published the views of people that the industry’s Agree/ way that Australia’s plain packaging is to multiple times in different newspapers. The Disagree campaign was unethical or a waste be implemented in this country. Applying content theme was assessed under 19 themes of money. Conversely, an article containing ‘scream test’ logic – the more effective the including: ‘Smokefree 2025’ (which included statements by tobacco retailers that plain tobacco control activity, the greater the references to a Smokefree NZ); consumption packaging will not be effective, or an industry industry’s response – would suggest that the and smoking prevalence; youth smoking and viewpoint on the need for the Agree/Disagree tobacco industry will fight these proposals as access; health effects; second-hand smoke; 12 campaign to counteract plain packaging, vigorously as possible. Consequently, it is smokefree areas including cars; point of sale would be coded as a negative opinion. So, also important to examine how newspapers display; plain packaging; health warnings it was possible to code articles for positive frame tobacco industry perceptions and on packs; advertising and promotion issues; event but negative opinion and vice-versa. arguments. pricing including tax increases; addiction; Similarly, the same article might have both prevention and education; cessation positive and negative opinions expressed. including the national Quitline; tobacco Method A copy of the coding framework is available industry actions; ‘endgame’; product issues; from the authors on request. economic issues including free trade; and Sources of articles other issues not already classified. These The data for this analysis consisted of Reliability of coding categories were adapted from the Smith et al. tobacco-related articles from NZ newspapers (2005) framework to give a better reflection of The author (SB) coded all the articles and published over the 12-month period between the current tobacco control policies at issue randomly selected 71 articles (13% of all 1 November 2011 and 31 October 2012. The in NZ. While more than one theme could be articles) spread throughout the 12 months of articles were found through three newspaper identified for each article, the focus was on reporting, which were then independently databases: 1) Newztext Plus – The Knowledge the main theme(s) contained in the article; scored by RM. Inter-rater agreement on the Basket;2) Factiva;and 3) Otago Daily Times themes that were only briefly mentioned and coding (including descriptors, content theme website. not elaborated upon were not included in the and tone variables) was assessed by Kappa Articles were obtained from eighteen statistic. The majority of the Kappa scores classification of the articles. different newspapers: NZ Herald; Dominion were between 0.66 and 0.96, an acceptable The tone of the article was assessed along Post; Otago Daily Times; Timaru Herald; level of agreement; the Kappa score for the two dimensions: a) event or action impact; Waikato Times; Bay of Plenty Times; ‘other’ category, however, was relatively low and b) opinion. The first dimension refers to Manawatu Standard; Northern Advocate; at 0.48. In those instances where the primary the impact of the event or action described in Taranaki Daily Times; Christchurch Press; coder (SB) felt uncertain as to the appropriate the article on smokefree objectives. The event Nelson Mail; Daily Post; Marlborough code, coding was discussed with the other in an article could be classified as having a Express; Southland Times; Sunday Star Times; authors to reach consensus. positive, negative, mixed or neutral impact Herald on Sunday; Hawkes Bay Today; and Descriptive statistics are provided for all on tobacco control initiatives. Events with Sunday News. These papers covered all daily variables. A standard Z-test, equivalent to a positive impact were those that lined up newspapers in the five main population 266 Australian and New Zealand Journal of Public Health 2014 vol . 38 no . 3 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia Media and tobacco a chi-square test, was used to assess the Figure 1: Number of articles, and repeated articles, on tobacco published between November 2011 and October 2012. difference between the proportions of 140 positive and negative responses for event and opinion variables, with p<0.05 considered statistically significant. All statistical analyses were performed using Stata 10.1. Results Tobacco articles A total of 537 separate articles were obtained from both national and regional newspapers: 60% were news items; 15% opinion pieces or editorials; and 23% letters to the editor. Month Ninety of these individual articles were Month repeated two or more times in different Number of articles Number of appearances including repeats newspapers; 56 articles were repeated in one Number of articles Number of appearances including repeats other newspaper; and the remainder were January with 15 articles (23% of all cessation articles focused on events or actions that repeated two or more times. Consequently, articles); ‘Smokefree 2025’ peaked in May were rated as having a positive impact on 693 articles were published in total. Figure 1 with 47 articles (16% of all Smokefree 2025 tobacco control objectives in comparison shows the number of individual articles and articles); and ‘pricing’ appeared 33 times (30% to articles focusing on events having a individual plus repeated articles published of all pricing articles) in May. The themes negative impact on smokefree objectives. over the 12 months from November 2011 for both ‘tobacco industry’ (32 or 33% of all News items had the highest percentage of to October 2012. The amount of tobacco industry articles) and ‘plain packaging’ (27 articles describing tobacco control actions coverage fluctuated over the course of or 29% of articles with plain packaging as a having a positive impact (67%), followed the year, with high numbers of articles in theme), however, peaked in August. by opinion pieces and editorials (53%), January, May, July and August. The number while letters to the editor had the lowest of repeated articles followed a similar trend. Tone of articles percentage of positive event articles (47%). This fluctuation makes it difficult to see the The corresponding percentages of articles general trend of tobacco coverage over time. Table 2 shows the distribution of event describing actions with a negative impact impact and opinion for the 537 published were 21% for news items, 20% for opinion articles. Overall, significantly (p <0.001) more Theme of articles pieces and editorials and 23% for letters to In total, 1,057 themes were identified in the the editor, respectively. Table 1: Themes present in 537 newspaper articles. 