Academy of Marketing Studies Journal (Print ISSN: 1095-6298; Online ISSN: 1528-2678)

Review Article: 2022 Vol: 26 Issue: 3

Effectiveness of Advertisements by National Tobacco Control Organisation of India: An Experimental Research

Ramasundaram G, PSG Institute of Management

Aiswarya B, Loyola Institute of Business Administration

Ajit S, St. Joseph’s College of Engineering

Sunil Vakayil, Loyola Institute of Business Administration

Citation Information: Ramasundaram, G., Aishwarya, B., Ajit, B., & Vakayil, S. (2022). Effectiveness of advertisements by national tobacco control organisation of india: An experimental research. Academy of Marketing Studies Journal, 26(3), 1-11.

Abstract

Smoking is one of the causes of death every year in the world. Smoking causes health problems to both smokers and passive smokers. Curbing the habit of smoking by individuals is one of the many measures every government is keen on undertaking. Many governments are using public service announcements with the anti-smoking message to create awareness about the ill effects of smoking and making the smoker quit smoking. The success of these public service announcements is debatable. This study tries to understand whether cinema halls can be used as a medium for targeted advertising of anti-smoking messages. This study attempts to estimate the effectiveness of anti-smoking advertisements shown in cinema halls in three cities in India. Effectiveness is studied in terms of the respondents following the preferred behavior for which the advertisement is created. Structural Equation Modelling is used to study behavioral change, considering attitude toward advertisements and the consequences of smoking as the influencing variables. It is found from the study that the anti-smoking advertisements showing the impact of smoking influence the decision of smokers to quit smoking.

Keywords

Cinema Hall Advertising, Anti-Smoking Advertisements, Attitude towards the Advertisement, Quit Smoking, National Tobacco Control Organization.

Introduction

Smoking, a man-made epidemic, occurs all over the world. About half of the male adult global population smokes. Consumption of tobacco causes deaths of more than seven million in the world per year, according to Global Tobacco Epidemic 2019 Report. If the current trends continue, it is said that by 2030, smoking will kill one in six people. Of the estimated 1.2 billion smokers worldwide, about 180 million (15%) are in India. According to a University of Toronto study, published in the Newswire 2017, the number of men smokers has increased to 108 million between 1998 and 2015. Found the number of men, in the ages 19 to 69 years, smoking any type of tobacco rose by about 36% from 79 million to 108 million, an increase of male smokers of around 29 million for the seventeen-year study period. The study suggests that there is a sharp increase in smoking among males in the ages 15-29 years. Among the urban population, there was an increase of 68 percent in the number of smokers during 1998-2015 and the increase was about 26% in the rural areas from 61 to 77 million (Dasgupta et al., 2011). There were about 11 million women who smoked which were about 10 percent of the total male smokers. According to The Tobacco Atlas 2016, around one million Indians die every year because of tobacco-related diseases. Past research advises the policymakers of India to implement strong tobacco control measures so that one-fourth of tobacco-related cases of stroke and heart attack can be avoided (Donovan, 1997).

Measures of Governments in India to control tobacco uses would also support to curb the incidence of cancer cases. Of the total cancer patients in India, almost 45 percent of males and 17 percent of females are because of tobacco use, and 80 percent of oral cancers are attributed to tobacco consumption (Elliott, 1993).

Mass media campaigns against the use of tobacco in many countries has proved successful in encouraging those using tobacco to quit. Campaigns showing highly intense effects of use of tobacco can increase knowledge of the health risks of tobacco use, and thereby compel tobacco users to quit, and promote behaviour change in both smokers and non-smokers (Johnson, 1981). Mass media campaigns involving social marketing like no smoking, don’t drink and drive, pay income tax has been proved to be the change agent for bringing the behavioural change, thereby influencing policy makers. For tobacco related diseases, many experts believe that, unlike the failure of intense anti-smoking messages in the package of cigarette packs, mass media campaigns play a critical role as they can cause population-wide changes in terms of knowledge about cigarettes, attitude towards cigarette smoking and behavioural changes among smokers and non-smokers. The latest NFHS survey attributes lack of research focus on marketing and policy to an increase in the smoking behaviour among Indians (Kishore, 2010). The use of anti-smoking advertising has been a more common social marketing tool to persuade the smokers to quit the habit of smoking and discourage non-smokers and create awareness about second-hand smoke. The aim of the present study was to explore the effectiveness of cinema advertising and to contribute to the knowledge base of social awakening and social marketing pertaining to the health impacts on smokers and passive smokers. It is also aimed to delivering outputs to suggest clearly the effect of social advertisement on behavioural changes. The findings of the study could be used to strengthen the approach of social marketing programmes.

