Young Consumers

Alcohol consumption among young consumers: a review and recommendations

Magdalena Cismaru Anne M. Lavack Evan Markewich
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Magdalena Cismaru Anne M. Lavack Evan Markewich, (2008),"Alcohol consumption among young consumers: a review and
recommendations", Young Consumers, Vol. 9 Iss 4 pp. 282 - 296
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 Alcohol consumption among young
consumers: a review and
recommendations
Magdalena Cismaru, Anne M. Lavack and Evan Markewich

Magdalena Cismaru, Anne Abstract

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M. Lavack and Evan Purpose This paper aims to examine social marketing programs aimed at preventing or moderating
Markewich are all based at alcohol consumption among young consumers. It seeks to show how protection motivation theory can
the University of Regina, be used as a theoretical framework to create effective communications targeting young people.
Regina/Saskatchewan, Design/methodology/approach Communication materials aimed at preventing or moderating
Canada. alcohol consumption among young people were identified and gathered from web sites in five
English-speaking countries (USA, Canada, Australia, New Zealand, and the UK). A qualitative review of
these materials was conducted.
Findings A majority of the alcohol moderation/prevention campaigns targeting young consumers
followed the tenets of protection motivation theory by focusing on the threat variables of severity and
vulnerability. Some campaigns also focused on costs, as well as self-efficacy and response efficacy.
Research limitations/implications Only English-language materials and materials targeting young
consumers have been considered, so findings cannot necessarily be generalized to other languages or
countries.
Practical implications Future youth alcohol moderation/prevention initiatives should include
self-efficacy messages, to increase confidence among young people that they are able to carry out the
recommended actions.
Originality/value The review presents a comprehensive examination of initiatives aimed at
preventing/reducing alcohol consumption among young consumers, and shows how protection
motivation theory can be successfully used in this context.
Keywords Alcoholic drinks, Young adults, Consumer protection
Paper type Research paper

Introduction
Evidence from the World Health Organization (WHO, 2004) shows an international pattern
among young people towards higher levels of alcohol use and binge drinking. Studies show
that underage drinking can have significant consequences, including societal problems and
negative health effects (WHO, 2002a, b; US Department of Health and Human Services,
2006). Drinking among young adults is also associated with negative outcomes, including
alcohol-related motor vehicle accidents (American Medical Association, AMA, 2007; US
National Institute on Alcohol Abuse and Alcoholism, 2004). Since underage drinking
threatens the health and well-being of young people, many government organizations have
become interested in using social marketing as a tool to prevent or moderate alcohol
consumption within this target group.
In this research we review social marketing campaigns aimed at preventing or reducing
Received March 2008 alcohol consumption among young people (including children, tweens, teenagers, and
Revised June 2008
Accepted August 2008 young people up to the age of 24), by examining relevant communication and program
materials from five English-speaking countries. Through a qualitative review of these
This research is supported with
funds from the University of
materials, we determine their adherence to the protection motivation model (Rogers, 1975,
Regina. 1983), a well-established model for changing health-related behaviour. To provide some

PAGE 282 j YOUNG CONSUMERS j VOL. 9 NO. 4 2008, pp. 282-296, Q Emerald Group Publishing Limited, ISSN 1747-3616 DOI 10.1108/17473610810920498
 context for this study, we first review the literature describing alcohol consumption among
young people.

Alcohol consumption among young people

Underage drinking is defined as occurring when an individual consumes alcohol while
below the legal drinking age (Drinkingfacts.ca, 2007). It should be noted that the legal
drinking age varies dramatically between countries, ranging from no minimum drinking age
in countries like China, Nigeria, Poland, Portugal, Thailand, and Vietnam, up to the highest
minimum legal drinking age (21) in the USA (Hanson, 2007).
Previous research demonstrates an international pattern among young people towards
higher instances of binge drinking and intoxication (WHO, 2004). A 2005 US National Survey
on Drug Use and Health estimates that there are 11 million underage drinkers in the USA (US
Department of Health and Human Services, 2007). Of these, nearly 7.2 million are
considered binge drinkers (i.e. consuming more than five drinks on a single occasion), and
more than two million are classified as heavy drinkers. Statistics in other countries show a
similarly high incidence of young people consuming alcoholic beverages in an unsafe
manner. In Canada, 15.3 percent of those aged 15 to 19 have consumed five or more drinks
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at a time on at least twelve occasions during the past year. An Australian study from 1999
through 2003 found that 10.7 percent of young people aged 14 to 19 were frequent binge
drinkers, defined as seven drinks for males or five drinks for females consumed during a
single occasion at least once per week (WHO, 2004).
Several factors influence the occurrence of underage drinking, including age, gender, race,
family circumstances, peers, and social/physical context. Age is the most consistent factor
influencing underage drinking, since as teenagers become older, overall alcohol
consumption tends to increase (Lang, 1985). Gender also influences underage drinking
patterns, since males typically drink more than females across all age groups. This may be
partially attributed to the fact that in order to reach the same blood alcohol concentration
(BAC) level as a female, a male usually must drink significantly more because BAC levels are
dependent on body weight (Lang, 1985). Race, especially in the USA, can be a major
indicator of underage drinking. While 60 to 65 percent of Caucasian children aged 12 to 13
are classified as drinkers, only 10 percent of African Americans and 10 to 13 percent of
Hispanic Americans fall into this category. Family, especially parents, can greatly influence
underage drinking habits by establishing and enforcing rules about drinking, and by
modeling alcohol consumption/moderation behaviour (Lang, 1985). Children of alcoholic
parents are more prone to anti-social behaviour, problems in school, emotional problems, as
well as greater responsiveness to negative peer pressure (Velleman and Orford, 2001).
Finally, peer pressure plays a major role in the amount of alcohol a teenager consumes, and
peer influences in teenage drinking tend to increase with age. Social situations and physical
surroundings can contribute significantly to the occurrence of underage drinking. As a result
of the perception that alcohol is a social lubricant, adolescents often view alcohol as an
essential part of the transition to adulthood (Coggans and McKeller, 1995).
There are numerous negative health effects associated with excessive alcohol consumption,
including liver cirrhosis and several types of cancer (World Health Organization, 2002).
Underage drinking may contribute to growth and endocrine effects that upset the hormonal
balance necessary during puberty to ensure normal development of bones, organs, and
muscles (US Department of Health and Human Services, 2006).
In addition to negative health effects, there are also many social problems associated with
underage drinking, primarily due to the link between alcohol and violence (WHO, 2002a, b),
as well as alcohols role in reducing inhibitions and encouraging high-risk behaviour. Alcohol
consumption among youth can lead to reduced levels of self-control and an impaired ability
to assess risk factors (WHO, 2002a, b). Alcohol use contributes to instances of suicide,
homicides, and sexual assaults, as well as increased risk of contracting HIV and other
sexually transmitted diseases due to higher instances of unprotected sex (Centers for
Disease Control and Prevention, 2006). Alcohol consumption contributes to drowning, falls,
fires, poisonings, and self-inflicted injury (US National Institute on Alcohol Abuse and

