Is the Howard Government's anti-drug advertising campaign likely to be effective?

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The issue
On March 25 2001 the first of a series of anti-drug advertisements was screened on Australian commercial television. This was the first stage in the National Illicit Drugs Campaign, conducted as part of the federal Government's National Illicit Drug Strategy, Tough on Drugs.
The advertisements gave vivid depictions of young people whose lives had been damaged by drug taking - one was a prostitute, another was being zipped into a body bag. While these images were presented there was a voice-over that had the young person, while still a child, voicing his/her hopes for the future.
The advertisements aim to shock the viewer into recognising that drugs destroy young lives.
The advertisements primarily targeted parents and were followed by a brochure titled 'Our Strongest defence Against Drugs - Families'. The brochure gave parents advice on how to discuss the issue of drugs with their children. Six and a half million copies of the brochure were distributed, one to each Australian household.
The campaign has met with a mixed response. There are those who hold that it has been a valuable initiative; there are others who argue that it has been a waste of funds that could have been better directed elsewhere.

What they said ...
'Parents are our greatest resource in fighting the drug problem'
Mr John Howard, Australian Prime Minister

'Does anyone really think an ad will suddenly enable parents to communicate with their kids, or kids to suddenly trust their parents?'
Mr Peter Ellingsen, a staff writer with The Age.
Echo Issue Outline 2001 / 11
Copyright © Echo Education Services
First published in The Echo on-line newspaper information site.

Issue outline by J M McInerney

Background
Prohibition and/or 'Harm Minimisation'
There are two broad approaches that can be adopted to illicit (illegal) drug use in any society. One is prohibition and the other is 'harm minimisation'. The prohibition approach is also sometimes referred to as 'zero-tolerance'.
1. A prohibition-based approach attempts to stamp out the problem by removing supply and reducing demand. To remove supply, it makes drug-trafficking illegal and attempts to prevent illicit drugs being imported into or manufactured in the country. To reduce demand, it is made an offence to take illicit drugs. Education programs are used to warn potential users of the dangers of illicit drugs.
Treatment programs for established drug users receive less emphasis in a prohibition approach. Where they occur, they often focus on abstinence-based treatment.
2. A 'harm minimisation' or 'harm reduction' approach starts from the belief that some level of drug taking will always occur within a society and, therefore, governments need to adopt strategies that will reduce the risks to drug users and the society at large.
Needle exchange programs are a harm-reduction strategy. Also part of a harm minimisation approach is the provision of safe injection venues, often referred to as 'shooting galleries'.
Education programs are part of a harm reduction approach, however, these programs aim not so much to prevent drug taking as to give information on how to use drugs with relative safety.
The extreme end of the harm minimisation approach is the medically regulated provision of heroin to addicts.

