Challenging Dogma - Spring 2009

Tuesday, May 5, 2009

Critiquing the “Above the Influence” Anti-Marijuana Campaign – Katie Poirier

The National Youth Anti-Drug Media Campaign, under the management of the Office of National Drug Control Policy, is responsible for creating the “Above the Influence” anti-marijuana advertisements posted online, in magazines, and aired on television. The original ads for the campaign are accompanied by dozens of “YouTube” video parodies created by youth across the nation, which mock the absurdity of these ads. The mission statement of the Above the Influence Campaign, as detailed on the website, is: “…to help you stay above the influence. The more aware you are of the influences around you, the better prepared you will be to stand up to the pressures that keep you down (1).” Although this is an admirable goal, it can be argued that the Above the Influence ad campaign does not focus on the most significant influences in adolescent marijuana use, nor does it effectively represent or relate to their experience.
Ignoring McGuire
Public Health interventions that use a messenger with similar characteristics to the target population have been found to be more effective than interventions that do not use messengers that mirror the target population (2). One example of an effective public health program that follows this principle is the “Truth” campaign. This campaign created a variety of ads that featured rowdy, rebellious teenagers to try to encourage youth to quit smoking and using tobacco products. This campaign was successful for many reasons, one being their use of teenagers in the ads to confront the teenage populations they were trying to reach. The ads addressed one of the major influences in youth tobacco use, which is teenagers’ desire to be defiant. Adolescents viewing these ads were able to relate to images of young adults confronting tobacco companies in a rebellious manner. Instead of disregarding the anti-tobacco message, teenagers responded positively to it (3-4).
Many of the Above the Influence ads use animals to convey the organization’s anti-marijuana sentiments. The “Stop Looking at Me” ad is a striking example of how the animal-as-messenger method is implemented. This commercial is a cartoon of a dog stating his disappointment in his teenage male owner for being unable to stop smoking marijuana. The dog walks away, clearly showing that he is passing judgment on his owner for smoking. This ad has come under particular scrutiny by America’s youth and has been the brunt of the YouTube parody-making movement (5).
One explanation as to why this ad is ineffective is that it does not follow the “McGuire’s Communication-Persuasion Matrix,” which is a facet of the broader “Mass Communications Theory” used in the social sciences. In his matrix, McGuire asserts that there are five factors to consider when creating a public health communication intervention. These factors include: Source (where the message is coming from), Receiver (the values and morals of the targeted audience), Channel (the medium of communication), Message (the core values being portrayed in the message itself) and Destination (the intended outcome for the message) (6). The “Stop Looking at Me” commercial blatantly disregards McGuire’s recommendations concerning the source of the message, by using an animal to deliver the message. The major complaints of young viewers support this claim (5).
The Above the Influence campaign also steers away from McGuire’s Matrix regarding the morals and values of the receiver. Teenagers who are smoking do not want to be told what to do. They are participating in this behavior because they know that it is dangerous, and because they know smoking will make a clear statement about their agency as an individual. The Florida Truth campaign found that there was 100% awareness among youth that smoking tobacco is dangerous to your health. Previous anti-smoking interventions tried to educate adolescents about these dangers, but they were ineffective because this information was already understood. Portraying tobacco use as a dangerous behavior may have influenced adolescents to use tobacco (4).
The Above the Influence campaign is similar to the Truth campaign in this sense because teenagers who use marijuana are already aware of how marijuana makes them act, and how other people react to them. By telling these teenagers what they already know (and doing it with talking cartoon dogs), the ad campaign cannot be successful in relaying a serious or effective anti-marijuana message.
McGuire’s Matrix is supported by other social scientists who have studied the concept of “psychological reactance” and the best ways to combat it. The “Psychological Reactance Theory” discusses the tendency for individuals to respond to a request in the opposite way as is intended. If an individual is asked to perform a certain behavior, this sometimes with strengthen their resolve to act in the opposite way, as an attempt to preserve their freedom and autonomy (7-8). Social scientists have studied the Reactance Theory and have determined that one way to combat reactance is to make the messenger as similar as possible to the target audience. When interpersonal similarities exist between these two groups, the message being sent appears less threatening, which decreases resistance to the message (2).
