Public outcry from health care organizations on changing behavior are usually done through promotions such as television advertisements that portray the dangers of a particular habit or through images that give out a stern message on how a particular habit can influence and change the life of an individual. The primary objective of this paper is to look at the different images used in promotions in the spreading of messages on the dangers of smoking and its effects (Kress et al, 2006). The paper will analyze the advertisements based on the multimodal techniques entailing the language features for instance, the use of verb moods, the use of imperatives and questions, and the choice of vocabulary used including the use of formal or informal languages. Other modes that will be used will be the use of analysis on the colors, the font size and type. This will enable the research to analyze the health promotion and its effectiveness in changing behavior.
Health promotion campaigns are considered to have high levels of efficacy when they spread awareness and change the knowledge, social beliefs, and the behaviors of a target audience. The main tactics health care promotions utilize in their campaigns is that of scare tactics. These tactics refer to spreading fear to a specific target audience. The fear is done to propel the audience to change their behavior in regards to better health (Clark, 2002). This is mainly seen in various adverts about the consumption of drugs such as the use of alcohol and cigarettes. This scare tactics is used as a means to scare people to leave their harmful behaviors. The study will look at three main advertisements on the health promotion of smoking and will look at the nature of these advertisements and whether they all use scare tactics as their main mode of communication to the target audience. By collecting this information, it will enable the research to understand the nature of health promotion advertisements on smoking and whether these advertisements are all based on using scare tactics as a mode of being effective (Cohall, 2011:76).
The research by Kress et al (1996) shows that scare tactics are a means used to alarm a target audience to change their health behaviors due to the consequences that are bound by the action. According to the study, the most health issues addressed using this means of fear appeal are campaigns on avoiding drugs, quit smoking and over speeding on the motorway. These tactics and advertisements often use shocking and graphic images and in other times use statistics to scare people into changing their behavior. The most common use of images used in smoking campaigns is the use of lungs that are laden with cancer. The use of fear appeal as well as shocking the target market towards a change of behavior is considered to be the most common method of driving change among the health campaigns on smoking. Job (1988) states that health promotion advertisements have the sole purpose of inflicting fear. However, the use of fear can be ineffective in producing the change required. The author however states that through certain conditions the use of fear in promotions can be effective. He highlights the following five elements as the main conditions for fear tactics to be effective:
- The campaign needs to offer a specific desired behavior
- Fear appeal in promotion materials can be effective when the fear onset occurs before the desired behavior
- When the event upon which the fear is supported is highly likely
- The level of fear elicited should only be such that the desired behavior is sufficient to reduce the fear inflicted
- The use of fear should occur as reinforcement for a desired behavior confirming its effectiveness.
Job (1988 p:163).
In a different study by Flay and Burton (1990), there are certain aspects that are considered influential in making the health promotions effective. According to the authors, for an effective campaign needs to be:
- High quality messages
- Reaching the target audience
- Gaining and keeping audience attention
- Encouraging interpersonal communication
Advertisements relying on spreading fear have been considered effective in certain cases according to Corcoran (2007) because when health campaigns spread fear to their target market, the message ends up resonating with the people as a reminder to the issues that will affect them. Machin&Mayr (2012) states that constant reminder of the adverse effects of the issues of smoking and other health issues presented in campaigns is necessary to help change behavior. Norfolk &Beckingham (1989) explain that the use of redundant message end up diminishing the effect of the health message because the intended audience have listened to the same message over again and may overlook the meaning. The meaning will not have the same shocking effect the advertisement aims to present to the audience. Therefore, the wording of the health promotion posters needs to be in a manner that will ensure there is the cause for alarm to the intended viewers. Clark (2002) states that the posters created in spreading health messages on smoking usually have redundant or repetitive messages mainly such as: ‘stop smoking’ and ‘smoking kills’. These two messages are considered as the most familiar ones in smoking posters and are used in the fear appeal tactics of health promotion posters. Maurer (2006) states that health promoters need to learn of the language to use in order to be alarming to the viewers of the message.