537 articles. Table 1 shows the distribution Figure 2 shows that, in terms of the top six Theme Number of % total of the 19 different tobacco themes in the themes articles individual themes, more articles reported newspaper articles. Of these, six themes positive rather than negative actions or “Smokefree”/2025 286 27.1% appeared in more than 5% of the total events, especially ‘smokefree areas’ , ‘cessation’ articles: Smokefree 2025; smokefree areas; Smokefree areas 120 11.4 and ‘pricing’, which had a very low percentage pricing; tobacco industry; plain packaging; Pricing 111 10.5 of negative event articles (3%, 6% and 5% and cessation. These six themes accounted Tobacco industry 97 9.2 respectively, p<0.001). ‘ Tobacco industry’ , for 73% of all published articles. Additionally, Plain packaging 94 8.9 understandably, was the only theme to have more than 5% of the articles were coded as Cessation 66 6.3 ‘other’, a category that included stories about Heath effects 46 4.4 prisoners’ responses to the introduction of Table 2: Distribution of tone in newspaper articles Youth smoking 40 3.8 smokefree prisons; comparisons between (N=537) according to impact and opinion. Point of sale display 35 3.3 tobacco control and alcohol policy, usually Number of % total with an emphasis on the comparatively weak Economic issues 30 2.8 articles articles nature of alcohol policy; and a supermarket Prevalence 14 1.3 Event impact chain’s decision to instruct staff to place Advertising 18 1.7 Positive 324 60 cigarette packets in a plastic bag before Addiction 18 1.7 Negative 115 21 handing them to customers, so that “no one Second hand smoke 14 1.3 Mixed 30 6 can actually see cigarettes”. Health warnings on pack 4 0.4 Neutral 68 13 Temporal variation in the appearance of Prevention/education 4 0.4 Opinion themes was also evident. For example, the “Endgame” 2 0.2 Positive 246 44 theme ‘smokefree areas’ peaked in January Product issue 1 0.1 Negative 78 15 with 20 of the total 120 articles published Mixed 111 21 Other 57 5.4 or 17% of all articles with smokefree areas No opinion 102 19 as a central theme; ‘cessation’ also peaked in Total themes 1,057 2014 vol . 38 no . 3 Australian and New Zealand Journal of Public Health 267 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia Num,ber Num,ber  of  appearances of appearances McGee, Bang and Marsh more negative than positive impact ratings only 18 (3%) were negative for both event are some themes under-represented when (59% vs. 17%, p<0.001). In most articles and opinion, (p<0.05). other themes are at their peak? In the present study, nearly three-quarters of all articles discussing the industry, representatives related to six themes. Because of the constant of tobacco companies and retailing: a) Discussion criticised tobacco control objectives; b) competition for space in newspapers, it is argued for the ineffective nature of tobacco possible that certain themes such as cessation This study examined NZ newspapers’ control activities; and c) promoted industry support may be deemed un-newsworthy at reporting of tobacco issues over one year, other times during the year and are ‘pushed sponsored actions such as the NZ Agree/ focusing on the portrayal of tobacco control out’ by other tobacco-related news items. Disagree campaign. initiatives to achieve a Smokefree NZ by 2025. In addition to this, tobacco-related themes The temporal variation in the appearance As shown in Table 2, in terms of the tone of in general could be under-represented in of certain themes is likely to be explained opinions expressed about these events, more response to other competing news topics. It by the tobacco-related events occurring articles significantly presented (p <0.001) is also possible that some themes (e.g. youth a positive opinion rather than a negative in NZ around that time. The theme of smoking and addiction) are more likely to opinion. For the top six themes (see Figure ‘pricing’, for example, was at its peak in May, be portrayed through a medium other than which coincided with the government’s 2), all showed positive opinions outweighing the newspaper, such as through other online introduction of the new budget on 24 May negative ones. This was even the case for articles, social media or television. 2012. The themes ‘tobacco industry’ and ‘plain articles containing industry themes, where Overall, published articles on tobacco packaging’ both peaked in August, at a time opinions expressed in the articles still smoking were about three times more likely when there was heated debate regarding the remained broadly supportive of tobacco proposal to introduce plain packaging in NZ. to emphasise events or actions consonant control objectives. ‘Cessation’ peaked in January when tobacco with tobacco control objectives compared In terms of opinions expressed, letters to the with events antithetical to tobacco control, price increases came into play. Quitline use editor had a higher proportion of articles and to report them with a positive tone also peaks at this time as smokers attempt to with positive opinions (54%) compared with rather than a negative tone. This finding is in quit in the New Year. The recent emphasis in news items (44%) and editorial pieces (41%). 