Smart Approaches to Marijuana (SAM)’s Drug Report’s Friday Fact report (December 6, 2024) (https://mailchi.mp/bf7c96acbb6d/whats-happening-now-in-ohio-10391847?e=be6aab6296-retrieved12/6/2024) stated: “Students who are exposed to marijuana advertising on billboards are more likely to use marijuana. According to the 2023 Monitoring the Future survey, 8th and 10th graders who reported seeing advertisements for marijuana on billboards were more likely to have used marijuana in the past year and the past month. Compared to those who never saw these marijuana billboards, those who reported seeing them more than once a day were 4 times more likely to have used marijuana in the past year and 7 times more likely to have used marijuana in the past month.”
The report goes on to quote the findings from a 2017 study: “exposure to marijuana advertisements was significantly associated with higher odds of marijuana use among adolescents. Regulations on marijuana advertisements and educational campaigns on harmfulness of illicit marijuana use are needed” (Dai, 2017). These findings are consistent with several other studies that found similar associations in the evaluation of the government-supported 1997 National Youth Antidrug Media Campaign (Hornik et al., 2008). This nation-wide campaign sponsored by the Office on Drug Control Policy was theoretically based on research available at the time regarding how best to deter substance use among adolescents. The campaign not only included messaging to youth (aged 11 to 17) directly but also indirectly to parents by encouraging parents and other adults to take actions such as discussing substance use with their children.
The evaluation of the campaign indicated that exposure over time to the ads actually increased the use of marijuana. Alvaro and colleagues (2013) conducted further analysis of the evaluation data classifying youth at the onset of the campaign as to use status: users, resolute nonusers, and vulnerable nonusers and examined attitudes towards the ads. They found a negative association between attitudes towards the ads and usage intentions and with actual use primarily for users. The authors state that this information should be used for preimplementation efforts to design ads with targeted groups in mind. Furthermore, the evaluators of the campaign found that the campaign’s focus on marijuana created the impression that use of marijuana was normative (Westat, 2002).
It is noteworthy to highlight that in additional analyses of the parent data, Huansuriya and colleagues (2013) found that the campaign impacted parental attitudes toward communicating with their children about substance use resulting in less favorable attitudes toward marijuana use. The analysis also indicated that the combination of negative attitudes toward marijuana use AND the perceived ability to refuse marijuana use impacted intentions to use marijuana.
Several researchers found that when an evidence-based prevention program such as a school-based curriculum was implemented during the campaign, there was evidence of lowered marijuana use (Longshore et al., 2006). From a theoretical perspective this makes sense as we know that when the awareness of the risks of a behavior are presented even in the context that behavior is perceived as normative, it is important to provide the skills and tools needed to resist engagement in that behavior (Ajzen & Fishbein, 1980).
What are the implications of these findings when conducting a media campaign whether billboards, social media messaging, commercials? There are several.
When conducting a media campaign it is important to better understand the characteristics of the group you wish to reach relative to the behavior being addressed, e.g., in the National Youth Anti-Drug Media Campaign youth 11-17 were not monolithic regarding their status versus substance use. Some were already using substances, some were ‘resolutely’ against using substances, and some were not using substances and were not resolute and vulnerable to use. Messaging needs to address the needs of these three groups (Alvaro et al., 2014).
All campaigns should be grounded in theory of human behavior. Scare tactics, incorrect information regarding consequences of substance use can turn the intended audience away from the ads.
As seen above, parents have a major influence on children’s normative beliefs, attitudes, and behaviors and as seen above play an important role in the prevention of risky behaviors. However, they need guidance and the media offers opportunities to provide such guidance to a broad audience.
Building on the learnings from this research and capturing some of the principles of behavioral and communication theories, Dr. William Crano and his colleagues at Claremont Graduate University have been working with a model called EQUIP to help prevention and communications practitioners develop effective and persuasive messages. The EQUIP model incorporates these concepts and serves as a guide to developers. It reminds developers that the communication must Engage receivers, have them Question their established belief, Undermine or destabilize the belief, Inform the receiver of a superior alternative, and Persuade the receiver to accept this alternative. Each of these interacting requirements should be met if the communication is to have maximal effect.