Literature Review

In recent years, Cinema attendance worldwide has increased rapidly and this had prompted marketers the use of cinema as an advertising medium to reach targeted audiences. Every year thousands of films are screened across the country (Lewis et al., 2007). Films in cinemas is becoming the next sought after advertising platform after television with the maximum potential to capture and convert audiences to potential consumers. Identified some advantages of advertising in cinemas. Cinema is an attractive medium with high quality presentation, a very good aesthetic environment and the family aspect of watching movies in cinema ensures reach and recall of advertisements (Ling et al., 2010). It’s a place where without much distractions, there is more chance for the purchase influencers in a family to watch the advertisements shown and thereby influence purchase of a product.

A Public Service Announcement (PSA) is an advertisement given by any government or non-government organization with the goal to create awareness, change attitudes and behaviour of public towards a social issue (Lundberg & Young, 2001). The objective of public service announcements is to inform and educate the masses about the concerned message rather than promoting to sell a product or service. Much of the PSAs themes are for some humanitarian cause, philosophical ideal, or political concept (MacKenzie et al., 1986). Cleanliness in the locality, ill effects of smoking, drinking etc., drunken driving etc. are some of the themes in PSAs normally taken up by government as well as non-governmental organizations to inform the public and change their opinion. Most PSAs are government sponsored or aired free in most media, making it a cost-effective model. The purpose of public advertising is predominantly for attaining the behavioural change like any other advertisements.

Many of the research done previously on advertising effectiveness has found that attitudes are key in predicting consumer behavior and how consumers respond to advertising. Explains attitude as an overall, long-term evaluation of a concept or object, such as a person, a brand or a service. Defines attitude as a person’s overall feelings toward a given object. An attitude is a way of behaving and acting in certain predictable way. According to a respondent’s attitude is formed from the belief he or she has about the thing or concept. The sequence of cognitive constructs as per the Theory of Reasoned Action is beliefs, attitudes, intentions and behaviour. Thus, the respondent’s intention to behave in particular way is an outcome of the attitude towards prescribed behaviour and belief on what others say about his specific way of acting (Mishra et al., 2016). Thoughts trigger emotions as a reactive process while events prompt behaviours as response. Cognitive process is a consequence of moods and affective reaction, transmuting into social behaviour.

From the theoretical perspective of advertising, the recipients of an advertising message first develop an attitude toward the advertisement that in turn influences the subsequent measures of advertising effectiveness such as brand attitude and purchase intentions. Attitude towards advertising is commonly considered as a one of the main factors which determine the effectiveness of advertising because of its predictiveness of behaviours. Attitude towards advertising is said to be built by beliefs about advertising. When these beliefs change, attitude towards the advertisement changes accordingly. This attitude change will in turn affect intention and behaviour of respondents has found that factors like ability to inform and credibility of the source are considered to be effective measures of the attitude towards the advertisement.

Generally, most health researchers and practitioners have suggested that advertising at the outset focuses on shift in the attitude towards behavior and societal expectation, which eventually result in individuals’ behavioural. It is not so easy distinguish between different measures including advertisements, contributing to success of social change. However, advertising may function more gradually and in an indirect manner. Conversely direct view postulates that persuading makes respondents change their intention and attitude, leading to adoption of the behavior that is actually aimed at. Extant empirical studies confirm the direct view of advertising comparing to its desired influence on behavior of respondents.

Over the years, the effectiveness of anti-tobacco, anti-smoking initiatives have been studied extensively and evaluated, of which only a few studies have taken into account the effectiveness of such programs in smoking initiation and control among youth (Brown & Moodie, 2012). In their research on controlling tobacco pandemic, have found that a targeted approach is more efficient. The importance of this targeted approach is that, a particular socio-cultural group in a region in which the targeted youth belongs may respond to anti-smoking initiatives and thereby influence the youth's smoking behaviour (Mehta, 2000).

