Microsoft word - final chapter 1-2

2.1 Demarketing
It is important to employ demarketing in order to reduce the number of cigarette consumers, because it is revealed that smoking is not exclusively the lifestyle of the well income consumers as mentioned by Lee, Cutler, and Burns (2004). Their research leads them to believe that there are no significant differences of smoker population based on either employment status or receipt or welfare. Lee’s findings conclude that smoking habit can be picked up by consumers of any income, this is most likely because of the To acquire a deeper understanding of what demarketing is. It is necessary to understand how a marketer utilizes the marketing mix to provoke a deconsumption of a product. Another understanding of demarketing as explained by Comm in Shiu (2009) is that demarketing refers to a deliberate attempt to induce consumers to buy less in product classes where environmental impacts are evident to disrupt. Ideally companies would do this voluntarily without regulative action. Obviously demarketing is of particular concern for products which pose health risks like tobacco, alcohol and non- prescription drugs (Comm, 1997). Traditionally, the 4Ps of marketing mix refers to various controllable elements of the marketing program. The underlying consumption is that a company needs to develop the right product, at the right price, to get it to its target market, in the right place and promote it to its target audience (Shiu et al., 2009). Therefore, in order to encourage deconsumption of a product through demarketing, firm must figure out a way to utilize the marketing mix to discourage instead of encouraging Demarketing is considered a part of social marketing, as explained by Peattie and Peattie (2009) The social marketing focus on changing behavior to increase the well-being of individuals and or/society, and is applicable to a wide range of issues, but majority of campaign relate to personal health. Campaign can involve the Demarketing of a particular type of product or behavior or the promotion of a particular type of product or behavior. And similar to commercial marketing, social marketing is founded on research that is intended to understand the target market, the competition and the marketing context. And it is also delivered through a manipulation of the marketing mix, and also the commercial Four Ps model with some adaptation in order to allow social marketers to talk about the social product and the social price. This model is developed in order to compete against the current behavior which the social marketers are trying to change. Similar to demarketing, social marketing aims to alter the customer behavior towards the targeted products which brought negative impact to the consumer, in order for them to increase well being, in this case the negative impact is health. To achieve demarketing goals concerning their own customers, one or more marketing decision variables can be addressed by firms, For example, Kotler and Levy in Shiu (2009) mention “steps to encourage deconsuming” these steps includes curtailing advertising expenditures and sales promotions, increasing price also other conditions of sale, and adding time and expenses in order for a customer to acquire the product. These steps are crucial in decreasing consumption because it encourages consumers to have negative attitude towards the product. Demarketing alone cannot be successful without the help from government regulation. Government employ more comprehensive demarketing activities to encourage people to quit the habit of smoking and develop a demarketing mix to combat smoking and smoking-related behavior more effectively (Hoek ; Wall, In Shiu 2009). Wall and Hoek’ s argument are supported by Wakefield and Chaloupka, in Shiu (2009), who reported that a comprehensive tobacco control programs involving a range of coordinated and coexisting tobacco control strategies that is delivered correctly can work in a synergistic fashion to reduce smoking rates. There are inside factors of the consumers that can help the successfulness of demarketing, which is the level of education of the consumers. Grinstein, Nisan (2009) claims that higher education levels, positively affect positive behavior towards the demarketing campaign, and that higher education level can reduce the negative response The following subchapters will describe each of the marketing mix in detail, and how each of the marketing mix affects consumer’s attitude towards tobacco industry, smoking behavior, and intention to quit smoking. The following paragraphs would end tails specifically how product in marketing mix, product replacement and price discrimination, place restriction, and counter promotion, would affect consumer attitude towards the supplying industry, smoking and the consumers intention to quit smoking. 2.2. Product
In order to discourage cigarette consumption, cigarette consumers must be educated about the product alternative of cigarette or surrogate products or Nicotine Replacement Therapy (NRT) products such as nicotine gum or nicotine patch. By reducing the price of NRT, increase its availability, and increase NRT use are an important component of a comprehensive tobacco control strategy (Chaloupka, Frank, Tauras, and John, 2004). By making cigarette consumers aware of NRT increase its availability and reduce its price, cigarette industry will have to compete with the healthier alternative of its products, which in turn provoke an attitude alteration towards cigarette industry, smoking, and Cigarette smoking has leads to cardiovascular diseases, in which cardiovascular diseases are a major killer worldwide, Cigarette smoking has been associated with higher serum levels of cholesterol, coronary vasomotor reactivity, platelet aggregation, and a prothrombotic state (Prasad, Kabir, Zubair, Dash, and Das 2009). Even with the consequences of smoking clearly written in cigarette packages, there are still young people who initiate in smoking behavior every year well aware of the health risks. However majority of smokers are trying to quit