© Cancer Council | 19/11/2018| cancervic.org.au

“13 Types of Cancer” Campaign Healthier Campapse Forum

November 19th 2018

© Cancer Council | 19/11/2018| cancervic.org.au

#rethinksugarydrink

#sugarydrinks

Alice Bastable

Healthy Lifestyles Campaign Manager

© Cancer Council | 24/10/2018| cancervic.org.au

#rethinksugarydrink

#sugarydrinks

Background in Australia

• The prevalence of overweight and obesity in adults rose from 57% in

1995 to 63% in 2014–15

• The prevalence of class 2 (BMI>35) and 3 obesity (BMI>40) in Australia

has doubled in 20 years

• 75% women and 83% of men (adults) in Australia may be overweight or

obese by 2025

Source: A picture of overweight and obesity in Australia, AIHW, 2018

Children • Victoria has the highest rates of childhood overweight/obesity in Australia

• Strong predictor of adult overweight/ obesity

Source: Children's headline indicators: overweight and obesity, AIHW, 2018

The rates of overweight/obesity in

Victorian children is now 31%

Childhood overweight and obesity trends over time

Victoria and Campaspe region

Source: Victorian PHS

Overweight (2016)

• Victorian average 30.6%

• Loddon Mallee 31.2%

Obese (2016)

• Victorian average 19.1%

• Loddon Mallee 24.2%

Obesity and cancer risk

Strength of the Evidence for a Cancer-Preventative Effect of the Absence of Excess Body

Fatness, According to Cancer Site or Type[2]

Cancer Site or Type Strength of the Evidence in

Humans

Relative Risk of the Highest

BMI Category Evaluated

versus Normal BMI (95% CI)

Oesophagus:

adenocarcinoma

Sufficient 4.8 (3.0-7.7)

Gastric Cardia Sufficient 1.8 (1.3-2.5)

Colon and Rectum Sufficient 1.3 (1.3-1.4)

Liver Sufficient 1.8 (1.6-2.1)

Gallbladder Sufficient 1.3 (1.2-1.4)

Pancreas Sufficient 1.5 (1.2-1.8)

Breast (post-menopausal) Sufficient 1.1 (1.1-1.2)

Corpus Uteri Sufficient 7.1 (6.3-8.1)

Ovary Sufficient 1.1 (1.1-1.2)

Kidney: renal cell Sufficient 1.8 (1.7-1.9)

Meningioma Sufficient 1.5 (1.3-1.8)

Thyroid Sufficient 1.1 (1.0-1.1)

Multiple Myeloma Sufficient 1.5 (1.2-2.0)

Sourced from IARC, 2016

The picture in Australia

Diet Items

3917 (3.4%)

7089 (6.1%)

7220 (6.2%)

3421 (2.9%)

3208 (2.8%)

1814 (1.6%)

539 (0.5%)

235 (0.2%)

157 (0.1%)

15588 (13.4%)

In 2010 it was estimated that:

• ~4000 cancer cases were

attributable to being above

a healthy weight

• ~7000 cancer cases were

attributable to poor diet

• ~1800 cancer cases were

attributable to inadequate

physical activity

Source: Whiteman, D. et al. Cancers in Australia in 2010 attributable to modifiable factors: summary and conclusions. Australian and New Zealand Journal of Public Health, 2015. 39(5): p. 477-484.

Obesity and cancer risk

• Cancer cases attributable to being above a

healthy weight is likely to increase over time

• Public awareness is low

- 40% in Australia

• May overtake tobacco as the leading preventable

cause of cancer

Why Sugary Drinks?

• WHO, WCRF and the ADGs all recommend that sugary drink consumption be

restricted or avoided altogether

• Largest source of added sugar in the Australian diet

• Offer no nutritional benefit • Contributes to weight gain

Why Sugary Drinks?