To provide the shock needed to viewers, the use of emphasis and the use of fact and statistics are necessary (Egger, 2013). Providing statistics creates an alarm for the audience since the message shifts its meaning from being opinions created by marketers to real world statistics. This information is therefore needed to provide the target market for them to fully understand the impact of smoking and its effects to their health. This is done to give them the impetus to change their behaviors and to stop smoking (Lupton, 2013: 44). For instance, a poster about the dangers of smoking showing the number of people smoking kills in a year is more effective that a poster on the same message that provides only the message-smoking kills. This ideology has been adopted in many of the messages and campaigns regarding smoking and has been effective (Cohall, 2011: 156). The national center for chronic diseases (2006) is a helpful study in providing insight as to how health care campaigns against chronic diseases have been helpful over the years. The study gives insight on the effective use of health care campaigns and how they have been successful in reducing bad health behaviors. It looks at the manner in which health care promotions have been increasing and how they are bring used to spread information on the causes and adverse effects of chronic diseases. Coombes (2010:56) states that health promotions are the fast ways of spreading health care information due to their short and precise use of words in their messages to put the message across. Unlike other modes of spreading health information such as posting of articles and media campaigns, in order to spread messages faster and for the message to be received abruptly, the message provided needs to be short and precise. This practice is witnessed in the use of posters and images.
According to Berkowitz (2017:77), the purpose of health campaigns is to ensure that the society changes its behavior to the better. This is largely enacted through providing information in a creative way so that the message can gain and keep audience attention and can be remembered easily remembered easily. Bonfiglio (2016:249) states that, images provide a better and a more lasting effect compared to the use of reading. When providing information, images are mainly the mode through which information is passed and the receivers of the message respond to better than any other mode of marketing. Simons-Morton et al(2012:46) shows that in health care, the use of scare tactics and appealing to the fear of the people has been considered the mode of spreading messages and which have been effective as they are the methods that have been utilized over time to spread the adverse effects of bad health behaviors. Health campaigns have been effective when they appeal to the fear of the people since it is the fear that has been identified as the main element that drives change. Fear is the main motivator behind people change their health behaviors. Kress (1996) in his research explains that the spread of health messages cannot be spread without appealing to the fear of the recipients. When looking to change the perspective of people and their health behaviors, it becomes apparent that the message given will explain the adverse consequences that will happen when one does not change their behavior. The author suggests that by default the messages given to those affected by a particular health behavior will always find the messages of them quitting their behavior as appealing to fear.
There have been conflicting views on the manner in which fear is effective in spreading health care messages. Job (1988) states that the relationship between fear and persuasion in the context of the fear is difficult to test because it predicts a complex series of interactions with no specific statement of the range of variation in fear (p164). This means that the level of fear needed to cause change cannot be measured and therefore this affects the effectiveness of fear tactics when spreading health care information. The author further adds that the motivation needed to change behaviors is not well documented and since the level of fear imposed cannot be measured, it becomes difficult to know whether the motivation provided by the messages are frightening enough to lead to behavior change. In other studies such as that of Simmons-Morton et al(2012), they state that the cognitive decision making process when recipients are exposed to messages of fear is to make a conscious decision to stop their habit. This means that when the target audience is presented with messages that are directed towards their fear, they end up making better decisions in regards to their health. Therefore, based on the study, making decisions is done better and more swiftly when exposed to messages of fear. Appealing to the fear of the recipients of the message creates the motivation needed for them to consider changing their behavior.
As a means of exploring the use of scare tactics in health promotion posters regarding the effects of smoking, the research looked at different posters and focused on the information provided. The posters are images with messages on the harmful effects of smoking. Linking with theoretical literary studies, the aim was to look at which of the posters chosen was more effective in changing behavior. The posters were chosen based on the messages they presented with each having a different mode of transmitting its messages for instance, the use of images, use of text and the use of providing facts. The posters can be referred to in the appendix. Based on the elements provided by Flay and Burton (1990) in the effectiveness of a campaign, the study was able to look at three health campaign posters and judge whether their scare tactics are effective. Multi modal elements of vocabulary choice, font used and visual aspects were considered in the analysis of the print advertisements in the study. Multimodal techniques are analysis techniques that provide the reader with different opportunities to look at different aspects of campaigns from the language used, the images and the font used. Multimodal technique was used as it is effective in analyzing posters. This is because posters have all the necessary facets present for multimodal analysis which are the language, the font style used and the images.
