Critique of the Partnership for a Drug Free America Television Ad Campaign & A Potential Alternative Intervention - Christian Pulcini
Introduction
Throughout the latter half of the 20th century and continuing into the 21st, public health interventions aimed at reducing illicit drug use among youths and adolescents have been fundamentally flawed in their reasoning and strategies behind the interventions. The over-reliance on traditional public health models to help structure interventions, such as the health belief model and theory of reasoned action, have steered public health professionals and organizations concerned with illicit drug use away from their original goals.
Partnership for a Drug-Free
No example is more prominent and memorable than the Partnership for a Drug Free America’s commercial campaign, which has targeted illicit drug use over the past 30 years. Although the Partnership touts it successes by citing an overall decline in drug use over the past 30 years, it fails to acknowledge that drug use reached its peak in the late-1990s years after its most well-known and widely distributed television advertisement “This is drugs. Now this is your brain on drugs. Any questions?”.[1]
The answer to this advertisement in the context of structuring successful public health intervention is most certainly “yes”. In fact, this advertisement can offer insight into the fundamental questions of why did the Partnership’s early interventions fail? And why will their advertisements aimed at preventing illicit drug use continue to fail to reach the youths and adolescents of the
The Nature of Drug Use & Missed Social Science Cues by the Partnership for a Drug-Free
The Partnership for a Drug-Free America has consistently employed more traditional health behavior models in constructing their market-based interventions. More specifically, “This is drugs. This is your brain on drugs. Any questions?” is an excellent example of a health belief model-based intervention. What is interesting about the reasoning behind this intervention is that the Partnership appears to completely ignore the multiple behavioral factors that influence drug use, and also fails to recognize the inadequacy of the health belief model in predicting complex behaviors. By reviewing psychological theory over the past thirty years in parallel with the foundations of the health belief model, one may attain a better understanding of why the Partnership for a Drug-Free America initially produced ineffective advertisements and why they continue to do so today.
When the first mass media campaign was launched by the Partnership for a Drug Free America, psychological theory held (as evidenced by the DSM-IV & ICD-10) that drug use is a largely atheoretical disease which can be classified by a traditional medical model conceptualization.[2] Many argued against this reductionist view of the illness however, as they felt it could not be classified under a single disease and instead involved multiple factors which could not be accurately defined.[3] As early as the mid-1980s, the psychological theory behind drug use began to shift to support the latter opinion and reject the more traditional classification of drug use. Psychologists found that the relationship between behavior and drug use is not easily categorized, and cannot be defined by a set of agreed upon variables.[4] More recently, psychologists have agreed that drug use is a multi-dimensional behavior that can be influenced by various factors including genetics, biology, environment, socio-cultural factors, and the biochemistry of the substance itself. The exact formula that leads an individual to use drugs is largely unknown, and could be any combination of the factors listed above.4 Modern psychopathology recognizes that physicians, sociologists, behavior-oriented researchers, and other scientists and social scientists that study drug use all produce different theories and interventions based on their discipline.[5] Therefore, although mainstream psychological theory failed to recognize the complexity of the behavior involved with drug use in the 1970s, it certainly has come to agree with other social sciences that drug use is not a behavior that can necessarily be predicted.
Although the health belief model has several limitations, the one that is most relevant to the psychological theory presented above (in the context of evaluating the Partnership’s intervention campaign) is that the health belief model has repeatedly been shown to be a poor predictor of complex behavior.[6] Why then would the Partnership utilize the health belief model in their marketing campaign to address drug use? Although the answer to this question is difficult to answer without input from the Partnership for a Drug-Free America, it can be postulated that the Partnership has consistently failed to incorporate social science theory into their interventions and consequently has failed to capture their target audience. They instead decided to adopt the health belief model as a common model to predict health behavior, not evaluating the efficacy of the model in predicting complex behaviors. Although the Partnership may not be held accountable for their failure to recognize drug use as a complex behavior when they initially produced their interventions (because mainstream psychological theory had not decided until the mid-1980s drug use was a complex behavior), their failure to adapt to new social science theories and abandon the health belief model in constructing illicit drug use interventions cannot be excused for at least the last 20 years.
