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A Critical Perspective on the Drug Czar's Antidrug Media Campaign

Wallack, William Dejong, Lawrence

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Journal of Health Communication

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10.1080/108107399127020

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This article was downloaded by: [University of Connecticut] On: 12 October 2014, At: 03:10 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK  Journal of Health Communication: International Perspectives Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uhcm20  A Critical Perspective on the Drug Czar's Antidrug Media Campaign William Dejong, Lawrence Wallack Published online: 29 Oct 2010.  To cite this article: William Dejong, Lawrence Wallack (1999) A Critical Perspective on the Drug Czar's Antidrug Media Campaign, Journal of Health Communication: International Perspectives, 4:2, 155-160, DOI: 10.1080/108107399127020 To link to this article: http://dx.doi.org/10.1080/108107399127020  PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the "Content") contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any  Do; wnloaded by [University of Connecticut] at 03:10 12 October 2014  form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-andconditions  A Critical Perspective on the Drug Czar's Antidrug Media Campaign WILLIAM DEJ ON G Harvard School of Public Health Boston, M assachusetts, USA  LAWREN CE WALLACK  Downloaded by [University of Connecticut] at 03:10 12 October 2014  P ortland State University P ortland, Oregon, USA T he US government's Office of National Drug Control Policy (ONDCP) launched its new antidrug media campaign in J uly 1998. T he campaign is likely to increase awareness of the youth drug problem, but shortcomings in the campaign's early implementation raise questions about its potential for changing behavior. Short comings include : a) T he Žrst wave of ONDCP's television advertisements are focused on reinforcing problem awareness but do not model skills or provide other information necessary for behavior change ; b) the campaign provides insufficient focus on promoting drug treatment and citizen involvement in local prevention activities, including political action; c) the campaign is being implemented without a major new investment in drug-treatment programs or community- based prevention programs ; d) T he campaign does not substantively address alcohol and tobacco, which pose a clear threat to health and serve as a ''gateway'' to illicit drug use ; and e) the Žrst wave of television advertisements use exaggerated fear appeals, a strat egy shown by research rarely to be successful. Only time will tell whether the ONDCP media campaign will succeed or fail. Using past research as a guide, there is legitimate reason for concern that the campaign will not live up to expectations.  ''These ads are designed to knock America upside the head and get America's attention,'' declared P resident Bill Clinton as he introduced the Žrst wave of television, radio, and print advertisements for the federal government's Žve-year, $2 billion ''National Youth Anti-Drug M edia Campaign'' (Shogren, 1998). This historic campaign, orchestrated by the Office of National Drug Control P olicy (ONDCP ), was launched amid equal amounts of optimism and criticism on July 9, 1998. The campaign is ambitious. Roughly half of the $2 billion was authorized by Congress, making this the largest public health media campaign ever launched in the United States. ONDCP is also negotiating for broadcasters and other media outlets to match the paid campaign with donated time or space equal in value to what the government buys (Shogren). There is much to admire about the new campaign, not the least of which is the federal government's enormous commitment to raising the visibility of the drug issue among youth. P utting money behind the message not only increases the message's reach, but also signals a greater seriousness about the issue. There is, in fact, little doubt the campaign will increase awareness of the drug problem. What happens after that, however, is unclear. Also noteworthy is the participation of the P artnership for a Drug-Free America, whose member agencies are creating the ads for the campaign. The partnership's advertising has been criticized in the past for its sensationalism and the indiscriminate use of fear tactics, as well as for factual inaccuracies (Buchanan & Address correspondence to Dr. DeJong, Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Avenue, Boston, M A 02115 , USA. E-mail : bdejong @ edc.org  J ournal of Health Communication, Volume 4, pp. 155­ 160, 1999 Copyright Ó 1999 Taylo r & Francis 1081-0730 /99 $12.00 1 .00  155  Downloaded by [University of Connecticut] at 03:10 12 October 2014  156  W . DeJ ong and L. W