5,6 NZ newspapers has been on the proposed line with those of Smith et al. (2005) who Both editorial pieces and letters to the editor introduction of plain packaging in NZ, and found that news coverage in Australia and expressed more negative opinions than news the US was generally supportive of tobacco about a third of articles relating to this theme items, 25%, 22% and 9% respectively. This control initiatives. Where negative opinion were rated as negative events, primarily court seemed especially so in the case of ‘pricing’, was presented, it tended to be in editorials, proceedings being taken against Australia, with many apparent smokers complaining of and the threats of both court action and trade opinion pieces and letters to the editor in tax increases. Finally, 135 (25% of all articles) bans to coerce the NZ government not to comparison to news items. This suggests that were coded as positive for both event and these types of articles are the main outlets 100 introduce this legislation. opinion, describing actions that were both in which people can express pro-smoking Such expected variations in theme 100 positive for tobacco control objectives and views. Comparison with news coverage in 90 appearance pose an important question: were reported in a positive light. Conversely, 90 other forms of visual and online media are difficult to make. Our own earlier research Figure 2: Main tobacco themes by event and opinion. Positive Event on NZ television content in 2004 suggested Positive Event that about a third of news and documentary 100 Positive Event Negative Event type programs did present content critical Positive Event Negative Event Negative Event of tobacco – more so than entertainment- 50 Positive Opinion Negative Event Positive Opinion oriented programs – but this was not 40 80 Positive Opinion 30 especially high, with two-thirds of coverage Negative Opinion Positive Opinion 40 70 30 10 Negative Opinion non-critical in tone. 20 Negative Opinion Positive Event 20 Negative Opinion The NZ tobacco control community may take Negative hear Event t from the nature and extent of coverage of tobacco control initiatives. Even where Positive Opinion 10 tobacco industry viewpoints were expressed, industry opinions did not go unchallenged as Negative Opinion countervailing opinions often accompanied them. More than half the stories with the tobacco industry as a theme still conveyed opinions sympathetic to NZ’s tobacco control objectives. The industry was portrayed as Newspaper article theme ‘big tobacco’ and ‘tobacco bullies’, who if they Newspaper article theme Newspaper article theme “really had a concern for others, they would Newspaper article theme   voluntarily withdraw their lethal product from   the market”. This study has several limitations. First and Newspaper article theme foremost, our analysis was limited to data 268 Australian and New Zealand Journal of Public Health 2014 vol . 38 no . 3 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia Percentage PePrecPerecnertcnaetgnaetgaege Percentage Media and tobacco collected from available NZ newspaper against using endgame in media reporting. be a major policy concern. In this regard, it records, so our findings may not apply to It may well muddy the waters around will be important to monitor product issues other media. Further, not all NZ newspapers Smokefree 2025, a specific national goal that in the media, given the looming potential were analysed, although we were able to is currently being widely reported in a very for the tobacco industry to heavily promote examine newspapers with larger circulations. positive fashion. Furthermore, readers may e-cigarettes in the future. For example, we did not assess community simply not know what ‘endgame’ means, and newspapers, which are typically published communicating the plethora of concepts References once a week. Consequently, we cannot and actions falling under endgame ideas 1. National Cancer Institute. The Role of the Media in determine the exact number of repeated may prove difficult. For example, the notion Promoting and Reducing Tobacco Use. Tobacco Control articles. The relationship between different of endgame has taken up a whole recent Monograph No.19. Bethesda (MD): US: Department of Health and Human Services, National Institutes of newspapers was not taken into account supplement of a tobacco control journal, Health, National Cancer Institute; 2008 where publication in one particular and endgame concepts include many 2. Harcup T, O’Neill D. What Is News? Galtung and Ruge newspaper may have made the article tobacco control initiatives already being revisited. Journal Stud. 2001;2:261-80. 3. Wallack L. Media advocacy: a strategy for empowering more likely to be repeated in others. Third, reported. There may also be public resistance people and communities . J Public Health Pol. funding resources only allowed for coding to the idea of tobacco control as a kind of 1994;15:420-36. 4. Wakefield MA, Brennan E, Durkin SJ, McLeod K, Smith one year’s newspaper content. However, our game played by tobacco control advocates KC. Making news: the appearance of tobacco control aim was to find out how newspapers were against the industry. Further research could organizations in newspaper coverage of tobacco presenting current NZ tobacco initiatives profitably examine public perceptions of control issues. Am J Health Promotion. 2012;26:166-71. 5. Smith KC, Terry-McElrath Y, Wakefield MA, Durrant, R. including Smokefree 2025, the ban on the endgame concept. More generally, it Media advocacy and newspaper coverage of tobacco point of sale advertising, and proposals would be of interest to examine how articles issues: A comparative analysis of 1 year’s print news in the United States and Australia. Nicotine Tob Res. for plain packaging. Strengths of the study expressing greater or lesser support for 2005;7:289-99. include access to one year’s worth of stories various tobacco control actions are perceived 6. Wakefield MA, Brennan E, Durkin SJ, McLeod, Smith from 18 different newspapers distributed by the public. KC. Still a burning issue: Trends in the volume, content, and population reach of newspaper coverage about throughout NZ, including some smaller Interestingly, there were relatively few articles tobacco issues. Crit Public Health. 