Wednesday, May 5, 2010

Improper Use of Theory Leads to an Ineffective “If You’re High, You Can’t Drive” Campaign – Julianne Burns

Marijuana, also known as cannabis or weed, is the most commonly abused illicit drug in the United States (1). According to the National Survey on Drug Use and Health from 2008, 15.2 million people aged 12 or older reported using marijuana within the past month. In that same year, 10 million people aged 12 or older reported driving under the influence of illicit drugs (2). Another report, the 2007 State of Maryland Adolescent Survey, showed that 11.1 percent of the state’s adolescent drivers reported driving while under the influence of marijuana on three or more occasions (3).

When marijuana is smoked, it causes a high that has many short-term effects, including memory and learning problems, distorted perception, difficulty thinking or problem solving, loss of coordination, and other effects (4). Studies have shown that being under the influence of marijuana increases one’s risk of getting into a car accident by reducing reaction time, affecting the ability to think, and decreasing ability to stay in one’s lane. These effects can last up to six hours after smoking occurs (4-5). With the commonness of marijuana use among the youth of today, and the dangers of driving while high, this poses a major public health concern.

Among marijuana users, it is thought that driving under the influence of marijuana has little, if any, affect on one’s risk of getting into a car accident (6-9). This incorrect understanding, along with select studies that argue that marijuana produces a small degree of driving impairment (10), it is difficult to deter adolescents from performing this activity. On top of that, testing the amount of marijuana in a person’s system is not an easy task. Therefore, it makes it difficult for law enforcement officials to properly and effectively prosecute drivers who have smoked marijuana during routine, road-side pullovers. With the complexity of testing marijuana levels, the enforcement of driving under the influence of drug laws is ineffective at best (4). With the current debate over the legalization of marijuana, and new legislations being passed that are more lenient with marijuana possession charges, there needs to be public health interventions to reduce the commonness of driving while high.

In order to fight driving while under the influence of marijuana, Mothers Against Drunk Driving (MADD) Canada created the “If you’re high, you can’t drive” campaign in 2005. The goal of this campaign was to raise awareness of the dangers of driving while high. MADD Canada released commercials aimed at young adults that attempted to show that smoking marijuana and driving is not acceptable (11). These commercials were ineffective in delivering that message for several reasons, three of which will be discussed here. I will use three of MADD Canada’s commercials to defend my arguments.

Critique 1 = Theory of Reasoned Action Misused, part 1

In the three commercials that will be discussed here, an inanimate object – specifically an alien on a t-shirt, a pirate on a rolling papers package, and a wooden mask hanging on a wall – attempt to convince the teenagers in the commercial that driving while high is a bad idea (12-14). In one of these commercials, an alien that is printed on one of the youth’s t-shirts speaks in a foreign alien-sounding language. Luckily, the commercial provides English subtitles for translation, and the viewer can see that the alien says: “I don’t know about this, guys. Why don’t we just stay here? That party sounds pretty lame. And let’s be honest, driving isn’t exactly a good idea right now. Not a good idea at all!” (12).

All three of these commercials are based on the Theory of Reasoned Action, a social science behavior model. According to this model, one will compare and evaluate his/her attitudes with the subjective norms for a specific behavior before making a decision. A person’s attitudes consist of all of the different beliefs the person has towards doing this behavior, weighted with the strength of each belief. Social norms take into account the attitudes of others, weighted against how highly the individual values each opinion. Before making a decision, one will analyze and compare his/her attitudes with the subjective norms for the behavior, and then will develop a behavioral intention that they will act upon (15-16).

In the previously mentioned commercial, MADD Canada is trying to convince adolescents that driving while under the influence of marijuana is not a good idea by showing you that some people think this action is dangerous – in this case, the alien. According to the Theory of Reasoned Action, if MADD Canada can make teenagers realize that others view driving high as wrong, they can change the subjective norms on driving high. The goal of this commercial is to change these subjective norms, and then in turn change the behavioral intention, favoring a decision to not drive while under the influence of marijuana.

