Unhealthy sport sponsorship at the 2017 AFL Grand Final: a case study of its frequency,duration and nature

Objective: To assess the frequency, duration and nature of unhealthy marketing during the highest‐rating sporting event in Australia in 2017. Methods: A content analysis of the 2017 Australian Football League (AFL) Grand Final television broadcast identified episodes of unhealthy food and sugary drink, alcohol and gambling marketing (and pro‐health marketing as a comparison). Results: There were 559 unhealthy marketing episodes (47 minutes 17 seconds). Most (81%) were for unhealthy food and sugary drink products, while alcohol (9%) and gambling (10%) were less frequent. The total duration of unhealthy marketing was delivered primarily via fixed advertising (55%), dynamic advertising (32%) and branded objects (11%). For unhealthy food and sugary drinks, at least one episode was visible 25% of the time. For each of alcohol and gambling, at least one episode was visible 4% of the time. Unhealthy food and sugary drink marketing peaked in Quarter 2. Pro‐health marketing was limited, with 26 episodes (2 minutes 59 seconds). Conclusions: The 2017 AFL Grand Final broadcast featured a high frequency and extensive duration of unhealthy marketing, especially for unhealthy food and sugary drink brands. Implications for public health: Findings strengthen evidence supporting calls to increase regulation of sport sponsorship by unhealthy brands.     

Comparing Sugary Drinks in the Food Retail Environment in Six NYC Neighborhoods

Obesity is a national public health concern linked to numerous chronic health conditions among Americans of all age groups. Evidence suggests that discretionary calories from sugary drink consumption have been a significant contributor to excess caloric intake among both children and adults. Research has established strong links between retail food environments and purchasing habits of consumers, but little information exists on the sugary drink retail environment in urban neighborhoods. The objective of this assessment was to compare various aspects of the sugary drink retail environment across New York City (NYC) neighborhoods with disparate self-reported sugary drink consumption patterns. In-store retail audits were conducted at 883 corner stores, chain pharmacies, and grocery stores in 12 zip codes throughout NYC. Results showed that among all beverage types assessed, sugary drinks had the most prominent presence in the retail environment overall, which was even more pronounced in higher-consumption neighborhoods. In higher- versus lower-consumption neighborhoods, the mean number of sugary drink varieties available at stores was higher (11.4 vs. 10.4 varieties), stores were more likely to feature sugary drink advertising (97 vs. 89 %) and advertising at multiple places throughout the store (78 vs. 57 %), and several sugary drinks, including 20-oz Coke^® or Pepsi^®, were less expensive ($1.38 vs. $1.60). These results, all statistically significant, indicate that neighborhoods characterized by higher levels of sugary drink consumption expose shoppers to sugary drinks to a greater extent than lower-consumption neighborhoods. This builds upon evidence documenting the association between the environment and individual behavior.     

Sugary drink consumption behaviours among young adults at university

Aim: Sugary drink consumption is associated with weight gain, and young adults are the highest consumers. To inform a university healthy beverage intervention, we studied the settings and the types and amounts of sugary drinks consumed by a sample drawn from the student population. Methods: Fifty university students (24 male) were recruited to keep records of all beverages consumed over four consecutive days. The records were analysed by gender, drink category and consumption setting. Results: Males drank marginally more sugary drinks than females (median daily intake of 526 mL compared with 300 mL, P = 0.06). Median energy intake from sugary drinks was 928 kJ for males and 481 kJ for females. Carbonated soft drinks and fruit‐based drinks accounted for 64% of energy from sugary drinks for males; and fruit and sweetened milk‐based drinks accounted for 68% of energy for females. Half of all sugary drink consumption occurred at home followed by social settings. Conclusion: Health promotion programmes aiming to reduce sugary drink consumption in this group would benefit from gender‐differentiated strategies with respect to types of drinks consumed with a focus on the home and social settings.     

