Challenging Dogma - Spring 2009

Thursday, May 7, 2009

The “Above the Influence” Campaign: Unsuccessfully using Social Cognitive Theory – Nicole Haddock


The National Youth Anti-Drug Media Campaign is quite possibly the most recognizable federal effort aimed towards preventing drug use among young people.  Its overall goal is to educate the youth, encourage them to reject illicit drugs such as marijuana, prevent the initiation of drug use, and to persuade current drug users to stop using illicit substances (1).  In 2007, Congress appropriated another $99 million to further this effort.  Since it was first enacted in 1998 the Office of National Drug Control Policy has spent more than $1.5 billion on this endeavor (2).  Eight years after the initiation of this campaign the United States Government Accountability Office (GAO) deemed this project unsuccessful.  According to a study conducted by Westat Inc. and the University of Pennsylvania it was uncovered that the campaign did not prevent the instigation of drug use; nor did it curtail anyone currently using drugs to stop.  Clearly the promotion of this campaign is costing sizeable amounts of money, and yielding disappointing results.  Even with the current information at hand the sponsorship of this program continues.  One of the current campaigns to become uprooted from this agenda is the “Above the Influence” campaign.  This particular operation uses glossy television ads and a colorful website to push forth their cause.  Unfortunately, much of the effort put into this crusade inefficiently uses Social Cognitive Theory to prevent drug use.

            Social Cognitive Theory employs both internal and external characteristics as a means to understanding behavior, and the promotion of behavior modification.  Some of the specific internal characteristics that the theory relies on are: 1) self efficacy – a person’s own self confidence that he/she can perform a behavior. 2) Expectations – what a person thinks will happen if they do the behavior; as well as whether or not the expected outcome is good or bad. 3) Emotional coping - the person’s ability to properly cope with the emotional repercussion of making the behavior change.  Additionally, there are a few key principles that encapsulate the external factors relied upon.  These principles being: 1) Vicarious learning – the observing, learning, and modeling of a behavior being completed by another individual. 2) Situation – the physical and social environment in which the behavior occurs. 3) Reinforcement – The positive or negative responses that follow the behavior (3).

            The American youth appear to be an idyllic group to promote Social Cognitive Theory as a way of preventing drug use.  According to one study, it is during the teenage years when most adolescents form small social groups where they explore behaviors, identities, and values.  It was also stated that during this time the peer influences consistently trump those presented by the parents (4).  With this information, utilizing Social Cognitive Theory appears to be a practical method that could potentially result in the prevention of adolescent drug use.  In spite of the positive rationale behind this thought, the “Above the Influence” media does not produce the desired outcome.   Though their television ads are spearheaded with the best intentions; the inappropriate use of this theory is producing opposite effects due to three specific factors.

1. Adolescents will perform risk taking behaviors without regard to consequences

            Recent studies have shown that once adolescents become socially integrated into their newly formed peer groups, they will engage more frequently in risk taking behavior.  The reckless behavior is often correlated with a desire to improve ones popularity with their friends.  Basically illustrating that even though the outcome of a situation could be harmful, it is worth doing a precarious behavior in order to maintain and enhance friendships (4).  This goes against the concept presented in Social Cognitive Theory that assumes people will evaluate the expectancies of the behavior and make the proper decision (3).

            There are two particular ads available for viewing on the “Above the Influence” website that disregards the risk taking behavior element.  The two ads are entitled “pony” and “slom”.  The pony ad shows a group of young men climbing through a barbed wire fence, and walking over to a pony to pull its tail in order to get kicked in the shin (5).  There is one gentlemen in the group who chooses to walk away because he is “above the influence” so to speak.  This ad completely ignores the actual magnetic pull that peer influence has.  The motivation behind risky behaviors is not rational.  Of course no one sits to themselves thinking that they would like to get kicked in the shin by a pony; but it has been shown that people will go to great lengths to improve status amongst their peers (4).