According to Simons-Morton et al (2012:157), advertisements on the dangers of smoking are usually in form of print media and television adverts. I therefore chose to follow the use of print media since Kress et al (1996) explains that print media has a lasting impression on the audience since it lasts more on billboards than advertisements last on television. Based on this ideology, analyzing print advert would be the most preferable in this analysis as well as influential in realizing its effectiveness in behavioral change. Three print adverts were analyzed and all had different aspects that were distinguishing in their nature. This was done in order to find out the most effective use of scare tactics in posters about smoking. The posters chosen however were creative advertisements meaning that they did not use certain aspects in the multimodal analysis such as the use of participants. The posters were mainly focused on the message other than the use of faces. According to Bonfiglio (2016:68) in order to make a message more appealing to its audience, the use of faces may lead to a better emotional relation with the recipients. Since the study did not have any human participants, the ethical consent forms were not used. The source where the posters were received from was a site that was free to access and the information is duly referenced in the study.
The study looks at the use of language, visual aspects, and the written elements such as the font style size and color. In the first poster (Appendix A), aspects of vocabulary choice is seen as being informal. The poster places a message across stating a cheaper way of looking smoking hot…quit!.The use of informal message is clear as it aims to resonate with its recipients. The poster according to Flay and Burton (1990) is an effective campaign as it meets all conditions necessary to enhance its reverberation in the audience.
The poster also promotes animal reminder disgust as explained by Rozin and Fallon (1987). The promotion leads to leading to biological reality beneath the sheen of human civilisation confronting us with the idea of our physicality, and decay of ageing. The poster (Appendix A) uses this phenomenon its presentation to enhance its effectiveness. The poster shows a woman who is supposedly decaying on one side due to smoking. The message used in the poster is also one that appeals to the fear of losing physical appeal. The image on the poster presents a beautiful lady but due to her smoking habit, her physical appearance is depreciating. The poster is using the animal reminder disgust in showing that the physical appearance will deteriorate the more a person uses cigarettes. The message used in the poster is also one that appeals to the fear of the audience. The poster places a number to phone in the poster that also appeals to the deterioration of the physical body. The phone number written in outstanding large yellow font shows the words new lung. Written in capital letters, this message is frightening as it reminds the audience of the consequences of smoking.
In the poster (Appendix B below), the focus is on the simplicity of the language and the image used. The fonts used are large and bear the message: smoking causes lung cancer. The message is written in large font that creates the effect of urgency. The picture is that of a lung that is made completely out of cigarettes. This is also an imaginative way of spreading the message. Based on multimodal techniques, the font used is made large for the target audience to understand the message. The poster focuses on presenting fear to the audience by emphasizing the most prominent messages in the poster, which is placed with an outstanding font size. This is done to give the main element of scare as the fonts are large and they cannot be missed. This provides the audience with the clear message on the adverse effects of smoking. The use of the lungs is also a scare tactic since it shows an image that the audience may relate with since it shows the state of the lungs once one starts to smoke. The image is creative and when put together with the words in the poster, it sends out a frightening message on the effect of smoking which. The language used is formal and simple in nature. This is another element in appealing to fear, the message is easy to understand making it more relatable to the audience.
Other posters are created for the sole purpose of presenting statistics to enlighten the people on the dangers of smoking. These posters according to Clark (2002) are more effective in spreading the message since people are more in tuned to believing facts rather than opinions. The poster (Appendix C below) is one of the posters that are created to provide information on the dangers of smoking. The poster uses creativity in its imaging and uses statement of facts to give the audience the factual basis of the claim-smoking kills.
