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The Effectiveness of Mass Media Campaigns: Youth Substance Abuse


Mass media poses a significant public health risk for youth (Am. Acad. Ped., 1995; 1996; 1999; 2001a ... Youth Substance Abuse Bill Bukoski, Ph.D., NIDA Robert ... – PowerPoint PPT presentation

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Title: The Effectiveness of Mass Media Campaigns: Youth Substance Abuse

The Effectiveness of Mass Media Campaigns Youth
Substance Abuse
  • Bill Bukoski, Ph.D., NIDA
  • Robert Orwin, Ph.D., Westat
  • June 7, 2006

  • 1. Youths Exposure to Mass Media.
  • 2. Possible Risks of Mass Media.
  • 3. Possible Benefits of Mass Media.
  • 4. Findings From Westats Evaluation of ONDCPs
    Anti-drug Abuse Campaign for Youth and Parents.

1. Mass Media is Pervasive in the Lives of Youth
(Kaiser Report, 2005)
  • TV, radio, music, magazines, movies, video games,
    cell, internet, e-mail, IM, cds, dvds, MP3, etc.
  • Youth (8-18) 6.5 hrs per day or 44.5 hrs per
    week all forms of media.
  • 30 multi-task phoneIMmusicTVsurf the web.
  • 53 - families have no rules - TV.
  • 51 - use web daily.
  • 32 - use IM daily
  • 2.25 hrs - parents 1.5 hrs exercise 50 min

2. Risks of Mass Media - Youth
  • Research an overwhelming presence of alcohol,
    tobacco, illicit drugs in mass media viewed by
    youth (Thompson, 2005).
  • Mass media portrays unhealthy behaviors as
    glamorous and risk-free (Brown and Witherspoon,
  • Mass media poses a significant public health risk
    for youth (Am. Acad. Ped., 1995 1996 1999
    2001a 2001b 2001c.)

Examples of Risk Alcohol
  • From 2001-2004, the ave. number of TV alcohol ads
    seen by youth increased 32 - 209 to 276 (CAMY,
  • The top 15 TV shows with the largest youth
    (12-17) audience had alc. ads (CAMY, 2005).
  • Natl long. survey (15-26) on ave. more al. ads
    (TV, radio, mags, billboards)- more drinking.
    Each ad seen increased num. of drinks consumed in
    past month by 1 holds also for greater al ad
    expenditures by market area (Snyder et al.,

Examples of Risk Alcohol
  • Ellickson et al. (2005) studied exposure effects
    of al ads (TV, mags, in-store displays, beer
    concessions) on drinking initiation and drinking
    freq. for 7-8-9th graders.
  • Multivariate analyes - increased exposure to al.
    ads in 8th grade for 1) 7th grade nondrinkers -
    predicted al initiation by 9th grade 2) 7th
    grade drinkers- predicted increased drinking
    freq. by the 9th grade.

Examples of Risk Smoking
  • In a nationally representative random digit phone
    survey of 10-14 year olds, Sargent et al. (2006)
    found a positive association between increased
    exposure to smoking in movies (N524 hits) and
    smoking initiation.
  • In comparison to the lowest Quartile of smoking
    in movies (Q1), Adjusted OR for having tried
    smoking was 1.7 for Q2 1.8 for Q3 and 2.6 for
    Q4. Attributable Risk 38.
  • Exposure was primary risk of smoking initiation
    for 38 who tried smoking.

Examples of Risk Drug Use
  • A recent study of more than 1200 films rated G,
    PG, PG-13, and R, and released between 1996 and
    2003 reported that 95 of films depicted
    substances (drugs, alcohol, tobacco) while the
    Motion Picture Association referenced drugs and
    alcohol in only 18 of its ratings (Thompson,
  • NIDAs PRISM award promotes accurate depictions
    of drug, alcohol, tobacco use in film, TV, video,
    music, and comic books (NIDA Press Release,

Just a Click Away Drug Use Web Sites
  • Wax (2002) indicates that the internet provides
    free, unedited, and nonrefereed information about
    recreational drug-taking behavior.
  • While anti-drug web sites exist, the web sites
    that espouse risk reduction, safe and
    responsible drug use are easily accessible by

Internet Drug Sales
  • Forman (2006) reports that the Internet conducts
    drug business transactions 24 hours a day, across
    the globe with relative anonymity.
  • The sale of prohibited Schedule I drugs
    (marijuana, heroin, crack cocaine) and Schedule
    II-V drugs (sedatives, analgesics, stimulants,
    steroids, etc.) can be obtained on-line from
    no-prescription web sites by anyone with access
    to a credit card to include youth.

