Stages of Involvement With Drugs and Alcohol: Analysis of Effects of Drug and Alcohol Abuse Advertising

ABSTRACT - Involvement with addictive substances such as drugs and alcohol is comprised of a series of stages. Individuals at different stages of the addictive process are influenced by different motives, social groups and other factors. The results reported in this paper suggest that anti-drug and alcohol campaigns can differentially impact upon individuals depending upon the stage in the addictive process that they belong to. Specifically, the campaign examined in this study appears to have had more impact upon non-users rather than users in terms of ad recall, ad evaluation and perceived effectiveness.

Citation:

Lorne Bozinoff, Victor Roth, and Colin May (1989) ,"Stages of Involvement With Drugs and Alcohol: Analysis of Effects of Drug and Alcohol Abuse Advertising", in NA - Advances in Consumer Research Volume 16, eds. Thomas K. Srull, Provo, UT : Association for Consumer Research, Pages: 215-220.

Advances in Consumer Research Volume 16, 1989      Pages 215-220

STAGES OF INVOLVEMENT WITH DRUGS AND ALCOHOL: ANALYSIS OF EFFECTS OF DRUG AND ALCOHOL ABUSE ADVERTISING

Lorne Bozinoff, Gallup Canada, Inc.

Victor Roth, University of Guelph

Colin May, Health and Welfare Canada

ABSTRACT -

Involvement with addictive substances such as drugs and alcohol is comprised of a series of stages. Individuals at different stages of the addictive process are influenced by different motives, social groups and other factors. The results reported in this paper suggest that anti-drug and alcohol campaigns can differentially impact upon individuals depending upon the stage in the addictive process that they belong to. Specifically, the campaign examined in this study appears to have had more impact upon non-users rather than users in terms of ad recall, ad evaluation and perceived effectiveness.

INTRODUCTION

Drug and alcohol abuse continues to be an area of considerable attention both in North America and in other countries around the world. Much of this attention has traditionally been focused on interdiction whereby governments attempt to stop the flow of illicit drugs from entering jurisdictions or attempt to prevent drug dealers from selling drugs through vigorous law enforcement.

Interdiction essentially tries to address the supply side of the drug and alcohol abuse problem. In recent years, some governments have also attempted to address the demand side of the drug and alcohol abuse problem. Attempts to reduce the demand for illicit drugs and alcohol typically involve marketing and promotion activities designed to dissaude individuals from using drugs and alcohol. Such attempts to reduce or eliminate consumption of a product represents countermarketing in which the goal is to designate the product as intrinsically unwholesome. In contrast, demarketing attempts to reduce demand for a product without discrediting the product itself (Kotler, 1973).

The effects of countermarketing efforts on drug and alcohol abuse have been reviewed by Bandy and President (1983) who looked at two decades of anti-drug and anti-alcohol advertising campaigns. Bandy and President attempted to ascertain whether such campaigns do in fact accomplish their objectives of reduced drug and alcohol use. Generally, the result of their review was inconclusive. One reason cited for this inconclusiveness is the reliance on user self-reports which are thought to have questionable validity because of potential under-reporting of usage.

DePaulo et al (1987) have suggested another reason for the inconclusiveness of previous studies because these studies fail to take into account the respondent's involvement with an addictive substance. These stages included trial, non-addictive use, addictive use, cessation and relapse back into addictive use. The central thesis of DePaulo et al is that the effectiveness of any drug and alcohol related marketing effort will vary according to stage at which particular individuals belong.

THEORETICAL BACKGROUND

The six-stage model is an adaption of a five stage sequence outlined by Lettieri, Sayers and Pearson (1980). Modifications to the Lettieri model included the addition of non-user s.ages in which drug 3=nd alcohol use is not contemplated or has been contemplated but no substance trial has occurred. Described below are the six stages of this adapted model

Stage 1: Usage Not Contemplated

The first stage is comprised of non-usage with no usage being contemplated. Everyone will start at this stage and remain at this stage until adolescence at which time some individuals will move onto the next stage.