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VOL. 9 NO. 4 2008 YOUNG CONSUMERS PAGE 283
 Alcoholism, 2004). Alcohol consumption also contributes to a higher incidence of traffic
accidents, one of the leading causes of death among teenagers (American Medical
Association, 2007). These risk factors are more potent for adolescents than adults because
children are more susceptible to risk-taking, have uncertain expectations regarding how
alcohol will affect their bodies, as well as an uncertain sensitivity and tolerance to alcohol (US
Department of Health and Human Services, 2006).
General policy recommendations to reduce or prevent underage drinking include changing
the social norms regarding how we think about alcohol (Alcoholfreechildren, 2005), and
sustaining national coalitions to confront issues associated with underage drinking (US
Department of Health and Human Services, 2007). Studies show that effective controls on
the price of alcohol and reinforcement of the legal drinking age are needed to reduce the
levels of binge drinking among college students, thereby reducing related health and
behavioural problems (Wechsler et al., 2002). Some US studies have demonstrated that
many youth drink despite an increased minimum drinking age, and therefore suggest that
communities should make a greater effort to increase enforcement of alcohol possession
laws (Dent et al., 2005), while at the same time increasing legal sanctions against alcohol
vendors who sell to minors (Holder, 2000; Willner et al., 2000). However, some studies
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suggest that parental guidance, rather than public policy, can best solve the problem of
underage drinking, since increased amounts of parental control (such as forbidding a child
from using alcohol at home) can reduce overall alcohol consumption by minors (Yu, 2003).

Social marketing and underage drinking

Evidence suggests that alcohol abuse among teenagers can be reduced through social
marketing initiatives (Hanson, 2007). As a result, social marketing campaigns aimed at youth
alcohol prevention or moderation have been developed in many countries.
Within the literature examining social marketing campaigns aimed at preventing or
moderating alcohol consumption among young consumers, several studies evaluate
campus interventions. For example, one study evaluated a campus-wide poster media
campaign intended to disseminate accurate, normative information regarding alcohol
consumption patterns among college students, and found that a poster campaign could
provide an inexpensive, accurate, and consistent means of reducing drinking among
students (LaBrie et al., 2007).
A recent Australian alcohol moderation campaign (called Is getting pissed getting pathetic,
just ask your friends) was designed to increase students awareness of excessive and
harmful drinking. Evaluation results showed that many students positively evaluated the
messages; however, some students responded negatively as a result of psychological
reactance (Ricciardelli and McCabe, 2008). Similar campaigns, such as Rutgers Universitys
RU SURE Campaign (Lederman and Stewart, 2005; Lederman et al., 2001), University of
Mississippis anti-drinking campaign (Gomberg et al., 2001), University of Arizonas
campaign to reduce binge drinking (Glider et al., 2001), the social norms marketing
campaign (DeJong et al., 2006), the Riding the tiger campaign (Pokinghorne and Gill,
1995), and the Done 4 campaign (Russell et al., 2005), led, in general, to positive results.
For example, the media campaign implemented at the University of Arizona, which
employed advertisements, non-alcohol activities, leaflets, and displays at events, had
reportedly led to a 29.2 percent decrease in binge drinking rates over a three-year period
(Glider et al., 2001). Similarly, students attending institutions that implemented a social
norms marketing campaign had a lower risk of alcohol consumption than students attending
institutions where no campaign was implemented (DeJong et al., 2006). On the other hand,
results of a case study regarding the Done 4 campaign concluded that the advertisement
was poorly constructed and led to confusion about social norms messages.
Therefore, although many studies suggest that social marketing campaigns designed to
prevent or reduce youth alcohol consumption can be effective (Yanovitzky and Stryker,
2001), it is important that such campaigns be guided by theory and research in order to
ensure positive results. Studies that examine fear appeals using Protection Motivation
Theory (Rogers, 1983) as a framework recommend increasing perceptions of severity and

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PAGE 284 YOUNG CONSUMERS VOL. 9 NO. 4 2008
 ones vulnerability to the negative effects associated with underage drinking, in order to
increase message effectiveness (Caspi et al., 1997; Champion et al., 2004; Zeigler et al.,
2005).