3. Benefits of Mass Media
  • Promotes messages that value rather than devalue
    youth (Klein et al., 1993).
  • Help youth make better decisions about health
    risks they face (Klein et al., 1993).
  • Multiple components TV-radio ads, web, videos,
    print, school/comm./parents, policy.
  • Mass media campaigns have been studied for over
    5 decades (Wartella et al., 1991).
  • Meta-analysis indicate effect sizes are small and
    can be negative or positive (Snyder et al.,

Theories for Mass Media(NCI, 2005)
  • Behavior is mediated by cognitions what people
    know and think drives actions.
  • Knowledge is necessary but not sufficient for
    behavior change.
  • Beliefs, Attitudes, Intentions, Perceptions,
    Motivation, Skills, Social Environment, Ad
    Exposure and Message Saliency influences behavior

Theories (cont.)
  • Theory of Reasoned Action (Fishbein Ajzen,
    1975). Beliefs, Attitudes, Intentions, Behavior.
  • Theory of Planned Behavior (Akzen, 1991). In
    addition --- Intentions are influenced by
    perceived behavioral control.
  • Social Innoculation Theory (McGuire,1964). Small
    doses of pro-ads are analyzed to promote negative

Theories (cont.)
  • Psychological Reactance (Brehm Brehm, 1981).
    If freedom to engage or not engage in a behavior
    is threatened or denied, motivational arousal is
    prompted to restore lost freedom.
  • Social Marketing (Zimmerman, 1997). Ads that
    appeal to the target audiences norms, attitudes,
    motivations does not try to change them. A
    focus on changing the social environment as well.
    Incorporates commercial marketing principles of
    product, price, place, and promotion.

Theories (cont.)
  • Sensation Seeking Targeting-SENTAR (Palmgreen
    Donohew, 2003). Focus is on sensation seeking
    a personality trait that represents a need for
    novel, complex, ambiguous, and emotionally
    intense stimuli associated with drug use. Media
    campaigns target high sensation seeking youth,
    include messages that are fast paced and elicit
    arousal, and match viewing habits of high
    sensation seekers.

Observation Media Health Communication Effects
  • In 2003, 83.6 of youths 12-17 (20.8M) reported
    exposure in past year to an alcohol or drug
    message poster, pamphlet, radio, TV, etc. (NSDUH
    Report, 2005).
  • BUT research findings on behavior are mixed.
  • Mendelson (1968) described mass communication as
    a sort of an aerosol spray. As you spray it on
    the surface, some of it hits the target most of
    it drifts away and very little of it penetrates.

Meta-Analysis of Media Health Campaigns on
  • Mediated health campaigns in the U.S. have small
    effect sizes in the short-term. ES average
    correlations (Synder et al., 2004).
  • ES .15 - seat belts
  • ES .13 - oral health
  • ES .09 - alcohol
  • ES .05 - heart disease prevention
  • ES .05 - smoking
  • ES .04 - sexual behaviors

Meta-Analysis of Substance Abuse Campaigns
(Derzon et al.,2002)
  • Substance Use ES .036 (pre-post)
  • Knowledge ES .049 (pre-post)
  • Attitudes ES .024 (pre-post)

Mass Media Effects on Substance Using Behaviors
Summary of Mass Media Benefits (Crano, 2002)
  • the results do not suggest that the mass media
    represents the magic bulletwhich will end
    drug-abuse in adolescents
  • most media researchers today recognize that the
    media alone are not likely to turn the tide of
    drug abuse
  • mass media are better viewed as part of an
    arsenal of weapons that may be directed at the

Recent Promising Findings
  • The National Legacy Foundation launched a
    national truth anti-smoking campaign for youth
    2000 to 2002. Costs 100 M per year with
    paid media ads. Based upon effective truth
    campaigns in Fl, Calif, Mass., etc.
  • Truth ads were hard hitting to reveal deceptive
    marketing by tobacco industry, e.g. promoted only
    glamour of use ignored multiple causes of
    death nicotine addiction, targeting teens to
    replace dying adults.

