Testing how adults respond to pictorial health warnings

What is shaping tobacco

Tobacco research sits at the meeting point of regulation, public health and farm livelihoods. Every study we take on in this sector follows strict ethical guidelines and focuses on compliance, awareness, livelihoods and cessation.

• Point-of-sale and packaging rules are tightly regulated
• Public-health programmes track awareness and cessation
• Farm households weigh alternative crops and livelihoods

A national health agency in South-East Asia, working in Indonesia & Malaysia. Client identity is withheld to protect confidentiality.

Organisation

A national health agency in South-East Asia

Sector

Tobacco

Team engaged

Market Research

Services

Quantitative research, Qualitative research, Reporting & insights

The agency was reviewing its pictorial warnings and wanted evidence on which images and messages were noticed, understood and likely to prompt thoughts of quitting.

• Deliver on the brief: testing how adults respond to pictorial health warnings.
• Measure how widespread each pattern is, and explain the reasons behind it.
• Give the client evidence it can act on within 8 weeks.

Scope: 2,000 adults, 12 group discussions.

Audiences we typically reach in tobacco

Retailers and point-of-sale ownersTobacco farmersPublic-health programme teamsAdults trying to quitRegulators and enforcement officials

Coverage: Indonesia & Malaysia. Markets: Indonesia and Malaysia.

• Indonesia
• Malaysia

A mixed-method design: structured research measured how widespread each pattern was, and qualitative conversations explained why.

1. 1Brief
2. 2Face-to-face survey with stimuli
3. 3Group discussions
4. 4Insight

Interviewers showed adults several warning designs in rotated order and asked about noticeability, understanding and emotional response. Group discussions explored reactions in more depth, including among non-literate participants.

Quantitative researchQualitative researchReporting & insights

• Respondents were selected across Indonesia & Malaysia using quotas set in advance for each location and respondent type, so no single area or group dominated.
• Qualitative participants were recruited purposively to cover the full range of experiences that mattered, rather than for statistical representation.

adults

2,000

group discussions

12

• Trained local-language interviewers conducted interviews in person, supervised in the field.
• Interviews and discussions were led by experienced moderators using a guide agreed with the client.

• Back-checks on a share of completed interviews
• Time and location checks on field interviews
• Supervisor accompaniment in the field
• Recordings and transcripts for every session
• Re-screening of qualitative recruits
• Logic and range checks on the final data
• Work carried out under our ISO 20252 quality procedures

• Cross-tabulation by key groups and locations
• Significance testing on the differences that mattered
• Thematic coding of interviews and discussions
• Journey and decision mapping

• Warnings showing specific, recognisable consequences with a quitline number performed best.

Testing with low-literacy audiences changed which designs looked most effective.

• Build on the core insight: testing with low-literacy audiences changed which designs looked most effective.
• Focus effort where the evidence was strongest: warnings showing specific, recognisable consequences with a quitline number performed best.
• Re-measure after the changes to confirm the effect.

• The agency used the results in its next warning rotation.

What changed in the business as a result of the work. Impact is described qualitatively.

• Insight report and management presentation
• Cleaned data file and data tables
• Interview summaries and key verbatims

• Repeat the measure after changes are in place to track progress.
• A natural follow-on question: what would help farmers move to alternative crops?