allack  Wallack, 1998). That said, no one questions the potential value of the creative services provided by the advertising agencies or the Partnership's commitment to the antidrug cause. A unique feature of the ON DCP campaign is its focus on parents and other in ¯ uential adults to urge them to take advantag e of everyday opportunities to talk with children about drugs and to make their wishes clearly known that the children stay drug-free. M any parents dismiss the idea that they can sway their children to avoid drugs (National Center on Addiction and Substance Abuse 1996), but research evidence shows that parental and family in ¯ uences have a strong protective eV ect (Resnick et al., 1997). This campaign may help parents recognize and act on that fact. At the same time, the scope and direction of the campaign raises many serious questions among prevention and health communications experts, who are perhaps justiŽed in wondering if the campaign, by ignoring the lessons learned from past scientiŽc research, will fail to live up to expectations. Studies of previous public health campaigns suggest a potential limitation of the ONDCP campaign. Years of drug prevention research have taught us that creating awareness is only a Žrst step in the behavior change process. After that, other means of in ¯ uencing people's behavior must be found, including addressing misperceptions that impede the adoption of the desired behavior ; modeling appropriate skills and demonstrating the beneŽts of alternative behaviors ; demonstrating to people that the desired behavior is fully within their capability ; and showing how to build social and other supports for sustaining the change in behavior (DeJong & Winsten, 1998 ; M aibach & Cotton, 1995). Unfortunately, most health-related public service campaigns never get past the stage of reinforcing people's awareness of the problem. That was certainly true of the P artnership's work in the 1980s and early 1990s. It is also true of the Žrst wave of ads released by ONDCP , which should cause real concern that the ONDCP campaign will stay stuck at the awareness stage. It is true that ONDCP 's strategy statement outlines several additional campaign objectives that are consistent with accepted models of the behavior change process. (''National Youth,'' 1998). It remains to be seen whether this document will actually serve as the basis for the campaign as it moves along. P ast research also suggests that very often the strongest mass media campaign will be one that is designed to leverage activity at the local level, in particular by motivating people's participation in community-based programs or encouraging their active support for policy change (Wallack & DeJong, 1995). ON DCP's television advertising could work in sync with community-based eV orts by (1) reinforcing the lessons on prevention behavior provided by school, worksite, and other programs ; (2) directing people into treatment programs ; and (3) telling people about eV ective strategies for changing policy, enhancing enforcement, or building up their community's prevention infrastructure, including mentoring or after-school programs. ON DCP's strategy statement includes activities to provide information and materials to local programs, to link national campaign activities with local communities, and to publicize phone numbers of local prevention and treatment organizations. These are worthy steps, but they fall far short of a full-blown campaign to promote treatment and citizen involvement in local prevention activities, including political action. We should caution, however, that such a campaign should not be implemented unless there is a concomitant eV ort to invest substantial new resources in proven  Downloaded by [University of Connecticut] at 03:10 12 October 2014  T he Drug Czar's Antidrug M edia Campaign  157  drug treatment programs and in community-based prevention programs. Indeed, even with the ON DCP campaign as it is now, we are concerned about the implications of the federal government's modest investment in these programs. One of the most important lessons from research on public health campaigns is that, although the mass media can be used to raise awareness and set the public agenda (Dearing & Rogers, 1996), producing meaningful changes in behavior is usually dependen t on the more intensive application of resources at the community and interpersonal level (F lora, M aibach, & M accoby, 1989). Unfortunately , if the ONDCP campaign motivates people to seek drug treatment, there will be insufficient treatment resources in place to serve them. If the campaign motivates parents and others to get involved in community-based prevention work, or even just to learn more about how to talk with their children, they will generally Žnd underfunded programs operating on shoestring budgets- programs that are unlikely to be