Effects of Drug Commercials on Young Viewers by Charles K. Atkin
Surveys reveal that exposure shapes children’s views of the amount of sickness in society and the e$cacy of medicinal cure or relief. A wide variety of plausible consequences can be traced to drug advertising. Some effects are obviously intended by the advertisers, while others are “side effects.” Commercials promoting remedies to combat colds, headaches, stomach aches, and sleeplessness feature the manifest message that proprietary drugs are effective, appropriate, and widely used. Youth heavily exposed to these ads should believe in the efficacy of the medicines, approve of them, and use them more than light viewers. Beyond this, young people may gain impressions about the high level of illness and medicine use in society from watching the televised vignettes of sick people ingesting proprietary drugs. While the vivid portrayal of speedy recovery from illness teaches the viewer that physical ailments can be quickly relieved, this lesson may be generalized to affect expectations about other types of problem-solving. The inference that life’s difficulties can be resolved rapidly may be drawn. Frequent exposure to depictions of sick people may alarm the young viewer or elevate the salience of becoming ill. Another possible misinterpretaion may result from the rewards from drug use. For example, since advertising messages display rewarding experiences from proper aspirin use, youthful viewers might incorrectly infer that greater quantities of aspirin intake yield proportionately greater benefits, or that aspirin use is beneficial even when there are no symptoms of physical illness. A frequently cited peril of proprietary drug commercials involves fostering positive orientations toward illicit drugs. Hearings by the Senate Commerce Committee and the Federal Communications Commission yielded extensive Chartes K. Atkin is Associate Professor of Communication at Michigan State University in East Lansing.
71
Journal of Communication, Autumn 1978
debates about this problem ( 2 , 4), and a growing research literature provides empirical evidence regarding the linkage between pharmaceutical advertising exposure and use of marijuana and other illegal drugs. In the most detailed investigation, Milavsky, Pekowsky, and Stipp found a slight negative association between television viewing and using illicit drugs among teenage boys ( 3 ) .This basic finding has been obtained in studies of adolescents by Jessor, Johnston, and Hulbert (see 2 ) and Brodlie (1).The drugs studied have included marijuana, amphetamines, barbituates, LSD, cocaine, and heroin. Two surveys have examined the relationship between TV viewing and overthe-counter drug use. Milavsky, et al. ( 3 ) reported a mild positive correlation, while Johnson found a slight negative association (2). There are no available research findings pertaining to the other issues investigated in this project. None of the studies cited here actually measured viewing of drug advertising. All relied on measures of television exposure time, which is merely an indicator of the opportunity for contact with ads. This investigation was designed so that the viewing of commercials was directly assessed. The degree of attention to ads will then be considered in conjunction with amount of viewing time to index exposure patterns.
Survey questionnaires were administered to 256 students in the fifth, sixth, and seventh grades in Lansing and Livonia, Michigan. The students were almost equally divided between those from middle-class and working-class backgrounds; there were slightly more females than males. They were a subgroup of a larger sample of 775 youth surveyed in a general study of responses to TV advertising. The students completed a 14-page omnibus instrument common to the total sample, followed by a special five-page supplement dealing with drug advertising and orientations. The key predictor variable is exposure to drug advertising, an index that takes into account the number of viewing opportunities and the closeness of attention to the messages. One page presented pictures and brief descriptions of four typical medicine commercials for Anacin, Digel, Sominex, and Pepto-
72
Effects of Drug Commercials on Young Viewers
Bismol.’ To measure intensity of attention to each ad, students were asked: “When this commercial comes on TV, how much do you watch it?” Response categories were “Always,” “Usually,” “Sometimes,” and “Never.” To measure frequency of viewing during periods when medicine advertising is most prominently featured, respondents reported how many hours they viewed TV on an average evening between 8:OO and 11:OO and how often they watched the national news broadcasts at 6:30. The intensity and frequency sub-indices were combined into an multiplicative Exposure Index. The other four pages of the drug section contained items dealing with perceptions, beliefs, concerns, attitudes, and usage patterns. The items are listed in Table 1, and the item wordings and response categories are displayed in Tables 2 and 3 . For seven variables, there were separate questions asking about both colds and stomach aches; these pairs of items were combined into indices. Table 1:
Partial correlations between drug advertising exposure and orientations Zero-order Fourth-order Drug orientation correlation partiaib
Perceived frequency of illness in society Perceived frequency of sleeping problems Perceived frequency of people using drugs
+.19’ +.07 +.16*
+.19* .04 +.19*
Belief in efficacy of drugs for others Belief in efficacy of sleeping pills Belief in efficacy of mood-altering drugs Belief in speed of drug relief for others Belief in speed of general problem-solving
+.14*
+.13*
+.I0 f.12’
+ .04
+ .07 +
Personal concern about becoming ill
+.22*
+.19*
Personal frequency of drug usage
+.17*
+.14*
Efficacy of drug for self
+.22*
+ .21*
Approval of drug usage for illness Approval of aspirin Approval of aspirin usage if not ill Approval of multiple aspirin usage Approval of sleeping pills
+.15* + .08
+.15* .09 .01
+.07
+ +.05 + .02
Approval of uppers and downers Approval of dope and grass
+.02 -.11
-- .09
+.05
+ .02 + .07
+
+.03
+.13’ .02
+
.oo
a Predictor variable is Exposure Index, a product of the degree of attention to four representative medicine commercials times the amount of viewing television during periods when medicine commercials are shown. b Fourth-order partials control for grade, sex, social status, and scholastic performance. * p < .05
‘ These brands arc among the most frequently advertised drug products on TV. according to recent Broadcast Advertising Reports. The matrix of intercorrelations for attention to these four diversified drug ads is highly positive.
