Communication Objectives for Youth Audiences³

Communication Objective 1:
Instill the belief that most young people do not use drugs.

One of the most important psychological mediators of drug use among adolescents is the perception that drug use is "normal," and that everyone does it. Adolescents consistently over-estimate the prevalence of drug use among their peers (Falco, 1992; Hansen & Graham, 1991), and are thus susceptible to a subtle and silent form of peer pressure to use drugs. For example, although teenagers believe that over 70 percent of their peers use marijuana at least occasionally, more than half of teenagers (56 percent) report that they have never tried marijuana (PATS, 1997).

Norm education -- that is, creating the perception that drugs are not used by most adolescents -- has been found to be effective in containing drug use among middle school students.⁴ This objective is particularly germane for middle school-aged adolescents: the vast majority of their peers do not use drugs, yet many believe that drug use is normative and socially acceptable. The objective may be less appropriate for high school-aged adolescents; given higher rates of actual use among high school students, messages executed against this objective may not be perceived as credible by this audience.

Numerous messaging strategies have been executed to communicate this objective. Anecdotal evidence suggests three important messaging considerations: (1) prevalence data that are presented should be perceived as credible, (2) the audience should be able to identify with the people shown in the message, and (3) non-users should be presented as being socially attractive.

In school-based interventions credibility of the norms and their relevance to the audience is often established by generating norms interactively. One way to do this is to elicit prevalence estimates from the students in a classroom, and then compare these estimates to actual prevalence rates generated in some fashion through student polling (Hansen & Graham, 1991).

The importance of portraying non-use as socially attractive was discussed in detail at the meetings of the Campaign Design Expert Panel. The concern was raised that teenagers are not likely to be swayed by the message that most of their peers do not use drugs so long as they are convinced that the really "cool" teenagers are using them. Thus, message executions should combine information about prevalence with a positive portrayal of non-use and a negative portrayal of drug users.

Communication Objective 2:
Enhance perceptions that using (specific) drugs is likely to lead to a variety of negatively valued consequences.

Trend analyses of drug use beliefs and behaviors over the past two decades indicate that increases in drug use rates are associated with a decline in the perception that drugs are dangerous, and vice versa (Bachman, Johnston, O'Malley, & Humphrey, 1988; Bachman, Johnston, & O'Malley, 1990; Johnston, O'Malley, & Bachman, 1996). Perceptions of three important categories of potential negative effects have been linked to adolescent drug use: social consequences, psychological consequences, and health consequences (Hansen, 1997).

Adolescents typically assess potential negative consequences differently than do adults. Adolescence is a time characterized by greater concern for the short-term rather than the long-term outcomes of a behavior. Thus, short-term negative consequences of drug use are likely to be more salient and important to adolescents than longer-term consequences. Moreover, since adolescents tend to have inflated estimates of their own invincibility, they find it easy to disregard potential negative physical consequences such as addiction and physical harm. A third consideration is that adolescence is a time of seeking and developing one's identity through social interactions and task mastery; thus, young people are likely to be heavily influenced by potential threats to their social lives and their increasing sense of control over their environment.

A special consideration when designing messages for older adolescents is that they are very aware and informed about drugs and drug use in their communities and schools. They are knowledgeable about a range of drugs, realize that different drugs can do them varying degrees of harm, and also differentiate between the risks of trial and the risks of regular use. Given that most high school students already make distinctions among different kinds of drugs and different use patterns, campaign messages should also be as specific, accurate, and concrete as possible. Messages that are vague or inaccurate are not likely to be perceived as credible by this target audience.

Based on consumer research, expert input, and the literature reported in Section 3 of this document, it appears likely that messages that communicate the following negative consequences of using drugs will be most effective in discouraging drug use among adolescents.

Social consequences of marijuana use:

• It can lead you to act in ways that make you look stupid and "uncool" (like hanging out with losers, or letting people take advantage of you).

• It can alienate you from your friends.

• Your parents will be angry and sad if they find out you are using marijuana.

• You may lose the trust and respect of your parents and siblings; you may have a negative influence on your siblings.

• It can make you lazy and unmotivated.

• It reduces your ability to focus and think clearly.

• It can make you "lose control" and make bad decisions. You tend to do things that you know are stupid or wrong (such as drive recklessly, or have unsafe sex) that you would not do otherwise.

• Short-term consequences such as losing driving privileges, failing a drug test, losing a summer job, getting thrown off a sports team, not having enough money for other desired things, doing badly at schoolwork, and getting into trouble with one's parents.

• Long-term consequences such as getting into trouble with the law, injuring oneself in a car crash, and dropping out of school.

Physical consequences of marijuana use:

• It causes a host of physical problems and diseases, just like cigarettes do.

• It reduces stamina and physical performance.