able to respond to increased demands on their strained resources. ON DCP was warned about this. At an early meeting about the design of the campaign, representatives of local community-based programs stated that the campaign would stimulate a demand for services that would outstrip their capacity to respond, a fact of life for both prevention and treatment services (''Paid M edia,'' 1997). The absurdity of this situation is evident if we draw a comparison to the business sector. No company would launch a multimillion dollar marketing campaign without having made sure that the advertised product is widely available. But that is in essence what ONDCP is doing. ONDCP will pay Disney (ABC-TV), Westinghouse (CBS-TV), Times-Warner, F ox, local broadcasters, and other media companies hundreds of millions of dollars to run its advertising while local treatment and prevention programs go wanting. ON DCP director General Barry M cCa V rey has acknowledged that the nation's prevention and treatment resources are inadequate. On Nightline, where he appeared on the day of the campaign launch, M cCaV rey touted the fact that, in 12 test markets for the campaign, local coalitions had received a 500% increase in telephone calls when the ONDCP advertisements ran. If people's response to these ads is to pick up the telephone and call, does the nation have enough drug treatment centers to help them ? M cCa V rey's response to this question was telling : ''No, we don't. . . . I think we've probably got around 50 percent of the treatment capacity we need. . . . We also don't really have the tools to pull together business leaders, educators, parents groups, etc. . . . They've got to see these ads and respond to them. (''Billion Dollar,'' 1998). How the public is to ''respond'' is not clear. Not only is there a lack of adequate infrastructure for community-based prevention and treatment, but the advertising produced so far does not spell out what people should do or how to do it. This even applies to the most straightforward part of the campaign, encouraging parents to talk to their children about drugs. Parents who already have a good relationship with their child might have the wherewithal to strike up a conversation about drugs. But what about those parents who do not know how to begin that conversation or how to get past their child's initial resistance? The conversation has to be ongoing, not a one-time thing, so how can parents maintain a dialogue with their child over time? If their child asks questions, where do parents go to get the facts ? And where do parents go for help if they believe their child is using drugs and don't know what to do about it ? Talking about this subject is difficult for parents, and many of them will not be able to do it just because a television ad tells them it is important. The advertising itself should touch on these issues. Early ads have displayed a toll-free  Downloaded by [University of Connecticut] at 03:10 12 October 2014  158  W . DeJ ong and L. W allack  telephone number, which provides a trained expert who can advise parents, but this is inadequat e if the ads do not demonstrate the availabilit y of eV ective strategies or otherwise sell the toll-free number as a good resource. There are additional issues about this tax-supported campaign that should concern the American public. M ost disconcerting is that it does not substantively address the two drugs that cause by any measure the greatest harm to American society : alcohol and tobacco. Indeed, for people under the age of 25 the most immediate and signiŽcant threats to their health are deaths from alcohol-related automobile crashes, homicide, and suicide plus alcohol-related injuries (National Institute on Alcohol Abuse and Alcoholism 1997). Consider also that substance abuse experts know that nearly all children who use drugs Žrst begin by experimenting with tobacco and alcohol, that in fact these substances seem to serve as a ''gateway'' to the very illicit drugs that so worries ONDCP (Kandel & Logan, 1984 ; Lindsay & Rainey, 1997). General M cCa V rey is quick to point out that Congress did not authorize the campaign to focus on alcohol and tobacco. ON DCP's remedy is to ask broadcasters to use a substantial portion of the time they are donating to the antidrug campaign to air public service announcements (P SAs) on other public health subjects, including alcohol and tobacco. ONDCP is providing P SAs it has gathered from other sources (''ONDCP Campaign,'' 1997). Unfortunately, there are very few PSAs on alcohol that are available, excluding anti-drunk-driving ads, which are hardly appropriate for elementary and middle school children, the main targets of the campaign. M others Against Drunk Driving is working to Žll the void, but it remains to be seen whether those P SAs will be approved or, if approved, whether they will be aired