The poster uses a gun as a means to portray the message and gives facts on the effects of smoking. According to MacDonald (2003:32), messages that are concrete with evidence are more likely to be believed in a sociological perspective because utilization of facts provides the perspective of validity to a message. Hence, posters on smoking that provide statistics and facts are more believable to the target audience. Based on the effectiveness facets provided by Flay and Burton (1990), the poster can be considered effective since it checks the criteria based on the authors formulation of effectiveness of health care promotion. The poster uses formal language in giving the facts of smoking dangers. According to Feinstein (1998:34) the simple the language the better to understand. This is seen in the poster (Appendix C). The poster does not use any fancy language and provides information that the target audience may be interested in. The poster also uses a question as a means to engage the audience. The font used in the words Smoking Kills are highlighted and are the most prominent words in the poster. This according to Feinstein (1998) is done to draw the attention to the most important part of the message given. The poster (Appendix C) is deemed effective as it has a high quality message; it reaches the target audience and keeps their attention. Finally, the poster encourages interpersonal communication among the recipients of the message. The provision of facts in the message allows for debates among the people as the more people talk about the message the higher the chance of promoting change.
According to Berkowitz (2017:78) any campaign be it in business or in health, the market is the determinant of the nature the promotion is going to take. The choice to use informal language is usually done as a means to relate easily with the audience. Therefore, when using such in the health campaigns it sends out a message that will be easily remembered by the recipients of the message. The poster can be considered effective based on the conditions provided by Flay and Burton (1990) which include reaching the target audience as well as gaining and keeping the audience attention. However, this poster only meets two of the main criteria provided for an effective health campaign. The study by Egger (2013) is used in the study to give the element of understanding on how language affects effectiveness of health care campaigns. Formal language and informal language are facets that are considered distinguishing in bringing their effectiveness to the health promotion campaign (p67). The language used in any promotion is essential in providing the desired effect to the spectator. The language that needs to be used needs to resonate with the target audience to provide an easy appeal for the behavior change needed. The use of formal language is considered to have more of an effect in health care promotion since the use of formal language augments the message meaning and makes it seem more serious. According to MacDonald (2003: 84), the use of informal language is used frequently in spreading fear since it makes the message concrete and it seems to resonate with the audience more than the use of formal language. This enables the message to carry the fear factor needed to change behavior.
The study by Maurer (2006) shows that when posters use certain fonts and language lead to more viewership and eventually enhanced effectiveness on the matter. The manner in which the posters and the words are arranged is a factor as to the viewership of the poster and the effectiveness of the message to those involved. The use of scare tactics is also lauded by Feinstein (1998) showing that the effects of health on individuals cannot be portrayed without fear. The facts of poor health behaviors and their effects on people’s lives is a matter that in its nature is fretful. Therefore, seeding such information cannot be done so without the element of fear. It is therefore an effective manner of giving this kind of information and the most effective. According to Bofiglio (2016),creative messages and images in posters create a relation with the message and the meaning. According to Coombes(2010:68) Creative images and wording provide an appeal easily accepted by the audience of the message as it uses a combination of visuals and creative font and wording making the message reverberate easily. The poster is therefore considered effective as it encourages interpersonal communication. This means that the poster leads to more people talking about it due to its creativity.
Health awareness campaigns are used to change the opinions and the attitudes towards a particular health habit. The study done analyzed three posters speaking of the effects of smoking and ascertained their effectiveness based on Flay and Burtons (1990) criteria, which entailed the use of high quality messages, reaching the target audience, gaining and keeping the audience attention and encouraging interpersonal communication. The research decided to focus mainly on health campaign print media due to their frequent use in health campaigns against smoking. The methodology utilized multimodal functions primarily focusing on the language, the font size used and the images used. Scare tactics were seen as the main mode of presenting health care messages to the audience since it is believed that the sue of scare tactics in health care promotion campaigns are the most effective. From the three posters used, it was also evident that their nature was different based in the language used and their effectiveness. Some of the posters as seen by Appendix A had the use of images and the use of scare tactics based. Compared to the criteria used in the study, the poster was considered effective. The poster was also seen to use animal reminder disgust phenomenon where the image presented reminds the audience of the diminishing state of their appearance and physicality due to smoking. The second poster Appendix B was mainly focused on the use of font and imagery. This was considered effective in its promotion since it has a high quality message and uses imagery to keep the attention of the target audience. The third poster Appendix C was considered to use facts in its promotion and this was seen to use scare tactics to promote change as it highlights the main message which is Smoking Kills. The use of facts is considered effective since it creates a sense of validity for the audience. The study therefore shows that the main approach to spreading health care messages is through scare tactics while using fear and disgust as the main elements to promote health-changing behavior.
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