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Drinking and the Mass Media TN1980 A TEAM OF RESEARCHERS from Michigan State University | carefully watched four episodes of television's top-rated pr~me- ~ time fictional shows and eight episodes of the top-rated soap operas. Every time a character took a drink, the researchers made a note of it. Every time a character mentioned alcohol or acted drunk, the researchers made another entry in their Togs. When they added up the number of times drinking was de- pictecI, a remarkable statistic emerged. "Television characters may not smoke or use drugs," ob- servect Bradley Greenberg, head of the Michigan State study, "but they drink with prodigious frequency." In the prime-time shows, characters consumed alcoholic beverages an average of eight times every hour. in the top-rated soap operas, each hour averaged over two depictions of drinking.) People on television drink alcohol more often than they drink other beverages, the opposite of what happens in real life (see Figure 7-~. The bev- iB. Greenberg. Television: Health issues on commercial television series. Health Promotion and the Mass Media. M. Trudeau and M. Angle, eds. Wash- ington, D.C.: National Academy Press, 1981. 82

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DRINKING AND THE MASS MEDIA / 83 AV E R AG E A N ~ IDA U ~ P ~ I O ~ in. in, is, ~ ~~ Be, i cow ~~ ,, ~ OCR for page 82
84 / ALCOHOL IN AMERICA Television is not the only mass medium through which peo- ple receive messages about drinking. But for many people it is the most important. Almost every home in America has at least one television set, and Americans spend an average of 30 hours a week watching television. When a person graduates from high school, he or she will probably have spent more time in front of a television than in a classroom. Throughout childhood and adolescence, television viewing takes up more hours on the average than any other single activity except sleeping. As with violence on television, it is very difficult to prove that so much drinking on television leads to more drinking in real life. But the sheer quantity of drinking to which people are exposed on television is reason for concern. Given the amount of television young people watch and the number of drinking incidents portrayed, a person under the legal drinking age will watch an average of over 3,000 acts of drinking every year. "Television has not been a very good educator about drinking in society," concludes Lawrence WalIack of the University of California at Berkeley. "The rate of drinking on television is greater than that in real life and the rate of problems associated with drinking tends to be much lower.... If indeed alcohol is a major public health problem and, as the pane} estimates, is responsible for 50,000-75,000 deaths annually you could not find this out from watching television." Advertising Alcohol: A Billion-DolZar Business Television and the other mass media cleliver another impor- tant set of messages about drinking: advertisements for alco- holic beverages. Each year the alcoholic beverage industry spends over $l billion advertising its products. "We will hear it on radio and see it on billboards, television, magazines, buses, subways, calendars, sports schedules, and most any other place where space is available," says Wallack. "The attention of the American public is clearly the focus of intense competition among alcoholic beverage producers." It was not always this way. When Prohibition ended, strong regulations were imposed on the marketing of beer, wine, and hard liquor. Federal regulators had to clear every ad for alco-

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DRONING AND THE MASS MEDIA / 85 holic beverages before it could run. Regulations and industry codes prohibited alcohol from being associated with women, patriotism, health, or any sort of glamorous activity. Neither wine nor liquor could be advertised on radio or television. Over the past few decades these restraints have gradually been weakening. Today several of the largest beer manufac- turers and importers including Anheuser-Busch, Heublein, Schlitz, Coors, and Van Munching are among the top adver- tisers on radio and television. Wine, too, is now advertised through these media. And no law explicitly bans the advertising of hard liquor on the air. "Given the permissive environment that has developed on so many other matters," says Stanley Cohen, Washington bureau chief of Advertising Age, "I assume it is only a matter of time before liquor will be on television, too." The marketing of alcoholic beverages today is virtually in- distinguishable from that of other products. Ads for alcoholic beverages are well researchecl, slickly produced, and backed by well-organized promotions at the retail level. Though the number of major brewers is dwindling, brands of beer are pro- liferating, many with their own advertising themes. "Alcoholic beverages have achieved respectability and are marketer! by the same people and through the same channels as soap, Chevys, and cigarettes," says Cohen. A good example of the new emphasis on marketing was the Coca-Cola Company's effect on the wine market. When Coca- Cola bought the Taylor brand of wines in the late 1970s, it set out to promote the image of wine as a drink that is consumed regularly rather than just on special occasions. Within a few years the amount of advertising in the wine industry nearly doubled largely because of Coca-Cola's aggressive marketing techniques. The tactics used to advertise alcohol differ little from those used with other products. Advertisements may indirectly as- sociate drinking with wealth, success, or social approval. They may portray drinking as a sexy, sophisticated act. "As might be expected," says WalIack, "advertising seeks to place the product in the best possible light and is little, if at all, concerned with its possible adverse consequences."

