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Week10--SocialmarketingaimedatDrunkdriving.pdf
Social marketing campaigns aimed at preventing drunk driving
A review and recommendations
Magdalena Cismaru and Anne M. Lavack Paul J. Hill School of Business, University of Regina, Regina, Canada, and
Evan Markewich Johnson-Shoyama Graduate School of Public Policy, University of Regina,
Regina, Canada
Abstract
Purpose – The purpose of this paper is to examine the role of social marketing programs in preventing drunk driving, and how protection motivation theory (PMT) can be used to create effective anti drunk driving communications.
Design/methodology/approach – Communication and program materials aimed at reducing drunk driving were identified and gathered from English-language websites from the USA, Canada, UK, Australia, and New Zealand, and a qualitative review was conducted.
Findings – The review provides a description of the key themes and messages being used in anti drunk driving campaigns, as well as target population, campaign components, and sources of funding. A key facet of this review is the examination of the use of PMT in social marketing campaigns designed to prevent drunk driving.
Originality/value – The review presents social marketing campaigns aimed at preventing drunk driving in English-speaking countries, and shows that PMT can be successfully used in this context. The paper provides a guide for future initiatives, as well as recommendations for social marketing practitioners.
Keywords Drink driving, Social marketing, Qualitative research
Paper type Research paper
Introduction According to the World Health Organization (WHO, 2004a), an estimated 1.2 million people worldwide are killed in road crashes each year, and as many as 50 million are injured. Many of these accidents are alcohol-related crashes. Indeed, out of 42,642 total traffic fatalities in the USA in 2006, 17,602 people died due to alcohol-related traffic injuries (41 percent). Of these, an estimated 13,470 involved a driver with an illegal blood alcohol concentration (BAC) of 0.08 or greater (Century Council, 2006; Mothers
The current issue and full text archive of this journal is available at
www.emeraldinsight.com/0265-1335.htm
This research is supported with funds from the University of Regina and Saskatchewan Health Research Foundation. The authors thank Adina Rudrick and Brad Smith for their contribution in the early stages of this research. The authors also thank the Editors and the anonymous reviewers for their valuable guidance.
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Received December 2007 Revised May 2008 Accepted February 2009
International Marketing Review Vol. 26 No. 3, 2009 pp. 292-311 q Emerald Group Publishing Limited 0265-1335 DOI 10.1108/02651330910960799
against drunk driving, MADD, 2008). Due to these staggering death tolls, governments and nonprofit organizations have become interested in using social marketing as a tool to prevent and reduce drunk driving (WHO, 2004a).
We examined the role of social marketing programs in preventing and reducing drunk driving, by collecting English-language drunk driving communication and program materials posted on the Internet. We conducted qualitative research to review these materials, in order to determine the nature of these social marketing efforts, key themes, campaign components, and targeted populations, as well as to examine how protection motivation theory (PMT), a well-established theory of health behavior (Rogers, 1983), can be used to create effective social marketing campaigns designed to prevent drunk driving.
This paper reports on the trends and key features revealed during this qualitative analysis. We begin with a review of the literature outlining issues regarding drunk driving, as well as aspects of social marketing and PMT. We then present the methodology for our study and provide a description of key findings. Social marketing implications are discussed.
Drunk driving Drunk driving is usually defined as driving with a specific amount of alcohol in the blood – known as an individual’s BAC – which can be measured through blood, urine, and breath tests that estimate the number of grams of ethanol per 100 ml of blood (Century Council, 2006; Robin, 1991). The legally allowable level for an individual’s BAC varies from 0 to 0.08 g/100 ml in various countries. For example, in Australia and Germany, a BAC of 0.05 g/100 ml is the legal limit for driving, while in the USA, Canada, and New Zealand the BAC limit is 0.08 g/100 ml (WHO, 2004a). It should be noted that the phrase “drunk driving” does not necessarily mean “drunkenness”; rather, it simply denotes that the person is over the acceptable BAC level for operating a motor vehicle (Ross, 1992).
Alcohol has a depressant effect on the brain and nerve pathways that control muscle actions (Buckner et al., 2007). With a high BAC, brain functions are slowed and it is more likely that a person’s reaction time, vision, information processing, and judgment while driving will be adversely affected (Hannigan et al., 1999). The intensity of the effects of alcohol can vary from person to person, depending upon physical and mental health, mood, and other factors. Nevertheless, as an individual consumes more alcohol, the BAC increases dramatically (Solomon et al., 2006). As well, an individual’s risk of being in a traffic accident increases as his/her BAC level increases (Kaplan and Prato, 2007). Indeed, studies show that the relative risk of crash involvement starts to increase significantly at a BAC level of 0.04 g/100 ml. At 0.10 g/100 ml the crash risk relative to a zero BAC is approximately five times as high, while at a BAC of 0.24 g/100 ml the crash risk is more than 140 times the risk relative to a zero BAC (Global Road Safety Partnership, 2007).
Significant economic costs result from drunk driving, including the direct costs of health care, property damage, motor vehicle repair, emergency attendance, and death (WHO, 2007). Other costs include increased law enforcement, social costs, imprisonment, compensation payments, unemployment, health and disability insurance, and loss of productivity in the workplace from injury or premature death.
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In 2002, the economic cost of alcohol-caused crashes in the USA totaled approximately $51 billion (Centers for Disease Control and Prevention, 2006).
