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PUBLISHED AS:
Cismaru, Magdalena, Anne M. Lavack, and Evan Markewich (2009), “Social Marketing Campaigns Aimed
at Preventing Drinking and Driving: A Review and Recommendations” International Marketing Review,
26(3), 292-311. (Impact Factor = 1.177)
Social Marketing Campaigns Aimed at Preventing Drinking and Driving:
A Review and Recommendations
1
Magdalena Cismaru, University of Regina
Anne M. Lavack, University of Regina
Evan Markewich, University of Regina
Revised May 11, 2008
Corresponding author: Magdalena Cismaru, Ph.D.
Assistant Professor, Faculty of Business Administration, University of Regina
3737 Wascana Parkway, Regina, SK S4S 0A2 Canada;
Phone: (306) 585-4723; Fax: (306) 585-4805;
E-mail: Magdalena.Cismaru@uregina.ca
1
This research is supported with funds from the University of Regina and Saskatchewan Health Research
Foundation. The authors thank Adina Rudrick and Brad Smith for their contribution in the early stages of
this research. The authors also thank the editors and the anonymous reviewers for their valuable guidance.
1
Social Marketing Campaigns Aimed at Preventing Drinking and Driving:
A Review and Recommendations
Abstract
Purpose - This paper examines the role of social marketing programs in preventing
drunk driving, and how Protection Motivation Theory can be used to create effective anti
drunk driving communications.
Design/methodology/approach - Communication and program materials aimed at
reducing drunk driving were identified and gathered from English-language websites
from the U.S.A., Canada, U.K., Australia, and New Zealand, and a qualitative review was
conducted.
Findings - The review provides a description of the key themes and messages being used
in anti drunk driving campaigns, as well as target population, campaign components, and
sources of funding. A key facet of this review is the examination of the use of Protection
Motivation Theory in social marketing campaigns designed to prevent drunk driving.
Originality/value – The review presents social marketing campaigns aimed at preventing
drunk driving in English-speaking countries, and shows that Protection Motivation
Theory can be successfully used in this context. The paper provides a guide for future
initiatives, as well as recommendations for social marketing practitioners.
Keywords: drinking and driving, drunk driving, social marketing, qualitative research.
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Introduction
According to the World Health Organization (WHO, 2004b), an estimated 1.2
million people worldwide are killed in road crashes each year, and as many as 50 million
are injured. Many of these accidents are alcohol-related crashes. Indeed, out of 42,642
total traffic fatalities in the U.S.A. in 2006, 17,602 people died due to alcohol-related
traffic injuries (41%). Of these, an estimated 13,470 involved a driver with an illegal
Blood Alcohol Concentration (BAC) of .08 or greater (Century Council, 2006; MADD,
2008). Due to these staggering death tolls, governments and nonprofit organizations have
become interested in using social marketing as a tool to prevent and reduce drunk driving
(WHO, 2004b),
We examined the role of social marketing programs in preventing and reducing
drunk driving, by collecting English-language drunk driving communication and program
materials posted on the Internet. We conducted qualitative research to review these
materials, in order to determine the nature of these social marketing efforts, key themes,
campaign components, and targeted populations, as well as to examine how Protection
Motivation Theory (PMT), a well-established theory of health behavior (Rogers, 1983),
can be used to create effective social marketing campaigns designed to prevent drunk
driving.
This paper reports on the trends and key features revealed during this qualitative
analysis. We begin with a review of the literature outlining issues regarding drunk
driving, as well as aspects of social marketing and Protection Motivation Theory. We
then present the methodology for our study and provide a description of key findings.
Social marketing implications are discussed.
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Drunk Driving
Drunk driving is usually defined as driving with a specific amount of alcohol in
the blood — known as an individual’s Blood Alcohol Concentration (BAC) – which can
be measured through blood, urine, and breath tests that estimate the number of grams of
ethanol per 100 millilitres of blood (Century Council, 2006; Robin, 1991). The legally
allowable level for an individual’s BAC varies from 0 to .08 g/100 ml in various
countries. For example, in Australia and Germany, a BAC of .05 g/100 ml is the legal
limit for driving, while in the United States, Canada, and New Zealand the BAC limit is
.08 g/100 ml (WHO, 2004b). It should be noted that the phrase ‘drunk driving’ does not
necessarily mean ‘drunkenness’; rather, it simply denotes that the person is over the
acceptable BAC level for operating a motor vehicle (Ross, 1992).
Alcohol has a depressant effect on the brain and nerve pathways that control
muscle actions (Buckner et al., 2007). With a high BAC, brain functions are slowed and
it is more likely that a person’s reaction time, vision, information processing, and
judgment while driving will be adversely affected (Hannigan et al., 1999). The intensity
of the effects of alcohol can vary from person to person, depending upon physical and
mental health, mood, and other factors. Nevertheless, as an individual consumes more
alcohol, the Blood Alcohol Concentration increases dramatically (Solomon et al., 2006).
As well, an individual’s risk of being in a traffic accident increases as his/her BAC level
increases (Kaplan and Prato, 2007). Indeed, studies show that the relative risk of crash
involvement starts to increase significantly at a blood alcohol concentration level of 0.04
g/100 ml. At 0.10 g/100 ml the crash risk relative to a zero BAC is approximately 5
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times as high, while at a BAC of 0.24 g/100 ml the crash risk is more than 140 times the
risk relative to a zero BAC (Global Road Safety Partnership, 2007).
