Advertising Moguls in Public Health: How Advertising Theory Can Help Inform the National Youth Anti-Drug Media Campaign - Krupa Vithlani
Adolescent drug use in the Unites States has been a cause of major concern over the last quarter of the twentieth century, with lifetime prevalence among youth continuing to increase throughout high school for some drugs such as marijuana, cocaine, and other stimulants (1). In 1975, a majority consisting of 55% of the nation’s youth had used an illicit drug by the time they graduated from high school, a trend that rose to 66% until the 1980s and returned to a previous high of 55% by the year 1999 (2). More recently, a 2007 study found that just under half (47%) of the nation’s high school students have tried an illicit drug by the time they graduate, which is still a considerably high rate of incidence (3). Though the annual prevalence rates of youth drug use are currently below their recent peaks, no significant further decline has occurred in 2007 as compared to previous years. The use of marijuana, on the other hand, is reported to be most pervasive, with approximately 20% of youth engaging in the activity as of 2007 (3-4).
In 1998, the U.S. Congress created the National Youth Anti-Drug Media Campaign (the campaign), in an attempt to curb the use of illicit drugs among the nation’s youth. The campaign’s stated primary goals are to prevent as well as to reduce the use of illicit drugs, with a central strategy using nationwide paid advertising to disseminate anti-drug messages to target youth populations (ages 9 to 18) and their parents (5). Administered by the White House Office of National Drug Control Policy (ONDCP), the campaign is the nation’s largest anti-drug media campaign and is generally regarded as the single largest source of drug-prevention messaging directed to youth. Although the campaign was initiated in 1998 with the overall aim of educating youth about the ill-effects of illicit and licit substances such as alcohol, methamphetamine, ecstasy and marijuana among others, it shifted its primary focus towards preventing teen marijuana use between 2002 and 2004.
According to the Government Accountability Office (GAO), however, the government’s investment of 1.4 billion dollars from 1998 to 2006 has yielded no significant favorable effect on marijuana initiation among non-drug-using youth or on discontinuing or declining use among prior users (6). What is more, the GAO, basing its conclusions on research conducted by Westat Incorporation, believed that the campaign may have even encouraged more teens to use marijuana (5). In spite of the GAO’s recommendation to stop funding for the campaign unless new strategies can be applied, the Bush administration sought an additional 120 million dollars in funding for the campaign in 2007, an increase in 20 million dollars from the campaign’s 2006 budget appropriations (6). In 2005, the campaign shifted focus from targeting parents and peers as the “Anti Drug” to encouraging teens to live “Above the Influence.” However, this shift in theme has not bought about a change in philosophy, as the campaign still erroneously conforms to the Theory of Reasoned Action (TRA) rationale in order to convey its anti-drug messages to youth.
The Theory of Reasoned Action (TRA) is an individual-centered model that views human behavior as a function of interactions between individual attitudes, social norms, and intention. A person’s intention is determined by weighing their personal attitude against perceived social norms. This intention then directly leads to behavior (7). Individual attitude towards a specific behavior is comprised of his or her opinion whether performing the behavior is good or bad. This attitude is influenced by the beliefs of the individual towards that behavior, referred to as behavioral beliefs (7). Social norms are comprised of the individual’s perceptions of the social pressures put on him or her to perform or not perform the behavior in question (7). These social norms, in turn, are influenced by individuals’ normative beliefs. It should be noted that the TRA model presumes behavior to be a rational process whereby individuals deliberate, whether consciously or unconsciously, the costs and benefits of performing a particular behavior. Additionally, it also assumes that behavior is planned and logically pre-analyzed, leaving little room for consideration of spontaneous behavior or a momentary change of mind on the individual’s part (7 & 8).
The TRA may be considered a reasonable theory to utilize when creating anti-drug interventions as it takes into consideration the power of social norms in shaping individual behavior. That is, the TRA model accounts for the individual’s intrinsic attitude as well as his or her social environment as embodied in the attitude of others. The individual’s own attitude towards drug use and his or her perception of the opinions of others (including peers and parents), are arguably two of the most important factors in shaping one’s intentions regarding drug use. A TRA-based intervention could potentially seek to manipulate the target youth’s personal attitudes and their perceived social norms in order to affect behavioral change. As such, anti-drug campaigns could attempt to instill a negative attitude in teens regarding marijuana use, expecting to negatively reinforce the use of drugs by depicting the use of marijuana as an undesirable social norm. Or conversely, a TRA-based intervention could be designed so as to positively influence youth by presenting social norms that promote a healthy, drug-free lifestyle. It appears that the Above the Influence campaign focuses on the former strategy of negative reinforcement, but it largely fails to do so effectively. A part of the failure of the campaign to effectively convey anti-drug messages to youth stems from basic limitations of the TRA model. This conventional logic model is mathematically structured such that it fails to appreciate the true dynamics of decision-making and is ineffective when it comes to predicting spontaneous behavior. Hence, TRA-based interventions cannot prevent or reduce risk behaviors such as smoking, drinking or drug use in social situations where teens, in an irrational or “hot” state of mind (9) that comes with their age-defined need for peer approval and social popularity, are unlikely to stop to carefully weigh the costs and benefits of the behavior they are about to engage in. Such is the case with the National Youth Anti-Drug Media Campaign and its Above the Influence message brand.
Above the Influence: Enduring Obstacles to Effective Campaign Messaging
One major setback of the campaign is that the commercials depict negative social norms associated with marijuana use in a highly exaggerated manner. It is important to recognize that health risks associated with substance abuse, sexual behavior and general well-being nevertheless rank low among the average adolescent’s other concerns (10). For the most part, an under-assessment of the risks related to drug use on the part of the youth presents a challenge in their ability to accurately relate to the negative consequences depicted in these commercials. What is more, several Above the Influence commercials portray negative consequences of drug use in an unrealistic fashion, such that they further undermine their own credibility and relevance to the reality of their target population. For instance, the “Not again” ad shows a couple with the ‘boy’ smoking marijuana as the ‘girl’ looks on in disappointment, with the words “not again” appearing next to her head. A space ship subsequently appears out of the sky, and an ‘alien’ emerges from it. It approaches the couple, and the boy offers him marijuana, which it turns down saying “no thanks.” The girl is pleasantly surprised by this gesture – as suggested by the heart symbol blinking near her head – and she decides to fly away with the alien instead, leaving the boy pondering at what just happened (11).