Marketing Campaign or Just Another Public Health Intervention?
In addition to the failure of the Partnership for a Drug-Free America to recognize that the health belief model cannot readily predict complex health behaviors, they also failed to incorporate more modern marketing theories in their interventions that are generally a better predictor of behavior. The Partnership claims they that are the pioneers who successfully breached the long-existing gap between public health and mass media, but they do not recognize that their advertisements fall short in addressing the problem of illicit drug use among youths because the foundation which produced their memorable yet ineffective messages was wrongly applied.[7]
This once again leads us back to a discussion of the health belief model and its limitations. The health belief model hypothesizes that behavior is based on individual, rational decisions which are not influenced by social or environmental factors. Besides the fact that these characteristics also support the first argument presented above, they also display that the Partnership was largely unaware of the components of a successful marketing campaign based on marketing theory. Marketing theory, almost in direct opposition to the health belief model, is a homogenous approach which concentrates on influencing the behavior of large portions of a population as opposed to individual idiosyncrasies.[8] The pattern that marketing theory follows to achieve this goal is as follows:
- First, they present to the group of people something they want, need, or desire.
- Second, they offer a promise that their product can fulfill the consumer’s newly discovered demand.
- Third, an image is given that reinforces the goals of the audience.
- Lastly, support must be offered to show how the promise will be delivered.[9]
If the marketing theory model explained above is compared to the Partnership’s health-belief model based intervention “This is drugs. This is your brain on drugs. Any questions?”, the distinctions and argument become much clearer. The first step in the marketing theory, which appeals to a groups wants, needs, and/or desires, is successfully addressed in the intervention. No teenager or adult wants their brain to be fried by drugs. It is unclear whether or not they are attempting to address a rational individual, which would indicate a health-belief model based intervention, or a group of people who are predictably irrational (marketing theory). Either way, it is safe to assume that any individual or group regardless of rationality would not want their brain fried by drugs. In terms of the first portion of the marketing theory, the intervention does appear to be successful. This also appears to be the case with the third component, as the strong, memorable image does reinforce the goal of the audience.
If the 2nd and 4th elements of marketing theory are discussed within the context of the intervention, one is able to realize that these are the crucial steps within marketing theory that are missing. In the television advertisement, there is no promise or proof that shows an individuals brain will be fried if they use drugs. Teenagers watching the commercial interventions who are considering using drugs may dismiss the strong imagery based on the lack of a promise, and make the assumption that the claim within the commercial is false. Logically the last component of the marketing theory cannot be addressed if the 2nd is not produced, which indicates that no support is offered by the Partnership which proves the adverse effects of drug use.
Overall, the “This is drugs. This is your brain on drugs. Any questions?” intervention does incorporate elements of marketing theory. It appears as if the Partnership however, when they attempted to merge mass media and public health, was largely unsuccessful in bridging the gap between public health and mass media because they picked up on parts of marketing theory and put it into a health belief model context. Instead, the Partnership should have fully utilized marketing theory as a better predictor of complex behaviors and dismissed the health belief model entirely. By incorporating marketing theory components into the a health belief model based intervention, the Partnership falls short of its goal and the commercial simply becomes another failed attempt to prevent illicit drug use among youths.
Later Intervention: Change or Just the Same?
It is important to mention that the Partnership, after their initial commercial campaign, decided to modify “This is drugs. This is your brain on drugs. Any questions?” commercial campaign to incorporate other public health based behavior models. It is unknown whether the Partnership viewed the early campaign as a failure and decided to change, or whether they felt they could strengthen their already successful campaign to combat illicit drug use among youths. Regardless, it appears as if the Partnership did strengthen their newest mass media product, but still fell short of obtaining the goal because of their reliance on the traditional health behavior models.