Significant economic costs result from drunk driving, including the direct costs of
health care, property damage, motor vehicle repair, emergency attendance, and death
(WHO, 2007). Other costs include increased law enforcement, social costs,
imprisonment, compensation payments, unemployment, health and disability insurance,
and loss of productivity in the workplace from injury or premature death. In 2002, the
economic cost of alcohol-caused crashes in the United States totaled approximately $51
billion (Centers for Disease Control and Prevention, 2006).
Drunk driving, along with its risk factors and economic costs, is largely
preventable. Preventative options include policies to reduce alcohol consumption, such as
an increased tax on alcohol in order to reduce heavy drinking (Levitt and Porter, 2001),
as well as linking the advertising for alcoholic beverages with pro-health and safety
messages (Marshall and Oleson, 1994). Other policy options are aimed at encouraging
people to think ahead and plan a safe ride home, such as the promotion of taxi companies
(Transport Canada, 2005), encouraging people to avoid riding with someone who has
been drinking, encouraging the use of seat belts, and increasing advertising to educate the
public about drunk driving avoidance strategies (Dejong and Atkin, 1995). Some policy
options focus on imposing stiffer penalties for drunk driving, including promptly
suspending the driver’s license of anyone who drives while intoxicated, and using
advertising to increase public knowledge of penalties imposed on drunk drivers (Sen,
2005). Enhanced law enforcement efforts can also reduce drunk driving, through
increasing the number of sobriety checkpoints (Kenkel, 1993), and encouraging the
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public to report suspected drunk drivers to law enforcement (MedicineNet, 2004). Some
policies are aimed at making it easier for authorities to prove a drunk driving offence has
occurred, such as mandatory authorization for breath or blood tests from a driver in the
event of a crash (De Cicco and Solomon, 2001). Still other policy efforts focus on
ensuring that previous drunk driving offenders do not re-offend, such as mandatory
rehabilitation programs for offenders (Transport Canada, 2005) and the introduction of
alcohol ignition interlock devices (Canada Safety Council, 2006). Finally, many
jurisdictions are investigating the possibility of reducing the legal BAC level in order to
reduce the number of traffic accidents (Centers for Disease Control and Prevention,
2006) and, in particular, lowering the legal BAC level for minors (Dejong and Russell,
1995) or imposing zero BAC tolerance for new drivers (Maskalyk, 2003). Social
marketing campaigns aimed at publicizing, implementing, and reinforcing these policy
recommendations have been developed in several countries.
Social Marketing and Drunk Driving
Several studies have examined preventive measures and the policy environment,
and how these relate to drinking and driving. For example, enforcement of drinking and
driving laws has led to an overall reduction in drunk driving among college students
(Wechsler et al., 2003). Increased promotion of safe ride programs in some areas has also
reduced drunk driving (Caudill et al., 2000). As well, reductions in legal BAC levels in
some jurisdictions are believed to have reduced accidents and deaths due to drunk driving
(Wagenaar et al., 2001).
Most of the literature examining social marketing in the context of drunk driving
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deals with the effects that the media have on reducing drunk driving. For example, Elder
et al. (2004) examined the effectiveness of mass media campaigns for reducing alcohol-
impaired driving and alcohol-related crashes, which included a review of eight studies
published between 1975 and 1998. Their analysis showed that the mass media campaigns
were generally carefully planned, well executed, attained adequate audience exposure,
and had the effect of significantly reducing the number of alcohol-related crushes.
A study by Murry et al. (1993) evaluated whether a paid advertising campaign
was effective at reducing young male drinking and driving, by using surveys at both the
campaign site and a control site. Their analysis showed that the advertising campaign
reduced drinking and driving behavior, and consequently reduced alcohol-related traffic
accidents. A study evaluating the effectiveness of anti-drunk driving public service
announcements (PSAs) found that ads focusing on relevant localized consequences have
more meaning to undergraduate college students than the more general campaigns they
usually reported seeing (Gotthoffer, 1999). In order to be effective, PSAs must take into
account the frequency of binge drinking, gender, and age, which are factors that influence
perceptions of drunk driving risk (Gotthoffer, 2001). Research suggests that media should
not be viewed as a short-term behavioral change agent, but rather as a change agent
intended to gradually restructure the public’s cognition about various issues related to
drunk driving (Bang, 2000).
It should be noted that even though these studies discuss using educational
materials or communication campaigns to fight drunk driving, few mention social
marketing or refer to the full range of elements that would comprise an effective social
marketing campaign. However, these studies demonstrate that mass media campaigns,
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combined with increased media attention, are effective in reducing the number of alcohol
related vehicle crashes (Elder et al., 2004; Yanovitzky and Bennett, 1999).
Protection Motivation Theory
Researchers have long attempted to understand the factors that influence the
persuasiveness of health communication, using theoretical frameworks such as Protection
Motivation Theory (PMT) (Prentice-Dunn and Rogers, 1986; Rogers, 1983). In our
analysis of social marketing campaigns aimed at drunk driving, we employ PMT because
it is a highly comprehensive theory of health communication (Boer and Seydel, 1996)
that is well accepted and widely used. Anti-drunk driving social marketing campaigns
seek to influence many of the cognitions that are the focus of PMT (Greening and
Stoppelbein, 2000; Murgraff et al., 1999; Simons-Morton et al., 2006).