with any frequency at times when children are watching television (''Interview,'' 1998). It is also problematic that the Žrst wave of ONDCP advertisements use exaggerated fear appeals. F or example, the advertisement used to launch the new campaign, which shows a young woman using an iron frying pan to destroy her kitchen, is a classic fear appeal. The underlying premise is that young people can be motivated to avoid drugs by vivid, emotionally charged portrayals of drugs' negative consequences. In fact, most experts have concluded that fear-based campaigns are extremely difficult to execute, rarely succeed, and should be used only under limited circumstances (Job, 1988). There is even a risk that fear appeals will backŽre if the public dismisses them as unrealistic exaggerations , which can make the problem behavior even more resistant to change (DeJong & Winsten, 1998). Even so, fear appeals continue to have strong intuitive appeal and are often used by advertising agencies for public service campaigns. Advertisers defend this by noting that focus group participants usually rate strong fear appeals as highly motivating and eV ective. But research has shown this is true even when subsequent experimental studies show those appeals to be ineV ective (Job). There are times, of course, when people need to be made aware of threats to their health, or when they need occasional reminders of those threats, especially when the target audience has low awareness or anxiety about a problem (DeJong & Winsten, 1998). ONDCP points to recent Žndings from the M onitoring the Future study, which show that adolescent substance use is related to young people's beliefs about the dangers involved (Johnston, Bachman, & O'M alley, 1997). Certainly, the ONDCP campaign should present the facts about the harm that drugs can do, but that advertising must avoid the type of needless exaggeratio n that will feed skepticism and even derision.  Downloaded by [University of Connecticut] at 03:10 12 October 2014  T he Drug Czar's Antidrug M edia Campaign  159  Outside experts who consulted on the campaign plan recommended that social scientists who understand behavior change theory be put in place to review the new advertising being developed , in part to help the advertising move beyond creating awareness, but also to avoid mistakes in execution (P ersonal correspondence of William DeJong to General Barry M cCa V rey, 1997). ONDCP 's installation of such a panel is an important step ; however, it will be important to watch closely to see if the panel will make a diV erence. Unfortunately, the panel was not in place soon enough to warn ONDCP not to air some of the advertisements released in the Žrst phase of the new campaign, which clearly violate basic principles of behavior change or run counter to what the research suggests is best practice. To cite one example, an advertisement directed to parents shows two attractive, upper-middle-class boys smoking marijuana. The message to parents is that drugs are a threat everywhere. But what is the message to teens ? Turn o V the sound to eliminate the announcer's voice, and we are left with an image advertisement for marijuana. Now that the panel is in place, will it have real in ¯ uence on the campaign ? The panel's role is to review advertising produced by the P artnership for a Drug-Free America as a check against mistakes. But much of what is wrong with most public service campaigns are sins of omission. It isn't so much that ads that model appropriate skills are badly done, but that they aren't done at all. Whether the panel will have a role in helping decide which ads are produced, as opposed to reacting to the Žnished product, is unclear. ONDCP promises that the panel will have in¯ uence. On the other hand, the P artnership was very hostile to this idea when it was Žrst proposed (P ersonal correspondence of William DeJong to General Barry M cCaffrey, 1997) and agreed to it only after extensive negotiation s with ONDCP . Only time will tell whether the ONDCP campaign will succeed or fail. But using past research as a guide, we are very concerned that the campaign will become yet another disappointment in a long history of public health media campaigns that fail to change health-related behavior. Our worry is that the current campaign will raise awareness of the problem but accomplish little more. Then, when the money eventuall y runs out and the campaign subsides, the public's awareness of the problem will subside as well and little permanent gain will have been realized. F ortunately, it is not too late for the campaign to be redirected. F oremost, we must fund, strengthen, and expand community-based prevention and treatment programs. Drug treatment works, yet as the ON DCP campaign has begun, existing treatment programs have long waiting lists. This situation is self-defeating , if not morally