73
jooeornaf of Cormmunication, Autumn 1978
Table 2:
Cross-tabulations between drug advertising exposure and drug orientations
Drug orientation
Heavy exposure
(N = 128) %
How often do you think that people get colds/stomach aches?
A lot Sometimes Almost never
21 72 7
32 59 9
When people get a stomach ache or a cold what do they usually do about it? (OE)
Take medicine Rest/Nothing Other/NA
62 25 13
73 14 13
When people get a cold/stomach ache, how much does it help if they take some medicine?
Very much Pretty much Not so much
13 68 19
20 65 15
When people feel sad, how much does it help them feel better if they take some pill or medicine?
Very much Pretty much Not so much
6 9 85
6 24 70
When people take some medicine for a cold/stornach ache, how long does it usually take them to feel better?
A few minutes One hour A few hours One day
15 33 30 22
27 32 27 14
When people have a problem that bothers them, how long does it usually take for them to solve it?
A few minutes One hour A few hours One day
12 17 42 29
13 22 36 29
6 32 62
12 40 48
How often do you worry about catching A lot cold/getting stomach aches? Sometimes Almost never
74
Light exposure (N = 128) %
When you get a cold/stomach ache, how much do you take some medicine for it?
Always Usually Sometimes Never
9 24 43 24
16 25 46 13
When you take some medicine for a cold/stomach ache, how much does it help make you feel better?
Always Usually Sometimes Never
5 31 43 21
12 38 39 11
When people have a stomach ache or a cold, what do you think is the best for them to do? (OE)
Take medicine Rest/Not hing Other/NA
33 38 29
47 25 28
If you had a cold, how many aspirin should you take to feel better? (OE)
Three or more Two One None
9 39 43 9
9 55 34 2
Effects of Drug Commercials on Young Viewers
Table 3:
Cross-tabulations between drug advertising exposure and drug approval
Drug orientation Here are some kinds of pills and drugs that some people use. For each one, mark whether it is a good thing or a bad thing for people to use: Aspirin Good thing In between Bad thing
Light exposure (N = 128)
Heavy exposure (N = 128)
%
Yo
59 35 6
63 32 5
Sleeping pills
Good thing in between Bad thing
11 49 40
9 51 40
“Uppers”
Good thing In between Bad thing
6 11 83
7 16 77
“Downers ”
Good thing In between Bad thing
5 9 86
4 16 80
“Dope ”
Good thing In between Bad thing
4 9 87
4 7 89
Good thing In between Bad thing
8 17 75
6 9 85
“Grass” or “pot”
In the analyses, zero-order correlation coefficients were computed between the Exposure Index and each criterion variable. Correlations greater than +.12 are significant at the .05 level. To control for spurious influences, partial correlations were calculated, controlling for grade, sex, scholastic performance, and social status. Since the children’s frequency of illness and their parents’ approval of medicine usage might also contaminate several relationships, these variables were added as controls in computing more conservative fifth- and sixth-order partial correlations.’ To provide a more concrete and interpretable representation of relationships, cross-tabulation comparisons between heavily and lightly exposed respondents were also computed. The Exposure Index was dichotomized at the median to yield a gross classification into “light” and “heavy” exposure groups of equal size. The percentages are displayed separately for each questionnaire item; in the seven cases where identical questions were asked about colds and These are the item wordings: “How often d o you get stomach aches,” “How often do you catch ~ ( ~ l t i sand , ’ ’ ”When you get a cold or a stomach ache, how much do your parents want you to take some medicine for it.” These variables are used as controls where indicated in the discussion of results.
75
Journal of Communication, Autumn 1978
stomach aches, responses are averaged. Analyses examine the strength of relationship under various antecedent or intervening conditions. Contingent partial correlations were calculated separately for boys vs. girls, older (7th grade) vs. younger (5th and 6th grades), higher status (middle-class parental occupations) vs. lower status (working class), brighter (high scholastic performance) vs. duller (low scholarship), generally sick (frequent colds and/or stomach aches) vs. generally well (infrequent illnesses), and those whose parents are highly medicine-oriented (always or usually recommend) vs. less medicine-oriented (sometimes or never recommend). The results of the study showed that children’s beliefs about the eficacy of medicine and illness in society were a8ected by the drug adoertising.