According to PMT, protection motivation is maximized when: (1) the threat to
health is severe (high perceived severity); (2) the individual feels vulnerable (high
perceived vulnerability); (3) the adaptive response is believed to be an effective means of
averting the threat (high response efficacy); (4) the costs associated with the adaptive
response are small (low costs); and (5) the person is confident in his or her abilities to
complete successfully the adaptive response (high self-efficacy) (Rogers, 1983). Such
factors produce protection motivation and, subsequently, the enactment of the adaptive or
coping response (Prentice-Dunn and Rogers, 1986; Rogers, 1983). Among these factors,
self-efficacy is believed to have the most significant impact on one’s decision to adopt a
recommended health behaviour (Milne et al., 2000; Rogers, 1983).
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Threat Appraisal
Within the PMT model, the threat appraisal mechanism is comprised of
vulnerability and severity. Using the drunk driving context, perceived vulnerability to the
threat refers to one’s subjective perception of the risk of causing a car accident. Perceived
severity of a threat refers to feelings concerning the seriousness of an accident. This
dimension includes evaluation of both health consequences (e.g., death, disability, and
pain) and possible social consequences (e.g., impact of the resulting health condition on
work, family life, and social relations). Previous research has shown that higher levels of
perceived vulnerability and perceived severity can produce greater changes in protection
motivation (Floyd et al., 2000; Milne et al., 2000). Previous research has also shown that
a minimum level of threat is required in order for a person to act. In other words, if a
person does not feel vulnerable, there will be no intention to change a behavior. If the
threat does not feel severe enough to warrant action, no response will take place
(Thesenvitz, 2000).
Coping Appraisal
The coping appraisal mechanism is comprised of response efficacy, self-efficacy,
and perceived cost. Perceived response efficacy refers to a person’s belief that the
recommended behaviors will be effective in reducing or eliminating the danger. Self-
efficacy refers to the person’s belief that he or she has the ability to overcome the cost
involved by the adoption of the recommended behavior. Perceived cost represents the
sum of all barriers to engaging in the recommended behavior, including monetary costs
and non-monetary costs such as time, effort, inconvenience, discomfort, social
disapproval, etc. Research suggests that higher levels of self-efficacy and response
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efficacy and lower levels of perceived cost can produce significantly greater changes in
protection motivation and persuasion (Floyd et al., 2000; Milne et al., 2000). According
to theory (Rogers and Prentice-Dunn, 1997) as well as empirical data (Milne et al., 2000),
the coping variables (response efficacy, self-efficacy, and costs) have a higher impact on
persuasion measures in comparison to the threat variables (vulnerability and severity).
Protection Motivation Theory (Rogers, 1983) has been widely used to help create
social marketing campaigns (Eppright et al., 2002; Lawrence, 1995). Indeed, a review of
the research using PMT (Rogers and Prentice-Dunn, 1997) shows that numerous studies
have tested either the threat appraisal and/or the coping appraisal in a wide variety of health
contexts with public policy implications such as change in lifestyle (e.g., smoking, regular
exercise, stress reduction), change in sexual behavior (e.g., AIDS-preventive actions), or
change in healthcare practices (e.g., inoculation against a virus, breast self-examination,
mammography), among others. Correlation studies, as well as studies using experimental
manipulations of PMT variables (particularly response efficacy and self-efficacy), often
produce main effects on intentions (Eagly and Chaiken, 1993). Indeed, two meta-analytic
reviews of 65 and 27 studies respectively representing over 20 health areas which included
approximately 37,700 participants (Floyd et al., 2000 and Milne et al., 2000) demonstrated
that, in general, increases in severity, vulnerability, response efficacy, and self-efficacy
facilitated adaptive intentions and behaviors. In addition, two recent reviews of social
marketing campaigns in the area of preventing and controlling obesity as well as limiting
smoking (Cismaru and Lavack, 2007a; 2007b) show PMT as a theoretical framework
which can be successfully used to create persuasive social marketing campaigns.
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Consider the following example of a social marketing campaign aiming to
eliminate drunk driving, which illustrates use of PMT principles. The “Tie One on for
Safety” public awareness project, running for more than 20 years, asks Americans to tie a
silver ribbon to their vehicles as a symbol of the driver’s pledge to drive safe, sober, and
buckled up (http://www.madd.org/Drunk-Driving/Drunk-Driving/Programs/View-
Program.aspx?program=10). The campaign’s fact sheet shows statistics describing how
many people are involved in drunk driving crashes and how many are injured or die as a
result (i.e., “Each year, nationally, more than 1,000 people typically die between
Thanksgiving through New Year’s in drunk driving crashes”). This information is meant to
increase perceived vulnerability and severity for the reader. The fact sheet posted on the
website provides specific recommendations about how to host a party responsibly, and
what it means to designate a non-drinking driver before partying begins (i.e., “Being the
designated driver doesn’t mean the “least drunk” person drives home. It means that, before
celebrations begin, an adult is designated to provide safe and sober transportation home and
only drinks non-alcoholic beverages”). These recommendations can be considered to
increase response efficacy, since the designated driver provides “safe transportation home,”
but also may involve some costs for taxi fare or non-monetary costs such as inconvenience
for the person who needs to abstain from drinking alcoholic beverages at the particular
party in the particular example provided. Other recommendations found on the same
website suggest that solving the problem is easy, thereby increasing self-efficacy (i.e., “It’s
easy to help reduce drunk driving through Tie One On For Safety. Click here to locate your
local MADD office — then make a call to find out how you can help”). Specific numbers
showing how effective this campaign is in terms of reducing accidents or deaths due to
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drunk driving indicate high response-efficacy (i.e., “Since 1980 - the year Mothers Against
Drunk Driving was founded - alcohol-related traffic fatalities have decreased by about 44
percent, from over 30,000 to under 17,000 and MADD has helped save over 300,000
lives”). This example demonstrates how PMT principles can guide the creation of social
marketing communication materials aimed at reducing drunk driving.