In accordance with the principles prescribed by the TRA model, the “Not again” commercial tries to influence the behavior of teenagers by showing that society (including the extraterrestrial civilization) disapproves of individuals who smoke marijuana. This negative social norm against the use of marijuana is primarily represented in the unfavorable reaction of the girl. Moreover, her abandonment of the boy is an attempt to manipulate the perceived social norms of adolescent marijuana users by indicating that their friends will leave them or avoid them if they continue their drug habit. While the message of this commercial may be reasonable, the manner in which it is communicated is highly unrealistic. The presence of an alien itself takes away any semblance of reality that the commercial might have otherwise held, leaving teens unable to relate with it. Additionally, this commercial might even be offensive to adolescents who may feel that it underestimates their intelligence, believing them to be foolish or naive. Whereas the use of stick or cartoon figures in this commercial might be appealing to elementary children, they are further likely to undermine the commercial’s credibility and serious message among its target teenage population.
An equally unrealistic Above the Influence commercial is the “Stop looking at me” ad, which depicts a pet dog reprimanding his adolescent owner for using marijuana (12). This commercial also fails to resonate with its target population, not taking into account that adolescents are less likely to take the idea of a talking dog seriously. The depiction of social norms against the use of marijuana – in this case the pet dog being disappointed – also represents an ineffective communication strategy of the campaign’s intended anti-drug message. That is to say, targeted adolescents are less likely to identify with negative social norms that come from a talking dog due to its sheer discrepancy with reality. Thus, a combination of the unrealistic depictions of negative social opinions regarding drug use and the tendency of the Above the Influence ads to underestimate teenagers’ sophistication and intelligence levels has resulted in anti-drug messaging that adolescents are largely unable to relate to. Consequently, commercials in the Above the Influence portfolio, such as “Not again,” “Stop looking and me,” and others, are not inclined to produce the desired change in behavior, whether prevention or reduction of drug use.
Another significant flaw in the Above the Influence campaign is that its commercials focus solely on the negative effects of smoking marijuana without presenting adolescents with any positive activities they can engage in as sound alternatives to drug use. Peers have an enormous impact, both negative and position, on the actions and behaviors of an adolescent with regard to risk behaviors such as alcohol consumption and marijuana use (8 & 10). A study conducted on this subject showed that adolescents, who had friends that were involved in ‘deviant’ behaviors such as marijuana use, were more likely to engage in such behaviors themselves (8). On the other hand, teens whose friends engaged in numerous school and community activities (like athletics, drama or volunteering) were less likely to engage in harmful behaviors like marijuana consumption (10). According to these studies, in order to be effective, anti-drug campaign ads need to portray teenagers involved in positive social activities instead of negative ones such as drinking or using drugs. Unfortunately, as they currently stand, most Above the Influence campaign ads are in complete contradiction to these findings. A majority of these commercials – “Dog,” “Not again,” “Shadow,” “Fire,” “Cocoon,” to name just a few – portray teenagers who are using marijuana, as opposed to showing positive examples of adolescents actively staying above the influence by engaging in alternative activities. The single exception to this trend is the “Fitting in” ad, which I believe is the only Above the Influence commercial that seeks to positively reinforce anti-drug attitudes in teenagers. This commercial shows an adolescent boy actively maneuvering to “fit” into different frames of various social situations and activities such as hanging out with friends at a café or skateboarding. However, when a frame depicting two youth engaging in marijuana use approaches the forefront of the screen, the protagonist makes the choice to walk away. The commercial then begs the target viewer to consider: “is everything worth fitting into?” (13). Unlike other ads in the Above the Influence campaign, “Fitting in” sympathizes with adolescents’ age-appropriate need to “fit in,” but it sends a strong message of youth empowerment by indicating that not all activities, especially drug use, may be worthwhile as there are always other “frames” or alternative activities one can opt for in order to gain social acceptance or peer approval.
A third important drawback of the Above the Influence campaign is that it does not effectively change individual attitudes towards marijuana use. That is to say, it fails to appeal to the core values adolescents commonly subscribe to, including independence, control, social or peer acceptance, and rebellion against authority. Studies have shown that teenagers, due to the influence of puberty and hormonal changes associated with it, are more likely to engage in rebellious, sensation seeking behavior than any other age group (14). Sensation seeking behavior, in turn, is directly proportional to the early onset of alcohol and drug abuse amongst teenagers (15 & 16). Most adolescents have positive personal attitudes towards marijuana because the use of it allows them to engage in sensation seeking, rebellious and risky behavior – values that they aspire or closely associate with. Thus, in order to prevent teenagers from partaking in the risky behavior of drug abuse, anti-drug campaigns like Above the Influence are burdened with off-setting adolescents’ pull towards marijuana use.
However, until now, the Above the Influence campaign has largely failed to take advantage of or associate its anti-drug messages with the aforementioned core values that adolescents strongly adhere to. In fact, unfortunately most of the campaign commercials do the exact opposite. These ads project the act of using marijuana as one that society (by extension authority figures such as parents, educational & professional institutions, and the law) disapproves of, thus unintentionally associating its use with core adolescent values of rebellion and independence. For instance, the “Not again” commercial conveys societal disapproval of drug use in the reactions of the ‘girl’ as well as the ‘alien’ who eventually abandon the ‘boy’ using marijuana. Unfortunately, it is the very condemnation of drug use that so widely appeals to the core teen value of rebellion, and is viewed in a positive rather than a negative light by most adolescents. The combination of such rebellion-conducive messages and portrayal of adolescents smoking marijuana without facing any realistic negative consequences may be contributing factors to the GAO/Westat Inc. report’s findings of higher propensities to use marijuana amongst youth. Ultimately, the inability of the Above the Influence campaign to alter individual attitudes towards marijuana use has rendered it ineffective in controlling the growing rates of drug use amongst adolescents.