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86 / ALCOHOL IN ~ERICA The effect of such advertising remains a point of controversy. Researchers have never been able to agree on whether alcohol advertising increases the amount people drink or simply influ- ences what brand of alcohol they buy. For instance, Mark Keller of Rutgers University contends that "you do not have to ad- vertise alcohol to people. Why is the industry here spending millions on advertising? Because there is competition over who is going to sell how much of what. But ~ do not know whether advertising really increases the volume of consumption." The National Research Council panel on alcohol abuse has also decided that the jury is still out on the influence of alcohol advertising. "It is generally thought that the main effect of commercial advertising is to alert the public to new brands, in competition with older ones, and conversely to protect or ex- pancT the market shares of established brands," the pane! con- cludes. "The available scientific evidence is too sparse to permit us any extended discussion of the effects of advertising policies. Nevertheless, important issues of principle are involved in such policies." These "issues of principle" may in fact be the most important aspect of the controversy surrounding alcohol advertising. Be- cause such advertising is invariably enmeshed in the much broader social context of drinking, it may be impossible to study the effects of that advertising in isolation. The issue then be- comes one of politics and public policy as much as scientific research. "The funciamental issue that we need to address is whether the wide-scale promotion of alcoholic beverages is con- sistent with the goals of a society concerned with minimizing the social, economic, and personal hardships associated with current levels of alcohol-related problems," says WalIack. Voluntary Restraint by Industry Despite the lack of hard evidence linking exposure to drink- ing or alcohol advertising to increased consumption, many groups and individuals have sought to limit the extent of these influ- ences. Within the television and advertising industries them- seIves, many people are concerned about alcohol-relatecl

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DRINKING AND THE MASS MEDIA / 87 problems and ways to prevent them. This concern has in turn lect to some innovative steps toward self-regulation. In the television industry one of the most prominent devel- opments of recent years has been the work of the Alcohol and Drug Abuse Committee of the Caucus of Producers, Writers, and Directors, a 160-member consortium of people involved in the creation of television shows. As with many individuals, the caucus was spurred into action by tragedy: In 1982 Natalie Wood and William Holden died in alcohol-related accidents, and an automobile accident caused by a drunk driver seriously injured Mary Martin and lanes Gaynor and killed Martin's man- ager. A few months after these accidents the caucus issued a white paper entitled "We've Done Some Thinking." The paper asked whether "any of us as members of the creative community in Hollywood unwittingly glorified the casual use of alcohol in one of our projects? . . . The answer, we fear, is yes." According to Larry Stewart, chairman of the caucus's Alcohol and Drug Abuse Committee, the paper circulated widely in Hollywood. "Our committee has attempted to bring an idea to the attention of the creative community, and we fee! confident that that com- munity will respond on its own in a positive way," says Stew- art. "We think we are sensible and that our colleagues are going to react sensibly." The paper drew heavily on the research of Warren Breed and lames Defoe, who had worked with such shows as "The lef- fersons," "M.A.S.H.," "All in the Family," and "One Day at a Time" to limit the amount of drinking shown. This process involves working directly with the scripts to monitor the ways in which drinking is portrayed. The white paper also inclucled a number of suggestions for writers, producers, and directors, such as not glamorizing alcohol, substituting other beverages for alcohol when possible, demonstrating that people do not have to drink to be normal, portraying critical reactions to heavy drinking, dealing with the full range of consequences of drink- ing, and showing that there are no miraculous cures for alco- holism. "We are not telling 'hove Boat' that they should not have a bar," says Stewart. "We are not teeing 'Cheers' or 'Archie Bunker'

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SS / ALCOHOL IN AMERICA to close down their sets because they take place in bars. But if drinking is not germane to the story, why show it? It if is germane, portray it, but do so with the awareness that the people we create become role models." Such voluntary efforts also have a place in the advertising industry. An example is the Code of Advertising Standards developed by the Wine Institute, a trade association of 460 California vintners. The code emphasizes promoting wine re- sponsibly, educating consumers about wine's heritage and moderate use, and participating in projects to reduce the misuse of alcohol. Specific parts of the code prohibit the use of athletes or celebrities attractive to young people, bar any suggestion of intoxication or drinking and driving, and discourage any as- sociation of wine with rites of passage. All of the Wine Institute's 460 members, representing 95 per- cent of the California wine industry, voluntarily subscribe to the code. Furthermore, the Wine Institute has asked the Bureau of Alcohol, Tobacco, and Firearms to extend these provisions by law to all alcohol advertising. Educational anti Training Programs The power of the mass media, so evident in the field of advertising, can also be turned to other purposes. In particular, the mass media are one of the best ways to convey health- related information about alcohol and the possible conse- quences of clrinking. Such educational campaigns are often mentioned as part of a comprehensive program to prevent al- coho! problems. Their potential strengths and weaknesses are the subject of the rest of this chapter. Educational campaigns draw on the moral authority of the government or a respected private organization to try to per- suade people to drink safely or appropriately. Generally, such programs have prestige and legitimacy in our society. However, even after decades of experience with educational campaigns, their effectiveness remains open to question. With some recent and notable exceptions, there is little hard evidence to show that past educational campaigns using the mass media have had any significant effect. Some people seem to pay no attention

