Thursday, May 6, 2010

Is There Any Buzz to the “Buzzed Driving is Drunk Driving Campaign”? – Matthew Reeder


Since its inception in 1980, Mothers Against Drunk Driving (MADD) has campaigned to bring greater awareness of the all too often fatal consequences of driving under the influence to the U.S. public. Unfortunately, drunk driving still remains a serious public health problem 30 years later. According to the 2008 summary statistics from MADD every 45 minutes someone is killed by a drunk driver (1). In addition, the Centers for Disease Control and Prevention (CDC) reports that an estimated 700 or more individuals are injured each day in alcohol-related crashes (2). Though down from recent years, the total estimate for people killed due to a drunk-driving related incident still reached nearly 12,000 in 2008. (1).
Statewide and community-based interventions have been implemented to combat the unfortunate results of this reckless behavior (3). National drunk-driving campaigns, such as the “Over the Limit. Under Arrest.” and “Friends Don’t Let Friends Drive Drunk” campaigns have flooded household televisions across the country in an attempt to bring about change (4). An additional intervention was added to the mix by the Ad Council and the National Highway Traffic Safety Administration (NHTSA) entitled “Buzzed Driving is Drunk Driving” aimed towards those who feel that it is okay to drive home if they are only a little “buzzed”. It is a compliment to the “Friends Don’t Let Friends Drive Drunk” media campaign but instead of focusing on the influences of friends and family the intervention concentrates on personal responsibility (4).
This review focuses on the “Buzzed Driving is Drunk Driving” campaign with the intention of critiquing its potential effectiveness in successfully creating behavior change among its main audience and also to provide some possible alternative approaches to addressing the problem with this particular campaign.
A Clip from the Campaign
The commercial is set in the back of an ambulance. For a moment you feel as if you are watching a Thursday night medical drama on television. Two paramedics work intensely on a body marked with cuts and bruises lying on a stretcher. On the other side of the stretcher sits a man, clearly upset by the recent events that have just taken place. The distraught man places his head in his hands and says, “This can’t be happening, we were just buzzed.” The paramedics at this point stop doing CPR, look at him, and say, “Just buzzed? You didn’t tell us that sir. You’re right, this isn’t happening, he’ll be fine.” Then, like a scene from a sitcom, the body of the man’s friend sits up on the stretcher and rather nonchalantly remarks, “yeah, I feel good.” Astonished, the man looks up and replies, “Really?” The paramedic replies, “No, not really” and the body on the stretcher lies back down and resuscitation begins once again. The scene ends with the words “Buzzed driving. Maybe we should stop acting like it’s no big deal” (5).
Critique 1: A Comedy of Errors
The first issue with this particular campaign video is the comical approach taken with an otherwise serious and humorless public health problem. After viewing the video the main content that sticks in the viewers mind is the rather comical part where the injured individual sits up and starts talking. This surely is not the overall message that the authors wished to convey with this commercial. In fact, commercials of this nature have received mixed results regarding their effectiveness in delivering their intended message. A study examining the effectiveness of health promotion television advertisements targeted toward 55 to 70 year-olds in Canada found that when humor was used in the commercial some individuals found it rather quite amusing and attention-grabbing, but the majority of viewers responded negatively, commenting that the use of comedy shifted the focus and took away from the overall message (6).
Indeed, using comedy as a means to deliver a message related to alcohol-use and driving unintentionally shifted the focus of this campaign advertisement. In essence, the creators of this campaign are trying to sell their message utilizing advertising and marketing theory techniques. At the core of every successful advertising campaign is a promise built around core values and beliefs (7). The promise that many who view this commercial may come away with is that drinking and driving is not that serious of a problem. The abrupt change in the mood of the commercial ineffectively portrays the consequences of drinking and driving as comical. This is likely to have a lasting effect on the consumer of this message. Ultimately, the commercial should convey the message that injury is a serious consequence of driving drunk, and death is an even more serious one. In this particular advertisement, though, it appears that the use of humor detracts from the main message and, therefore, may be less likely to alter drinking and driving behaviors. If the commercial itself is not taking drunk-driving serious, how do they expect viewers to take it serious when placed in a similar situation?
