D.A.R.E.’s Failed Attempt to “Just Say No”-Sarah Doersam

Young adults in today’s generation are exposed to drugs, gangs and violence in a variety of ways; from what they see on television ads to what they are taught in their school systems. The way they choose to respond to the information they are given also varies in multiple ways, depending on factors from their environment to their personal behaviors. In today’s society, where teens have access to any type of information they desire, it is imperative that public health officials are successful in relaying and delivering their desired message to young adults (undoubtedly a complicated task). A major ineffective public health intervention that was implemented in the 1980s and 1990s to keep young adults off of drugs and away from gangs and violence is the D.A.R.E. program (Drug Abuse Resistance Education) (see Figure 1).

Figure 1.

The D.A.R.E. program, founded in 1983 in Los Angeles, is a “drug resistance education” program taught to young adults from kindergarten to the 12^th grade, and was implemented in 75% of American school districts and in more than 43 countries around the world (1). The program was led by community police officers, who taught a series of lessons inside school classrooms about how to resist peer pressure and “live productive drug and violence-free lives” (1). According to the D.A.R.E. website, “millions of school children around the world will benefit from D.A.R.E.; the highly acclaimed program that gives kids the skills they need to avoid involvement in drugs, gangs, and violence” (1). Students who enter the D.A.R.E. program sign a pledge to never use drugs or join a gang after the ten-week curriculum. To date, this program has failed to meet federal guidelines that the program be both research-based and effective, disqualifying them from eligibility for receiving federal grant money. According to the Center for Disease Control and Prevention, throughout the 1990s (at the height of the D.A.R.E. campaign) marijuana, cocaine, methamphetamines, and steroid use all increased in students in 9^th to 12^th grades (2). Unfortunately, the D.A.R.E. campaign failed to accomplish what it set out to do, and in fact during the height of its implementation, illicit drug use rates among young adolescents rose.

This public health program, intended to raise awareness, and in return decrease rates of drug use and gang participation failed on multiple levels. Despite annual spending of 1 to 1.3 billion dollars in 2001, the U.S. Surgeon General placed D.A.R.E. under the category of “Ineffective Programs”, and the Department of Education has prohibited schools from spending its “Safe and Drug-Free Schools” money on D.A.R.E. because of its ineffectiveness (3). In addition, multiple studies have been conducted refuting D.A.R.E.’s efficacy. According to a Time article, D.A.R.E.’s “goals include teaching kids creative ways to “just say no" to drugs, while simultaneously bolstering their self-esteem (which D.A.R.E. founders insist is related to lower rates of drug use). [According to Time] it's apparently not a bad way of educating five-year-olds about the dangers of drinking cleaning fluid. But it's a bust at keeping teenagers from smoking pot” (4). The article also found that D.A.R.E. status in the sixth grade was negatively related to self-esteem at age 20, indicating that individuals who were exposed to D.A.R.E. in the sixth grade had lower levels of self-esteem 10 years later (4).

Another study at the University of Illinois suggested that some high school seniors who’d been in D.A.R.E. classes were more likely to use drugs than their non-D.A.R.E. peers. More than 1,000 10 year-olds enrolled in D.A.R.E. classes were given a survey about drug use and self-esteem, and then, a decade later, the same group filled out the same questionnaire. Results from the study showed that 20-year-olds who’d had D.A.R.E. classes were no less likely to have smoked marijuana or cigarettes, drank alcohol, used "illicit" drugs like cocaine or heroin, or caved in to peer pressure than kids who’d never been exposed to D.A.R.E. (4). Researchers from this study also speculated that “by making drugs seem more prevalent, or "normal" than they actually are, the D.A.R.E. program might have actually pushed kids who are anxious to fit in towards drugs” (4).

Lynam et al. also conducted a study in 1999 that studied the long term effects of the D.A.R.E. program. The authors initially sampled a group of 230,000 sixth graders during the 1987-1988 school year in a Midwest metropolitan area. Data was collected before and after entry into the D.A.R.E. program, and follow-up questionnaires were collected from participants over a five year period when students were in the sixth to tenth grades. The 1, 002 participants (average age was 20.1 years) that were followed up with were sent a questionnaire asking about their use of alcohol, tobacco, marijuana and other illegal drugs. Results show the D.A.R.E. program had no effect on alcohol, cigarette, marijuana, or illicit drug use. Additionally, D.A.R.E. status had no effect on peer-pressure resistance levels, and D.A.R.E. status in the sixth grade was negatively related to self-esteem (5). Clearly, the program’s solution to “just say no” was an ineffective anti-drug message that wasted millions of dollars.