The revamping of the 1980s Partnership for a Drug Free America anti-narcotics commercial in the late 1990s features a woman with a frying pan, who smashes an egg after declaring “this is your brain, now this is your brain after you snort heroin”.[10] She continues to destroy the entire kitchen with the pan stating “And this is what your family goes through, and your friends, etc., etc.”.[11] The intervention attempts to portray the outcome expectancies for the viewer(s), perceived social approval, and to strengthen the feelings of the viewer(s) towards the outcomes. These are all important components of the theory of reasoned action, a model similar to the health belief model which integrates outcome expectancies, perceived social approval, and different attitudes and beliefs towards the behavior.[12]
Although interventions based on the theory of reasoned action have more potential than the health belief model to be successful in predicting behaviors surrounding the use of illicit drugs, the Partnership once again fell short in fully recognizing the nature of the problem. Even more so than the original commercial campaign; this commercial relies on those youths considering illicit drug use to be able to make a rational, planned decision. It also does not provide any explanation of the disconnect between intentions and behavior. In other words, impulse behavior is not accounted for within the theory of reasoned action. For example, the contents of the commercial assume that before using drugs the teenager is going to be in a rational mindset to ask questions such as: what is this drug going to do to my brain? How is it going to effect my family and friends? How am I going to feel about myself if I do the drugs?. Several surveys of teens agree, including ones published by the Partnership for a Drug Free America, that drug use is usually not pre-meditated and the decision to use drugs is based on their immediate availability.[13] Teens in these surveys also overwhelmingly agree that they know any kind of drug use is bad (89%), but what is interesting is that over 18% of students nationally are engaging in illicit drug use (alone) according to the Youth Risk Behavior Survey.[14] It is obvious that the decision to use drugs is often not rational, planned, or intended, but instead is based on the disconnect between intention and behavior, which the theory of reasoned action fails to address.
Even though social sciences have a difficult time agreeing on the exact components of the behavior which encompass drug use, they all agree that the decision to engage in the behavior is often not planned, rational, and intended.[15] The partnership does make a better attempt at addressing illicit drug use among youths in their second campaign, but still falls short in assessing the nature of drug use and consequently fails in constructing a successful intervention.
Conclusion: Flaws that Need to be Addressed
The Partnership for a Drug Free America should be applauded for their persistence in attempting to curb illicit drug use among youths from the latter half of the 20th century until present. But as what often occurs with public health interventions, persistence with the wrong framework and structure leads to continued failure. The Partnership’s over-reliance on traditional health behavior models, such as the health belief model and theory of reasoned action, and their failure to apply marketing principles to a marketing campaign have led to 30 years of misled advertisements, wasted public dollars, and ineffective efforts. Until the Partnership is able to incorporate modern social science theory into their interventions, their efforts are doomed to continuously fall short in reaching out to the youths of America.
Introduction to an Alternative Intervention
Given the fundamental flaws in the Partnership for a Drug Free America’s commercial intervention, it provides a significant opportunity to suggest an alternate intervention which addresses each of the previously addressed flaws and may serve as a guide for a future successful intervention aimed at preventing the use of illicit drug among teens. By creating a commercial based on marketing theory (instead of the traditional health behavior models) which addresses the limitations of the Partnership’s current campaign, more teens at risk of using drugs will be reached if the proposed intervention is implemented.
The Intervention: “Fate” & Positive Choices
To truly understand the context of the proposed intervention, it is imperative to give a short background of the television advertisement it is based upon. A recent commercial by Nike (entitled “Fate), which shows very brief clips of two notable football players, LaDainian Tomlinson and Troy Polamalu, developing into the excellent players they are today is an solid foundation for a public health intervention.[16] As the original commercial displays how these two players were born to be excellent football players, a public health intervention could also portray the same idea. The commercial shows images of the players as children and adolescents, running to class with books in their arms, running up stairs, etc. to portray that they not only worked hard, but were also destined to do what they have done. Nike’s Vice President states “The beauty of this ad is it reminds us of how much hard work, sacrifice, and yes, fate it takes to make it to the top of the sport of football”.[17] The commercial finishes with a dramatic clash of the two players in an actual game.