Drunk driving, along with its risk factors and economic costs, is largely preventable. Preventative options include policies to reduce alcohol consumption, such as an increased tax on alcohol in order to reduce heavy drinking (Levitt and Porter, 2001), as well as linking the advertising for alcoholic beverages with pro-health and safety messages (Marshall and Oleson, 1994). Other policy options are aimed at encouraging people to think ahead and plan a safe ride home, such as the promotion of taxi companies (Transport Canada, 2005), encouraging people to avoid riding with someone who has been drinking, encouraging the use of seat belts, and increasing advertising to educate the public about drunk driving avoidance strategies (Dejong and Atkin, 1995). Some policy options focus on imposing stiffer penalties for drunk driving, including promptly suspending the driver’s license of anyone who drives while intoxicated, and using advertising to increase public knowledge of penalties imposed on drunk drivers (Sen, 2005). Enhanced law enforcement efforts can also reduce drunk driving, through increasing the number of sobriety checkpoints (Kenkel, 1993), and encouraging the public to report suspected drunk drivers to law enforcement (MedicineNet, 2004). Some policies are aimed at making it easier for authorities to prove a drunk driving offence has occurred, such as mandatory authorization for breath or blood tests from a driver in the event of a crash (de Cicco and Solomon, 2001). Still other policy efforts focus on ensuring that previous drunk driving offenders do not re-offend, such as mandatory rehabilitation programs for offenders (Transport Canada, 2005) and the introduction of alcohol ignition interlock devices (Canada Safety Council, 2006). Finally, many jurisdictions are investigating the possibility of reducing the legal BAC level in order to reduce the number of traffic accidents (Centers for Disease Control and Prevention, 2006) and, in particular, lowering the legal BAC level for minors (Dejong and Russell, 1995) or imposing zero BAC tolerance for new drivers (Maskalyk, 2003). Social marketing campaigns aimed at publicizing, implementing, and reinforcing these policy recommendations have been developed in several countries.
Social marketing and drunk driving Several studies have examined preventive measures and the policy environment, and how these relate to drinking and driving. For example, enforcement of drinking and driving laws has led to an overall reduction in drunk driving among college students (Wechsler et al., 2003). Increased promotion of safe ride programs in some areas has also reduced drunk driving (Caudill et al., 2000). As well, reductions in legal BAC levels in some jurisdictions are believed to have reduced accidents and deaths due to drunk driving (Wagenaar et al., 2001).
Most of the literature examining social marketing in the context of drunk driving deals with the effects that the media have on reducing drunk driving. For example, Elder et al. (2004) examined the effectiveness of mass media campaigns for reducing alcohol-impaired driving and alcohol-related crashes, which included a review of eight studies published between 1975 and 1998. Their analysis showed that the mass media campaigns were generally carefully planned, well executed, attained adequate audience exposure, and had the effect of significantly reducing the number of alcohol-related crushes.
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A study by Murry et al. (1993) evaluated whether a paid advertising campaign was effective at reducing young male drinking and driving, by using surveys at both the campaign site and a control site. Their analysis showed that the advertising campaign reduced drinking and driving behavior, and consequently reduced alcohol-related traffic accidents. A study evaluating the effectiveness of anti-drunk driving public service announcements (PSAs) found that ads focusing on relevant localized consequences have more meaning to undergraduate college students than the more general campaigns they usually reported seeing (Gotthoffer, 1999). In order to be effective, PSAs must take into account the frequency of binge drinking, gender, and age, which are factors that influence perceptions of drunk driving risk (Gotthoffer, 2001). Research suggests that media should not be viewed as a short-term behavioral change agent, but rather as a change agent intended to gradually restructure the public’s cognition about various issues related to drunk driving (Bang, 2000).
It should be noted that even though these studies discuss using educational materials or communication campaigns to fight drunk driving, few mention social marketing or refer to the full range of elements that would comprise an effective social marketing campaign. However, these studies demonstrate that mass media campaigns, combined with increased media attention, are effective in reducing the number of alcohol related vehicle crashes (Elder et al., 2004; Yanovitzky and Bennett, 1999).
Protection motivation theory Researchers have long attempted to understand the factors that influence the persuasiveness of health communication, using theoretical frameworks such as PMT (Prentice-Dunn and Rogers, 1986; Rogers, 1983). In our analysis of social marketing campaigns aimed at drunk driving, we employ PMT because it is a highly comprehensive theory of health communication (Boer and Seydel, 1996) that is well accepted and widely used. Anti-drunk driving social marketing campaigns seek to influence many of the cognitions that are the focus of PMT (Greening and Stoppelbein, 2000; Murgraff et al., 1999; Simons-Morton et al., 2006).
According to PMT, protection motivation is maximized when: . the threat to health is severe (high perceived severity); . the individual feels vulnerable (high perceived vulnerability); . the adaptive response is believed to be an effective means of averting the threat
(high response efficacy); . the costs associated with the adaptive response are small (low costs); and . the person is confident in his or her abilities to complete successfully the
adaptive response (high self-efficacy) (Rogers, 1983).
Such factors produce protection motivation and, subsequently, the enactment of the adaptive or coping response (Prentice-Dunn and Rogers, 1986; Rogers, 1983). Among these factors, self-efficacy is believed to have the most significant impact on one’s decision to adopt a recommended health behaviour (Milne et al., 2000; Rogers, 1983).
Threat appraisal Within the PMT model, the threat appraisal mechanism is comprised of vulnerability and severity. Using the drunk driving context, perceived vulnerability to the threat
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refers to one’s subjective perception of the risk of causing a car accident. Perceived severity of a threat refers to feelings concerning the seriousness of an accident. This dimension includes evaluation of both health consequences (e.g. death, disability, and pain) and possible social consequences (e.g. impact of the resulting health condition on work, family life, and social relations). Previous research has shown that higher levels of perceived vulnerability and perceived severity can produce greater changes in protection motivation (Floyd et al., 2000; Milne et al., 2000). Previous research has also shown that a minimum level of threat is required in order for a person to act. In other words, if a person does not feel vulnerable, there will be no intention to change a behavior. If the threat does not feel severe enough to warrant action, no response will take place (Thesenvitz, 2000).
Coping appraisal The coping appraisal mechanism is comprised of response efficacy, self-efficacy, and perceived cost. Perceived response efficacy refers to a person’s belief that the recommended behaviors will be effective in reducing or eliminating the danger. Self-efficacy refers to the person’s belief that he or she has the ability to overcome the cost involved by the adoption of the recommended behavior. Perceived cost represents the sum of all barriers to engaging in the recommended behavior, including monetary costs and non-monetary costs such as: time, effort, inconvenience, discomfort, social disapproval, etc. Research suggests that higher levels of self-efficacy and response efficacy and lower levels of perceived cost can produce significantly greater changes in protection motivation and persuasion (Floyd et al., 2000; Milne et al., 2000). According to theory (Rogers and Prentice-Dunn, 1997) as well as empirical data (Milne et al., 2000), the coping variables (response efficacy, self-efficacy, and costs) have a higher impact on persuasion measures in comparison to the threat variables (vulnerability and severity).