Protection motivation theory

To better understand the factors that influence the persuasiveness of public health
communication, US researchers commonly use protection motivation theory (PMT) as a
theoretical framework (Maddux and Rogers, 1983; Prentice-Dunn and Rogers, 1986;
Rogers, 1983). PMT is a highly comprehensive theory of health communication that is well
accepted and widely used (Boer and Seydel, 1996). Social marketing campaigns aimed at
reducing or preventing youth alcohol consumption seek to influence many of the cognitions
that are the focus of PMT (Caspi et al., 1997; Champion et al., 2004; Zeigler et al., 2005).
According to PMT (Rogers, 1975, 1983), protection motivation is maximized when:
B the threat to health is severe (high perceived severity);
B the individual feels vulnerable (high perceived vulnerability);
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B the adaptive response is believed to be an effective means of averting the threat (high
response efficacy);
B the costs associated with the adaptive response are small (low costs); and
B the person is confident in his or her abilities to complete successfully the adaptive
response (high self-efficacy).
Such factors produce a state of protection motivation, and subsequently encourage the
adoption of the adaptive or coping response (Maddux and Rogers, 1983; Prentice-Dunn
and Rogers, 1986; Rogers, 1975, 1983). Among the factors that play a role in PMT,
self-efficacy is believed to have the most significant impact on ones decision to adopt a
recommended health behaviour (Milne et al., 2000; Rogers, 1975, 1983).
To illustrate the use of PMT principles, consider the following example of a social marketing
campaign aimed at reducing underage drinking. The National Underage Drinking
Prevention campaign, developed by the Substance Abuse and Mental Health Services
Administration (SAMHSA), is a comprehensive portal of resources providing information
about underage drinking, as well as ideas for combating this issue
(www.stopalcoholabuse.gov/default.aspx). The campaigns educational brochure,
Underage Drinking: Myths and Facts, states that:

Alcohol increases your risk for many deadly diseases, such as cancer. Drinking too much alcohol
too quickly can lead to alcohol poisoning, which can kill you.

This information about the possible negative consequences of drinking is meant to increase
perceived vulnerability and severity for the reader. The same brochure states that:

If you really want to fit in, stay sober. Most young people dont drink alcohol. Research shows that
more than 70 percent of youth aged 12 to 20 havent had a drink in the past month.

This information attempts to reduce the perceived costs of abstaining from alcohol, since
many young consumers might otherwise believe that drinking alcohol will make them fit in
better with friends and peers. It suggests that abstaining from alcohol is something most
young people do, and therefore the reader can successfully do it, too; this is meant to
increase the perception of self-efficacy. Another resource entitled Guide to Safe and Sober
Event Planning, found on the same web site, provides specific activities young people can
engage in to have a successful party without consuming alcohol. This information reduces
the perceived costs involved in adopting the recommended behaviour (i.e. that a lack of
alcohol will result in an unsuccessful party), while at the same time increasing the perception
of response efficacy by emphasizing that the desired outcome (a fun and successful party)
will be achieved.

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VOL. 9 NO. 4 2008 YOUNG CONSUMERS PAGE 285
 Research design and methodology
The present research study provides a comprehensive examination of youth alcohol
prevention and moderation campaigns in five English-speaking countries (USA, Canada,
Australia, New Zealand, and the UK). This research involved conducting a qualitative
content analysis of alcohol moderation/prevention communication materials targeting young
consumers. We searched the Internet for relevant communication materials using keywords
such as alcohol moderation, alcohol prevention, anti-drinking, underage drinking,
child drinking, adolescent drinking, teen drinking, and young adult drinking,
combined with campaign-related terms such as social marketing, deterrents,
deterrence policy, campaign, program, brochure, PSA, public service
announcement, media, and Protection motivation theory. We also searched
health-related government web sites such as the US Department of Health and Human
Services, National Institutes of Health, Health Canada, Australia Department of Human
Services, UK Government Department of Health, and similar web sites from the five
countries. References to campaigns and programs discussed in academic papers located
through ABI-Inform, Blackwell Synergy, Cambridge Journals Online, Child Development,
JSTOR, Medline, PsychInfo, and other databases were also used as means of finding
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additional campaigns.
Each campaign was analyzed to determine its adherence to protection motivation theory,
and its inclusion of the key elements of PMT (i.e. severity, vulnerability, response efficacy,
self-efficacy, and costs). 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 campaigns adherence to the tenets of protection motivation theory.

