Thursday, December 16, 2010

Underage Drinking: A Critique of the We Don’t Serve Teens Campaign - Jane Huston

Problem and Intervention: Underage Drinking
Underage drinking is a serious public health problem in the United States. According to one survey, nineteen percent of teens aged twelve to twenty had five or more drinks on a single occasion in the past thirty days (1). Research shows the earlier teens begin drinking, the more likely they are to develop alcohol dependence or other alcohol problems. For example, those who began drinking before age fourteen were three times more likely to develop alcohol dependence than those who waited until age twenty-one (1). Most interventions tend to target teens ages sixteen to twenty, though sometimes the audience is younger. There are three main approaches to underage drinking interventions: attempts to change individual knowledge, attitudes and beliefs about alcohol; attempts to reduce the availability of alcohol in the environment of those underage; and community level interventions, increasing education, enforcement and clinical interventions through government, police departments and health departments (1).
The “We Don’t Serve Teens” campaign is a national effort by the Federal Trade Commission that aims to reduce access to alcohol for people under twenty-one. The education and promotion do not directly target teens, but parents, alcohol merchants, and others who may be willing to purchase alcohol for teens. Examples include advice on how to talk to your teen about alcohol, statistics on the dangers of teen drinking, and posters and other promotional materials. In this paper, I will critique the We Don’t Serve Teens (WDST) campaign based on three observations I have made that have roots in social science: the theory of psychological reactance, the irrationality of behavior, and the core value of rebellion. While the concepts apply generally to the campaign as a whole, I will focus on a specific poster, reading “The legal drinking age is 21. Thank you for not serving alcohol to teens.”
The Theory of Psychological Reactance
Jack Brehm first posited psychological reactance in 1966. The theory states that when a person’s freedom is threatened, or even if they perceive freedom may be threatened, the person becomes motivated to prevent further loss of freedom and also to re-establish the freedom that was lost (2). In this definition, freedom should be interpreted quite broadly as anything that a person can realistically do and feels free and able to do. Whenever one of these possible actions or choices is taken away or threatened, that threat can induce reactance in the individual. The level of the response depends on the relative importance of the freedom and the proportion of freedoms threatened, compared to other options. If the freedom is merely threatened, the likelihood of the threat actually happening will influence the level of reactance as well. Though a person is not likely to be conscious of reactance when it occurs, he or she will simply desire to assert the ability to choose. The individual knows she can do what she wants, that she doesn’t have to do what she doesn’t want, and she is free to choose.
An additional important characteristic of psychological reactance is the effect of age. As age increases, susceptibility to psychological reactance decreases (3). This means teens and young adults are the most likely to feel reactance when faced with threats to freedoms. As mentioned earlier, the targets of most underage drinking campaigns are those aged sixteen to twenty; this audience is highly likely to feel psychological reactance. Campaigns against underage drinking must take the idea of reactance into account when designing any intervention.
How does psychological reactance affect alcohol consumption? To answer this question, one can look back to the early 1980s, when the legal drinking age in the United States was raised to twenty-one. Following this policy change, the newly “underage” college students had significantly higher alcohol consumption than their of-age counterparts. This difference was not seen in other common campus drugs, such as marijuana, that are illegal regardless of age. The illegality of the alcohol could induce reactance in the underage students, who deal with the lost freedom by engaging in the restricted behavior and drinking excessively. One study that examined this phenomenon theorized, “denying students the opportunity to make choices in this area may be perceived by students as a coercive attempt to limit their behavioral freedom. According to reactance theory, students under the legal drinking age may then try to regain this lost behavioral freedom by making an even greater effort to acquire and consume alcoholic beverages” (4).
More specifically, one can examine the WDST campaign in the context of psychological reactance. The poster proclaiming that the legal drinking age is twenty-one is a prime example of an ad likely to inspire reactance. The tone of the poster could be interpreted as condescending; everyone knows the legal drinking age in the United States, so stating that fact is at best unnecessary, and at worst, seen as “talking down” to the readers. Secondly, the line “Thanks for not providing alcohol to teens” assumes the compliance instead of presenting it as a choice. This may further threaten a person’s perceived freedoms to buy what they please and for whom they please. While this poster is targeting people who are of legal age to purchase and consume alcohol, many of the people who buy alcohol for teens have recently turned twenty-one and are still young adults who are susceptible to psychological reactance.
Another aspect of the WDST campaign is the call for parents to talk to their kids about alcohol. This is another opportunity for psychological reactance to undermine the intended effects. Conversations with parents are almost guaranteed to inspire reactance in teens:
with the onset of puberty, maturational factors lead children to desire, experience, and express the need for attitudinal freedoms as a way of adopting an adult identity. Once children enter puberty, the take the liberty of forming their own judgments and begin to observe the world more critically. They tend to question what their parents or the authorities say, and their receptivity to messages from adults decreases drastically. (5)
Assuming these psychological assumptions are true, a parent speaking with a teen and encouraging them not drink may result in the teen becoming even more determined to drink. I believe it certainly is possible for adults to speak with teens about alcohol consumption, but the adults must be very careful in the messages they deliver and in how they present the messages. It is not only what one says that counts, but also how one says it. In examining language of anti-smoking campaigns with regards to reactance, researchers found that implicit message that emphasize the freedom of choice were viewed more positively by teens than explicit messages, that seemed to preach anti-smoking rhetoric. The explicit messages inspired more reactance than messages encouraging freedom to choose (5). Anti-alcohol campaigns can learn a lot from anti-smoking campaigns, as they have similar target audiences, messages, and goals.
One lesson to be learned from psychological reactance is the importance of testing and re-testing the messages for any intervention. Even the simplest alcohol message, ones that the creators may think are neutral, must be tested with members of the target audience to discover the actually effects. This may seem like more work than a busy public health professional wants to take on, but without knowing how the target audience perceives the message, the professionals may end up implementing an intervention whose messages are poorly received by the targets and therefore, ineffective. Such messages are unlikely to prevent the targeted behavior and may actually increase risky behavior (6).
The Irrationality of Behavior
A second critique of the WDST campaign is its assumption that behavior is rational. The tagline “It’s unsafe. It’s illegal. It’s irresponsible.” appears throughout campaign materials. This message operates on the assumption that if people know a behavior is generally bad then they will avoid it. However, the irrationality of human behavior can be seen in numerous situations (7). After all, emotions play a key role in decision-making, and emotions are certainly not rational (8). Most people know it is illegal t provide alcohol to people who are underage, but they are doing it anyway. Perhaps someone is buying alcohol for an underage sibling or friend; in this case, they probably feel a close attachment to the underage person, and their emotions and feeling of liking are motivating their decision to break the law and provide the alcohol.
One example of irrational behavior that applies to underage drinking and provision of alcohol to teens is the optimist bias. According to the optimistic bias, people often have a mistaken belief that their chances of experiencing a negative event are lower than that of one’s peers (9). For example, a person may continue to purchase alcohol to minors, knowing it’s illegal, because they believe they will not be caught or punished.
Core Values: Rebellion
A final critique of the WDST campaign is the creator’s disregard of the core value of any teens: rebellion. As mentioned above, teens often feel the need to explore their developing identities and the desire to question authority (5). An extension of questioning authority is rebelling against it, and underage drinking is a prime opportunity for rebellion. With WDST, the FTC is targeting the alcohol providers, including vendors to prevent teens from purchasing alcohol. Yet research shows that the majority of teens who drink alcohol do not purchase it themselves (10). Most teens instead use older siblings, friends, or even parents as sources of alcohol. I believe that if teens are motivated to drink, they will find a way to procure alcohol; if one avenue is unavailable, they will simply turn to someone or something else as a way to consume alcohol and further rebel against authority. Therefore, by targeting providers of alcohol and not teens themselves, this campaign neglects the true source of the problem: teen’s desire and motivation to drink.
A New Approach to Prevention of Underage Drinking: The Most of Us Campaign
In light of these critiques, how can public health professionals better address teenage/underage drinking? I believe that being aware of reactance, irrationality, and core values can lead to a more effective campaign that relies on emotions, community, and the core value of a sense of belonging. The foundation of the campaign is that messages are aimed at teens and created by teens. “Most of Us” refers to the majority of teens who do not consume alcohol. The campaign will consist of television commercials, billboards, and print ads that show teens having fun, being a part of a group of friends, and enjoying popular music, clothing, culture, all without alcohol. The commercials will be similar to some product commercials that could be for almost any product (such as the Abercrombie & Fitch or Pepsi ads), but provide images and stories that teens will see and think, “I want to be like that.”
An important component of the Most of Us campaign will be an online community. The focus of the website will not be anti-alcohol messages, but instead focus on everything teens do that doesn’t involve alcohol. There will be chat rooms and message boards about sports, music, art, movies, and other activities that do not feature alcohol. Teens can form local chapters that host alcohol-free events, like concerts, parties, outdoor activities, etc. Overall, the Most of Us Don’t campaign will succeed in the key areas where WDST failed: psychological reactance, irrational behavior, and core values. In the rest of this paper, I will discuss these strengths of the campaign.
Addressing Psychological Reactance
The most important social science topic regarding WDST is the theory of psychological reactance. Where WDST ignored the implications of inducing reactance in its target audience, Most of Us will invest significant efforts into minimizing reactance. One possible avenue to lessen reactance is through similarity of message source. “Similarity should decrease the negative force toward resistance by influencing perceptions of the degree of threat. Similarity and liking profoundly affect social perception—people interpret the actions of liked others in positive, flattering ways” (11). The source of any message presented by the campaign will be other teenagers. Alternatively, many communications may appear ‘sourceless’ as they merely tell the story of teens having fun without alcohol use.
To further guard against reactance, the campaign must acknowledge that reactance is possible in even the most carefully designed campaign. It is necessary to test different messages with samples of the target audience to find one least likely to inspire reactance. Before releasing any television, radio, or print ad, the campaign will conduct surveys and focus groups with teens to ensure that the final message is receive positively by most teens.