A public health intervention aimed at keeping adolescents off drugs could use the marketing theory strategies utilized in the Nike commercial. First, the commercial would begin exactly the same; with two athletes born and excelling from youth to adolescence. At this point, the public health intervention would deviate from the actual commercial. It would show one of the players working hard and the other player experimenting with marijuana around high school age. Both players would still be shown at big name colleges, one displayed as scoring a touchdown and the other player who had experimented with drugs as not living up to his potential. It would show them after the game, one getting high fives with people all around him encouraging him, with the other using some sort of illicit drug(s). The last shot would be the football player who worked hard scoring a touchdown on a NFL team, and the drug user in a secluded room alone using drugs. The final message would be “What fate gives, drugs can take away”, in which the famous successful football player (ideally LaDainian Tomlinson because of his clean record and respect he receives from in and out of the NFL) would deliver the message to keep consistent with the Nike message and to directly influence the youth of the United States.
Although the exact representations in the commercial may be improved upon by marketing experts, the basic idea and message of the commercial could be effective according to marketing theory. This intervention could also be extended to other public health interventions (ex. Teen pregnancy) and sports (ex. Women’s basketball) to potentially influence a wider audience.
A Better Predictor of Complex Behavior: An Intervention with Potential
The first fundamental flaw in the Partnership’s commercial campaign is their use of the health belief model, which has repeatedly been shown to be a poor predictor of complex behavior.[18] The proposed commercial intervention, which is based on marketing theory, more accurately recognizes that behaviors surrounding drug use are often complex and cannot be predicted utilizing traditional health behavior models. In fact, one of the strengths of marketing theory is that it accounts for behavior(s) of individuals being dynamic.[19] The commercial involving two football players does not assume that each individual watching makes independent decisions regarding drug use, but instead it attempts to influence the decisions’ of a group of individuals (causing herd mentality) who are considering and/or exposed to drug use. More specifically, the advertisement forces a group of teens to consider the consequences of drug use, but also reinforces the idea that drug use is not acceptable among a group of individuals (NFL players) who teens often aspire to be.
The proposed campaign could be more successful because it does not attempt to simplify behaviors surrounding of drug use. Instead, it realizes that drug use among teens has multiple contributing factors, and does not attempt to address these multiple factors with a model that does not lend itself to doing so. As a result, the intervention based on marketing theory has the potential to be more successful than the original ad campaign in predicting and/or preventing drug use among a large faction of teens who aspire to be NFL football players.
Applying Marketing Theory to Construct a Successful Intervention
In addition to the failure of the Partnership for a Drug-Free America to recognize that their intervention, based on the health belief model, cannot readily predict complex health behaviors, they also failed to incorporate more modern marketing theories in their interventions (which are generally a better predictor of behavior). The proposed intervention however utilizes marketing theory to construct an intervention which has the potential to reach out to teens and more effectively prevent drug use.
Marketing theory, almost in direct opposition to the health belief model, is a homogenous approach which concentrates on influencing the behavior of large portions of a population as opposed to individual idiosyncrasies.[20] The pattern that marketing theory follows to achieve this goal is as follows:
- First, they present to the group of people something they want, need, or desire.
- Second, they offer a promise that their product can fulfill the consumer’s newly discovered demand.
- Third, an image is given that reinforces the goals of the audience.
- Lastly, support must be offered to show how the promise will be delivered.[21]
In regards to how the proposed intervention relates to marketing theory, the goal of the commercial is to tap into the viewer’s desire to become a professional football player (as researched for the original commercial). The promise of the advertisement is that it is possible for those who are naturally gifted to become NFL players, but not for those who use drugs and do not work hard. Ultimately it draws comparisons to the two individuals’ choices, where the one football player chooses to use his natural talent while the other chooses to throw it all away. The supports are the images of the players growing up and making choices, and the apparent success and failure of each player is how the promise will be fulfilled. It is important to note that the commercial also incorporates the social aspect of using drugs and how using drugs can have adverse consequences on relationships.
