GrogWatch has featured a number of education campaigns aimed at reducing alcohol-related harm over the years and congratulated the people who have run them. This week we ask Professor Steve Allsop, Director of the National Drug Research Institute at Curtin University, how worthwhile education campaigns are when the evidence points towards alternative strategies being more effective.
Mass media campaigns and other education initiatives are popular preventives, but do they work? The evidence suggests not¹. Comprehensive reviews consistently illustrate they have little impact on alcohol consumption and related harm, leading some to conclude that they don’t work and with limited resources we should abandon them in favour of strategies that do work. Similar conclusions have been reached in relation to illicit drugs². On the other hand, such initiatives appear to be a critical component of the success we have had in reducing tobacco related harm.
Some commentators have suggested that mass media campaigns are more likely to be effective when they are:
- well-resourced and enduring
- target a clearly defined audience
- are based on advanced marketing strategies that effectively target, communicate with, and have relevance for, and credibility with, the audience
- provide a credible message to which the audience is frequently exposed.³
I would add that they need to be integrated with other prevention initiatives, which has not been the norm in the alcohol field (apart from drink driving, where highly visible random breath tests have been supported by a robust media campaign). This approach to education has been adopted more consistently for tobacco harm prevention. For example, campaigns have been integrated with strategies that directly address access to tobacco and environmental controls (where you can and cannot smoke). This could be why there is evidence that education campaigns are an important part of reducing smoking, whereas there is little supporting evidence about the impact of education campaigns on alcohol-related harm.
Are we also looking for the wrong outcomes from an education campaign? We might ask why we would expect an isolated education campaign to reduce alcohol-related harm. Education might inform and increase awareness but it cannot uniquely change behaviour in the context of increasing alcohol availability, for example. Surely we should measure the impact of alcohol campaigns/education in terms of their ability to enlighten and contribute to informed decision making – people have a right to be informed about risk, even if they don’t always heed the advice.
We might also assess whether such approaches can contribute to community and political support for the strategies that have been shown to impact on behaviour. For example, before legislation requiring wearing seat belts was introduced, mass media campaigns about the risks appeared to have little impact on behaviour, leading some to conclude that they didn’t work. But would we have had the same community support and political will to change the legislation, which did have public health benefits, without the campaign?
I am not arguing for the status quo in relation to education campaigns, nor do I support expending limited resources on a strategy that has little value. But, before we write off campaigns, we should consider whether they might just be an important piece in the jigsaw puzzle to build and maintain support for strategies that the evidence tells us will change behaviour and risk.
GrogWatch is interested in what your experience has been with education campaigns? Do you think they work?