2011;21:313-25 regional newspapers, and the use of a 7. Dunlop SM, Cotter T, Perez D, Chapman S. Tobacco in about point of sale advertising, suggesting the news: Associations between news coverage, news reliable coding frame to describe the stories. that this is no longer especially newsworthy. recall and smoking-related outcomes in a sample of Our analysis of reliability indicated levels of One question for advocates is what to do Australian smokers and recent quitters. Health Educ agreement similar to that found in the earlier Res. 2012;27:160-71 with what appear to be ‘dead issues’ like 5,6 8. Ministry of Health. Health Effects of Smoking. Wellington research using this coding scheme. Coding this? Should people move on, and under (NZ): Government of New Zealand; 2012. agreement was poorest for the ‘other’ themed 9. SF2025 National Working Group. Smokefree Aotearoa/ what circumstances should we revisit them? New Zealand by 2025: Next Steps 2011-2015 [Internet]. category, which included a wide range of We noted that in many articles the industry Wellington (NZ): National Working Group; 2011 [cited content sometimes tangentially related to was fond of repeating the failure of existing 2013 Jan 16]. Available from: http://www.ash.org. tobacco control. nz/site_resources/library/Smokefree_2025_next_ tobacco control initiatives such as point of steps-_2012-2015.pdf What does this research say about how sale advertising. 10. McGee R, Ketchel J. Tobacco imagery on New Zealand television 2002-2004. Tob Control. 2006;15:412-14. tobacco control advocates should try and It will be important to monitor the effect 11. Nielsen Consumer and Media Insights. Newspapers Year present stories? Given the overall positive of actions now in place, and to state clearly on Year Comparative Results [Internet]. Wellington (NZ): nature of opinions expressed about tobacco Nielsen; 2012 2011 [cited 2013 Jan 22]. Availablefrom: and repeatedly that such actions have h ttp://nz.nielsen.c om/produc ts/documen ts/ control, advocates should continue to be been shown to work. Perhaps what will NewspaperToplineComparitivesQ42011-Q32012.pdf positive about the effects of these initiatives, 12. Chapman S. If you can’t count it … it doesn’t count: be newsworthy are quantitative estimates A commentary on Bardsley & Olekains the poverty and present evidence backing up their of the impact of such actions on smoking of econometrics in explaining complex social and arguments. uptake by young people and quitting among behavioural change. Health Promot J Austr. 1999;9: 206-7. It is also important to counter tobacco adults. There were few articles dealing 13. Audit Bureau of Circulations. Press Audit Results industry arguments effectively, since their with tobacco dependence and addiction, [Internet]. Wellington (NZ): ABC; 2013 [2013 Jan 8]. Available from: http://newspaper.abc.org.nz/audit.ht countervailing opinions and arguments are although advocates may feel that this is ml?org=npa&publicationid=%25&mode=embargo& being reported – sometimes unchallenged. important to counter industry and some npa_admin=1&publicationtype=19&memberid=%2 This was especially so in view of the industry’s media viewpoints promoting smoking and its 5&type=%25. 19 14. Cohen J. A coefficient of agreement for nominal scales . response to the plain packaging proposals, consequences as a personal responsibility. Educ Psychol Meas. 1960;20:37-46. and unsubstantiated industry statements Similarly, discussion of cessation should 15. STATA: statistical software [computer program]. Version 10.1. College Station (TX): Stata Corporation; 2010. that previous tobacco control initiatives, such perhaps receive more media space, given its 16. Pederson LL, Nelson DE, Babb S, London J, Promoff as restrictions on point of sale advertising, importance for achieving Smokefree 2025. G, Pechacek T. News media outreach and newspaper have been ineffective. Smokefree 2025 was One option would be for tobacco control coverage of tobacco control. Health Promot Pract. 2012;13:642-7. one of the most common themes, expressed advocates to incorporate messages about 17 Holland B. It’s unethical. The Press. 2012, Oct 22: 16. in about one in every four articles, and cessation into media releases about other 18. Warner KE. An endgame for tobacco. Tob Control. 2013;22 Suppl 1: i3-i5. advocates should keep emphasising this goal. tobacco control initiatives, to keep cessation 19. MacKenzie R, Chapman S, Holding S. Framing On the other hand, ‘endgame’ as a concept in the public arena. responsibility: coverage of lung cancer among smokers was scarcely mentioned, although it is not and non-smokers in Australian television news. Aust N Finally, it is worth noting that there was only Z J Public Health. 2010;35:66-70. known whether this reflects resistance on one article reporting on product issues, 20. McKee M. E-cigarettes and the marketing push that the part of advocates to use the term or of surprised everyone. BMJ. 2013;347:f5780. although the issue of what is in cigarettes newspapers to take it up. We would argue and controls on additives to tobacco should 2014 vol . 38 no . 3 Australian and New Zealand Journal of Public Health 269 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

Newspaper coverage of tobacco control in New Zealand

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Wiley
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© 2014 Public Health Association of Australia
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1326-0200
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10.1111/1753-6405.12216
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Abstract

of influence in modern society, and Objective: The New Zealand (NZ) government has proposed that the country be ‘Smokefree’ by Tmedia coverage can determine what 2025. This paper examines how NZ newspapers have portrayed tobacco control initiatives to we perceive as the norm, and what we view as achieve this goal. being ‘good’ , ‘bad’ , ‘important’ or ‘insignificant’ . The types of events and issues published in Method: We examined tobacco-related articles from NZ newspapers published between newspapers are those journalists and news 1 November 2011 and 31 October 2012, using a coding frame to capture smoking themes, editors have deemed for various reasons to portrayal of actions and degree of support expressed for various pro- and anti- tobacco control be newsworthy and, in a sense, the media objectives. can define reality in public discourse. As Results: A total of 537 separate articles were obtained from national and regional newspapers. one journalist noted, “if you don’t exist in Six themes appeared in more than 5% of the total articles: Smokefree 2025; smokefree areas; the media, to all intents and purposes, you pricing; tobacco industry; plain packaging; and cessation. Overall, articles on tobacco smoking don’t exist”. Consequently, the media may were three times more likely to emphasise actions consonant with tobacco control objectives have a powerful