Qualitative research findings

Our search revealed over 30 anti-drinking programs or campaigns targeting young
consumers (see Table I). Most of them (18) were developed in the USA, but several were
found in Canada (4), Australia (5), New Zealand (3) and the UK (5). Most of the campaigns
and programs were initiated and developed by government or non-profit organizations and
are intended to create awareness about the risks associated with underage drinking (e.g.,
US National Underage Drinking Prevention campaign; Youth Alcohol campaign), change the
acceptance and celebration of drunkenness and intoxication to reduce the amount young
people drink at a given time (e.g., Its Not the Drinking, Its How Were Drinking; Be Part of It,
Not Out of It), or provide alternatives for having a successful party without drinking (e.g., A
Guide to Safe and Sober Event Planning). Some campaigns encourage parents to talk to
their kids about alcohol (e.g., Talking Before They Start Drinking campaign), pointing out to
adults that kids mimic their behaviour (e.g., Children Mimic Their Heroes; Is Your Drinking
Affecting Their Thinking). Other campaigns advocate against supplying alcohol to young
people (e.g., Should You Supply).
Campaigns included a wide variety of different components, including web sites and print
materials such as posters and brochures, as well as radio and TV public service
announcements (PSAs). In addition, some campaigns incorporated community and
mass-media events, partnerships with universities or high-schools, awards, newsletters, and
other components. Campaigns took place at a variety of levels, including the international,
national, provincial/state, or community level.
In examining whether the campaigns adhered to protection motivation theory, it was
apparent that most of the campaigns focused on threat variables, (i.e. severity and
vulnerability) by emphasizing the potentially severe consequences associated with
underage drinking (e.g. Smashed or Young Road Users). Some campaigns provide
information about all PMT variables (e.g., 100% Control campaign; National Underage
Drinking Prevention campaign). Yet other campaigns focused on how young consumers are
influenced by the people around them (i.e. peer pressure and family influence) (e.g., Face It,
Parents; Not Everybody is Doing It! Most Youth Dont!). Finally, there were some community
programs that did not seem to directly adhere to PMT principles (e.g., campaigns like

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PAGE 286 YOUNG CONSUMERS VOL. 9 NO. 4 2008
 Table I Campaigns and programs against under-age drinking found on the internet grouped by the country (listed in
alphabetical order)

Campaign description and web Campaign Adherence to

Campaign/year address Initiator components PMT

International
SADD (Students Against Aims to provide students with the best Robert Anastas at Posters, kits, TV Includes
Drinking and Driving) prevention and intervention tools Wayland High School in ads, information about
campaigns (since 1981) possible to deal with the issues of Massachusetts merchandise, all PMT variables
underage drinking, drug use, impaired events,
driving and other destructive decisions. counselling,
Founded in the USA, also operates in stores,
Australia and New Zealand (sadd.org/ newsletters,
mission.htm) campaigns,
activities, web site
USA
AlcoholEduw for High Web-based course that incorporates Mothers Against Drunk School-based Focuses on
School prevention techniques with essential Driving curriculum severity,
science-based alcohol education in program, web site vulnerability and
order to change attitudes, motivate response
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behaviour change, and support safer efficacy

decisions (outsidetheclassroom.com/
prodandserv/highschool/
alcoholEdu_highschool/)
Be Cool. Be You. Dont Aims to reduce the serious, and often National Institute on Fact-sheet, TV Includes
Drink. The Party is Over fatal, consequences of alcohol use in Alcohol Abuse and and radio PSAs, information about
young people (http://pubs.niaaa.nih. Alcoholism of the U.S. PSAs for parents all PMT variables
gov/publications/PSA/underage.htm) National Institutes of and adolescents,
Health brochure for
parents, posters,
web site
By Our Own Hands US national media campaign aimed at US Department of Health Television and Includes
dispelling misconceptions about & Human Services radio PSAs, information about
alcohol use among youth, and billboards, bus all PMT variables
reinforcing the positive activities among cards, brochures,
youth (hhs.gov/news/press/ posters, other
pre1995pres/920513.txt; printed materials,
mediacampaign.org/publications/ web site
strat_overview/notes.html)
Campus Community Prevention initiative designed to reduce State Department of Campus Focuses on
Alcohol Management high-risk drinking and related problems Alcohol and Drug programs severity and
Project (CCAMP) among young adults aged 18-24. Aims Program; Alcohol and including a social vulnerability
to reduce access to alcohol by Drug Education and marketing
underage drinkers, reduce the number Prevention Team; several campaign with
of students who supply alcohol to California universities posters,
youth, and reduce the number of advertisements in
students who experience the Daily Titan
alcohol-related problems such as student
alcohol poisoning, fights, sexual newspaper, and
assault and regret (http://campusapps. web site
fullerton.edu/news/2007/
240_alcoholmgm.html)
Center on Alcohol Program monitors the marketing Georgetown University; Research reports, Focuses on
Marketing and Youth practices of the alcohol industry to The Pew Charitable press releases, severity and
focus attention and action on industry Trusts; Robert Wood fact sheets, vulnerability; also
practices that jeopardize the health and Johnson Foundation instructions for addresses peer
safety of Americas youth. Uses public taking action, web pressure
health strategies that limit the access to site
alcohol and the appeal of alcohol to
underage persons (http://camy.org)
Community Alliance Dedicated to creating and County of Orange Health Presentations, Does not seem to
Network implementing prevention strategies Care Agency training, adhere to PMT
that denormalize the use of alcohol, workshops, principles
tobacco and other drugs (canoc.org/ technical
main/index.html) assistance,
education
materials, web site