Attention. Averaging the attention rate data across the four specific drug commercials, 7 percent of the students report that they “always” watch the ads, 19 percent say they “usually” watch, 52 percent indicate viewing “sometimes,” and 22 percent report “never.” Attention to drug product advertising is somewhat lower than for other types of messages studied, including PSAs, Saturday candy and cereal commercials, and hygiene product ads. Fifth-grade students devote more attention than 6th and 7th graders, as 33 percent vs. 20 percent watch at least “usually.’’ Lower status youngsters (29 percent) attend slightly more closely than those from higher status backgrounds (21 percent). Perceptions of reality. Several items dealt with the perceived frequency of illness in society and the perceived frequency of medicine use to relieve these problems. Table 1 shows that those children with relatively heavy exposure to medicine advertising are somewhat more likely to perceive that people are often sick and often use medicine. Since sleeping problems are qualitatively different from headaches and stomach aches, this perception is analyzed separately; the correlation with advertising exposure is modest. Controlling for the four demographic variables, the partial correlations for both illness and medicine usage perceptions remain at 19; the partial is negligible for sleeplessness. The raw relationships are presented in percentage form in Table 2. Comparing heavy and light viewers of medicine advertising, 32 percent vs. 21 percent perceive “ a lot” of stomach aches or colds. Perceptions of what people usually do for illness also varies according to amount of exposure: 73 percent of the heavy viewers cite medicine in response to the open-ended question, compared to 62 percent of those lightly exposed. Light viewers are more likely to perceive that people rest or do nothing. Belief in general efectiveness of medicine. Drug ads often feature authoritative claims and dramatic demonstrations of the speed and efficacy of medicine in relieving illness and other problems. To the extent that children accept these assertions, their beliefs in the potency of over-the-counter drugs may be influenced. Indeed, there are indications that children do not challenge the credibility of drug ads: when asked about untrue commercials in an earlier section of the questionnaire, only 1 percent of the sample nominated a drug ad. As exposure to advertising increases, students tend to believe that colds and stomach aches can be effectively combatted with medicine (see Table 1).
+.
76
Effects of Drug Commercials on Young Viewers
Comparing light and heavy viewers, 13 percent vs. 20 percent think that drugs are “very” helpful. On the other hand, the association between exposure and belief in the efficacy of sleeping pills is minimal; the partial correlation is +.03. To assess whether medicine efficacy claims are generalized to beliefs of emotional rather than physical relief, one item asked whether pills help a sad person to feel better. Most students reject such benefits, but heavy viewers display a substantial tendency to believe that mood-altering pills might help “pretty much” (see Table 2). However, the linear relationship between exposure and emotional relief is not substantial (see Table 1). Another pair of items examined beliefs regarding the quickness of relief that people generally obtain from cold and stomach ache medicine. There is a modest positive relationship (see Table 1). In particular, heavy viewers are almost twice as likely as light viewers to think that relief occurs within “a few minutes” (see Table 2). The possible carry-over effect on expectations regarding the quickness of general problem solving was assessed with an item asking, “when people have a problem that bothers them, how long does it usually take for them to solve it?” The correlation with medicine advertising exposure is slightly positive (see Table I). A small difference is also found between heavy and light viewers, where 35 percent of the heavy viewers estimate from “a few minutes” to “one hour,” compared to 29 percent of the light viewers (see Table 2 ) . Concern. Two items tapped how often the child worried about getting a stomach ache and catching a cold. The index correlates moderately with advertising exposure (see Table 1). Since the frequency that the child actually does become ill may account for some of this relationship, a fifth-order partial correlation was computed to control for this variable and the demographic variables. The partial correlation remains significant at +.16. In Table 2, it can be seen that 38 percent of the lightly exposed students worry, while 52 percent of the heavily exposed show concern. l h g w a g e . Children viewing the most drug advertising are much more likely to use medicine for stomach aches and colds (see Table 1). Those who “always” take drugs tend to be heavy viewers (see Table 2). However, drug usage may be a function of both illness frequency and parental attitude toward drugs, s o these factors were controlled along with the demographics. The sixthorder partial declines to only +.03,indicating that the independent effect of advertising may be negligible. Drug eficcicy. A pair of follow-up items asked the respondents to describe the extent to which they personally feel better after taking medicine when ill. The relationship as shown in Table 1 is fairly strong, even when the demographics are partialed out. In terms of percentage differences, 36 percent of the light viewers vs. .50 percent of the heavy viewers say they frequently attain relief from colds and stomach aches. Approvul of proprietary drugs. A series of questions dealt with attitudinal responses to over-the-counter medicine, particularly aspirin. An open-ended question asked what people should do if they become sick. Mention of medicine-oriented remedies correlates mildly with the Exposure Index; the fifthorder partial that controls for parental attitude is f.13. Most heavy advertising viewers recommend drug usage, while the light viewers tend to advise resting or doing nothing (see Table 2).
77
Journal of Communication, Autumn 1978
Specific approval of aspirin is slightly correlated with seeing medicine ads; the fifth-order partial correlation is +.08. Among heavy viewers, 63 percent think that aspirin is a “good thing;” 59 percent of the light viewers give this rating (see Table 3). To test whether advertising overly encourages reliance on aspirin, other questions asked the children to write the number of aspirin that they should take and to answer “is it OK to take aspirin if you are not really sick-yes, maybe, or no?” The estimate of proper aspirin dosage is correlated slightly with exposure (fifth-order partial r = +.08), while approval of aspirin usage for nonsickness is unrelated to advertising viewing (see Table 1). The percentage findings show that the light and heavy viewers don’t differ in approval of taking three or more aspirin, but heavy viewers tend to recommend two aspirin while light viewers suggest one or none (see Table 2). Approval of sleeping pills is correlated positively with exposure, but the application of control variables reduces this to a null relationship. In fact, the dichotomous comparison of heavy and light viewers in Table 3 shows that 9 percent of the former group and 11 percent of the latter feel that sleeping pills are a “good thing.” Approval of illicit drugs. Orientations toward illegal drug substances were measured by asking whether each of four drugs is “ a good thing or bad thing for people to use.” An index of pill approval (uppers and downers) is essentially unrelated to medicine advertising exposure, while the index of smoking drugs (dope, grass/pot) is negatively related to a slight extent (see Table 1). The dichotomous cross-tabulations in Table 3 are slightly divergent from the linear correlational findings for uppers and downers: although few students in either group feel positively about these drugs, those who heavily view proprietary ads are more likely to give a neutral rather than disapproving response. The negative association for the cannibis-related substances is reflected in the Table 3 percentage data. Averaging responses to the different labels for this type of drug, 86 percent of the heavy viewers vs. 81 percent of the light viewers express negative evaluations. Contingent interactions. Since the six interacting variables produce more than I00 contingent partial correlations between the exposure and criterion variables, this presentation will describe only the basic patterns of findings. There is no consistent difference in the correlations between the responses of two age subgroups; in the case of proprietary drug approval, the partial correlation for older students is moderately strong while there is no association in the younger age category. Males and females do not show any general differences in response to drug advertising, except for perceived frequency of illness where a strong partial correlation occurs for boys and no relationship is found among girls. The correlations are generally stronger for responses from higher status rather than lower status backgrounds. In particular, the relationships between exposure and belief in medicine speed, medicine efficacy for self, and approval of medicine usage exist primarily among the higher status subgroup. Responses of students who rank higher in school performance tend to have stronger correlations than from scholastically less successful students, especially on medicine efficacy for self and approval of medicine usage. The pattern of correlations is slightly more positive for students who are usually healthy than
78
Effects of Drug Commercials on Young Viewers
for those who are often ill; the largest difference occurs for concern about becoming sick. Finally, students whose parents generally disapprove of medicine usage are slightly more responsive to proprietary drug advertising. For instance, there is a moderate association between exposure and approval of medicine use among those with disapproving parents, while the relationship is negligible for students whose parents encourage medicine consumption. Assessing this diversijied set of findings, it appears that televised advertising for proprietary drug products most strongly shapes children’s views of the amount of societal sickness and reliance on medicine. These advertisements also appear to increase children’s concerns about getting sick and to heighten self-perception of medicinal relief. Approval of advertised drugs is less closely related to exposure, as are beliefs that medicine works fast and effectively. Inferences of causality in these relationships must be drawn cautiously in the absence of time-order evidence, however. Specific effects on orientation toward sleeping pills seem to be very limited, and there is no evidence that advertising contributes to positive attitudes toward illicit drugs; indeed, approval of cannabis-related substances is inversely related to medicine exposure. The overall lack of attitudinal impact of medicine ads may be explained by the fact that there are so many other interpersonal influences operating on attitudes toward drugs; in competition with messages from parents, peers, and teachers, the possible indirect impact of ads for aspirin or sleeping pills is bound to be restricted. For instance, there is a stronger inverse correlation for children whose parents disapprove of medicine usage than for those who have parents that support medicine-taking. In addition, it is likely that children who see the most medicine ads on TV also view a greater number of public service announcements that seek to discourage drug use; these anti-drug messages may serve to counter the influence of conventional medicine ads. The analysis of differential associations between exposure and the various criterion variables does not provide a clear and consistent pattern. The combination of contrasting interactions prevents simple generalizations about the conditions most likely to facilitate or inhibit advertising effects. Nevertheless, this is the tentative profile of the type of pre-adolescent who tends to be more influenced by over-the-counter drug ad commercials: a bright, higher status male or female who is usually healthy and whose parents disapprove of medicine usage. REFERENCES I . Hrodlie, J. “Drug Abuse and Television Viewing Patterns.” Psychology 9, 1972, pp. 33-36. 2. Federal Communications Commission. Panels on Televised Ooer-the-Counter Drug Advertising. Washington, D.C., May 1976. 3. Milavsky, H . , B. Pekowsky, and H . Stripp. “TV Drug Advertising and Proprietary and Illicit Drug Use Among Teenage Boys.” Public Opinion Quarterly 39, 1975-76, pp. 457-481. 4. United States Senate. The Relationship Between Drug Abuse and Advertising: Hearing before the Senute Subconmiittee of the Comniittee on Cornmerce. Serial No. 91-94. Washington, D.C.: U.S. Government Printing Office, 1971.