• It causes overeating and weight gain.

Middle school-aged children acknowledge a range of negative consequences of drug use. All the risks of using marijuana are important for this age group, but social risks may be most salient to them.

High school-aged adolescents give little credence to the idea that marijuana use can cause them to suffer dire, irreversible damage (although they are willing to acknowledge that it can mess up other people's lives). The negative psychological and aspirational consequences of using marijuana are likely to be most important to members of this group, especially when those consequences are seen as being personally relevant. Messages that highlight concrete and immediate consequences (such as falling grades) and that present them as barriers to long-term goals (such as not graduating from high school, or not getting into college) are more likely to be effective than messages that only mention long-term negative consequences. Messages should enhance the sense that all users are vulnerable to these risks, even those who think they have their marijuana habit under control. One way to do this is to demonstrate these consequences for "regular" adolescents, rather than focus on the destroyed lives of hard-core users from whom adolescents can easily dissociate themselves.

Consequences of inhalant use:

Physical consequences of using inhalants -- such as brain damage, death, delirium, hallucinations, chemical imbalances, breathing difficulty, and damage to several body systems -- should be emphasized. Adolescents know that inhalants have negative physical consequences, but many of them are not aware of the more catastrophic and irreversible harm that inhalants can do, even the first time they are used. Thus, messages about inhalants should focus on discouraging trial and use by communicating the immediate as well as the long-term physical consequences of use.

Communication Objective 3:
Enhance perceptions that a drug-free lifestyle is more likely to lead to a variety of positively valued consequences.

Psychologists have long made a persuasive case that the carrot-and-stick approach works better than the stick alone. The National Youth Anti-Drug Media Campaign will feature positive messages to emphasize the benefits of remaining drug-free and celebrate the attitudes and behaviors of teenagers who have managed to stay off drugs. The idea is to convey a range of short- and long-term benefits of a drug-free lifestyle, and to portray such a lifestyle as being "cool" and attractive.

A large proportion of early teens (69 percent), and close to half of all teenagers (42 percent) are non-users who believe that drug use is risky (PDFA, 1994c). The Partnership for a Drug-Free America calls these adolescents their "loyal franchise" and suggests that maintaining this loyal franchise by affirming their choice to stay off drugs is an important part of all anti-drug campaigns. Their research shows that messages that highlight the benefits of non-use are most effective with this group (PDFA, 1996).

Based on consumer research, expert input, and the literature reported in Section 3 of this document, the following message strategies that depict positive consequences of a drug-free lifestyle are likely to be most effective in reinforcing non-users.

Social benefits:

• Being "cool" and socially attractive, and earning the respect of peers.

• Being part of a close-knit circle of friends and sharing new and exciting experiences.

• Earning the respect and trust of parents and siblings. Setting a good example for younger siblings.

• Having a strong sense of self-worth and self-respect.

• Setting a good example for others (particularly younger siblings).

• Gaining greater control over one's life and the direction it is taking. Working towards one's academic and career goals.

• Achieving personal growth and excellence.

• Staying fit.

• Performing well in sports.

For high school-aged adolescents, it may not be sufficient to market a "cool" image of non-users; in fact, this may not even be perceived as credible since many of the "coolest" high school kids also use marijuana. The focus for this age group should be on self-control and personal growth. Not using drugs in the face of peer pressure should be tied in with asserting one's identity. Messages for this age group should also focus on the aspirational benefits of staying drug-free, and should convey the idea that staying away from drugs is a first step in realizing one's immediate and long-term goals.

Communication Objective 4:
Enhance personal and social skills that promote positive lifestyle choices as well as resistance to drug use.

The most effective drug prevention programs have included drug resistance skills training, either alone or in combination with other program elements (Botvin et al., 1990; Pentz et al., 1989). Contemporary school-based approaches incorporate drug resistance skills into a broader set of essential personal and social skills (Botvin et al., 1995a). These skills include decision-making and self-regulation skills, cognitive skills for resisting interpersonal and media influences, adaptive coping strategies for dealing with stress and anxiety, and general social and assertiveness skills (e.g., requests and refusals). The underlying skill is demonstrated in relevant situations for the target audience. In school-based programs, children may also be given the opportunity to rehearse these skills to build mastery and confidence.

Interpersonal and coping skills that have been found to be effective in helping adolescents resist pressures to use drugs are shown in Table 3. Messages designed to enhance these skills should be framed carefully so as not to have the unintended effect of eroding inhibitions and increasing participation in social activities and events that encourage drug use.

Media presence of drug use is a powerful influence on adolescents, particularly because they do not recognize popular culture as an influence. Therefore, inculcating critical viewing skills and a sensitivity to the distorted images presented by popular culture are important for building resistance skills.