Theory of Reasoned Action

The multiple studies that confirm D.A.R.E.’s unsuccessful public health campaign to “just say no” prove that the intervention failed to consider, and appropriately apply several social sciences theories. First, the intervention failed to successfully apply the Theory of Reasoned Action. The Theory of Reasoned Action “suggests that a person's behavior is determined by his/her intention to perform the behavior and that this intention is, in turn, a function of his/her attitude toward the behavior and his/her subjective norm” (6). The Theory of Reasoned Action also holds that only specific attitudes toward the behavior in question can be expected to predict that behavior, and suggests that behavioral change ultimately is the results of changes in beliefs, and that people will perform a certain behavior if they think they should perform it. The D.A.R.E. program assumed that if they could change young adults’ beliefs about drugs, violence and gangs by telling them to “just say no”, they would be able to change their behavior and keep more adolescents off of drugs and out of gangs. This model is supposed to work on an individual level; it assumes individuals will rationally weigh their perceived outcome expectancies against their perceived subjective norms of changing a behavior (7). The campaign fails in that it does not consider the fact that people, especially adolescents, can act and behave irrationally. Although participants in a campaign, in this case a large population of adolescents, can be given accurate information and facts (drugs are bad, ect.), they sometimes do still participate in the wrong behavior. D.A.R.E. only offers its participants one solution concerning drugs, violence and gangs; to “just say no”, and they assume kids who participate will consider this to be a rational solution to drug abuse and resistance. D.A.R.E. does not consider that it is highly unlikely that adolescents will act “rationally” in every situation they come across where drugs, gangs and violence are involved.

The Psychological Reactance Theory

The Psychological Reactance Theory is defined as “an adverse affective reaction in response to regulations or impositions that impinge on freedom and autonomy and is especially common when individuals feel obliged to adopt a particular opinion or engage in a specific behavior” (9). According to the theory, reactance “often encourages individuals to espouse an opinion that opposes the belief or attitude they were encouraged, or even coerced, to adopt” (9). The D.A.R.E. campaign never considered this possibility over their two decade run. “Reactance” occurs whenever a free behavior is restricted, and this is exactly what happened with this campaign. D.A.R.E restricted participants’ behavior with “just say no”, so many acted out and did exactly the opposite behavior D.A.R.E. intended. The program took away young adults’ freedom to make their own decisions about actions to take in peer groups and social settings, making adolescents try to re-establish their freedom by rebelling against the program altogether.

D.A.R.E. was not the only public health campaign that failed to consider the Psychological Reactance Theory; “Above the Influence”, a more recent anti-drug campaign, also unintentionally caused adolescents to rebel against the intended message. The Above the Influence campaign was created with the intention to target teens with anti-drug messages, primarily concerning the use of marijuana (10) (See Figure 2 below). Despite a great deal of funding provided by the government, Above the Influence, similar to D.A.R.E. failed to successfully influence teenagers not to abuse marijuana, or other types of recreational drugs. The advertisements created for this campaign told viewers that they must live “above the influence” or they would become just another statistic of a teen lost to drugs. By depicting teenagers who smoke marijuana as lazy and irresponsible, the campaign dissociated their target audience and caused them to rebel (as seen in many parody UTube videos). The campaign did not give teens a sense of control, and that loss of control and freedom was the primary instigator for rebellion, and a failed public health intervention. Because the campaign focused on how teens should not behave and what they should not do, many teens felt that their personal freedoms were threatened. Above the Influence failed to create a sense of identity for its target audience and, similar to D.A.R.E., only focused on restricting young adults’ behaviors. In a report released in 2006, the United States Government Accountability Office “did not find that the youth anti-drug media campaign was effective in reducing youth drug use” (11). The study found that that “among current, non-drug-using youth, exposure to the campaign had unfavorable effects on their anti-drug norms and perceptions of other youths’ use of marijuana- that is greater exposure to the campaign was associated with weaker anti-drug norms and increases in the perception that others use marijuana” (11).

Figure 2.

