Entry Category
Best Health & Wellness Program
Name of Intervention/ Program
Quitline: Take the first step Campaign
Background and Situation Analysis
In September of 2023, the ACEs Aware initiative launched a website for Stress Busters, seven research-backed strategies to help people manage day-to-day stress and counter toxic stress from Adverse Childhood Experiences (ACEs). Having emphasized the
MORE has worked with the Massachusetts Tobacco Cessation and Prevention Program (MTCP) for over 25 years as their agency of record. MTCP’s mission is to invest in and work with communities, especially those that are historically oppressed, to reverse unjust policies, share decision-making power, and build community capacity to live a life free of commercial tobacco and nicotine. They accomplish their work through a network of contracted agencies to provide technical assistance around local tobacco policy; smoke-free housing; communications; youth engagement; health equity; tobacco dependence in substance use and mental health treatment and recovery; tobacco treatment training and technical assistance to health care providers; and operation of the Massachusetts Quitline (1-800-QUIT-NOW) and QuitWorks referral programs.
In addition, MTCP funds municipal boards of health to support the enactment and enforcement of local tobacco regulations. It also funds regional Tobacco-Free Community Partnership programs, which are based in community organizations and collaborate with local boards of health. These programs provide outreach and education to community organizations, health centers, housing authorities, educational institutions, and the media.
Smoking is the leading cause of preventable death and disease in Massachusetts, where more than 9,300 people die each year from smoking. Nationally, tobacco kills more people than motor vehicle crashes, AIDS, homicides, and poisonings combined. MTCP was also faced with a growing population of people who use vaping devices and nicotine pouches, and in 2019 there was a multistate outbreak of EVALI. Although smoking is at a historical low, there are still significant gaps in the prevalence of smoking and quitting among different populations. Higher smoking rates, lower quit rates, and/or higher rates of tobacco-related health outcomes are reported more for the following groups of people than the Massachusetts overall population:
- Black non-Hispanics and Hispanics
- Individuals that have MassHealth insurance
- Individuals with lower income
- Individuals with less than a high school education
- Persons with disabilities
- Individuals experiencing poor mental health
- Individuals who identify as LGBT
Given this context, MTCP set out to develop a new tobacco cessation campaign to reach adults in 2020, that has evolved year-over-year into 2025. Armed with the knowledge that people can double their chances of quitting when they receive support, our goal was to connect people who use tobacco with the Massachusetts Quitline (1-800-QUIT-NOW), which offers no-cost quit coach services and quit medicines. With MTCP and MORE’s focus on racial and health equity, the campaign was developed with representation from the audience and community along the way. In 2024-2025, we ventured into reaching primary care providers and will soon be targeting behavioral health providers to support their patients’ quit journeys.
Priority Audiences(s)
- Primary audience:
- Adults, ages 25-55, who use nicotine products
- English and Spanish-language
- Massachusetts residents, with a special focus on 30 priority communities that had higher rates of smoking and/or had larger populations of communities of color.
- Secondary audience:
- Health care providers
- Community-based organizations
Behavioral Objectives
Quitting tobacco and nicotine products acts as the behavioral focus for this campaign, with the actual product being engaging with the Massachusetts Quitline (1-800-QUIT-NOW) and the core product being living a nicotine-free life. Based on these features, the communication objectives are:
- Knowledge: We want our audience to know about the free quit resources and supports that are available to them.
- Attitude: We want our audience to feel confident that using these quit resources and supports will positively impact their quit journey.
- Behavior: We want our audience to connect with the Quitline to ultimately benefit from the quit resources and supports.
Description of Strategy/Intervention
To develop effective and empathetic messaging, MORE and MTCP prioritized audience research as the foundation of the campaign. Partnering with a market research firm, we conducted an online survey of current tobacco users to better understand their knowledge, attitudes, and beliefs about quitting and available support services. The findings revealed several key insights that shaped our messaging strategy:
- Many tobacco users were unaware of the free support available through 1-800-QUIT-NOW, including coaching and quit medications at no out-of-pocket cost.
- Messaging needed to be empowering, compassionate, and informational, reflecting a deep understanding of tobacco users’ experiences.
- A common barrier was the fear of being judged or feeling embarrassed when seeking help. It was essential that the campaign made support feel approachable and stigma-free.
- People were motivated by the positive effects of staying tobacco-free, though these motivators varied widely. Therefore, messaging needed to stay broadly relatable.
Using these insights, we developed several creative concepts and tested them through an online discussion board with current BIPOC tobacco users, conducted in both English and Spanish (n=31). Participants reviewed both new creative concepts and existing marketing collateral. One concept emerged as the strongest: “Take the First Step.” To bring it to life, we incorporated community feedback into a new look and feel, featuring bright colors and fresh photography of diverse individuals captured in an outdoor shoot. We then re-tested the revised creative with the same group via a survey tool (n=27). The updated materials were preferred over previous iterations and received high marks for being clear, inclusive, relatable, and motivating.