For high school-aged adolescents, it is also important to emphasize that marijuana is not a solution to life's problems and stresses. In fact, it can actually worsen some of the common problems of adolescence -- academic and extracurricular challenges, disagreements with parents, and peer relationships. Instead, adolescents should be encouraged to avoid the escapism of drugs and to work towards constructive solutions to their problems.

Communication Objective 5:
Reinforce positive uses of time (as behavioral alternatives to drug use).

Adolescents who are involved in constructive, adult-supervised activities during after-school hours and on weekends are less likely to use drugs (Buckhalt et al., 1992; Carnegie Council on Adolescent Development, 1992; Shilts, 1991; Van Nelson et al., 1991). Thus, encouraging and enabling adolescents to engage in such positive activities is a powerful way to prevent drug use. A range of appropriate activities and options should be made salient and attractive to adolescents. Moreover, youth engaged in these activities should be reinforced for their involvement and accomplishments.

Messages executed against this objective have the potential to generate demand for recreational, athletic, educational, or vocational services that may not currently be adequately available to youth in a given community. To avoid this situation, messages that recommend activities that require the provision of specific services should be planned in collaboration with campaign partner organizations that can offer these services.

Summary of youth communication objectives

Table 4 summarizes the communication objectives for youth audiences and specifies which of these are most important for each of the three age groups targeted by this campaign. The objectives that are important for each age group are indicated by circles.

Communication Objectives for Parent/Caregiver Audiences

Communication Objective 1:
Enhance perceptions of harm associated with adolescent use of marijuana and inhalants.

Although nearly all parents dread the thought that their children may get involved with "hard" drugs, many parents do not fully appreciate the dangers associated with marijuana and inhalants (National Survey of American Attitudes on Substance Abuse II, 1996; PDFA, 1994a). Getting parents to have a realistic understanding and appreciation of the specific dangers of these drugs is thus an important communication objective for this campaign. Not only will this enhance the likelihood that parents will take action to prevent drug use among their children, but it will also enable them to serve as informed and credible sources of information for their children.

This objective is particularly important for the many baby-boomer parents who are former or, less commonly, current substance users. Some of these parents report having difficulty reconciling their past drug use and its corresponding lack of harm with their current desire to prevent their children from using drugs. Although audience research must be conducted to determine the most effective message strategies for these parents, there are two promising message themes that can be used to "drive home" the dangers of marijuana for parents who grew up thinking that marijuana is a relatively benign drug. These are:

• The consequences of using marijuana and inhalants are potentially more severe now than in the past, both because the drugs are more potent and because the social and physical environment in which adolescents live is more dangerous.

• Adolescents initiate drug use at earlier ages now than in the past, and the earlier an adolescent initiates drug use, the greater the likelihood that a serious problem will develop as a result.

Although most parents recognize the seriousness and pervasiveness of adolescent drug use, they tend to underestimate or deny the possibility that their own children might use drugs (PATS, 1997; PDFA, 1994b). It seems that parents are well aware of the fact that licit and illicit drugs are commonly used by teenagers, but relatively fewer parents believe that their own children participate in these activities. The impact of anti-drug messages is attenuated by this "self-positivity" bias -- a general underestimation of the probability of "bad things" happening to oneself or to one's family (Taylor and Brown, 1988). Unless drug prevention messages are seen as personally relevant, parents and caregivers are unlikely to heed the call to action.

To achieve this communication objective, specific message strategies must be developed to enhance the perceived personal relevance of drug-prevention messages in the minds of target audience members. The phrasing of messages, the selection of actors or models, and the situations depicted must gain viewers' attention and convey that "this message is relevant to you" (Parrott, 1995). One way to do this, for example, is to simply call attention to the fact that parents are likely to incorrectly conclude that their children are not at risk. Another technique is to encourage parents to recall other specific instances when their child surprised them by doing something he or she was not supposed to do.

Communication Objective 3:
Enhance perceptions of personal efficacy to prevent adolescent drug use (i.e., let parents know that their actions can make a difference).

Despite research that shows the strong protective effect of family and parental variables (Newcomb & Felix-Ortiz, 1992; Resnick et al., 1997), many parents feel overwhelmed by environmental factors and believe themselves to be incapable of exerting a protective influence. In one recent survey, 40 percent of parents indicated that they believe that once a child becomes a teenager, parents have very little influence over the child's decision to smoke, drink, or use illegal drugs (National Survey of American Attitudes on Substance Abuse II, 1996).

Feelings of inefficacy are strong predictors of inaction (Bandura, 1997). Parents must be helped to believe that there are specific actions they can take -- actions that are well within their abilities -- that will have a profound protective influence on the life of their adolescent. Once parents believe that they can protect their children, they are dramatically more likely to take action.