unacceptable. In the realm of prevention, it is vital that the federal government increase its investment in youth programs, including mentoring (Tiernay, Grossman, & Resch, 1995). and ''beacon'' or ''full service'' schools, (Dryfoos, 1998 ; M cGillis, 1996). which have been shown to have great potential in helping reduce a range of youth-related problems, including substance use. Then, ON DCP should reorient its campaign to promote behavior change, primarily by directing the public to local resources where they can Žnd information, help, and support. This would be a plan that re¯ ects our scientiŽc knowledge of health communication campaigns while taking into account the practical realities of prevention and treatment eV orts at the local level.  References The billion dollar crapshoot : Is this the best way to attack the drug crisis ? (1998, July 9)  Downloaded by [University of Connecticut] at 03:10 12 October 2014  160  W . DeJ ong and L. W allack  Nightline. New York : ABC N ews. Unedited transcript available on-line at http :// www.ABCN EWS.com. Buchanan, D., & Wallack, L. (1998). This is the P artnership for a Drug-F ree America : Any questions ? J Drug Issues, 28 329­ 356. Dearing, J. W., & Rogers, E. M . (1996). Agenda- setting. Thousand Oaks, CA: Sage. DeJong, W., & Winsten, J. A. (1998). T he media and the message : Lessons learned from past public service campaigns. Washington, DC : The N ational Campaign to P revent Teen P regnancy. Dryfoos, J. (1998). Full- service schools : A revolution in health and social services for children, youth, and families. San F rancisco, CA: Jossey-Bass P ublishers. F lora, J., M aibach, E., & M accoby, N . (1989). The role of media across four levels of health promotion intervention. In L. Broclow, J. E. F ielding, & L. B. Lave (Eds.), Annual review of public health (Vol. 10). P alo Alto, CA : Annual Reviews. Interview with Bobby Heard, Director of P rograms, M others Against Drunk Driving (1998, September 17). Job, R. (1988). EV ective and ineV ective use of fear in health promotion campaigns. Amer J Public Health, 78, 163­ 167. Johnston, L. D., Bachman, J. G., O'M alley, P . M . (1997). Monitoring the future : Questionnaire response from the nation's high school seniors. Ann Arbor, M I : Institute for Social Research. K andel, D. B., & Logan, L. A. (1984). P attern s of drug use from adolescence to young adulthood : I. P eriods of risk for initiation, continued use, and discontinuation. Amer J Public Health, 74, 660­ 666. Lindsay, G. B., & Rainey, J. (1997). P sychosocial and pharmacologic explanations of nicotine's ''gateway drug'' function. J School Health, 67, 123­ 126. M aibach, E. W., & Cotton, D. (1995). M oving people to behavior change : A staged social cognitive approach to message design. In E. W. M aibach & R. L. P arrott (Eds.), Designing health messages : Approaches from communication theory and public health practice. Thousand Oaks, CA: Sage. M cGillis, D. (1996). Beacons of hope : New York City's school- based community centers (N CJ 157667 ). Washington, DC : U.S. Department of Justice. N ational Center on Addiction and Substance Abuse (CASA). (1996). National survey of American attitudes towards alcohol and substance abuse II : T eens and their parents. N ew York : CASA. N ational Institute on Alcohol Abuse and Alcoholism (N IAAA). (1997). T he ninth special report to the U .S. Congress on alcohol and health. Rockville, M D : NIAAA. T he National Youth Anti- Drug Media Campaign: Communications strategy statement . (1998). Washington, DC : Office of N ational Drug Control P olicy. ONDCP campaign design expert panel meeting. (1997, November 24). P orter Novelli, Washington, DC. P aid M edia Campaign Initiatives. (1997, M arch 14). F ocus meeting to discuss target audience and objectives, Office of National Drug Control P olicy, Washington, DC. P ersonal correspondence of William DeJong to General Barry M cCa V rey. (1997, December 1). Office of N ational Drug Control P olicy, Washington, DC. Resnick, M . D., Bearman, P . S., Blum, R. W., Bauman, K . E., & Harris, K . M . et al. P rotecting adolescents from harm : F indings from the N ational Longitudinal Study on Adolescen t Health. J AMA, 278, 823­ 832. Shogren, E. (1998, July 10). Clinton, Gingrich drug plan hits the air. Los Angeles T imes, A12. Tiernay, J. P ., Grossman, J. B., & Resch, N . L. (1995). M aking a di€ erence : An impact study of Big Brothers/ Big Sisters. P hiladelphia, PA: P ublic/P rivate Ventures. Wallack , L., & DeJong, W. (1995). M ass media and public health : M oving the focus of change from the individual to the environment. In T he e€ ects of the mass media on the use and abuse of alcohol. Rockville, M D : U.S. Department of Health and Human Services, National Institute on Alcohol Abuse and Alcholism.              

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