The current Australian approach to the drug problem.
Over the past three and a half years the federal government has funded a drugs strategy titled, 'Tough on Drugs, the National Illicit Drug Strategy'.
1. When this strategy was announced, in November 1997, it was promoted as a mixed approach incorporating both prohibition and 'harm minimisation, strategies.
The strategy adopted a three-pronged approach - reduce supply (primarily through law enforcement efforts against importers and traffickers); reduce demand (primarily through a 'zero tolerance' approach within schools); and 'harm minimisation'.
However, 'harm minimisation' appeared to refer to the 'treatment of illicit drug users' and the strategy seemed to favour 'abstinence-based treatment'.
It also provided additional funds for the trial of non-heroin drugs designed to replace addicts' dependence on heroin and/or to help them detoxify.
The federal government has never supported 'shooting galleries' or the regulated supply of heroin to registered users.
2. In March 1998, the Prime Minister announced the second instalment of the National Illicit Drugs Strategy (NIDS).
This was at the first meeting of the National Council on Drugs. The Council was established as a group of independent experts on the drug problem that would assist the government in the development of policy and strategies.
By March 1998, the government was no longer presenting harm minimisation as a separate strategy, but classing it as a demand reduction strategy. What appeared to be meant by 'harm minimisation' was treatment to free the addict of his/her addiction and research into abstinence-based treatments.
Grants were made to non-government treatment organisations, with their progress to be evaluated and their outcomes monitored.
3. The television advertising campaign marks the beginning of the third stage of the 'Tough on Drugs' strategy. (Some media commentators are calling it the second stage, preferring to roll the 1997 and 1998 initiatives together.)
The advertising campaign was to have been started in 2000. However, there was a drawn-out dispute over the nature of the booklet directed to parents that was to accompany the advertisements. A sub-committee of the National Council on Drugs had drafted the booklet. However, the Prime Minister's office rewrote this initial booklet to make it more of a 'zero-tolerance' document.
'Harm minimisation' advocates on the National Council on Drugs then worked to have the language in the booklet softened. Even after this process its critics consider the booklet 'one-sided and negative'.
One harm-minimisation advocate has resigned from the National Council on Drugs and a further four have been removed.
The Federal Health Department site describes this stage of the Tough on Drugs strategy as follows:
'$27.5 million has been allocated for the development and implementation of a community education and information campaign.
The National Illicit Drugs campaign is a comprehensive community drug prevention campaign, designed to educate and inform the community about the dangers of illicit drug use.
The campaign launched on 25 March 2001 was the first stage of the campaign aiming to:
a) inform parents of the important role they play in preventing illicit drug use amongst young people;
b) Inform the community, particularly parents of the harms associated with illicit drug use.
The campaign is designed to motivate, support and equip parents with information to assist in their discussions with their children. It is comprised of a mass reach national media strategy, public relations activities, a strategy for parents of non-English speaking backgrounds, a website and a 1-800 telephone information line. Campaign resources include a booklet for parents that will reach all households in Australia through a national delivery and a pamphlet.'
4. It was intended that this first advertising campaign would be followed by a second aimed at young people. It now appears that this will not go ahead until after the next federal election.
It was also originally intended that a parental education campaign would be run, following the advertisements and booklet mail-out. No date has been set for this program.
Internet links

The Prime Minister, Mr John Howard's launch speech for Tough on Drugs - the National Illicit Drugs Strategy (NIDS) can be found at http://www.nor.com.au/users/gaiaguys/drugspe.htm
The speech was delivered on November 2, 1997, at the Ted Noffs Foundation, Randwick, Sydney.
It gives a detailed account of the three main emphases that make up the strategy. It also suggests what the federal government means when it refers to 'harm minimisation'.

An overview the federal government's National Illicit Drug Strategy (NIDS) can be found on a sub-site of the federal Government's Public Health site.
The overview was first released in March 1998, and has been supplemented since. It details the aims and objectives of the 2001 advertising campaign, part of the National Illicit Drugs Campaign
The overview can be found at http://www.health.gov.au/pubhlth/strateg/drugs/illicit/index.htm

The National Illicit Drugs Campaign has its own web site that includes pdf format versions of the parent brochure and support materials sent out after the advertising campaign. Adobe Acrobat Reader is required to read or download these files. They can be found at http://www.drugs.health.gov.au/index.htm
Also available on this site are the research findings on which the government based its advertising campaign and brochure strategy. These can be found at
http://www.health.gov.au/pubhlth/nidc/campaign/research.htm

Open Family is an Australian foundation established in 1981. It works with homeless and disaffected young people. Its principal aim is 'to improve the well-being and self-worth of alienated and excluded Australian children, through unconditional support ... with the view to reconnecting them with the community'.
Les Twentyman of Open Family Australia has criticised the government-funded anti-drug advertising campaign.
A sub-section of the Open family site looks at the impact of family dysfunction and breakdown on youth homelessness and substance abuse.
This material can be found at http://www.openfamily.com.au/familybreakdown.htm#content

Family Drug Support is a project of the Damien Trimingham Foundation. Its objectives are to strengthen and develop the harm reduction approach to alcohol and drug issues. It focuses on education, health promotion and treatment activities.
Mt Trimingham, a former member of the National Council on Drugs, has also been critical of the booklet and brochure accompanying the advertisement campaign.
Family Drug Support's home page can be found at http://www.fds.org.au/images/mainimage_0.jpg

The Family Drug Support site includes a number of articles written to advise families where one or more of the children have a drug problem. A set of links to these articles can be found at http://www.fds.org.au/newsletter_articles.html