role in determining the rather than against them, and to report them with a positive rather than negative tone. effectiveness of public health policies such as Conclusions: NZ tobacco control advocates can take heart from the nature and extent of tobacco control policy through its influence coverage of tobacco control initiatives. Opportunities for further media advocacy are discussed. on individuals and policymakers. From a Key words: tobacco control, media, advocacy, smokefree, 2025 public health perspective, coverage can help inform the public of health issues and government actions to address those issues. Tobacco control initiatives such as the plain positively influence smokers’ perceptions of achieve this goal. These are outlined in packaging of cigarettes can be portrayed in the harms of tobacco and act as significant ‘Smokefree Aotearoa/New Zealand 2025 7 9 specific ways, and this can greatly influence prompts to quit. Logic’, and include: 1) protecting children their public perception and their palatability. from exposure to tobacco smoking and its Each year, about 5,000 people die in New promotion by supporting plain packaging, Previous Australian and US research Zealand (NZ) through smoking and 300 New health warnings on packs, and smokefree indicates that although coverage may vary Zealanders die from exposure to second-hand cars and communities; 2) reduction in considerably across a year, tobacco events smoke, and half of all long-term smokers 8 demand and supply achieved through are seen as newsworthy; reporting of them will die from a smoking-related disease. To policy changes such as increases in taxation is frequent with one article reported on reduce this toll, the NZ government made and further regulating and restricting the average every four days per newspaper; and a commitment in March 2011 to a goal of 9 sale of tobacco; and 3) support for smoking reporting is generally sympathetic to tobacco a Smokefree NZ by 2025. This goal aims 5,6 cessation both at the individual level control objectives. Studies have shown to have less than 5% of the population through supporting smokers with Quitline that enhancing media coverage of tobacco identifying as current smokers by 2025 and, and nicotine replacement therapy, and at control initiatives is one way of influencing to achieve this goal, 40,000 smokers need to a national level through promoting the their effectiveness, as it shapes the values successfully quit smoking annually leading up 9 Smokefree 2025 goal. held by the community. Furthermore, recent to 2025, assuming no new smokers start. Australian research suggests that news stories In this paper we examine the portrayal of A number of tobacco control initiatives about tobacco and its health effects can Smokefree 2025 tobacco control initiatives in have been identified as necessary to 1. Preventive and Social Medicine, Otago University, New Zealand Correspondence to: Professor Rob McGee, Preventive and Social Medicine, Otago University, Dunedin School of Medicine, Dunedin 9054, New Zealand; e-mail: rob.mcgee@otago.ac.nz Submitted: July 2013; Revision requested: August 2013; Accepted: January 2014 The authors have stated they have no conflict of interest. Aust NZ J Public Health. 2014; 38:265-9; doi: 10.1111/1753-6405.12216 2014 vol . 38 no . 3 Australian and New Zealand Journal of Public Health 265 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia McGee, Bang and Marsh the print media. As far as we are aware, there centres of Auckland, Hamilton, Wellington, with tobacco control objectives; for example, have been no published papers examining Christchurch and Dunedin, and the 15 daily an article about political support for plain how the print media is portraying the path papers with circulation figures of 10,000 or packaging would be coded as having a to a Smokefree NZ. While the portrayal more as well as the three weekly papers. positive impact. On the other hand, an article about the tobacco industry’s 2012 Agree/ of tobacco issues in the media has been Disagree campaign to counteract legislation addressed prior to Smokefree 2025, this Coding of articles for plain packaging (see: www.agreedisagree. has primarily involved tobacco imagery in Three tobacco-related keywords were co.nz) would be coded as having a negative the visual media. Newspapers here have used to search for relevant articles on the impact. Mixed impact was used for articles retained a steady readership even during newspaper databases: smoking, tobacco and that talked about, for example, both political a tough market. If anything, newspapers cigarettes. For the article to be eligible for support for plain packaging and the tobacco are perhaps even more accessible through inclusion, the main event or issue discussed industry’s actions to counter that support, or easy access to newspaper articles online. had to be tobacco related; this eliminated discussed events or initiatives that might have Smokefree 2025 is a national goal requiring articles that only briefly mentioned one or an uncertain effect on tobacco control. broad action on several fronts, and it is more keywords. Items retrieved included meaningful to examine how often and how The opinion dimension assessed the general news articles, editorials from the newspaper sympathetically this goal and associated impression that a reader of the article editors, opinion pieces submitted by other tobacco control initiatives have been would be left with. Was the article broadly writers, and letters to the editor. All were portrayed by the NZ media. supportive of, or hostile towards, tobacco coded using a system adapted from the 5,6 control objectives? This could be reflected Smith et al. (2005) framework. This coding At the same time, newspapers have the ability by either the views of people interviewed frame included three main sets of variables: to present the tobacco industry’s version of or mentioned in the news article, or the descriptors, content theme and tone. events and industry reaction to these policy explicit views of the writers in opinion pieces proposals. Smokefree initiatives will not only The article descriptors included the month or letters. For example, a positive opinion have an impact on industry profits in NZ, but of publication, type of article, name of code would be used for articles containing will