Background:
Approximately 130000 Ukrainians die from tobacco-related diseases each year. The use of ENDS and HTPs is increasing in Ukraine, especially among youth. These novel products until recently were not regulated, with only one exception the ban on sales for minors.

Objective:
Change public perception and social norms towards ENDS and HTPs, and build a supporting environment for the legislative process.

Methods:
In line with the WHO annual communication campaign ‘COMMIT TO QUIT’, PHC of the MOH of Ukraine, NGO Life and Vital Strategies conducted the multi-channel integrated massmedia campaign ‘Harmless Smoking Does Not Exist’, featuring a prominent oncologist and anti-tobacco ambassador, Anton Shkiryak. Sociological agency KIIS conducted a concept-testing study to understand the relative effectiveness of the campaign messages and execution concepts. According to the focus-groups results, one concept was chosen and adapted. The campaign incorporated COVID-19 messaging to warn about harms of smoking and the use of e-cigarettes and HTPs, and had a strong policy message. Sociological agency KIIS conducted the baseline and endline surveys among Ukrainian smokers and non-smokers aged 18–30 years to probe attitudes towards e-cigarettes and HTPs, and report campaign impact.

Results:
It is estimated that the ‘Doctor’s Warning’ campaign reached 24 million people on TV, radio, street posters and social media, despite a very limited budget. The campaign changed the attitudes of youth: 47% responders-smokers are thinking to stop using ENDS or HTPs after the campaign, and 78% responders-nonsmokers said that the campaign stimulates people not to start smoking. Supported by the strategic communication work and complex advocacy activities during the last 3 years, the new law was adopted in December 2021. In January 2022, the President signed the new comprehensive tobacco control law that will save lives and protect millions of Ukrainians from the harms of tobacco use.

Conclusions:
Sustained and robust mass media campaigns can change public attitudes and social norms around e-cigarettes and HTPs, and catalyze effective regulation and policy adoption.