Trends in purchasing patterns of sugar‐sweetened water‐based beverages in a remote Aboriginal community store following the implementation of a community‐developed store nutrition policy

Aim: Aboriginal people living in remote communities experience high levels of chronic illness partly as a result of diet‐related body mass index above 25 kg/m². Remote stores are typically the only source of food and store nutrition policies are effective in enabling better health for community residents by changing product lines. The aim of the present study was to examine trends in purchasing patterns of sugar‐sweetened water‐based beverages in a remote Aboriginal community store following the implementation of a community‐developed store nutrition policy. Methods: Documents outlining the objectives and strategies of the store policy were examined. Store sales data were quantified to determine changes in purchasing patterns, volume of beverages sold, sugar and energy purchased before and after the withdrawal of the three highest selling sugar‐sweetened water‐based beverages. Results: The community‐developed policy was effective in implementing changes to product lines sold in the remote Aboriginal store. The withdrawal of the three top selling sugar‐sweetened water‐based beverages did not affect the total volume of all beverages sold but a shift in purchasing trends towards beverages with lower or zero sugar content resulted in a reduction in sugar and kilojoules consumed through water‐based beverages. Conclusion: The approach of a community‐driven store nutrition policy described here was successful and could be applied to other products in store that provide excess kilojoules with minimal nutritional benefit. The policy and aspects of implementation could also be applied in other remote Aboriginal communities.     

Food and beverage price discounts to improve health in remote Aboriginal communities: mixed method evaluation of a natural experiment

Objective: Retrospectively evaluate food price discounts in remote Aboriginal community stores. Methods: Four price discount strategies of 10% were designed in 2010, aiming to influence grocery, fruit, vegetables and diet soft‐drink sales. This natural experiment across a group of stores was evaluated using an explanatory, sequential mixed method design through analysis of store point‐of‐sale, document, observation and interview data. The outcome was measured by change in: 1) percentage of grocery sales to total food and beverage; 2) fruit and vegetable sales; and 3) diet soft‐drink sales. Qualitative data enabled the interpretation of outcomes through understanding perceived success and benefits, and enablers and barriers to implementation. Results: Eighteen community stores and 54 informants participated. While targeted price discounts were considered important to improving health, no discernible effect was evident, due to inadequate design and communication of discount promotion, and probably inadequate magnitude of discount. Conclusions: Strategy impact on food and beverage sales was limited by promotion and magnitude of discount. Implication for Public Health: This study demonstrates key factors and commitment required to design, communicate, implement and monitor strategies to improve health in this challenging remote retail context. Evaluation of natural experiments can contribute evidence to policy‐making.     

Nothing beats taste or convenience: a national survey of where and why people buy sugary drinks in Australia

Objective : There is limited knowledge of what influences sugary drink purchasing decisions in the Australian population. This study aimed to identify the most common locations and reasons across different demographic groups for purchasing sugary drinks in Australia. Methods : A total of 891 respondents (who purchased sugary drinks for personal consumption at least occasionally) from a broader national population telephone survey of Australian adults conducted in 2017 (n=3,430) were included in the analysis. Results : ‘Taste’ was a ubiquitous reason for purchase (94%) and the majority also agreed with ‘easily available’ (76%). Males, younger people and people of lower socioeconomic status (SES) were significantly more likely to agree that sugary drinks were ‘cheap’ and ‘better value than water’. Furthermore, males and younger people were more likely to report buying sugary drinks because they were ‘part of a meal deal’. The most common purchase locations were supermarkets (56%), followed by convenience stores (19%) and food or entertainment venues (17%). Conclusion : Taste is paramount in decisions to purchase sugary drinks, and widespread availability and value for money support consumption. Implications for public health : Policies and interventions targeting point‐of‐sale sugary drink purchasing decisions among the most ‘at risk’ consumers are warranted.     

Estimating tobacco consumption in remote Aboriginal communities using retail sales data: some challenges and opportunities

Objective: To describe and discuss challenges and opportunities encountered when estimating tobacco consumption in six remote Aboriginal communities using tobacco sales data from retail outlets. Approach: We consider tobacco sales data collected from retail outlets selling tobacco to six Aboriginal communities in two similar but separate studies. Despite challenges – including: not all outlets provided data; data not uniform across outlets (sales and invoice data); change in format of data; personnel change or management restructures; and anomalies in data and changes in community populations – tobacco consumption was estimated and returned through project newsletters and community feedback sessions. Amounts of tobacco sold were returned using graphs in newsletters and pictures of items common to the community in community feedback sessions. Conclusions: Despite inherent limitations of estimating tobacco consumption using tobacco sales data, returning the amount of tobacco sold to communities provided an opportunity to discuss tobacco consumption and provide a focal point for individual and community action. Using this method, however, may require large and sustained changes be observed over time to evaluate whether initiatives to reduce tobacco consumption have been effective. Implications: Estimating tobacco consumption in remote Aboriginal communities using tobacco sales data from retail outlets requires careful consideration of many logistical, social, cultural and geographic challenges.     

