The media can influence public perceptions of health issues,1 2 health-related behaviour3 4 and governmental responses to health issues.5 6 Although tobacco is a newsworthy subject,7^–9 smoking-related news coverage is understudied. Further investigation of smoking-related media discourse is required,10 so that tobacco control media advocacy efforts can garner maximum political and public support.11 A range of tobacco-related news media analyses have contributed to this goal.8 9 12^–14 Descriptive news analyses have found policy issues9 and secondhand smoke in particular to be the most prominent tobacco issue in the news,7 8 15 and have also established that overall coverage as well as “opinionated” coverage is largely favourable to tobacco control. In addition, studies have linked news coverage to either behavioural4 16 or policy outcomes.17 18

The analysis of news coverage has been informed by the concept of the “news frame”—the result of the journalistic selection process that decides what elements of a story receive focus, and what elements are ignored.19 News frames make “one basic interpretation more readily discernible, comprehensible, and memorable than others” (Entman, p. 7)20 and shape how events or issues are publicly defined and discussed.21 Competing stakeholders use media advocacy to construct and advance news frames that support their ownership of or affinity with the way a problem is constructed in the media. Tobacco control agencies and the tobacco industry are competing stakeholders in relation to media portrayals of tobacco, smoking and smokers.

The majority of news studies on tobacco have simply set out to describe either the general news environment on the topic or coverage of one specific issue. To date, no studies have focused on portrayals of smokers. A study of US news articles about passive smoking noted the changing profile of smokers from 1981 to 1994—from rarely appearing in news articles in the early 1980s to being associated with deviance by the 1990s.22 This paper adds to news studies on tobacco and limited research on the depiction of smokers, by showing changes in how “the smoker” has been constructed in a sample of smoking-related newspaper articles from a major Australian newspaper from 1995 to 2005.

This 11-year period was a time of changing social attitudes towards smoking in Australia.23 An overview of the tobacco-related events that occurred during 1995–2005 in Australia, and specifically within the state of Victoria, where this study was conducted, gives a sense of the social context accompanying the generation of smoking-related newspaper articles that contained representations of “the smoker”. Consistent with changes in the broader Australian population, between 1995 and 2005, there was a decrease in the prevalence of regular smokers in the state of Victoria, from 25.1% in 199524 to 18.5% in 2005,25 and a decrease in adolescent smoking from 19% in 1999 to 9% in 2005.26 Changes in the way tobacco was taxed nationally resulted in higher cigarette prices from 1999, with increases after this time being in line with inflation.27 Tobacco control campaigns over this period featured television and radio advertisements that emphasised the serious health effects of smoking and directed smokers to sources of help to quit.28 29 The Victorian Tobacco Act was amended in 2000 and 2001 to ban tobacco advertising at point-of-sale, and there was ongoing development of smoke-free legislation: in 2001, smoke-free dining and shopping centre laws were implemented; smoke-free gambling was in place by 2002; and in 2003, the Victorian government announced a plan to make all workplaces, including bars, smoke-free in mid-2007.30 There were also two smoking-related legal cases that generated considerable media attention during this period.14 31

This paper aims to show the overall patterns of change over time in the kinds of representation of “the smoker” that have been in circulation in smoking-related newspaper articles from a major Australian newspaper from 1995 to 2005. This paper also examines the extent of media advocacy undertaken in support of tobacco control and public relations undertaken in support of tobacco promotion. Insights into the role that media advocacy plays in the representation of smokers may assist a strategic response by those engaged in tobacco control media advocacy.

METHODS

The news coverage analysed was limited to articles from The Age newspaper, one of two major daily newspapers—and the nation’s leading newspaper in terms of journalistic awards—in Melbourne, capital city of the state of Victoria, Australia, from 1 January 1995 to 31 December 2005. The Age and the other major daily newspaper in Melbourne present tobacco-related news coverage in a comparable fashion: reporting on similar tobacco control topics, and presenting a parallel range of positions in relation to tobacco control objectives and progress in both the hard news and opinionated coverage (Centre for Behavioural Research in Cancer, unpublished data). Circulation figures in 200532 show that The Age reached 10.8% of the Victorian population during the week, and 16.5% on Saturdays. For the years 2001–2005, articles were selected from those collected as part of a larger project monitoring news coverage of tobacco issues in Australia and the US.7 33 34 The articles in this Australian newspaper archive were located by a media monitoring company using the following search terms: smoke, smoker, smoking, tobacco, cigarette, cigar, quit, quitting, quitline, nicotine, nicotine replacement therapy and Zyban (a prescription medication designed to help smokers quit more easily). For the years 1995–2000, which predated the larger project, articles were sourced from The Age newspaper CD-ROM archives by replicating the search terms used by the media monitoring company.