            The second ad discussed brings about a concept called “slomming”.  “Slom” is an acronym standing for “sticking leaches on myself”.  The ad conveys young people engaging in slomming to gain the pleasurable effects of getting high.  At the conclusion of the ad they ask the question “what could you be convinced to do?”  The producers of this commercial have created a fictitious and absurd practice, too extreme to be considered a way of getting high as a comparison to marijuana smoking.  According to their thought process sticking leeches onto ones self is so completely nonsensical that absolutely no one would want to try this practice.  The researchers in this campaign are failing to acknowledge the research they have at their fingertips.  Evidence has been brought forth showing that adolescents will engage in risky behaviors if it gets them desired outcome of peer acceptance (4).  Moreover, a study conducted at Texas State University found that exposure to anti-marijuana advertising might actually change young viewers attitudes of marijuana to being a more positive one; thus directly leading to an increased risk of using marijuana (2).  

2. Where are the positive behaviors to model?

            A crucial element of Social Learning Theory is the providing of behaviors to emulate (3).  Several of the promotional ads show the faulty application of this theory by having no positive behavior for the viewer to learn and act upon.  Two particular television ads support the given accusation.  The first ad is entitled “fire”.  It starts with a depressingly monotone set of music while zooming in on different teens taking their “prized possessions” and setting them on fire.  After ending the commercial stating “marijuana costs you more than you think”, the hope is people will calculate their losses if they participate in this deviant behavior (5).  But, where is their alternative behavior?  If anything this commercial depicts young people destroying their things, while maintaining laissez faire attitudes about it.  In each scenario there is no remorse or emotion shown as these people loose what it supposed to be most important to them.

            The second ad I would like to address is called “shadow”.  This ad begins with mellow guitar music and a singer recited versus such as: “I can conquer anything, at least for these few hours” and “we can walk hand in hand”.  While the music is playing there is a young man playing basketball by himself and you can see his shadow following him around the court.  Suddenly he drops the ball and makes eye contact with a “devious” looking counterpart and chooses to join him in his activities.  His “activities” assuming to be marijuana smoking.  The concluding phrase being “how much of yourself are you leaving behind?” (5)  Again, there is no positive behavior to learn from.  In actuality the opposite affect is occurring.  There is a man singing enticing lyrics as we watch this individual choose the undesirable behavior.  They pose the question of how much of yourself are you leaving behind?  Well according to this commercial not very much considering it’s only your shadowing that you’re loosing. 

            This campaign is failing to correctly identify the behavior that adolescents are supposed to model.  Leading to the conclusion that this endeavor may be promoting the opposite of what its intentions are.    The perception that adolescents will automatically dismiss the poor behavior choice is a dangerous one.  According to the study conducted by Westat Inc. and the University of Pennsylvania, it was identified that those who were exposed more frequently to the campaign adopted a more “pro-drug” attitude (1).

3. The source conveying the message is an inappropriate one

            As previously stated, it is during the teenage years when adolescents explore new behaviors and are heavily influenced by their peers (4).  According to research adolescents who engage in risk taking behaviors rarely do it alone; and adolescents who take on substance abuse and delinquency often have friends who participate in the same behaviors (6-7).

            With that said, the “Above the Influence” campaign thinks it is a wise decision to use dogs as the motivating influence to prevent or stop marijuana use.  The first television ad to be discussed is identified under the heading “dog”.  The commercial begins with a young girl named Lindsey entering her kitchen after school and getting a drink out of her refrigerator.  Her dog then jumps onto to the counter discussing with her that she is not the same person when she smokes weed and that he would like his friend back (5).  It is evident that the campaign developers are ignoring the importance of peer influence.  They have reduced to showing a talking dog.  Additionally, the girl in the commercial is looking at the dog entirely baffled.  According to her facial expression she is evidently not taking this seriously, and if anything she is nothing but disturbed by her talking pet.  This commercial also fails to recognize that teens who participate in illicit activities have a network of friends who similarly practice such behaviors (4).  The young girl Lindsey most likely has a group of friends who will continue to support her drug usage; her dog will not be able to cease her behaviors.

            There is a second commercial produced by the “Above the Influence” campaign that further enforces my point.  “I feel bad” is the final ad to be discussed.  The opening of this commercial starts with a poorly drawn childish cartoon representing a man sitting in a windowsill while smoking a joint.  His dog lie sleeping on the floor when the man begins to say the he feels badly about smoking pot.  The dog awakes and the man says that he would feel less bad if the dog would smoke with him.  The produces of this commercial are disregarding the fact that adolescents who do drugs do not rely on the company of their dog in order to comfortably smoke marijuana.  As indicated earlier Adolescents are rarely alone when they participate in drug use (6).  They even end the commercial showing the man reaching out to the dog with a caption saying “wait I need you” (5).  There is a point made in Social Cognitive Theory stating that the social/ physical environment, and the person perception of those factors plays a part in behavioral decisions (3).  The examples demonstrated in the commercials do not show individuals with positive perceptions of their environment.  They show unrealistic situations, where neither party are taking the circumstances in a serious manner.    