Changing Community Readiness to Prevent the Abuse of Inhalants and Other Harmful Legal Products in Alaska

This paper presents results from an application of the Community Readiness Model (CRM) as part of a multi-stage community mobilization strategy to engage community leaders, retailers, parents, and school personnel in preventing youth use of inhalants and other harmful legal products in rural Alaska. The CRM is designed to assess readiness to address a single social problem, based on a limited set of key informant interviews. In this study, researchers conducted 32 baseline and 34 post-intervention community readiness assessment interviews in four rural Alaskan communities. These interviews with key informants from the communities were coded and analyzed using CRM methods to yield readiness scores for each community. The aggregate results were analyzed using hierarchical linear modeling (HLM), and the individual community scores were analyzed in the context of the overall study. Significant positive changes in community readiness were found across six readiness dimensions as well as for the overall readiness score. Variation in the degree of changes in readiness across the four communities is attributed to differences in the intervention's implementation. The implications of these results include the potential for CRM assessments to serve as an integral component of a community mobilization strategy and also to offer meaningful feedback to communities participating in prevention research.     

Evaluation of a multi-component community tobacco intervention in three remote Australian Aboriginal communities

OBJECTIVES: To assess the effect of community tobacco interventions in Aboriginal communities. METHODS: The study consisted of a pre- and post-study of the effect of a multi-component tobacco intervention conducted in six Aboriginal communities in the Northern Territory (NT). The intervention included sports sponsorship, health promotion campaigns, training health professionals in the delivery of smoking cessation advice, school education about tobacco, and policy on smoke-free public places. The study was conducted in three intervention communities and three matched control communities. Surveys were used to measure changes in prevalence of tobacco use, changes in knowledge, and attitudes to cessation in intervention communities. RESULTS: Tobacco consumption decreased in one intervention community compared with the matched control community; the trends of consumption (as measured by tobacco ordered through points of sale) in these communities were significantly different (t = -4.5, 95% CI -33.6 - (-12.5), p < or = 0.01). Community samples in intervention communities included 920 participants. There was no significant change in the prevalence of tobacco use, although knowledge of the health effects of tobacco and readiness to quit increased. CONCLUSIONS: Although it is difficult to demonstrate a reduction in tobacco consumption or in the prevalence of tobacco use as a result of multi-component community tobacco interventions delivered in Aboriginal communities, such interventions can increase awareness of the health effects of tobacco and increase reported readiness to cease tobacco use.     

How the “Are We Drinking Ourselves Sick?” Communication Campaign Built Support for Policy Action on Sugary Drinks in Jamaica

Background: This study assesses the effectiveness of a campaign “Are We Drinking Ourselves Sick?” that ran nationally in Jamaica in four phases from 2017 to 2019 to increase knowledge about the harms of sugary drinks, shift attitudes, and build support for policy actions to address sugary drink consumption, including a tax and a ban in schools. Methods: Campaign impact was measured in representative cross-sectional household surveys of adults ages 18 to 55. A baseline survey was conducted before the launch of the campaign (n = 1430). Evaluation surveys were conducted mid-campaign (n = 1571) and post-campaign (n = 1500). Campaign impact was assessed by comparing changes across survey periods on key knowledge, attitudinal and policy support outcome indicators. The independent association between campaign awareness and outcomes was analyzed using logistic regression analyses. Results: The campaign was recalled by more than 80% of respondents and was well-received with 90% or more respondents describing it as believable and relevant. There was a decline in knowledge on the harms of sugary drinks from the baseline to post-campaign period, notably on risks of diabetes (adjusted odds ratio or AOR = 0.62, p < 0.001), overweight and obesity (AOR = 0.58, p < 0.001), and heart disease (AOR = 0.79, p < 0.003). However, post-campaign awareness was independently associated in logistic regression analysis with improved knowledge of the harms of sugary drinks, including risks of diabetes (AOR = 1.45, p = 0.019), overweight or obesity (AOR = 1.65, p = 0.001), and heart disease (AOR = 1.44, p = 0.011). Support for government action remained high across survey waves (≥90%), and campaign awareness was independently associated with increased policy support for sugary drinks taxes (Mid-campaign: AOR = 1.43, p = 0.019; post-campaign: AOR = 1.46, p = 0.01) and restrictions on sugary drinks in schools (AOR = 1.55, p = 0.01). Conclusion: This study demonstrates the role that media campaigns can play in maintaining knowledge and concern about the health harms of sugary drinks and increasing support for policy passage.     