In the following section, we outline the methodology for our review of social
marketing programs and campaigns relating to drinking and driving, as well as our
examination of the use of PMT in this particular social context. This study addresses a
gap in the literature by providing a qualitative analysis of English-language social
marketing campaigns, discussing major themes, campaign components, and target
population, as well as assessing the appropriateness of the usage of the PMT (Rogers,
1983) in a drunk driving prevention context.
Research Design and Methodology
This research involved conducting a qualitative analysis of English-language anti-
drunk driving communication materials posted on the Internet. We searched for keywords
including “anti-drinking campaigns,” “drinking and driving,” “drunk driving,” “drink
driving,” “driving under the influence,” “alcohol and driving,” “Protection Motivation
Theory and drunk driving,” and “social marketing and drunk driving.” We also searched
health-related government websites such as the U.S. Department of Health and Human
Services, National Institutes of Health, Health Canada, and similar websites from five
English-speaking countries (U.S.A., Canada, U.K., Australia, and New Zealand).
References to campaigns and programs discussed in academic papers located through
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Medline, ABI-Inform, PsychInfo, and other databases were also used as a means of
finding additional campaigns.
Once identified, each individual campaign’s information was evaluated in terms
of its content to assess its salient components as well as the presence of the variables
considered by PMT to be important predictors of behavioural change. For example,
regarding vulnerability, we looked for statistics meant to make the reader aware of the
fact that the risks of someone causing a car accident significantly increases if one drives
under the influence. Links such as “statistics,” “incidence,” or “the issue” were accessed
to locate this information. Regarding severity, we searched for information showing the
severe consequences of drunk drinking. Keywords such as “death,” “fatalities,” and
“victims” were particularly relevant. Regarding self-efficacy and costs, phrases such as
“it is easy,” “here are some steps,” and “tips” were searched, whereas response-efficacy
information was generally found when there was a formal evaluation. However, there
were few campaigns that neatly showed all of the information about all of the PMT
variables on a single page; rather, the information was often spread over several pages
and/or links. For this reason, we considered it appropriate to conduct a qualitative
analysis of the materials, by reading them in their totality and looking for keywords that
helped us assess the presence of variables considered by PMT to be important predictors
of behavioural change. As part of this process, we created Table 1, 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 campaign’s adherence to the tenets of Protection Motivation Theory.
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Qualitative Research Findings
Our search revealed over 25 anti-drunk driving programs or campaigns (see Table
1). Some of these were developed by nonprofit organizations such as Mothers against
Drunk Driving and Students against Drinking and Driving, or nonprofit organizations
such as the Canadian Public Health Association. In some countries, federal or
state/provincial governmental organizations took the lead (e.g., Texas Department of
Transportation). Still other campaigns were developed by organizations or companies
involved in the alcohol industry, such as the Brewers Association of Canada, or Molson
Breweries. Although most of the campaigns are intended to either create awareness about
the risks associated with drunk driving (e.g., Smashed), provide guidelines regarding
sensible drinking (e.g., Drinking and You), or provide alternatives to drunk driving
(e.g., Miles with a Mission), some go beyond this and encourage the public and
businesses to call police if they see an impaired driver (e.g., Operation Lookout).
Campaigns included a wide variety of different components, including websites
and print materials such as posters and brochures, as well as radio and TV public service
announcements (PSAs) that included celebrity spokespersons or interviews with victims
and survivors. In addition, some campaigns incorporated community and mass-media
events, partnerships with retail stores, awards, newsletters, scholarships, insurance
folders, litterbags, t-shirts, car wash kits, magnets, buttons, etc. Campaigns took place at
the international, national, provincial/state, or community level. Some of the campaigns
include involvement with liquor stores, restaurants, bars, and other public places where
drinking and driving behavioural change could take place.
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In examining whether the campaigns adhered to Protection Motivation Theory, it
was apparent that most of the campaigns focus on threat variables, (i.e., severity and
vulnerability) by emphasizing the potentially severe consequences associated with drunk
driving (e.g., Save a Life). Some campaigns provide information about all PMT variables
(e.g., Designate a Driver). Others do not appear to adhere to PMT principles at all (e.g.,
Positive Choices), usually because of their very narrow scope (i.e., to make teens aware
of the alternatives they have to getting in a car with someone who has been drinking
alcohol). Only a few campaigns (e.g., 1-888 TAXIGUY) seem to stress self-efficacy,
which has been found to be the most important predictor of behaviour change (Milne et
al., 2000). In the following sections, we present the initiatives grouped by their country of
origin.