• Simple, single achievable behaviour

• Built off previous success of LiveLighter campaign

- Behaviour change

- Cost effectiveness ($5.22 back for every $1 spent )

Sugary Drink Consumption (N= 2,786) LiveLighter Campaign 2015

31.3%† 30.2%

22.0%*

28.8%

0%

20%

40%

60%

80%

100%

VIC SA

Morley BC, Niven PH, Dixon HG, et al. Controlled cohort evaluation of the LiveLighter mass media campaign’s impact on adults’ reported consumption of sugar-sweetened beverages. BMJ Open 2018;0:e019574. doi:10.1136/bmjopen-2017-019574

In Campaspe region

Source: Victorian PHS

Daily soft drink consumption • Campaspe 21.3% • Loddon Mallee 19.1% • Rural Victoria 18.8% • Victoria 15.9% Of those who drink SSB daily • Campaspe average 473ml • Victorian average 595ml

What does 473ml sugary drink look like?

Source: Victorian PHS

A can of cola ~14 teaspoons of sugar

What does 473ml sugary drink look like?

Source: Victorian PHS

A Can Of Cola Water

1 day 14 teaspoons 0

1 week 98 teaspoons 0

4 weeks 392 teaspoons 0

1 year 5096 teaspoons 0

10 years 50, 960 teaspoons 0

20 years 101, 920 teaspoons 0

407kg of

sugar!

What does 473ml sugary drink look like a week?

Source: LiveLighter sugary drink calculator

Effective campaigns are needed

Smoking prevalence in Australia and major policy changes

Source: Tobacco in Australia: facts and issues and AIHW, National Drug Strategy Household

Survey detailed report: 2013 - Supplementary tables, 2014, AIHW: Canberra.

Cancer Council Victoria addresses

broader factors in obesity prevention

“13 Types of cancer campaign”

Campaign objective

To communicate that one way of avoiding weight gain, which increases cancer risk, is to cut sugary

drinks from your diet.

Communication objectives

• To make Victorians understand and believe how consuming too much sugar leads to unhealthy weight

gain which increases cancer risk and feeds cancer growth.

• To create a sense of personal susceptibility regarding the risk of obesity-related cancer.

• To motivate people at risk of weight gain, or who are already an unhealthy weight to make healthier

choices, in particular cutting back on high sugar foods and sugary drinks.

• To instill a sense of urgency in making avoiding high sugar foods, especially sugary drinks.

Target audience

Primary - Women and men aged 25–49 years

Secondary - Parents of primary and high school children

- Regional/rural/remote areas

- GPs

• Informed by successes of previous campaigns

• Focus group testings for TVC

• Focus group testing with cancer survivors

• Engagement of clinical networks

• Consultation with eating disorder, body image, women's health and

Aboriginal and Torres Strait Islander groups

• Consultation with internal stakeholders

• Consultation with external stakeholders

• Consultation with Cancer Research UK

“13 Types of cancer campaign”

Campaign elements

• Advertising

- 30 sec, 15 sec, 6 sec TVC

- Radio

- Digital – including social media, banners, video, Near Me mobile

- Out of home

- Cinema

TVC

Social media

Social media

Outdoor advertising

Campaign elements

• GP support package (sent state-wide)

• Website

• Videos, animations

• Fact Sheets

• Health professional training

Fact Sheets

Website

Support videos

Health professional training

Dates for 2019:

Sat 23rd Feb

Sat 30th March

Thursday 16th May

* Regional training available on

request

Evaluation design

VIC

NS

W,

Qld

, S

A,

Tas, A

CT

,

NT

2018

20 Aug – 16 Sep 23 Sep – early Nov 26 Oct – 30 Nov

Campaign burst

(~800 TARPs)

N=850 N=680

Baseline

Survey Follow-up Survey

Baseline Survey

N=850

Follow-up Survey

N=680

Thank you!

© Cancer Council | 24/10/2018| cancervic.org.au

Alice.bastable@cancervic.org.au

| “13 Types of Cancer”

36

Negative based stereotypes

• In Victoria evaluation on the 2015 Sugary Drinks campaign saw no difference in negative overweight stereotypes.

• In Western Australia surveys on over 7,000 people have not found any increase in negative stereotypes held about people carrying excess weight through similar campaigns.

Source: