Anti-Drug Campaigns (Edexcel A-Level Psychology): Revision Notes
Anti-Drug Campaigns
Introduction to anti-drug campaigns
Psychologists collaborate with medical and nursing professionals to develop health campaigns that communicate important messages to the public. These campaigns use advertising and promotional strategies to encourage positive behavioural change in the general population.
Health campaigns have historically addressed various topics, including breast and testicular cancer self-assessments, childhood vaccination programmes, and substance use prevention. From a substance perspective, anti-smoking campaigns have been particularly prominent. The psychologist's role is essential in ensuring that the strategies underlying these campaigns are evidence-based and likely to produce positive outcomes.
The role of psychologists in health campaigns is critical for ensuring that interventions are grounded in psychological theory and research evidence. This evidence-based approach increases the likelihood that campaigns will effectively influence attitudes and behaviours, leading to meaningful improvements in public health outcomes.
Stoptober 2014
Overview of the campaign
Stoptober is an annual mass quit attempt campaign led by Public Health England, representing the largest coordinated smoking cessation effort in the UK. The campaign operates on a simple principle: stopping smoking for 28 days in October makes individuals five times more likely to quit permanently. With over 8 million smokers in England and smoking remaining the leading cause of preventable premature death and chronic disease (causing approximately 80,000 deaths and costing the NHS an estimated $2.7 billion annually), the campaign addresses a pressing public health concern.
The 28-day principle is central to Stoptober's effectiveness: quitting for just four weeks makes smokers five times more likely to quit permanently. This evidence-based approach provides a clear, achievable goal that can lead to long-term behaviour change.
Introduced in 2012, Stoptober capitalises on a trend of assigning monthly themes, similar to how 'Movember' promotes male cancer fundraising through facial hair growth. The campaign emphasises positive and motivational messaging whilst acknowledging that quitting can be difficult and intimidating for many people.
Campaign implementation and reach
The 2013 Stoptober challenge attracted 250,000 participants in England and Wales, with over 65% (160,000 people) successfully completing the 28-day period. Research indicated that 50,000 individuals remained smoke-free after 12 months.
The 2014 campaign featured comedians to enhance the positive tone and add humour to communicate with smokers effectively. The campaign utilised multiple advertising platforms, including television, radio, road shows, online media and social media, creating scale and relevance. From 8 September 2014, Stoptober encouraged smokers to join the challenge and prepare to quit from 1 October by providing free online support tools. These tools complemented the 28-day journey and were designed to offer daily support, incorporating humorous content through physical packs, smartphone applications, text messages and email programmes.
The multi-platform approach was crucial to Stoptober's success. By using television, radio, online media, and social media simultaneously, the campaign achieved broad reach across different demographics and ensured that smokers encountered the message through multiple touchpoints, reinforcing the campaign's key themes.
Television advertising included an innovative 3-minute 'sketch show' broadcast during the Emmerdale commercial break. The sketch, available for download online, featured comedians such as Paddy McGuinness and Al Murray (The Pub Landlord) delivering Stoptober's key messages humorously.
The advert included pictures of individuals representing the general public, creating an inclusive atmosphere so all smokers could feel represented. The images reflected diverse ages, ethnic backgrounds, and included both men and women. This approach helped draw in all smokers and was important for encouraging participation.
Use of humour and messaging strategies
The comedic tone was carefully employed to avoid mentioning cancer or respiratory disease explicitly. The humour was inclusive to avoid alienating key audiences. Some health benefits of not smoking were subtly included in the advert. Al Murray's character hints that taste buds will improve and pub customers will realise how unpleasant his beer tastes if they stop smoking. Using humour in this manner prevents people from viewing the campaign as pressurising, which has made direct health campaigns less effective in the past, as people report feeling lectured and become more reluctant to change their behaviour.
Why Humour Matters in Health Campaigns
Traditional fear-based health campaigns often make people feel lectured, which can lead to defensive reactions and resistance to behaviour change. By using humour instead, Stoptober avoids this pitfall and creates a more positive, approachable campaign that smokers are more willing to engage with rather than dismiss.
References to willpower featured prominently in the advert. At one point, Al Murray discusses how willpower is a British trait, referencing the war. This approach helps viewers identify with historical events that required determination and aims to instil pride. These traits help individuals become more resilient to the demands of quitting smoking.
Whilst the main focus highlighted the benefits of not smoking, links to some negatives of continuing to smoke were included. This involved making jokes about the Coldplay song 'Yellow' being written for smokers, referencing the tendency for smokers' fingers to become yellowed due to nicotine in cigarettes.