The National Institute on Drug Abuse (NIDA) is a United States government agency whose primary aim is to conduct, collate and disseminate research to help combat substance abuse.
NIDA's home page can be found at http://165.112.78.61/

One of the areas that NIDA has been investigating is the role of families in preventing substance abuse.
NIDA has published a number of papers on this issue. One of these is Drug Abuse Prevention Through Family-Based Interventions: Future Research by Kathleen E. Etz, Elizabeth B. Robertson, and Rebecca S. Ashery
This is a lengthy paper, however the third paragraph makes the interesting point that children from families where their parents and/or siblings are drug users (including users of alcohol and tobacco) are at greater risk of substance abuse themselves. The article includes a range of other factors including poverty and poor attachment with parents that can pre-dispose a young person to substance abuse.
The article can be found at
http://165.112.78.61/pdf/monographs/monograph177/001-011_Etz.pdf
It is in pdf format and requires Adobe Acrobat Reader to be read or downloaded.
A clickable list of other NIDA articles on the influence of family intervention on drug taking can be found at http://165.112.78.61/pdf/monographs/monograph177/download177.html
All these articles are in pdf format and require Adobe Acrobat Reader.

Arguments in favour of the Howard Government's --anti-drug advertising campaign
1. Research indicates that families are a powerful influence on children's behaviour
Recent American research by the National Centre on Addiction and Substance Abuse at Columbia University supports the view that strong parents, who set clear rules and closely monitor their children, are most effective in safeguarding them from drug abuse.
Research conducted for the Australian federal government indicates that 71 percent of 15-to-17-year-olds said their parents could influence them not to use drugs.
Federal Health Minister, Michael Wooldridge, has noted that the campaign is based on both Australian and overseas research.

2. Previous health or social issue advertising campaigns appear to have been successful
It has also been noted that previous advertising campaigns, especially those that have sought to reduce drink driving have been particularly effective. Supporters of the anti-drug campaign argue that it is likely to be similarly successful.
This point was made in an editorial published in The Age on March 27, 2001. The editorial states, '... if the anti-drug campaign achieves only a fraction of the success in lowering the incidence of drug abuse that the TAC campaign apparently achieved in lowering accident deaths, then taxpayers' money will have been well spent.'

3. The advertising campaign is primarily intended to raise awareness
Defenders of the advertising campaign have noted that it is important not to over-estimate what it is intended to achieve. From this point of view all the advertising campaign is aimed to do is heighten awareness of the problem of drugs and provoke discussion of the problem.
Dr Norman Swan has summed up this point. Dr Swan has stated, '... all the television component is doing is preparing the ground, providing motivation and giving credibility to the leaflet drop.
It will also provoke conversations at work, at dinner parties and over the back fence - again part of the 'softening' process and a well-recognised sign that campaigns are being noticed and have a chance of being effective.'
Overseas research has indicated that straight information campaigns targeting drug-users or potential drug users have not been effective.
The hope of this campaign is that the advertising component will both reduce parents' reluctance to discuss drugs with their children and will make the children more responsive to the arguments their parents put.

4. An information brochure supports the advertising campaign
To critics who claim that an advertising campaign is not an effective strategy to effect complex problems such as drug addiction, defenders of the government strategy note that an information brochure has followed the advertisement.
Dr Norman Swan has described the intention of the brochure. 'The core goal of the printed material is to get parents to talk to their children about drugs. It provides facts and figures, almost a script, for parents to follow.'
It was felt this was necessary because Australian-based research had indicated that though many parents wished to speak to their children about drugs, they were unsure of how to do so.
The federal Health Minister, Dr Michael Wooldridge, has noted, 'When we spoke to parents it came through clearly that parents were scared of talking about drugs with their children.
They fear making drugs seem more interesting or giving the wrong information in a life and death area.'

5. The advertising campaign is only part of a variety of Government funded initiatives
Supporters of the government-funded advertising campaign have also noted that the advertisements and brochure are only a relatively small part of the government's total anti-drug strategy which has included additional funding to customs and police to improve the likelihood of limiting supply; funds to community support groups working with addicts; funds to research groups investigating ways of treating addicts and funds towards the development of school-based education programs promoting zero tolerance. There has also been money devoted to diversion programs in an attempt to treat addicts rather than incarcerate them.
It has further been noted that the government also plans to bring out a further set of advertisements directed toward at-risk young people.