An important aspect of the Theory of Reasoned Action that this commercial did not take into account is how important the attitude and opinion of these inanimate objects would be to adolescents. According to this theory, the importance of the opinion of others is weighted against the actual opinion of others, and all of those weighted opinions collectively make up the subjective norms (15-16). It is unrealistic to assume that teenagers will value the opinion of an alien on a t-shirt, a pirate on a bag of rolling papers, or a wooden mask hanging on the wall. Therefore, adolescents will not take the commercial seriously, and the desired behavior change that MADD Canada hopes to see will not be seen.

Critique 2 = Theory of Reasoned Action Misused, part 2

A major public health concern plaguing the United States is driving while under the influence of alcohol. There is a great deal of attention paid to this issue, especially how dangerous it is and how stupid one has to be to drive drunk, so as a result, drinking and driving is frowned upon. When compared to driving while drunk, driving while high does not have as negative an association attached to it. There is much less media attention dedicated to educating youth about the dangers of driving while high, and it is consequently viewed differently. When compared against alcohol, marijuana is viewed as far less dangerous than alcohol (6-8). A common misunderstanding among teenagers is that driving while under the influence of marijuana is not harmful and does not affect one’s driving (9). It is even thought that marijuana can have some positive affects on driving (8-9). For example, it may be argued that being under the influence of marijuana can help to make one more cautious and/or relaxed, help one to concentrate more, and make one more in tune with the driving task (8). Because of these general misconceptions about the dangers of driving while high, teens need to be re-educated, and need to hear the truth about the effects of driving high.

One of the major goals of MADD Canada’s campaign was to shed light on the dangers of driving while high. As was stated previously, the commercial attempted to deter adolescents from driving while under the influence of marijuana by portraying this behavior as socially unacceptable. However, no explanation as to why this behavior is socially unacceptable was provided. There is no evidence given in this commercial, so the general misconceptions could not be corrected. If teenagers have false beliefs that marijuana will not affect their driving, and these beliefs are deeply rooted, having someone tell them that driving while high is dangerous without providing an explanation will not be effective.

Within this Theory of Reasoned Action, the commercial producers focused on the wrong aspect of the theory. Instead of focusing on the subjective norms, they should have focused on the each individual’s attitude towards this situation. The root of the problem is the misconception that driving while high is not dangerous, and this is a belief that is shared by many adolescents. Therefore, individual attitudes rather than the subjective norms should have been focused on for a more effective commercial. A study by Diane M. Morrison concluded that changing one’s attitudes would have more of an affect than changing the norms towards marijuana use (17). By completely ignoring the attitudes aspect of the Theory of Reasoned Action, the effectiveness of the campaign was greatly affected.

Critique 3 = Commercial May Cause Psychological Reactance

In one of the commercials, a mask that was hanging on the wall of a teen’s room reprimanded him and his friend. This wooden mask shouted:

I can’t believe you boys! I’m so disappointed in the two of you. Why are you so stupid sometimes? Getting behind the wheel? What were you thinking? You’re smoking pot and then thinking that you were going to drive? Get out of my sight and use your heads next time. Stupid! Stupid! Mind boggling. (13)

Due to the demanding nature of the mask, this commercial may be ineffective. Having an unkind, condescending mask telling a teenager what to do may cause this teen to experience psychological reactance. In a study that looked at why the National Youth Anti-Drug Media Campaign didn’t work, the researchers suggested that psychological reactance may have been to blame for the ineffectiveness of the campaign (18). According to the Psychological Reactance theory, if a person feels like his/her perceived behavioral freedoms are threatened or reduced, he/she will react against whatever is threatening those freedoms. This reaction against the threat in order to restore one’s perceived behavioral freedoms is called reactance. This oftentimes occurs when someone feels pressured to accept a certain opinion or engage in a specific behavior (19-20).

