What do we know What do we know about about

effectiveness of effectiveness of information and information and

educationeducation

Alcohol and other Drugs

• Unpleasant

• Health

consequences,

• Economic burden

• Social injustice

• Impediment to

happiness

1. Others given privileges

2. Symbol of pleasure

3. Expectations

4. Removing of withdrawal discomfort

•Pleasurable

•Rewarding

•Positive and Beneficial

•Attractive

+

Peer/ Social Pressure Availability

AffordabilityAdvertising

Alcohol Use

Many study have cast serious doubt Many study have cast serious doubt about the effectiveness of alcohol about the effectiveness of alcohol education programmes and prevention education programmes and prevention strategies.strategies.

Overall alcohol education seems to bring Overall alcohol education seems to bring about short term increasing knowledge about short term increasing knowledge but effects on attitudes and behaviour but effects on attitudes and behaviour have been mixed and sometimes negativehave been mixed and sometimes negative

Actual alcohol use remains unaffectedActual alcohol use remains unaffected

Conclusions Conclusions Nothing really works Nothing really works

Everything works but no one system is superior to any Everything works but no one system is superior to any other (doing something is better than nothing, within other (doing something is better than nothing, within limits anything goes)limits anything goes)

Nothing works but their own programmes Nothing works but their own programmes

Some things works for quite well for some people but Some things works for quite well for some people but nothing works for everyonenothing works for everyone

In most of these programmes the success is In most of these programmes the success is determined not by quantitative measures but through determined not by quantitative measures but through subjective ‘gut’ feelingssubjective ‘gut’ feelings

But there is reason for optimism as But there is reason for optimism as the theoretical base and evaluation the theoretical base and evaluation research in the field have improved, research in the field have improved, the reason for failure of previous the reason for failure of previous prevention efforts have become prevention efforts have become clearer. clearer.

There is better sense of what works, There is better sense of what works, at what costat what cost

Fear TacticsFear Tactics Rationale – if young people made aware of Rationale – if young people made aware of

the dangers and the negative consequence the dangers and the negative consequence of alcohol they would not useof alcohol they would not use

The aim is to instill a kind of enmity The aim is to instill a kind of enmity towards alcoholtowards alcohol

This approach appears to encourage This approach appears to encourage provoke and challenge young people to provoke and challenge young people to experiment with alcohol, a total reverse of experiment with alcohol, a total reverse of the expectationthe expectation

Fear TacticFear Tactic Risk taking is attractive in some degree to Risk taking is attractive in some degree to

everyone everyone

It excites the ‘forbidden fruit’ syndromeIt excites the ‘forbidden fruit’ syndrome

For young people the risk of a behaviour is its For young people the risk of a behaviour is its major motivating characteristic – ‘the peril is major motivating characteristic – ‘the peril is the lure’the lure’

For those who are already involve in alcohol use For those who are already involve in alcohol use a psychological defensive mechanism will be a psychological defensive mechanism will be triggered by ‘fear communication and make the triggered by ‘fear communication and make the message ineffective’message ineffective’

Awareness DevelopmentAwareness Development Rationale – before alcohol use can be address Rationale – before alcohol use can be address

constructively, people must be aware that it constructively, people must be aware that it exists and must perceive it as a problemexists and must perceive it as a problem

This is not generally sufficient for desired This is not generally sufficient for desired changes in alcohol use behaviourchanges in alcohol use behaviour

Awareness campaigns have to be developed Awareness campaigns have to be developed

with this limitations in mind they should with this limitations in mind they should designed to foster and facilitate changes by designed to foster and facilitate changes by providing venues various follow up activitiesproviding venues various follow up activities

Cognitive StrategyCognitive Strategy This is a further development of This is a further development of

awareness approach awareness approach

Rationale 1 - knowledge is an effective Rationale 1 - knowledge is an effective deterrent to alcohol usedeterrent to alcohol use

Rationale 2 – relationship between Rationale 2 – relationship between knowledge and behaviour co-vary in knowledge and behaviour co-vary in positive direction because young people positive direction because young people value good health and they will wisely value good health and they will wisely utilize objective information to gain and utilize objective information to gain and maintain healthmaintain health

Cognitive StrategyCognitive Strategy

Provide information on Provide information on 1. What are drugs1. What are drugs2. How drugs are used2. How drugs are used3. Why alcohol is to be avoided3. Why alcohol is to be avoided4. Why certain people may be at risk for alcohol 4. Why certain people may be at risk for alcohol

useuse5. What communities could do about their 5. What communities could do about their

alcohol problemalcohol problem6. Information focuses primarily on biological, 6. Information focuses primarily on biological,

chemical, historical and legal process including chemical, historical and legal process including knowledge about alcohol and the consequences knowledge about alcohol and the consequences

of alcohol use of alcohol use

Cognitive StrategyCognitive Strategy

This approach is greatly ineffective when not This approach is greatly ineffective when not accompanied any other effective interventions accompanied any other effective interventions