Also, advertisers are interested in understanding how men and women receive and evaluate information. Men and women take different meanings from the same advertisements they both see. For men, the primary message of a given advertisement is important and enough whereas women not only evaluate the primary message but they devour multiple clues from the message and link together threads to understand and infer the inner meaning of the message (Nagar, 2016). Examine the impact on gender on extent of influence of content in advertisement designed for adolescents and report significant impact of gender on content and message (Soames Job, 1988).

At the National Institute of Mental Health and Neuro-Sciences have evaluated the effects of anti-smoking advertisements on smokers and found that smokers respond positively to graphical content of these advertisements by showing readiness to quit smoking. They have designed a ladder-type questionnaire consisting of statements based on the thoughts of smokers about quitting smoking habit. They have designed the questionnaire on a 10 point scale, a score of 1 showed unwillingness to quit, whereas a score of 10 implied readiness to quit smoking. For this research, 2 of the 10 statements in the questionnaire were used namely, quit smoking in the next six months and cut in the number of cigarettes smoked.

Records the effects of smoking as increased risk of cancer, heart disease, stroke, lung diseases and diabetes. Similarly, second hand smoke causes stroke, lung cancer, and coronary heart disease in adults. Second hand smoking or passive smoking affects non-smokers and among them mainly children. Children suffer from acute respiratory infections, ear disease, asthma and other respiratory ailments because of this second hand smoking. These health hazards as a result of smoking necessitate government to launch anti-smoking campaigns every year to check and eliminate smoking habit among members. People who have started smoking find it very hard to get out of smoking and mostly because of the lack of awareness about its harmful effects. These anti-smoking campaigns are trying to inform the smoker about the ill effects of smoking and motivate people to quit smoking. From previous studies, it can be inferred that there is a clear gap in the amount of effort required to get smokers to quit and the efforts made by the government or communities. Also, effectiveness studies done previously in Cinema hall advertising had studied only product or services advertisements and not on public service announcements. The aim of the present study is to understand whether anti-smoking advertisements in cinema halls are effective in making the smokers to decide on quitting smoking and to add knowledge of social marketing on effects of smoking and passive smoking in terms of literature. The findings of the study could be used to strengthen the approach of social marketing programmes.

Methodology

This study aims to investigate the effects of fear appeal anti-smoking advertisements shown in cinema halls on the behaviour towards smoking. The study was conducted among the smokers in three metropolitan cities in Tamil Nadu state namely, Chennai, Madurai, and Coimbatore. These cities were selected for the study since they are the top three highly populated cities in Tamil Nadu and also these cities have more number of smokers and cinema halls than other cities. The respondents are the movie audience who are smokers. The total number of respondents for the study is 360. From the ratio of population of these cities, the number of respondents for the study was calculated. One hundred and eighty respondents from Chennai, one hundred respondents from Coimbatore and eighty respondents from Madurai were met and responses were collected from them.

The respondents form each city was selected for the study using convenience sampling technique, wherein the researcher collected data from movie audiences of ten different cinema halls, constituting standalone cinema halls as well as multiplexes in the cities randomly. Data collection was tough because smoking is prohibited in cinema halls and also people didn’t readily disclose smoking habits to strangers and there was no available sampling frame of smokers. After careful study for almost two months in few cinema halls in the cities about the behaviour of smokers, it was found that most of the smokers after watching the movie bought cigarettes from the nearby shop outside the cinema hall and smoked. So, data was collected from the movie audience after they come out of the cinema hall and smoke in the shops nearby, ascertaining that they have watched the movie in the cinema hall Tables 1 & 2.

Table  1
Table Showing The Demographic Details Of The Respondents
Particulars No of respondents % of respondents
City Chennai 180 50
Coimbatore 100 27.8
Madurai 80 22.2
Gender Male 324 90
Female 36 10
Age Group 18 to 20 146 40.6
21 to 30 130 36.1
30 to 40 84 23.3
Education School 97 26.9
UG 105 29.1
PG 60 16.67
Professional 93 25.8
Didn’t complete school 5 1.3
Table 2
Table Showing The Mean, Standard Deviation And Reliability Values Of Variables
Particulars CONSEQUENCE Aad QUIT SMOKING
N 360 360 360
Mean 2.7250 2.6319 4.1792
Std. Deviation 1.2398 0.8530 0.8230
Cronbach Alpha 0.889 0.762 0.849