(Continued)

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VOL. 9 NO. 4 2008 YOUNG CONSUMERS PAGE 287
 Table I
Campaign description and web Campaign Adherence to
Campaign/year address Initiator components PMT

Cool Spot Teen focused web page providing National Institute on Web site Provides
information about alcohol and resisting Alcohol Abuse and information about
peer pressure (thecoolspot.gov/) Alcoholism; National severity,
Institutes of Health; US vulnerability, and
Department of Health costs
and Human Services
Face It, Parents A campaign to warn adults about the Oregon Department of Posters, web site Focuses on
perils of underage drinking (oregonlive. Human Services, vulnerability and
com/news/argus/index.ssf?/base/ Addictions and Mental severity
news/1205257800137890. Health Division and the
xml&coll 6) Oregon Liquor Control
Commission
National Plant the Schools, businesses, families and National Family Bulbs, planting Does not adhere
Promise Week youth across America plant red tulip Partnership; NIMCO accessories, web to PMT principles
bulbs to serve as a reminder to stay site
alcohol and drug-free. Coincides with
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national Red Ribbon Week and

provides an opportunity to reinforce the
Say No to Drugs message
(plantthepromise.com/)
National Underage Comprehensive portal of US Federal Substance Abuse and PSAs, links to Includes
Drinking Prevention resources for information on underage Mental Health Services resources, web information about
campaign drinking and ideas for combating this Administration site all PMT variables
issue (stopalcoholabuse.gov/) (SAMHSA)
Natural High Aims to encouraging young people not Sundt Memorial Educational Provides
to use alcohol or drugs and to inspire Foundation materials, videos, information about
them to make healthy choices assemblies, web all PMT variables
(drugfreewave.com/index.html) site
Reach Out Now Dedicated to providing school-based, SAMHSA, Scholastic Inc Curriculum, web Focuses on
underage alcohol use prevention site severity and
materials in time for Alcohol Awareness vulnerability
Month each April (teachin.samhsa.gov)
Red Ribbon Week Since Aims to increasing awareness about Orange County Health Events, training Does not seem to
1987 alcohol and drug prevention, is Care Agency schools, links to adhere to PMT
celebrated during last week of October resource material, principles
in schools and communities web site
(ochealthinfo.com/adept/red-ribbon/)
Strategies To Act Now Annual weeklong conference that Youth Alcohol and Drug Conferences and Does not seem to
(STAN) Planning engages participants in the process of Abuse Prevention Project workshops, web adhere to PMT
constructing a substance abuse and/or site principles
violence prevention activity for their
school and community (yadapp.com/
stan.htm)
Talking Before They Start Campaign to encourage parents to talk SAMHSA TV and radio Focuses on
Drinking Campaign with their children about alcohol (http:// PSAs, web site severity and
family.samhsa.gov/stop/) vulnerability
Too Smart To Start Designed to educate 9- to 13-year-olds SAMHSA Implementation Focuses on
about the harms of alcohol use and to strategies and severity and
support parents and caregivers as they materials, web site vulnerability
participate in their childrens activities
(toosmarttostart.samhsa.gov/)
UCSC Alcohol and Other On-campus resource for students with Health educators, peer Individual support Focuses on
Drug (AOD) Abuse concerns about alcohol and other drug educators and senior and referral, peer severity and
Prevention Program use in their own lives or in their administrators from each education, vulnerability but
community (http://reg.ucsc.edu/ of the nine University of academic provides specific
navigator/2007-08_Navigator/ California campuses classes, staff advice regarding
Appendix_D.pdf) training, resource how much one
library, web site can responsibly
drink

(Continued)

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PAGE 288 YOUNG CONSUMERS VOL. 9 NO. 4 2008
 Table I
Campaign description and web Campaign Adherence to
Campaign/year address Initiator components PMT

Youth to Youth Community-based drug prevention and Youth to Youth Conferences, Provides
youth leadership program focusing on International training, information about
harnessing the powerful influence of workshops, web all PMT variables
peer pressure making it a positive site
force that encourages young people to
live free of alcohol (youthtoyouth.net/)

Canada
Be Prepared to Talk to Dedicated to implementing education Educalcool Guide for Parents Addresses all
Your Children and prevention programs designed to and Children, PMT variables
help young people and adults make interactive
enlightened, responsible decisions animations
about drinking (educalcool.qc.ca/en/)
Drinking Facts Provides information about alcohol Canadian Public Health Video materials, Focuses on
consumption to young people Association posters, fact severity,
(drinkingfacts.ca/english/index.asp) sheets, quizzes, vulnerability, and
discussion costs
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guides, web site

Most Youth Dont! Aims to replace the false norm that Alberta Alcohol and Drug Media, Focuses on the
everybody is doing it with the true Abuse Commission promotional social component
information about most students (AADAC) materials, and included in PMT
demonstrate moderate and activities
responsible behaviour (aadac.com/
documents/not_everybody_faq.doc)
Smashed Young Road Raises awareness about the societal Transport Canada Road Magazine, Global Focuses on
Users impact of road traffic injuries, Safety Road Safety severity and
highlighting the risks for young road Week, vulnerability
users (tc.gc.ca/hookedonroadsafety/ conferences, web
menu.htm) site

