They tan, they vape, but they don’t drink. The challenges of getting health messages through to gen Z

A growing number of young Australians are thumbing their noses at long-established health messages — they’re tanning, vaping and having unsafe sex in increasing numbers. But the same generation is avoiding alcohol, with the under-30s increasingly dubbed “sober curious” — and alcohol retailers are finding it tough to keep up with demand for zero-alcohol drinks. Memories of messages such as “slip, slop, slap”, “every cigarette is doing you damage” and even the impact of the infamous 1980s Grim Reaper AIDS campaign are fading, as experts grapple with how to get the youngest adults to live healthier lives. Despite decades of work to bring down smoking rates, the number of teenagers and young adults who vape has tripled in nearly five years, according to the British Medical Journal, and experts are trying to combat the spike to ensure vapes don’t become the new cigarettes. The Australian Bureau of Statistics this week revealed young people aged 15 to 24 were more likely to experience sunburn than people aged 65 years and over. Women aged 15 to 24 were more likely to attempt to get a sun tan than men in the same demographic. And notification rates for all sexually transmitted infections (STIs) are on the rise — including a tripling of rates of infectious syphilis and a doubling of gonorrhoea rates in the past decade. There were nearly 33,000 gonorrhoea notifications in Australia in 2022, with the highest notification rate among those aged 20 to 24 years, according to research from the Kirby Institute. “We’re not getting the messaging right or it’s not permeating within (the younger) cohort,” Daniel Vujcich, chief executive of WAAC — formerly the WA Aids Council — told The Sunday Times. He said some drivers for the rise included changing sexual practices as sex became less stigmatised, as well as reduced use of condoms due to complacency or a belief that STIs were no longer a risk. “Research tells us that most WA students don’t think of HIV or STIs more generally as something that is relevant to them,” Mr Vujcich said. “They think about STIs as things that happen to other people. “We know from the epidemiology that’s actually not borne out in reality and that young people are very susceptible to STIs.” Australian Health Promotion Association vice-president Luke van der Beeke also said the latest sun protection data could point to a bigger problem. “The relatively high likelihood of people 15-24 years experiencing sunburn versus those who are 65 years and older can’t solely be attributed to an assumed lack of exposure to health marketing campaigns,” he said. “It would be interesting to know if the very low number of people (aged) 65 plus experiencing sunburn is a function of fewer older Australians venturing out into the sun.” Melissa Ledger, cancer prevention and research director at Cancer Council WA said its 20 years of skin cancer campaigns were rarely targeted towards young people, citing challenges with funding. “If there was sufficient investment, we could have tailored, targeted campaigns and programs that would address some of these gaps,” she said. But despite the greater likelihood of teens and young adults vaping, tanning and having a sexually transmitted infection, they’re also more likely to be teetotal — or at least drink far less than their parents and grandparents. Just 29 per cent of people aged 18-24 drank alcohol each month, according to the most recent data from the Australian Institute of Health and Welfare, meaning it was most common that young people would drink weekly, but not as often as every day, for the first time since 2010. One in five drank less often than once a month, and 16 per cent have never had alcohol — up from 7.5 per cent 22 years ago. According to health insurer Bupa, those aged 18-29 were cutting back the most and rated the highest in showing they would like to drink less. The same sentiment has been reported by Endeavour, the parent company of big liquor chains Dan Murphy’s and BWS, which has seen sales of zero-alcohol drinks grow exponentially in the past few years. La Trobe University researchers Amy Pennay and Michael Livingston said though young people were often perceived as out of-control and high-risk drinkers, data suggested the reality was “startlingly different”. More negative media coverage and increasing public concern about the impacts of alcohol are just some of the factors believed to drive the decline in youth drinking, they said. Mr van der Beeke also suggested technology and social media may have a role to play in changing how young people interact, reducing the appeal of alcohol as a tool for hastening social connectedness. “I’d argue it’s easier to target young people with health messaging today due to the proliferation of social media,” he said. “The way we promote and encourage healthy behaviours through the media has changed, because the media landscape itself has changed.” Mr Vujcich and Ms Ledger agreed there was no need to revert back to fear-based campaigns, like the Grim Reaper ad — which aimed to raise public awareness about AIDS, but instead resulted in a decrease in testing among gay men and contributed to violence against the LGBTQIA+ community. Mr Vujcich said younger people were resistant to graphic messaging. “Young people these days are really savvy at knowing when authority figures are trying to scare them into changing their behaviours,” he said. “It doesn’t respect the intelligence of young people and it doesn’t recognise that young people are rational.” Ms Ledger added: “Hard-hitting doesn’t necessarily equal graphic.” But Mr van der Beeke said an overwhelming number of studies had shown graphic warning labels on cigarette packets were highly effective in decreasing the positive perception of smoking. He argued the decrease in smoking levels, but increase in vaping levels, was due to a lack of warning labels on e-cigarette packaging. “Research by The Behaviour Change Collaborative in 2022 found the absence of warning labels suggested to some teens that the e-cigs weren’t as harmful as smoking or alcohol use precisely because they were absent from packaging,” he said. With fewer young people engaging with traditional forms of media, Mr Vujcich stressed the way health messages were communicated had to change. “We’re finding ourselves increasingly doing our messaging through things like TikTok and through social media, and again through sponsoring things like podcasts,” he said. “The messaging that is most effective is really straight-forward, sex-positive messaging that is based in evidence.” WAAC in a recent campaign partnered with Perth influencer Tim Collins — or 100percentthattim on TikTok — where he tackled the subject of gonorrhoea. “It’s really something that was a bit different, bit unique and that encouraged people to share it to a tonne of their friends,” Mr Vujcich said. “Through campaigns like that, we’ve been able to reach tens of thousands of young people in ways that we wouldn’t be able to if we took a more traditional or conventional approach.” The video has already garnered more than 40,000 views across TikTok and Instagram since it was posted at the end of May. Mr van der Beeke said it was not the case that organisations had neglected health campaigns in recent years, but the way health messages were communicated evolved continuously. “But it’s important to recognise that health messaging is only one piece of the jigsaw when it comes to encouraging healthy behaviours,” he said. “Health promoters consider a wide range of factors when developing and implementing health promotion strategies, not just communications.”