Do mass media campaigns work for reducing alcohol and other drug use and harms?
February 2025
Health promotion is about supporting people to improve their health by facilitating autonomy and behaviour change. Fundamental to health promotion is building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services.
Health promotion mass media campaigns aim to provide information to individuals and communities to support them to improve their overall health, wellbeing, and quality of life.
Mass media campaigns are a cost effective strategy to deliver knowledge and information to large groups. Health information is shared via television, social media, radio, or print to achieve a wide reach.
The effectiveness of mass media campaigns is not well established. Campaigns that promote smoking cessation and physical fitness can be effective. However, there is little evidence that mass media campaigns targeting drug use or alcohol consumption work.
Campaigns are often shown to increase knowledge and intention to change behaviour when evaluated. However, this does not necessarily translate to reduced consumption.
How can we evaluate mass media campaigns?
Evidence to support the effectiveness of mass media campaigns is not substantial due to poor or inconsistent evaluation. Studies evaluating campaigns also vary in the type of campaign, outcome measures, underlying theory, comparison groups, and overall design, so it can be hard to draw definitive conclusions.
Long periods between the campaign and potential outcomes linked to it, difficulty in isolating the effects of the campaign compared to other influences, and several other confounding factors make the evaluation of mass media campaigns difficult.
Campaigns should have clear, measurable aims—like reducing use, increasing knowledge, or changing beliefs or attitudes—that are developed before the campaign is implemented. The impact of campaign exposure on these measures should be one of the main goals of the evaluation, with long term follow up to ensure that changes are sustained.
But instead of just evaluating how the campaign impacted the audience after it’s finished, evaluation should be built into the campaign design at every stage— it’s ideal to evaluate the campaign while it is being developed (‘formative’ evaluation) and while it is running (‘process’ evaluation), as well as after the campaign ends (‘outcome’ evaluation).
Where do mass media campaigns fall short?
Mass media campaigns for alcohol and other drug use often employ scare tactics to promote abstinence, depicting a ‘worst case’ scenario. These types of campaigns can have minimal impact on general populations, who may not experience problems with their alcohol and other drug use.
The initial impact of shock campaigns wains over time, which means that future campaigns have been designed with an increased shock factor.
Further, fearmongering exacerbates stigma for people using alcohol and other drugs by associating them with negative emotions and perceptions instilled by the messaging. This only serves to further detach vulnerable groups who use alcohol and other drugs from society and acts as a deterrent from help seeking.
Mass media campaigns can have unanticipated consequences. An evaluation of the US media campaign My Anti Drug found that exposure to the campaign was linked to increased use of cannabis. This highlights the importance of more careful and deliberate messaging in mass media campaigns.
When are mass media campaigns effective?
Campaigns have had positive results for some health behaviours. Mass media campaigns targeting smoking have been positively associated with smoking cessation, particularly in the context of comprehensive tobacco control policies and programs. This suggests that campaigns have potential as a first step intervention.
Mass media campaigns should be designed, developed, and delivered by trained professionals with experience in evidence based alcohol and other drug prevention, planning, and implementation.
The International Standards on Drug Use Prevention report found that mass media campaigns can be effective if:
- The target audience is well defined
- They aim to change social norms around alcohol and other drug use, focusing on education and improving self efficacy
- They are based on a solid theoretical basis
- Messaging is based on strong formative research
- They are delivered in connection with other community programs
- The target audience is adequately exposed to them over a long period of time
- They are evaluated systematically
- They target parents as well as children and adolescents
People respond better to mass media campaigns that resonate with their character, situation, or experience.
Ultimately, mass media campaigns for alcohol and other drug use behaviours can be effective, but they need to have evaluation built in from the get go, ensure that they align with the target audience, be based on the evidence, be delivered together with other community interventions, and deliver messaging that encourages positive behaviour rather than using scare tactics.
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