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DRINKING AND THE MASS MEDIA / 89 to the messages about health that they get through the media. Those who do pay attention are also those most likely to have their preexisting beliefs confirmed. For these and other reasons, many social scientists have concluded that mass media edu- cational campaigns are doomed to fail. Dissenting social scientists argue that past campaigns have been poorly planned, executed, or evaluated. They also point out that mass media campaigns are most effective when com- binect with other, reinforcing measures. "Given the lack of both formative research and sufficient evaluation, it is no wonder that previous public education campaigns aimed at reducing the incidence of alcohol abuse have had such inconclusive re- sults," writes John Hochheimer of Stanford University. "Proper use of the mass media for effective dissemination of messages is a multifaceted process that requires a great deal of planning, ~ 1 Friends Don't let friends drive drunk. If your friend has had too much to drink, he doesn't have to drive. Here's one way to keep your friend alive . . . d r n r e y o u ~ f r i e n d h o m e U.S. Department of Transportation Natbnal Highway lYaNk Sandy AdministKnbn .- .m .E an Em to _ C: ._ I Suggestions for specific actions or behaviors tend to be more effective than general admonitions in mass media educational campaigns.

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90 / ALCOHOL IN~ERICA evaluation, and willingness to replan during the campaign if necessary." At the same time, not all educational campaigns have been a failure. it is true that the most successful campaigns have focused on other health concerns, such as smoking or heart disease, rather than on drinking problems. Nevertheless, these efforts can give direction to an alcohol-related campaign. One such well-known program is the Three Community Study of the Stanford Heart Disease Prevention Project. The Three Community Study set out to determine if state- of-the-art mass media programming could influence the factors associated with the risk of heart disease. The Department of Communication at Stanford University produced more than 50 television spots and more than 100 radio spots of 10 to 60 sec- onds' cluration, plus more than three hours of television pro- gramming, many hours of radio programming, newspaper columns, advertisements, and direct mail. These messages were designed to educate people about the risks of heart disease and to encourage them to reduce those risks through dietary changes, giving up cigarettes, a return to ideal weight, and programs of regular exercise. Wherever pos- sible, the messages mentioned specific skills or techniques that people could use to achieve these changes. In one of the two experimental towns in central California, the Three Community Study went beyond this mass media approach. Either at home or in formal classes, physicians and other health educators individually taught the people at highest risk of heart disease some specific skills that they could use to achieve a healthier lifestyle. The results of the Three Community Study were striking. After two years the people in both experimental towns had average reductions in the overall estimated risk of heart disease of between 16 and IS percent. In a control town the average risk increased 6.5 percent. Overall, the people in the experi- mental towns clid not lose weight, but the people in the control town gained weight. As expected, the town receiving both the mass media infor- mation and the intensive training had the largest initial overall reduction in risk. But by the end of two years, the town re-

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DRINKING AND THE MASS MEDIA / 91 ceiving only the mass media information had caught up with the town that also received the personalizecl training. Still, the training had a specific noticeable effect. In the control town and the town receiving only the mass media information, few peo- ple managed to quit smoking. But of the people who received individualizes! instruction, half of those who had been smokers quit. There are many questions that would have to be answered before a program similar to the Three Community Study could be widely applied to alcohol problems. For instance, what is the best way to scale up a relatively small program to a national equivalent? In the Three Community Study, the organizers of the program were highly committed. In a national program of alcohol education, the organizations called upon to administer the program may initially be skeptical or indifferent. Never- theless, the combination of mass media health information and personalized training is a promising one. Educational training programs on alcohol would be a valuable step forward, al- though at this stage their primary goal should be the collection of further research data. Lessons for Future Educational Campaigns The Three Community Study demonstrated several impor- tant rules that any similar program should follow. An important set of rules concerns the messages sent through the mass media. "A message shouic! not try to be all things to all people," writes Hochhe~mer. "It should be targeted to a specific audience, which involves defining who that audience is, what those people are like, what it is we want to change, what the best strategy is to change it, ant! what is the most efficacious method of dissem- inating that information." This approach acknowledges "that the audience is an equal partner in the communication pro- cess," according to Hochheimer. The source of the message is also important. The credibility, attractiveness, and forcefulness of the source all influence how much impact a message has. For instance, in some cases the government may not have much credibility as a source of health information, according to Hochheimer. The government's po-