The Use of Advertising Theory to Bolster Campaign Messaging
In order to effectively reduce marijuana consumption and use of other illicit drugs amongst U.S. teenagers, extensive changes in intervention models are required in the field of public health. Instead of relying on traditional public health models, such as the theory of reasoned action, which overlook essential social factors influencing the decision-making process of teenagers indulging in high-risk behavior, focus needs to shift on newer and more comprehensive alternative models that cater to the core values of the target population (17).
The creators and supporters of the campaign tend to distinguish it from previous efforts of its kind by emphasizing that it is “…modeled on advertising industry and market research best practices.” As part of its initial phases, the campaign executed “exploratory research” which includes literature reviews, expert opinions, scientific claims, interviews of affected communities, and communication with an “expert panel.” Subsequent best practices that the campaign professes to have employed include qualitative or “focus group” testing, quantitative or “copy” testing, as well as tracking ad assessment studies measuring teen awareness and memory of the commercials (18).
At first glance, many Above the Influence ads strike one as being well made and unique; almost all commercials follow a story or message directly related to youth, while many hold the attention of the viewer well. For instance, the “Stop looking at me” ad depicts an engaging dialogue between the dog and its adolescent owner that compels the viewer to follow their exchange, conveyed in the form of scribbled writing above stick drawings of the protagonists. Though this ad is at first visually appealing and can capture the attention of its target audience, the use of comic images and the idea of a judgmental pet dog separate it from reality, consequently undermining the ability of teenagers to identify with the substance and content of the message.
Although the visual quality of most Above the Influence commercials indicates consultation of advertising industry experts, a deeper evaluation of the campaign on the basis of “the advertising theory” is called for. Two principles of this theory form the essence of all commercial advertisements: “the Promise,” and the “Support” for that promise. According to this theory, the Promise is a fundamental element of all ads and is essentially the selling point of any commercial (19). On the other hand, the Support refers to the combined effect of select images, words, symbols, metaphors, background music, and overall feel of the commercial to support that Promise and persuade the viewer that they want the product being advertised. The Promise is the center-piece of any advertisement; and the best ones are carefully crafted such that “[p]romise, large promise is the soul of the advertisement.” (19). In other words, the larger the Promise, the more effective the advertisement. In the world of commercials, even a Promise so huge that it is absurd has the potential to be enormously successful if it offers the consumer something he or she aspires. Conversely, the key function of the Support is to reinforce “the promise of happiness engineered by advertisers through the consumption of images which appeal to human needs and sensuality” (20). It should be noted that with the simple formula of the Promise and the Support, commercial advertisements calculatingly appeal to the core values of its target population. In other words, successful commercials rarely sell the material product they are representing; instead they seek to assimilate with human aspirations and values such as love, freedom, independence, beauty, youth, acceptance, accomplishment, and control.
The ultimate objective of public health, on the other hand, is usually to discourage or encourage a particular health behavior or lifestyle choice among its constituents. However, years of failed or vaguely successful public health campaigns have proven that health does not sell. In light of this, the market strategy of appealing to core human values has an incredible potential to bolster such public health campaigns that often experience difficulty on the account that they are lacking a material product to “sell” to their target population.
As it currently stands, the Above the Influence campaign just scratches the surface of advertising and marketing principles, focusing more on the outer appearance and attractiveness of the ads as opposed to critically analyzing what most appeals to adolescents. The advertising theory, if used wisely and constructively, has the potential to transform the Above the Influence campaign into a successful endeavor capable of reducing marijuana use amongst youth. In order to strike a chord among its target population, the campaign must consciously utilize core youth values such as rebellion, independence, control and social acceptance.
To begin with, the social consequences of marijuana consumption need to be more realistically depicted. Current campaign commercials such as “Not again,” “Dog,” and “Don’t look at me” are ineffectual. Teenagers cannot relate to the consequences of marijuana consumption depicted in these commercials, since they are not reasonably portrayed. That is to say, that although their central message or Promise may be reasonable, the Support for these ads is weak and unrealistic. Your girlfriend leaving you for an alien because you are using marijuana or your talking pet dog reproaching you for the same are exaggerated consequences of marijuana use that teenagers can not relate to. One key way in which the consequences can be made more realistic is by fortifying the Support for these commercials. Campaign ads such as “Not again,” “Stop looking at me,” and “Dog” need to be replaced with commercials that depict real-life teenagers delivering the anti-marijuana message. By showing other youth – rather than cartoon stick figures and animals – delivering the anti-drug message, these commercials will better connect with marijuana users who will be able to relate to the intended message. Additionally, marijuana using teens will be more accepting of an anti-marijuana message delivered by peers who are similar to them in that they are experiencing the same everyday conflictions and emotional ups and downs. In addition, this strategy incorporates a compelling personal story and a face into the commercial, further strengthening the Support for the anti-drug message. Thus, using teenagers as familiar conveyers of the message is an effective way of presenting the consequences of using marijuana more persuasively.
There are, in fact, several Above the Influence commercials, such as “Fire” and “Achievements” for instance, that do portray other teenagers delivering the anti-marijuana message. However, these commercials remain ineffective because the content of the message is negative, rather than positive. Instead of expressing an appealing Promise by depicting teenagers participating in healthy, alternative activities these commercials focus solely on the negative outcomes of marijuana use. On the contrary, improved ads that employ a positive Promise with appropriate Support are more likely to succeed in empowering youth and reinforcing a positive identity of adolescents that resist drugs.
The “Achievements” commercial shows several marijuana using teenagers talking about how they abandoned their friends, disappointed their mother or got failing grades because they were addicted to marijuana (21). This commercial portrays marijuana users in a negative light, labeling them as irresponsible and reckless. Additionally, it fails to provide them with any alternative healthy activities they can engage in. Likewise, the “Fire” commercial depicts three teenagers abandoning the activities that they are involved in because of marijuana. The girl burns her athletic certificates in the fireplace, one of the boys chars his guitar on the grill, meanwhile the other sets fire to his car (22). The commercial attempts to show that using marijuana will eventually lead to the individual giving up healthier hobbies that he or she was once interested in. Again, though both these commercials have strong Support due to the memorable and jarring images used to convey their anti-drug message, the Promise they both offer is weak in that they focus on the negative aspects of smoking marijuana without highlighting any positive outcomes of not smoking marijuana.