PMT (Rogers, 1983) has been widely used to help create social marketing campaigns (Eppright et al., 2002; Lawrence, 1995). Indeed, a review of the research using PMT (Rogers and Prentice-Dunn, 1997) shows that numerous studies have tested either the threat appraisal and/or the coping appraisal in a wide variety of health contexts with public policy implications such as change in lifestyle (e.g. smoking, regular exercise, stress reduction), change in sexual behavior (e.g. AIDS-preventive actions), or change in healthcare practices (e.g. inoculation against a virus, breast self-examination, mammography), among others. Correlation studies, as well as studies using experimental manipulations of PMT variables (particularly response efficacy and self-efficacy), often produce main effects on intentions (Eagly and Chaiken, 1993). Indeed, two meta-analytic reviews of 65 and 27 studies, respectively, representing over 20 health areas which included approximately 37,700 participants (Floyd et al., 2000; Milne et al., 2000) demonstrated that, in general, increases in severity, vulnerability, response efficacy, and self-efficacy facilitated adaptive intentions and behaviors. In addition, several recent reviews of social marketing campaigns in the area of preventing and controlling obesity, limiting smoking, as well as underage drinking (Cismaru and Lavack, 2007a, b and Cismaru et al., 2008) show PMT as a theoretical framework which can be successfully used to create persuasive social marketing campaigns.
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Consider the following example of a social marketing campaign aiming to eliminate drunk driving, which illustrates use of PMT principles. The “Tie One on for Safety” public awareness project, running for more than 20 years, asks Americans to tie a silver ribbon to their vehicles as a symbol of the driver’s pledge to drive safe, sober, and buckled up (www.madd.org/Drunk-Driving/Drunk-Driving/Programs/View- Program.aspx?program¼10). The campaign’s fact sheet shows statistics describing how many people are involved in drunk driving crashes and how many are injured or die as a result (i.e. “Each year, nationally, more than 1,000 people typically die between Thanksgiving through New Year’s in drunk driving crashes”). This information is meant to increase perceived vulnerability and severity for the reader. The fact sheet posted on the web site provides specific recommendations about how to host a party responsibly, and what it means to designate a non-drinking driver before partying begins (i.e. “Being the designated driver doesn’t mean the ‘least drunk’ person drives home. It means that, before celebrations begin, an adult is designated to provide safe and sober transportation home and only drinks non-alcoholic beverages”). These recommendations can be considered to increase response efficacy, since the designated driver provides “safe transportation home,” but also may involve some costs for taxi fare or non-monetary costs such as inconvenience for the person who needs to abstain from drinking alcoholic beverages at the particular party in the particular example provided. Other recommendations found on the same web site suggest that solving the problem is easy, thereby increasing self-efficacy (i.e. “It’s easy to help reduce drunk driving through Tie One On For Safety. Click here to locate your local MADD office – then make a call to find out how you can help”). Specific numbers showing how effective this campaign is in terms of reducing accidents or deaths due to drunk driving indicate high response-efficacy (i.e. “Since 1980 – the year Mothers Against Drunk Driving was founded – alcohol-related traffic fatalities have decreased by about 44 percent, from over 30,000 to under 17,000 and MADD has helped save over 300,000 lives”). This example demonstrates how PMT principles can guide the creation of social marketing communication materials aimed at reducing drunk driving.
In the following section, we outline the methodology for our review of social marketing programs and campaigns relating to drinking and driving, as well as our examination of the use of PMT in this particular social context. This study addresses a gap in the literature by providing a qualitative analysis of English-language social marketing campaigns, discussing major themes, campaign components, and target population, as well as assessing the appropriateness of the usage of the PMT (Rogers, 1983) in a drunk driving prevention context.
Research design and methodology This research involved conducting a qualitative analysis of English-language anti-drunk driving communication materials posted on the Internet. We searched for keywords including “anti-drinking campaigns,” “drinking and driving,” “drunk driving,” “drink driving,” “driving under the influence,” “alcohol and driving,” “protection motivation theory and drunk driving,” and “social marketing and drunk driving.” We also searched health-related government websites such as the US Department of Health and Human Services, National Institutes of Health, Health Canada, and similar websites from five English-speaking countries (USA, Canada, UK, Australia, and New Zealand). References to campaigns and programs discussed in
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academic papers located through Medline, ABI-Inform, PsychInfo, and other databases were also used as a means of finding additional campaigns.
Once identified, each individual campaign’s information was evaluated in terms of its content to assess its salient components as well as the presence of the variables considered by PMT to be important predictors of behavioural change. For example, regarding vulnerability, we looked for statistics meant to make the reader aware of the fact that the risks of someone causing a car accident significantly increases if one drives under the influence. Links such as “statistics,” “incidence,” or “the issue” were accessed to locate this information. Regarding severity, we searched for information showing the severe consequences of drunk drinking. Keywords such as “death,” “fatalities,” and “victims” were particularly relevant. Regarding self-efficacy and costs, phrases such as “it is easy,” “here are some steps,” and “tips” were searched, whereas response-efficacy information was generally found when there was a formal evaluation. However, there were few campaigns that neatly showed all of the information about all of the PMT variables on a single page; rather, the information was often spread over several pages and/or links. For this reason, we considered it appropriate to conduct a qualitative analysis of the materials, by reading them in their totality and looking for keywords that helped us assess the presence of variables considered by PMT to be important predictors of behavioural change. As part of this process, we created Table I, which lists the salient components of each campaign, including campaign title and year, campaign description and web address, initiator of the campaign, campaign components, and our assessment of the campaign’s adherence to the tenets of PMT.