serve as a model for other jurisdictions newspaper, and the number of appearances, expressions of support for plain packaging, or to follow suit, perhaps in much the same where the same article was published the views of people that the industry’s Agree/ way that Australia’s plain packaging is to multiple times in different newspapers. The Disagree campaign was unethical or a waste be implemented in this country. Applying content theme was assessed under 19 themes of money. Conversely, an article containing ‘scream test’ logic – the more effective the including: ‘Smokefree 2025’ (which included statements by tobacco retailers that plain tobacco control activity, the greater the references to a Smokefree NZ); consumption packaging will not be effective, or an industry industry’s response – would suggest that the and smoking prevalence; youth smoking and viewpoint on the need for the Agree/Disagree tobacco industry will fight these proposals as access; health effects; second-hand smoke; 12 campaign to counteract plain packaging, vigorously as possible. Consequently, it is smokefree areas including cars; point of sale would be coded as a negative opinion. So, also important to examine how newspapers display; plain packaging; health warnings it was possible to code articles for positive frame tobacco industry perceptions and on packs; advertising and promotion issues; event but negative opinion and vice-versa. arguments. pricing including tax increases; addiction; Similarly, the same article might have both prevention and education; cessation positive and negative opinions expressed. including the national Quitline; tobacco Method A copy of the coding framework is available industry actions; ‘endgame’; product issues; from the authors on request. economic issues including free trade; and Sources of articles other issues not already classified. These The data for this analysis consisted of Reliability of coding categories were adapted from the Smith et al. tobacco-related articles from NZ newspapers (2005) framework to give a better reflection of The author (SB) coded all the articles and published over the 12-month period between the current tobacco control policies at issue randomly selected 71 articles (13% of all 1 November 2011 and 31 October 2012. The in NZ. While more than one theme could be articles) spread throughout the 12 months of articles were found through three newspaper identified for each article, the focus was on reporting, which were then independently databases: 1) Newztext Plus – The Knowledge the main theme(s) contained in the article; scored by RM. Inter-rater agreement on the Basket;2) Factiva;and 3) Otago Daily Times themes that were only briefly mentioned and coding (including descriptors, content theme website. not elaborated upon were not included in the and tone variables) was assessed by Kappa Articles were obtained from eighteen statistic. The majority of the Kappa scores classification of the articles. different newspapers: NZ Herald; Dominion were between 0.66 and 0.96, an acceptable The tone of the article was assessed along Post; Otago Daily Times; Timaru Herald; level of agreement; the Kappa score for the two dimensions: a) event or action impact; Waikato Times; Bay of Plenty Times; ‘other’ category, however, was relatively low and b) opinion. The first dimension refers to Manawatu Standard; Northern Advocate; at 0.48. In those instances where the primary the impact of the event or action described in Taranaki Daily Times; Christchurch Press; coder (SB) felt uncertain as to the appropriate the article on smokefree objectives. The event Nelson Mail; Daily Post; Marlborough code, coding was discussed with the other in an article could be classified as having a Express; Southland Times; Sunday Star Times; authors to reach consensus. positive, negative, mixed or neutral impact Herald on Sunday; Hawkes Bay Today; and Descriptive statistics are provided for all on tobacco control initiatives. Events with Sunday News. These papers covered all daily variables. A standard Z-test, equivalent to a positive impact were those that lined up newspapers in the five main population 266 Australian and New Zealand Journal of Public Health 2014 vol . 38 no . 3 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia Media and tobacco a chi-square test, was used to assess the Figure 1: Number of articles, and repeated articles, on tobacco published between November 2011 and October 2012. difference between the proportions of 140 positive and negative responses for event and opinion variables, with p<0.05 considered statistically significant. All statistical analyses were performed using Stata 10.1. Results Tobacco articles A total of 537 separate articles were obtained from both national and regional newspapers: 60% were news items; 15% opinion pieces or editorials; and 23% letters to the editor. Month Ninety of these individual articles were Month repeated two or more times in different Number of articles Number of appearances including repeats newspapers; 56 articles were repeated in one Number of articles Number of appearances including repeats other newspaper; and the remainder were January with 15 articles (23% of all cessation articles focused on events or actions that repeated two or more times. Consequently, articles); ‘Smokefree 2025’ peaked in May were rated as having a positive impact on 693 articles were published in total. Figure 1 with 47 articles (16% of all Smokefree 2025 tobacco control objectives in comparison shows the number of individual articles and articles); and ‘pricing’ appeared 33 times (30% to articles focusing on events having a individual plus repeated articles published of all pricing articles) in May. The themes negative impact on smokefree objectives. over the 12 months from November 2011 for both ‘tobacco industry’ (32 or 33% of all News items had the highest percentage of to October 2012. The amount of tobacco industry articles) and ‘plain packaging’ (27 articles describing tobacco control actions coverage fluctuated over the course of or 29% of articles with plain packaging as a having a positive impact (67%), followed the year, with high numbers of articles in theme), however, peaked in August. by opinion pieces and editorials (53%), January, May, July and August. The number while letters to the editor had the lowest of repeated articles followed a similar trend. Tone of articles percentage of positive event articles (47%). This fluctuation makes it difficult to see the The corresponding percentages of articles general trend of tobacco coverage over time. Table 2 shows the distribution of event describing actions with a negative impact impact and opinion for the 537 published were 21% for news items, 20% for opinion articles. Overall, significantly (p <0.001) more Theme of articles pieces and editorials and 23% for letters to In total, 1,057 themes were identified in the the editor, respectively. Table 1: Themes present in 537 newspaper articles. 