As mentioned before, teenagers are easily influenced by their surrounding environment. Research has shown that youth who had friends that were involved in undesirable behaviors – such as using marijuana – were more likely to indulge in such behaviors themselves. In contrast, teenagers whose friends were involved in alternative activities such as sports or community service were more averse to using marijuana. Accordingly, it is essential that Above the Influence campaign commercials focus on portraying teenagers partaking in desirable alternative activities, rather than depicting teens who are using marijuana. For this reason, campaign commercials would be more successful by presenting teens involved in activities like playing sports, participating in the school musical, creating artwork and other such enjoyable and healthy activities. As mentioned earlier, the sole Above the Influence campaign that has succeeding in doing so is “Fitting in.” Alternatively, the “Try football” ad, as suggested by its title, also tries to urge youth in participating in alternative activities, but it does so rather ineffectively. This ad depicts a tall boy smoking marijuana who smugly tells a smaller boy passing by with his dog that he uses drug to “impress the ladies.” The smaller boy simply responds by suggesting that he “try football” instead (23). Though the message of this ad is positive and sound, it has been made with poor Support in that it employs unrealistic and childish images (cartoon stick figures of the same style that was used for the ads “Not again” and “Stop Looking at me).
In addition to focusing on positive outcomes of not using marijuana, it is important for the campaign to affect change in individual attitudes towards marijuana use. Hence, the message relayed through the campaign needs to appeal to the core values of the target population. As previously stated, teenagers are more likely to engage in rebellious, sensation-seeking which drives them to try risky, and at most times, unhealthy activities such as alcohol use and drug abuse, including marijuana consumption (15 & 16). Consequently, in order for campaigns like Above the Influence to be effective in changing individual attitudes towards marijuana, it needs to abandon conventionality and opt for an element of vigor and rebellion. On the contrary, current Above the Influence commercials – “Not again” being a prime example – present the act of marijuana consumption as a negative activity that society frowns upon. While this message appears to be reasonable to adults with the expectation that it would lead to the logical conclusion that marijuana should not be used due to the negative social opinions associated with it. However, to the average adolescent who gains satisfaction from rebelling against societal norms that they view as authority, this message encourages them to use marijuana simply because that makes them a rebel, a desirable teenager trait.
The Above the Influence campaign can draw from the example of the anti-tobacco Truth campaign in appealing to the core values that teenagers strongly adhere to. The anti-smoking message delivered by this campaign is peppered with essential youth core values. The campaign ads depict mature and sophisticated youth rebelling against big tobacco, exposing their research as biased, and challenging them to reveal the facts about smoking. These commercials portray non-smoking youth as smart, cool and independent individuals who are defying the authority – in this case, the tobacco industry – that is pushing them towards smoking. The Truth campaign depicts the act of not smoking, rather than that of smoking, as the rebellious thing to do, thus appealing to the important core value of rebellion that teenagers hold dear. Moreover, these campaign commercials do not just show one individual, but instead a group of like-minded individuals who are all committed to fighting big tobacco. The objective behind such imagery is to instill a desire amongst teenagers to become part of a continuously growing movement, providing them with a feeling of independence and belonging, both essential teen core values. The Above the Influence campaign needs to similarly depict groups of young non-marijuana users as independent, unique and intelligent individuals rebelling against the norm of smoking marijuana amongst teenagers. Such positive labeling of non- users will encourage teenagers to not consume marijuana, leading to a reduction in the high rates of teenage marijuana use.
The Above the Influence campaign is based on traditional public health models that are obsolete and inadequate for designing effective health interventions. In order to be successful, campaign creators and administrators need to rethink their advertising strategy to ensure that all future ads are comprised of both a powerful, positive Promise as well as age-appropriate Support that does not leave the target youth with the feeling that the ad is an insult to his/her intelligence and hence inapplicable or irrelevant to them.
REFERENCES
1. Oetting, E. R., Beauvais, Fred. (1990). Adolescent Drug Use: Findings of National and Local Surveys, pp. 385. Journal of Consulting and Clinical Psychology 1990, Vol. 58, No. 4, 385-394.
2. Johnston, L. D., O'Malley, P. M., & Bachman, J. G. (2000). Monitoring the Future national survey results on adolescent drug use: Overview of key findings. Bethesda, MD: National Institute on Drug Abuse, 1999.
3. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2008). Monitoring the Future national results on adolescent drug use: Overview of key findings, pp. 6. Bethesda, MD: National Institute on Drug Abuse, 2007.
4. Substance Abuse and Mental Health Services Administration. Results from the 2006 National Survey on Drug Use and Health: National Findings. (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293).
5. United States Government Accountability Office. Contractor’s National Evaluation Did Not Find That the Youth Anti-Drug Media Campaign Was Effective in Reducing Youth Drug Use. Washington, DC:GAO 06-818, 2006.
6. Leinwand, D. (August 2006) Anti-drug advertising campaign a failure, GAO report says. USA Today. Retrieved December 6, 2009, from: http://www.usatoday.com/news/washington/2006-08-28-anti-drug-ads_x.htm.
7. Ajzen, I., & Fishbein, M. Understanding attitudes and predicting social behavior. New York: Psychology Press, 1980.
8. Edberg, M. Essentials of Health Behavior: Social and Behavioral Theory in Public Health. 2007.
9. Ariely, D., Predictably Irrational: The Hidden Forces That Shape Our Decisions. New York, NY: HarperCollins, 2008.
10. Eme, R., Maisiak, R., Goodale, W. Seriousness of adolescent problems. Adolescence 1979; 14 53: 93–99.
11. Above The Influence. “Not Again” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
12. Above The Influence. “Stop Looking At Me” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
13. Above The Influence. “Fitting in” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
14. Zuckerman, M. Behavioral Expressions and Biosocial Bases of Sensation Seeking. New York: Cambridge University Press, 1994.
15. Ball, S.A., Carroll, K.M., Rounsaville, B.J. Sensation seeking, substance abuse, and psychopathology in treatment-seeking and community cocaine abusers. Journal of Consulting and Clinical Psychology 1994; 62:1053–1057.