79
Surveys reveal that exposure shapes children’s views of the amount of sickness in society and the e$cacy of medicinal cure or relief. A wide variety of plausible consequences can be traced to drug advertising. Some effects are obviously intended by the advertisers, while others are “side effects.” Commercials promoting remedies to combat colds, headaches, stomach aches, and sleeplessness feature the manifest message that proprietary drugs are effective, appropriate, and widely used. Youth heavily exposed to these ads should believe in the efficacy of the medicines, approve of them, and use them more than light viewers. Beyond this, young people may gain impressions about the high level of illness and medicine use in society from watching the televised vignettes of sick people ingesting proprietary drugs. While the vivid portrayal of speedy recovery from illness teaches the viewer that physical ailments can be quickly relieved, this lesson may be generalized to affect expectations about other types of problem-solving. The inference that life’s difficulties can be resolved rapidly may be drawn. Frequent exposure to depictions of sick people may alarm the young viewer or elevate the salience of becoming ill. Another possible misinterpretaion may result from the rewards from drug use. For example, since advertising messages display rewarding experiences from proper aspirin use, youthful viewers might incorrectly infer that greater quantities of aspirin intake yield proportionately greater benefits, or that aspirin use is beneficial even when there are no symptoms of physical illness. A frequently cited peril of proprietary drug commercials involves fostering positive orientations toward illicit drugs. Hearings by the Senate Commerce Committee and the Federal Communications Commission yielded extensive Chartes K. Atkin is Associate Professor of Communication at Michigan State University in East Lansing.
71
Journal of Communication, Autumn 1978
debates about this problem ( 2 , 4), and a growing research literature provides empirical evidence regarding the linkage between pharmaceutical advertising exposure and use of marijuana and other illegal drugs. In the most detailed investigation, Milavsky, Pekowsky, and Stipp found a slight negative association between television viewing and using illicit drugs among teenage boys ( 3 ) .This basic finding has been obtained in studies of adolescents by Jessor, Johnston, and Hulbert (see 2 ) and Brodlie (1).The drugs studied have included marijuana, amphetamines, barbituates, LSD, cocaine, and heroin. Two surveys have examined the relationship between TV viewing and overthe-counter drug use. Milavsky, et al. ( 3 ) reported a mild positive correlation, while Johnson found a slight negative association (2). There are no available research findings pertaining to the other issues investigated in this project. None of the studies cited here actually measured viewing of drug advertising. All relied on measures of television exposure time, which is merely an indicator of the opportunity for contact with ads. This investigation was designed so that the viewing of commercials was directly assessed. The degree of attention to ads will then be considered in conjunction with amount of viewing time to index exposure patterns.
Survey questionnaires were administered to 256 students in the fifth, sixth, and seventh grades in Lansing and Livonia, Michigan. The students were almost equally divided between those from middle-class and working-class backgrounds; there were slightly more females than males. They were a subgroup of a larger sample of 775 youth surveyed in a general study of responses to TV advertising. The students completed a 14-page omnibus instrument common to the total sample, followed by a special five-page supplement dealing with drug advertising and orientations. The key predictor variable is exposure to drug advertising, an index that takes into account the number of viewing opportunities and the closeness of attention to the messages. One page presented pictures and brief descriptions of four typical medicine commercials for Anacin, Digel, Sominex, and Pepto-
72
Effects of Drug Commercials on Young Viewers
Bismol.’ To measure intensity of attention to each ad, students were asked: “When this commercial comes on TV, how much do you watch it?” Response categories were “Always,” “Usually,” “Sometimes,” and “Never.” To measure frequency of viewing during periods when medicine advertising is most prominently featured, respondents reported how many hours they viewed TV on an average evening between 8:OO and 11:OO and how often they watched the national news broadcasts at 6:30. The intensity and frequency sub-indices were combined into an multiplicative Exposure Index. The other four pages of the drug section contained items dealing with perceptions, beliefs, concerns, attitudes, and usage patterns. The items are listed in Table 1, and the item wordings and response categories are displayed in Tables 2 and 3 . For seven variables, there were separate questions asking about both colds and stomach aches; these pairs of items were combined into indices. Table 1:
Partial correlations between drug advertising exposure and orientations Zero-order Fourth-order Drug orientation correlation partiaib
Perceived frequency of illness in society Perceived frequency of sleeping problems Perceived frequency of people using drugs
+.19’ +.07 +.16*
+.19* .04 +.19*
Belief in efficacy of drugs for others Belief in efficacy of sleeping pills Belief in efficacy of mood-altering drugs Belief in speed of drug relief for others Belief in speed of general problem-solving
+.14*
+.13*
+.I0 f.12’
+ .04
+ .07 +
Personal concern about becoming ill
+.22*
+.19*
Personal frequency of drug usage
+.17*
+.14*
Efficacy of drug for self
+.22*
+ .21*
Approval of drug usage for illness Approval of aspirin Approval of aspirin usage if not ill Approval of multiple aspirin usage Approval of sleeping pills
+.15* + .08
+.15* .09 .01
+.07
+ +.05 + .02
Approval of uppers and downers Approval of dope and grass
+.02 -.11
-- .09
+.05
+ .02 + .07
+
+.03
+.13’ .02
+
.oo
a Predictor variable is Exposure Index, a product of the degree of attention to four representative medicine commercials times the amount of viewing television during periods when medicine commercials are shown. b Fourth-order partials control for grade, sex, social status, and scholastic performance. * p < .05
‘ These brands arc among the most frequently advertised drug products on TV. according to recent Broadcast Advertising Reports. The matrix of intercorrelations for attention to these four diversified drug ads is highly positive.