This study was conducted on youth belonging to the age group of eighteen years and forty years using structured questionnaire. 146 respondents belong to the age between 18 and 20 years, 130 respondents belong to the age group of 21 and 30 years and 84 respondents are above 30 years of age. 97 respondents have completed only school, 105 respondents have completed UG degree, 60 respondents have completed PG degree, 93 have completed professional course and 5 respondents have not completed schooling (Pollay & Mittal, 1993). A well-structured questionnaire was employed to gather data from the respondents. The first part consists of questionnaire was based on the demography of the respondents and in the second part of the questionnaire, the respondents were asked to respond to a few sets of scales including health and social consequences of smoking and attitude towards the advertisement (Smith & Stutts, 2006). The respondent’s decision to quit smoking was measured using two scales taken from which are, quit smoking in the next six months and cut in the number of cigarettes smoked.

The advertisements used for the study were those advertisements by National Tobacco Control Organization which were mandatorily shown in cinema hall before the start of the movie and during the intermission of the movie (Thurstone, 1928). These public service advertisements were categorized as fear appeal advertisements. One advertisement named as “Mukesh ad” where Mukesh, who was affected by cancer was shown with a background explanation of his tragic death. The second advertisement is the “Child ad” where a child was watching her father smoking, the third “Dhuan ad” which showed how smoking in public is strictly prohibited and the fourth “Dravid ad” where Cricketer Rahul Dravid explains about the benefits of quitting smoking (Tan & Chia, 2007). A pilot study among cinema hall audience regardless of whether they smoke or not was undertaken to ascertain the validity of the scales used in the study and the level of fear these advertisements create in their minds (Vanderbruggen et al., 2020). The number of respondents of the pilot study was 60. Most of the respondents were able to understand and give responses to the scales used in the pilot study. Regarding the level of fear, they felt both “Mukesh ad” and “Child ad” as ads having high fear levels, the “Dhuan ad” to be of moderate fear and “Dravid ad” to be of low fear level.

Hypothesis

In order to test the influence of demography on the attitude and behavior intent, the following hypothesis was proposed based on previous research findings.

H1: Anti-smoking advertising in cinema halls will not have the desired effect on smokers in their decision to quit smoking.

Table 2 shows the mean, standard deviation, and the number of respondents for each variable. The average value for the explanatory variables, attitude towards the advertisement (Aad=2.6319), and perception about consequences (consequence=2.7250) show that the respondents neither agree nor disagree that these factors are useful in assessing the respondent’s decision to quit smoking (Wong & Cappella, 2009). But the mean value for decision to quit smoking (quit smoking=4.1792) shows that the respondents strongly agree that they would quit smoking.

Table 2 also reports the Cronbach’s Alpha values of the variables used in this study. Cronbach’s Alpha is employed to verify the internal reliability of the variable and a Cronbach’s Alpha value of 0.7 or higher is considered acceptable (Nunnally, 1978). Both the independent variables yielded value more than 0.70 and therefore, the reliability analysis for the variables in this study are acceptable.

Table 3, for attitude towards the advertisement (ad), the mean value for both male and female respondents are nearly equal whereas for perception about consequences the mean value of female is more than males and for quit smoking, the mean value is nearly equal for both male and female respondents. The standard deviation values indicate that the deviation from the mean values for both male and female respondents is low.

Table  3
Table Showing The Gender Differentiated Mean And Standard Deviation Values
  Gender N Mean Std. Deviation Std. Error Mean
Aad Female 36 2.4722 0.85519 0.14253
Male 324 2.6497 0.85227 .04735
CONSEQUENCE Female 36 3.8819 0.91512 0.15252
Male 324 2.5965 1.20506 0.06695
QUITSMOKING Female 36 4.3333 0.69693 0.11616
Male 324 4.1620 0.83507 0.04639

Table 4, the significance value for Levene’s test of equality of variances, it can be inferred that the variability in the two variables Aad and Quit smoking is not the same. So the t, df, significance values for equal variances not assumed are taken for discussion and for Consequence, equal variance assumed is taken for discussion.