Australia
100% Control Campaign Raises awareness about the harms West Australian Media, factsheets, Addresses all
(targeting 12 to 17 years associated with alcohol. It uses a range Government, Alcohol and information cards, PMT variables
old) of school and community-based Other Drugs Program, posters,
strategies to compliment its primary Public Health Division of billboards,
media component (dao.health.wa.gov. the Department of Health publications for
au) teachers,
merchandise,
school based
strategies,
community based
strategies, web
site
Are You Responsible? Be Encourages the community to think Community Media releases, Does not seem to
Part of It Not Out of It about their level of responsibility in Builders/Wollongong ads on local adhere to PMT,
relation to young people and alcohol. Local Area Command television, radio although it
The campaign aims to target the supply and print media, emphasizes that
of alcohol to young people. Be Part Of It posters, youth can miss the
Not Out Of It is designed to prompt pamphlets, fun if they drink too
young people to think about the way promotional much (costs)
they drink, how much they drink, and material,
how they might take a less risky operational
approach to drinking component, web
(communitybuilders.nsw.gov.au/ site
drugs_action/respon.html)
National Alcohol Intended to reduce the growing Australian Government Print resource Provides
Campaign to target number of young people who are Department of Health card, parent information about
teenage drinking (2000) excessively consuming alcohol or and Aging brochure, all PMT variables
getting drunk and getting drunk newspaper and
quickly (health.gov.au/internet/wcms/ magazine
publishing.nsf/Content/ advertisements,
health-mediarel-yr2000-mw-mw20012. web site
htm)

(Continued)

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 Table I
Campaign description and web Campaign Adherence to
Campaign/year address Initiator components PMT

Play Now/Act Now
Youth Alcohol Campaign
(2002)
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Encourages young adults to showcase New South Wales Educational Focuses on
their creative talent through the Government resources, fact severity and
production of a short film or video sheets, film/video, vulnerability
centred on the issues of excessive creative writing,
alcohol consumption among young graphic design
people (playnowactnow.net.au/) competitions, web
site
Increases young peoples Victorian Government Toll-free telephone Focuses on
understanding of the negative Minister for Health number, severity,
consequences of drinking and their television, cinema, vulnerability, and
awareness of the services available to radio, internet, response
help someone with an alcohol problem outdoor and efficacy
(health.vic.gov.au/drugs/alcohol/youth/ in-venue
campaign.htm) advertising, web
site

New Zealand
Children Mimic Their
Heroes
Its Not the Drinking is
How We are Drinking
Should You Supply
Attempts to make adults aware of the Alcohol Advisory Council Fact sheets, Focuses on
fact that children mimic them in both of New Zealand (ALAC) posters, web site severity and
good and bad behaviour (alac.org.nz/ vulnerability
Campaign.aspx?PostingID 2488)
Aims at changing the acceptance and ALAC Television, facts Focuses on
celebration of drunkenness and and figures, severity
intoxication and at reducing the amount supporting
of alcohol consumed on each occasion material,
(alac.org.nz/ magazines, web
CampaignItsNotTheDrinking.aspx) site
Community based intervention ALAC Radio ads, print Includes
concerning the dangers of supplying media interviews information about
alcohol to teenagers (alac.org.nz/ with community all PMT variables
InpowerFiles/Publications/ workers, media
CategorisedDocument.Document1. events, billboard
1082.d1f140dc-c857-4ea2- ads, printed
86dc-1184b7d28cae.pdf) material

UK
The Drinkaware Addresses alcohol abuse by UK Youth and the Posters, youth Focuses on
Challenge encouraging young people to create Drinkaware Trust club alcohol severity and
their own alcohol education projects policies, first aid vulnerability
(ukyouth.org/whatwedo/Programmes/ projects,
YAA/drinkaware.htm http://drinkaware. presentations,
co.uk/) dramatic
performances,
web site
Is Your Drinking Affecting Highlights the vital role parents of Mature Enjoyment of Radio and Focuses on
Their Thinking under-18s play in determining the Alcohol newspaper severity and
attitude of their kids toward alcohol advertising vulnerability
consumption; challenges parents and
young people to review their attitudes
toward drinking; appeals to adults not
to buy alcohol for persons under the
age of 18 (meas.ie/page.
php?intPageID 123)
Know Your Limits Urges young drinkers to know their UK Government TV ads, posters, Addresses all
limits and to stay within them (dh.gov. Department of Health and web site PMT variables
uk/en/News/Currentcampaigns/index.
htm; dh.gov.uk/en/News/
Currentcampaigns/index.htm)

(Continued)

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PAGE 290 YOUNG CONSUMERS VOL. 9 NO. 4 2008
 Table I
Campaign description and web Campaign Adherence to
Campaign/year address Initiator components PMT

St Patricks Day Aims at combating under-age drinking Mature Enjoyment of Radio and Does not seem to
Advertising campaign to and challenges adults to examine Alcohol newspaper adhere to PMT
combat underage whether their attitude toward alcohol is advertisements principles
drinking adversely influencing their children. An
appeal to off-licensees not to sell
alcohol to those under the age of 18; an
appeal to adults not to purchase
alcohol for under-age teenagers; an
appeal aimed at young adults urging
them not to over-indulge in alcohol
(meas.ie/page.php?intPageID 297)
Respect Alcohol Respect UK national awareness campaign to Union of Students in Posters, articles, Focuses on
Yourself highlight the risks involved in excessive Ireland and Mature radio and TV severity and
alcohol consumption (meas.ie/page. Enjoyment of Alcohol interviews, and vulnerability
php?intPageID 124) campus events
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Striving Together to Achieve Rewarding Tomorrow). This is perhaps not surprising, since
community programs may involve partnerships and interventions that follow theoretical
frameworks other than PMT. In the following sections, we present a description of the social
marketing initiatives grouped by their country of origin.