16. Kosten, T.A., Ball, S.A., Rounsaville, B.J. A sibling study of sensation seeking and opiate addiction. The Journal of Nervous and Mental Disease 1994; 182:284–289.
17. Siegal, M., & Donner, L. Marketing Public Health: Strategies to Promote Social Change. Sudbury: Jones and Bartlett Publishers, 2004.
18. National Youth Anti-Drug Media Campaign. Washington, DC: White House Office of National Drug Control Policy (ONDCP). http://www.mediacampaign.org/about.html.
19. Ogilvy, D. How to Build Great Campaigns (pp. 98-103). In: Confessions of an Advertising Man. New York, NY: Atheneum, 1964.
20. Harms, J., Kellner, D. Toward a Critical Theory of Advertising. Southwest Missouri State University & University of Texas at Austin. Retrieved December 8, 2009, from http://www.uta.edu/huma/illuminations/kell6.htm.
21. Above The Influence. “Achievements” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
22. Above The Influence. “Fire” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
23. Above The Influence. “Try Football” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
In 1998, the U.S. Congress created the National Youth Anti-Drug Media Campaign (the campaign), in an attempt to curb the use of illicit drugs among the nation’s youth. The campaign’s stated primary goals are to prevent as well as to reduce the use of illicit drugs, with a central strategy using nationwide paid advertising to disseminate anti-drug messages to target youth populations (ages 9 to 18) and their parents (5). Administered by the White House Office of National Drug Control Policy (ONDCP), the campaign is the nation’s largest anti-drug media campaign and is generally regarded as the single largest source of drug-prevention messaging directed to youth. Although the campaign was initiated in 1998 with the overall aim of educating youth about the ill-effects of illicit and licit substances such as alcohol, methamphetamine, ecstasy and marijuana among others, it shifted its primary focus towards preventing teen marijuana use between 2002 and 2004.
According to the Government Accountability Office (GAO), however, the government’s investment of 1.4 billion dollars from 1998 to 2006 has yielded no significant favorable effect on marijuana initiation among non-drug-using youth or on discontinuing or declining use among prior users (6). What is more, the GAO, basing its conclusions on research conducted by Westat Incorporation, believed that the campaign may have even encouraged more teens to use marijuana (5). In spite of the GAO’s recommendation to stop funding for the campaign unless new strategies can be applied, the Bush administration sought an additional 120 million dollars in funding for the campaign in 2007, an increase in 20 million dollars from the campaign’s 2006 budget appropriations (6). In 2005, the campaign shifted focus from targeting parents and peers as the “Anti Drug” to encouraging teens to live “Above the Influence.” However, this shift in theme has not bought about a change in philosophy, as the campaign still erroneously conforms to the Theory of Reasoned Action (TRA) rationale in order to convey its anti-drug messages to youth.
The Theory of Reasoned Action (TRA) is an individual-centered model that views human behavior as a function of interactions between individual attitudes, social norms, and intention. A person’s intention is determined by weighing their personal attitude against perceived social norms. This intention then directly leads to behavior (7). Individual attitude towards a specific behavior is comprised of his or her opinion whether performing the behavior is good or bad. This attitude is influenced by the beliefs of the individual towards that behavior, referred to as behavioral beliefs (7). Social norms are comprised of the individual’s perceptions of the social pressures put on him or her to perform or not perform the behavior in question (7). These social norms, in turn, are influenced by individuals’ normative beliefs. It should be noted that the TRA model presumes behavior to be a rational process whereby individuals deliberate, whether consciously or unconsciously, the costs and benefits of performing a particular behavior. Additionally, it also assumes that behavior is planned and logically pre-analyzed, leaving little room for consideration of spontaneous behavior or a momentary change of mind on the individual’s part (7 & 8).
The TRA may be considered a reasonable theory to utilize when creating anti-drug interventions as it takes into consideration the power of social norms in shaping individual behavior. That is, the TRA model accounts for the individual’s intrinsic attitude as well as his or her social environment as embodied in the attitude of others. The individual’s own attitude towards drug use and his or her perception of the opinions of others (including peers and parents), are arguably two of the most important factors in shaping one’s intentions regarding drug use. A TRA-based intervention could potentially seek to manipulate the target youth’s personal attitudes and their perceived social norms in order to affect behavioral change. As such, anti-drug campaigns could attempt to instill a negative attitude in teens regarding marijuana use, expecting to negatively reinforce the use of drugs by depicting the use of marijuana as an undesirable social norm. Or conversely, a TRA-based intervention could be designed so as to positively influence youth by presenting social norms that promote a healthy, drug-free lifestyle. It appears that the Above the Influence campaign focuses on the former strategy of negative reinforcement, but it largely fails to do so effectively. A part of the failure of the campaign to effectively convey anti-drug messages to youth stems from basic limitations of the TRA model. This conventional logic model is mathematically structured such that it fails to appreciate the true dynamics of decision-making and is ineffective when it comes to predicting spontaneous behavior. Hence, TRA-based interventions cannot prevent or reduce risk behaviors such as smoking, drinking or drug use in social situations where teens, in an irrational or “hot” state of mind (9) that comes with their age-defined need for peer approval and social popularity, are unlikely to stop to carefully weigh the costs and benefits of the behavior they are about to engage in. Such is the case with the National Youth Anti-Drug Media Campaign and its Above the Influence message brand.
Above the Influence: Enduring Obstacles to Effective Campaign Messaging
One major setback of the campaign is that the commercials depict negative social norms associated with marijuana use in a highly exaggerated manner. It is important to recognize that health risks associated with substance abuse, sexual behavior and general well-being nevertheless rank low among the average adolescent’s other concerns (10). For the most part, an under-assessment of the risks related to drug use on the part of the youth presents a challenge in their ability to accurately relate to the negative consequences depicted in these commercials. What is more, several Above the Influence commercials portray negative consequences of drug use in an unrealistic fashion, such that they further undermine their own credibility and relevance to the reality of their target population. For instance, the “Not again” ad shows a couple with the ‘boy’ smoking marijuana as the ‘girl’ looks on in disappointment, with the words “not again” appearing next to her head. A space ship subsequently appears out of the sky, and an ‘alien’ emerges from it. It approaches the couple, and the boy offers him marijuana, which it turns down saying “no thanks.” The girl is pleasantly surprised by this gesture – as suggested by the heart symbol blinking near her head – and she decides to fly away with the alien instead, leaving the boy pondering at what just happened (11).