The backlash:  The “Above the Ignorance” campaign

            Since the “Above the Influence” campaign has come under much scrutiny in recent times with regard to cost and ineffectiveness, there has been a revolt campaign against it.  The “Above the Ignorance” campaign is the alternative to show people the positive aspects of marijuana and to expose the hypocrisies within the “Above the Influence” campaign.  On their website one can gain access to numerous articles linking marijuana use to the prevention of Alzheimer’s disease, all the way to the rehabilitation of post traumatic stress disorder (PTSD) patients.  There is even a “frequently asked questions” section describing 43 negations of common misconceptions about the negative effects of marijuana.  Furthermore, there is a discussion board in which people discuss their frustrations with the “Above the Influence”.  Some topics frequently commented on are: the notion that the “Above the Influence” campaign is around simply to sell t-shirts to make money; and that not all marijuana users are unsuccessful and unhappy individuals (8).

In Summary

            The Social Cognitive Theory is an excellent model to employ when trying to enact behavioral change.  However, it needs to be done properly in order to achieve the desired behavior.  Unfortunately the “Above the Influence” campaign did not succeed when choosing this model.  In actuality the ads backfired because the conveyed messages did not resonate with the intended audience.  Adolescents reacted negatively to the misleading ads; not surprisingly the adverse effect happened – drug use was not reduced or prevented, and teens adopted more “pro-drug” attitudes in the end.  Undoubtedly ads that exaggerate and stretch reality are useless and costly means to prevent drug abuse.  With the government already spending over $1.5 billion on this effort, it seems a wise decision to put further monies towards improved efforts hoping that drug abuse will one day be prevented.

Potential Solutions 

Counterargument 1:  Let them keep rebellion while making the right choice.

            In Florida during 1997, the state legislature reached a settlement with big tobacco giving them the finances to create what is known as the “Truth” campaign.  This campaign sought to use their new funding for the creation of a dedicated, anti-tobacco counter-marketing effort, with their sole focus being the reduction of youth smoking prevalence.  Investigators began by performing interviews in places such as malls and skate parks; each of which are places that youth feels comfortable.  Interviewers were keen to get honest and real opinions from the teens so they used bad language, and dressed according, then without much effort the interviewers were seen as peers.  A trust was built and from that point they began gaining valuable information (9).            

Whilst conducting qualitative interviews with young adults, the researchers who developed Florida’s “Truth” campaign noted some interesting findings.  They first learned that there was 100% awareness that tobacco killed.  Each young person they spoke to led them to believe that their schools and health educators did a fantastic job of informing them of the dangers that smoking causes.  They concluded that a youth’s reason for smoking had nothing to do with rational decision making, but rather emotion (9).  With the everyday decisions and stressors that teens face, the negative effects of tobacco did not even begin to register on their scale of importance.  Youth did not see tobacco as a big deal; things such as the implication of divorce, drugs, unwanted pregnancy, and even school shootings are situations that weighed heavily upon teens.  If anything, tobacco was a significant, visible, and available tool that youth could take advantage of, while also exhibiting the element of control.  Similar to getting a tattoo or dying ones hair, tobacco was means of rebellion that teens could use to show the world they made the decision themselves (9).

The proposed solution then became to turn the tables on big tobacco.  For many years well trained interventionists spent countless hours trying to explain that tobacco kills.  Unfortunately, what they did not understand (but big tobacco did) is that knowing tobacco use can be fatal became a unique selling point.  The study designers began formulating a way to get teens to turn against tobacco while still allowing them to possess the component of rebellion (9).  This mutinous rejection of tobacco and tobacco advertising illustrates youths’ asserting their independence and individuality, while countering the marketing efforts of big tobacco.  For example, one well known television commercial features youths piling up body bags outside the steps of a tobacco company’s headquarters, yelling loudly through megaphones stating that these body bags represent the 1200 people that tobacco kills daily (10).  What the truth campaign recognized that the aforementioned “Above the Influence” campaign did not is that youths’ make completely irrational decisions and they will continue to do so regardless of the consequence.  The “Truth” campaign shed light on the idea that we could still allow teens to make decisions and flaunt their individuality, while still choosing the healthier behavior of not smoking. 