As demonstrated with the increase in recreational drug use trends during the 1990s, D.A.R.E. failed to successfully reign in its target audience; adolescents, again, reinforcing their failure to apply the Psychological Reactance Theory. The D.A.R.E. campaign tells its participants not to do drugs by unsuccessfully using police officers to deliver their message. Because the target audience is adolescents, the program should not have used a population (police officers) that is so different from them. According to a PBS released study, “the young adolescent brain works differently than an adult brain, and responds differently, especially in emotional situations, acts more impulsively and considers consequences less compared to adults” (12). Although the police officers may have taught accurate information about drugs, violence and gangs, they were unsuccessful in delivering their message because they do not easily relate to the adolescent population; their brains work differently. This sent the wrong message to teens that drugs are a law enforcement issue, not a public health issue.

Additionally, a police officer may “intimidate adolescents who have experimented with drugs from asking lifesaving questions out of fear that they would get into trouble” (13). Fear-based advertising “is a specific type of social marketing that employs scare tactics or other anxiety-producing mechanisms to highlight the dangers of engaging (or not engaging) in a certain practice”, in this case, teen drug use (14). This type of strategy was also implemented by the New York City Department of Health and Mental Hygiene with its anti-smoking campaign, “Smoking Kills” in 2009. The Department believed that by using graphic images smokers would become more aware of the health risks associated with the behavior and be influenced to quit (See Figure 3. below). Instead, when smokers saw the graphic images on the cigarette packages, they became stressed out and smoked even more, completely negating the purpose of the campaign. Similar to the failed “Smoking Kills” campaign, D.A.R.E. unsuccessfully used fear to try and implement their message to a target audience that was completely dissimilar to those who were relaying the message; causing the target population to rebel against the intended message.

Figure 3.

Optimistic Bias Theory

The D.A.R.E. campaign also fails to consider the Optimistic Bias Theory and its effect on adolescents. Optimistic bias is commonly defined as the mistaken belief that one's chances of experiencing a negative event are lower (or a positive event higher) than that of one's peers (15). This means that giving statistics and facts alone are not enough in public health campaigns; they need to tell a story and be able to capture the viewers’ emotion to be powerful and impactful. According to this theory, people do not believe their own risk of adverse behaviors is elevated. Weinstein (1980) demonstrated that “a majority of college students believed their chances of events such as divorce and having a drinking problem to be lower than that of other students, and their chances of events such as owning their own home and living past 80 years of age to be higher than that of other students” (15). The implementers of the D.A.R.E. campaign did not consider the fact that many adolescents feel like they are immortal and that nothing bad could ever happen to them (i.e. being confronted with drugs and potentially becoming addicted). Weinstein also says “It is possible to be optimistically biased by being overconfident about the objective chances of experiencing a positive event (or avoiding a negative event), irrespective of how one's chances compare with those of one's peers” (15). Again, D.A.R.E.’s failed campaign negated to consider vital Social Science theories.

Proposal for an Alternative Intervention

An alternative intervention to the D.A.R.E. campaign could show significant improvements in the campaign’s lack of beneficial results. By incorporating the appropriate Social Sciences theories and learning from what was unsuccessful in the old D.A.R.E. campaign, the new program can better organize and apply its approach. The new anti-drug campaign will be called “Dare to Dream and Succeed” and will incorporate, and appropriately use Advertising Theory, Psychological Reactance Theory and the Social Cognitive Theory.

Advertising Theory

Rather than using facts and figures to relay a public health campaign, an adolescent anti-drug campaign would be more effective if it was based on Advertising Theory. Advertising is a form of communication used to persuade its audience to take action in respect to products, ideas or services, and if appropriately used can be successful in public health campaigns. The “Dare to Dream and Succeed” campaign will advertize teen (the target audience) involvement in things other than drugs, like sports or clubs (anything that requires ambition and goal setting) and will use a messenger more similar to them, yet able to catch and hold a teenager’s attention; Justin Bieber. To make this advertisement successful, it will incorporate a promise, support, and core values. Justin Bieber will deliver a message that tells adolescents to follow their dreams by being involved in ‘healthy and safe’ activities so one day they too can be successful, and possibly even famous. The promise made in this advertisement will be that if you get involved in activities that support your long term goals (whether it be joining a team to be a professional athlete or joining the debate club to be a successful lawyer) you, like Justin Bieber, can be successful, happy, and potentially rich and famous (which is what will appeal to the target audience most). This promise is supported by Justin Bieber telling the target audience if they get involved in following their dreams and don’t allow drugs to get in their way, they can be like him. Also, this advertisement incorporates core values of hard work, dedication, attractiveness, money and success, which are ideals this audience values. A good public health campaign the “Dare to Dream and Succeed” can turn to is the Truth Campaign (see Figure 4 below).