In accordance with the principles prescribed by the TRA model, the “Not again” commercial tries to influence the behavior of teenagers by showing that society (including the extraterrestrial civilization) disapproves of individuals who smoke marijuana. This negative social norm against the use of marijuana is primarily represented in the unfavorable reaction of the girl. Moreover, her abandonment of the boy is an attempt to manipulate the perceived social norms of adolescent marijuana users by indicating that their friends will leave them or avoid them if they continue their drug habit. While the message of this commercial may be reasonable, the manner in which it is communicated is highly unrealistic. The presence of an alien itself takes away any semblance of reality that the commercial might have otherwise held, leaving teens unable to relate with it. Additionally, this commercial might even be offensive to adolescents who may feel that it underestimates their intelligence, believing them to be foolish or naive. Whereas the use of stick or cartoon figures in this commercial might be appealing to elementary children, they are further likely to undermine the commercial’s credibility and serious message among its target teenage population.
An equally unrealistic Above the Influence commercial is the “Stop looking at me” ad, which depicts a pet dog reprimanding his adolescent owner for using marijuana (12). This commercial also fails to resonate with its target population, not taking into account that adolescents are less likely to take the idea of a talking dog seriously. The depiction of social norms against the use of marijuana – in this case the pet dog being disappointed – also represents an ineffective communication strategy of the campaign’s intended anti-drug message. That is to say, targeted adolescents are less likely to identify with negative social norms that come from a talking dog due to its sheer discrepancy with reality. Thus, a combination of the unrealistic depictions of negative social opinions regarding drug use and the tendency of the Above the Influence ads to underestimate teenagers’ sophistication and intelligence levels has resulted in anti-drug messaging that adolescents are largely unable to relate to. Consequently, commercials in the Above the Influence portfolio, such as “Not again,” “Stop looking and me,” and others, are not inclined to produce the desired change in behavior, whether prevention or reduction of drug use.
Another significant flaw in the Above the Influence campaign is that its commercials focus solely on the negative effects of smoking marijuana without presenting adolescents with any positive activities they can engage in as sound alternatives to drug use. Peers have an enormous impact, both negative and position, on the actions and behaviors of an adolescent with regard to risk behaviors such as alcohol consumption and marijuana use (8 & 10). A study conducted on this subject showed that adolescents, who had friends that were involved in ‘deviant’ behaviors such as marijuana use, were more likely to engage in such behaviors themselves (8). On the other hand, teens whose friends engaged in numerous school and community activities (like athletics, drama or volunteering) were less likely to engage in harmful behaviors like marijuana consumption (10). According to these studies, in order to be effective, anti-drug campaign ads need to portray teenagers involved in positive social activities instead of negative ones such as drinking or using drugs. Unfortunately, as they currently stand, most Above the Influence campaign ads are in complete contradiction to these findings. A majority of these commercials – “Dog,” “Not again,” “Shadow,” “Fire,” “Cocoon,” to name just a few – portray teenagers who are using marijuana, as opposed to showing positive examples of adolescents actively staying above the influence by engaging in alternative activities. The single exception to this trend is the “Fitting in” ad, which I believe is the only Above the Influence commercial that seeks to positively reinforce anti-drug attitudes in teenagers. This commercial shows an adolescent boy actively maneuvering to “fit” into different frames of various social situations and activities such as hanging out with friends at a café or skateboarding. However, when a frame depicting two youth engaging in marijuana use approaches the forefront of the screen, the protagonist makes the choice to walk away. The commercial then begs the target viewer to consider: “is everything worth fitting into?” (13). Unlike other ads in the Above the Influence campaign, “Fitting in” sympathizes with adolescents’ age-appropriate need to “fit in,” but it sends a strong message of youth empowerment by indicating that not all activities, especially drug use, may be worthwhile as there are always other “frames” or alternative activities one can opt for in order to gain social acceptance or peer approval.
A third important drawback of the Above the Influence campaign is that it does not effectively change individual attitudes towards marijuana use. That is to say, it fails to appeal to the core values adolescents commonly subscribe to, including independence, control, social or peer acceptance, and rebellion against authority. Studies have shown that teenagers, due to the influence of puberty and hormonal changes associated with it, are more likely to engage in rebellious, sensation seeking behavior than any other age group (14). Sensation seeking behavior, in turn, is directly proportional to the early onset of alcohol and drug abuse amongst teenagers (15 & 16). Most adolescents have positive personal attitudes towards marijuana because the use of it allows them to engage in sensation seeking, rebellious and risky behavior – values that they aspire or closely associate with. Thus, in order to prevent teenagers from partaking in the risky behavior of drug abuse, anti-drug campaigns like Above the Influence are burdened with off-setting adolescents’ pull towards marijuana use.
However, until now, the Above the Influence campaign has largely failed to take advantage of or associate its anti-drug messages with the aforementioned core values that adolescents strongly adhere to. In fact, unfortunately most of the campaign commercials do the exact opposite. These ads project the act of using marijuana as one that society (by extension authority figures such as parents, educational & professional institutions, and the law) disapproves of, thus unintentionally associating its use with core adolescent values of rebellion and independence. For instance, the “Not again” commercial conveys societal disapproval of drug use in the reactions of the ‘girl’ as well as the ‘alien’ who eventually abandon the ‘boy’ using marijuana. Unfortunately, it is the very condemnation of drug use that so widely appeals to the core teen value of rebellion, and is viewed in a positive rather than a negative light by most adolescents. The combination of such rebellion-conducive messages and portrayal of adolescents smoking marijuana without facing any realistic negative consequences may be contributing factors to the GAO/Westat Inc. report’s findings of higher propensities to use marijuana amongst youth. Ultimately, the inability of the Above the Influence campaign to alter individual attitudes towards marijuana use has rendered it ineffective in controlling the growing rates of drug use amongst adolescents.