From 1995 to 2005, 1236 articles were sourced––including news articles, editorials, letters and columns––that met the inclusion criteria of being at least seven lines long and containing at least 50% of paragraphs relating to tobacco issues. In order to make the coding process more manageable, a random sample of 50% of the articles published in each year of the sample was selected, reducing the total number of articles to 618.

A qualitative content analysis of the 618 articles was undertaken, mindful of one of the main tenets of critical discourse analysis: that texts be interpreted in relation to their sociocultural context.35 36 In order to develop a list of coding categories that described the variety of ways in which smokers were represented in the sample, two researchers engaged in an iterative process of reading and coding clusters of articles, comparing interpretations and refining the coding framework.

Additional coding rules were developed during the process to improve consistent application of the framework: a passage of text was required to be at least two sentences long to qualify as a possible coding category, and a coding category was to be coded once only per article. Also, there was no limit to the number of different coding categories––which were entitled “representational categories” (RCs) of the smoker––that could be identified in each article. The final coding framework, consisting of 21 RCs, was applied by two researchers to a sample of 30 articles with an 89% rate of coding concordance.

Coding rules were also developed to capture the media advocacy undertaken to further tobacco control and the public relations undertaken in support of tobacco promotion interests. Each article was examined for organisations that have a vested interest in the promotion or control of tobacco: by a spokesperson being quoted or by the views of a named organisation being represented in a general way (see online appendix for a list of organisations). Each article was coded for the presence or absence of one or more tobacco control media advocacy statements and tobacco promotion public relations statements.

A series of bivariate logistic regression analyses were used to examine changes in the prevalence of RCs in the 618 sampled articles across the years. The presence or absence of each specific RC was the dependent variable, with year the linear predictor variable. A similar set of analyses examined changes across years in the prevalence of statements from tobacco control and tobacco promotion sources. Analysis of RCs by news articles and opinion articles over time were not conducted, as there were insufficient cell sizes. As it was possible for articles to include one, both or neither of the statements, we used a series of two-way chi-square analyses. The first set was conducted on each RC to test for the presence (or absence) of tobacco control advocacy statements, the second set to test for the presence (or absence) of tobacco promotion public relations statements and, finally, another set to test for whether neither of these statements appeared within each RC.

RESULTS

There were 618 articles in total, an average of 56 per year (minimum 37, maximum 76). Overall, 69.9% were hard news articles and 30.1% were opinion articles such as letters, columns and editorials, and this percentage did not vary significantly over time. Of the total sample of articles, 19.3% appeared in the early general news section (first four pages) of the newspaper, with a trend towards a linear increase over time (year) (Linear odds ratio (OR) 1.07, 95% confidence interval (CI) 1.00 to 1.14).

Distribution of representational categories

Overall, 24.8% of the 618 articles contained at least one RC, 31.6% contained two, 20.6% contained three, 11.3% contained four, and 11.9% contained five or more RCs. Of the 21 RCs initially identified, the 13 most prevalent RCs, which each occurred in more than 50 of the 618 articles, are displayed in table 1. By far the most common RC, occurring in 43.4% of articles, was “smoker as regulated citizen”, whereby smokers were portrayed as being subject to or influenced by some kind of tobacco policy. Eight of the 13 most prevalent RCs reflected broader tobacco control outcomes of decreasing smoking, restricting where smoking can occur and reducing its social acceptability. Aside from “smoker as regulated citizen”, these included “smoker at risk” (26.2%), “smoker as selfish polluter” (19.7%), “smoker as supported potential quitter” (18.8%), “smoker as tobacco industry pawn” (17.0%), “smoker as quitter” (13.8%), “smoker as drain on the economy” (10.0%) and “smoker as nicotine addict” (9.2%).

Two of the 13 most prevalent RCs of the smoker are readily utilised in support of a pro-tobacco agenda: “smoker as free agent” (20.2%) and “beneficiary of the positive functions of smoking” (8.6%). There were three RCs that were harnessed by both tobacco control and tobacco industry sources: “smoker as statistic” (19.1%) (depending on the presentation of information about increasing rates of people smoking); “smoker as tobacco industry litigant” (12.8%) (as the litigating smoker can be portrayed as either justified or not for attempting to sue tobacco companies for smoking-related illness); and “smoker as vulnerable youth” (12.3%) (depending on whether the protection offered to youth against smoking is ventured as part of a comprehensive tobacco control solution or, according to the tobacco industry, simply an education problem that needs to be addressed).