73
jooeornaf of Cormmunication, Autumn 1978
Table 2:
Cross-tabulations between drug advertising exposure and drug orientations
Drug orientation
Heavy exposure
(N = 128) %
How often do you think that people get colds/stomach aches?
A lot Sometimes Almost never
21 72 7
32 59 9
When people get a stomach ache or a cold what do they usually do about it? (OE)
Take medicine Rest/Nothing Other/NA
62 25 13
73 14 13
When people get a cold/stomach ache, how much does it help if they take some medicine?
Very much Pretty much Not so much
13 68 19
20 65 15
When people feel sad, how much does it help them feel better if they take some pill or medicine?
Very much Pretty much Not so much
6 9 85
6 24 70
When people take some medicine for a cold/stornach ache, how long does it usually take them to feel better?
A few minutes One hour A few hours One day
15 33 30 22
27 32 27 14
When people have a problem that bothers them, how long does it usually take for them to solve it?
A few minutes One hour A few hours One day
12 17 42 29
13 22 36 29
6 32 62
12 40 48
How often do you worry about catching A lot cold/getting stomach aches? Sometimes Almost never
74
Light exposure (N = 128) %
When you get a cold/stomach ache, how much do you take some medicine for it?
Always Usually Sometimes Never
9 24 43 24
16 25 46 13
When you take some medicine for a cold/stomach ache, how much does it help make you feel better?
Always Usually Sometimes Never
5 31 43 21
12 38 39 11
When people have a stomach ache or a cold, what do you think is the best for them to do? (OE)
Take medicine Rest/Not hing Other/NA
33 38 29
47 25 28
If you had a cold, how many aspirin should you take to feel better? (OE)
Three or more Two One None
9 39 43 9
9 55 34 2
Effects of Drug Commercials on Young Viewers
Table 3:
Cross-tabulations between drug advertising exposure and drug approval
Drug orientation Here are some kinds of pills and drugs that some people use. For each one, mark whether it is a good thing or a bad thing for people to use: Aspirin Good thing In between Bad thing
Light exposure (N = 128)
Heavy exposure (N = 128)
%
Yo
59 35 6
63 32 5
Sleeping pills
Good thing in between Bad thing
11 49 40
9 51 40
“Uppers”
Good thing In between Bad thing
6 11 83
7 16 77
“Downers ”
Good thing In between Bad thing
5 9 86
4 16 80
“Dope ”
Good thing In between Bad thing
4 9 87
4 7 89
Good thing In between Bad thing
8 17 75
6 9 85
“Grass” or “pot”
In the analyses, zero-order correlation coefficients were computed between the Exposure Index and each criterion variable. Correlations greater than +.12 are significant at the .05 level. To control for spurious influences, partial correlations were calculated, controlling for grade, sex, scholastic performance, and social status. Since the children’s frequency of illness and their parents’ approval of medicine usage might also contaminate several relationships, these variables were added as controls in computing more conservative fifth- and sixth-order partial correlations.’ To provide a more concrete and interpretable representation of relationships, cross-tabulation comparisons between heavily and lightly exposed respondents were also computed. The Exposure Index was dichotomized at the median to yield a gross classification into “light” and “heavy” exposure groups of equal size. The percentages are displayed separately for each questionnaire item; in the seven cases where identical questions were asked about colds and These are the item wordings: “How often d o you get stomach aches,” “How often do you catch ~ ( ~ l t i sand , ’ ’ ”When you get a cold or a stomach ache, how much do your parents want you to take some medicine for it.” These variables are used as controls where indicated in the discussion of results.
75
Journal of Communication, Autumn 1978
stomach aches, responses are averaged. Analyses examine the strength of relationship under various antecedent or intervening conditions. Contingent partial correlations were calculated separately for boys vs. girls, older (7th grade) vs. younger (5th and 6th grades), higher status (middle-class parental occupations) vs. lower status (working class), brighter (high scholastic performance) vs. duller (low scholarship), generally sick (frequent colds and/or stomach aches) vs. generally well (infrequent illnesses), and those whose parents are highly medicine-oriented (always or usually recommend) vs. less medicine-oriented (sometimes or never recommend). The results of the study showed that children’s beliefs about the eficacy of medicine and illness in society were a8ected by the drug adoertising.