International campaigns
Perhaps the largest international organization positioned to reduce or eliminate underage
drinking through large-scale social marketing campaigns is Students Against Drinking and
Driving (SADD). SADD is linked with many partners, including government, non-profit
organizations, and the corporate sector. As shown in Table I, SADD attempts to provide
young people with prevention and intervention techniques to deal with the issues of
underage drinking, through programs such as Designated Driver and Safe Rides. SADD
campaigns address all PMT variables in a comprehensive manner.

Campaigns from the USA

Of all the English-speaking countries, the USA has the highest legal drinking age of 21, and
also exhibits the largest number of social marketing campaigns targeted against underage
drinking. Campaigns are initiated by various levels of government, non-government
organizations (NGOs), and the private sector.
One example of an NGO campaign is AlcoholEduw for High School from Mothers against
Drinking and Driving (MADD). This campaign focuses on increasing perceived severity and
vulnerability by giving first hand accounts of the consequences of underage drinking, in
order to change the attitudes and behaviour of young people towards alcohol, and
emphasize healthier decision-making. The Natural High campaign also inspires youth to
make healthier choices, but provides information about all PMT variables rather than
focusing on severity and vulnerability. The Youth to Youth campaign concentrates on youth
leadership programs in order to make peer pressure become a positive force against
underage drinking, and it does so by providing information about all PMT variables. The
Center on Alcohol Marketing and Youth monitors how the marketing practices of the alcohol
industry affect the heath and safety of Americas youth; this campaign provides links to
resources that examine the relationship between PMT variables and underage drinking. An
example of a NGO program that does not adhere to PMT principals is the National Plant the
Promise Week, which focuses on positive symbolism as a means of promoting the message
about underage drinking.
Several government social marketing campaigns, such as the Community Alliance Network,
Red Ribbon Week, and Too Smart to Start, also focus on increasing public awareness while
promoting prevention strategies to combat underage drinking. Most government

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VOL. 9 NO. 4 2008 YOUNG CONSUMERS PAGE 291
 campaigns appear to focus on PMT principles. For example, the By Our Own Hands
campaign considers all PMT variables in order to make youth aware of the dangers of
alcohol, while identifying key underage drinking reduction and prevention strategies. The
National Underage Drinking Prevention Campaign also provides information about all PMT
variables through a comprehensive portal of resources on underage drinking. Other
government campaigns, such as Campus Community Alcohol Management Project
(CCAMP), Cool Spot, Reach Out Now, and Talking Before They Start Drinking, focus on the
PMT variables of severity and vulnerability by providing a series of photographs of
alcohol-related tragedies and exploring the potential risks associated with underage
drinking, while at the same time providing suggestions regarding how to mitigate the
problem of underage drinking. Face It, Parents, developed by Oregon Department of
Human Services, Addiction and Mental Health Division in collaboration with Oregon Liquor
Control Commission, is designed to warn adults about the perils of underage drinking.

Campaigns from Canada

Canada also provides social marketing campaigns targeting alcohol moderation/prevention
young consumers, but to a lesser extent than the USA. Two of the major campaigns identified
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are initiated by a government organization (Transport Canada) and a non-government

organization (Canadian Public Health Association). The Smashed campaign from Transport
Canada focuses on severity and vulnerability in order to raise awareness about the societal
impact of road traffic injuries. It highlights the risks for young drivers regarding road safety
and alcohol consumption, and gives specific advice about how to prevent traffic injuries. The
Drinking Facts campaign from the Canadian Public Health Association focuses on all PMT
variables, since it provides information about alcohol consumption, as well as information
guides for parents and educators to spark conversations about alcohol consumption with
youth. These guides include lists of reasons for youth not to drink, as well as information for
youth who want help resolving their problems with alcohol.
Be Prepared to Talk to Your Children aims to implement education and prevention programs
designed to help young people and adults make responsible decisions about drinking. One
of the developed tools, The Guide for Parents and Children, addresses all PMT variables by
emphasizing the dangers associated with underage drinking, as well as providing specific
advice about how to drink responsibly and what to do in specific situations to avoid
irresponsible drinking or minimize the negative effects of drinking. Most Youth Dont! is a
campaign that attempts to change the falsely perceived norm that everybody is doing it,
by presenting statistical information showing that most students are moderate and
responsible with respect to alcohol consumption. The campaign components include
media, promotional materials, as well as other activities.