Community-Based Efforts Aim to Improve the Food Environment within a Highly Obese Rural Appalachian County

Rural communities in Appalachia are displaying increased obesity prevalence, yet traditional interventions have not provided a broad enough impact to improve dietary consumption patterns. Therefore, expanding efforts that address the food environment and incorporate behavioral nudges through community-developed marketing strategies may be a viable mechanism to improve food and beverage choices within this unique population. This study installed shelf-wobblers across n = 5 gas stations in one rural Appalachian county in Kentucky. Smart Snacks were identified from store inventory lists utilizing the CDC Food Service Guideline for Federal Facilities calculator and were categorized into high-protein snacks, low-fat carbohydrate snacks, meal replacement snacks, and no-calorie beverages. NEMS-CS audits were conducted, and monthly sales data was collected at baseline and for six months thereafter for each store location. A difference-in-difference model was used, adjusting for total sales or total mean sales for each Smart Snack model to assess the percentage change within and between stores. Overall, percent change in mean sales and total sales across all stores resulted in a percentage increase of sales of Smart Snack items following wobbler installment. This study provides unique insight into how a community-driven approach to marketing can influence the sale of healthier food and beverage items.     

Impact on Dietary Choices After Discount Supermarket Opens in Low-Income Community

Objective

To examine (1) the association of a new supermarket opening with dietary intake and perceptions of healthy food availability, and (2) associations of distance to the primary food store and mean prices of fruits, vegetables, and sugary beverages with levels of consumption of these foods and body mass index in a low-income, southeastern community.

Stop the Pop: A Mixed-Methods Study Examining Children’s Physical and Emotional Responses during Three Days of Sugary Drink Cessation

Despite public health efforts to reduce sugary drink consumption, children’s intake continues to exceed recommendations. While numerous barriers to lowering sugary drink consumption have been identified, aversive feelings during sugary drink cessation may further challenge sustained reduction in children’s sugary drink consumption. Herein, we describe “Stop the Pop”, an intervention to examine children’s physical and emotional responses during three days of sugary drink cessation. Children (n = 150) ages 8–14, who reported habitual consumption of ≥12 ounces of sugary drinks daily, were instructed to avoid sweetened beverages for three days. At baseline and on each day of cessation, children completed a daily feelings questionnaire, and a subset of children (n = 30) also completed a qualitative interview following cessation. During sugary drink cessation, children reported physical and emotional improvements, including being less tired, angry, and annoyed; having less trouble sleeping; and less frequently arguing with others, getting in trouble, and getting mad. However, unfavorable responses, such as mood disturbances and having less energy, were reported by some participants. Our results suggest that children who habitually consume sugary drinks may experience physical and emotional improvements during short-term sugary drink cessation, although longer-term examination is needed and inter-individual variability in responses to cessation warrants further study.     

Using financial incentives to increase fruit and vegetable consumption in the UK

Encouraging the consumption of fruits and vegetables can help people increase their intake of micronutrients, dietary fibre and non‐nutrient substances, which together have benefits for health. A high intake of fruits and vegetables is associated with a lower risk of a number of diseases including heart disease, stroke, type 2 diabetes and some cancers. Among the numerous barriers to purchasing fruits and vegetables, price is still cited as a common factor. Therefore, more needs to be done to incentivise consumers to pick up more of these foods during their weekly shop. The UK Public Health Responsibility Deal seeks to reshape the food environment through behaviour change interventions; however, evidence to support the effectiveness of altering environments to change behaviour as a means to improve population health is weak. In particular, reducing price is a frequently considered policy to improve dietary habits. However, few studies to date have evaluated the effectiveness of such interventions on encouraging fruit and vegetable consumption. Our goal (The Co‐operative Group), in line with the Public Health Responsibility Deal, is to do more to create a positive environment that supports and enables people to increase their fruit and vegetable consumption. In light of this, we piloted a coupon incentive scheme in July 2012 for low fruit and vegetable spenders to see if making these items more affordable would encourage purchases and facilitate increased consumption. Results showed that sales of fruits and vegetables increased by 23.2% during the four‐week campaign, with 132 000 redemptions of the coupon by 90 000 members.     

