The Power of Positive Peer Pressure Social Norm Marketing:

1. The Power of Positive Peer PressureSocial Norm Marketing: Jan L. Gascoigne, Ph.D., CHES Linda Hancock, FNP, Ph.D. Ruth McGinley, RN, BSN

2. What Will We Promote? How We See the Problem is How We Define the Solution

3. Illness or Health “Anyone can be an alcoholic” Vs. “Anyone can be healthy” What Do We Want To Normalize?

4. Health Promotion If we want health we must promote health

5. Make Smoking HistoryAdvertisement Campaign 3000 Kids Start Smoking Everyday 1st Bike 5 years old 1st Hamster 8 years old 1st Cigarette 11 years old

6. Traditional Health Education Strategies • “If only you knew...” • “I’m okay...You, not so much...” • “Health Terrorism”

7. “If only you knew...” • Information • Motorcycle Helmets Save Lives • Seat Belts Save Lives: “Buckle Up for Safety” • Alcohol is a Drug • Smoking Causes Cancer

8. “I’m okay...You, not so much...” • Preaching • Smoking Doesn’t Make You Look Cool • I Don’t Drink, You Shouldn’t Either

9. Health Terrorism: • Scaring the Health into Students • There are bad things out there • Everyone is at risk

10. Traditional Health Education Strategies • “Health Terrorism” • Sex = AIDS & Death or Pregnancy • “Drink, Drive, and Die”

11. Traditional Health Education Strategies • Information • Raises awareness, but does not necessarily translate to behavior • Skill Building • Often does not reach the target population • May conflict with cultural and environmental values • Scare Tactics • Negative marketing • No credibility • Sets a norm that the behavior is common

12. Social Marketing • Is a health promotion strategy • Utilizes commercial marketing techniques to promote health behaviors and social justice issues • Creates advertising and promotional materials for organizations or concepts • Addresses the needs of the target population • Takes time and persistence to create change

13. Social Marketing • Has a focused message • Take on one issue at a time • Requires saturation of the target community

14. Social Norms Marketing Social Marketing Plus Social Norms Theory

15. Marketing Based on research. Consumer focused! Social Marketing GOAL: Behavior change Commercial Marketing GOAL: Sell products or services Social Norms Marketing (SNM) Goal: Promote healthy social norms

16. Social Norm TheoryPro-Active Prevention Most students are making HEALTHY CHOICES and have Healthy Attitudes about pertinent Life issues

17. Most Students Most Students do not know they are Most Students

18. Silent Majority The “Perceived Norm” of irresponsible behavior becomes acceptable-- Healthy students become the “Silent Majority”

19. Misperceptions of Peer Attitudes and Perceived Campus Norms for Alcohol Use Among Students.(Perkins & Berkowitz, 1986) • “Drinking is never a good thing to do.” • “Drinking is all right, but a student should never get ‘smashed’.” • “An occasional ‘drunk’ is okay as long as it doesn’t interfere with grades and responsibilities.” • “An occasional ‘drunk’ is okay even if it does occasionally interfere with grades or responsibilities.” • “A frequent ‘drunk’ is okay if that’s what the individual wants to do.”

20. Percentage Distribution of Personal Attitudes and Perceived Campus Norms for Alcohol Use Among Students (Perkins & Berkowitz, 1986)

21. Misperceptions andSocial Norms Theory “This theory holds that if students perceive something to be the norm, they tend to alter their behavior to fit that norm, even if it isn’t reality. So if students think heavy drinking is normal, they’ll drink more. If they think responsible drinking is normal, they’ll drink more responsibility.” - Michael Haines, NIU

22. Where Do MisperceptionsCome From? • Extreme Behavior Stands Out • The Media • Perceptions of College Life • Carriers of Misperception • “Bystander” Syndrome

23. Why It Works? • It is cost effective • It is local- it is about me • Marketing is a powerful • It is tradition-forming • It is campus or community-wide

24. Downsides? • Telling the truth is dangerous • People will want to add their own stuff • Harm reduction focus • It takes time and patience to get saturation • You will get bored, your students/staff will • get bored--keep the faith • The “most” can isolate the “some” • Very hard to get buy-in/consistent messages • People may feel attacked--”that can’t work”

25. Montana Model: Systemic CoordinationMontana Model Linkenbach & D’Atri 1998

26. Social Norm Marketing Steps & Components Montana Model Linkenbach & D’Atri, 1998

28. Focus Area: Reduce Tobacco Use Among College Students Participants: Oswego State University University of Maryland University of Hawaii-Manoa Univ. of Texas Pan American Gustavus Adolphus College Bowie State University Training: Administration, Students Project Timeline: 5 Years Survey: BACCHUS Tobacco Survey Budget: Training Survey Marketing Materials Advertising BACCHUS & CDC Social Norms Tobacco Project