smoking, Strong desire to quit smoking is possessed by the majority of smokers. However, the addictive nature of tobacco, act as a powerful deterrent regarding initiating and sustaining quitting attempts (Shiu et al., To aid consumers in quitting smoking, drug company manufacture product alternatives and surrogate products, there are also smoking cessation therapies like the Varenicline (Chantix). The effectiveness of smoking cessation drug aid has proves to be effective in helping smokers quit smoking. Varenicline has been compared with placebo in five studies 3-7 and with sustained-release bupropion (Wellbutrin SR sr) in three studies of healthy persons highly motivated to quit smoking.5-7 O on average, patients had been smokers for 20 to 25 years and reported smoking approximately one pack per day. Most patients (approximately 90 percent) had tried to quit at least once.3-7 based on these studies, about 20 percent of patients taking varenicline will be continuously abstinent from smoking one year after treatment compared with less than 10 percent of patients taking placebo (Love, Bryan, Merz, and Tonja, 2009). Through this kind of product elaboration, marketers can educate the consumers that there are means to quit smoking, this knowledge might change the consumers behavior and attitude towards smoking and Modern countries government, have issued a policy that obligates cigarette company to include Visual warnings in cigarette packages. According to Morvan, Gabriel, Gall-Elly, Rieunier, and Urien (2011) This method is currently the most effective in influencing deconsumption in tobacco because of its shocking image of what smoking causes in the long run, these visual warnings are pictures of throat cancer, lung cancer, mouth cancer and tongue cancer. Pictorial warnings reach smokers more and were more effective than textual warnings. With this information, three hypotheses came out, and those hypotheses were whether or not product elaboration would affect consumers attitude towards tobacco industry, smoking and intention to quit smoking. (a) Product elaboration negatively affects consumers’ attitude toward the tobacco (b) Product elaboration negatively affects consumers ‘attitude toward smoking (c) Product elaboration positively affects consumers ‘intention to quit smoking. 2.3. Price
The cigarette price is insignificant, even though consumers evaluate cigarette prices as being high these do not dissuade them from smoking (Raptou, Mattas, Tsakiridou, and Katrakilidis, 2005). Due to the addictive nature of cigarette, cigarette consumer would not hesitate to purchase cigarette regardless of its price. The lack of nicotine inside the consumers body, would lead to an unease sensation, which inevitably leads to consumption. However, if the cigarette price were to be raised above the consumer’s tolerance, the demand for cigarette would eventually declines. Significant increases in cigarette excise taxes adopted by many states in recent years, combined with the industry initiated price increases following the Master Settlement Agreement, account for much of the recent reductions in cigarette smoking (Chaloupka et al., 2004). This supports the previous argument and it shows that cigarette is less inelastic than what In strictly economic terms, price increases have a dampening effect on demand (Varian in Shiu, 2009). Levy, Chaloupka, Gitchell, in Shiu (2009) reports that taxation induced large price increases can result in reducing smoking prevalence by at least 10%. Maxwell (2002) report that pricing has a direct effect on consumer’s attitude. From the information above, it is evident that by increasing the taxation, tobacco company would have no choice but to raise its existing price, this action leads to consumers disappointment and decrease in demand, which in the long run will change the consumers attitude towards the tobacco company and smoking itself, also by increasing the price, the willingness to buy cigarette is decreased, making it the perfect opening for smokers to have an intention to quit smoking. (a) Price elaboration does not affect consumers’ attitude toward the tobacco industry (b) Price elaboration does negatively affect consumers’ attitude toward smoking (c) Price elaboration does positively affect consumers’ intention to quit smoking. 2.4. Place
One of the strongest governmental demarketing actions takes the form of smoking bans in public and workplace (Shiu et al., 2009). Government across the globe have issued at least one regulations against smoking in public place, Asian countries like Singapore who is currently at a great war against cigarette bans smoking indoors. Even countries like Indonesia has grown to push smokers to stop smoking by restricting the places they are allowed to smoke in, these attempts were making a smoking room in public places, strictly no smoking in school/campus grounds and no smoking inside government Two studies indicate that smoking bans may lead to increased cigarette consumption before and after work among some groups. This is a reminder to be cautious in implementing smoking place restrictions, although it may seem that there are less smokers visually, does not mean that the consumption actually decreases, moreover if the place restriction expose passerby to second-hand smoking. However, there are a few negative side effects of smoking place restrictions, there are evidence that smoking bans may lead to an increasing concentration of smoking at building entrances and exits, thereby creating more intensive SHS exposure at these locations. Smoking bans may also lead to unhealthy changes in smoking behavior (Bell, McCullough, Devries, Demarketing campaign have over time projected a negative view of smoking in public places leading to a negative public perception of smoking and of smokers, resulting in a negative stereotyping and stigmatization of smokers (Gilbert, Hannan, Lowe; Pechman and Knight, In Shiu, 2009). Negative public perception toward smoker could be utilized to encourage them to quit smoking, as this negative perception toward smoker can be used to make smoker feels somewhat alienated than the rest of the population. Through place elaboration, it is hoped that consumers could change their attitude towards tobacco industry, smoking, and intention to quit smoking. (a) Place elaboration does not affect consumers’ attitude toward the tobacco industry (b) Place elaboration does negatively affect consumers’ attitude toward smoking (c) Place elaboration does positively affect consumers’ intention to quit smoking. 2.5. Promotion
