Changing human behaviour is never straightforward. People can understand the risks and grasp the logic, but daily habits, culture, and social pressure can take hold, which is why the most effective campaigns don’t just inform.
They pierce through denial and make change feel urgent. Sometimes, only something heart-wrenching will do.
In the 1980s and ’90s, government advertising didn’t mince words or images. The work was stark, blunt and sometimes frightening.
One of the most famous examples remains the 1987 “AIDS: Don’t Die of Ignorance” campaign. Every household in the UK received a leaflet with no-frills typography screaming danger. On TV, a giant granite tombstone slammed onto the screen, the word AIDS chiselled onto its surface as John Hurt’s sombre voiceover warned of the deadly virus.
The design was severe and theatrical, featuring Gothic lighting, slow camera movements, and a score that rumbled like an earthquake. Prime Minister Margaret Thatcher attempted to block it, claiming it was too explicit, but it prevailed. Within a year, 98% of the public understood how HIV spread.
Drink-driving ads took the same uncompromising route. One notorious ad showed a mother spoon-feeding her paralysed son a liquidised Christmas dinner. The camera lingered on the slurry in the bowl, the silence broken only by her whisper: “Come on, Dave, just one more.” Complaints flooded in and the ad was pulled, but it won a British TV Award and, more importantly, shifted behaviour on roads.
In all of these examples, the creative approach stripped away polish, embraced discomfort, and used design, sound and narrative tension to make consequences unforgettable.
The softer touch of the 2010s
By the 2010s, the tide had turned. Inspired by the rise of “brand purpose” in commercial advertising, government health campaigns softened their tone. The visual identity became brighter, the language more hopeful, and mascots replaced the mortuary slabs.
Change4Life epitomised this era. Its sunny yellow logo, bouncy stick-figure characters and playful typography felt more like a children’s TV programme than a government campaign. The work leaned into partnership with supermarket tie-ins, recipe cards, and playful animations. The design world embraced vibrant colour palettes and handwritten fonts. Fear was out and friendliness was in.
Public Health England’s One You campaign, which launched the NHS Couch to 5K app in 2016, followed a similar idea. The app’s design was uplifting with bold images and motivational copy. On social media, relatable hashtags encouraged people to share their progress.
This gentler creative language lowered barriers and made small, positive steps feel achievable.
However, you could argue that getting up off the couch isn’t comparable to giving up a lifelong addiction to a habit that will probably kill you. So, when it comes to the most resistant audiences, this softer tone often bounced off.
Confronting denial head-on
Our campaign for Greater Manchester’s recent stop-smoking charge, “You’ll miss much more”, had to buck this soft and gentle trend in a big way and deliver an altogether different creative energy. In fact, it’s more in line with the 80s and 90s than now, because it had to puncture denial in hardened smokers who had ignored every previous warning.
The creative team leaned heavily on personal storytelling. In the TV spot, we see a daughter on her wedding day and, as the camera focuses on her wedding speech, the scene twists and dissolves to her father in a hospital bed. The sound design is brutal, as the bride’s joy gives way to the chilling audio of a death rattle. The casting made it more powerful, as the actor playing the father was a former smoker turned stop-smoking counsellor, adding authenticity to every strained breath.
Further executions were equally evocative, showing families missing precious milestones – baby’s first steps, birthdays and graduation. The focus is on the devastating effect smoking has on families and the people they love, and leaves the viewer in no doubt that smoking will see them miss out on the things they value most in life.
App registrations for quitting support rose by 360% in the first phase, then 900% in the second. Three-quarters of all new registrations in Greater Manchester originated directly from the campaign, and most individuals set quit dates as well.
This says to me that tone, craft and execution matter as much as the message. A campaign for healthier family dinners may thrive on playful animation and upbeat copy. Still, when the brief demands cutting through denial, only the darkest palette and the most uncomfortable sound will do.
The World Health Organisation discusses behaviour change as a sequence: awareness, attitude, and then action. Ultimately, the role of creative is to decide how that sequence lands.
In an era of endless scroll, creative teams may be tempted to keep everything bright and upbeat. Yet there’s still a place for work that unsettles and makes audiences squirm. Sometimes, the best creative decision is to make people uncomfortable because, when the stakes are high, hope might not be enough.