Qualitative research findings Our search revealed over 25 anti-drunk driving programs or campaigns (Table I). Some of these were developed by nonprofit organizations such as MADD and Students against Drinking and Driving (SADD), or nonprofit organizations such as the Canadian Public Health Association. In some countries, federal or state/provincial governmental organizations took the lead (e.g. Texas Department of Transportation). Still other campaigns were developed by organizations or companies involved in the alcohol industry, such as the Brewers Association of Canada, or Molson Breweries. Although most of the campaigns are intended to either create awareness about the risks associated with drunk driving (e.g. Smashed), provide guidelines regarding sensible drinking (e.g. Drinking & You), or provide alternatives to drunk driving (e.g. Miles With a Mission), some go beyond this and encourage the public and businesses to call police if they see an impaired driver (e.g. Operation Lookout).
Campaigns included a wide variety of different components, including websites and print materials such as posters and brochures, as well as radio and TV PSAs that included celebrity spokespersons or interviews with victims and survivors. In addition, some campaigns incorporated community and mass-media events, partnerships with retail stores, awards, newsletters, scholarships, insurance folders, litterbags, t-shirts, car wash kits, magnets, buttons, etc. Campaigns took place at the international, national, provincial/state, or community level. Some of the campaigns include involvement with liquor stores, restaurants, bars, and other public places where drinking and driving behavioural change could take place.
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U S
A ,
b ec
a m
e in
te rn
a ti
o n
a l)
C el
eb ri
ty sp
o k
es p
er so
n a t
n a ti
o n
a l
ev en
ts a n
d fe
a tu
re d
in p
ri n
t, ra
d io
, a n
d T
V P
S A
s, w
eb si
te
In cl
u d
es in
fo rm
a ti
o n
a b
o u
t a ll
P M
T v
a ri
a b
le s
(c o n ti n u ed
)
Table I. Campaigns and programs
against drinking and driving found on the
internet grouped by the Country
Preventing drunk driving
299
C a m
p a ig
n /y
ea r
C a m
p a ig
n d
es cr
ip ti
o n
a n
d w
eb a d
d re
ss In
it ia
to r
C a m
p a ig
n co
m p
o n
en ts
A d
h er
en ce
to P
M T
C a n a d a
1 -8
8 8
T A
X IG
U Y
E n
co u
ra g
es p
eo p
le to
p la
n b
ef o re
th ey
p a rt
y a n
d ta
k e
a ca
b h
o m
e b
y ca
ll in
g th
e to
ll -f
re e
n u
m b
er w
w w
.m to
.g o v
.o n
.c a /e
n g
li sh
/s a fe
ty /i
m p
a ir
ed /p
ro g
ra m
s. h
tm
T A
X IG
U Y
In c.
a n
d M
o ls
o n
, C
a n
a d
a 1 -8
8 8
T A
X IG
U Y
li n
k s
ca ll
er s
d ir
ec tl
y to
a p
a rt
n er
ta x
ic a b
co m
p a n
y in
th ei
r ci
ty
R ed
u ce
s co
st a n
d in
cr ea
se s
se lf
-e ffi
ca cy
A rr
iv e
A li
v e
D ri
v e
S o b
er T
o el
im in
a te
im p
a ir
ed d
ri v
in g
in O
n ta
ri o ;e
n a b
le s
p eo
p le
a n
d co
m m
u n
it ie
s to
sh a re
re so
u rc
es a n
d in
fo rm
a ti
o n
th a t
w il
l p
re v
en t
in ju
ri es
a n
d sa
v e
li v
es w
w w
.a rr
iv ea
li v
e. o rg
O n
ta ri
o C
o m
m u
n it
y C
o u
n ci
l o n
Im p
a ir
ed D
ri v
in g
(O C
C ID
)
E v
en t,
P S
A s,
p ri
n te
d m
a te
ri a ls
, in
su ra
n ce
fo ld
er s,
p o st
er s,
li tt
er b
a g
s, re
ci p
e ca
rd s,
t- sh
ir ts
, ca
r w
a sh
k it
s, w
eb si
te
P ro
v id
es sp
ec ifi
c a lt
er n
a ti
v es
to d
ru n
k d
ri v
in g
. S
ee m
s to
fo cu
s o n
re sp
o n
se a n
d se
lf -e
ffi ca
cy in
th e
ca m
p a ig
n ,
b u
t p
ro v
id es
in fo
rm a ti
o n
re g
a rd
in g
se v
er it
y a n
d v
u ln
er a b
il it
y o n
th e
w eb
si te
B re
w er
s A
ss o ci
a ti
o n
o f
C a n
a d
a a n
ti d
ri n
k in
g a n
d d
ri v
in g
ca m
p a ig
n s
A sk
s p
eo p
le to
a b
st a in
fr o m
d ri
n k
in g
a n
d d
ri v
in g
w w
w .b
re w
er s.
ca /d
ef a u
lt _
e. a sp
?i d ¼
1 0
B re
w er
s A
ss o ci
a ti
o n
o f
C a n
a d
a R
a d
io ,
T v
, a n
d o u
td o o r
ca m
p a ig
n s,
p ri
n t,
p o st
er s,
b ro
ch u
re s,
p o in
t- o f-
sa le
m es
sa g
es ,
m a g
n et
s a n
d b
u tt
o n
s, w
eb si
te
D o es
n o t
se em
to a d
h er
e w
it h
P M
T p
ri n
ci p
le s
D ri
n k
in g
, D
ri v
in g
, M
a k
in g
th e
R ig
h t
C h
o ic
e
A tr
a in
in g
p ro
g ra
m fo
r st
u d
en t
d ri
v er
s. A
v a il
a b
le in
d ri
v in
g sc
h o o ls
a cr
o ss
Q u
eb ec
w w
w .e
d u
ca lc
o o l. q
c. ca
/e n
/p ro
g ra
m s/
d ri
n k
in g
-d ri
v in
g -
m a k
in g
-t h
e- ri
g h
t- ch
o ic
e/ in
d ex
.h tm
l
É d
u c’
a lc
o o l
G u
id es
, o th
er p
u b
li ca
ti o n
s, w
eb si
te P
ro v
id es
so m
e in
fo rm
a ti
o n
a b
o u
t P
M T
v a ri
a b
le s
D ri
n k
in g
F a ct
s P
ro v
id es
in fo
rm a ti
o n
a b
o u
t a lc
o h
o l
d ri
n k
in g
, in
cl u
d in
g im
p a ir
ed d
ri v
in g
w w
w .d
ri n
k in
g fa
ct s.
ca /e
n g
li sh
/i n
d ex
.a sp
C a n
a d
ia n
P u
b li
c H
ea lt
h A
ss o ci
a ti
o n
V id
eo m
a te
ri a ls
, p
o st
er s,
fa ct
sh ee
ts ,
q u
iz ze
s, d
is cu
ss io
n g
u id
es ,
w eb
si te
D o es
n o t
se em
to a d
h er
e w
it h
P M
T p
ri n
ci p
le s
(c o n ti n u ed
)
Table I.