Embracing Irrational Behavior
Another critique of WDST is the assumption of rational behavior; WDST presents facts, rules, and consequences of not following rules. Assuming people act rationally, it may be effective to educate them on the laws governing alcohol use; however, as we now know, human behavior is often not rational and governed by our wants and desires instead of logic. Fortunately, people often act irrationally in predictable ways, and the campaign can take advantage of people’s tendency to make decisions about behavior using emotional cues instead of purely logical ones (7). Instead of presenting statistics on teen drinking or consequences of early initiation of drinking, this campaign will turn to advertising and marketing theory. The principles of these theories involve making a promise to your target audience and supporting that promise with music, stories, and images (12). For the Most of Us campaign, the promise is that you will have fun with friends without consuming alcohol. The support will be delivered through images of teens having fun, wearing fashionable clothing and accompanied by popular music. By invoking strong emotional reactions, the campaign can take advantage of the irrationality of behavior.
Core Values: Belonging
The final critique of WDST involved the core value of rebellion, and WDST’s failure to recognize the power of core values in influencing behavior. The Most of Us campaign will appeal to the core value of belonging, or people’s desire to feel like a part of a group (13). The opinions and actions of a peer group can greatly affect teens’ behavior and decisions. According to one review, “while [older generations] are most influenced by authority figures and…data and facts, post-modern youth are more likely to make a decision based on the influence of their own peers. Our research has further confirmed that the biggest factor determining the choice a teenage will make is the experience of their core group of three to eight friends” (14). With this knowledge, the Most of Us campaign can provide a peer group of teens that do not drink. The appeal to a sense of belonging will mainly occur through the online community, providing a place where teens can interact with other teens who don’t drink alcohol. Instead, they can bond over other shared activities and interests, like music, movies, sports, or art.
Conclusion
Underage drinking is certainly a problem that merits attention from public health professionals in the United States. The current We Don’t Serve Teens campaign focuses on reducing teens’ access to alcohol by targeting vendors, parents and other adults who may provide alcohol to teens and underage drinkers. However, based on three social science theories and principles, this approach is inherently flawed. Drawing support from the theory of psychological reactance, the assumption of rational behavior, and the importance of core values, I have demonstrated where the WDST campaign went wrong. Furthermore, I have proposed an alternative approach that addresses these concerns and has a greater chance of success, based on theoretical principles.