Attention. Averaging the attention rate data across the four specific drug commercials, 7 percent of the students report that they “always” watch the ads, 19 percent say they “usually” watch, 52 percent indicate viewing “sometimes,” and 22 percent report “never.” Attention to drug product advertising is somewhat lower than for other types of messages studied, including PSAs, Saturday candy and cereal commercials, and hygiene product ads. Fifth-grade students devote more attention than 6th and 7th graders, as 33 percent vs. 20 percent watch at least “usually.’’ Lower status youngsters (29 percent) attend slightly more closely than those from higher status backgrounds (21 percent). Perceptions of reality. Several items dealt with the perceived frequency of illness in society and the perceived frequency of medicine use to relieve these problems. Table 1 shows that those children with relatively heavy exposure to medicine advertising are somewhat more likely to perceive that people are often sick and often use medicine. Since sleeping problems are qualitatively different from headaches and stomach aches, this perception is analyzed separately; the correlation with advertising exposure is modest. Controlling for the four demographic variables, the partial correlations for both illness and medicine usage perceptions remain at 19; the partial is negligible for sleeplessness. The raw relationships are presented in percentage form in Table 2. Comparing heavy and light viewers of medicine advertising, 32 percent vs. 21 percent perceive “ a lot” of stomach aches or colds. Perceptions of what people usually do for illness also varies according to amount of exposure: 73 percent of the heavy viewers cite medicine in response to the open-ended question, compared to 62 percent of those lightly exposed. Light viewers are more likely to perceive that people rest or do nothing. Belief in general efectiveness of medicine. Drug ads often feature authoritative claims and dramatic demonstrations of the speed and efficacy of medicine in relieving illness and other problems. To the extent that children accept these assertions, their beliefs in the potency of over-the-counter drugs may be influenced. Indeed, there are indications that children do not challenge the credibility of drug ads: when asked about untrue commercials in an earlier section of the questionnaire, only 1 percent of the sample nominated a drug ad. As exposure to advertising increases, students tend to believe that colds and stomach aches can be effectively combatted with medicine (see Table 1).
+.
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Effects of Drug Commercials on Young Viewers
Comparing light and heavy viewers, 13 percent vs. 20 percent think that drugs are “very” helpful. On the other hand, the association between exposure and belief in the efficacy of sleeping pills is minimal; the partial correlation is +.03. To assess whether medicine efficacy claims are generalized to beliefs of emotional rather than physical relief, one item asked whether pills help a sad person to feel better. Most students reject such benefits, but heavy viewers display a substantial tendency to believe that mood-altering pills might help “pretty much” (see Table 2). However, the linear relationship between exposure and emotional relief is not substantial (see Table 1). Another pair of items examined beliefs regarding the quickness of relief that people generally obtain from cold and stomach ache medicine. There is a modest positive relationship (see Table 1). In particular, heavy viewers are almost twice as likely as light viewers to think that relief occurs within “a few minutes” (see Table 2). The possible carry-over effect on expectations regarding the quickness of general problem solving was assessed with an item asking, “when people have a problem that bothers them, how long does it usually take for them to solve it?” The correlation with medicine advertising exposure is slightly positive (see Table I). A small difference is also found between heavy and light viewers, where 35 percent of the heavy viewers estimate from “a few minutes” to “one hour,” compared to 29 percent of the light viewers (see Table 2 ) . Concern. Two items tapped how often the child worried about getting a stomach ache and catching a cold. The index correlates moderately with advertising exposure (see Table 1). Since the frequency that the child actually does become ill may account for some of this relationship, a fifth-order partial correlation was computed to control for this variable and the demographic variables. The partial correlation remains significant at +.16. In Table 2, it can be seen that 38 percent of the lightly exposed students worry, while 52 percent of the heavily exposed show concern. l h g w a g e . Children viewing the most drug advertising are much more likely to use medicine for stomach aches and colds (see Table 1). Those who “always” take drugs tend to be heavy viewers (see Table 2). However, drug usage may be a function of both illness frequency and parental attitude toward drugs, s o these factors were controlled along with the demographics. The sixthorder partial declines to only +.03,indicating that the independent effect of advertising may be negligible. Drug eficcicy. A pair of follow-up items asked the respondents to describe the extent to which they personally feel better after taking medicine when ill. The relationship as shown in Table 1 is fairly strong, even when the demographics are partialed out. In terms of percentage differences, 36 percent of the light viewers vs. .50 percent of the heavy viewers say they frequently attain relief from colds and stomach aches. Approvul of proprietary drugs. A series of questions dealt with attitudinal responses to over-the-counter medicine, particularly aspirin. An open-ended question asked what people should do if they become sick. Mention of medicine-oriented remedies correlates mildly with the Exposure Index; the fifthorder partial that controls for parental attitude is f.13. Most heavy advertising viewers recommend drug usage, while the light viewers tend to advise resting or doing nothing (see Table 2).