IMR 26,3
300
C a m
p a ig
n /y
ea r
C a m
p a ig
n d
es cr
ip ti
o n
a n
d w
eb a d
d re
ss In
it ia
to r
C a m
p a ig
n co
m p
o n
en ts
A d
h er
en ce
to P
M T
iD R
IV E
T o
ra is
e a w
a re
n es
s a m
o n
g d
ri v
er s
u n
d er
th e
a g
e o f
2 5
a b
o u
t th
e ri
sk s
a n
d co
n se
q u
en ce
s o f
a g
g re
ss iv
e a n
d u
n sa
fe d
ri v
in g
p ra
ct ic
es in
cl u
d in
g im
p a ir
m en
t b
y a lc
o h
o l
a n
d d
ru g
s w
w w
.m to
.g o v
.o n
.c a /e
n g
li sh
/s a fe
ty /i
m p
a ir
ed /p
ro g
ra m
s. h
tm
M in
is tr
y o f
T ra
n sp
o rt
a ti
o n
in p
a rt
n er
sh ip
w it
h th
e O
n ta
ri o
C o m
m u
n it
y C
o u
n ci
l o n
Im p
a ir
ed D
ri v
in g
(O C
C ID
), O
n ta
ri o
S tu
d en
ts A
g a in
st Im
p a ir
ed D
ri v
in g
(O S
A ID
), a n
d T
h e
S tu
d en
t L
if e
E d
u ca
ti o n
C o m
p a n
y
V id
eo p
re se
n ta
ti o n
a n
d p
re se
n te
r’ s
g u
id e
d el
iv er
ed fr
ee o f
ch a rg
e to
co m
m u
n it
y p
o li
ce ,
p u
b li
c h
ea lt
h w
o rk
er s,
d ri
v in
g sc
h o o ls
, a n
d ro
a d
sa fe
ty a d
v o ca
te s
D o es
n o t
se em
to a d
h er
e w
it h
P M
T p
ri n
ci p
le s
K ee
p Y
o u
r D
re a m
s A
li v
e –
D o n
’t D
ri n
k a n
d D
ri v
e
T o
ed u
ca te
p eo
p le
a b
o u
t th
e d
a n
g er
s o f
d ri
n k
in g
a n
d d
ri v
in g
a n
d sa
v e
li v
es w
w w
.m a st
.m b
.c a /T
A D
D /a
b o u
t. h
tm
T ee
n s
A g
a in
st D
ri n
k in
g a n
d D
ri v
in g
S ch
o o l
p re
se n
ta ti
o n
s, p
o st
er s,
p ri
ze s,
ju d
g in
g ,
w re
ck ed
ca r,
fa ta
l v
is io
n g
la ss
es ,
v is
it s
to th
e h
o sp
it a l,
b a n
n er
s, m
a ll
d is
p la
y s,
ev en
ts ,
w eb
si te
G o es
b ey
o n
d p
ro v
id in
g in
fo rm
a ti
o n
in a
w ri
tt en
fo rm
. In
cr ea
se s
th e
p er
ce p
ti o n
o f
a ll
P M
T th
ro u
g h
v er
y v
iv id
m et
h o d
s, su
ch a s
v is
it s
to th
e h
o sp
it a l
M il
es W
it h
a M
is si
o n
R ed
u ce
s th
e o p
p o rt
u n
it y
fo r
p er
so n
a l
in ju
ry o r
fa ta
li ty
b y
p ro
v id
in g
C a n
a d
ia n
s w
it h
p re
-p a id
ta x
i fa
re th
a t
ca n
b e
p u
rc h
a se
d o r
ea rn
ed w
w w
.t a x
im il
es .c
o m
/
T a x
i M
il es
T a x
i m
o n
ey th
a t
ca n
b e
p u
rc h
a se
d o r
ea rn
ed ,
w eb
si te
D ea
ls w
it h
ef fi
ca cy
a n
d co
st s
O p
er a ti
o n
lo o k
o u
t E
n co
u ra
g es
th e
p u
b li
c a n
d b
u si
n es
se s
to ca
ll p
o li
ce if
th ey
se e
a n
im p
a ir
ed d
ri v
er w
w w
.n o rm
ie .c
a /A
C T
IO N
3 .h
tm
A ct
io n
S u
d b
u ry
A g
a in
st D
ru n
k D
ri v
in g
In fo
rm a ti
o n
p o st
er s,
w eb
si te
D ea
ls w
it h
re sp
o n
se ef
fi ca
cy a n
d se
lf -e
ffi ca
cy ,
b u
t a ls
o p
ro v
id es
in fo
rm a ti
o n
a b
o u
t se
v er
it y
a n
d v
u ln
er a b
il it
y R
ep o rt
A ll
Im p
a ir
ed D
ri v
er s
(R A
ID )
P ro
v id
es th
e p
u b
li c
w it
h in
st ru
ct io
n s
a n
d p
o li
ce p
h o n
e n
u m
b er
s to
re p
o rt
im p
a ir
ed d
ri v
er s
w w
w .o
a d
d .c
a /r
a id
_ o ri
ll ia
.h tm
D o u
g la
s G
. A
b er
n et
h y
, O
ri ll
ia A
g a in
st D
ru n
k D
ri v
in g
P re
ss re
le a se
s, ra
d io
P S
A s,
w eb
si te
D ea
ls w
it h
re sp
o n
se ef
fi ca
cy a n
d se
lf -e
ffi ca
cy ,
b u
t a ls
o p
ro v
id es
in fo
rm a ti
o n
a b
o u
t se
v er
it y
a n
d v
u ln
er a b
il it
y
(c o n ti n u ed
)
Table I.