Presenting the advert as a chat show format, with an audience filmed within the advert, created a group-based approach. Viewers, whilst not in the actual audience, were likely to feel part of the wider group. When considering making change, feeling supported by others, even if not directly known, increases self-belief that the desired change can be achieved.
The group-based approach taps into an important psychological principle: social support and group identification can significantly enhance motivation and self-efficacy. Even indirect group membership, such as being a viewer of the campaign, can provide a sense of collective effort that strengthens individual commitment to behaviour change.
The 'sketch show' advert generated publicity for the campaign and announced the arrival of a refreshed Stoptober. Throughout September, comedians delivered shorter adverts reinforcing Stoptober's key messages through television and radio, explaining why smokers should act immediately and sign up online to start their quit attempt on 1 October. Online and social media advertising directed smokers to the sign-up page and Stoptober's proven support tools.
Target audience
The campaign targets all smokers. As the legal age to purchase cigarettes is 18, the campaign is ultimately directed towards adults. However, the accessibility of the language used and the incorporation of humour is also likely to gain the attention of teenagers who have started smoking.
Psychological theories applicable to anti-drug campaigns
Hovland-Yale model of persuasion
This model identifies several factors affecting how likely a change of attitude is through persuasion. For example, it examines how likely someone will consider stopping smoking and be receptive to campaigns such as Stoptober. The model states that three prominent factors need consideration for a campaign to be persuasive. This has led psychologists to examine the science of persuasion to discover how to change attitudes with the ultimate goal of changing behaviour.
The Hovland-Yale Model: Three Key Factors for Persuasion
For a health campaign to successfully persuade individuals to change their behaviour, it must carefully consider three critical elements: the credibility of the source delivering the message, the content and structure of the message itself, and the characteristics of the target audience. All three factors must align for maximum persuasive impact.
1. The source (who is giving the message)
According to credibility theory, people are more likely to be persuaded when a source presents itself as credible. For example, if the person providing the message is an expert in the field, they are viewed as more trustworthy.
2. The message (what the message is saying)
The content of the message is an important factor. Two-sided messages, those which highlight both sides of the argument, have a greater influence on attitudes than one-sided messages, as long as the two-sided argument eventually gives a solid opinion. This suggests that an effective campaign to stop smoking needs to highlight both sides of the smoking debate and then be clearly conclusive about why the benefits of quitting outweigh reasons to smoke.
Understanding Two-Sided Messages
A two-sided message acknowledges both perspectives of an issue before presenting a clear conclusion. For anti-smoking campaigns, this means:
Step 1: Acknowledge the smoker's perspective "We understand that smoking may help you relax and provide social opportunities..."
Step 2: Present the counter-argument "However, the health risks including lung cancer, heart disease, and reduced life expectancy far outweigh these temporary benefits..."
Step 3: Provide a clear conclusion "The overwhelming evidence shows that quitting smoking will improve your health, finances, and quality of life."
This approach is more persuasive than simply stating "smoking is bad" because it demonstrates understanding of the smoker's experience whilst building a compelling case for change.
3. The audience
The characteristics of the audience strongly affect how likely someone is to be persuaded. Individuals considered to be more intelligent are more likely to be persuaded by valid arguments because they have a longer attention span and can understand the arguments better. The campaign will, therefore, need to be structured around the audience characteristics it is aiming to persuade.
Culture can also be a contributory factor in relation to how messages are received by the audience and, therefore, how persuasive the messages are. For example, Wang et al. (2000) found Americans prefer products that offered 'separateness' whereas Chinese prefer products that offered 'togetherness'. This suggests different cultures would be more influenced by messages that support their opinions.
Elaboration likelihood model of persuasion (Petty and Cacioppo, 1986)
This model aims to examine attitude change by looking at persuasion and factors that increase the likelihood of persuasion occurring. Under this model, persuasion depends on the level of scrutiny given to a message. The level of scrutiny falls along a continuum from close scrutiny, or central processing, which involves examining an argument closely, to peripheral processing where short-cut cues are used to understand a message. The level of scrutiny and processing depends on motivation. People who are less motivated use peripheral cues that lead to 'less stable' attitude changes, which are less likely to lead to behaviour change. People who are well motivated undertake central processing, which is more likely to lead to sustained changes in behaviour (Crano and Prislin, 2006).
Central vs. Peripheral Processing: The Key to Lasting Change
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Central processing involves deep, thoughtful analysis of a message's arguments. This requires both motivation and ability to think carefully, but results in stable, long-lasting attitude and behaviour changes.