29. Social Norms Demonstration Sites that Focus on Priority Populations • Bowie State - Historically Black College/ University - 88% African American • University of Texas Pan-American - 85% Hispanic population (Mexican American and Puerto Rican) • University of Hawaii at Manoa - 75% AsianAmerican/ Pacific Islander population

30. Demonstration Site Campaign Materials • Staff Training • Bi-Annual Report • Documentation Book • Advertising Money • Technical Assistance • Promotional Items

31. Data Collection Process • Survey students in the Spring semester • Dillman mailing method • Random sample of undergraduate full-time students • Return rates range from 30% - 55% • Use data to develop four messages

32. Preliminary 2002-2003 Data • 24% began smoking during college years • 59% say it is unlikely that they will be smoking one year from now • 72% say it is unlikely that they will be smoking after graduating from college • 51% of smokers say they have made one or more serious attempts to quit

33. Message Objective- Prevent Initiation of Tobacco Use Most students choose not to smoke. • Distributed in August/September • Promotions items (highlighters with logo and statistic) are distributed at Orientation/ Academic Advising • 500 Posters • 500 Highlighters • Print Ads for campus publications

34. Percentage of students who had not smoked in the last 30 days Institution Percent of Change Bowie State University 5% Univ. of Hawaii@Manoa 2% U. of Texas-Pan American 11% University of Maryland 4% Gustavus Adolphus College 8% Oswego State University 5%

35. Message Objective - Eliminate Secondhand Smoke Most students prefer to socialize in a smoke-free environment • Distributed in November to support task force and policy change initiatives on campus • Promotional items: Frisbees with the logo and statistic

36. Percentage of students who prefer to socialize in a smoke-free environment Institution Percent of Change Bowie State University 4% Univ. of Hawaii@Manoa 6% U. of Texas-Pan American 6% University of Maryland 6% Gustavus Adolphus College 5% Oswego State University -4%

37. Message Objective - Promote Cessation All things being equal, most students would rather date a non-smoker. • Distributed in January/February • Often in conjunction with Valentine’s Day • Promotional items: candy mints with logo and statistic

38. Percentage of students who would rather date a non-smoker, all things being equal Institution Percent of Change Bowie State University no change Univ. of Hawaii@Manoa 3% U. of Texas-Pan American 6% University of Maryland 2% Gustavus Adolphus College no change Oswego State University no change

39. Message Objective - Promote Cessation Most students would support a friend who wants to quit smoking. • Distributed in March to encourage cessation at the end of the year or for graduation.

40. Students who said they would support a friend who wants to quit smoking Institution Percent of Change Bowie State University 31% Univ. of Hawaii@Manoa 8% U. of Texas-Pan American 10% University of Maryland 21% Gustavus Adolphus College 18% Oswego State University 4%

41. Lessons learned while working with campuses • Little opposition to tobacco issues • Be prepared for cessation opportunities • Educate faculty and other allies about project • Get students involved; message, distribution • Document what is happening on campus • Work with local community organizations; ACS, ALA

42. A Comprehensive Plan for Tobacco Reduction University of Wisconsin Oshkosh

43. Grant Support • Wisconsin Tobacco Control Board • American Cancer Society • Center for Tobacco Research and Intervention (CTRI)

44. UW Oshkosh Comprehensive Tobacco Use Reduction Plan • Goal • Reduce tobacco use by 4% in one year • Objectives • Policy initiatives • Social norms campaign • Education • Cessation • Community Partnerships

45. Survey instrument • Used CDC definition of a smoker • Developed UW Oshkosh College Tobacco Survey • Knowledge • Behavior • Attitudes • Demographics

46. Social norms marketing campaign • Developed/administered survey • Chose most powerful norm statistic • Utilized brainstorming, focus groups and individual feedback • Used theme consistently/repeatedly

47. What we need to address 100% 80% 60% 40% 20% 0% Perception Reality Survey data 39% 96% 57% Smokers who want to quit before graduation

48. Website • www.uwosh.edu/programs/youknowyouwantto • Reinforces Campaign Theme • Provides information • Upcoming events • Cessation resources • Quit kit resources • Links

49. Marketing survey results • Poster 88% • Art car 75% • Jane 51% • Info tables 63% • Campus paper 46%

50. Change in perception