A ban on cigarette advertising through television and radio has been in place in the U.S. since the 1971 (Shiu et al., 2009). These bans restrict the promotional impact it will have to young adolescence if it were to be nonexistent, the bans restrict visualization of a person smoking a cigarette, making big companies like Philip Morris have to remove their beloved icon Marlboro Man, as well as Camel’s Joe Camel. And in radio stations, cigarette advertising is almost nonexistent. The findings by Shiu are supported by Iwasaki, Tremblay, and Tremblay (2006) who argues that advertising restrictions, especially the current policy that includes a ban on broadcast advertising and the provisions of the National Advertising Settlement, reduce the equilibrium level of consumption. Because previous studies show that cigarette advertising has little or no effect on market demand, it appears that advertising restrictions lower consumption by reducing price competition. These findings disprove the old findings that cigarette consumption is not affected by the advertising restriction. Another method of discouraging young adolescence to pick up the habit and encourage smokers to quit smoking is Government anti smoking campaign, as mentioned by Gilbert (2008) anti-smoking campaigns have encouraged a large proportion of smokers to quit smoking and discouraged many people from starting smoking, in the case of young people, and particularly young women, anti-smoking campaigns have been less able to discourage the initiation and maintenance of smoking. But anti-smoking campaigns are not more important than any other 4Ps in demaketing. The federal taxes, and the anti-smoking campaigns, are statistically significant in reducing cigarette sales in California, the magnitude of the two are quite comparable (Hu, Sung, and Keeler, 1995). This proves any of the demarketing 4Ps is comparably equal in influencing attitude toward Tobacco Company, smoking, and intention to quit smoking. One other thing that needs to be considered is in-store marketing, according to Bell, Corsten, and Knox (2011) exposure to in–store marketing (control) variables such as special offers seen at shelf and exposure variable (time spent shopping) leads to unplanned purchase. Therefore a ban on in-store marketing helps to discourage consumer to unplanned purchase of cigarettes. This would help greatly in demarketing cigarette through ban on promotion and helps to encourage intention to quit smoking. One other thing that marketer use to appeal to their consumers is package design. According to Landwehr, Mcgill, and Herrmann (2011). Consumers frequently see faces on inanimate objects (products) and that marketer can design these “faces” to convey brand image and personality. Through package design, marketer can attract and give happy feelings to consumer, this attribute of the product subconsciously affect consumer’s decision in purchasing or in this research non-purchasing decision. (a) Promotion elaboration negatively affects consumers’ attitude toward the tobacco (b) Promotion elaboration negatively affect consumers’ attitude toward smoking (c) Promotion elaboration positively affects consumers’ intention to quit smoking. 2.6. Attitude towards tobacco companies
By providing alternative and surrogate products, attach visual warnings in cigarette packages, increase the tobacco tax, and anti smoking campaign, attitude towards Tobacco Company is altered because of the negative images consumers are made aware of (Morvan et al., 2011). By having negative attitude towards Tobacco Company, a consumer does not want to be associated by the negativity of the tobacco company, which encourages a negative attitude towards intention to quit smoking. H 5: Consumers’ attitude toward the tobacco industry will negatively affect their 2.7. Attitude toward smoking
Discrimination of smokers through bans on smoking indoors and in public places creates a negative image toward smoking and smokers, this negative image is further acknowledge through anti smoking campaign by the government. Therefore consumers attitude toward smoking, will negatively affect their intention to quit smoking. H6: Consumers’ attitude toward smoking will negatively affect their intention to quit 2.8. Intention to quit smoking
The intention to quit is the only single dependent variable in this research model, Intention to quit is affected by all of the 4Ps and also the attitude towards tobacco industry, and attitude toward smoking. Later in the research, attitude towards intention to quit smoking will determine the accuracy of all the hypotheses. 2.9 Conceptual framework after model
2.10 Empirical Study
*Accessibility instead of price *Cost of involvement instead of price *Social communication instead of promotion variable *Socioeconomic variable *Psychological variable *Smoking place restriction *Cigarette price



Kedves Mindenki! Potenciális ügyfeleim! Az alábbiakban olyan egészségügyi tudnivalókat gyűjtöttem össze, amelyek szükségessé válhatnak túrák-expedíciók során, ahogy közös túránk esetében is. A felkészülés fontos fázisa az egészségügyi háttér megteremtése. Erre a túrát megelőzően hónapokkal előre gondolni kell. Attól függően, hogy milyen terül


Journal of Paediatric Respirology and Critical CareEvidence based management of acute bronchiolitis Sou-Chi SIT Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Bronchiolitis is a common acute lower respiratory tractroutine use of salbutamol is not recommended judgingdisease affecting infants. It is associated with viralinfection and respiratory sync

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