Relationship between Frequency of Sugary Food and Drink Consumption with Occurrence of Dental Caries among Preschool Children in Titiwangsa, Kuala Lumpur

Dental caries are attributed to various factors including diet. The present crosssectional study determined the frequency of sugary food and drink consumption and defined its relationship to dental caries among preschool children. A total of 50 preschoolers (aged 5-6 years) in three kindergartens of the Department of Community Development (KEMAS) in Titiwangsa, Kuala Lumpur participated in this study. A set of structured questionnaires was used to assess the frequency of sugary food and drink consumption. Dental check ups were performed by a dentist. The dft index (decayed, filled teeth) was used to describe incidence of caries in subjects. Results showed that 62% of the subjects had dental caries. with the mean dft score being 3.72. The frequency of sugary food consumption by the majority of subjects was 2 times a day, while the frequency of sugary drink consumption was more than 3 times a day. There was no significant relationship between frequency of sugary food and drink consumption with incidence of caries. Subjects with high dft scores were more likely to report dental pain. The prevalence of dental caries in preschoolers in this study was high, indicating a need for effective dental health promotion to improve dental health status of this age group.     

A social marketing campaign to promote low-fat milk consumption in an inner-city Latino community.

The authors proposed the Lowfat Milk Campaign, a multifaceted social marketing campaign to promote the use of low-fat milk in the Washington Heights-Inwood neighborhood of New York City, a low-income, inner-city, Latino community. The campaign was designed for implementation by the Washington Heights-Inwood Health Heart Program, a community-based cardiovascular disease prevention agency. The first phase of the campaign began in November 1990. A followup phase for the period 1991-92 is in progress. The campaign focuses on a clear, relatively easily accomplished behavioral change, a switch by consumers of whole milk to low-fat milk, which may significantly reduce the fat consumption of persons in such a population, particularly children. The campaign strategy featured a mix of traditional health education methods, intensive local information media publicity, and innovative marketing techniques. In addition to increasing consumer demand for low-fat milk, the campaign successfully promoted institutional changes that are expected to facilitate healthy dietary choices in the future by members of the study population. Schools and other institutions that serve milk have been persuaded to begin offering low-fat milk in addition to, or instead of, whole milk. An essential component of campaign strategy was building support from key community organizations and leaders. Significant assistance was provided by the local school district, parents associations, churches, newspapers, radio stations, fraternal organizations, and a coalition of child care agencies.(ABSTRACT TRUNCATED AT 250 WORDS)     

Point-of-Purchase Price and Education Intervention to Reduce Consumption of Sugary Soft Drinks

Objectives. We investigated whether a price increase on regular (sugary) soft drinks and an educational intervention would reduce their sales.Methods. We implemented a 5-phase intervention at the Brigham and Women''s Hospital cafeteria in Boston, Massachusetts. After posting existing prices of regular and diet soft drinks and water during baseline, we imposed several interventions in series: a price increase of 35% on regular soft drinks, a reversion to baseline prices (washout), an educational campaign, and a combination price and educational period. We collected data from a comparison site, Beth Israel Deaconess Hospital, also in Boston, for the final 3 phases.Results. Sales of regular soft drinks declined by 26% during the price increase phase. This reduction in sales persisted throughout the study period, with an additional decline of 18% during the combination phase compared with the washout period. Education had no independent effect on sales. Analysis of the comparison site showed no change in regular soft drink sales during the study period.Conclusions. A price increase may be an effective policy mechanism to decrease sales of regular soda. Further multisite studies in varied populations are warranted to confirm these results.Consumption of regular (sugary) soft drinks has risen substantially over the past 25 years. Of all individual food types, soft drinks are the single largest contributor to caloric intake in the United States; they account for 7% of all calories consumed daily from 1999 through 2001 compared with 2.8% from 1977 through 1978.^1,2 The increased intake of regular soft drinks and other sugary beverages has significant health implications, including weight gain and an increased risk of developing diabetes.^3,4Individual-level interventions, those targeting 1 individual or a small group of individuals at a time, can lead to a reduction in sugary beverage consumption. One trial reduced the consumption of sugary beverages and achieved modest weight loss goals among adolescents who were randomized to receive home deliveries of noncaloric beverages and counseling on healthy beverage consumption.⁵ A school-based nutrition education program for children aged 7 through 11 years achieved a modest reduction in carbonated beverage consumption and decreased the incidence of obesity and overweight.⁶Population-level point-of-purchase strategies have the potential for larger effects at lower cost. Point-of-purchase interventions have successfully increased sales of fruits and vegetables in a cafeteria⁷ and low-fat snack foods in vending machines⁸ through the posting of educational messages and a reduction in the price of those items. Additionally, levying taxes has been associated with reduced cigarette smoking rates in several areas, including New York City⁹ and the state of California.¹⁰Public health leaders have called for the taxation of sugary beverages to discourage consumption and to raise public health funding for obesity prevention programs.^11,12 Alternatively, salient information about the health effects of regular soft drinks may affect consumption. To determine whether point-of-purchase strategies can reduce the consumption of regular soft drinks, we employed price and educational interventions in a hospital cafeteria.     