A. Campaigns Originating in the U.S.A.
Perhaps the largest international organization aimed at reducing or eliminating
drinking and driving through massive social marketing efforts is Mothers against
Drinking and Driving (MADD), which was originally founded in the United States.
MADD has several partners and sponsors, but the most notable are from the automobile
and insurance sectors. In Table 1 we can see that MADD provides three notable
international campaigns that adhere to PMT: Designate a Driver, Tie One On For
Safety, and Take the Wheel. The Take the Wheel campaign focuses on threat appraisal,
in an attempt to create motivation to eliminate drinking and driving. It uses statistics
showing the number of people directly involved in a drunk driving accident as well as the
number of people that might experience property damage, suffer an injury, attend a
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funeral, or be killed due to a drunk driver. The Tie One on for Safety campaign focuses
on heightening the public’s attention on drinking and driving by asking Americans to tie
a silver MADD ribbon to their vehicles as a pledge to drive safe, sober, and buckled up
during the holiday season and throughout the year. The Designate a Driver campaign
positions itself as a program that is relatively easy to administer with little or no cost,
through reinforcing the widely known perceived threat inherent in drinking and driving,
while showing that all one has to do to be safe is plan ahead and designate a driver.
Similar to MADD’s Designate a Driver Program, Students against Drinking
and Driving (SADD) utilizes high response efficacy by demonstrating positive and
attractive alternatives to drinking and driving. However, SADD also focuses on both high
perceived severity and vulnerability by emphasizing the effects that alcohol can have on
young people, including how alcohol alters vision, reaction times, perception of distance,
and overall abilities.
The United States also provides examples of campaigns that are initiated by
government, non-government organizations (NGOs), and private industry. For example,
the Texas Department of Transportation offers the Save a Life campaign, which focuses
on showing the public the severity of alcohol-related accidents through various statistics,
and increasing perceived vulnerability through visual imagery of the aftermath of car
accidents. The AADD (Artists Against Drunk Driving) initiative provides severity and
vulnerability information, but also emphasizes the social costs of drinking and driving.
American private industry, on the other hand, does not seem to produce
campaigns that adhere to PMT principles. The Positive Choices campaign from the
Family Advisor Aurora Casket Company, Inc. is directed at educating parents and school
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administrators to teach children about the dangers and consequences of underage
drinking. The Anheuser-Busch Know When to Say When campaign focuses on
community-based alcohol awareness and education programs, such as server training
programs, designated driver programs, and safe driving programs, rather than focusing on
the threat aspects from the PMT model. Previous research has found that drinking and
driving ads from corporate sponsors such as breweries and distillers are less likely to
mention threats or negative consequences, and are also less likely to use fear arousal,
compared to drinking and driving ads sponsored by governments and nonprofit
organizations (Lavack, 1999).
B. Campaigns Originating in Canada
Of the five countries, Canada appears to provide the largest number of social
marketing campaigns against drunk driving, which are initiated by various levels of
government, NGOs, and private industry. This may be the reason why Canada’s drunk
driving death toll is only 261 per 100,000 population, compared to the U.S. death toll of
454 per 100,000 population (WHO, 2004a). Some Canadian campaigns, such as “Work
Hard-Play Hard” from SGI Canada emphasize adaptive responses to drinking and
driving (i.e., getting home safely by designating a sober driver). The Hooked on Road
Safety campaign provides a risk assessment of drinking and driving in terms of injuries,
accidents, death tolls, and economic costs, while describing how drivers can be effective
in reducing the associated danger. The iDrive and Drinking Facts campaigns are
intended to raise awareness about the consequences of drinking and driving, thereby
heightening perceived severity and vulnerability.
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Some campaigns initiated by NGOs, such as Drinking and Driving, Making the
Right Choice, provide information about problems associated with alcohol consumption
and strategies to help individuals who drink to stay healthy. Other programs, such as
Operation Lookout, Report All Impaired Drivers (RAID), and Arrive Alive Drive
Sober, recommend behaviors to reduce or eliminate the danger from drinking and
driving, and promote self-efficacy by offering cost efficient solutions to drinking and
driving while emphasizing the consequences of drinking and driving. The Keep Your
Dreams Alive — Don’t Drink and Drive campaign highlights all PMT variables by
exploiting visual expression, real life accounts, and statistics in order to reduce the
occurrence and consequences of drinking and driving.
Canadian private industry also initiates awareness campaigns, such as 1-888
TAXIGUY, which focuses on increasing self-efficacy by increasing public knowledge
about safe low cost alternatives to drinking and driving. Similar to the U.S. Anheuser-
Busch Know When to Say When campaign, the Brewers Association of Canada’s anti-
drinking and driving campaign does not seem to adhere to PMT principles, but rather
attempts to appeal to the public conscience by simply asking people to drink responsibly.