Truth Campaign (cont.)
  • Hersey et al. (2005) reports on a national random
    digit dial phone survey of 16,000 youths 12-17
    (before, 8 months and 15 months after launch)
    that youths in television markets with higher
    campaign exposure by comparison had
  • Significantly more negative beliefs and attitudes
    about tobacco industry lower intentions to use,
    and lower receptivity to pro-tobacco ads and
    marketing practices, e.g. brand merchandise, etc.

Truth Campaign (cont.)
  • Farrelly et al., 2005 reports a dose-response
    relationship between exposure to truth ads and
    youth smoking prevalence.
  • The study compared Gross Rating Points (GRPs) for
    the truth campaign in each of 210 U.S. television
    markets for schools in those markets that were
    involved in MTF 1997-2002 (MTF controls

Truth Campaign (cont.)
  • Farrelly et al., (2005) reports that
  • Smoking prevalence for youth in grades 8, 10, 12,
    declined on average from 25.3 (1999) to
    18(2002) with the largest decline occurring for
    8th graders.
  • Exposure to the truth campaign accounted for
    22 of this decrease in smoking prevalence.
  • The decline in prevalence as of 2002 was
    equivalent to having 300,000 fewer youth smokers
    as a result of the truth campaign.

Recent Promising Findings In-School Media
  • In a national RCT, Slater et al. (2006) tested in
    middle schools a media program (print, posters,
    T-shirts, book covers, water bottles) with the
    positive theme of Be Under Your Own Influence
    in combination with related community activities.
  • Findings Dramatic and significant drug
    reductions were reported for treatment vs.
    comparison students.
  • OR Marijuana .50 Tob. .49 Alcohol .40

Mass MediaSchool Programs
  • In a RCT (1997-2002) with 45 high schools and
    feeder schools, Longshore et al. (2006) tested
    the effects (on 9th graders) of ONDCPs Anti-Drug
    Campaign in combination with a drug prevention
    program - ALERT Plus (in 7th and 8th boosters
    9th and 10th).
  • Findings 1) Sign. lower monthly marijuana for
    ALERT Plus and weekly exposure to ONDCPs media
    campaign - synergistic effect
  • 2) No comparable main effects for ALERT PLUS or
    ONDCPs media campaign.

Mass Media and High Sensation-Seeking Youth
  • Palmgreen et al. (2005) reports on an
    interrupted time-series analysis of exposure to
    ONDCPs media campaign (Marijuana Initiative) in
    two counties in Kentucky (Oct. 2002 June 2003)
    that compared High Sensation-Seeking (HSS) vs.
    Low Sensation-Seeking youth (LSS).
  • Findings 1) Sign. reductions in 30 day
    marijuana use for HSS teens 2) Sign. increase in
    perceived negative consequences of marijuana
    (HSS) 3) No campaign effects for LSS.

30-day Marijuana Use Regression Plots for HSS and
LSS Youth
Mass Media for Youth Parents (NSDUH Report,
  • In 2003, 14.6 M youth 12-17 (58.9) talked with
    parents over the past year about the dangers of
    tobacco, alcohol, or drug use.
  • Youth who talked with parents were sign. less
    likely to report past month alcohol use, binge
    drinking, and illicit drug use.
  • Youth who reported seeing anti-drug media
    messages over the past year were sign. less
    likely to report past month binge drinking and
    illicit drug use.

Dual Mass Media Youth and Parents ONDCPs
  • Major Goals 1) enable youth to reject illegal
    drugs 2) prevent initiation of marijuana 3)
    promote drug cessation for occasional users.
  • 19982005, campaign costs 1.325 Billion.
  • Dual Media Campaigns 1) Youth (9 to 18) 2)
    Parents/Caregivers --- Westats evaluation of
    Phase 3 of campaign - September 1999.
  • Campaign paid ads on TVPSAs, radio, ads in
    magazines and newspapers, billboards, movie
    spots, video rentals web site press.
  • Partnership for a Drug-Free America--- media