Critique 2: Belief in Rational Behavior
The second potential issue with the “Buzzed” media campaign is the underlying assumption that individuals make rational decisions and are able to do so at any time. The Health Belief Model is one of many traditional social science theory models that do not take into account the irrational behavior and decision making of individuals. At the core of the model is the belief that individuals assess the costs and benefits of adopting a particular health behavior along with their perceived susceptibility to a particular health problem (8). The “Buzzed” campaign is asserting that individuals who are under the influence are able to coherently and systematically weigh the costs and benefits of drinking and driving, thus making a rational decision to either drive drunk or not drive drunk. Indeed, there may be no better definition of irrational or unplanned behavior than being under the influence of a drug or substance.
In fact, there are additional variables that go into an individual’s decision-making process. A study performed by Gulliver and Begg (9) found that an individual’s personality influences their decision of whether or not to be involved in risky driving behavior. The authors found that individuals, particularly young adult males, who harbor aggressive behaviors or feelings of alienation, are more prone to dangerous driving behaviors. Therefore, there may be multiple factors interacting concomitantly to influence behavior. Interventions that do not take these factors into account are likely to be less successful than those that do.
Critique 3: Lack of a Defined Promise and Core Values
As described previously, it is difficult to establish exactly what the authors of the “Buzzed” campaign wish to emphasize in their commercial. One may come away with the notion that driving under the influence, even if a little “buzzed”, can result in serious consequences. On the contrary, another individual may come away thinking that it can’t possibly be that serious given the humorous delivery of the message. Still, others that see the commercial may rebel completely against the commercial’s message because they may feel as if it is suggesting that they not drink at all. The lack of clarity of the “promise” of the ad and supporting core values may be a potential issue for this particular campaign message.
Convincing people to change their attitudes and feelings about certain risky behaviors is a daunting task. In fact, those who participate in risky behaviors such as drunk driving oft times know that they are putting themselves or others in harm’s way, but may feel that accidents or injuries related to such behavior only happens to other people who do not have control over their own situation. Such an optimistic bias has been seen in studies regarding smokers and their perceived risk of death or disease from smoking habits. In a study of 200 adolescent smokers, the majority of smokers recognized that smoking was an addictive behavior and could result in early morbidity and mortality; however, with regards to their own personal risk of disease or death, smokers were more likely than nonsmokers to doubt that it would ever happen to them (10). With the additional challenge of convincing individuals that they too are at risk, a campaign without a clear and concise message is surely to be less effective and reach fewer people.
Proposed Intervention
The “Buzzed Driving is Drunk Driving” media campaign has several strengths. First is the fact that the campaign is an extension of the “Friends Don’t Let Friends Drive Drunk” campaign, aimed primarily at an individual’s social network. Understandably, the authors also wished to target the individual’s behavior and attitude as well concerning drunk-driving. Running these two campaigns together may have a greater ability of influencing behavior-change than running any one alone. Second, the campaign does not rely on citing multiple public health facts and statistics about the detrimental effects of drunk driving in its campaign advertisement, but rather tries to convey its message through a form of storytelling and depiction of possible real life events. Doing so is far more interesting and attention-grabbing than the citation of statistical facts alone, no matter how alarming those statistics may be.
By adding a few components to the program and simply by looking at it from a different point of view, the creators of the “Buzzed” media campaign could improve the quality and effectiveness of its message. Fear appeal has been used in a variety of public health campaigns to help promote behavior-change in individuals (11). Incorporating more fear-based characteristics into the campaign message rather than comedy may have a greater impact on the audience.
Additionally, by understanding why individuals choose to drink and drive, the authors of this campaign could establish a more effective message tailored to a particular audience of individuals. Utilizing research, focus groups, and questionnaires could help the creators of the program identify their target populations. Finally, through the use of core values and a public health promise, the authors of the “Buzzed” campaign could improve the effectiveness of their message by attacking the specific needs and wants of its audience.
Defense 1: Serious Times Call for Serious Measures
Though comedy is refreshing at times and can help grab the attention of viewers, there is a time and a place for everything, and comedy in an anti-drunk driving campaign may not be the place for it. Rather, a more serious approach could be taken, such as eliciting fear. There has been some controversy in the past as to the actual effectiveness of campaigns that use fear to promote or change behavior (12). A meta-analysis of fear appeals found that the use of fear can actually help to motivate attitude, intention, and changes in behavior, especially when this approach is combined with messages of “high-efficacy” (11).