Arguments against the Howard Government's anti-drug advertising campaign
1. The campaign simplifies or ignores the causes of addiction
It has been claimed that the campaign ignores the social, economic and familial problems that frequently give rise to drug use in young people.
Margaret Hamilton, one of the members of the National Council on Drugs has stated that a majority of heroin dependent users were 'lonely, unconnected (and) poor'.
According to this line of argument, economic disadvantage and family dysfunction and breakdown were major factors predisposing young people to substance abuse.
A senior family Court judge, Justice sally Brown, has made a similar point claiming that most people who died from heroin overdoses were long-term users from low socio-economic backgrounds. 'Save for a few, they have ended up at the bottom of the socio-economic heap.'
From this perspective it is wrong headed to be targeting parents in advertisements, as the parents of children most likely to become addicts will be heading poor, dysfunctional, fractured families.
It is suggested that it would be better to address the social and economic causes of disadvantage than conduct advertising campaigns.

2. The campaign implies advertisements can alter behaviour and supply skills
Advertisements, it is claimed, are rarely successful at altering complex or addictive behaviours. For example, it has been argued that the scare campaign conducted to promote safe sex, as a means of combating AIDS, has not had an enduring effect.
Similar criticisms have been made of advertising campaigns aimed at discouraging smokers.

It has also been suggested that an advertising campaign will not improve family relations nor give parents the necessary communication skills.
Mr Peter Ellingsen, a staff writer with The Age, has posed the rhetorical question, 'Does anyone really think an ad will suddenly enable parents to communicate with their kids, or kids to suddenly trust their parents?'

3. The campaign focuses primarily on middle class families
It has also been suggested that the advertising campaign and the accompanying booklet show a middle class view of society.
A family Court judge, Justice Sally Brown, has noted, 'The whole format - the families in the television advertisements, the booklet itself, the tone of the envisaged discussion between parents and children - is firmly middle class.'
Justice Brown went on 'the victim of a heroin overdose is a middle-class child, well-educated, socially competent and apparently on a straight track to creative and fulfilling adulthood.'
The advertisements have been criticised for being unrealistic. In focussing on a well-educated and aspiring section of society, the advertisements and booklet appeared to be ignoring the lower socio-economic groups where drug addiction leading to death is more likely to occur.

4. The brochure accompanying the advertising campaign is inadequate
It has been claimed that the brochure accompanying the advertisements is inadequate because it adopts a too prohibitive approach to the drug issue. It offers no 'harm minimisation' perspective and so, it is claimed, is of limited use to parents whose children are already taking illicit drugs.
It also does not consider the possibility that the parent may currently be using illicit drugs themselves.
It has also been suggested that the approach adopted is unhelpfully alarmist as it implies that one hit creates a 'junkie'.
Further, it has been argued, no booklet, however useful and well balanced, can make up for a history of poor communication within a family.

5. The money spent on the advertising campaign should have been directed elsewhere
The $27 million spent on the advertising campaign and accompanying mail-out, could, it has been claimed, have been better spent elsewhere.
Alex Wodak, the president of the National Drug and Alcohol Research Centre has claimed that there is no evidence that mass media campaigns reduce drug use. Dr Wodak has claimed that the $27 million would be better spent on places in methadone and other treatment programs for as many as 15,000 Australians.
Dr Wodak has claimed, 'There is a great shortfall at the moment, where people are finding it desperately hard to get into detox centres and treatment programs ...'