Stage 2: Usage Contemplated

In today's society, most adolescents are likely to move to the next stage which is non-usage with usage being contemplated. This stage is similar to Roger's (1983) knowledge stage in the innovation diffusion process. Individuals in this stage have not tried drugs or alcohol but have seriously considered trying drugs. Drug and alcohol abuse prevention programs are typically geared to this stage.

Stage 3: Trial

This stage includes the initial use of a substance. The novice is typically introduced to the substance by a more experienced peer (Kandel and Maloff, 1983). Because of the gateway effect trial o. one drug often leads to trial and use of another harder drug. As DePaulo et al (1987) note, the use of some substances does not inexorably lead to the use of other substances. Social drinkers do not automatically become heroin users.

Stage 4: Light Use

Many individuals can consume addictive substances without becoming addicted. Social drinkers do not necessarily become alcoholics. For some substances such as alcohol, light use may be acceptable while light use of other substances like heroin and cocaine is not acceptable. This stage man be skipped if usage after trial is sufficiently heavy.

Stage 5: Moderate Use

The dividing line between the previous stage and this stage is necessarily subjective but is nonetheless instructive because it involves a movement away from socially acceptable light use to heavy use.

Stage 6: Heavy Use

Most models conceptualize this stage as one of addiction. The user appears to be irrational at this stage because the benefits of usage appear to be outweighed by the disadvantages. (Faik, Dews, and Schuster, 1983). Operationalization of addictive use requires medical examination and is not amenable to survey research.

The remaining stages of the model are comprised of cessation of addictive use, post-cessation behavior and relapse - repeat dependence. These stages are relatively rare in the general population and are typically not the target of marketing efforts.

VARIATIONS IN INFLUENCES BETWEEN STAGES

The underlying motivational factors are believed to differ between each stage. It is hypothesized that the factors involved in moving from stage l to stages 2 and 3 are based upon peer pressure and other forms of social reinforcement (Lang 1983). The motivation to move from stage 3, trial to stage A, light use is believed to be sensual pleasure tea. euphoria of getting high) and immediate gratification. The motivation to move from stage 4 to s,ages 5 and 6, moderate and heavy usage, is believed to be tension-reduction whereby stress and anxiety are reduced (Marlatt 1976).

The central hypotheses then is that anti-drug and alcohol campaigns which are designed to influence one motivational factor are likely to be effective for only some of the stages of drug and alcohol use.

METHOD

Anti-Drug and Alcohol Abuse Campaign

The hypotheses that anti-drug and alcohol campaigns will have differential effects upon individuals depending on their stage of drug and alcohol use was tested by analyzing the effects of Health and Welfare Canada's Really Me anti-drug and alcohol campaign. The Really .Me campaign is a multi-media campaign which had been running for about six months prior to the research. The campaign makes heavy use of TV advertising which is supplemented with radio ads and transit shelter ads.

Two advertisements were run in English Canada and two advertisements were run in French Canada. The ads were targeted to youth aged 11 to 17. The themes of the campaign were that drug and alcohol use was not "cool", that drug and alcohol use was not a sign of growing up and that each individual should make up his/her own mind about using drugs and alcohol without peer pressure.

These ads are clearly designed to prevent individuals from moving from stages 1 and 2 where peer pressure is critical to stages 3 and 4. The ads are hypothesized to have less impact upon individuals in stages 5 and 6. These campaign themes which are designed to reduce peer pressure can be contrasted to the themes of other anti-drug and alcohol campaign which stress the health consequences of drugs and alcohol or the legal consequences. Such themes would be expected to be more effective for other stages of drug and alcohol use.

Sample

A total of 1440 English speaking and 762 French speaking youth were interviewed in person by the Canadian Gallup Poll. The sample was based an a multi-stage modified probability design in which census areas were first stratified by region and community size. A random sample of census areas was then drawn and clusters of 7 interviews were conducted in each area. Quotas were set by age for each census area. One limitation of the sample was the-need to obtain parental approval prior to conducting the interview.

Dependent Measures

Respondents were first given a self completed portion of the questionnaire which was comprised of a series of drug and alcohol usage measures. Upon completion of this portion of the questionnaire, respondents were given seals to seal their questionnaires in order to maintain their anonymity. Respondents were then asked a series of questions concerning the campaign. Drug usage was grouped into two categories. Those who have never tried or seriously considered using drugs (stage l), were grouped with those who have seriously considered using drugs but had never tried any of several drugs (stage 2). The second group was comprised of those who had used any of several drugs (stage 3) such as marijuana, cocaine, heroin and LSD. There were few individuals in the sample who could be categorized as light, moderate or heavy drug users.