There is no assurance that, this kind of There is no assurance that, this kind of knowledge leads to attitude and behavioural knowledge leads to attitude and behavioural changechange

It has aroused young peoples interest in alcohol It has aroused young peoples interest in alcohol and some times associated with increased, and some times associated with increased, rather than decreased experimentation rather than decreased experimentation

Building self-esteem Building self-esteem

Rationale – individuals with low self esteem and Rationale – individuals with low self esteem and poor self concept are more likely than others poor self concept are more likely than others to engage in the alcohol use to engage in the alcohol use

Programmes focus on Programmes focus on 1.1. Developing individuals feelings of self worth and Developing individuals feelings of self worth and

valuevalue2.2. Teach to accept and play down failings and Teach to accept and play down failings and

difficulties difficulties 3.3. Self – labeling of failure of this courage Self – labeling of failure of this courage 4.4. Appreciation of ones natural or developed strengths Appreciation of ones natural or developed strengths

and uniqueness are encourage and uniqueness are encourage

Building self-esteemBuilding self-esteem Available data do not support the Available data do not support the

existence of a specific personality profile existence of a specific personality profile of all alcohol usersof all alcohol users

Characteristics found to be associated Characteristics found to be associated with alcohol users do not occur exclusively with alcohol users do not occur exclusively in alcohol users, nor are they totally in alcohol users, nor are they totally absent among non usersabsent among non users

Many young alcohol users are healthy and Many young alcohol users are healthy and high self esteemhigh self esteem

Building self-esteemBuilding self-esteem

No rationale reasons for believing that increasing No rationale reasons for believing that increasing peoples self esteem will lead to a decrees of peoples self esteem will lead to a decrees of their alcohol usetheir alcohol use

Evidence for the beneficial effects of raising Evidence for the beneficial effects of raising self esteem as an effective process in health self esteem as an effective process in health education is almost totally lackingeducation is almost totally lacking

Most research does not support a strong Most research does not support a strong relationship between low self esteem and drug relationship between low self esteem and drug useuse

Decision Making ProgrammesDecision Making Programmes

These programme teach a process for making These programme teach a process for making rationale decisions about alcohol use including:rationale decisions about alcohol use including:

A strategy for identifying problems A strategy for identifying problems Creating solutionsCreating solutions Making choices among alternatives Making choices among alternatives Taking necessary actionsTaking necessary actions

Often decision making exercises take the form of Often decision making exercises take the form of role playing in which participants at on the role of role playing in which participants at on the role of people who are confronted with alcohol problem and people who are confronted with alcohol problem and go through the above mentioned steps go through the above mentioned steps

Decision Making ProgrammesDecision Making Programmes

Learning to make correct decision is Learning to make correct decision is important, but it is not sufficient to important, but it is not sufficient to produced desired changes in alcohol produced desired changes in alcohol related behaviourrelated behaviour

If someone believes that alcohol helps If someone believes that alcohol helps them to enjoy and relax, and if alcohol them to enjoy and relax, and if alcohol is attractive and beneficial, for him what is attractive and beneficial, for him what would be his best decision that could be would be his best decision that could be made at a party?made at a party?

Resistance Skills TrainingResistance Skills Training This teachers participants to identify and This teachers participants to identify and

assertively resist pressures and influences assertively resist pressures and influences to use alcohol from pears, siblings, media to use alcohol from pears, siblings, media etc, etc,

Programmes develop skills to deal with Programmes develop skills to deal with such pressuressuch pressures

Discussion and role plays on how to say no Discussion and role plays on how to say no to offersto offers

Questions remain regarding the Questions remain regarding the effectiveness of this approacheffectiveness of this approach

Alternative to Alcohol useAlternative to Alcohol use

Rationale – young people use alcohol because the Rationale – young people use alcohol because the lack opportunity to engage in more constructive lack opportunity to engage in more constructive self enhancing activity self enhancing activity

Aimlessness and boredom contribute heavily to Aimlessness and boredom contribute heavily to alcohol usealcohol use

Reducing time of exposure to ‘at risk’ situations Reducing time of exposure to ‘at risk’ situations

Alternatives are designed to help ‘at risk’ teens Alternatives are designed to help ‘at risk’ teens develop positive healthy substitutes for the drug develop positive healthy substitutes for the drug and alcohol use behaviours they may unwisely and alcohol use behaviours they may unwisely choose for their rites of passagechoose for their rites of passage

Alternative to alcohol useAlternative to alcohol use

Alternative activities have had disappointing Alternative activities have had disappointing effects in reducing alcohol use perhaps the effects in reducing alcohol use perhaps the approach does not address known risk factors approach does not address known risk factors and reasons for using alcoholand reasons for using alcohol

Jeffrey Wragg (1986) pointed out that the Jeffrey Wragg (1986) pointed out that the studies give no support to the proposal of an studies give no support to the proposal of an ‘alternative model’‘alternative model’

Values ClarificationValues Clarification

This is based on the premise that people This is based on the premise that people make many important life decisions without make many important life decisions without understanding the reasons for their understanding the reasons for their choices and the action.choices and the action.