Further implications
It obviously remains to be seen whether the current anti-drugs advertising campaign and the emphasis being placed on the family as a preventative agent will have a beneficial effect on Australia's drug problem.
It is difficult not to see the initiative as damagingly short-term. If you believe that parents have an enduring role to play in preventing their children from becoming substance abusers then presumably more than an advertising campaign and a mail-out are necessary to have them perform this role.
It has been claimed that where advertising campaigns have worked in the past, as was initially the case with the safe-sex AIDS campaign, it was because once awareness had been increased, there were medical and community support services available to support those who wished to act responsibly. This included education programs in schools, counselling and syringe-distribution centres.
Here the message appears to be primarily 'Don't do it' and there do not appear to be adequate services available either for those who have trouble getting that message across or for whom it is already too late.
It is interesting to note that according to the information supplied in the parent booklet the Government has granted $57 million to 133 non-government treatment programs.
The Government is leaving what it terms 'the crucial work of ... tackling the drug problem at the grassroots level' to 'charitable and non-government organisations'. Furthermore some 133 such organisations received in total, over a period of two years, only a little more than twice the funding made available for the 2001 television advertising campaign.
It seems that the Government does not place a particularly high priority on treating those with a substance abuse problem.
It is also interesting to note that in the lead-up to the release of this advertising strategy there has been a significant change in the balance of views within the National Council on Drugs.
When the Prime Minister, John Howard, announced his National Illicit Drugs Strategy, on March 16 1998, he did so at the first meeting of the National Council on Drugs.
The Council was an amalgam of independent community groups with a variety of perspectives on how best to approach substance abuse. It included a number of representatives of organisations that had a 'harm minimisation' approach.
One of these representatives has recently resigned and four have not had their tenure renewed.
The Government has a clear preference for zero-tolerance approaches. It now seems likely that it will not even receive minority reports from the National Council on Drugs that present a different point of view.
More radical approaches to the drug problem, such as supervised injection centres, will only receive federal support if there is a change of government at the next election.


Newspaper items used in the preparation of this outline
Available as a press cuttings package (with an issue outline reprint): price: $27.00 (NO LONGER AVAILABLE)

Sources
The Age
23/3/01 page 6 news item by Darren Gray, 'Drug campaign targets families'
23/3/01 page 6 news item by Brett Foley, 'Helping young stay, not stray'
24/3/01 page 1 news item by Caroline Overington, 'PM to launch drug ads'
25/3/01 page 1 news item by Brendan Nicholson, 'Images to jolt a nation'
25/3/01 page 14 comment by Terry Lane, 'Let's try a summit of the sensible'
26/3/01 page 2 news item by Melissa Fyfe and Sophie Douez, 'PM urges redoubled drug effort'
26/3/01 page 2 news item by Melissa Fyfe, 'Poppins character is bad medicine'
27/3/01 page 4 news item by Darren Gray, 'No injecting rooms or heroin trials'
27/3/01 page 12 editorial, 'Anti-drug ads are not enough'
28/3/01 page 14 cartoon by Tanberg, 'Tough on drugs'
28/3/01 page 15 comment by Dr Norman Swan, 'Anti-drug ads won't hurt - at best'
29/3/01 page 6 news item by Amanda Dunn, 'Teenagers shocked by TV ad campaign'
29/3/01 page 6 news item by Amanda Dunn, 'Images prompt flood of tears'
29/3/01 page 6 comment by Chloe Saltau, 'One hit does not a junkie make'
30/3/01 page 15 comment by Peter Ellingsen, 'Drug users won't buy Howard's message'
31/3/01 page 9 analysis by Murray Mottram, 'Drug deaths defy an optimistic hope that a family can provide protection'
1/4/01 page 19 analysis by Steve Dow, 'Shock tactics: can Howard reach Australia's youth?'
1/4/01 page 19 news item by Steve Dow, 'Get real - this message is lost'
2/4/01 page 13 comment by Tony Hewison, 'School is the place to defeat drug abuse'
5/4/01 page 3 news item by Chloe Saltau, 'Drug ads unrealistic, says judge'

The Australian
26/3/01 page 3 news item by Sarah Stock, 'Parents in front line of PM's drug war'
5/4/01 page 4 news item by Louise Milligan, 'Howard's message on drugs "ignorant"'

The Herald Sun
23/4/01 page 4 news item by Rick Wallace and Andrew Probyn, 'National drug assault'
26/3/01 page 4 news item by Rick Wallace, 'More raw drug ads on the way'
27/3/01 page 18 editorial, 'Spotlight on parents'
27/3/01 page 18 comment by Kevin Donnelly, 'Strong parents fend off drugs'