Point-of-purchase alcohol marketing and promotion by store type--United States, 2000-2001

Alcohol consumption is the third leading preventable cause of death in the United States, accounting for approximately 100,000 deaths annually. Efforts to reduce the adverse health and social consequences from alcohol use include policies to restrict access to alcohol among underaged persons (i.e., persons aged <21 years) and to reduce alcohol-impaired driving among persons of all ages. Recent studies have focused on alcohol marketing as a potentially important contributor to alcohol consumption, particularly among underage drinkers. Point-of-purchase (POP) (i.e., on-site) marketing, including alcohol advertising and placement, can increase alcohol sales and consumption substantially, thereby increasing the risk for various alcohol-related health outcomes, including alcohol-impaired driving and interpersonal violence. To assess the type and frequency of POP alcohol marketing, researchers with the ImpacTeen Project collected and analyzed store observation data during 2000-2001 from 3,961 alcohol retailers in 329 communities throughout the United States. This report summarizes the results of the study, which indicate that POP alcohol marketing is extensive in certain store types frequented by teenagers and young adults. Public health agencies and policy makers should work with liquor control boards to reduce POP marketing that could promote risky or underage drinking.     

Bikes for Life: Measuring the effects of a bicycle distribution program on 6 to 12-year-old children’s BMI and health behaviors

Treating pediatric obesity is challenging. The objective was to evaluate effect of receiving a bicycle on (a) physical activity, (b) sedentary activity, (c) Body Mass Index (BMI), and (d) eating habits.A stepped-wedge randomized controlled trial of 6- to 12-year-old patients with overweight/obesity was conducted April 2012–2018. Participants were randomized to wait 0, 2, 4, or 6 months for a bicycle. Outcomes on activity, BMI and eating were collected at 3, 6, 9- and 12-months after children received a bicycle.A total of 525 participants with 387 (74%) completed 3-month follow-up questionnaire, and 346 (66%) completed 12-month follow-up visit. Participants were mostly Latino/a (71%) and low income (58%), and 31% had never ridden a bicycle. Median baseline BMI was 98th percentile. At 3 months, 62% reported bicycle use last week, on average 3.6 days. Time spent on sedentary activities decreased by 48 min/day (p = 0.04), and time spent playing sports increased by 1.7 h/week (p < 0.01). No reduction in BMI was seen. Consumption of sugary drinks decreased (by 0.59 servings/week, p < 0.01), and consumption of vegetables increased (0.71 servings/week, p = 0.04). At 12 months, sedentary time, sugary drink and vegetable consumption remained significantly more favorable than at enrollment (p < 0.01, p < 0.01, p = 0.04 respectively), but not significantly different (p = 0.47 for sedentary, p = 0.73 for sugary drink) and significantly less favorable (p < 0.01 for vegetables) than at the time of intervention.Participants reported riding bicycle, improved activity and dietary habits, though reversion towards baseline behavior was seen by one year and no change in BMI from enrollment.     

Differences in the perception of a mass media information campaign on drug and alcohol consumption

The two-month mass media campaign in Belgium on drug and alcohol consumption "Alcohol and other drugs. The facts and fictions" initiated in January 2008 has been evaluated shortly after by a phone survey. This article reports some indicators on the public awareness of the campaign, and the differences in the perception according to age groups and education levels.About 1,000 respondents (n = 1,002) accepted to participate in the campaign evaluation. Response rate is 37.1%. Global perception of the campaign - measured by the capacity to identify the campaign adequately - is 18.8%. This perception varies between age groups and education levels: 30% of the youngest age group (14-35 yrs) have seen the campaign, 13% of people aged 56 and over (p<0.001). The lower the education level, the lower the probability to have seen the campaign (11% in the lowest group, 25% in the highest one, p<0.001).Among the respondents who have seen the campaign, newspapers are the most often cited media for the oldest age groups. Inversely, young people have mainly identified the campaign on street boards or on post cards.The privileged type of media is also function of the education level. People belonging to the lowest educational level report more often to have seen the campaign on TV (85% vs 51% in the highest group, p<0.01), while the reverse is true for seeing the campaign via the newspapers or the street boards.The results indicate that there are socio-economic variations in the perception of the campaign. In health promotion, reaching lower socio-economic groups still remains a real challenge. Channels for such campaigns have to be carefully chosen to reach their target groups and ask to be complemented with community based interventions.