Figure 4.

The Truth Campaign “is the largest national youth-focused anti-tobacco education campaign ever and is designed to engage teens by exposing Big Tobacco's marketing and manufacturing practices, as well as highlighting the toll of tobacco in relevant and innovative ways” (16). The Truth Campaign has been very successful in delivering their message; “seventy-five percent of all 12 to 17 year-olds in the nation - 21 million - can accurately describe one or more of the Truth ads, nearly 90 percent of youths aged 12 to 17 - 25 million - said the ad they saw was convincing, and eighty-five percent - 24 million - said the ad gave them good reasons not to smoke” (16). Thanks in large part to the Truth Campaign, declines in smoking rates among high school students has decreased by more than one million. This public health campaign has been so successful because of its effective use of Advertising Theory, and its ability to “capture the promotion of rebellion against the tobacco industry as a call to action to commit to a tobacco-free lifestyle” (17). The Dare to Dream and Succeed campaign, similar to the Truth Campaign, will not be a rebellion against abusing drugs, but call for a rebellion against unhealthy influences that get in the way of reaching your dreams.

Psychological Reactance Theory

This new campaign’s advertisement will target young adolescents though the Psychological Reactance Theory; understanding that a person will react to a perceived threat to their freedom when they are told what to do as well as what not to do. By turning the tables and delivering the message that drugs will take away your freedom to reach your dreams, teens will be more likely to rebel against experimenting with and abusing them. This new campaign will focus on positive messages; that by staying involved, you can reach your dreams. The Dare to Dream and Succeed campaign gives young adults a sense of ownership that they can reach their dreams, take control of their lives and make their own decisions, without the influence of drugs. This campaign can be successful if they follow in the Truth Campaign’s footsteps by delivering the message that the unhealthy behavior is what is taking their freedom away, and that is what teens should rebel against.

Social Cognitive Theory

The Dare to Dream and Succeed campaign will also be successful if it applies the Social Cognitive Theory. The Social Cognitive Theory defines human behavior “as a triadic, dynamic and reciprocal interaction of personal factors, behavior, and the environment” (18). This campaign will consider young adults’ environment, behavior, and personal factors and recognize that each person is different, behaves differently, and is in a different environment. Simply “just say no” cannot be universally applied to each individual and thought to be successful, so the new anti-drug campaign will equip its target audience with tools that can be used in a variety of environments and peer-pressure situations; the ability to recognize drugs are what will take away their freedoms. Because the new campaign offers young adults the opportunity to aspire to be something and to be involved with activities that lead them to their dreams, they have multiple reasons to not get involved with drugs.

According to the Social Cognitive Theory, a behavior change is “made possible by a personal sense of control”. When individuals have ownership in their actions (self-efficacy), they are more likely to adapt to positive health behavior changes (19). When young adults have ownership in something, they are more likely to make the decision to not do drugs. Having something they are involved with gives them an ownership over something that drugs would interfere with. Also, incorporating “modeling behavior” is essential when utilizing the Social Cognitive Theory. When a ‘model person’, someone that is similar to the individual, successfully masters a difficult situation, “social comparison processes can enhance self-efficacy beliefs”, and ultimately successful behavior changes; when young adults see their peers (and Justin Bieber!) making health choices not to do drugs, they will be more likely to do the same.

If Dare to Dream and Succeed can be turned into a movement, similar to “the 84” campaign, a successful public health initiative is much more probable. The 84 is “a youth led movement fighting for a tobacco-free generation in Massachusetts”, and has successfully marketed their organization into a movement (20) (See Figure 5 below). The “84” represents the 84% of Massachusetts teens who choose not to smoke, giving teens a positive association to be a part of. This movement is successful in that it, similar to the Truth Campaign, organizes teens to fight against the tobacco industry for trying to infringe upon their freedoms. The 84 successfully leads young adults in a rebellion against smoking, and a movement to “do positive things” (20). Dare to Dream and Succeed needs to implement the 84’s strategy of calling teens to join a movement to do “positive things”, and NOT to do drugs.

Figure 5.