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92 / ALCOHOL IN AMERICA sition should therefore be carefully studied in designing an educational campaign on alcohol-related problems. As another example, the use of older celebrities like Dick Van Dyke or Art Carney in educational campaigns about alcohol may have little relevance to younger people. The message itself should be specific and to the point. Re- search shows that messages advocating a specific behavior are better than vague admonitions. Thus the message "If your friend is drunk at a party, take him home in his car and ask another friend to drive behinc! to pick you up" is better than "Friends don't let friends drive drunk," according to Hochheimer. An- other example of a specific message is "Why not make every third drink a soft drink at the next party." Messages that rely on fear- such as "Drunk drivers add color to our highways" or movies portraying the evils of alcohol or drug addiction may backfire. If messages are too heavy-handed, people may ignore or avoid them to avoid feeling the emotions that such messages are supposec! to engender. People may also see them as exaggerated and consequently dismiss less drastic messages as equally biased. An educational campaign should also make use of a variety of different media. The obvious media are television, radio, and newspapers. But there are also billboards, direct mail, maga- zines, newsletters, films, subway and bus ads, and the insertion of materials into paychecks. These messages shouIcl be coor- dinated so that they reinforce each other and do not conflict. In addition, educational campaigns should draw on the profes- sional knowledge and skills of people trained in the behavioral and communication sciences. Past programs that have relied exclusively on the expertise of commercial advertisers or the enthusiasm of local volunteer groups have generally not achieved their desired ends. Finally, educational campaigns must do more than just sup- ply people with information. They must suggest specific be- haviors and teach specific skills that enable people to make changes that they want to make. If possible, this education can take the form of low-key training programs. There is even an institutional base that can support these programs local hos- pitals and the rapidly expanding network of health mainte-

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DRINKING AND THE MASS MEDIA / 93 nance organizations. These organizations can offer individualized training at a relatively low cost. They have the potential to make it relatively easy and, perhaps more important, relatively unem- barrassing for people to learn ways to moderate their drinking. With regard to the overall prospects for eclucational programs dealing with alcohol-related problems, the pane} concluded, ". . . Where is potential in these areas, but it does not lie where we have commonly looked. It is not exclusively in the schools or in mass media advertising. It may be in information and training programs sponsored by universities and health main- tenance organizations focusing on the health risks of some drinking practices and teaching techniques for modifying per- sonal drinking habits." The Conflict Between Education and Other Media Messages As we saw in the first part of this chapter, educational pro- grams using mass media may have a formidable barrier to over- come. They must rely at least in part on the media to convey their messages. Yet these same media also transmit many mes- sages that implicitly or explicitly glamorize drinking. As a re- sult, says Lawrence WalIack, alcohol educational campaigns "exist in a generally hostile environment rich with messages supporting and encouraging the use and misuse of alcohol. The major contributor to this antieducation environment is clearly alcoholic beverage advertising. The massive amount of mis- leading information being disseminated through alcoholic bev- erage advertising acts as a barrier to the success of community- based programs and larger public information efforts. Televi- sion programming is also a great, though inadvertent, contrib- utor to this vast reservoir of misinformation." One measure of the relative strengths of advertising and al- coho! education is the resources devoted to each. In a recent year the National Institute on Alcohol Abuse and Alcoholism spent $~.4 million to provide information on alcohol to the public. Even if each of the states spent $1 million on similar efforts, the combined resources for public alcohol education- about $60 millionwould equal only half of the advertising budgets of either the Anheuser-Busch or Miller brewing

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94 / ALCOHOL IN ~ERICA companies. Compared with the over $l billion spent yearly on alcohol advertising, these public expenditures are almost . it- . nslgnl~lcant. There are several ways to narrow this gap. One is to increase funds for public alcohol education. Voluntary, self-initiated re- straints, such as those advocated by the Caucus of Producers, Writers, and Directors and the Wine Institute, are a second approach. A third approach involves governmental legislation or regulation. This last approach, says Stanley Cohen, "requires a cohesive and realistic strategy. The odds are not attractive, but they are not impossible." WalIack suggests two governmental policies that he sees as "a starting point for further discussion." The first is to withdraw the business tax deduction for advertising alcoholic beverages. An estimated $350 million of the $1 billion spent on alcohol advertising is now declucted from corporate taxes. Waliack's second suggestion is to levy a 10 percent tax on alcoholic bev- erage advertising to fund educational campaigns. This would be a way "to fund advertisements that show the other side of the alcoholic beverage story," he says. Compared with the number of messages in the mass media that promote or glamorize drinking, an eclucational campaign can seem "a slim reed," in the words of Stanley Cohen. But an educational campaign does not have to act alone. Such cam- paigns can reinforce the many other forces in society that tend to moderate drinking. They can draw attention to laws that prohibit specific actions like drinking and driving. Or they can be a vehicle for some other way of preventing alcohol problems, such as individualized training. As part of a multifaceted pro- gram of prevention, educational campaigns can be both easier to get started and more effective once they are launched.