C. Campaigns Originating in the U.K.
In the U.K., the Drinking & You campaign focuses on the severity and perceived
threats associated with alcohol consumption, including the severe legal consequences of
drunk driving, and advises having a designated driver or arranging to go home by public
transportation or taxi. The THINK Christmas Drink Drive Campaign highlights a
mixture of the legal and personal consequences in order to convince all drivers, with a
18
particular focus on young male drivers aged 17-29 years, that a drunk driving conviction
has the potential to ruin their life (high severity). It also aims to instill the belief that even
one or two drinks before driving are too many, in order to reinforce and build the social
stigma around drunk driving. The THINK! Drink Drive Campaign was developed after
four phases of extensive independent qualitative and quantitative research with the target
audience. The findings of this research showed that the personal consequences of a drunk
driving conviction are highly motivating for young men. Although the personal
consequences of a drunk driving conviction may seem lower key and lack impact
compared to an alcohol-related crash, young men believe that using public service
announcements to portraying a drunk driving conviction is more realistic than a crash
scene, as well as more thought provoking and more personally relevant. The campaign
used a variety of communication activities to persuade all drivers to avoid drunk driving,
including TV, radio, online ads, and advertising in pubs. Overall, the U.K. approach
seems to focus specifically on the PMT variables of severity and vulnerability.
D. Campaigns Originating in Australia
The Australian government sponsors the Brain Campaign to combat drinking
and driving, focusing on the PMT variables of severity and vulnerability by explaining
how alcohol affects a person’s brain functions, judgment, and ability to drive. The We
Are Fighting to Save Lives campaign is similar to the Brain Campaign, with its strong
focus on the human costs of drinking and driving as well as the effects that alcohol has on
one’s ability to operate a motor vehicle. In contrast, the Drink Drive Initiatives
Campaign as well as the Only a Little Bit Over Campaign focus on the severe impact
19
of drunk driving in terms of legal consequences. Both campaigns have a major television
and radio focus, as well as outdoor advertising and websites, and provide the public with
information regarding changes to the law, new penalties, and a key message that those
who choose to drink and drive will be caught. Some of the Australian PSAs such as
'Only a little bit over? You Bloody Idiot' use the slogan “If You Drink Then Drive
You’re a Bloody Idiot,” which is also featured in campaigns running in New Zealand.
Overall, the Australian approach to anti-drunk driving campaigns focuses on severity and
vulnerability.
E. Campaigns Originating in New Zealand
The New Zealand campaign, If You Drink Then Drive You’re a Bloody Idiot,
is also highly focused on showing the public the perceived vulnerability and severity
associated with drinking and driving, but offers only a few specific recommendations that
deal with BAC zero tolerance options. The campaign features numerous PSAs, stressing
death as “the ultimate price of drink driving” as well as focusing on severe legal penalties
such as imprisonment, loss of license, and fines. Like the Australian approach, New
Zealand’s campaigns focus primarily on severity and vulnerability
Discussion and Conclusion
This review presents social marketing campaigns aimed at preventing drunk
driving in English-speaking countries, and shows how Protection Motivation Theory has
been successfully used in this context. The paper provides recommendations for social
marketing practitioners, as well as a guide for future initiatives.
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The campaigns described are designed to motivate the public to undertake a
variety of behaviors, including drinking in moderation or abstaining from alcohol use,
choosing a designated driver, or choosing a safe ride home such as a taxi or public transit.
They include a variety of components such as public service announcements on TV or
radio, posters, billboards, t-shirts, etc. as well as scholarships, community meetings, and
educational materials to use in schools.
Theory suggests that Protection Motivation Theory can be an appropriate
framework to use for developing social marketing campaigns aimed at combating drunk
driving. Our review shows that many drunk driving campaigns highlight the PMT
variables believed to trigger behavioral change (i.e., perceived vulnerability, severity,
response and self-efficacy). A focus of many campaigns is on the threat variables (i.e.,
severity and vulnerability), particularly in the U.K., Australia, and New Zealand.
Although the threat variables are important, social marketing communicators
should also provide specific advice about how to avoid drunk driving, advice which
ideally should involve low costs and which people should feel confidently able to follow.
Since perceived self-efficacy is the most important determinant of behavior change,
making people feel that they can actually follow the recommendations should constitute
one of the main objectives of any anti-drunk driving campaign. Although Canada has
many campaigns focusing on the coping variables and the U.S.A. and U.K. have at least
one, Australia and New Zealand do not. Therefore, future campaigns should include
information about self-efficacy and response efficacy to increase the likelihood that these
messages will be effective.
21
It should be noted that no evaluation data regarding the effectiveness of any of the
campaigns presented in this review was found. Although overall trends regarding the
number of U.S. fatalities caused by drunk driving between 1990 and 2006 are available
(NHTSA, 2008), the assessment of the effectiveness of each individual campaign cannot
be estimated. This is due to the fact that many campaigns run simultaneously,
components of the same campaign can be released at different points in time, and there
are other factors (such as the number of cars on the streets or miles driven in any given
year) which can significantly influence the number of fatalities. Therefore, our discussion
of the campaigns is based on their likelihood of success, given our knowledge of
Protection Motivation Theory. Further research could involve specific evaluations to
assess the effectiveness of campaigns that adhere to the Protection Motivation Theory to
varying degrees.
22
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27
Table 1: Campaigns and Programs against Drinking and Driving Found on the Internet Grouped by the Country
Campaign /
Year
Campaign Description and Web Address Initiator Campaign
Components
Adherence to Protection
Motivation Theory
U.S.A.
AADD (Artists
Against Drunk
Driving)
Initiative
Provides free-of-charge portraits to family members of
victims of drunk driving accidents
http://www.artistsagainstdrunkdriving.com/content/view
/3/1/
Nikki Smith Portraits of victims
of drunk driving
accidents in New
Mexico from 2006
forward; fund
raisers, website
Provides severity and
vulnerability information.