Therefore, although the Partnership for a Drug Free America does incorporate some aspects of marketing theory, the new ad campaign has the potential to be more successful because it accurately reflects all components of marketing theory instead of just two of them. Teens will be able to see through the players’ choices that the promise of the consequences of using drugs will be fulfilled, and will consequently make better choices when presented with the opportunity to use illicit drugs.
Rational or Predictably Irrational? A Better Model to Prevent Drug Use Among Teens
The third limitation of the Partnership’s drug ad campaign occurred after they had revamped their original campaign. The “revamping” involved using the health belief model to construct an intervention, with the new commercial implementing components of the theory of reasoned action. Although the theory of reasoned action has more potential than the health belief model to be successful in predicting behaviors surrounding the use of illicit drugs, the Partnership once again fell short in fully recognizing the nature of the problem as the new commercial relies on those youths considering illicit drug use to be able to make rational, planned decisions.
Because the recommended ad campaign is based on marketing theory, it does not assume that a teen is going to be able to make a rational, planned decision when considering drug use. Instead, it postulates that behavior is predictably irrational.[22] The proposed intervention exposes a group of teens to an idea and promise that if they decide to use drugs, then they will not be able to succeed in athletics regardless of inherent ability. This could potentially be a much stronger motivator, as teens would see a promise of something they aspire to be fulfilled in the new intervention, whereas in the original intervention no promise is fulfilled.
These components of the proposed intervention strongly support the need for the Partnership to realize that decisions involving drug use are often not planned and rational, but instead are impulsive and irrational. The proposed intervention targets a group of individuals who aspire to be athletes, as opposed to the Partnership’s campaign which fails to address the aspirations and desires of its viewers. Although the proposed marketing campaign may need several commercials to address the different desires and aspirations of different groups of teens, this model has been shown a much more effective predictor of behavior.
Conclusion
Even though the Partnership for a Drug Free America has consistently failed to incorporate social science theory into their interventions, more specifically marketing theory, there is still hope for the Partnership to construct a potentially successful ad campaign in the future. By implementing the proposed intervention, using the Nike “Fate” commercial as a model, many of the fundamental flaws in the Partnership’s original and revamped campaign would be addressed. As a result, the prevention of teen drug use in the
References
[1] Partnership for a Drug Free
[2] Parents. The Anti Drug.
[3] Pattison, E. M., Sobell, M. B., & Sobell, L. C.. Emerging concepts of alcohol dependence,
[4] Shaffer H.J., Neuhaus Jr. C. Testing Hypotheses: An Approach for the Assessment of Addictive Behaviors. 1985. p. 87-103.
[5] Maddux J., Winstead B. Psychopathology: A Foundation for a New Understanding. 2005. p. 308.
[6] Becker MH, ed. The health belief model and personal health behavior. Health Educ Monogr. 1974;2:Entire Issue.
[7] Partnership for a Drug Free
[8]
[9] Siegel M, Siegel LD. Marketing Public Health. 2004. p. 57-58.
[10] Partnership for a Drug Free
[11] Partnership for a Drug Free
[12] Fishbein M,
[13] Partnership for a Drug Free
[14] Youth Risk Behavior Surveillance – United States 2007. MMWR.
[15] Shaffer H.J., Neuhaus Jr. C. Testing Hypotheses: An Approach for the Assessment of Addictive Behaviors. 1985. p. 87-103.
[16] Nike Corporation. “Fate” Available at http://www.nikebiz.com/media/pr/2008/10/09_Fate.html. Accessed
[17] IBID.
[18] Becker MH, ed. The health belief model and personal health behavior. Health Educ Monogr. 1974;2:Entire Issue.
[19] Siegel M, Siegel LD. Marketing Public Health. 2004. p. 57-58, 204.
[20]
[21] Siegel M, Siegel LD. Marketing Public Health. 2004. p. 57-58.
[22] Ibid.
Labels: Adolescent Health, Blue, Drug Use, Health communication
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