537 articles. Table 1 shows the distribution Figure 2 shows that, in terms of the top six Theme Number of % total of the 19 different tobacco themes in the themes articles individual themes, more articles reported newspaper articles. Of these, six themes positive rather than negative actions or “Smokefree”/2025 286 27.1% appeared in more than 5% of the total events, especially ‘smokefree areas’ , ‘cessation’ articles: Smokefree 2025; smokefree areas; Smokefree areas 120 11.4 and ‘pricing’, which had a very low percentage pricing; tobacco industry; plain packaging; Pricing 111 10.5 of negative event articles (3%, 6% and 5% and cessation. These six themes accounted Tobacco industry 97 9.2 respectively, p<0.001). ‘ Tobacco industry’ , for 73% of all published articles. Additionally, Plain packaging 94 8.9 understandably, was the only theme to have more than 5% of the articles were coded as Cessation 66 6.3 ‘other’, a category that included stories about Heath effects 46 4.4 prisoners’ responses to the introduction of Table 2: Distribution of tone in newspaper articles Youth smoking 40 3.8 smokefree prisons; comparisons between (N=537) according to impact and opinion. Point of sale display 35 3.3 tobacco control and alcohol policy, usually Number of % total with an emphasis on the comparatively weak Economic issues 30 2.8 articles articles nature of alcohol policy; and a supermarket Prevalence 14 1.3 Event impact chain’s decision to instruct staff to place Advertising 18 1.7 Positive 324 60 cigarette packets in a plastic bag before Addiction 18 1.7 Negative 115 21 handing them to customers, so that “no one Second hand smoke 14 1.3 Mixed 30 6 can actually see cigarettes”. Health warnings on pack 4 0.4 Neutral 68 13 Temporal variation in the appearance of Prevention/education 4 0.4 Opinion themes was also evident. For example, the “Endgame” 2 0.2 Positive 246 44 theme ‘smokefree areas’ peaked in January Product issue 1 0.1 Negative 78 15 with 20 of the total 120 articles published Mixed 111 21 Other 57 5.4 or 17% of all articles with smokefree areas No opinion 102 19 as a central theme; ‘cessation’ also peaked in Total themes 1,057 2014 vol . 38 no . 3 Australian and New Zealand Journal of Public Health 267 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia Num,ber Num,ber  of  appearances of appearances McGee, Bang and Marsh more negative than positive impact ratings only 18 (3%) were negative for both event are some themes under-represented when (59% vs. 17%, p<0.001). In most articles and opinion, (p<0.05). other themes are at their peak? In the present study, nearly three-quarters of all articles discussing the industry, representatives related to six themes. Because of the constant of tobacco companies and retailing: a) Discussion criticised tobacco control objectives; b) competition for space in newspapers, it is argued for the ineffective nature of tobacco possible that certain themes such as cessation This study examined NZ newspapers’ control activities; and c) promoted industry support may be deemed un-newsworthy at reporting of tobacco issues over one year, other times during the year and are ‘pushed sponsored actions such as the NZ Agree/ focusing on the portrayal of tobacco control out’ by other tobacco-related news items. Disagree campaign. initiatives to achieve a Smokefree NZ by 2025. In addition to this, tobacco-related themes The temporal variation in the appearance As shown in Table 2, in terms of the tone of in general could be under-represented in of certain themes is likely to be explained opinions expressed about these events, more response to other competing news topics. It by the tobacco-related events occurring articles significantly presented (p <0.001) is also possible that some themes (e.g. youth a positive opinion rather than a negative in NZ around that time. The theme of smoking and addiction) are more likely to opinion. For the top six themes (see Figure ‘pricing’, for example, was at its peak in May, be portrayed through a medium other than which coincided with the government’s 2), all showed positive opinions outweighing the newspaper, such as through other online introduction of the new budget on 24 May negative ones. This was even the case for articles, social media or television. 2012. The themes ‘tobacco industry’ and ‘plain articles containing industry themes, where Overall, published articles on tobacco packaging’ both peaked in August, at a time opinions expressed in the articles still smoking were about three times more likely when there was heated debate regarding the remained broadly supportive of tobacco proposal to introduce plain packaging in NZ. to emphasise events or actions consonant control objectives. ‘Cessation’ peaked in January when tobacco with tobacco control objectives compared In terms of opinions expressed, letters to the with events antithetical to tobacco control, price increases came into play. Quitline use editor had a higher proportion of articles and to report them with a positive tone also peaks at this time as smokers attempt to with positive opinions (54%) compared with rather than a negative tone. This finding is in quit in the New Year. The recent emphasis in news items (44%) and editorial pieces (41%). 