Preventing drunk driving
301
C a m
p a ig
n /y
ea r
C a m
p a ig
n d
es cr
ip ti
o n
a n
d w
eb a d
d re
ss In
it ia
to r
C a m
p a ig
n co
m p
o n
en ts
A d
h er
en ce
to P
M T
H o o k
ed o n
R o a d
S a fe
ty R
a is
es a w
a re
n es
s a b
o u
t th
e so
ci et
a l
im p
a ct
o f
ro a d
tr a ffi
c in
ju ri
es ,
h ig
h li
g h
ti n
g th
e ri
sk s
fo r
y o u
n g
ro a d
u se
rs . P
ro m
o te
s a ct
io n
a ro
u n
d k
ey fa
ct o rs
w h
ic h
h a v
e a
m a jo
r im
p a ct
o n
p re
v en
ti n
g ro
a d
tr a ffi
c in
ju ri
es :
h el
m et
s, se
a t
b el
ts ,
d ri
n k
d ri
v in
g ,
sp ee
d in
g ,
a n
d in
fr a st
ru ct
u re
w w
w .t
c. g
c. ca
/h o o k
ed o n
ro a d
sa fe
ty /m
en u
.h tm
T ra
n sp
o rt
C a n
a d
a R
o a d
S a fe
ty M
a g
a zi
n e,
G lo
b a l
R o a d
S a fe
ty W
ee k
, co
n fe
re n
ce s,
w eb
si te
F o cu
se s
o n
se v
er it
y a n
d v
u ln
er a b
il it
y
T a k
e C
a re
O u
t T
h er
e W
o rk
H a rd
-P la
y H
a rd
A tt
em p
ts to
re d
u ce
d ri
n k
in g
a n
d d
ri v
in g
w w
w .s
g i. sk
.c a /s
g i_
p u
b /r
o a d
_ sa
fe ty
/d ri
n k
in g
_ a
n d
_ d
ri v
in g
/d ri
n k
in g
_ a n
d _
d ri
v in
g .h
tm w
w w
.s g
i. sk
.c a /s
g i_
p u
b /r
o a d
_ sa
fe ty
/d ri
n k
in g
_ a n
d _
d ri
v in
g /p
a rt
n er
s. h
tm
S G
I C
a n
a d
a T
V a n
d ra
d io
ca m
p a ig
n ,
w eb
si te
P ro
v id
es in
fo rm
a ti
o n
a b
o u
t se
v er
it y
, v
u ln
er a b
il it
y ,
a n
d a d
v ic
e o n
a b
st a in
in g
fr o m
d ri
n k
in g
a n
d d
ri v
in g
(c o st
s) U K
D ri
n k
in g
& Y
o u
(s in
ce 1 9 9 1 )
C o n
su m
er si
te a b
o u
t g
o v
er n
m en
t g
u id
el in
es fo
r se
n si
b le
d ri
n k
in g
a n
d o n
e’ s
h ea
lt h
. In
cl u
d es
a d
ri n
k in
g a n
d d
ri v
in g
se ct
io n
w w
w .d
ri n
k in
g a n
d y
o u
.c o m
/# ;
w w
w .a
im -d
ig es
t. co
m
A lc
o h
o l
in M
o d
er a ti
o n
(f o u
n d
ed in
U .K
, b
ec a m
e in
te rn
a ti
o n
a l)
W eb
si te
P ro
v id
es in
fo rm
a ti
o n
a b
o u
t m
o st
o f
th e
P M
T v
a ri
a b
le s
T H
IN K
! C
h ri
st m
a s
D ri
n k
D ri
v e
ca m
p a ig
n A
im s
to co
n v
in ce
a ll
d ri
v er
s, w
it h
a p
a rt
ic u
la r
fo cu
s o n
y o u
n g
m a le
d ri
v er
s a g
ed 1 7 -2
9 y
ea rs
, th
a t
a d
ri n
k d
ri v
e co
n v
ic ti
o n
h a s
th e
p o te
n ti
a l
to ru
in th
ei r
li fe
b y
h ig
h li
g h
ti n
g a
m ix
tu re
o f
th e
le g
a l
a n
d p
er so
n a l
co n
se q
u en
ce s
w w
w .t
h in
k ro
a d
sa fe
ty .g
o v
.u k
./ ;
w w
w .t
h in
k ro
a d
sa fe
ty .
g o v
.u k
./ ca
m p
a ig
n s/
d ri
n k
d ri
v e/
d ri
n k
d ri
v e.
h tm
U K
D ep
a rt
m en
t fo
r T
ra n
sp o rt
P S
A s,
p o st
er s
a n
d le
a fl
et s,
w eb
si te
F o cu
se s
o n
se v
er it
y
A u st ra li a
B ra
in C
a m
p a ig
n E
x p
la in
s ro
a d
sa fe
ty is
su es
w w
w .r
ta .n
sw .g
o v
.a u
/r o a d
sa fe
ty /a
lc o h
o ld
ru g
s/ ca
m p
a ig
n s/
in d
ex .h
tm l
R o a d
s a n
d T
ra ffi
c A
u th
o ri
ty (N
S W
) T
V a d
s, w
eb si
te F
o cu
se s
o n
se v
er it
y a n
d v
u ln
er a b
il it
y
(c o n ti n u ed
)
Table I.