Removing comedy from the campaign and instilling more fear into the campaign message would help to create a more serious atmosphere for the problem of drinking and driving. An example of a similar public health campaign that effectively uses the fear approach in their program is the “Idaho Meth Project” (13). The “Idaho Meth Project” advertisements delineate methamphetamine use as something that takes away freedom, happiness, and ultimately destroys lives. The graphic nature of their campaign creates an image that is long-lasting and the apparent decrease in methamphetamine use in the state of Idaho is evidence of its effectiveness (13).
There is a fine line, though, of how much fear appeal to use in a public health intervention. It has been suggested that if not properly executed, fear appeal campaigns can backfire, resulting in feelings of defensiveness and rebellion by the intended population (11-12). However, if effectively utilized, they may be successful in persuading individuals participating in a certain behavior to alter or abandon it (12). Utilizing fear appeal in the “Buzzed Driving is Drunk Driving” campaign may be necessary to get the message across.
Defense 2: The Ecological Approach
In a study examining the social and behavioral theories and models used to address unintentional injury problems, the Theory of Reasoned Action, the Theory of Planned Behavior and the Health Belief Model were all among the most often utilized theories (14). All of these models are individual-level models that assume rational decision making and fail to account for additional variables that may have an impact on behavior.
One particular social and behavioral model that takes the interaction of multiple factors into account is the ecological model. The ecological model states that an individual’s overall health and well-being is affected by their biological makeup, behavior, and the various environments in which they live (8,15). This theory-based approach has been utilized in the development of interventions addressing other behavioral-based problems, such as overweight and obesity in children and adolescent smoking (16-17). Though it may be quite difficult to create an anti-drinking and driving campaign advertisement that encompasses all of these variables within the span of 30 seconds, it may be efficacious to consider an ecological-type model when designing and executing the overall message of the campaign.
In an effort to account for multiple factors affecting irrational behavior, the “Buzzed” media campaign could take an in-depth look at the possible reasons to why individuals choose to drink and drive perhaps through the use of focus groups and questionnaires in varying parts of the country with a multiple range of age groups. Additionally, prior research has been conducted with the aim of identifying the social mechanisms behind adolescent drinking and driving (18-19). By utilizing the research findings of others in addition to the administration of focus groups and questionnaires, the campaign could target its advertisements to a variety of populations, personalities, and behavior-types more effectively.
Defense 3: Addressing the Core Values
An ideal template for an advertisement for a public health program is to first figure out what the audience wants to hear based on their needs, desires, and values, and then tailor it in such a way that they feel as if those needs, desires, and values will be met if they decide to participate or not participate in a particular behavior (7). In fact, when examining television advertisements today, many may seem completely irrelevant to the product that is being advertised. The creators of such commercials are focusing in on what the consumer’s wants, needs, and values are and have figured out what these particular things are from extensive research (7).
The very same advertising methods could be used in the “Buzzed” campaign. Viewers may not want to be told consistently that it is bad to drink and drive. In fact, most viewers probably already know that. Finding out what viewers want to hear and supporting that message with core values that the viewers can relate to may help the message come through loud and clear. For example, anti-smoking campaigns recently have been successful in their efforts to reduce smoking among youth by creating a message that is relevant to them and focuses on core values that every young person can identify with, freedom and independence (20). Similarly, the “Buzzed” campaign could focus on a particular demographic and support their message with the core values that that particular audience identifies with, whether it is freedom, independence, love, family, responsibility, or a combination of all of them.
The “Buzzed Driving is Drunk Driving” media campaign administered by the Ad Council and the NHTSA is a genuine message to help control and put a stop to the devastating effects of drunk-driving. Though there are many aspects of the campaign message that are effective, a few areas for potential improvement have been identified. Of these is the non-serious nature of the commercials in which a more serious approach may be more effective in communicating positive behavior-change.
Utilizing fear appeal in the campaign message may help to effectively convey to the audience the seriousness and scope of the problem. The next identified area for improvement is the campaign’s underlying assumption that individuals are able to make rational decisions at all times, even when under the influence. Utilizing an ecological-based model rather than the commonly used individual-based social and behavioral science models may help to identify the biological, social, and environmental factors that influence the decision-making process in those who choose to drive under the influence.
Finally, developing a campaign message that is clear and supported with core values, such as freedom, love, independence, and family, to name a few, may help to influence viewers to change their behavior while at the same time fulfilling their wants and needs as individuals.

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