Campaigns from Australia

Two of Australias campaigns, National Alcohol Campaign to Target Teenage Drinking, as
well as the 100% Control Campaign, are dedicated to decreasing the number of youth who
consume alcohol to excess. These campaigns provide information about all PMT variables,
with a focus on providing alarming statistics associated with underage drinking in order to
show the negative consequences of excessive alcohol consumption, the economic costs of
underage drinking, and the possible dangers associated with binge drinking. The campaign
also provides materials focused on underage drinking prevention strategies, which include
brochures, magazine and newspaper advertisements, and construction of youth oriented
web sites that are aimed at reducing underage drinking. The Youth Alcohol Campaign
focuses on the PMT variables of severity and vulnerability in order to increase young
peoples understanding about the negative consequences associated with alcohol
consumption, thereby creating a high level of response efficacy by influencing young
peoples attitudes, decisions, and behaviours concerning alcohol consumption. The Are you
Responsible? campaign is committed to addressing the problems associated with
underage drinking and the secondary supply of alcohol to young people. Be Part of It, Not
out of It emphasizes what youth can miss if they drink too much. Play Now/Act Now is an
initiative aimed at encouraging young adults to showcase their creative talent through the

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PAGE 292 YOUNG CONSUMERS VOL. 9 NO. 4 2008
 production of a short film or video centered on the issue of excessive alcohol consumption
among young people. It focuses on the threat PMT variables, especially severity; however, it
also provides specific tips that encompass the PMT coping variables.

Campaigns from New Zealand

New Zealands Should You Supply is a community based intervention that examines the
dangers of supplying alcohol to teenagers, and includes information about all PMT
variables. The campaign considers where teenagers acquire their alcohol and parental
attitudes towards supplying alcohol to youth. The web site also examines the effect of the
campaign on teenage drinking levels, as well as the overall impact of the campaign on
parents. A campaign entitled Its Not the Drinking, Its How Were Drinking attempts to
change the New Zealand drinking culture a culture where people drink too much at a time
and accept being drunk. Children Mimic their Heroes attempts to make adults aware of the
fact that children and youth imitate them in both good and bad behaviour, so parents should
be aware of the potential influence of their own drinking habits. These latter two campaigns
from New Zealand focus on the PMT threat variables (severity and vulnerability).
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Campaigns from the UK

The Know Your Limits campaign developed by the UK Department of Health urges young
drinkers to know their limits and stay within them. It provides facts about alcohol as well as
tips about what to do when things go wrong or out of control, thereby addressing most of the
PMT variables. Campaign components include TV ads as well as posters and a web site.
The Drinkaware Challenge, initiated by UK Youth in collaboration with the Drinkaware Trust,
addresses alcohol abuse by encouraging young people to design their own alcohol
education projects such as posters, youth club alcohol policies, first aid projects,
presentations, or dramatic productions. Factual information is provided on the web site,
primarily serving to heighten perceived severity and vulnerability.
Is Your Drinking Affecting Their Thinking, St Patricks Day Advertising Campaign to Combat
Underage Drinking, as well as Respect Alcohol Respect Yourself, are all campaigns
developed by Mature Enjoyment of Alcohol (MEAS) in Ireland, directed at combating
underage drinking. These campaigns are designed to challenge adults to examine whether
their own attitudes toward alcohol consumption are adversely influencing their children.
These campaigns also focus on the severe consequences of underage drinking.
Also in the UK, a new Licensing Act is attempting to tackle underage alcohol sales through a
campaign aimed at outlets selling alcohol. This educational campaign is combined with
tough enforcement which tests over 3,000 off-licenses, pubs, and clubs to see whether they
sell alcohol to minors, removing the licenses of offending outlets (Brighton business.co.uk,
2007; Politics.co.uk, 2008).

Conclusion
The USA, Canada, Australia, New Zealand, and the UK have developed numerous social
marketing campaigns to prevent or reduce underage drinking. Campaigns include a variety
of components such as PSAs, posters, billboards, and print ads, as well as community
engagement and educational materials to use in schools. Campaigns are designed to
motivate the public to undertake a variety of behaviours, including encouraging youth to
abstain from alcohol use or drink only in moderation, talking with kids or peers about alcohol
issues, and abstaining from supplying young consumers with alcoholic beverages.
Protection motivation theory (PMT) is an appropriate framework to use for developing alcohol
moderation/prevention campaigns targeting young consumers, since high levels of severity
and threat can significantly influence behaviour change. The present review shows that
campaigns focus on the threat variables (i.e. severity and vulnerability), particularly in the
USA, Canada, and Australia.
To improve the effectiveness of social marketing campaigns, communicators should
continue to focus on increasing the perceived vulnerability and severity, but should also

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VOL. 9 NO. 4 2008 YOUNG CONSUMERS PAGE 293
 provide specific advice about how to avoid underage drinking. This advice should ideally
emphasize low costs and high levels of self-efficacy, so that people feel confident about
being able to follow the advice. Since perceived self-efficacy is often the most important
determinant of behaviour change, making people feel that they can actually follow the
recommendations should constitute one of the main objectives of any alcohol prevention or
alcohol moderation campaign targeting young consumers.

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Health Challenge, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, available at:
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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 Marketing Theory, Social Marketing Quarterly,
International Review on Public and Nonprofit Marketing, Canadian Public Policy, Advances
in Consumer Research, and elsewhere. Magdalena Cismaru is the corresponding author
and can be contacted at: Magdalena.Cismaru@uregina.ca
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 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 on a series of articles that deal with social
marketing.

To purchase reprints of this article please e-mail: reprints@emeraldinsight.com

Or visit our web site for further details: www.emeraldinsight.com/reprints

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PAGE 296 YOUNG CONSUMERS VOL. 9 NO. 4 2008
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