IMR 26,3
302
C a m
p a ig
n /y
ea r
C a m
p a ig
n d
es cr
ip ti
o n
a n
d w
eb a d
d re
ss In
it ia
to r
C a m
p a ig
n co
m p
o n
en ts
A d
h er
en ce
to P
M T
D ri
n k
D ri
v e
In it
ia ti
v es
C a m
p a ig
n P
ro v
id e
th e
p u
b li
c w
it h
fa ct
u a l a n
d a cc
u ra
te in
fo rm
a ti
o n
a b
o u
t ch
a n
g es
to th
e la
w a n
d n
ew p
en a lt
ie s;
co m
m u
n ic
a te
th e
b en
efi ts
o f
n ew
in it
ia ti
v es
a n
d en
co u
ra g
e p
o si
ti v
e co
o p
er a ti
o n
; h
ig h
li g
h t
th e
ri sk
o f
d et
ec ti
o n
a n
d re
su lt
in g
p en
a lt
ie s
fo r
th o se
d et
ec te
d w
w w
.t ra
n sp
o rt
.s a .g
o v
.a u
/r ss
/c o n
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In examining whether the campaigns adhered to PMT, it was apparent that most of the campaigns focus on threat variables, (i.e. severity and vulnerability) by emphasizing the potentially severe consequences associated with drunk driving (e.g. Save a Life). Some campaigns provide information about all PMT variables (e.g. Designate a Driver). Others do not appear to adhere to PMT principles at all (e.g. Positive Choices), usually because of their very narrow scope (i.e. to make teens aware of the alternatives they have to getting in a car with someone who has been drinking alcohol). Only a few campaigns (e.g. 1-888 TAXIGUY) seem to stress self-efficacy, which has been found to be the most important predictor of behaviour change (Milne et al., 2000). In the following sections, we present the initiatives grouped by their country of origin.
Campaigns originating in the USA Perhaps, the largest international organization aimed at reducing or eliminating drinking and driving through massive social marketing efforts is Mothers against Drinking and Driving (MADD), which was originally founded in the USA. MADD has several partners and sponsors, but the most notable are from the automobile and insurance sectors. In Table I we can see that MADD provides three notable international campaigns that adhere to PMT: Designate a Driver, Tie One On For Safety, and Take the Wheel. The Take the Wheel campaign focuses on threat appraisal, in an attempt to create motivation to eliminate drinking and driving. It uses statistics showing the number of people directly involved in a drunk driving accident as well as the number of people that might experience property damage, suffer an injury, attend a funeral, or be killed due to a drunk driver. The Tie One On For Safety campaign focuses on heightening the public’s attention on drinking and driving by asking Americans to tie a silver MADD ribbon to their vehicles as a pledge to drive safe, sober, and buckled up during the holiday season and throughout the year. The Designate a Driver campaign positions itself as a program that is relatively easy to administer with little or no cost, through reinforcing the widely known perceived threat inherent in drinking and driving, while showing that all one has to do to be safe is plan ahead and designate a driver.
Similar to MADD’s Designate a Driver Program, SADD utilizes high response efficacy by demonstrating positive and attractive alternatives to drinking and driving. However, SADD also focuses on both high perceived severity and vulnerability by emphasizing the effects that alcohol can have on young people, including how alcohol alters vision, reaction times, perception of distance, and overall abilities.
The USA also provides examples of campaigns that are initiated by government, non-government organizations (NGOs), and private industry. For example, the Texas Department of Transportation offers the Save a Life campaign, which focuses on showing the public the severity of alcohol-related accidents through various statistics, and increasing perceived vulnerability through visual imagery of the aftermath of car accidents. The Artists Against Drunk Driving (AADD) initiative provides severity and vulnerability information, but also emphasizes the social costs of drinking and driving.
American private industry, on the other hand, does not seem to produce campaigns that adhere to PMT principles. The Positive Choices campaign from the Family Advisor Aurora Casket Company, Inc. is directed at educating parents and school
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administrators to teach children about the dangers and consequences of underage drinking. The Anheuser-Busch Know When to Say When campaign focuses on community-based alcohol awareness and education programs, such as server training programs, designated driver programs, and safe driving programs, rather than focusing on the threat aspects from the PMT model. Previous research has found that drinking and driving ads from corporate sponsors such as breweries and distillers are less likely to mention threats or negative consequences, and are also less likely to use fear arousal, compared to drinking and driving ads sponsored by governments and nonprofit organizations (Lavack, 1999).
Campaigns originating in Canada Of the five countries, Canada appears to provide the largest number of social marketing campaigns against drunk driving, which are initiated by various levels of government, NGOs, and private industry. This may be the reason why Canada’s drunk driving death toll is only 261 per 100,000 population, compared to the US death toll of 454 per 100,000 population (WHO, 2004b). Some Canadian campaigns, such as “Work Hard-Play Hard” from SGI Canada emphasize adaptive responses to drinking and driving (i.e. getting home safely by designating a sober driver). The Hooked On Road Safety campaign provides a risk assessment of drinking and driving in terms of injuries, accidents, death tolls, and economic costs, while describing how drivers can be effective in reducing the associated danger. The iDrive and Drinking Facts campaigns are intended to raise awareness about the consequences of drinking and driving, thereby heightening perceived severity and vulnerability.
Some campaigns initiated by NGOs, such as Drinking and Driving, Making the Right Choice, provide information about problems associated with alcohol consumption and strategies to help individuals who drink to stay healthy. Other programs, such as Operation Lookout, Report All Impaired Drivers (RAID), and Arrive Alive Drive Sober, recommend behaviors to reduce or eliminate the danger from drinking and driving, and promote self-efficacy by offering cost efficient solutions to drinking and driving while emphasizing the consequences of drinking and driving. The Keep Your Dreams Alive – Don’t Drink and Drive campaign highlights all PMT variables by exploiting visual expression, real life accounts, and statistics in order to reduce the occurrence and consequences of drinking and driving.
Canadian private industry also initiates awareness campaigns, such as 1-888 TAXIGUY, which focuses on increasing self-efficacy by increasing public knowledge about safe low cost alternatives to drinking and driving. Similar to the US Anheuser-Busch Know When to Say When campaign, the Brewers Association of Canada’s anti-drinking and driving campaign does not seem to adhere to PMT principles, but rather attempts to appeal to the public conscience by simply asking people to drink responsibly.