Designate a
Driver
Asks that motorists designate a driver who will refrain
from alcohol consumption. A direct call-to-action at
locations where alcohol is being served.
http://www.madd.org/Drunk-Driving/Drunk-
Driving/Programs/View-Program.aspx?program=11
Mothers Against
Drunk Driving,
(founded in the
U.S.A., became
international)
Posters and table
tents, website
Includes information about all
PMT variables.
Know When to
Say When
(since 1982)
Responsibility
Matters
National
Designated
Driver
Awareness
Week
Programs to fight drunk driving by encouraging the use
of designated drivers or alternate transportation, and to
educate young people about the dangers of drunk
driving.
http://www.beeresponsible.com/home.html
Anheuser-Busch Community-based
alcohol awareness
and education
programs, national
ad campaigns,
newspaper ads, TV
ads, website.
Does not seem to adhere to
PMT principles.
Positive Choices
Public service program designed to make teens aware of
the alternatives they have to getting in a car with
someone who has been drinking alcohol.
http://www.positive-choices.org/details.html
Family Advisor
Aurora Casket
Company, Inc.
College
scholarships can be
won by students or
parents making a
“positive promise”
Does not seem to adhere with
PMT principles.
Take the Wheel
Encourages a community’s business, city, law
enforcement, education, and faith community
representatives to join together, take ownership, and
develop a solution to stop drunk driving.
http://www.madd.org/Drunk-Driving/Drunk-
Driving/Programs/View-Program.aspx?program=14
Mothers Against
Drunk Driving
(founded in the
U.S.A., became
international)
Town hall
meetings, youth
programs, court
monitoring
program, law
enforcement
Focuses on severity and
vulnerability. Provides
specific recommendations
about how to prevent drinking
and driving.
28
Campaign /
Year
Campaign Description and Web Address Initiator Campaign
Components
Adherence to Protection
Motivation Theory
crackdowns,
posters, brochures,
and PSAs, website
Tie One On For
Safety ribbon
campaign
(since 1986)
Asks Americans to tie a silver MADD ribbon to their
vehicles as a pledge to drive safe, sober, and buckled up
during the holiday season and throughout the year. Also
encourages safe holiday parties.
http://www.madd.org/Drunk-Driving/Drunk-
Driving/Programs/View-Program.aspx?program=10
Mothers Against
Drunk Driving
(founded in U.S.A.,
became international)
Celebrity
spokesperson at
national events and
featured in print,
radio, and TV
PSAs, website
Includes information about all
PMT variables.
Canada
1-888
TAXIGUY
Encourages people to plan before they party and take a
cab home by calling the toll-free number
http://www.mto.gov.on.ca/english/safety/impaired/progr
ams.htm
TAXIGUY Inc. and
Molson Canada
1-888 TAXIGUY
links callers
directly to a partner
taxicab company in
their city
Reduces cost and increases
self-efficacy.
Arrive Alive
Drive Sober
To eliminate impaired driving in Ontario; enables people
and communities to share resources and information that
will prevent injuries and save lives.
http://www.arrivealive.org/
Ontario Community
Council on Impaired
Driving (OCCID)
Event, PSAs,
printed materials,
insurance folders,
posters, litterbags,
recipe cards, t-
shirts, car wash
kits, website.
Provides specific alternatives
to drunk driving. Seems to
focus on response and self-
efficacy in the campaign, but
provides information
regarding severity and
vulnerability on the website.
Brewers
Association of
Canada anti
drinking and
driving
campaigns
Asks people to abstain from drinking and driving.
http://www.brewers.ca/default_e.asp?id=10
Brewers Association
of Canada
Radio, tv, and
outdoor campaigns,
print, posters,
brochures, point-
of-sale messages,
magnets and
buttons, website
Does not seem to adhere with
PMT principles
Drinking.
Driving. Making
the Right Choice
A training program for student drivers. Available in
driving schools across Quebec.
http://www.educalcool.qc.ca/en/programs/drinking-
driving-making-the-right-choice/index.html
Éduc’alcool Guides, other
publications,
website
Provides some information
about PMT variables.
Drinking Facts
Provides information about alcohol drinking, including
impaired driving.
Canadian Public
Health Association
Video materials,
posters, fact sheets,
Does not seem to adhere with
PMT principles
29
Campaign /
Year
Campaign Description and Web Address Initiator Campaign
Components
Adherence to Protection
Motivation Theory
http://www.drinkingfacts.ca/english/index.asp quizzes, discussion
guides, website
iDRIVE
To raise awareness among drivers under the age of 25
about the risks and consequences of aggressive and
unsafe driving practices including impairment by alcohol
and drugs.
http://www.mto.gov.on.ca/english/safety/impaired/progr
ams.htm
Ministry of
Transportation in
partnership with the
Ontario Community
Council on Impaired
Driving (OCCID),
Ontario Students
Against Impaired
Driving (OSAID),
and The Student Life
Education Company.
Video presentation
and presenter’s
guide delivered
free of charge to
community police,
public health
workers, driving
schools, and road
safety advocates.
