“Just a couple of other points to add to the mix
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- 1 -make sure all keywords are relevant your website. For example I have a good quality score for "web marketing" as it has a good keyword density on my landing page. However, the keyword "internet marketing" (which means the same thing) and in another adgroup with related adtext has a lower quality score. This is becuase I don't use the word internet marketing on my landing.
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[*]2 - You mention campaigns but not adgroups. Are all your keywords in one adgroup? My adgroups have very few keywords in but the keywords are very tight to the subject keyword or phrase. For example I do not have "web marketing" and "internet marketing" in the same adgroup even though they are very closely related. It is far better to have many adgroups with highly targeted keywords and adtext.
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[*]3 - Are you deep linking to the relevant page your keywords are related to? What I mean by this is, if you have separate pages on your website talking about a specific category, product or service, make sure your destination URL is going to that page and not your homepage.
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The regional aspect makes no difference to the quality score only the traffic volume and if you don't bid on the bigger keywords you will get no traffic at all. It's one of the perils of regional targeting I am afraid.
No your advert will not show on the first page of listings if you do not bid the minimum bid shown by Google
hope that helps
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Thanks for the feed-back. Yes I am linking the advert directly to the relevant page in the site.
I decided to separate into 2 different campaigns adverts that are not completely related to each other for fear of one affecting the other in the quality score.
Yes, I have added a lot of negative words, especially: free, downloads, jobs, vacancies, recruitment, etc

Like sjr 4x4 I was hoping that low bids I have would at least show sometimes in my local radius, but what is still not clear, if anybody knows please, is if a lower bid will put your advert on any page after the first one. When I search in Google I don't stop at the first page. Sometimes I look at 25 pages if I am not finding what I am looking for.
I am now going to write more keywords in the landing pages. I guess Google will be furious if I hide them, I don't think that you can get away with that anylonger.