Background notes
Background notesResults from the featured study led the non-partisan Citizens Against Government Waste agency to condemn ("nothing more than smoke and mirrors") the campaign as one of the two worst money-wasting initiatives of the US Office of National Drug Control Policy. However, it remains possible that the campaign really did have the intended impacts, but these were not picked up by the study. Alternatively, if it was ineffective, how could this have happened?
From the perspective of the current revised campaign, one explanation for the previous apparent failures is that the earlier brand (My Anti-Drug) stuck more in the minds of committed drug users, who therefore reported more exposure to the ads, creating the illusion that the ads had caused their commitment to drug use. This seems an unlikely explanation for the featured report's findings, since it concerned only children who had not yet even tried cannabis, or had not done so at the previous round of interviews, children who hardly seem among the most committed of drug users.
Another possible explanation is that the study was unable to statistically even out differences between the kinds of children who recalled seeing many ads, and those who recalled few. Assuming recall represented real media consumption habits, at the extremes it seems likely that the roughly 1 in 6 children who saw no ads in a month, led very different lives to the roughly 1 in 6 who saw at least 12. Despite comprehensive attempts to eliminate this risk, it remains possible that these differences obscured the impacts of the campaign.
Also the featured report was exclusively concerned with non-users of cannabis, leaving open the possibility of positive impacts on the more high-risk children who had already tried the drug. Towards the end of the study period there were enough cannabis users in the sample to test whether greater exposure to the campaign led them to quit or cut back in the following year. Neither was found to have been the case. The same report found that youngsters at high risk of substance use, including in particular those prone to seek thrills and highs ('sensation-seeking'), thought least well of the TV ads and were significantly more likely to believe they exaggerated the problem. Like the samples as a whole, these high-risk children generally exhibited neutral or somewhat negative links between exposure to the campaign and use of cannabis and related attitudes and beliefs. Most significantly, after the campaign began to focus on cannabis, the link between seeing or hearing more ads and tending to later initiate cannabis use was "particularly pronounced" among high sensation-seekers. Together these findings make it very unlikely that neutral or negative impacts among non-users were counterbalanced by impacts on higher risk children, including those who had already tried the drugs.
Another set of arguments accepts that the campaign was ineffective, and try to explain why. The study authors themselves advanced the possibility that these brief ads, seen or heard typically once or twice a week, were 'swamped' by the much louder and more persistent chorus of anti-drug voices in America, for example, those of parents, schools, and the media more broadly than anti-drug ads.
Another explanation they offered is that no matter what deterrent impact the campaign's explicit messages may have had, they were (possibly more than) counterbalanced by an implicit message that cannabis use was common among children of the same age as the viewer or listener. Indeed, other reports on the study found that the more exposure children reported to the ads, the more of their age-mates they thought used cannabis, among the strongest findings in the study. These perceptions about how common cannabis use was among their peers were related to how likely a child was to later use cannabis, possibly accounting for the tendency for exposure to be related to cannabis use. Beliefs about how 'normal' substance use is among people you relate yourself to are in some circumstances a powerful influence on your own substance use, one harnessed by several prevention programmes. Perhaps the campaign gave young people the message that drugs were a "big problem" among their age-mates and therefore widespread and hard-to-resist. Why else, they might subliminally have reasoned, would the government be so keen to warn us about them and think we need help to resist? Similar mechanisms have been observed in school drug education trials, where teaching drug refusal skills appears to have fostered the impression that there was a greater need to resist because substance use, and offers of substances to use, were relatively commonplace (1 2). College-based alcohol prevention efforts have also sometimes seemed to foster similar impressions.
The featured study had to rely on 'messy' real-world data. Others have been able to exercise greater control in examining how children react to these and similar ads. They support the simple explanation that the campaign seemed ineffective because it was, and also show how it might have been counterproductive.
One such study tested 30 ads from the Partnership for a Drug Free America, which produced most of the campaign ads. Several of the researched ads actually featured in the early stages of the campaign. The study recruited 3608 US middle and high school pupils to view the 30 ads and assess how effectively each would turn their peers away from using drugs. A programme about video and news production techniques was used as a control condition against which to compare the ads. Surprisingly, six of the 30 ads were seen as less effective than this comparator; put another way, compared to simply neutrally watching TV, they were seen as actually promoting drug use. Another eight were seen as equally (in)effective, leaving only just over half performing better than a programme not intended to be anti-drug at all. Given the campaign's later focus on cannabis, it was not a good portent that two-thirds of the poor-performing ads focused on this drug. In contrast, just two of the ads which outperformed the neutral programme focused on cannabis, and one was only marginally better.
