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Practice Profile

Mass Media Campaigns to Prevent Illicit Drug Use of Youth

Evidence Ratings for Outcomes:

No Effects - One Meta-Analysis Drugs & Substance Abuse - Multiple substances
No Effects - One Meta-Analysis Juvenile Problem & At-Risk Behaviors - Intentions to use drugs

Practice Description

Practice Goals/Target Population
Mass media campaigns have become a common way of delivering preventive health messages to the general population. The goal of these campaigns is to reach a large number of people, including those who may be difficult to access through traditional approaches, to change health-related behaviors and attitudes. Although antidrug mass media campaigns can be seen by almost anyone in the general population who is exposed to the message, the campaigns usually concentrate on preventing, reducing, or stopping the illicit drug use of young people (which generally includes individuals 26 and younger), because initiation of substance use typically begins during adolescence or young adulthood (Ferri et al. 2013).

Media campaigns targeting illicit drug use focus on the abuse of drugs such as methamphetamine, heroin, cocaine, and marijuana. Other types of media campaigns may concentrate on preventing misuse of licit drugs, such as alcohol or tobacco, but studies of those types of campaigns were not included in this review.

Practice Components
Mass media campaigns can be implemented and disseminated using several different forms of media, including television commercials, radio broadcasts, newspaper or magazine advertisements, billboard posters, brochures or posters on buses and subways, as well as Internet-based campaigns. Exposure to a campaign is generally passive, meaning people happen to see the message during routine viewing of media, such as television or magazines. Media campaigns may be part of a larger information or social marketing program, or they may be standalone interventions. The duration of campaigns can vary. They may be of short duration or extend over long periods (Wakefield, Loken, and Hornik 2010).

Ferri and colleagues (2013) categorized media campaigns into two types: information campaigns and social marketing campaigns. Information campaigns focus on providing information about the dangers and risks of illicit substances, or about treatment and counseling services that may be available for drug users. The main objectives in information campaigns are warning, empowerment, and support. Social marketing campaigns attempt to clarify misconceptions young people may have about the extent and acceptance of drug use among their peers. The main objectives of social marketing campaigns are to correct erroneous normative beliefs, to set or clarify social and legal norms, and to establish positive role models.

Practice Theory
Media campaigns that concentrate on preventing youths’ illicit drug use are based on many theoretical models, such as the health belief model, the theory of reasoned action/theory of planned behavior, the social norms theory, the super-peer theory, and the social leaning theory.

  • The health belief model is based on the idea that a lack of knowledge about the harms to an individual’s health may lead to drug use (Glanz, Rimer, and Lewis 2002). Thus, providing factual information about the dangers of drugs should prevent or reduce abuse by creating negative attitudes toward drug use.
  • The theory of reasoned action/theory of planned behavior argues that drug use is a rational decision based on an individual’s attitude toward drugs, the social norms perceived by the individual, and the perceived control over that individual’s behavior (Ajzen 1991). Media campaigns set about to clarify social norms about drug use.
  • Social norms theory argues that behavior is affected by an incorrect perception about how other people think and act about drug use (Perkins and Berkowitz 1986). Media campaigns based on this theoretical model attempt to dispel the misconception that many young people use drugs. Similar to the social norms theory, the super-peer theory argues that media portrayal of drug use, sex, or violence influences vulnerable teens (Strasburger, Wilson, and Jordan 2008). Media campaigns based on this theory would also attempt to correct misconceptions and erroneous information.
  • Social learning theory argues that an individual’s personality is a product of the interaction between the environment, behaviors, and the psychological processes of the individual (Bandura 1977). Media interventions based on this theory would promote positive role models or prosocial behaviors.

Meta-Analysis Outcomes

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No Effects - One Meta-Analysis Drugs & Substance Abuse - Multiple substances
Through analyzing the results from five randomized controlled trials (RCTs), Ferri and colleagues (2013) found no significant effect of media campaigns on illicit drug use (standardized mean difference= –0.02). Although youth exposed to antidrug media campaigns tended to, on average, use fewer illicit drugs compared with youth not exposed to media campaigns, the differences between the groups was not significant. However, the authors cautioned that further evaluation studies are needed.
No Effects - One Meta-Analysis Juvenile Problem & At-Risk Behaviors - Intentions to use drugs
Ferri and colleagues (2013) examined the results from four RCTs and found mass media campaigns had no significant effect on intentions not to use, intentions to reduce use, and intentions to stop use of illicit drugs (standardized mean difference=–0.07). Again, the authors cautioned that further evaluation studies are needed.
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Meta-Analysis Methodology

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Meta-Analysis Snapshot
 Literature Coverage DatesNumber of StudiesNumber of Study Participants
Meta-Analysis 11999 - 201086740

Meta-Analysis 1
Ferri and colleagues (2013) reviewed the effectiveness of mass media campaigns that aim to prevent or reduce the use of or intention to use illicit drugs among young people. Notably, the review did not include mass media campaigns that sought to promote licit drugs. For the review, young people included anyone under age 26. To be included in the review, studies had to be one of the following type: 1) randomized control trials (RCTs) in which the unit of randomization is an individual or a cluster (i.e., the school, community, or geographical region); 2) controlled trials without randomization allocating schools, communities, or geographical regions; 3) prospective and retrospective cohort studies; 4) interrupted time series; and 5) controlled before and after studies. The review authors did an electronic search of databases such as Cochrane Central Register of Controlled Trials, Medline through PubMed, Embase, and ProQuest Dissertations and Theses. Conference proceedings were also assessed, and investigators or experts in the field were also contacted about unpublished or incomplete trials.