The “Stop Looking at Me” ad makes no attempt at choosing a messenger with similar characteristics as the target audience. It is so far off that instead of the anti-marijuana message seeming threatening, since it delivered by a talking dog, adolescents see these commercials as ridiculous and are disregarded. The message being sent by the Above the Influence campaign is that you should not smoke marijuana because you will lose your friends and family’s respect. Many marijuana users are already socially marginalized and are not necessarily concerned about keeping such relationships strong. Much like the anti-tobacco campaigns that risked having their “tobacco is dangerous” message backfire, the Above the Influence campaign has been mocked excessively by marijuana-using teens because of an un-relatable message, which was not exactly the outcome they were hoping for.
Lack of Consideration of Other Influences
Another important component of what makes the Above the Influence campaign unsuccessful is the lack of deeper consideration of what causes and influences marijuana use in youth populations. These commercials portray marijuana users as having an obvious agency in their decision to smoke. Many of the commercials try to show that smoking affects not just the individual, but also the relatives and friends of the smoker. While this may be true, the commercials make it seem as though people who use marijuana are in control of their actions and that they should be more than capable of stopping. This is not to say that the ads encourage individuals to quit by increasing their self-efficacy, rather these ads present smoking as a choice that is easily reversed.
This is evident in the “Stop Looking at Me” ad, where the dog states that he is ashamed of the young man for not being able to stop, and walks away disappointed. The ads try to shame smokers into quitting, which they represent as an easy task, rather than considering the multitudinous external factors that influence people to smoke, and continue smoking. The Above the Influence campaign ads are based off of the “Theory of Reasoned Action.” This traditional model of behavior addresses the link between an individual’s attitude toward a behavior, and their perception of the social norms about that same behavior. The individual weighs their attitude against what they perceive as the social norm, and this weighing of options results in an intention to do a behavior. The Above the Influence campaign plays at the stigmatization of marijuana users as “pot-heads” in order to encourage them to stop smoking. They make references to the sluggish, lazy, boring qualities of people who smoke marijuana, which results in their families and friends judging them. The hope is that smokers will see these ads, consider the detriment of being judged for smoking marijuana, and then just stop. While this may seem like a good tactic, the ads do not explain that there are many reasons (personal, environmental, economical) why people would smoke marijuana, and that these are not always so simply overcome (9-12).
In order to get adolescents to respond positively to these commercials, youth who smoke marijuana need to be represented as something other than shameful individuals or delinquents. Youth marijuana use is due, in part, to the desire to rebel, therefore representing this same image as something undesirable may actually encourage marijuana use among this population by bolstering the identity and camaraderie of rebellious youth.
Reliance on Rational Decisions
Another strike against the Above the Influence ad campaign is that the ads in the campaign were created based on a behavior model that makes the assumption that human behavior is rational. The campaign was influenced by the Theory of Reasoned Action, which requires that individuals are able to make a rational weighing of options before choosing whether or not to participate in a particular behavior. This model does not consider that humans act based on other forces such as one’s emotions. The model does include social forces, by including social norms into one’s decision-making prior to a behavior, but there is a plethora of additional forces that influence human behavior.
The Above the Influence campaign functions on the concept that if you tell a marijuana user that their families, friends, (and possibly their pets), will be disappointed in them for smoking, that this will result in marijuana use cessation based on that one piece of information. If humans were able to engage in rational decision-making then they might see the benefit in stopping because of the shame they may feel. However, in reality, individuals are influenced by a whole host of factors that make rationality not quite so simple.
The question of whether or not humans are capable of rational decision-making becomes more complicated when discussing adolescents. Developmental psychologists have studied brain development in adolescents to see whether or not their incomplete development affects their behavior. Studies have shown that adolescents are more likely to participate in risky behavior, as compared to adults. The environment that decision-making occurs in is a very important consideration, and can drastically change the outcome of an adolescent’s weighing of options prior to engaging in a behavior. Teenagers are more likely to make an irrational decision, as compared to adults, if they are in the presence of their peers, in an emotionally-charge situation, in an unfamiliar environment, or if they are acting spontaneously (13). The decision to start, or continue, using marijuana often happens in exactly these types of environments. This finding supports the claim that rational decision-making is not always possible for humans, especially adolescents. The Above the Influence campaign relies on the belief that adolescents can make the rational choice not to smoke marijuana, which is one major reason why the campaign was ineffective.