An offshoot of this study demonstrated that even though child viewers may imagine such ads would deter other children, this does not necessarily mean they deter the viewers themselves. One of the two cannabis ads which did relatively well depicted the 'gateway' theory – a teenage girl recounting how the first drug she used was cannabis, thinking "I'd never have a real problem with it", only to develop an appetite which soon escalated to "crack ... angel dust, everything". A more detailed analysis of this tactic was conducted in Philadelphia, where 418 school pupils were randomly allocated to view one of four versions of a TV programme. One included a sequence of ads which stressed the gateway message in four graphic depictions of the consequences of "hard" drug use, ending with the teenage girl's account of how it can all start with cannabis. The control condition was the TV programme without the ads. On all the many measures of how the children reacted, the hard-hitting gateway sequence left them feeling more positive about cannabis and more likely to use the drug. On their own, none of the differences was statistically significant, but this aggregation of wrong-way-round outcomes (which included a near significant weakening of belief in the gateway theory itself) was a strong indication of a boomerang effect. It happened at least partly because the bulk of children unlikely to use cannabis anyhow were unmoved by the ads, while those most likely to use tended to "move towards disbelieving that regular marijuana use has negative consequences". The researchers conjectured that these children rejected the gateway depiction because it was contradicted by their own experiences, a speculation strengthened by the fact that these youngsters were indeed the ones most sceptical about cannabis leading to harder drugs. The upshot was that children who had little room to become more anti-cannabis were unaffected, while those with a more pro-cannabis profile were moved in the wrong direction.
These studies suggest that among young people most likely to use cannabis, focusing on harmful consequences was a difficult strategy to carry off with any credibility in respect of a drug where clear-cut examples are hard to find. Some other features may also have undermined the campaign's effectiveness. A major theme implied that the choice young people faced was between cannabis use and other valued activities and identities, yet the experience of many will have been that usually no such dilemma presents itself in real-life. Underlying this was the emphasis on cannabis use detrimentally dominating young lives, a depiction which all but a few could deflect as 'nothing like them' or their friends. Finally, there were explicit urges to independence of mind ("We need to stand up for ourselves and become independent thinkers"); if taken to heart, these might as easily have led to rejection of the government-sponsored messages as their acceptance.
Set against these studies is one which found the campaign did have anti-cannabis impacts, dismissed in the featured report as concerning only two medium-sized cities for one six-month portion of the campaign. The six months concerned were the first of the cannabis-specific campaign phase. Rather than following up the same children, in 1999 the study selected 48 samples of 100 children and allocated one sample to be followed up in each of the succeeding 48 months. Effectively, each month the study tracked an aging sample, not of the same children, but of children sampled from the same schools. When in late 2002 the refocused campaign started, the researchers observed a significant downturn in the proportion of children who said they had used cannabis in the past month, but only among the half of the samples highest in sensation-seeking tendencies. At the same time, across the entire samples (but seemingly The relevant passage reads: "Other interrupted time-series analyses for the combined sample also indicated statistically significant reductions in mediating variables such as positive marijuana attitudes and beliefs over the same period. Before the initiative, low-sensation seekers (not specifically targeted by the campaign) displayed much weaker upward developmental trends in marijuana use, attitudes, and beliefs; this trend was not altered by the initiative." most so among the high sensation-seekers) there were significant reductions in pro-cannabis attitudes and beliefs, but not Since no such trend was mentioned. in the perhaps more powerful social norms perceptions of the prevalence and acceptability of cannabis use among friends. These findings suggest the more high risk children did respond as intended to the campaign. However, even among high sensation-seekers, there was no correlation between seeing or hearing more of the ads and being less likely to have used cannabis. In some respects these results duplicated the national study's findings of no link between campaign exposure and use among high sensation-seekers, but a downturn in past-month use among this group over 2002 and 2003/2004. From the start the national study had argued that without a confirming link with exposure, such evidence was insufficient to indicate a protective effect of the campaign. Findings from the national study outlined above indicative of at best a neutral impact among high-risk children, plus the weaknesses of the two-city study (notably the fact that only half the relevant-age children responded to the surveys) and its geographical and time limitations, mean the case for a deterrent impact among high sensation-seekers nationally cannot be considered persuasive.
In the same communities this study had been preceded by one which developed anti-cannabis ads targeted specifically at high sensation-seeking teenagers and broadcast them in TV slots known to appeal to this group. Especially among this group, the ads were viewed substantially more often than in the national campaign tested by the featured study, and they had been carefully constructed in the light of feedback from the intended targets. A similar methodology to that used in the later study (see above) produced results indicating that in both cities the campaigns had not affected past-month cannabis use by the half of the samples lowest in sensation-seeking. But among their higher sensation-seeking targets, in two of three cases (one city was subject to two campaigns a year apart) onset of the campaigns coincided with a drop in the proportion admitting past-month cannabis use. However, this study suffered from an even lower (around a third in the city where this could be assessed) participation rate than the subsequent study. Also, it is unclear why during the second campaign in one of the cities, use levels actually rose, only to fall after the campaign had ended. Nevertheless these results indicate that in certain circumstances a well targeted campaign can affect children most likely to use cannabis. Unfortunately, for this study we have no national findings to set those from the two cities in context; it remains possible that had these been available, as with the later study, they might have called in to question whether these findings were limited to the areas and/or to the methodology employed.