Value clarification programmes examine Value clarification programmes examine the relationship between an individuals the relationship between an individuals values and the consequences of his or her values and the consequences of his or her behaviourbehaviour

It demonstrates that personnel values are It demonstrates that personnel values are incompatible with alcohol use.incompatible with alcohol use.

Values ClarificationValues Clarification

Programmes may include activities that Programmes may include activities that either assist individuals to identify either assist individuals to identify existing values or select a set of positive existing values or select a set of positive valuesvalues

Value clarification programmes are Value clarification programmes are postulated to operate by placing an postulated to operate by placing an individuals values in a central position to individuals values in a central position to influence life choices; and by changing influence life choices; and by changing perceptions that alcohol use is inconsistent perceptions that alcohol use is inconsistent with an individuals overall life objectiveswith an individuals overall life objectives

Norm - SettingNorm - Setting

These programmes establish conservative These programmes establish conservative regarding norms and focus onregarding norms and focus on

Correcting erroneous perceptions of the Correcting erroneous perceptions of the prevalence and acceptability of alcohol prevalence and acceptability of alcohol useuse

Establishing conservative group normsEstablishing conservative group norms

Norm - SettingNorm - Setting

The emphasis is not on facts and information The emphasis is not on facts and information about alcohol use but focuses on opinion. about alcohol use but focuses on opinion. Young people frequently overestimate the Young people frequently overestimate the prevalence and acceptability of alcohol, prevalence and acceptability of alcohol, tobacco and other drug use among peerstobacco and other drug use among peers

These programmes are postulated to operate These programmes are postulated to operate through lowering expectations about through lowering expectations about prevalence and acceptability of use and the prevalence and acceptability of use and the reduced availability of alcohol in peer – reduced availability of alcohol in peer – oriented social settingsoriented social settings

SOME OTHER INEFFECTIVE SOME OTHER INEFFECTIVE STRATEGIESSTRATEGIES

One Session StandOne Session Stand

The programmes which are limited to one The programmes which are limited to one session or one lecture can do little to help session or one lecture can do little to help the situation since the problem is not really the situation since the problem is not really alcohol but the behaviour associated with alcohol but the behaviour associated with them. Bringing about behaviour and attitude them. Bringing about behaviour and attitude change will clearly not be possible in one change will clearly not be possible in one session. Alcohol education should be a part session. Alcohol education should be a part of a broader ongoing programme which tries of a broader ongoing programme which tries to change the social milieuto change the social milieu

Law enforcement agencies Law enforcement agencies or expert approachor expert approach

Despite the well meaning and genuine Despite the well meaning and genuine intentions of members of law enforcement intentions of members of law enforcement agencies there is reason to suspect that agencies there is reason to suspect that many young people may misinterpret their many young people may misinterpret their approaches. Many adolescents are anti approaches. Many adolescents are anti “authority” in their views and may react “authority” in their views and may react negatively to police and other authoritative negatively to police and other authoritative figures figures

Ex addicts testimonials Ex addicts testimonials

This approach can have the same effect This approach can have the same effect as fear tactics. Ex – addicts have not as fear tactics. Ex – addicts have not been successful educators because been successful educators because adolescents may acquire the notion that adolescents may acquire the notion that alcohol dependence is easily cured. They alcohol dependence is easily cured. They ignore or do not realize how hard the ex- ignore or do not realize how hard the ex- addicts may have had to work to be free addicts may have had to work to be free of drug dependence. The major message of drug dependence. The major message of this approach is the non-verbal one, of this approach is the non-verbal one, ““I gave it up and look at me nowI gave it up and look at me now””

Public Service Announcements Public Service Announcements (PASs) (PASs)

These are messages prepared by non-These are messages prepared by non-governmental organizations, health agencies governmental organizations, health agencies and media organizations that deal with and media organizations that deal with responsible drinking, the hazards of drinking- responsible drinking, the hazards of drinking- driving and related topics.driving and related topics.

Despite their good intentions, PASs are an Despite their good intentions, PASs are an ineffective antidote to the high-quality pro-ineffective antidote to the high-quality pro-drinking messages that appear much more drinking messages that appear much more frequently as paid advertisements in the mass frequently as paid advertisements in the mass mediamedia

Counter Advertising Counter Advertising This involves disseminating information about This involves disseminating information about

a product, its effects and the industry that a product, its effects and the industry that promotes it in order to decrease its appeal promotes it in order to decrease its appeal and use.and use.

Tactics include health-warning labels on Tactics include health-warning labels on product packaging, such as those that explain product packaging, such as those that explain that alcohol may cause birth defects when that alcohol may cause birth defects when consumed during pregnancyconsumed during pregnancy

Although a significant proportion of the Although a significant proportion of the population reports seeing these warning labels, population reports seeing these warning labels, research indicates that exposure produces no research indicates that exposure produces no change in drinking behaviourchange in drinking behaviour