I feel that this same technique could easily be applied to a reformulation of the “Above the Influence” campaign.  An example that comes to mind would be showing the typical young rebel, channeling a James Dean appearance that many young men aspire to.  He has tattoos and plays in a band, but he chooses not smoke or do drugs; then show how he gets the girl of his dreams while all the other so called “bad boys” are sitting there either single or boring their girlfriend because he isn’t coherent enough to keep her entertained.  Make the rebellion against all the guys who aren’t up to par with the James Dean rebel who gets what he wants by not smoking.

Counterargument 2: Give them a positive example

            The “Above the Influence” campaign did not give direct positive examples for youth to follow.  They showed teens in unrealistic situations where they exhibit a laissez faire attitude while they dispose of their valuable possessions (5).  To help aid in the fixing of this flaw I will pull another reference from the “Truth” campaign.  Before the “Truth” campaign went national it began in the state of Florida.  Within Florida a group called “SWAT” was started; the acronym standing for “Students Working Against Tobacco”.  “SWAT” worked to mobilize, educate and equip Florida youth to revolt against and de-glamorize big tobacco. “Truth” wanted to empower teens by getting to join this statewide program, to disseminate campaign messages, and to rally support for tobacco control policy.  Florida youth smoking rates quickly declined.

            This appears to be a worthwhile effort in an attempt to modify the “Above the Influence” campaign.  It seems a logical decision to begin a group that works to riot against teen drug use.  Drug use allows teens to have control and emanates a sexy insubordinate attitude (4).  By starting statewide groups, we could educate teens to promote the costly expenses of rehab, the numerous amounts of money that the drug industry takes from users, and the money that the public looses while paying taxes to keep drug users and sellers in prison.

            Groups could be marketed through hard-hitting advertisements that show youths confronting the drug industry.  Television and print ads could easily advertise “edgy” youths (those who are on the cutting edge of trends) promoting the statewide groups (10).  It would also be necessary for the groups to be multiethnic in order to reinforce its appeal to African Americans, Hispanics, and Asians etc.  What such groups would provide is a positive example to model, whilst giving the youth a chance to rebel and be unique at the same time.

This leads me to segue into the last counterargument regarding the source conveying the message.

Counterargument 3: Combine positive role models with clever branding to convey the message

            In addition to having positive role models, like the ones that would be present in the groups similar to “SWAT”, there is also hidden potential in the use of branding.  The core strategy of the “truth” campaign is to market the message as a brand to appeal to youths most at risk of not smoking (10).  It made since to researchers that they deliver the campaign just like other successful youth products such as Abercrombie and Fitch and Nike.  Brands serve as a means for youth to identify themselves to the world; brands could be identified as choosing a haircut, piercing, or clothing style.  Florida’s “truth” campaign allowed teens to identify with a brand that was much like a piercing that they could show to those in their surroundings (9).

            Another example of a successful branding attempt was that done by the “National Heart, Lung, and Blood Institute”.  In 2002 the NHLBI launched “The Heart Truth Campaign”, the first federally sponsored national campaign aimed at increasing women’s awareness of heart disease.  According to a survey conducted by the American Heart Association, only 34% of women knew that heart disease was their leading cause of death (12).  From this survey a call to action was made and a successful brand known as “The Red Dress” came to fruition.    The symbol of the red dress was designed to emphasize that heart disease was not only a “mans” disease.  The symbol was paired with a tag line saying, “heart disease doesn’t care what you wear – it’s the #1 killer of women”.  Following the launch of the red dress symbol, coverage of the heart disease issue increased 70%.  And four years later approximately 60% of women knew heart disease was their number one killer (12).

            Due to such research there is clearly something to be said for the impact of branding.  It is possible that such a technique could be used to aid in the counter intervention of the “Above the Influence” campaign.  My proposal would be to start with a bracelet similar to those offered through the Lance Armstrong Foundation and Susan G. Komen breast cancer foundation.  Each has rubber bracelets that can be purchased for small amounts donated to the charities.  The one offered through the Lance Armstrong Foundation is yellow and has he words “Livestrong” etched into it; the bracelet one can find through Susan G. Komen is pink and states “fight for a cure” (14-15).  We could develop a bracelet in a particular color chosen to represent the cause and etch into it – “live without chains”.  This phrase being used to symbolize the chains that trap and hold onto drug users and sellers.

