This project complements the efforts of HealthBridge and the Vietnam Public Health Association (VPHA) to foster the implementation of smoke-free policy in Vietnam and to support the long-term national plans to decrease the social acceptability of smoking in the country. It is hoped that these efforts will lead to declines in smoking rates and in passive smoking. In addition to the anticipated long-term effects on smoking, this project also seeks to increase the capacity of the Vietnam Public Health Association to work in tobacco control.

Objectives

The objectives of the project are to:

• Improve current levels of public awareness of health consequences of active smoking and secondhand smoke exposure (SHS);
• Increase public support of smoking bans in the public places;
• Improve the behavior of smokers (not to smoke in the vicinity of others) and non-smokers (confident to request smokers not to smoke in their vicinity);
• Build capacity of the Viet Nam Public Health Association to work effectively in tobacco control.

Results

Progress towards the goal of reducing the social acceptability of smoking is being achieved through the following strategies:

Production of evidence-based media products: The findings from a formative research and baseline survey were used to develop materials and to design a media campaign. Some images used in the Australian campaign, "Every cigarette kills", were adapted for use in the Vietnamese campaign. The main messages used for the campaign were "Speak up for your health and your beloved" and "Speak up for your health and your surroundings". The project team produced seven TV spots, three radio spots, and one poster. In addition, they produced talk shows, television and radio education sessions, leaflets targeting children and women, and training materials.

Conduct of a multi channel media campaign. The campaign was run by both central television (VTV1 and VTV3) and provincial television in three provinces (Thai Binh, Da Nang and Ben Tre) using the same TV spots. It was also run by central and local (in Thai Binh province) radio and by one newspaper. The campaign design was based on the knowledge and experience of consultants, information collected from the research, and the best possible arrangements with media agencies. HealthBridge and VPHA made special efforts to mobilize support from powerful political agencies. A monitoring system was set up to assess the media campaign.

Mobilization of community support for the campaign was undertaken in Thai Binh province. Two groups have been mobilized: women through the Women's Union and primary school children through the Department of Education and Training. Representatives of both groups were educated of the harmful effects of smoking and how to avoid exposure to SHS. They also helped to disseminate the message (via a leaflet) to the broader community. Several other community-based activities were also organized by youth and PPHA.

Implementation of a smoke-free policy in several settings, including health facilities, government and party offices, and public transportation, in Thai Binh province. The PPHA took the lead role in implementing the policy, and gained the support of other members of the provincial TCWG.

Progress towards the goal of developing the capacity of the Vietnam Public Health Association is being achieved through the following strategies:

Active involvement of VPHA in all steps of project development and implementation. The knowledge of VPHA staff members of tobacco control has been improved significantly through their active participation in the TCWG meetings and their attendance at important regional and national tobacco control workshops and capacity building programs. Staff skills in planning, coordinating and monitoring project activities, conducting research, developing IEC materials, designing and conducting media campaigns, and mobilizing the public has been also improved.

Networking: The relationship between VPHA with HealthBridge has been strengthened throughout the project implementation. While every organization has clear responsibilities, the two partners have been working as a team throughout the project, sharing ideas, discussing and finding solutions for problems. The relationship of VPHA with VINACOSH and other active agencies in tobacco control has also been developed and extended through the coordinating TCWG meetings. PPHA have also improved their credibility and prestige in tobacco control by playing the lead role in coordinating and implementing tobacco control programs at the provincial level. Relationships with the media have been extended and developed through multi-direction contacts over the life of the project. The visibility of VPHA in the regional and national tobacco control community has been much improved.

The project is ongoing. project's most recent report is available here.

Lessons learned

• The instruments used in research are crucial, and should be carefully developed taking into consideration local cultural context/languages.
• Selecting the field site should be based on the representativeness of the proposed study site, not just on its convenience to the researchers.
• Careful recruitment of interviewers and training is important; however, strict supervision is crucial to detect and manage any problems in a timely manner
• Keeping field intervention bias-free is always a challenge. Working carefully with local partners from an early stage to identify all possible risks and to develop measures to limit the impact of these risks is important.
• Keeping the commitment of VTV (Vietnam TV) to a low cost, appropriate airing campaign was a challenge. Meeting with people in positions of authority to increase their understanding of the importance of the messages being aired and developing a network of supporters is important.
• Support from national committees such as the National Committee for Science and Education and the National Committee for Culture and Sports is very helpful to gain permission from the national television network to air TV spots at reasonable peak times with adequate frequency and at no cost. Advocacy using different channels is a key skill at this interventional stage of the project
• Working closely with local partners could identify opportunities to integrate project activities with low cost and good participation.
• To be cost effective, a media intervention program should be as specifically targeted as possible.
• The ability to remain flexible in staffing arrangements is crucial to successful project implementation.
• Sincerity and openness can help in difficult negotiations. A sense of sharing and helping may have higher value than just salary.

Recommendations

The next phase of campaign should be monitored strictly.

The post intervention evaluation study should be designed early enough to ensure that it is properly designed and finished on time.