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Journal of Communication, Autumn 1978
Specific approval of aspirin is slightly correlated with seeing medicine ads; the fifth-order partial correlation is +.08. Among heavy viewers, 63 percent think that aspirin is a “good thing;” 59 percent of the light viewers give this rating (see Table 3). To test whether advertising overly encourages reliance on aspirin, other questions asked the children to write the number of aspirin that they should take and to answer “is it OK to take aspirin if you are not really sick-yes, maybe, or no?” The estimate of proper aspirin dosage is correlated slightly with exposure (fifth-order partial r = +.08), while approval of aspirin usage for nonsickness is unrelated to advertising viewing (see Table 1). The percentage findings show that the light and heavy viewers don’t differ in approval of taking three or more aspirin, but heavy viewers tend to recommend two aspirin while light viewers suggest one or none (see Table 2). Approval of sleeping pills is correlated positively with exposure, but the application of control variables reduces this to a null relationship. In fact, the dichotomous comparison of heavy and light viewers in Table 3 shows that 9 percent of the former group and 11 percent of the latter feel that sleeping pills are a “good thing.” Approval of illicit drugs. Orientations toward illegal drug substances were measured by asking whether each of four drugs is “ a good thing or bad thing for people to use.” An index of pill approval (uppers and downers) is essentially unrelated to medicine advertising exposure, while the index of smoking drugs (dope, grass/pot) is negatively related to a slight extent (see Table 1). The dichotomous cross-tabulations in Table 3 are slightly divergent from the linear correlational findings for uppers and downers: although few students in either group feel positively about these drugs, those who heavily view proprietary ads are more likely to give a neutral rather than disapproving response. The negative association for the cannibis-related substances is reflected in the Table 3 percentage data. Averaging responses to the different labels for this type of drug, 86 percent of the heavy viewers vs. 81 percent of the light viewers express negative evaluations. Contingent interactions. Since the six interacting variables produce more than I00 contingent partial correlations between the exposure and criterion variables, this presentation will describe only the basic patterns of findings. There is no consistent difference in the correlations between the responses of two age subgroups; in the case of proprietary drug approval, the partial correlation for older students is moderately strong while there is no association in the younger age category. Males and females do not show any general differences in response to drug advertising, except for perceived frequency of illness where a strong partial correlation occurs for boys and no relationship is found among girls. The correlations are generally stronger for responses from higher status rather than lower status backgrounds. In particular, the relationships between exposure and belief in medicine speed, medicine efficacy for self, and approval of medicine usage exist primarily among the higher status subgroup. Responses of students who rank higher in school performance tend to have stronger correlations than from scholastically less successful students, especially on medicine efficacy for self and approval of medicine usage. The pattern of correlations is slightly more positive for students who are usually healthy than
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Effects of Drug Commercials on Young Viewers
for those who are often ill; the largest difference occurs for concern about becoming sick. Finally, students whose parents generally disapprove of medicine usage are slightly more responsive to proprietary drug advertising. For instance, there is a moderate association between exposure and approval of medicine use among those with disapproving parents, while the relationship is negligible for students whose parents encourage medicine consumption. Assessing this diversijied set of findings, it appears that televised advertising for proprietary drug products most strongly shapes children’s views of the amount of societal sickness and reliance on medicine. These advertisements also appear to increase children’s concerns about getting sick and to heighten self-perception of medicinal relief. Approval of advertised drugs is less closely related to exposure, as are beliefs that medicine works fast and effectively. Inferences of causality in these relationships must be drawn cautiously in the absence of time-order evidence, however. Specific effects on orientation toward sleeping pills seem to be very limited, and there is no evidence that advertising contributes to positive attitudes toward illicit drugs; indeed, approval of cannabis-related substances is inversely related to medicine exposure. The overall lack of attitudinal impact of medicine ads may be explained by the fact that there are so many other interpersonal influences operating on attitudes toward drugs; in competition with messages from parents, peers, and teachers, the possible indirect impact of ads for aspirin or sleeping pills is bound to be restricted. For instance, there is a stronger inverse correlation for children whose parents disapprove of medicine usage than for those who have parents that support medicine-taking. In addition, it is likely that children who see the most medicine ads on TV also view a greater number of public service announcements that seek to discourage drug use; these anti-drug messages may serve to counter the influence of conventional medicine ads. The analysis of differential associations between exposure and the various criterion variables does not provide a clear and consistent pattern. The combination of contrasting interactions prevents simple generalizations about the conditions most likely to facilitate or inhibit advertising effects. Nevertheless, this is the tentative profile of the type of pre-adolescent who tends to be more influenced by over-the-counter drug ad commercials: a bright, higher status male or female who is usually healthy and whose parents disapprove of medicine usage. REFERENCES I . Hrodlie, J. “Drug Abuse and Television Viewing Patterns.” Psychology 9, 1972, pp. 33-36. 2. Federal Communications Commission. Panels on Televised Ooer-the-Counter Drug Advertising. Washington, D.C., May 1976. 3. Milavsky, H . , B. Pekowsky, and H . Stripp. “TV Drug Advertising and Proprietary and Illicit Drug Use Among Teenage Boys.” Public Opinion Quarterly 39, 1975-76, pp. 457-481. 4. United States Senate. The Relationship Between Drug Abuse and Advertising: Hearing before the Senute Subconmiittee of the Comniittee on Cornmerce. Serial No. 91-94. Washington, D.C.: U.S. Government Printing Office, 1971.
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