5,6 NZ newspapers has been on the proposed line with those of Smith et al. (2005) who Both editorial pieces and letters to the editor introduction of plain packaging in NZ, and found that news coverage in Australia and expressed more negative opinions than news the US was generally supportive of tobacco about a third of articles relating to this theme items, 25%, 22% and 9% respectively. This control initiatives. Where negative opinion were rated as negative events, primarily court seemed especially so in the case of ‘pricing’, was presented, it tended to be in editorials, proceedings being taken against Australia, with many apparent smokers complaining of and the threats of both court action and trade opinion pieces and letters to the editor in tax increases. Finally, 135 (25% of all articles) bans to coerce the NZ government not to comparison to news items. This suggests that were coded as positive for both event and these types of articles are the main outlets 100 introduce this legislation. opinion, describing actions that were both in which people can express pro-smoking Such expected variations in theme 100 positive for tobacco control objectives and views. Comparison with news coverage in 90 appearance pose an important question: were reported in a positive light. Conversely, 90 other forms of visual and online media are difficult to make. Our own earlier research Figure 2: Main tobacco themes by event and opinion. Positive Event on NZ television content in 2004 suggested Positive Event that about a third of news and documentary 100 Positive Event Negative Event type programs did present content critical Positive Event Negative Event Negative Event of tobacco – more so than entertainment- 50 Positive Opinion Negative Event Positive Opinion oriented programs – but this was not 40 80 Positive Opinion 30 especially high, with two-thirds of coverage Negative Opinion Positive Opinion 40 70 30 10 Negative Opinion non-critical in tone. 20 Negative Opinion Positive Event 20 Negative Opinion The NZ tobacco control community may take Negative hear Event t from the nature and extent of coverage of tobacco control initiatives. Even where Positive Opinion 10 tobacco industry viewpoints were expressed, industry opinions did not go unchallenged as Negative Opinion countervailing opinions often accompanied them. More than half the stories with the tobacco industry as a theme still conveyed opinions sympathetic to NZ’s tobacco control objectives. The industry was portrayed as Newspaper article theme ‘big tobacco’ and ‘tobacco bullies’, who if they Newspaper article theme Newspaper article theme “really had a concern for others, they would Newspaper article theme   voluntarily withdraw their lethal product from   the market”. This study has several limitations. First and Newspaper article theme foremost, our analysis was limited to data 268 Australian and New Zealand Journal of Public Health 2014 vol . 38 no . 3 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia Percentage PePrecPerecnertcnaetgnaetgaege Percentage Media and tobacco collected from available NZ newspaper against using endgame in media reporting. be a major policy concern. In this regard, it records, so our findings may not apply to It may well muddy the waters around will be important to monitor product issues other media. Further, not all NZ newspapers Smokefree 2025, a specific national goal that in the media, given the looming potential were analysed, although we were able to is currently being widely reported in a very for the tobacco industry to heavily promote examine newspapers with larger circulations. positive fashion. Furthermore, readers may e-cigarettes in the future. For example, we did not assess community simply not know what ‘endgame’ means, and newspapers, which are typically published communicating the plethora of concepts References once a week. Consequently, we cannot and actions falling under endgame ideas 1. National Cancer Institute. The Role of the Media in determine the exact number of repeated may prove difficult. For example, the notion Promoting and Reducing Tobacco Use. Tobacco Control articles. 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Press Audit Results industry arguments effectively, since their with tobacco dependence and addiction, [Internet]. Wellington (NZ): ABC; 2013 [2013 Jan 8]. Available from: http://newspaper.abc.org.nz/audit.ht countervailing opinions and arguments are although advocates may feel that this is ml?org=npa&publicationid=%25&mode=embargo& being reported – sometimes unchallenged. important to counter industry and some npa_admin=1&publicationtype=19&memberid=%2 This was especially so in view of the industry’s media viewpoints promoting smoking and its 5&type=%25. 19 14. Cohen J. A coefficient of agreement for nominal scales . response to the plain packaging proposals, consequences as a personal responsibility. Educ Psychol Meas. 1960;20:37-46. and unsubstantiated industry statements Similarly, discussion of cessation should 15. STATA: statistical software [computer program]. Version 10.1. College Station (TX): Stata Corporation; 2010. that previous tobacco control initiatives, such perhaps receive more media space, given its 16. Pederson LL, Nelson DE, Babb S, London J, Promoff as restrictions on point of sale advertising, importance for achieving Smokefree 2025. G, Pechacek T. News media outreach and newspaper have been ineffective. Smokefree 2025 was One option would be for tobacco control coverage of tobacco control. Health Promot Pract. 2012;13:642-7. one of the most common themes, expressed advocates to incorporate messages about 17 Holland B. It’s unethical. The Press. 2012, Oct 22: 16. in about one in every four articles, and cessation into media releases about other 18. Warner KE. An endgame for tobacco. Tob Control. 2013;22 Suppl 1: i3-i5. advocates should keep emphasising this goal. tobacco control initiatives, to keep cessation 19. MacKenzie R, Chapman S, Holding S. Framing On the other hand, ‘endgame’ as a concept in the public arena. responsibility: coverage of lung cancer among smokers was scarcely mentioned, although it is not and non-smokers in Australian television news. Aust N Finally, it is worth noting that there was only Z J Public Health. 2010;35:66-70. known whether this reflects resistance on one article reporting on product issues, 20. McKee M. E-cigarettes and the marketing push that the part of advocates to use the term or of surprised everyone. BMJ. 2013;347:f5780. although the issue of what is in cigarettes newspapers to take it up. We would argue and controls on additives to tobacco should 2014 vol . 38 no . 3 Australian and New Zealand Journal of Public Health 269 © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia

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