The Use of Advertising Theory to Bolster Campaign Messaging
In order to effectively reduce marijuana consumption and use of other illicit drugs amongst U.S. teenagers, extensive changes in intervention models are required in the field of public health. Instead of relying on traditional public health models, such as the theory of reasoned action, which overlook essential social factors influencing the decision-making process of teenagers indulging in high-risk behavior, focus needs to shift on newer and more comprehensive alternative models that cater to the core values of the target population (17).
The creators and supporters of the campaign tend to distinguish it from previous efforts of its kind by emphasizing that it is “…modeled on advertising industry and market research best practices.” As part of its initial phases, the campaign executed “exploratory research” which includes literature reviews, expert opinions, scientific claims, interviews of affected communities, and communication with an “expert panel.” Subsequent best practices that the campaign professes to have employed include qualitative or “focus group” testing, quantitative or “copy” testing, as well as tracking ad assessment studies measuring teen awareness and memory of the commercials (18).
At first glance, many Above the Influence ads strike one as being well made and unique; almost all commercials follow a story or message directly related to youth, while many hold the attention of the viewer well. For instance, the “Stop looking at me” ad depicts an engaging dialogue between the dog and its adolescent owner that compels the viewer to follow their exchange, conveyed in the form of scribbled writing above stick drawings of the protagonists. Though this ad is at first visually appealing and can capture the attention of its target audience, the use of comic images and the idea of a judgmental pet dog separate it from reality, consequently undermining the ability of teenagers to identify with the substance and content of the message.
Although the visual quality of most Above the Influence commercials indicates consultation of advertising industry experts, a deeper evaluation of the campaign on the basis of “the advertising theory” is called for. Two principles of this theory form the essence of all commercial advertisements: “the Promise,” and the “Support” for that promise. According to this theory, the Promise is a fundamental element of all ads and is essentially the selling point of any commercial (19). On the other hand, the Support refers to the combined effect of select images, words, symbols, metaphors, background music, and overall feel of the commercial to support that Promise and persuade the viewer that they want the product being advertised. The Promise is the center-piece of any advertisement; and the best ones are carefully crafted such that “[p]romise, large promise is the soul of the advertisement.” (19). In other words, the larger the Promise, the more effective the advertisement. In the world of commercials, even a Promise so huge that it is absurd has the potential to be enormously successful if it offers the consumer something he or she aspires. Conversely, the key function of the Support is to reinforce “the promise of happiness engineered by advertisers through the consumption of images which appeal to human needs and sensuality” (20). It should be noted that with the simple formula of the Promise and the Support, commercial advertisements calculatingly appeal to the core values of its target population. In other words, successful commercials rarely sell the material product they are representing; instead they seek to assimilate with human aspirations and values such as love, freedom, independence, beauty, youth, acceptance, accomplishment, and control.
The ultimate objective of public health, on the other hand, is usually to discourage or encourage a particular health behavior or lifestyle choice among its constituents. However, years of failed or vaguely successful public health campaigns have proven that health does not sell. In light of this, the market strategy of appealing to core human values has an incredible potential to bolster such public health campaigns that often experience difficulty on the account that they are lacking a material product to “sell” to their target population.
As it currently stands, the Above the Influence campaign just scratches the surface of advertising and marketing principles, focusing more on the outer appearance and attractiveness of the ads as opposed to critically analyzing what most appeals to adolescents. The advertising theory, if used wisely and constructively, has the potential to transform the Above the Influence campaign into a successful endeavor capable of reducing marijuana use amongst youth. In order to strike a chord among its target population, the campaign must consciously utilize core youth values such as rebellion, independence, control and social acceptance.
To begin with, the social consequences of marijuana consumption need to be more realistically depicted. Current campaign commercials such as “Not again,” “Dog,” and “Don’t look at me” are ineffectual. Teenagers cannot relate to the consequences of marijuana consumption depicted in these commercials, since they are not reasonably portrayed. That is to say, that although their central message or Promise may be reasonable, the Support for these ads is weak and unrealistic. Your girlfriend leaving you for an alien because you are using marijuana or your talking pet dog reproaching you for the same are exaggerated consequences of marijuana use that teenagers can not relate to. One key way in which the consequences can be made more realistic is by fortifying the Support for these commercials. Campaign ads such as “Not again,” “Stop looking at me,” and “Dog” need to be replaced with commercials that depict real-life teenagers delivering the anti-marijuana message. By showing other youth – rather than cartoon stick figures and animals – delivering the anti-drug message, these commercials will better connect with marijuana users who will be able to relate to the intended message. Additionally, marijuana using teens will be more accepting of an anti-marijuana message delivered by peers who are similar to them in that they are experiencing the same everyday conflictions and emotional ups and downs. In addition, this strategy incorporates a compelling personal story and a face into the commercial, further strengthening the Support for the anti-drug message. Thus, using teenagers as familiar conveyers of the message is an effective way of presenting the consequences of using marijuana more persuasively.
There are, in fact, several Above the Influence commercials, such as “Fire” and “Achievements” for instance, that do portray other teenagers delivering the anti-marijuana message. However, these commercials remain ineffective because the content of the message is negative, rather than positive. Instead of expressing an appealing Promise by depicting teenagers participating in healthy, alternative activities these commercials focus solely on the negative outcomes of marijuana use. On the contrary, improved ads that employ a positive Promise with appropriate Support are more likely to succeed in empowering youth and reinforcing a positive identity of adolescents that resist drugs.
The “Achievements” commercial shows several marijuana using teenagers talking about how they abandoned their friends, disappointed their mother or got failing grades because they were addicted to marijuana (21). This commercial portrays marijuana users in a negative light, labeling them as irresponsible and reckless. Additionally, it fails to provide them with any alternative healthy activities they can engage in. Likewise, the “Fire” commercial depicts three teenagers abandoning the activities that they are involved in because of marijuana. The girl burns her athletic certificates in the fireplace, one of the boys chars his guitar on the grill, meanwhile the other sets fire to his car (22). The commercial attempts to show that using marijuana will eventually lead to the individual giving up healthier hobbies that he or she was once interested in. Again, though both these commercials have strong Support due to the memorable and jarring images used to convey their anti-drug message, the Promise they both offer is weak in that they focus on the negative aspects of smoking marijuana without highlighting any positive outcomes of not smoking marijuana.