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Peripheral processing relies on superficial cues (like celebrity endorsements or attractive presentation). This requires less effort but produces temporary attitude changes that are unlikely to result in sustained behaviour modification.
For anti-drug campaigns to be truly effective in changing behaviour long-term, they must provoke central processing rather than relying solely on peripheral cues.
Many messages lead to both central and peripheral processing operating simultaneously. This theory implies that information campaigns should seek to provoke central processing of their message. A campaign fronted by a celebrity may provoke interest and, through peripheral processing, lead the viewer to understand the message. However, to change habitual behaviours and bring about long-lasting change, a message has to provoke deeper thought.
Two conditions are necessary for 'effortful processing' to occur. The recipient of the message must be both motivated and able to think carefully. A person's motivation to consider messages can be influenced by numerous variables, including the perceived personal relevance of the message and whether the person enjoys thinking in general. A person's ability to think carefully can also be influenced by numerous variables, including the amount of distraction present in the persuasion context and the number of times the message is repeated. If a person is both motivated and able to think carefully about the issue and relevant information presented, it can generate an attitude that is integrated into the person's overall beliefs.
Requirements for Effortful Processing
For a health campaign to provoke the deep, central processing that leads to lasting behaviour change, two conditions must be met:
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Motivation: The individual must want to think about the message. This is enhanced when:
- The message is personally relevant
- The individual has a high need for cognition
- The topic is important to them
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Ability: The individual must be capable of processing the message. This is enhanced when:
- Distractions are minimised
- The message is repeated appropriately
- The arguments are clear and understandable
Fear arousal (Janis and Feshbach, 1953)
Fear arousal health promotions aim to inform individuals of the risks of engaging in particular behaviour, such as smoking. Health messages based on fear arousal may include graphic images such as those placed on cigarette packets in recent years, depicting the damage caused to internal organs as a result of smoking. Hammond et al. (2003) found that pictorial messages on cigarette packets were more effective in encouraging behaviour change than written warnings.
Health communications which stimulate higher levels of fear have been shown to increase the likelihood that individuals will accept the health recommendations being made within a health campaign. It has been shown that high-fear messages produce more attitude and behaviour change than health communications that do not highlight hazards of the behaviour and are, therefore, viewed as low-fear messages.
Whilst high-fear messages have an impact on behaviour change, it is necessary to use an appropriate fear level for the campaign, as found by Janis and Feshbach (1953). The individual must be able to identify with the message and consider it possible to happen to them. If the fear arousal is too high for the behaviour, it increases the potential for the individual to dismiss it as unlikely to happen to them and, therefore, does not lead to behaviour change. The need to apply an appropriate fear level to the health message may contribute to the inconsistent results within the fear arousal literature as to whether high or low fear messages are most effective.
The Fear Arousal Paradox
While higher fear levels can increase message acceptance, excessively high fear can backfire. When fear is too intense, individuals may employ defensive mechanisms such as:
- Denial ("That won't happen to me")
- Avoidance (ignoring the message entirely)
- Dismissal (viewing the threat as exaggerated)
The most effective approach uses moderate fear that is realistic and relatable, allowing individuals to identify with the threat whilst maintaining belief in their ability to take preventive action.
Janis and Feshbach (1953) - Fear arousal study
Classic Study: Fear Arousal and Dental Hygiene
Aim: To investigate the effect of fear arousal levels within health communications on dental hygiene.
Participants: Two hundred students were separated into four groups of 50 participants.
Procedure: Each group was allocated a fear arousal level: minimal, moderate, high arousal, and a control group. Participants were exposed to different health messages as determined by their arousal level.
- The high-fear arousal group were shown pictures and descriptions of diseased mouths, including explanations about the pain of tooth decay and gum disease and awful consequences like cancer and blindness.
- The moderate-fear arousal group were shown similar pictures and descriptions to the high fear arousal group, but they were much less disturbing and dramatic.
- The minimal-fear arousal group were given a lecture about teeth and cavities, but without referring to very serious consequences and using diagrams and X-rays rather than emotive pictures.
- The control group were given a lecture of the same length as the other conditions (15 minutes), but this group was given a lecture on the structure and functioning of the human eye.
Findings: The high-fear arousal message created the most worry in the students and was rated as more interesting. This condition also showed a high level of the individuals thinking more about the condition of their teeth than for the moderate- or minimal-fear arousal groups. However, they concluded that whilst the high-fear messages did generate most concern about dental health, the overall effectiveness of a health promotion campaign is likely to be reduced by the use of strong fear appeal, as it produced the least change in behaviour.