The primary outcome of interest for the review was self-reported or biomarker-assessed illicit drug use, which was examined in five RCTs. These RCTs included a wide variety of participants, including Asian American girls ages 10 to 14 (Fang, Schinke, and Cole 2010), college students ages 17 to 19 (Lee et al. 2010), 13- to 14-year-old girls from the United States and Canada (Schwinn, Schinke, and Noia 2010), sixth and seventh grade students (Slater et al. 2006), and 13-year-old students from Australia (Newton et al. 2010). The five RCTs included 5,470 study participants.

Another outcome of interest was the intentions not to use, to reduce use, or to stop use of illicit drugs, which were examined in four RCTs that included 1,270 student participants. These studies also included a wide variety of participants, including Asian American girls ages 10 to 14 (Fang, Schinke, and Cole 2010), seventh through ninth graders from a rural southwestern Mexican American community (Polansky et al. 1999), middle and high school students in urban Philadelphia (Yzer et al. 2003), and middle and high school students 13 to 17 years old (Zhao et al. 2006).

The included studies used continuous outcome measures; thus, the standardized mean difference with the corresponding 95 percent confidence intervals was calculated for the meta-analysis. The analysis of RCTs used a random-effect model to take into consideration the heterogeneity among the studies.
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Cost

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There is no cost information available for this practice.
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Evidence-Base (Meta-Analyses Reviewed)

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These sources were used in the development of the practice profile:

Meta-Analysis 1
Ferri, Marica, Elias Allara, Alessandra Bo, Antonio Gasparrini, and Fabrizio Faggiano. 2013. “Media Campaigns for the Prevention of Illicit Drug Use in Young People.” Cochrane Database of Systematic Review Issue 6.
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Additional References

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These sources were used in the development of the practice profile:

Ajzen, Icek. 1991. “The Theory of Planned Behavior.” Organizational Behavior and Human Decision Processes 50:179–211.

Bandura, Albert. 1977. Social Learning Theory. New York, N.Y.: General Learning Press.

Fang, Lin, Steven P. Schinke, and Kristin C.A. Cole. 2010. “Preventing Substance Use Among Early Asian American Adolescent Girls: Initial Evaluation of a Web-Based Mother-Daughter Program.” Journal of Adolescent Health 47(5):529–32.

Glanz, Karen, Barbara K. Rimer, and Frances Marcus Lewis. 2002. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, Calif.: Wily and Sons.

Lee, Christine M., Clayton Neighbors, Jason R. Kilmer, and Mary E. Larimer. “A Brief, Web-Based Personalized Feedback Selective Intervention for College Student Marijuana Use: A Randomized Clinical Trial.” Psychology of Addictive Behaviors 24(2):265–73.

Newton, Nicola C., Maree Teesson, Laura E. Vogl, and Gavin Andrews. 2010. “Internet-Based Prevention for Alcohol and Cannabis Use; Final Results of the Climate Schools Course.” Addiction 105(40:749–59.

Perkins, H. Wesley, and Alan D. Berkowitz. 1986. “Perceiving the Community Norms of Alcohol Use Among Students: Some Research Implications for Campus Alcohol Education Programming.” International Journal of the Addictions 21(9–10):961–76.

Polansky, Joan M., Lydia P. Buki, John J. Horan, Sherry Dyche Ceperich, and Deborah Dyer Burows. 1999. “The Effectiveness of Substance Abuse Prevention Videotapes With Mexican American Adolescents.” Hispanic Journal of Behavioral Sciences 21(2):186–98.

Schwinn, Traci M., Steven P. Schinke, and Jennifer Di Noia. 2010. “Preventing Drug Abuse Among Adolescent Girls: Outcome Data From an Internet-Based Intervention.” Prevention Science 11(1):24–32.

Slater, Michael D., Kathleen J. Kelly, Ruth W. Edwards, Pamela J. Thurman, Barbara A. Plested, Thomas J. Keefe, Frank R. Lawrence, and Kimberly L. Henry. 2006. “Combining In-School and Community-Based Media Efforts: Reducing Marijuana and Alcohol Uptake Among Younger Adolescents.” Health Education Research 21(1):157–67.

Strasburger, Victor C., Barbara J. Wilson, and Amy B. Jordan. 2008. Children, Adolescents, and the Media, Second Edition. Sage Publications.

Wakefield, Melanie A., Barbara Loken, and Robert C. Hornik. 2010. “Use of Mass Media Campaigns to Change Health Behavior.” Lancet 376:1261–71.

Werb, Dan, Edward J. Mills, Kora DeBeck, Thomas Kerr, Julio S.G. Montaner, and Evan Wood. 2011. “The Effectiveness of Anti–Illicit Drug Public Service Announcements: A Systematic Review and Meta-Analysis.” Journal of Epidemiology and Community Health 65:834–40.

Yzer, Marco C., Joseph N. Cappella, Martin Fishbein, Robert C. Hornik, and R. Kirkland Ahern. 2003. “The Effectiveness of Gateway Communications in Antimarijuana Campaigns.” Journal of Health Communications 8(2):129–43.

Zhao, Xiaoquan, Sarah Sayeed, Joseph N. Cappella, Robert Hornik, Martin Fishbein, and R. Kirkland Ahern. 2006. “Targeting Norm-Related Beliefs About Marijuana Use in an Adolescent Population.” Health Communication 19(3):187–96.
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Practice Snapshot

Age: 10 - 19

Gender: Both

Race/Ethnicity: Asian/Pacific Islander, Black, Hispanic, White

Settings: Other Community Setting

Practice Type: Alcohol and Drug Prevention, Community Awareness/Mobilization

Unit of Analysis: Persons