As mentioned before, teenagers are easily influenced by their surrounding environment. Research has shown that youth who had friends that were involved in undesirable behaviors – such as using marijuana – were more likely to indulge in such behaviors themselves. In contrast, teenagers whose friends were involved in alternative activities such as sports or community service were more averse to using marijuana. Accordingly, it is essential that Above the Influence campaign commercials focus on portraying teenagers partaking in desirable alternative activities, rather than depicting teens who are using marijuana. For this reason, campaign commercials would be more successful by presenting teens involved in activities like playing sports, participating in the school musical, creating artwork and other such enjoyable and healthy activities. As mentioned earlier, the sole Above the Influence campaign that has succeeding in doing so is “Fitting in.” Alternatively, the “Try football” ad, as suggested by its title, also tries to urge youth in participating in alternative activities, but it does so rather ineffectively. This ad depicts a tall boy smoking marijuana who smugly tells a smaller boy passing by with his dog that he uses drug to “impress the ladies.” The smaller boy simply responds by suggesting that he “try football” instead (23). Though the message of this ad is positive and sound, it has been made with poor Support in that it employs unrealistic and childish images (cartoon stick figures of the same style that was used for the ads “Not again” and “Stop Looking at me).
In addition to focusing on positive outcomes of not using marijuana, it is important for the campaign to affect change in individual attitudes towards marijuana use. Hence, the message relayed through the campaign needs to appeal to the core values of the target population. As previously stated, teenagers are more likely to engage in rebellious, sensation-seeking which drives them to try risky, and at most times, unhealthy activities such as alcohol use and drug abuse, including marijuana consumption (15 & 16). Consequently, in order for campaigns like Above the Influence to be effective in changing individual attitudes towards marijuana, it needs to abandon conventionality and opt for an element of vigor and rebellion. On the contrary, current Above the Influence commercials – “Not again” being a prime example – present the act of marijuana consumption as a negative activity that society frowns upon. While this message appears to be reasonable to adults with the expectation that it would lead to the logical conclusion that marijuana should not be used due to the negative social opinions associated with it. However, to the average adolescent who gains satisfaction from rebelling against societal norms that they view as authority, this message encourages them to use marijuana simply because that makes them a rebel, a desirable teenager trait.
The Above the Influence campaign can draw from the example of the anti-tobacco Truth campaign in appealing to the core values that teenagers strongly adhere to. The anti-smoking message delivered by this campaign is peppered with essential youth core values. The campaign ads depict mature and sophisticated youth rebelling against big tobacco, exposing their research as biased, and challenging them to reveal the facts about smoking. These commercials portray non-smoking youth as smart, cool and independent individuals who are defying the authority – in this case, the tobacco industry – that is pushing them towards smoking. The Truth campaign depicts the act of not smoking, rather than that of smoking, as the rebellious thing to do, thus appealing to the important core value of rebellion that teenagers hold dear. Moreover, these campaign commercials do not just show one individual, but instead a group of like-minded individuals who are all committed to fighting big tobacco. The objective behind such imagery is to instill a desire amongst teenagers to become part of a continuously growing movement, providing them with a feeling of independence and belonging, both essential teen core values. The Above the Influence campaign needs to similarly depict groups of young non-marijuana users as independent, unique and intelligent individuals rebelling against the norm of smoking marijuana amongst teenagers. Such positive labeling of non- users will encourage teenagers to not consume marijuana, leading to a reduction in the high rates of teenage marijuana use.
The Above the Influence campaign is based on traditional public health models that are obsolete and inadequate for designing effective health interventions. In order to be successful, campaign creators and administrators need to rethink their advertising strategy to ensure that all future ads are comprised of both a powerful, positive Promise as well as age-appropriate Support that does not leave the target youth with the feeling that the ad is an insult to his/her intelligence and hence inapplicable or irrelevant to them.
REFERENCES
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9. Ariely, D., Predictably Irrational: The Hidden Forces That Shape Our Decisions. New York, NY: HarperCollins, 2008.
10. Eme, R., Maisiak, R., Goodale, W. Seriousness of adolescent problems. Adolescence 1979; 14 53: 93–99.
11. Above The Influence. “Not Again” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
12. Above The Influence. “Stop Looking At Me” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
13. Above The Influence. “Fitting in” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
14. Zuckerman, M. Behavioral Expressions and Biosocial Bases of Sensation Seeking. New York: Cambridge University Press, 1994.
15. Ball, S.A., Carroll, K.M., Rounsaville, B.J. Sensation seeking, substance abuse, and psychopathology in treatment-seeking and community cocaine abusers. Journal of Consulting and Clinical Psychology 1994; 62:1053–1057.
16. Kosten, T.A., Ball, S.A., Rounsaville, B.J. A sibling study of sensation seeking and opiate addiction. The Journal of Nervous and Mental Disease 1994; 182:284–289.
17. Siegal, M., & Donner, L. Marketing Public Health: Strategies to Promote Social Change. Sudbury: Jones and Bartlett Publishers, 2004.
18. National Youth Anti-Drug Media Campaign. Washington, DC: White House Office of National Drug Control Policy (ONDCP). http://www.mediacampaign.org/about.html.
19. Ogilvy, D. How to Build Great Campaigns (pp. 98-103). In: Confessions of an Advertising Man. New York, NY: Atheneum, 1964.
20. Harms, J., Kellner, D. Toward a Critical Theory of Advertising. Southwest Missouri State University & University of Texas at Austin. Retrieved December 8, 2009, from http://www.uta.edu/huma/illuminations/kell6.htm.
21. Above The Influence. “Achievements” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
22. Above The Influence. “Fire” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
23. Above The Influence. “Try Football” commercial. Washington, DC: National Youth Anti-Drug Media Campaign. http://www.abovetheinfluence.com/the-ads/default.aspx?path=nav
Labels: Adolescent Health, Drug Use, Health Communication, Pink
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