     
Table 4
Table Showing The Results Of Independent Sample T Test
  Levene's Test for Equality of Variances t-test for Equality of Means
F Sig. t df Sig. (2-tailed) Mean Difference Std. Error Difference
Aad 0.014 0.905 -1.182 43.094 0.244 0.17747 0.15019
Consequence 9.138 0.003 6.202 358 0.000 1.2854 0.20728
Quitsmoking 0.652 0.420 1.370 46.928 .177 0.17130 0.12508

The significant values for attitude towards advertisements is 0.244 (t value=-1.182) and Quit smoking is 0.177 (t value=1.370) which are more than 0.05, there is no statistically significant difference between male and female respondents. The significant value for perception about consequences is 0.000 (t-value=6.202) which is less than 0.05, there is a statistically significant difference between male and female respondents in their perception about the consequences of smoking. Also, from the mean values, it can be inferred that male respondents disagree and female respondents agree that the consequences of smoking are severe. From the mean values, it can be inferred that both male and female respondents show more readiness to quit smoking after watching the advertisements.

Measurement Model

The structural equation modelling on the effectiveness of cinema advertisements model is developed and analysed using AMOS software Figure 1.

Figure 1: The Sem Model For Effectiveness Of Cinema Advertising.

The exogenous variables are the factors like attitude towards the advertisement and perception about consequences which influence the endogenous variable, the decision to quit smoking.

The chi square value of 20.523 is not so large, CMIN/DF=0.622 is less than 1 and also, the RMSEA value is 0.000. The reason for such low values for the indices is the sample size. Since the sample size of 360 is very large for a Structural equation Model, the above indices need not describe the true fit of the model Table 5. The other Goodness of Fit indices like GFI, AGFI can be looked into to ascertain whether the proposed model is good enough. The p value for the model is 0.956 which is more than 0.05 and the absolute goodness of fit indices like GFI and AGFI values are more than 0.95, the incremental fit indices like NFI and RFI are all above 0.95 and RMR (0.035) is less than 0.09 indicate that the proposed cinema advertising model fit is good enough to explain the endogenous variable.

Table 5
Table Showing The Model Fit Indices
Model CMIN DF CMIN/DF p value GFI AGFI NFI RFI RMR
Quit smoking 20.523 33 0.622 0.956 0.990 0.983 0.988 0.982 0.035

From the estimates shown in Table 6, it is inferred that both the exogenous variables, Attitude towards the advertisement (Aad) and Perception about the consequences (consequence) are having an influence on the endogenous variable, Decision to quit smoking (quit smoking). From the model regression values, it can be inferred that, attitude towards the advertisements (0.16) and perception about consequences (0.19) both influence the respondents’ decision not to smoke. From the above analysis it can be inferred that the hypothesis that anti-smoking advertising in cinema halls will not have the desired effect on smokers in their decision to quit smoking is rejected.

Table 6
Table Showing The Estimates For The Effectiveness Of Cinema Advertising Model
Estimate S.E. C.R. P
Quit smoking Aad .160 .051 3.131 .002
Quit smoking Consequence .190 .038 5.032 ***
Credible Aad 1.000
Relevant Aad .859 .080 10.772 ***
Informative Aad 0.956 0.085 11.238 ***
Believable Aad 0.547 0.051 10.769 ***
Cancer_ad Consequence 1.000
Dravid_ad Consequence 1.012 0.055 18.323 ***
Dhuan_ad Consequence 1.046 0.059 17.786 ***
Child_ad Consequence 0.985 0.054 18.134 ***
Quit 6 mnts Quit smoking 1.000
Cutnoofcigrtes Quit smoking 0.948 0.126 7.497 ***

The standardised value for decision to quit smoking is grouped into Low, Medium and High to identify the number of people who will show readiness to quit smoking after watching the advertisements. Table 7, it can be inferred that majority of the respondents show high chances of quitting smoking i.e. either reduce the number of cigarette or quitting smoking in the next six months. The city wise breaks up too show similar results where majority of the respondents in the three cities show high chances of quitting smoking.