EQUIP Model Elements
The Engage feature of EQUIP is a critical element in all communications programming. Attracting the audience to the message with content—surprising facts, unexpected approaches—or executional elements—bright colors, music, movement etc. are all designed to attract and hold the audience’s attention long enough to get the message across.
As described, the Question phase is to reduce a receivers’ certainty in the validity of their attitudinal position. For example, they may think that vaping tobacco protects against getting addicted to nicotine; so challenging that position with straight and authoritative statements on the addictive qualities of nicotine, whether smoked or vaped, in addition to suggesting that the sooner they quit, the better for their health. The message gives the right information and an incentive to quit.
The Undermine element requires that the persuasive message not only raises doubt about a belief’s validity, but provides a credible alternative to the destabilized attitude, a reason to abandon the attitude and adopt a new position. The Question and Undermine phases work together.
The Inform, as the term implies, provides information that is topic-relevant and evidence-based; and usually identifying appropriate sources that add to its credibility. The EQUIP model helps to construct such messages.
Emphasizing social impact rather than physical harms may also produce better responses among youth who are more concerned about their social life rather than their health. At the same time, it is important to avoid overstating physical harms or extreme effects of the use of substances that can readily be disproved or dismissed. As in the ‘scare tactics’ of old, such statements can lead to message rejection.
The final EQUIP element, Persuade, includes the need to motivate acceptance, and to mitigate resistance. This then allows for a reasonably open-minded consideration of the substance use persuasive prevention communication.
5. Pilot test all of the messages with representatives of the audience you wish to reach.
6. And think and plan carefully about:
The Message….what and how is it said
The Source…who is the sender of the message
The Outcome…what are the campaign goals
For more detailed information see Prevention Nugget from May 24, 2021
“Developing Prevention Messages that Can Work”
References:
Ajzen, I. & Fishbein, M. (1980). Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall.
Alvaro, E.M. Crano, W.D., Siegel, J.T., Hohman, Z., Johnson, I. & Nakawaki, B. (2013). Adolescents' attitudes toward antimarijuana ads, usage intentions, and actual marijuana usage. Psychology of Addictiive Behaviors, 27(4),1027-35. doi: 10.1037/a0031960. Epub 2013 Mar 25. PMID: 23528197; PMCID: PMC4480868.
Dai, H. (2017). Exposure to advertisements and marijuana use among US adolescents. Prevention of Chronic Disease, 14:170253. DOI: http://dx.doi.org/10.5888/pcd14.170253.
Hornik, R., Jacobsohn, L., Orwin, R., Piesse, A. & Kalton, G. (2008). Effects of the National Youth Anti-Drug Media Campaign on youths. American Journal of Public Health, 98(12), 2229-2236. doi: 10.2105/AJPH.2007.125849. Epub 2008 Oct 15. PMID: 18923126; PMCID: PMC2636541.
Huansuriya, T., Siegel, J.T. & Crano, W.D. (2014). Parent-child drug communication: pathway from parents' ad exposure to youth's marijuana use intention. Journal of Health Communications, 19(2):244-259. doi: 10.1080/10810730.2013.811326. Epub 2013 Dec 5. PMID: 24308793.
Longshore, D., Ghosh-Dastidar, B. & Ellickson, P.L. (2006). National Youth Anti-Drug Media Campaign and school-based drug prevention: Evidence for a synergistic effect in ALERT Plus. Addiction Behavior, 31(3):496-508. doi: 10.1016/j.addbeh.2005.05.032. Epub 2005 Jun 23. PMID: 15979245.
Westat. (November 2002). Evaluation of the National Youth Anti-Drug Media Campaign: Fifth Semi-Annual Report of Findings, https://archives.nida.nih.gov/sites/default/files/fullreport.pdf, retrieved December 9, 2024.
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