In our example, the commercial may cause the adolescents to feel like their freedom to choose whether or not to drive while under the influence of marijuana is being threatened. In response to this perceived threat, the adolescent will try to regain this freedom by reacting against it. One way to restore the threatened freedom is to engage in the forbidden behavior (19). This kind of response is known as the boomerang effect, where the opposite effect that was desired was observed in response to persuasive messages (21). If this were to occur in response to these MADD Canada commercials, not only would the commercial be ineffective, but it would have the opposite effect – you may see an increase in the prevalence of driving while high.

When MADD Canada made this particular commercial, they ignored the sensitivity and mindset of teenagers. Adolescence is often viewed as a time of rebellion. Studies have shown that adolescents are more susceptible to engaging in risky or dangerous behavior (22). Adolescents need to feel autonomous, self-determined and competent, which are three human needs that are considered when discussing psychological reactance (23). If a message is delivered using controlling language, and the content is overly proscriptive, the message may result in the boomerang effect, and cause the opposite behavior to be experienced (23). In this commercial, the mask is yelling at and speaking condescendingly towards the teenagers. This could make the teenager feel like his/her autonomy and self-determination are threatened. When the mask uses negative, blaming words, such as “stupid”, and employs name calling, this could make the teenager feel like his/her competence is being threatened. These are the three human needs that are considered in psychological reactance, and would therefore spark a reaction on the part of the teenager to regain those freedoms. The message and method of delivery in this commercial could be viewed as controlling and condescending, and because of this, will cause the commercial to be ineffective.

Alternative Approach Proposal

In order to create an effective campaign to combat driving while under the influence of marijuana, several things should have been done differently than MADD Canada’s “If you’re high, you can’t drive” campaign. The overall goal of this new campaign, which will be called “Riding High”, will be to change the attitude of teenagers, and to correct the misconceptions that they have about the dangers of driving while high. It will consist of several commercials and advertisements that capture the teenagers’ attention, relay information about the dangers of driving while under the influence of marijuana, and direct them to further educational resources. The educational resources will be easily accessible though a fantastic web site called “” that will be extremely user friendly, appealing, educational, and fun. The information that will be available at this web site will range from personal stories from teenagers who have experienced the dangers of driving while high, to scientific research papers that explain why driving high is dangerous, to scary statistics. There will be chat rooms and discussion boards for anyone who wants to speak with others or share knowledge.

The commercials for this campaign will have a scenario that is similar to the following scenario. The commercial will open with a group of teenagers laughing and having a good time while walking towards a car. On the way to the car, they will see Snoop Dog walking by, or some other celebrity who is notorious for smoking marijuana. The teenagers will start talking to Snoop Dog, and will tell him that they’re on their way to McDonald’s. Snoop Dog will reply by saying something like, “Why don’t you boys just take a cab? I don’t know about you, but I have a much slower reaction time when I’m stoned, and I don’t drive my best after a blunt or two. Everyone says that they drive better when they’re high, but that’s bull. Any given time on any given day you will see me smoking, but you will never see me behind the wheel.” The commercial will continue with back and forth, friendly conversation, and it will end with all of them reaching an agreement together that taking a taxi is a better decision than driving their car. At the end of the commercial, the “Riding High” web site will be shown, and it will state that you can get more information at Also, to draw teenagers to this website, there will be something that is appealing to the adolescents besides knowledge. For example, it may say, “Come to this web site to enter in for a chance to win two front-row tickets to Snoop Dog’s next concert”. Whoever partners with the campaign to be featured on the commercial or website will also be asked to donate something like concert tickets in order to promote the campaign.

The campaign will also consist of several initiative-taking actions. There will be a major push to lobby for more effective laws against driving while under the influence of marijuana and more effective ways to detect the marijuana levels at road-side pullovers. There will be chat rooms, discussion boards and external links to places where you can learn more information about how you can make a difference. The basic goal is to spread information about the dangers of driving while high to everyone so that it can be seen as a social norm that if you’re high, you don’t drive.

