Glenda B. Claborne
Comm 620 (Spring ' 98)
Paper # 3
Persuasion Research and Alcohol Public Policy.
If I were to draw the history of research and public policy on alcohol and alcohol-related diseases, it would be a pendulum swinging back and forth between targeting alcohol as a special agent of personal and social disorder as in Prohibition and Temperance Movement times to targeting the alcoholic as a special host of a special addictive substance which seems to be the line being taken by current research funded by the National Institute on Alcohol Abuse and Alcoholism. The former emphasis worked within the framework of sin, stigma and society; the latter works within the framework of disease, determinism (biological) and diversity (cultural). While the former treated alcoholism largely as a moral issue and the latter sees it largely as a health issue, both operated also from economic interests: the former on the assumption that sober workers (comprised mostly by immigrants) were more productive, the latter on the assumption that a healthier citizenry keeps the healthcare budget healthy.
With alcoholism seen as a socio-economic and moral issue during Prohibition, alcohol was seen as the problem and therefore the solution to the problem was to remove the substance out of reach of sinful men. When outright prohibition was losing support in the early part of this century, outright prohibition gave way to controlling the situation or environment in which alcohol is made available. This has led to legal restriction of alcohol sales to minors, licensing requirements, zoning regulations and other governmental acts. These legislative measures continue to this day even after Repeal of National Prohibition in the early 1930s because the hypothesis that reduction of supply and demand of alcohol decreases the incidence of alcohol-related problems have been supported by research on the effectiveness of such measures (Du Mouchel, Williams, & Zador, 1987; O'Malley & Wagenaar, 1991; Cook, 1981, Grossman, Coate & Arluck, 1987; Coate & Grossman, 1988).
Since the 1930s, beginning with the Yale Center of Alcohol Studies, studies of alcoholism and alcohol-related issues focused on physiological and biochemical causes of alcoholism rather than on the direct effects of alcohol as a 'demonic' substance. One of the initial findings was that the major alcohol-related disease, liver cirrhosis, was caused by malnutrition rather than by alcohol per se (Jellinek, 1942). This finding was later modified by latter studies which showed that animals that were given alcohol and adequate nutrition developed liver cirrhosis anyhow (Lieber, 1989). The shift from 'alcohol-did-it-all' (Prohibition era) to 'not alcohol' back to 'alcohol-did-it' (Keller, 1982) was reinforced with the findings in the early 1970's about fetal alcohol syndrome which showed that alcohol can be a teratogen (Streissguth, 1976). Also, with findings that alcoholism does run in families from studies of adoptees and separated twins (Goodwin, 1979), the debunked question in the 1940's of whether alcoholism is inherited is being asked again and reflected in ongoing research on possible genes determinant of alcohol addiction. This reflects a movement between looking at alcoholism as a multi-faceted problem to a special problem of especially vulnerable individuals.
Despite the shifts in alcohol research findings, scientific research has had significant impact on public health policies. The findings about the direct links between alcohol and liver cirrhosis have led to public health policies intensifying efforts to reduce heavy drinking patterns. The finding that alcohol is a teratogen has led to legislation in 1988 requiring all alcoholic beverages to carry a label warning the public about health risks associated with alcohol, specifically including birth defects (Public Law 100-690). Research on highway safety which showed increases in alcohol-related traffic accidents following the lowering in the early 1970's of the minimum legal drinking age (MLDA) in many States have led to legislation raising the MLDA to 21 in all States.
The effectiveness of public health policies and programs regarding alcohol varies. While legislative measures regarding minimum age laws and the production, distribution, pricing and consumption of alcohol have been found to be effective in reducing alcohol-related traffic accidents, warning labels have been found to have little or no effect in changing attitudes about alcohol (Graves, 1992; Greenfield, Graves, & Kaskutas, 1992). Since public awareness campaigns seem to be the domain of persuasion research, what does the ineffectiveness of warning labels imply to persuasion research and what findings in persuasion research can remedy or counter the ineffectiveness of these labels?
To be sure, it is now widely accepted in persuasion research that the mere provision of information about the deadly consequences of certain behaviors is not likely to change attitudes. Petty and Cacioppo (1986) have found that people process information either through an issue-based central mode of thinking or through peripheral cues in the environment depending on their degree of involvement in the issue and ability to process the information. In the area of violent TV programs, Bushman and Stack (1996) have found that warning labels increased interest in violent programs especially when the label source was authoritative, that high-reactance individuals were especially interested in watching violent programs with warning labels and that warning labels increased interest in violent programs more than did informational labels. Reviews of the research on fear appeals (Boster & Mongeau, 1984; Sutton, 1982) have concluded that generally high -fear appeals are more effective than low-fear appeals but this is only to the extent that the researchers manipulated fear successfully and that personality factors set limits on the impact of fear appeals.
The above findings regarding certain personality factors most susceptible to either core or peripheral cognitive processing, most adversely responsive to warning labels and most effectively responsive to high-fear appeals seem to support the trend towards narrowing the research agenda to specific medical and psychological conditions of the alcoholic. What does this say to public health policy on prevention of alcohol-related diseases and problems? That public policy on alcohol should focus only on at-risk and vulnerable populations and not waste time and money on public awareness programs? But this only brings research and public policy face to face with the problem of identifying at-risk populations. In the face of political and socio-cultural implications of identifying special categories of people susceptible to addictive behaviors, it is understandable why current medical research on alcoholism seem intent on pinning the causal agents of addiction on unquestionable biological factors. The choice of preventive and control measures seem to be either to identify the causal agent in the man or to continue controlling the availability of the external causal agent (alcohol) or both. What research is there in social influence which explicitly places the individual in the context of his socio-cultural environment and what does this suggest about formulating messages that would change attitudes and behaviors towards alcohol?
Because language expectancy theory and expectancy violations theory are based on the assumption that expectations are rule-governed and based on socio-cultural norms, these theories are good frameworks for research into the kinds of socially and culturally-based expectations regarding alcohol use and the kinds of messages that can be tailored to these expectations. Can message formulation about alcohol prevention combine expectations about medical and socio-cultural consequences of alcohol abuse in warning labels and awareness campaigns and be more effective?
References
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