In general, there were no significant changes over time in the frequency of occurrence of most of the RCs. However, changes in frequency were found in five RCs. There were two RCs that increased significantly in prevalence between 1995 and 2005: “smoker as tobacco industry pawn” increased from 3.8% in 1995 to 27.5% in 2005 (linear OR 1.14, 95% CI 1.06 to 1.23); and “smoker as tobacco industry litigant” increased from 5.7% in 1995 to 17.5% in 2005 (linear OR 1.14, 95% CI 1.05 to 1.24). In contrast, “smoker as quitter” (22.6% in 1995 to 12.5% in 2005; linear OR 0.92, 95% CI 0.85 to 0.99) and “smoker as drain on the economy” (high of 21.6% in 1997 to low of 2.5% in 2004; linear OR 0.90, 95% CI 0.82 to 0.99) decreased significantly over time. “Smoker as vulnerable youth” showed the most significant decline over the time period examined, with 24.5% in 1995 to 2.5% in 2005 (linear OR 0.82, 95% CI 0.75 to 0.90).

Statements from tobacco control and tobacco promotion sources

Using the coding parameters outlined previously, each article was coded for the presence of statements from tobacco control and tobacco promotion advocates. Overall, 30.6% of articles contained a statement from a tobacco control source, and 13.6% contained a statement from a tobacco promotion source. In addition, 62.9% of articles saw neither source quoted. Figure 1 indicates that the prevalence of tobacco control advocacy statements showed a trend for a linear decline over time from 41.5% in 1995 to 15.0% in 2004 (37.5% in 2005) (linear OR 0.94, 95% CI 0.89 to 1.00). However, there was a more marked decrease in tobacco promotion public relations statements over time with a significant decrease from 22.6% in 1995 to 7.5% in 2005 (linear OR 0.89, 95% CI 0.82 to 0.96).

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Figure 1 Percentage of articles from a sample of 618 smoking-related articles from The Age newspaper in Melbourne, Australia, from 1995 to 2005, that contain tobacco control advocacy statements or tobacco promotion public relations statements.

The relationship between representational categories and statements from tobacco control or tobacco promotion sources

Table 2 shows the extent to which statements from tobacco control or tobacco promotion sources appeared in articles with each RC. Articles with statements from tobacco control sources were more likely to occur in RCs featuring “smoker as statistic” (p<0.01). This reflects the journalistic convention that, when research results are released on smoking trends, the data are usually accompanied by a tobacco control statement urging further tobacco control action. Tobacco control statements were also more likely in articles featuring the “smoker as supported potential quitter” (p<0.001) because tobacco control sources were invariably those providing the support. In contrast, tobacco promotion public relations statements were more likely to feature in articles with the following RCs: “smoker as drain on the economy” (p<0.01), “smoker as tobacco industry litigant” (p<0.01) and “smoker as tobacco industry pawn” (p<0.001). This shows the kinds of smoker representations that tobacco companies and pro-tobacco organisations are emphasising or responding to, or are being sought for comment on by journalists.

There was an over-representation of statements in articles where the “smoker as vulnerable youth” occurred (tobacco control statements: p<0.05; tobacco promotion statements: p<0.05). Compared with articles featuring other RCs, articles with the “smoker as the beneficiary of the positive functions of smoking” RC were more likely not to contain a tobacco promotion public relations statement (p<0.05).

DISCUSSION

This paper adds to existing news studies on tobacco, and limited information about how smokers are depicted in the news media, by showing the overall patterns of change in how smokers were represented in a major Australian newspaper over an 11-year period. The analyses indicate that, although the prevalence of RCs do fluctuate over time due to specific events in different years, there were overall linear changes in the prevalence of some RCs, which we have identified.