References:
(1) Hingson, R.W., Assailly, J.P., Williams, A.F. (2004) Underage Drinking: Frequency, Consequences, and Interventions. Traffic Injury Prevention, 5(3): 228-236
(2) Brehm, JW. 1966. “A theory of psychological reactance” in Organization Change: A Comprehensive Reader. Ed. Burke, WW, Lake, DG, Paine, JW. Jossey-Bass: San Francisco, 2009
(3) Hong, S.M., Giannakopoulos, E., Laing, D., Williams, N.A. (2001) Psychological Reactance: Effects of Age and Gender. The Journal of Social Psychology, 134 (2): 223-228
(4) Allen, D.N., Sprenkel, D.G., Vitale, P.A. (1994) Reactance Theory and Alcohol Consumption Laws: Further Confirmation among Collegiate Alcohol Consumers. Journal of Studies on Alcohol, 55 (1): 34-40.
(5) Grandpre, J., Alvaro, E.M., Burgoon, M., Miller, C.H., Hall, J.R. (2003). Adolescent Reactance and Anti-Smoking Campaigns: A Theoretical Approach. Health Communication, 15 (3): 349-366
(6) Campo, S., Cameron, K.A. (2006) Differential Effects of Exposure to Social Norms Campaigns: A Cause for Concern. Health Communication, 19(3): 209-219.
(7) Ariely D. Predictably Irrational: The Hidden Forces that Shape our Decisions. New York: HarperCollins Publishers, 2008
(8) DeMartino B, Kumaran D, Seymour B, Dolan RJ. (2006) Frames, biases, and rational decision making in the human brain. Science, 313: 684-687.
(9) Weinstein ND. (1980) Unrealistic optimism about future life events. Journal of Personality and Social Psychology, 39:806-820
(10) Morleo, M., Cook, P.A., Bellis, M.A., Smallthwaite, L. (2010) Use of fake identification to purchase alcohol amongst 15-16 year olds: a cross-sectional survey examining alcohol access, consumption and harm. Substance Abuse Treatment, Prevention, and Policy, 5(12).
(11) Silvia PJ. (2005) Deflecting reactance: The role of similarity in increasing compliance and reducing resistance. Basic and Applied Social Psychology, 27:277-284.
(12) Evans WD, Hastings G. (2008) Public health branding: Recognition, promise, and delivery of healthy lifestyles (Chapter 1). In: Evans WD, Hastings G, eds. Public Health Branding: Applying Marketing for Social Change. Oxford: Oxford University Press, pp. 3-24.
(13) Campbell, C., Murray, M. (2004) Community health psychology: promoting analysis and action for social change. Journal of Health Psychology, 9(2): 187-195.
(14) McCrindle, M. (2003) Understanding Generation Y. Principle Matters, The Australian Leadership Foundation. Available from
(15) “We Don’t Serve Teens: A National Campaign to Prevent Underage Drinking.” Federal Trade Commission. Available at http://www.dontserveteens.gov/

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