Table 7
Cross Tabulation Showing The Decision To Quit Smoking And Respondents Of The  Three Cities
  Decision to quit smoking Total
Low Medium High
City Chennai Count 10 30 140 180
% within City 5.6% 16.7% 77.8% 100.0%
Coimbatore Count 6 17 77 100
% within City 6.0% 17.0% 77.0% 100.0%
Madurai Count 5 6 69 80
% within City 6.2% 7.5% 86.2% 100.0%
Total 21 53 286 360

Table 8 show the number of times the respondents watched movies in cinema halls in a year. Majority of the respondents go to cinema halls for more than 5 times, from which it can be inferred that the respondents have more chances of viewing the anti-smoking advertisements.

Table 8
Table Showing The Number Of Times The Respondent View Movies In Cinema Halls In
A year
Particulars No of movies viewed in cinema halls in a year Total
less than 5 6 to 10 more than 10
City Chennai 60 75 45 180
Coimbatore 32 40 28 100
Madurai 30 27 23 80
Total 122 142 96 360

Discussion

From the findings of the study, it is clear that the probability of reaching out to smokers about the ill effects of smoking is more when the advertisements are shown in the cinema halls. It is one way that the smoker is made to watch the anti-smoking advertisements compulsorily.

All these four advertisements which were shown in the movie halls were fear advertisements. All the four advertisements in focus in the research shows the consequences of smoking. To make the fear message effective, the source of message should be creditble and reliable. It should be relevant for both smokers as well as non-smokers, and it should be informative and believable so that the message reaches the audience. Since the advertisements are given by the National Tobacco Control Organisation, credibility issues won’t arise. Some people respond to high levels of threat being used in an advertisement, whereas some people respond more to lower levels of threat being used in an advertisement. This research studied the effectiveness of advertisements with all the three levels of threat. “Mukesh ad” and “Child ad” had high level of threat, “Dhuan ad” had moderate level of threat and “Dravid ad” had low level of threat. That is the reason that the respondents who saw the advertisements formed an attitude towards the advertisement and also thought about the consequences of smoking which led to their decision not to smoke. From the Table 7 majority of the respondents have made a decision to quit smoking in the near future.

Advertisements need to be designed so as to attract audiences and make them watch till the end, containing more of positive information like benefits of non-smoking as negative information may not appeal viewers most of the time. Moreover, advertisement would be more of an education than information provider.

Even though the data collection was done just before the lockdown imposed due to the pandemic, the results can be extrapolated to the future as the government has relaxed much of the standard operating procedures, one of which is opening cinema halls to 100% occupancy. Also, there is scope for many films being shown in the cinema halls which were waiting for release for the past one year. So there will be much crowd in the cinema halls.

There are conflicting data about smoking during the COVID pandemic. Found that there is a reported increase in the number of cigarettes smoked during the lockdown. A report 2020 in “The Guardian” shows that millions of people have started to smoke more than how many they used to smoke before the pandemic. Whereas another report from Money Control News 2020 shows that the lockdown has made around 50% of the people surveyed to have quit smoking due to fear of the severity of the health effects of COVID. There are more chances that those people, who have quit smoking due to the fear of COVID, may quit smoking permanently if they are bombarded with anti-smoking messages again and again through various means.

The data about the number of movies watched by respondents in a year shows that there is a huge opportunity for the National Tobacco Control Organisation to target the smokers explaining the ill effects of smoking. Also, the data from the shows that majority of the smokers who watched the advertisements either want to quit smoking in the next six months or will reduce the number of cigarettes smoked in the future, which is again a positive note for the organisation to look into the best way to advertise.

Conclusion

According to the findings, in-film advertising in cinema halls is one the most effective medium to promote anti-smoking advertisements. The results of this study would help enhance government agencies’ ability in devising a better advertising campaign to educate the target audience on the ill effects of smoking. Also even though cinema halls are a big medium for targeted advertising, a little more effort on stressing on the ill effects of smoking through other means of advertising like bill boards in the entry and exit points of cinema halls will have more effect, as there are more chances that discussion about smoking and its ill effects can happen often among peers or family members which will reinforce the message shown in the advertisement in the cinema hall. This will have an impact on the smoker in a big way. But there are no such studies done on this idea which can be used for future research.

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Received: 05-Mar-2022, Manuscript No. AMSJ-22-11653; Editor assigned: 07-Mar-2022, PreQC No. AMSJ-22-11653(PQ); Reviewed: 21-Mar-2022, QC No. AMSJ-22-11653; Revised: 23-Mar-2022, Manuscript No. AMSJ-22-11653(R); Published: 28-Mar-2022

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