Dare to Dream and Succeed’s campaign success is dependent on the incorporation of each of the previous models appropriately and in a cohesive manner. It is important that we look to the old D.A.R.E campaign to examine where and why it was unsuccessful, and learn from their mistakes. Impacting a teen’s behavior and decisions is not an easy task, but it is possible and has been done before with multiple successful public health programs like the 84 and Truth campaigns. If we can look to what is successful, learn from past mistakes and consider the implications of Social Science Theories, Dare to Dream and Succeed has the potential to join the ranks with the 84 and Truth campaigns as public health successes.

References

1. Drug Abuse Resistance Education. D.A.R.E official website. Accessed on December 2, 2011 at: http://www.dare.com/home/Resources/Default5647.asp?N=Resources&M=16&S=0.

2. The Center for Disease Control and Prevention. Trends in the Prevalence of Marijuana, Cocaine, and Other Illicit Drug Use, National YRBS: 1991-2009. Accessed on December 2, 2011 at: http://www.cdc.gov/healthyyouth/yrbs/pdf/us_drug_trend_yrbs.pdf.

3. Drug Policy Alliance, D.A.R.E. New York, NY: Drug Policy. Accessed on December 1, 2011 at: http://www.drugpolicy.org/library/factsheets/D.A.R.E/index.cfm.

4. Reaves, J. (2001). Time, U.S. Just say no to DARE. Accessed on December 1, 2011 at: http://www.time.com/time/nation/article/0,8599,99564,00.html#ixzz1fFIMYosm.

5. Lynam DR et al. Project D.A.R.E.: No Effect at 10 Year Follow up. Journal of Consulting and Clinical Psychology 1999; 67: 590-593.

6. University of Twente. Health Communication. Theory of Planned Behavior/Reasoned Action. Accessed on December 1, 2011 at: http://www.utwente.nl/cw/theorieenoverzicht/Theory%20clusters/Health%20Communication/theory_planned_behavior.doc/.

7. Siegel, Lecture, Theory of Reasoned Action. Boston University School of Public Health. October 6,2011.

8. University of Twente. Health Communication. Health Belief Model. Accessed on December 2, 2011 at: http://www.utwente.nl/cw/theorieenoverzicht/Theory%20clusters/Health%20Communication/Health_Belief_Model.doc/.

9. Psychlopedia, Everything Psychology. Psychological Reactance Theory. Accessed on December 1, 2011 at: http://www.psych-it.com.au/Psychlopedia/article.asp?id=65.

10. Above the Influence, website. Accessed on December 2, 2011 at: http://www.abovetheinfluence.com/.

11. United States Government Accountability Office (2006). ONDCP media campaign: contractor’s national evaluation did not find that the youth anti-drug media campaign was effective in reducing youth drug use.

12. Frontline. Inside the Teenage Brain. Accessed on December 1, 2011 at: http://www.pbs.org/wgbh/pages/frontline/shows/teenbrain/interviews/todd.html.

13. Common Sense, for Drug Policy. The Effective Drug Control Strategy 1999. Accessed on December 2, 2011 at: http://www.csdp.org/edcs/page10.htm.

14. Bradley, I. (2011). Clinical Correlations. Ethical Considerations on the Use of Fear in Public Health Campaigns. Accessed on December 2, 2011 at: http://www.clinicalcorrelations.org/?p=4998.

15. National Cancer Institute. Optimistic Bias. Accessed on December 1, 2011 at: http://cancercontrol.cancer.gov/brp/constructs/optimistic_bias/index.html.

16. Truth Campaign. Protect the Truth. Accessed on December 2, 2011 at: http://www.protectthetruth.org/truthcampaign.htm.

17. Evans, W.D. Hastings, G. (2008). Chapter 1: public health branding: recognition, promise, and delivery of healthy lifestyles. Public Health Branding: Applying Marketing for Social Change, Oxford: Oxford University Press. 3-24.

18. Stone, D. (1993) Social Cognitive Theory. Learning. Accessed on December 1, 2011 at http://www.mendeley.com/research/social-cognitive-theory/#.

19. Luszczynska, A., Schwarze, R. Predicting Health Behavior. Social Cognitive Theory. Accessed on December 2, 2011 at http://www.ihepsa.com/files/predicting%20Health%20beh%20avior.pdf#page=144.

20. The 84, website. Accessed on December 2, 2011 at: http://the84.org/.