Building on the success of the “Take the First Step” concept, we created a suite of campaign assets that all pointed to a new landing page: mass.gov/quitting. Every element of the campaign was designed to be judgment-free, inclusive, and informative, helping people feel seen, supported, and empowered to take their first step toward quitting tobacco.
Implementation
Since its initial launch, the Take the First Step campaign has been implemented through a series of large-scale media buys and smaller, more targeted initiatives. Each campaign run has been tailored to best reach the intended audiences—whether statewide or within priority communities—depending on the media strategy and goals.
The campaign’s creative assets include a robust suite of English and Spanish-language materials, such as digital videos for social media, connected TV (CTV), and YouTube; static and animated display ads; radio spots; transit advertisements; convenience store posters; print newspaper ads; and Google search ads. In addition to general quitting messages, we developed a series of social media ads promoting tailored specialized support for individuals who use menthol products, people who are pregnant, and individuals with behavioral health conditions.
Media placements were strategically planned to either saturate the state or focus narrowly on priority communities—particularly for traditional media formats like transit and newspaper ads. Organic outreach supported paid placements, with videos and graphics regularly posted across MTCP social media channels. We also created a range of print collateral in English and Spanish, including a comprehensive brochure, a poster, a provider overview, convenient wallet cards, and tote bags. These materials are available at no cost through the Massachusetts Health Promotion Clearinghouse (massclearinghouse.ehs.state.ma.us) and are distributed widely by the eight regional Tobacco-Free Community Partnerships (TFCPs) and Boards of Health.
In early 2024 (January–March), the campaign re-launched on YouTube (English and Spanish) and Facebook/Instagram (English) to align with “quit season,” capitalizing on the motivation around New Year’s resolutions. From April through July, the campaign extended its reach through Google ads, CTV, and in-store posters targeting individuals at the point of sale.
To expand outreach to healthcare providers, a new social media campaign targeting Primary Care Providers ran on LinkedIn and Facebook in November and December 2024. This effort was supported by purchased email lists and featured messaging designed to help providers support patients in quitting. Building on this model, a similar effort targeting behavioral health providers is planned for Spring 2025.
Together, these efforts reflect a comprehensive, multi-channel approach to tobacco cessation outreach. By combining broad-reaching media with targeted messaging, community-level materials, and provider engagement, Take the First Step meets people where they are—whether online, at the point of sale, in a healthcare setting, or within their local community. The campaign’s layered strategy ensures that individuals seeking to quit have access to timely, culturally appropriate, and supportive resources across a variety of touchpoints.
Evaluation Methods and Results
To evaluate the effectiveness of the Take the First Step campaigns, we monitored a range of paid media metrics, including impressions, click-through rates (CTR), video views, and completion rates. These helped gauge how well the ads captured attention and drove engagement. For traditional media, such as convenience store posters and newspaper ads, we used trackable QR codes to measure user interaction and drive-to-web activity. Google Analytics provided insight into website performance, tracking sessions, unique visitors, time on page, and traffic sources. Collectively, these data points informed both reach and effectiveness, guiding opportunities for future optimization.
In 2024, paid media played a critical role in driving engagement. During the January 8-week campaign, the landing page saw 15,425 sessions—up from just 799 in the prior 8 weeks—along with 24,892 ad clicks and 479,158 video views. The April–July campaign added 10,600 clicks and 1.79 million video views. While performance varied across media pulses, these differences reflect strategic variations in media plans and budgets rather than campaign effectiveness. What remained consistent was the clear link between paid investment and audience response.
In addition, over 18,000 campaign materials were distributed via the MA Health Promotion Clearinghouse in 2024.
Working alongside MTCP’s epidemiologists, we have been able to prove that the campaign has made increases in calls and enrollments while the campaign runs. The first iteration of the campaign resulted in a 66% increase in Quitline intakes as compared to the same period the year prior. The second launch of the campaign resulted in a 79.4% increase in Quitline intakes in the priority communities, as compared to the same period the year prior.
For the January 2024 campaign, intake data was analyzed from 1/28–3/23. While the CDC Tips campaign also ran during this time (starting 2/5), it was statewide and not focused on priority communities. During this period, there were 220 Quitline intakes, with 82.3% self-referrals—an 11.1% increase in total intakes and a 19.9% increase in self-referrals over the same period in 2023. Among those intakes, 38.6% identified as BIPOC, slightly up from 37.6% the prior year. For self-referrals, that figure was 40.4%, up from 39.7%. Intake data showed an 8.8% decrease in behavioral health program calls but a 6.5% increase in menthol-related calls. Spring/Summer 2024 campaign data is not yet available.
Lastly, the provider-focused campaign on Facebook and LinkedIn met all performance benchmarks. Early email campaign results also show promising engagement, with unique open rates ranging from 15–34%.
These findings confirm that paid media is essential for driving awareness, engagement, and action—especially within our priority communities. The consistent increases in web traffic, Quitline intakes, and material distribution underscore the campaign’s effectiveness. As we look ahead, ongoing data collection and collaboration with MTCP will continue to guide and refine our approach for even greater impact.
Entry Letter: T