The state of Kuwait is a country in theMiddle East, whose affluence began following the discovery of crude petroleumin 1938, which led to a boom in the country as a whole. Kuwait currently has apopulation of 3.9 million and a per capita GDP of $63,863 (Health Data, 2018). As of 2016, the WHO FrameworkConvention on Tobacco Control (FCTC) report estimates that the total prevalenceof smokers in Kuwait is approximately twenty percent(WHO FCTC, 2006). Only three years after the EnvironmentalProtection Agency in the United States issued a report identifying second handsmoking as a carcinogen in 1992, the Kuwaiti government initiated progressivesteps in the control of tobacco consumption by placing a smoking ban in publicspaces (WHO FCTC, 2016). However due to the lack of appropriate lawenforcement of the stated policies, the tobacco industry in Kuwait was notdissuaded (WHO FCTC, 2016). The problem is further illustrated when physicians inside thehospital grounds perpetuate the social norm of indoor tobacco use, despite theknowledge of the harmful effects of smoking.
Aliterature review revealed that 18.4% of physicians in Kuwait are currentsmokers (Behbehani, Hamadeh, & Macklai, 2004), with morehistorical questionnaires revealing that up to 45% of male physicians weresmokers (Bener, Gomes, & Anderson, 1993). The #HealthyKuwait Campaign isfocused on addressing the elimination of tobacco product consumption onhospital grounds among physicians working in Mubarak Al-Kabir Hospital (MKH), oneof the five Kuwait University affiliated government hospitals. A literaturereview for this campaign reveals the target audience is comprised of male physicians,with the mean age of 44.6 ±9.1 years(Behbehani et al., 2004), of Middle Eastern ethnicity, andmiddle to high socioeconomic status.
The intention of the campaign is toutilize social norms and the diffusion of innovation theories to target the audiencethrough persuasive measures and alter current social norms. The utilization of opinionleaders to alter the prevailing social norms will be the desired outcome of thecampaign. Key informants will be interviewed from the medical community to gainin-depth qualitative insight to characterize the habits of the tobacco usingphysician prototype and identify opinion leaders within this subculture.Formative research will be utilized to further identify the shared beliefsamongst the group. The research reveals that 18% of physicians currently smoke,and 31% are Kuwaiti nationals (Behbehaniet al., 2004). Questions regarding Knowledge andattitude towards tobacco control showed that smokers were less knowledgeableabout the harmful effects of smoking and have less favorable attitudes towards tobaccocontrol (Behbehani et al., 2004).
Thus, those who identify with thisprototype are more inclined to engage in behaviors associated with this group (Hogg & Reid, 2006), further reinforcing the social normstheory which posits that the individual will seek external factors from thereference group, which the individual identifies with, in order to ascertainhow to behave in an ambiguous situation. Kuwait as a collectivistculture (Hofstede Insights, 2018) issusceptible to trends and the heightened interest in social media can beadopted to target the subculture of smoking physicians. One study demonstratedvia survey that approximately 94% of medicalstudents, 79% of medical residents, and 42% of practicing physicians use socialmedia (Bosslet, Torke, Hickman, Terry, & Helft, 2011). Targetingmaterials to a specific audience segment increases likelihood of exposure,liking, and behavior change (McGuire, 2001; Slater, 1996).
McGuireet al. emphasize that the audience must tune in to the message, attend to themessage and like and maintain interest in the message in order for behavioralchange to occur (McGuire, 2001).