Closing Words

            In order to effectively develop a counter intervention to that of the “Above the Influence” campaign, it is crucial that certain topics be addressed and modified.  First it is imperative that investigators understand the decisions teens make are irrational; they often do not want to be part of a crowd but rather stand out and challenge society’s views.  We as public health specialists need to give them the room to be individuals, while making healthy decisions.  Secondly, if we work under the impression that teens are heavily influenced by their peers then we must offer them a worthy example to follow.  Groups such as “SWAT” are great ways for teens to become involved in a positive cause, and they can still act out and riot against an industry.  Lastly the idea of an identifiable brand is similar to the icing on a cake.  Like a piercing or a tattoo, a bracelet symbolizing their cause is an outward method that teens can use to show opinions, feelings, and attitudes toward drug use.  These modifications suggest the potential toward a promising intervention against teen drug use.  Successful programs and charities such the “truth” campaign and the Susan G. Komen foundation are proof that industry beliefs can precede changes in behavior.  This implies that the magnitude of differences in industry beliefs could lead to observed differences in teen drug use.


             1.  United States Government Accountability Office.  Contractor’s National       Evaluation Did Not Find That the Your Anti-Drug Media Campaign Was  Effective in Reducing Youth Drug Use. Washington, DC:GAO 06-818,2006

            2.  Students for Sensible Drug Policy.  Eliminate the Wasteful National Youth Anti-Drug Media Campaign.  Washington, DC: Students for Sensible Drug Policy.

            3.  Edberg, Mark (2007). Social Cognitive Theory (pp. 51-56) Essentials of health behavior: Social and behavioral theory in public health. Sudbury, Massachusetts: Jones and Bartlett Publishers.

            4.  Feldstein, S.W., Miller, W.R. Substance use and risk-taking among adolescents.  Journal of Mental Health: 2006 6: 633-643.

            5.  Above the Influence.  The Ads.  Washington, DC: National Youth Anti-Drug Media Campaign.

            6.  McCambridge, J., & Strang, J. (2003). Development of a structured generic drug intervention model for public health purposes: A brief application of motivational interviewing with young people. Drug and Alcohol Review,

22, 391 – 399.

   7.  Kosterman, R., Hawkins, J. D., Guo, J., Catalano, R. F., & Abbott, R. D. (2000). The dynamics of alcohol and marijuana initiation: Patterns and predictors of first use in adolescence. American Journal of Public Health, 90,

360 – 366.

8.  Live above the influence of ignorance, Marijuana & Hemp Facts.  Above the Ignorance.  Above the Ignorance campaign.    

            9.  Hicks, JJ. The strategy behind Florida’s “truth” campaign. Tobacco Control [series online]. 2001; 10:3-5. Available at: Accessed April 20, 2009

            10.  Davis, K.C., Farrelly, M.C., Healton, C.G., Hersey, J.C., Haviland, M.L., Messeri, P. (2002). Getting to the Truth: Evaluating National Tobacco Countermarketing Campaigns. American Journal of Public Health, 90, 901-907.

            11.  Florida Department of Health. Students working against tobacco. 2008. Available at  Accessed on April 21, 2009.

            12  Farrelly, M.C., Haviland, M.L., Niederdeppe, J. (2004). Confirming “truth”: More Evidence of a Successful Tobacco Countermarketing Campaign in Florida. American Journal of Public Health, 94, 255-257.

            13.  Long, T., Ruoff, B., Taubenheim, A., Temple, S., Wayman, J. (2008). The Heart Truth: Using the Power of Branding and Social Marketing to Increase Awareness of Heart Disease in Women. Soc Mar Q., 14, 3-29.

            14. Lance Armstrong Foundation. Livestrong Lance Armstrong Foundation. 2009. Available at www.livestrong.or.  Accessed on April 24, 2009.

            15.  Susan G. Komen Breast Cancer Foundation. Susan G. Komen for the cure 2009. Available at Accessed on April 24,2009.

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