Representations of the smoker that support tobacco control dominated smoking-related articles in The Age newspaper during 1995–2005. The context to this coverage was the tobacco control activity that occurred in Victoria over the 11 years, which drove the kinds of tobacco-related issues that both created and attracted media attention. The depictions of the smoker that supported tobacco control were enhanced by the presence of one or more tobacco control advocacy statements occurring in one in three articles in the sample––statements that highlighted and promoted tobacco control interpretations of events. That these statements declined over time is perhaps related to advocacy efforts being reduced once the legislative and policy gains that marked the period were won. There was increased public acceptance of the tobacco control policies that were implemented during this time, including increased support for smoking bans37 and acceptance of anti-smoking advertising campaigns, and thus less need to cite tobacco control voices in particular.38 39

In contrast, our finding that tobacco promotion public relations statements were less prevalent (occurring in 13.6% of articles) than tobacco control advocacy statements, and became less frequent over time, suggests that the tobacco industry has either reduced its activity in relation to shaping smoking-related discourses in Australian newspapers or is not being sought for comment with as much frequency by journalists. This trend may also be indicative of a broader shift in how tobacco companies engage with the media. In response to the 1998 Master Settlement Agreement in the United States, at least one major tobacco company officially shifted its policy so that its website became a primary means of communicating company policy.40 This de-emphasising of the news media as a communication conduit may have contributed to the downward trend reported here. Another possible reflection of the tobacco industry’s position in relation to the news media is our finding that, compared with articles featuring other RCs, articles with the “smoker as the beneficiary of the positive functions of smoking” RC were more likely not to contain a tobacco promotion public relations statement. This indicates that the tobacco industry is not associated with this depiction of the smoker in the news media, in contrast to their massive investment in advertising and promotion of the positive functions of smoking in marketing efforts.41

Research has confirmed that the public continue to view the tobacco industry as untrustworthy and dishonest.42 43 One strategy used by the tobacco industry to circumvent a poor public profile has been the cultivation of “front groups” in the media to promote their agenda. In this study, two organisations that made tobacco promotion public relations statements have proven links to the tobacco industry: The Tobacco Institute44 and The Australian Hotels’ Association.5 45 The low prevalence of tobacco promotion public relations statements found in this sample of newspaper articles suggests that the strategy of using front groups has not been particularly utilised in the Australian media during the past decade. Front groups may instead be engaged in other roles, such as lobbying legislators for pro-tobacco policy changes.

However, the tobacco industry has been asked to comment on, or chosen to engage with, media reports about tobacco litigation, seen in the large proportion of tobacco promotion public relations statements in articles with RCs connected to legal proceedings: “smoker as drain on the economy”, “smoker as tobacco industry litigant” and “smoker as tobacco industry pawn”. This indication that the tobacco industry can take up a particular position in relation to legal proceedings is also reflected by Milberger and colleagues,46 who have shown that, during lawsuits, tobacco company representatives are willing to contradict the admission made in other contexts that smoking causes cancer.

A previous specific examination of the news coverage of a tobacco legal case in the Australian news media found that the frame most frequently used in relation to the coverage was that smokers engage their free will in smoking and, as a consequence, are responsible for any resulting smoking-related disease.31 This construction of the smoker was captured in the present study by the “smoker as informed risk taker” RC. However, in this analysis, the “smoker as informed risk taker” RC was infrequent, showing that there is more scope in articles specifically about tobacco legal cases for discourses highlighting personal responsibility. To counteract this possibility, tobacco control media advocates should continue to promote the notion of the “smoker as tobacco industry pawn”. This would also contribute to the observation made in other research that tobacco-related lawsuits offer tobacco control advocates scope to frame tobacco issues in a way that can garner new public support for tobacco control policies.14 31

There are additional studies suggested by the findings of this analysis. The RCs of the smoker developed here could be used to examine the newspaper coverage accompanying specific tobacco-related events. This kind of analysis could resource targeted and timely tobacco control media advocacy strategies. It needs to be noted that the RCs in this study were developed from an Australian news context. Prior to applying the RCs to the news media of other countries, it would be necessary to ascertain whether different or additional RCs were required. Also, an examination of the views of the reporters who generate tobacco-related articles might illuminate the role that reporters’ values play in the construction of smoking-related discourse in Australian newspapers. In addition, the ways in which readers engage in public discourse on smoking could be investigated by comparing the prevalence of RCs in letters and opinion/editorials with the hard news coverage written by journalists. A limitation of our study was that we were unable to show this comparison because of the small cell sizes associated with the opinionated coverage. Although selecting a systematic random sample of public health news coverage is an effective means of managing the coding process and can produce estimates that closely approximate complete coverage,47 a smaller resulting sample limits the potential for more in-depth subgroup analyses.

In conclusion, this analysis has shown that, due to the level of tobacco control media advocacy, and the way in which smokers are represented, the smoking-related discourse in an Australian newspaper predominantly supported tobacco control objectives. However, tobacco control advocates should remain vigilant in monitoring discourses surrounding smoking-related legal issues in order to prevent pro-tobacco representations of the smoker from gaining traction.