Alcohol users were categorized into five groups - non-triers (stages 1 and 2), triers (stage 3), light users (stage 4), moderate users (stage 5) and heavy users (stage 6). Light users are those who drank less than once a month, moderate users are those who have less than four beers per week (or the equivalent in wine and liquor) and heavy users are those who have four beers or more each week.

Given the use of self-report measures of drug and alcohol abuse, some drug and alcohol usage has undoubtedly gone unreported.

Independent Measures

There were three types of independent measures - advertising recall, advertising evaluations, and perceived advertising effectiveness.

Advertising recall measures included unaided recall of any anti-drug/alcohol advertisements, unaided recall of the Really Me campaign, and aided recall of each television advertisement.

Advertising evaluation measures included interest in the two ads compared to other ads, believability of the people in the ads, and likelihood of talking to friends about the ads.

Perceived advertising effectiveness measures included likelihood of thinking about drug and alcohol use as a result of seeing the ads and whether the ads swill make drug and alcohol use less popular.

Two caveats are required regarding the measures. First, usage is undoubtedly under-reported since respondents are essentially required to report illegal behaviors. Second, one may question the designation of behavioral measures as independent variables since the campaign ultimately is trying to reduce usage behavior. However, in the short term, such behaviors are clearly established and the most the campaign can accomplish is to communicate key informational elements and attempt to change attitudes. It is unrealistic to expect such campaigns to immediately alter ingrained behaviors such as drug and alcohol use.

TABLE 1

PROPORTION OF RESPONDENTS RECALLING ANTI-DRUG/ALCOHOL ADVERTISEMENTS

RESULTS AND DISCUSSIONS

Advertising Recall

Approximately 80% of respondents in both the English and French samples have ever seen an anti-drug or alcohol advertisement. There were no differences in advertisement awareness between the different levels of drug and alcohol usage (Table 1)

There were significant differences in awareness of the Really Me campaign between drug users and non-users. In the English sample, significantly more (P=.05) users (47%) than non-users (38.9%) were aware of the campaign while in the French sample, significantly more (p=.05) drug non-users (77%) than users (67.8%) were aware of the campaign (Table 1).

There were also significant differences in aided recall levels depending upon drug and alcohol usage. In the English sample, aided awareness of each of the two ads differed significantly (p=.05) depending upon level of alcohol use. However, aided recall did not monotonically decline as alcohol usage increased.

In the French sample, both drug and alcohol usage was related to aided awareness of both French ads. Drug non-users were significantly more likely (p=.05) to recall seeing both ads than drug users (55.7% vs 44.50% and 79.7% vs 65.8%) (Table 1)

While the English sample results are mixed and at times contradictory, the French sample results clearly support the hypothesis hat recall of ads which utilize a drug/alcohol use prevention approach are no; as well recalled among those who already use drugs/alcohol. Overall, eight of sixteen multiple two-way comparisons were significant at the p=.05 level.

TABLE 2

PROPORTION OF RESPONDENTS AGREEING WITH AD EVALUATION STATEMENTS

Advertising Evaluation

Significantly more ( )=.01 ) English drug nonusers (93.8% and 90.8%) indicated that the people in the two ads were believable then did drug users (80.4% and 82.3%) (Table 2) In addition, the proportion indicating that the people in the ads were believable declined significantly in a generally monotonic manner across the various levels of alcohol usage.

For example, 94.6% of alcohol non-users felt that the people in the first ad were believable compared with only 78.7% of heavy alcohol users (Table 2).

In the French sample, believability ratings did not vary across either alcohol or drug usage levels.

Not unexpectedly, respondent ratings of whether the people in the ads were like their friends varied significantly across both alcohol and drug usage levels in both the English and French samples. For example 60.8% of drug non-users felt that the people in the first ad were like their friends compared with only 46.3% who felt this way among the drug users (Table 2). In addition, 61.5% of those in the English sample who had never tried alcohol indicated that the people in the first ad were like their friends compared with only 31.3% of alcohol heavy users.