Proven Ineffective
A multi-year, national study of the Office of National Drug Control Policy’s National Youth Anti-Drug Media Campaign was done in 2005 by Westat, Incorporated. This evaluation was performed using longitudinal survey data. Westat’s evaluation showed that the campaign was unsuccessful in reducing the prevalence of youth drug use through the duration of the entire campaign. The campaign did not reduce the amount of new marijuana users, nor did it reduce the amount that current users smoked. The study also showed that while youth were able to recall the advertisements, the reported take-home message from the ads was that drug use was commonplace (14). This result shows that the ad campaign actually may have had an opposite effect than what was intended. The message that the campaign hoped to disseminate was that smoking marijuana will cause you to become ostracized, but the actual perceived message was that smoking is nothing out of the ordinary.
Although the Above the Influence campaign was highly supported by the government, was allocated $1.2 billion of federal funding, used a variety of media outlets, and was created using feedback from teenagers; this public health intervention was unsuccessful. These factors should have worked together to make this campaign produce decreased prevalence of marijuana use in teenagers nationwide, but this outcome was never actualized. In retrospect, more time should have been spent considering what the desired outcome would be, as well as how the message being sent would ultimately be interpreted. Incorporating theories and behavior models from the social and behavioral sciences would have benefited this campaign.

An Alternative Intervention-Katie Poirier

The Above the Influence campaign was an important step in understanding how to approach the issue of adolescent marijuana use. While this campaign was proven to be unsuccessful, it can serve as a foundation from which public health practitioners can build a stronger and more informed intervention.
The following sections describe my recommendations for revamping the Above the Influence campaign. The media is an incredibly powerful tool for influencing behavior on the population level; therefore the reformed campaign will also consist of television commercials and online video clips. This new campaign will be referred to as the “Get Real” campaign.
Bringing Back McGuire
The major complaint that adolescents had about the Above the Influence campaign (specifically the “Stop looking at me” commercial), was that they could not connect to the messenger. It is important that the messenger shares as many characteristics with the recipient cohort as possible, as shown by McGuire’s Communication-Persuasion Matrix, and supported by the Psychological Reactance Theory. Instead of utilizing talking animals or parental figures, the Get Real campaign uses rebellious, socially marginalized, pot-smoking adolescents. The use of this type of messenger encourages teenagers to relate to the adolescents presented in the commercials, in the hopes that they will then respond to the campaign’s message. This is meant to parallel the same method that was used and proven to be effective in Florida’s “Truth” campaign (3-4).
The commercials and online video clips are short interviews, roughly 30-45 seconds long, each focusing on a “real” teenager who smokes marijuana, and the repercussions that they face. These commercials will be short and rough, shot with a hand-held camera without any editing. This style is meant to give viewers an honest and “real” depiction of how smoking marijuana can affect their life. This approach is in stark contrast to the Above the Influence Campaign, which did not try to present reality, and which is most obvious in their “Stop Looking at Me” cartoon featuring the talking dog. This presentation of “real life” in the Get Real commercials makes it possible for adolescents to feel a close connection to the individuals depicted in the commercials.
Another important component of the McGuire’s Communication-Persuasion Matrix that the Above the Influence campaign did not adhere to is that the message being presented needs to represent the morals and values of the recipients. The Above the Influence campaign focused on relaying the message that smoking pot is dangerous, and can ruin your social life. These messages do not hold much significance for teens who smoke despite their knowledge of the dangers (and may even smoke because it is dangerous), and for those teens who relate to the rebellious and marginalized population that is being represented as undesirable.
The Get Real campaign’s message is built upon the concept that teens want to be treated as adults. They do not want to be lectured or told what to do, and they do not want to be lied to. Each Get Real commercial will focus on telling teens a different message about how marijuana affects the brain and the body, their social life, day-to-day functioning, social circles, family and friends, and their general lifestyle. It will be a transparent representation of the life of pot-smoking adolescents, told directly by the adolescents themselves. This format will win teenage viewers over by not treating them like children, and by telling them the real facts.
Another feature of the Get Real campaign commercials, that was incorporated to make the teenage audience feel as thought they are being treated as adults, is a lack of “moral of the story” endings. The majority of the Above the Influence campaign commercials carry a heavy and obvious message that is laid out for the viewer. Because teenagers do not respond well to being told what to do, the Get Real campaign did away with this feature. The Get Real commercials do not present a clearly stated and overwrought message, but instead represent an issue associated with marijuana use, as told directly by the featured adolescent. The commercials end in silence, so as to allow the viewer to formulate their own thoughts and opinions about what they saw, and the final image of each commercial is an image of the symbol signifying the Get Real campaign. This format is intended to give adolescents the freedom to decide for themselves what to think about the issues that are presented, rather than telling them what to feel, much like an authoritative figure would. Giving teenagers the opportunity to think for themselves is a way to cater to the values that they consider important, which here are independence and autonomy. Following McGuire’s Matrix in this way encourages adolescents to take the campaign seriously, which will allow them to benefit from the campaign and actually consider the detriments of smoking marijuana.
