Background:
Social media, synergised with mass media, may provide a powerful, low-cost channel of communication for public health interventions, including promotion of new policies such as graphic health warnings on tobacco packs. However, the evidence on the efficacy of social media to support tobacco control within low -and middle-income countries, is sparse. An innovative website was developed to examine the potential of social media to increase bridging and bonding of social capital and self-efficacy to quit, given the importance of providing cessation support services, which are seen as the 'weakest link' in WHOs MPOWER framework.

Methods:
A population level, mass media campaign; “People Behind the Packs” was synergized with social media to raise awareness of new graphic health warnings and support tobacco cessation in Bangladesh. One website page contained four public service announcements featuring patients suffering from diseases depicted on new pack warnings. Another, “I can quit" page, provided quit tips from a doctor. Site metrics were reviewed and an online Survey Monkey questionnaire administered to explore attitudes and cessation related behaviors of tobacco users who accessed the webpages.

Results:
Site metrics identified 100,410 (65% of website visitors) viewed the quit page immediately following the intervention, with around 24,000 (15%) accessing patient testimonial messages, and 20,474 (13%) signing the petition. Viewing by gender was balanced (46% females and 54% males) with 4.8 million “Likes” on campaign content on Facebook over the 6-week campaign period, with the top five posts reaching 1.68 million people. 1225 respondents completed the self-administered survey. Responses identified good discussion with others about quitting or cutting down (23%), intentions to cut-down (36%) or quit smoking (45%).

Conclusions:
Social media can provide low-cost interventions to engage audiences, promote discussion, and support policy and cessation related behaviors. This impact may be increased when linked to other mass media campaign components.