Word of mouth stimulation by the advertisements was also higher among non users than users. For example, 47.2% of those who had never tried alcohol in the English sample indicated that !h,Y were likely to talk to their friends about the second ad compared with only 19.7% who indicated they would talk to their friends among heavy alcohol users (Table 2).

The data suggests that whether the respondent has used drugs or alcohol has a strong bearing on how the respondent evaluates an anti drug/alcohol ad in terms of believability, similarity to peer group members and word of mouth stimulation. Overall, eighteen of twenty-four multiple two-way comparisons were significant at the p=. )5 level.

TABLE 3

PROPORTION OF RESPONDENTS AGREEING WITH AD PERCEIVED EFFECTIVENESS

Perceived Advertisement Effectiveness

Alcohol and drug usage also had a significant effect upon the perceived effectiveness of the advertisements. Significantly more (p=.01) English drug non-users (71.3%) than users (58.9%) indicated that they would be likely to think about drug use after seeing the first ad (Table 3). Similarly, significantly more (p=.01) English alcohol non-users (73.2%) than heavy alcohol users (61.4%) indicated that they would be likely to think about alcohol use after seeing the first ad.

When asked whether they felt that the ads would make drug and alcohol use less popular, significantly fewer (p=.01) drug users than non-users in both samples indicated that the ads would make drug use less popular. Heavy alcohol users were also significantly less likely to feel the ads would make alcohol use less popular compared to non-users (Table 3).

Overall, fifteen of sixteen multiple two-way comparisons were significant at the p=.05 level.

CONCLUSIONS AND IMPLICATIONS

These results generally confirm DePaulo et al's hypothesis that stage of addictive substance use will differentially affect the impact of anti-drug/alcohol campaigns. The campaign discussed in this paper was specifically designed to act in a preventative role with a goal of reducing the number of individuals who try drugs. Overall, the results indicated that ad recall, ad evaluation and perceived ad effectiveness are all higher among non-users than among users. This is a positive outcome because it suggests that the campaign was most effective with the intended target groups. On the downside, there remains the need to address drug and alcohol usage among current users since the campaign was less effective with these individuals.

This result also highlight the need to evaluate the effectiveness of anti-drug and alcohol campaigns by taking into account the usage stage of the respondents. The relative effectiveness of some campaigns can well be blurred when different usage groups are aggregated together.

REFERENCES

Bandy, Patricia and Patricia Alford President (1983), "Recent Literature on Drug Abuse Prevention and Mass Media: Focusing on Youth, Parents, Women and Elderly" Journal of Drug Education, 13(3), 255-271.

DePaulo, P., M. Rubin and B. Milner (1987), "Stages of Involvement with Alcohol and Heroin: Analysis of 2.e Effects of Marketing on Addiction," in Advances in Consumer Research, Vol. 14, eds. Melanie Wallendorf and Paul Anderson, Provo, UT: Association for Consumer Research, 521 -525.

Falk, John L., Peter B. Dew,, and Charles R. Schuster (1983), "Commonalities in the Environmental Control of Behavior," in Commonalities in Substance Abuse and Habitual Behavior, eds. Peter K. Levison, Dean R. Gerstein, and Deborah R. Maloff, Lexington, MA: Lexington.

Kotler, P. (1983) "The Major Tasks of Marketing Management", Journal of Marketing, 37,4, 42-49. - Lang, Alan R. (1983), "Addictive Personality: A Viable Construct?" in Commonalities in Substance Abuse and Habitual Behavior, eds. Peter K. Levison, Dean R. Gerstein, and Deborah R. Maloff, Lexington, MA: Lexington

Lettieri, Dan J., Mollie Sayers, and Helen Wallenstein Pearson (1930),Theories on Drug Abuse: Selected Contemporary Perspectives (NIDA Research Monograph #30), Rockville MD: National Institute on Drug Abuse.

Marlatt, G. Alan (1976), "Alcohol, Stress and Cognitive Control," in Stress and Anxiety, Vol.3, ed. I.b. Sarason and C.D. Speilberg, Washington, D.C.: Hemisphere.

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