Campaigns originating in UK In UK, the Drinking & You campaign focuses on the severity and perceived threats associated with alcohol consumption, including the severe legal consequences of drunk driving, and advises having a designated driver or arranging to go home by public transportation or taxi. The THINK Christmas Drink Drive Campaign
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highlights a mixture of the legal and personal consequences in order to convince all drivers, with a particular focus on young male drivers aged 17-29 years, that a drunk driving conviction has the potential to ruin their life (high severity). It also aims to instill the belief that even one or two drinks before driving are too many, in order to reinforce and build the social stigma around drunk driving. The THINK! Drink Drive Campaign was developed after four phases of extensive independent qualitative and quantitative research with the target audience. The findings of this research showed that the personal consequences of a drunk driving conviction are highly motivating for young men. Although the personal consequences of a drunk driving conviction may seem lower key and lack impact compared to an alcohol-related crash, young men believe that using PSAs to portraying a drunk driving conviction is more realistic than a crash scene, as well as more thought provoking and more personally relevant. The campaign used a variety of communication activities to persuade all drivers to avoid drunk driving, including TV, radio, online ads, and advertising in pubs. Overall, UK approach seems to focus specifically on the PMT variables of severity and vulnerability.
Campaigns originating in Australia The Australian government sponsors the Brain Campaign to combat drinking and driving, focusing on the PMT variables of severity and vulnerability by explaining how alcohol affects a person’s brain functions, judgment, and ability to drive. The We Are Fighting to Save Lives campaign is similar to the Brain Campaign, with its strong focus on the human costs of drinking and driving as well as the effects that alcohol has on one’s ability to operate a motor vehicle. In contrast, the Drink Drive Initiatives Campaign as well as the Only a Little Bit Over Campaign focus on the severe impact of drunk driving in terms of legal consequences. Both campaigns have a major television and radio focus, as well as outdoor advertising and websites, and provide the public with information regarding changes to the law, new penalties, and a key message that those who choose to drink and drive will be caught. Some of the Australian PSAs such as “Only a Little Bit Over? You Bloody Idiot” use the slogan “If You Drink Then Drive You’re a Bloody Idiot,” which is also featured in campaigns running in New Zealand. Overall, the Australian approach to anti-drunk driving campaigns focuses on severity and vulnerability.
Campaigns originating in New Zealand The New Zealand campaign, If You Drink then Drive You’re a Bloody Idiot, is also highly focused on showing the public the perceived vulnerability and severity associated with drinking and driving, but offers only a few specific recommendations that deal with BAC zero tolerance options. The campaign features numerous PSAs, stressing death as “the ultimate price of drink driving” as well as focusing on severe legal penalties such as imprisonment, loss of license, and fines. Like the Australian approach, New Zealand’s campaigns focus primarily on severity and vulnerability.
Discussion and conclusion This review presents social marketing campaigns aimed at preventing drunk driving in English-speaking countries, and shows how PMT has been successfully used in
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this context. The paper provides recommendations for social marketing practitioners, as well as a guide for future initiatives.
The campaigns described are designed to motivate the public to undertake a variety of behaviors, including drinking in moderation or abstaining from alcohol use, choosing a designated driver, or choosing a safe ride home such as a taxi or public transit. They include a variety of components such as PSAs on TV or radio, posters, billboards, t-shirts, etc. as well as scholarships, community meetings, and educational materials to use in schools.
Theory suggests that PMT can be an appropriate framework to use for developing social marketing campaigns aimed at combating drunk driving. Our review shows that many drunk driving campaigns highlight the PMT variables believed to trigger behavioral change (i.e. perceived vulnerability, severity, response, and self-efficacy). A focus of many campaigns is on the threat variables (i.e. severity and vulnerability), particularly in UK, Australia, and New Zealand.
Although the threat variables are important, social marketing communicators should also provide specific advice about how to avoid drunk driving, advice which ideally should involve low costs and which people should feel confidently able to follow. Since perceived self-efficacy is the most important determinant of behavior change, making people feel that they can actually follow the recommendations should constitute one of the main objectives of any anti-drunk driving campaign. Although Canada has many campaigns focusing on the coping variables and the USA and UK have at least one, Australia and New Zealand do not. Therefore, future campaigns should include information about self-efficacy and response efficacy to increase the likelihood that these messages will be effective.
It should be noted that no evaluation data regarding the effectiveness of any of the campaigns presented in this review was found. Although overall trends regarding the number of US fatalities caused by drunk driving between 1990 and 2006 are available (National Highway Traffic Safety Administration, 2008), the assessment of the effectiveness of each individual campaign was not estimated. This is due to the fact that many campaigns run simultaneously, components of the same campaign can be released at different points in time, and there are other factors (such as the number of cars on the streets or miles driven in any given year) which can significantly influence the number of fatalities. Therefore, our discussion of the campaigns is based on their likelihood of success, given our knowledge of PMT. Further research could involve specific evaluations to assess the effectiveness of campaigns that adhere to the PMT to varying degrees.
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About the authors Magdalena Cismaru is an Associate Professor of Marketing in the Paul J. Hill School of Business at the University of Regina. Her research focusing on social marketing and health decision-making has been published in Journal of Health Psychology, Marketing Theory, Social Marketing Quarterly, International Journal of Public Health, Young Consumers, International Review on Public and Nonprofit Marketing, and elsewhere. Magdalena Cismaru is the corresponding author and can be contacted at: [email protected]
Anne M. Lavack is Dean and Professor of Marketing in the Paul J. Hill School of Business at the University of Regina. Her research focusing on social marketing has been published in Social
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Marketing Quarterly, Canadian Journal of Public Health, International Journal of Nonprofit and Voluntary Sector Marketing, Journal of Consumer Marketing, Addiction Research and Theory, and elsewhere.
Evan Markewich has a Master of Public Administration degree with a specialization in Public Policy from the Johnson-Shoyama Graduate School of Public Policy at the University of Regina. Evan focused much of his graduate research on environmental policy, pension reform and public finance. Currently, he is working as a Policy Analyst for the Saskatchewan Workers’ Compensation Board.
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