Alternative Approach Reason 1 = Need to Use People With Highly Regarded Opinions

Whoever is delivering the messages in the “Flying High” commercials need to have highly regarded opinions, from the perspective of teenagers. According to the Theory of Reasoned Action, subjective norms are an important part of the decision-making process. If teenagers don’t respect the opinions of the message deliverer, such as in the case of the MADD Canada commercials where inanimate objects were the message deliverers, the commercial will not be effective, and behavior change will not likely be seen. Therefore, we need to find out who it is that adolescents respect, and have them express their opinions on our commercials.
The main character of the commercial will be a role model, who is someone whom teenagers respect, whether it’s a celebrity, a parent, or any other respected individual. If an older role model is on the commercial explaining the dangers of driving while high, teens are more likely to listen and follow that advice than if they were listening to the advice of an inanimate object. It would also be beneficial to have a celebrity who is known to smoke. Our target audience will be young adults who enjoy smoking weed and getting high. If we have a role model who likes to get high, but warns teenagers of the dangers of driving while high, it will be more effective than having a role model who is against getting high in general because the teens will see that they can still get high, as long as they are responsible about it.

It will also be helpful to have other teenagers involved in the commercial. Studies have shown that peer drug use has a large influence on one’s current drug use (24-26). Peer influence is especially instrumental in the start and persistence of smoking marijuana (26). If along with the role model there were teenagers in the commercials, and there was friendly, educational conversation occurring, this would be very effective. In the MADD Canada commercials, the teenagers in the commercials did not say anything – the conversation was very one-sided. In the “Riding High” commercials, there will be a dialog, with the teenagers and the role model discussing the issue and coming to the conclusion together that driving while high is dangerous. Therefore, at the end of the commercial, teenage viewers will see that the opinion of one of their role models, along with other teenagers who are like themselves and their peers, is that driving high is dangerous. Hopefully, this will cause behavior change, favoring not driving while high.

Alternative Approach Reason 2 = Using the Health Belief Model

In the commercials that will be created for this campaign, it is also important that information about why it is dangerous to drive while under the influence of marijuana be provided. As was said before, the root of the problem is that teenagers have a misconception that driving while high is not dangerous. One of the main goals of the commercial should be to change these misconceptions, and thus change the attitudes of adolescents. A model of behavior that may be helpful for this situation would be the Health Belief Model. According to this model, before an individual makes a decision, he/she will weigh the perceived barriers of doing an action with the perceived benefits. When looking at the perceived benefits of performing an action, one will look at his/her perceived susceptibility of getting a condition and the perceived severity of that condition (27-28). In this situation, the behavior would be choosing or not choosing to drive if one was under the influence of marijuana. The perceived susceptibility would be the perceived likelihood that the teenager will experience a negative effect of driving while high, such as getting into an accident. The perceived severity would be how bad the teenager feels these negative effects will be, such as how bad of an accident they get into will be.

When using the Health Believe Model in our particular situation, we want to increase each teenager’s perceived benefits of avoiding driving while under the influence of marijuana. To do this, we need to educate these teenagers on the dangers of driving. We need to inform these adolescents that marijuana impairs one’s judgment, affects concentration and decreases reaction time, and thus increases one’s risk of getting into a car accident if he/she drove while under the influence of marijuana (5). If teenagers understood this danger, their perceived susceptibility of being negatively affected by driving high would increase, since they would know that their chance of getting into an accident would increase. Their perceived severity of being negatively affected by driving high would also increase, since they will know all of the negative affects that come from car accidents. With these new perceptions, the teenagers will see a large perceived benefit of avoiding getting behind the wheel after smoking marijuana, and hopefully they will come to the conclusion that driving while high is a bad idea.

Another way to deter adolescents from driving while high using the Health Belief Model would be to increase the effectiveness of detection of people who drive under the influence of marijuana, and increasing the punishment that goes along with being caught. Researchers need to come up with a valid and effective means of testing whether or not someone is stoned, and then have a harsh consequence for this action. Unlike driving while high, many young people are deterred from driving under the influence of alcohol because the legal penalties are so severe. If an individual has been drinking, in theory they would weigh the perceived barriers and benefits of driving home drunk. Although it may appear more convenient to drive oneself home, the perceived susceptibility of getting pulled over and arrested for driving under the influence of alcohol is high, especially with breathalyzers, random road sobriety checkpoints, and the wild driving that accompanies being drunk. The perceived severity of this offense would be major, since the individual would get charged with a Driving Under the Influence charge. In this case, the perceived benefits of not driving while drunk outweigh the convenience of driving oneself home. Therefore, according to the Health Belief Model, the adolescent will choose to not get behind the wheel.

