Media Literacy to
Prevent Substance Use
Brian A. Primack, MD, PhD
June 2013
Commonwealth Prevention Alliance

Rideout, 2010

Rideout, 2010

vs
18000
16000
14000
12000
10000
8000
6000
4000
2000
0
Total hours
Rideout, 2010
School TV

1200
1000
800
600
400
200
0
Minutes/Week
Watch
Screens
Talk to Their
Children McCannon, 2001

• Part 1: Alcohol
• Part 2: Tobacco
• Part 3: Media Literacy

• Part 1: Alcohol
• Part 2: Tobacco
• Part 3: Media Literacy

Reaching youth better than school
8-12 year olds could name more brands of beer than they could US presidents
Taylor, 1990

• Part 1: Alcohol
• Part 2: Tobacco
• Part 3: Media Literacy

• Direct and indirect medical costs from one year of smoking in the US
– $157 billion (75 direct, 82 indirect)
• Immunize the entire 3 rd world
– $2 billion

“Our studies report on youngsters' motivation for starting, their brand preferences, as well as the starting behavior of children as young as 5 years old.”
-- Brown and Williamson Tobacco
Company

100
90
80
70
60
50
40
30
20
10
0
Smoke
Marlboro,
Camel, or
Newport
Youth Adults CDC, 2004

Compound Hookah/Cigarette Ratio
Smoke Volume
Tar
Nicotine
CO
PAHs
130.2
38.5
2.3
10.2
19.3

20
15
10
5
0
40
35
30
25
Cigarettes Hookah
* Includes little cigars, cigarillos
Cigars* Smokeless
Ever Used
Past 30 Days

• Hookah smoking tricks
– Hookah bazooka (1 million hits)
– Making clouds and hearts
• How to set up a hookah
• Hookah “facts”

• PfizerHealth video “how to smoke”
(Chantix advertisement)
• “MindMaster” advertisement
• “Drinking beer and smoking cigarettes”
(parody music video)
• eCigarette news report

Overall
Portrayal
Positive
Netural
Negative
Cigarette
(%)
Hookah
(%)
P
<.001
24
33
42
92
8
0

Short-Term
Health
Long-Term
Health
Anti-Smoking
Cigarette
(%)
50
44
39
Hookah
(%)
18
2
0
How to Quit 21 0
P
<.001
<.001
<.001
<.001

• Part 1: Alcohol
• Part 2: Tobacco
• Part 3: Media Literacy

Public Service Announcements
• Do have an effect
• About 50 “just say yes” for each “just say no”
• US PSA budget is about 1/30 of England,
Canada

• “Tar Wars” – 4 th and 5 th grade
• “Social influences” programs
– Grade school: effect on body
– Middle school: peer pressure, friends, family
– High school: self esteem, aspirations

• Peterson, AV, JNCI 2000
• Curriculum for youth, 3 rd -10 th grades
• 47.25 hours total
• “Social Influences” approach
• How to say no, effects on body, resisting peer influence, self esteem, etc.
• 20 school districts got the program, 20 did not
• 94% follow up, high implementation fidelity

• No difference in smoking at 12 th grade
• No difference in smoking 2 years after high school
• No difference among boys or girls
• No difference among people of other subgroups (such as family risk for smoking)

Is Media Literacy Different?

Major Reasons for Media Literacy
• Fun, creative
• Someone to rebel against
• Developmentally appropriate
• Most effective for the ones most at risk
• Empowering, not protectionist

The ability to access, analyze, evaluate, and produce media messages in a variety of forms

• All media messages are constructed.
• Each medium has different characteristics, strengths and a unique “language” of construction.
• All media messages contain embedded values and points of view.
• People use their individual skills, beliefs, and experiences to construct their own meanings from messages.
• Media messages must be considered within a social, political and economic context.
• Media and media messages can influence beliefs, attitudes, values, behaviors and the democratic process.

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450,000
400,000
350,000
300,000
250,000
200,000
150,000
100,000
50,000
0
AIDS Alcohol Drugs Homicide Motor
Vehicle
Smoking Suicide
Deaths per Year in the US

450,000
400,000
350,000
300,000
250,000
200,000
150,000
100,000
50,000
0
AIDS Alcohol Drugs Homicide Motor
Vehicle
Smoking Suicide
Deaths per Year in the US

Cigarette Additives that start with A or B
Acetanisole, Acetic Acid, Acetoin, Acetophenone, 6-
Acetoxydihydrotheaspirane, 2-Acetyl-3- Ethylpyrazine, 2-Acetyl-5-
Methylfuran, Acetylpyrazine, 2-Acetylpyridine, 3-Acetylpyridine, 2-
Acetylthiazole, Aconitic Acid, dl-Alanine, Alfalfa Extract, Allspice Extract,
Oleoresin, And Oil, Allyl Hexanoate, Allyl Ionone, Almond Bitter Oil,
Ambergris Tincture, Ammonia, Ammonium Bicarbonate, Ammonium
Hydroxide, Ammonium Phosphate Dibasic, Ammonium Sulfide, Amyl
Alcohol, Amyl Butyrate, Amyl Formate, Amyl Octanoate, alpha-
Amylcinnamaldehyde, Amyris Oil, trans-Anethole, Angelica Root Extract, Oil and Seed Oil, Anise, Anise Star, Extract and Oils, Anisyl Acetate, Anisyl
Alcohol, Anisyl Formate, Anisyl Phenylacetate, Apple Juice Concentrate,
Extract, and Skins, Apricot Extract and Juice Concentrate, 1-Arginine,
Asafetida Fluid Extract And Oil, Ascorbic Acid, 1-Asparagine Monohydrate,
1-Aspartic Acid, Balsam Peru and Oil, Basil Oil, Bay Leaf, Oil and Sweet
Oil, Beeswax White, Beet Juice Concentrate, Benzaldehyde, Benzaldehyde
Glyceryl Acetal, Benzoic Acid, Benzoin, Benzoin Resin, Benzophenone,
Benzyl Alcohol, Benzyl Benzoate, Benzyl Butyrate, Benzyl Cinnamate,
Benzyl Propionate, Benzyl Salicylate, Bergamot Oil, Bisabolene, Black
Currant Buds Absolute, Borneol, Bornyl Acetate, Buchu Leaf Oil, 1,3-
Butanediol, 2,3-Butanedione, 1-Butanol, 2-Butanone, 4(2-Butenylidene)-
3,5,5-Trimethyl-2-Cyclohexen-1-One, Butter, Butter Esters, and Butter Oil,
Butyl Acetate, Butyl Butyrate, Butyl Butyryl Lactate, Butyl Isovalerate, Butyl
Phenylacetate, Butyl Undecylenate, 3-Butylidenephthalide, Butyric Acid

www.toyourhealthmedical.com

bprimack@pitt.edu