Evaluation - Strengths:
- The study demonstrated that, after a delay between giving the message and measuring any behaviour change, a low-fear message is more persuasive than a high-fear message.
Evaluation - Weaknesses:
- The research was conducted using self-report techniques, which are biased on the part of the participant as they may report what they assume the researcher is looking for. As a result, the findings may not accurately identify factors influencing attitude and behaviour change.
Supporting Evidence from Leventhal and Watts (1966)
Leventhal and Watts (1966) used low, mild and strong threat messages (on lung cancer) to influence attitudes towards chest X-rays and stopping smoking. Their high-fear movie included close-ups from a lung surgery operation.
The three groups were compared for the number of people who took X-rays immediately after the communications; an X-ray booth was available right outside the movie theatre. The results showed that the smokers in the audience did not take X-rays after exposure to the high-threat film, though did take X-rays after the low and moderate threat films.
Reports of success in reducing smoking were collected three months later, and a greater proportion of subjects exposed to the strong high-fear film claimed success in cutting back.
This suggests a complex relationship between fear level and behaviour: high fear may inhibit immediate action but could potentially influence long-term behaviour change.
Evaluation
Strengths and weaknesses of psychological theories
One way to evaluate an anti-drug campaign is to consider the strengths and weaknesses of the psychological theories that inform it. The Hovland-Yale model is too simplistic. The idea that processing occurs in order, through attention, comprehension, acceptance and retention is not necessarily the case. For example, once we start to think about the meaning of the message, we go back and pay some or all of it more attention, so individuals are not processing in a simple stage-by-stage manner. Furthermore, the Hovland-Yale model concentrates on external processes (the communication, the communicator, etc.) but does not take sufficient account of the underlying internal factors associated with the viewer (for example, attention, comprehension), which is accounted for in the elaboration likelihood model.
The elaboration likelihood model of persuasion does not result in quick attitudinal change. Whilst it is likely to result in long-standing behaviour change, it develops over a prolonged period of time and, therefore, is less effective for rapid behaviour change. The model is somewhat oversimplified in considering that the two forms of processing act as separate processes, rather than on a continuum. It is likely that individuals use both forms of processing. The model is not clear as to how the two processes interact. It is also difficult to tell which type of processing people will use. This makes it difficult to predict behaviour from the model.
The elaboration likelihood model accounts for individual differences in a manner that the other models fail to do. It recognises how the same message can be processed differently by different people using different processes. It suggests that individuals with a high need for cognition use the central route, whereas individuals with low need for cognition use the peripheral route. The consideration of two routes may be considered more realistic than the one route of persuasion outlined by the Hovland-Yale model as individuals are complex in their processing.
The fear arousal approach is useful for increasing health behaviours in individuals, as it demonstrates that fear arousal may not be the most effective way of promoting healthy living. However, this approach does not consider other reasons, besides fear, as to why an individual may adopt a health behaviour. The approach suggests that graphic images on health campaigns may not be the most effective way to encourage individuals to change harmful behaviour. Despite this, cigarettes currently depict such images on their packets. This would suggest that the application of this approach, in practice, is inconsistent with the findings.
Research limitations
Critical Limitation: Self-Report Bias
Research in this area is usually conducted using self-report techniques. These are biased on the part of the participant as they may report what they assume the researcher is looking for. As a result, the findings of research in this area may not accurately identify factors influencing attitude and behaviour change.
This methodological limitation affects the reliability and validity of findings across all theories discussed, making it difficult to draw definitive conclusions about which approaches are most effective in real-world health campaign settings.
Key Points to Remember:
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Anti-drug campaigns use psychological theories to encourage positive behaviour change, particularly in relation to smoking cessation.
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The Stoptober 2014 campaign used humour, inclusivity and multiple media platforms to encourage smokers to quit for 28 days, with 250,000 participants in 2013 and 65% successfully completing the challenge.
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The Hovland-Yale model identifies three key factors in persuasion: the source (credibility), the message (two-sided arguments are more effective), and the audience (intelligence and culture influence receptiveness).
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The elaboration likelihood model distinguishes between central processing (deep, motivated thought leading to lasting change) and peripheral processing (quick, superficial understanding leading to temporary change).
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Fear arousal can be effective in health campaigns, but Janis and Feshbach (1953) found that moderate fear messages produce more behaviour change than high-fear messages, as excessively high fear can lead to dismissal of the message.
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All theories have limitations, particularly regarding research methodology (self-report bias) and real-world application (complexity of human behaviour and processing).