Three general strategies have been shown to be effective in helping audience members overcome their feelings of inefficacy:

• Providing persuasive assurances (from credible sources) that effective actions can be taken by any parent.

• Demonstrating the recommended actions in a variety of relevant circumstances, and with a variety of models.

• Clarifying that most parents already have the skills they need to successfully perform the recommended actions. One way to accomplish this is by calling attention to other ways in which parents have successfully used those skills.

Parents can take many important actions to protect their children from drug use and other associated risks. While some of these actions pertain directly to how parents deal with the issue of drugs per se, others are more general parenting skills.

The media campaign will recommend to parents the following simple but effective skills in a manner that identifies and enhances their ability to put those skills into action.

Communication skills

• Discuss what the adolescent did each day after school and praise appropriate activities.

• Establish and clearly communicate drug non-use expectations.⁵

• Use anti-drug media messages (e.g., televised advertisements) as a catalyst for discussion and message reinforcement.⁶

• Provide positive reinforcement when the adolescent initiates communication about drugs.⁷

• Establish protective routines focused on the situations most likely to lead to substance use, particularly after-school hours. Specifically, ensure that the adolescent is usually occupied during after-school hours by requiring that homework be done or that he or she participate in adult-supervised recreational activities.

• Stay involved in and actively monitor the adolescent's activities (e.g., know his or her friends and the friends' parents, and communicate with those parents to stay better informed of the adolescent's activities).

• Establish rules that decrease the likelihood of the adolescent's being in situations that are conducive to drug use. Specifically, prohibit the adolescent from spending time with friends in anyone's home when there are no adults present, and discourage or prohibit any unsupervised association with other adolescents who use drugs. Establish and consistently apply a curfew and have rules regarding keeping a parent informed of whereabouts at all times.

• Encourage compliance with these rules by consistently applying mild negative consequences for infractions.

Parents who feel that taking action against drugs in the school or community is, in part, their responsibility are less likely to have children who use drugs (National Survey of American Attitudes on Substance Abuse II, 1996). Parents' participation in community and school drug efforts discourages their children from using drugs in three ways. First, it conveys to the child the parents' commitment to an anti-drug stance. Second, it helps to ensure that prevention programs are available in the community. Third, it helps to ensure that local prevention programs are responsive to the needs of community members.

Two specific actions will be suggested to parents:

• Inquire about and insist that an effective anti-drug program be implemented at your child's school.

• Take action to support community anti-drug activities.

Parents are a child's first and most important role models. They influence children by their words and their behavior. Adolescents think that the most important action that parents can take to discourage their children from using drugs is to refrain from using drugs themselves (ONDCP, 1997). Since most adolescents also regard cigarettes and alcohol as "drugs," and older adolescents think that these substances are actually more harmful than marijuana, parents who smoke cigarettes and drink alcohol beyond moderation are unintentionally setting a bad example. While encouraging parents to quit smoking and drinking alcohol is outside the scope of this campaign, parents should be encouraged to consider the effects of their own habits on their children.

Communication Objectives for Other Youth-Influential Adults

Communication Objective 1:
Enhance perceptions of harm associated with use of marijuana and inhalants.

While specific estimates are elusive, there is evidence that, like many parents, youth-influential adults tend to underestimate the potential harm associated with use of marijuana and inhalants. Correcting this misperception is an important step in motivating this audience to take appropriate actions.

As is the case with the parent audience, research must be conducted with members of this audience to determine the most effective messages for enhancing their perceptions of harm associated with use of marijuana and inhalants. See the discussion of Parent/Caregiver Communication Objective 1 for potentially promising message themes to help youth-influential adults recognize that their relatively benign perceptions of marijuana use, possibly formed through personal experience, are no longer accurate or appropriate.

Communication Objective 2:
Enhance perceptions of personal efficacy to prevent drug use (i.e., what you do can make a difference).

As previously stated, feelings of inefficacy are the strongest predictor of inaction (Bandura, 1997). Youth-influential adults must be made to believe that there are specific actions they can take -- actions that are well within their abilities -- that will help to prevent adolescents in their families and communities from becoming involved in drug use. Once youth-influential adults believe this, they will be more motivated to take action.

See the discussion of Parent/Caregiver Communication Objective 3 for strategies to enhance perceptions of personal efficacy.

Communication Objective 3:
Encourage specific individual-focused and community-focused actions to facilitate adolescent drug use prevention.

There are many important actions that youth-influential adults can take to protect adolescents from drug use. The specific individual-focused actions to be recommended are:

• Communicate to youth the harmful (social, physical, and aspirational) consequences of using specific drugs.

• Communicate to parents the need to take specific actions to prevent youth drug use. (See the communication objectives for Parent/Caregiver audiences.)

• Advocate for effective anti-drug programs in schools and communities.

• Take action to support community anti-drug activities.