DESLEY BLANCH : A computer-generated photo of your future smoker’s face when you’re aged 50 or 60 was enough to encourage a significant number of young adult smokers to quit.
The study was conducted in pharmacies throughout Perth in Western Australia by Mrs Oksana Burford, a pharmacist and lecturer at the School of Pharmacy at Perth’s Curtin University.
Educational anti-smoking information was given to all 160 participants and half of them were photographed with internet-based APRIL photo-ageing software which simulates the effects of smoking on their faces at an older age.
The results showed 13.8 per cent of participants exposed to the photo-ageing technology reported quitting altogether, while only 1.3 per cent of the group not exposed to the photographs quit smoking.
Oksana Burford is co-author of the study.
OKSANA BURFORD : Well, literature has shown now that young smokers are definitely resistant to the traditional non-smoking messages or even advice. I mean they justify -- oh look, that’s a long term smoker, I won’t be smoking when I’m older.
They just feel they won’t develop heart disease, cancer or anything like that. In essence, they’re bullet proof, they’re young, they’re healthy and oh, they’ll quit in years to come.
But this in particular, this was a different approach, it was more of a personalised health promotion message, so showing them their photo-aged face was a very motivating factor because this time it was their face and premature ageing, that’s a very realistic fear for the youngsters.
DESLEY BLANCH : So how does that long term smoker’s face look like? What were the participants seeing in their own faces and how they’d look after years of smoking?
OKSANA BURFORD : Yes, a smoker’s face has actually got a classical definition; there are lines, wrinkles on the face typically radiating at right angles from the upper and lower lips, there’s also gauntness of facial features, there’s a greyish, sort of slightly pigmented grey appearance of the skin, slightly plethoric skin as well, definitely it goes on. There is evidence to show that.
DESLEY BLANCH : And what was their reaction when they saw their photo?
OKSANA BURFORD : Some of them would exclaim, there were a few obscenities, but generally, they were saying, oh my gosh, I look like Dad or I look like Mum. They could really see themselves in the future.
DESLEY BLANCH : So tell us about the psychology that’s driving your research as you capitalised on a person’s face and how it presents over the years?
OKSANA BURFORD : The face, the human face, it’s the most important sort of social object in the visual domain. It defines really who you are, what you are, how old you are. That’s the first thing when we approach someone, when we meet them, that’s exactly where we look. Though the sort of psychology behind it, it was an extremely important health promotion message this time, because yes, it was all revolving around the importance of the face.
DESLEY BLANCH : I guess it brings it right back home, doesn’t it. You’re seeing yourself and how you’re going to look.
OKSANA BURFORD : Yes, that’s right.
DESLEY BLANCH : So a very personal approach. You conducted your study throughout a number of pharmacies right across the city of Perth. So how was the research designed?
OKSANA BURFORD : It was a randomised controlled trial, so we did have intervention and control participants. So as a pharmacist, I was just working in eight different community pharmacies across the Perth metropolitan area and these participants were completely unaware.
They were just walking into my pharmacy, either waiting for a prescription or buying OTC meaning over the counter medications, some hair colours or otherwise, it may be cough medicines; and if they were in that right demographic group--18 to 30 year olds, I’d tell them about it.
I mean some of them I could hear them coughing and I’d say, ‘Ooh are you a smoker?’ ‘Oh yes, I know, I know, I shouldn’t.’
So I would ask them if they wanted to participate, so it was complete randomised allocation into groups: control people and intervention.
Now everyone received the standard smoking cessation counselling by myself as a pharmacist, otherwise the intervention recruited participants; they received the photo-ageing photo.
DESLEY BLANCH : Now how does a process of photo-ageing work?
OKSANA BURFORD : It’s actually been designed by a company called APRIL Age and they’re in Canada. It’s internet-based, 3-dimensional age Progression software. It creates aged images of faces from a standard digital photograph. So, I would just take a quick photo of the person and then download it onto my computer and then the wrinkling ageing algorithms, they’ve been based upon normative data for many people, broad variety of ages, ethnicities, lifestyle habits, and within literally a couple of minutes, I’d have a photo-aged picture of their face.
DESLEY BLANCH : Fully aged. Did you give them the photo to take home and keep looking at?
OKSANA BURFORD : Yes, actually. We conducted a pilot trial a few years before this, and yes, that was one the things. In the pilot trial we didn’t give them the photo and they commented saying, oh, we’d have really liked that photo. Now this time we did. I emailed it to them, within 24 hours. It was very surprising, they actually kept it, every person who received the photo-ageing kept their photo as ghastly as some of those photos were.
At the conclusion of the trial at six months, I would ring them up and ask them, have you kept your photo? Yes. So it meant that much to them. One person actually even commented that he’d use it as his screen saver on his computer.
DESLEY BLANCH : Ooh, he’s keeping it right in front of him, isn’t he?
OKSANA BURFORD : Yeah, that’s right.
DESLEY BLANCH : So after the six month period, what did your results reveal?
OKSANA BURFORD : The primary outcome, one in seven smokers stopped smoking, after they were shown images of their future self as a smoker and a non-smoker.
Apart from that also, the second outcome, the research also showed a greater proportion of smokers in the intervention group, that’s the ones that received the photo-ageing photo; they moved to a lower smoking dependence score than say the controlled smokers and that was validated using the Fagerstrom scale of nicotine dependence.
DESLEY BLANCH : So you test them if nicotine is in the bloodstream. Is that it?
OKSANA BURFORD : Hmm, actually, it was just verbally. That one was that’s available just on the internet as well, the quick questions: how many cigarettes do you smoke? When you first get up in the morning how quickly do you smoke your first cigarette? Within the first half-an-hour or the first hour or whatever, so that’s called the nicotine scale of dependence.
Otherwise, actually good point Desley, the smokers that stopped smoking after they were shown their images, that was done with validating it with a C.O. breath monitor, so a carbon monoxide breath monitor.
DESLEY BLANCH : Now they’ve been many anti-smoking messages, so why do you think your message was so successful?
OKSANA BURFORD : I think you have to have the right message for the right group. There are a lot of anti-smoking messages, health promotion, also different ways, you know, gums therapy, the nicotine replacement therapy, cold turkey definitely is still one of the best ways.
This one I think was the right message for the right group. It’s showing, not just graphic images of parts of the body, etc. to the youngsters, but they were confronted with how their continued smoking would affect themselves, their facial skin ageing and I think this was a very powerful message that really, combined with my sort of health care counselling, that this time the message got through to them.
DESLEY BLANCH : There are many people around the world smoking. So how do you take this research to those people out there?
OKSANA BURFORD : Oh, I would love to do that. In Australia, our smoking cessation messages and different ways that we’ve been sort of aiming at our research, there’s a lot of it in Australia and our rates have been declining.
This would be tremendous to keep photo-ageing this research maybe with the younger asthmatics even. They know they shouldn’t be smoking but they still do. So there’s lots of further education and research that I would like to continue. It all comes down to funding now.
This was part of my PhD; I’ve finished by PhD, so really we need in essence, funding to continue on.
DESLEY BLANCH : A very personal approach to give young smokers a glimpse into their future if they continue to smoke is research conducted by Mrs Oksana Burford, a pharmacist and lecturer at the School of Pharmacy at Perth’s Curtin University in Western Australia.