In our country, it is very difficult for law enforcement officers to detect the amount of marijuana that a person has smoked while doing a road-side pull-over (10). Because of this, there are lots of people who can get away with driving while under the influence of marijuana. There is little motivation to not drive while high if everyone knows they won’t get caught. With an effective detection technique and severe penalties to punish those who drive while high, this may deter many teenagers. Their perceived susceptibility of getting caught would increase and the severity of the consequences of doing this will also increase. A study by McCarthy et al. showed that a majority of adolescents would be deterred from driving under the influence if there was effective roadside drug testing and consequences (7). Therefore, a good way to change the behavior of teenagers regarding driving while high would be to use the Health Belief Model to change individual attitudes.

Alternative Approach Reason 3 = Avoid Psychological Reactance

In this alternative campaign, a large attempt should be made to avoid reactance on the part of teenagers, and especially avoid the boomerang effect. To do this, we need to ensure that the commercials avoid threatening persuasion tactics (20). In the commercial with the mask hanging on the wall, the mask is very threatening and belittling. It even goes so far as to call the adolescents “stupid”. Instead of making the teenagers feel threatened, and taking away their freedoms, the people on the commercial should take a more friendly and positive approach. In our example commercial, Snoop Dog did not tell the children they were wrong. He did not use threatening words or talk condescendingly. He had a friendly conversation with the teenagers, and together, they reached an agreement that smoking while high was wrong.

A method of decreasing reactance would be to include a person on the commercial that most adolescents can relate to. Studies have shown that if people feel like they have something in common with a message deliverer, they are less likely to experience reactance (29). In our example commercial, the viewer and Snoop Dog both like to smoke marijuana – it is what they have in common. When Snoop Dog tells them not to drive while high rather than telling them to stop smoking marijuana all together. He is basically saying, “You know what boys, I like to smoke marijuana, too. We have that in common. Just be responsible about it.” With this kind of approach, the teenagers don’t feel like their perceived freedom to smoke marijuana is affected, and they also feel like they can make a responsible decision when they smoke.

The reason why other teenagers were included in the commercial was because it is someone that the viewer can possibly relate to, so that the chance of reactance can decrease. In the commercial, there will be three or four different teenagers and they will all be a little different. If some of the viewers can relate to one of these characters in the commercial, they will be more likely to listen to the message.


MADD Canada’s campaign to combat driving while under the influence of marijuana was ineffective. When MADD Canada tried to influence adolescent’s subjective norms of driving while high using the Theory or Reasoned Action, they fell short for two reasons. Firstly, they didn’t take into account how teenagers would value (or in our case, not value) the opinion of an inanimate object. They did not include people who are well-respected among teenagers in their commercials. Also, they focused on the subjective norms side of the Theory of Reasoned Action instead of focusing on the attitudes. MADD Canada should have focused on changing the attitudes that adolescents have about driving while high, since the misconceptions are the main problems. MADD Canada also failed to consider that this commercial may cause psychological reactance among the audience of teenagers.

In order to effectively deter teenagers from driving while high, the most important thing that needs to be done is education. Teenagers need to be taught why driving while under the influence of marijuana is dangerous. From here, we can create negative associations between driving and being stoned, and make this somewhat of a social norm. It is also important that the commercials effectively use the Theory or Reasoned Action and the Health Believe Model, and try to avoid any Psychological reactance.

With the prevalence of marijuana smoking among teenagers, the growing leniency of marijuana laws, and the common misconceptions about driving while high, it is important that we start educating youth now. Although it may take a while for everyone to fully understand the dangers of driving high, and it may be even longer before effective detection of marijuana levels and punishment of driving while high are in effect, we need to start somewhere.


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