Does not seem to adhere with
PMT principles
Keep Your
Dreams Alive –
Don’t Drink and
Drive
To educate people about the dangers of drinking and
driving and save lives.
http://www.mast.mb.ca/TADD/about.htm
Teens Against
Drinking and Driving
School
presentations,
posters, prizes,
judging, wrecked
car, fatal vision
glasses, visits to
the hospital,
banners, mall
displays, events,
website
Goes beyond providing
information in a written form.
Increases the perception of all
PMT through very vivid
methods, such as visits to the
hospital.
Miles With a
Mission
Reduces the opportunity for personal injury or fatality by
providing Canadians with pre–paid taxi fare that can be
purchased or earned.
http://www.taximiles.com/
Taxi Miles Taxi money that
can be purchased
or earned, website.
Deals with efficacy and costs.
Operation
Lookout
Encourages the public and businesses to call police if
they see an impaired driver.
http://www.normie.ca/ACTION3.htm
Action Sudbury
Against Drunk
Driving
Information
posters, website
Deals with response efficacy
and self-efficacy, but also
provides information about
severity and vulnerability.
Report All
Impaired
Drivers (RAID)
Provides the public with instructions and police phone
numbers to report impaired drivers.
http://www.oadd.ca/raid_orillia.htm
Douglas G.
Abernethy, Orillia
Against Drunk
Driving
Press releases,
radio PSAs,
website.
Deals with response efficacy
and self-efficacy, but also
provides information about
severity and vulnerability.
30
Campaign /
Year
Campaign Description and Web Address Initiator Campaign
Components
Adherence to Protection
Motivation Theory
Hooked on Road
Safety
Raises awareness about the societal impact of road
traffic injuries, highlighting the risks for young road
users. Promotes action around key factors which have a
major impact on preventing road traffic injuries:
helmets, seat belts, drink driving, speeding, and
infrastructure.
http://www.tc.gc.ca/hookedonroadsafety/menu.htm
Transport Canada
Road Safety
Magazine, Global
Road Safety Week,
conferences,
website
Focuses on severity and
vulnerability.
Take Care Out
There
Work Hard-Play
Hard
Attempts to reduce drinking and driving.
http://www.sgi.sk.ca/sgi_pub/road_safety/drinking_and_
driving/drinking_and_driving.htm
http://www.sgi.sk.ca/sgi_pub/road_safety/drinking_and_
driving/partners.htm
SGI Canada TV and radio
campaign, website
Provides information about
severity, vulnerability, and
advice on abstaining from
drinking and driving (costs).
U.K.
Drinking &You
(since 1991)
Consumer site about government guidelines for sensible
drinking and one’s health. Includes a drinking and
driving section.
http://www.drinkingandyou.com/#
http://www.aim-digest.com
Alcohol in
Moderation (founded
in U.K, became
international)
Website Provides information about
most of the PMT variables.
THINK!
Christmas Drink
Drive campaign
Aims to convince all drivers, with a particular focus on
young male drivers aged 17-29 years, that a drink drive
conviction has the potential to ruin their life by
highlighting a mixture of the legal and personal
consequences
http://www.thinkroadsafety.gov.uk./
http://www.thinkroadsafety.gov.uk./campaigns/drinkdriv
e/drinkdrive.htm
UK Department for
Transport
PSAs, posters and
leaflets, website.
Focuses on severity.
Australia
Brain Campaign
Explains road safety issues
http://www.rta.nsw.gov.au/roadsafety/alcoholdrugs/cam
paigns/index.html
Roads and Traffic
Authority (NSW)
TV ads, website Focuses on severity and
vulnerability
Drink Drive
Initiatives
Campaign
Provide the public with factual and accurate information
about changes to the law and new penalties;
communicate the benefits of new initiatives and
encourage positive cooperation; highlight the risk of
Roads Safety
Australia
Department for
Transport, Energy,
and Infrastructure
PSAs on TV and
radio, billboards,
website
Focuses on severity, especially
in terms of legal
consequences.
31
Campaign /
Year
Campaign Description and Web Address Initiator Campaign
Components
Adherence to Protection
Motivation Theory
detection and resulting penalties for those detected.
http://www.transport.sa.gov.au/rss/content/safer_people/
issues/drink_drive_initiatives_campaign.htm
Only a Little Bit
Over Campaign
It demonstrates the increased levels of police
enforcement now on Victoria roads. It also reinforces the
fact that every police car is equipped to conduct
preliminary breath testing and that back streets are being
targeted. The message is that those who choose to drink
and drive are going to be caught.
http://www.tacsafety.com.au/jsp/content/NavigationCont
roller.do?areaID=13&tierID=1&navID=8A3442C4&nav
Link=null&pageID=145
Transport Accident
Commission
Major television
focus, supported by
radio, magazine,
online, and outdoor
advertising
Focuses on severity, especially
in terms of legal
consequences.
We Are Fighting
to Save Lives
To help reduce the road toll.
http://home.vicnet.net.au/~padd/padd1.html
People Against
Drunk Driving
(P.A.D.D.)
Incorporated
Print materials,
ads, website
Focuses on severity and
vulnerability.
New Zealand
If you Drink
then Drive
You’re a Bloody
Idiot
To improve land transport to make a better New Zealand
http://www.landtransport.govt.nz/road-user-
safety/motorists/drink.html
Land Transport NZ TV and print ads,
website
Focuses on severity and
vulnerability; provides
specific recommendations
(costs).