Addressing Other Influences
The Above the Influence campaign was not successful, in part, because it was created based on traditional models of behavior. The specific model used was the Theory of Reasoned Action, which focuses on social norms as the sole external factor that influences individual behavior. There are numerous factors that can influence an adolescent’s decision to smoke marijuana. They can include: anxiety, peer pressure, exposure to other individuals with high risk of early substance use, disengaged parents, lack of family standards concerning substance use, and many others (15-16).
To incorporate the wide variety of factors that influence marijuana use, each commercial will be a short interview where one factor is addressed. These commercial interviews will serve as quick glimpses into the real experience of someone, to gain a better understanding of how people are influenced to smoke marijuana. Openly discussing the reasons why people initiate marijuana use, and how these influences affect them personally, will allow adolescents to gain a larger understanding of the issues surrounding marijuana use. This will allow adolescents to become better educated about the influences that they may be experiencing, and how to combat them. Marijuana use is often a symptom of something else, and this approach may serve to uncover these influences for teenagers.
By talking candidly about people’s experiences and what influenced their decision to start and continue smoking marijuana, the Get Real campaign seeks to “re-frame” marijuana use. The social sciences’ “Framing Theory” discusses how “frames” are used as a mechanism of human understanding. Frames are a collection of ideas and concepts surrounding a certain subject. Humans work within these frames to process new information, and (it is argued) they can only understand new information by filtering it through already existing frames. These frames are mechanisms for organizing information, and can be engaged by simple cues, such as images or words (17).
Framing can be used to change people’s opinions and behaviors, at the population level. Smoking marijuana is perceived as an act done by rebellious youth who are social outcasts, looking to have a good time with their peers. The Get Real campaign works to re-frame marijuana use as an act that is done to fill a personal void, or is the result of some harmful influence. Changing how people understand and conceptualize marijuana use is a method of modifying their behavior, in this case, influencing them to stop using marijuana.
Allowing for Irrationality
The Above the Influence campaign requires adolescents to think and act rationally. This caveat is a major contributor to the campaign’s failure to reduce marijuana use among teens. In lieu of a traditional behavior model, which relies upon the false concept that humans act rationally, the Get Real campaign is equipped with a fail-safe that allows for human irrationality.
At the end of every commercial the symbol representing the Get Real campaign is displayed. This symbol serves as a visual cue for adolescents that, when in a situation similar to ones presented in the campaign commercials, will remind them of their reaction to the commercials. When an adolescent sees a Get Real commercial they will internalize their reaction to the interview, along with the Get Real symbol. When they are in a similar situation themselves, where they may not be able to exercise self-control or rational decision-making, the experience will bring to mind the Get Real symbol and their previous sentiments regarding marijuana. The purpose of this symbol is to act as a reminder for adolescents who find themselves in an environment where the may smoke marijuana, and make the decision not to smoke easier.
The cue used in the Get Real campaign’s intervention strategy is doubled as a brand symbol for the campaign. “Marketing Theory” considers an organization’s brand to be incredibly important, since the brand allows you to create and sell a certain image or concept along with your product. The product being “sold” by the Get Real campaign is abstinence from marijuana use. Brands create associations with specific values, which for the Get Real campaign, would be: truth, freedom, autonomy, and independence. The brand symbol for Get Real is meant to be associated with an individual’s ability to stop smoking marijuana. By adhering to the Marketing Theory, and through its use of branding and cues, the Get Real campaign allows for irrational behavior, unlike the Above the Influence campaign (18).
In Conclusion
The majority of public health interventions do not consider the possible benefits of incorporating behavioral theories from the social and behavioral sciences. The example of the failed Above the Influence campaign is a solid example of how traditional models of behavior can be disastrous for interventions. The Get Real campaign offers a solid example of how the social sciences can be integrated into public health, and how this can improve their chances of success. The field of public health needs to make a concerted effort to include these long-standing theories of behavior from the social sciences in their interventions.


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