Alcohol-Related Risk Taking Among Teenagers: An Investigation of Contributing Factors and a Discussion of How Marketing Principles Can Help

William J. Bums, University of Iowa Sarah E. Hampson, Oregon Research Institute Herbert H. Severson, Oregon Research Institute Paul Slovic, Decision Research ABSTRACT
The role of risk perceptions and po-sonality in adolescents' particip^on in alcohol-related risk taking (including the consumption of alcohol and alcohol use in connection with driving or riding in acar) was investigated using covariance structure modeling. The modeling analysis indicated that factors pertaining to perceptions that the benets of using alcohol outweigh the risks, grade level, and desired indepoidence were the only variables to directly affect participation. Personality characteristics (sraisation seeking, ego control, independence, and achievement-orientation) were found to indirectly influence participation through their direct influoice on adolescents* perceptions of benefits and risks associated with alcohol use. This model applied equally well to boys and girls. These fndings are integrated within a social marketing framework and of'er strategies to reduce alcohol-related risk taking among adolescents. drinking five or more alcoholic beverages on a single occasion, riding in a car with an intoxicated driver, and driving a car while intoxicated. The remaining activities included other adolescent problem behaviors such as tobacco and illicit substance use, as well as more socially acceptable risk taking sudi as driving an all-terrain vehicle. The rating scales assessed a number of aspects of risk perception that we have examined in previous studies (e.g., Slovic, 1987) togetho^ with perceptions of social influoices and rqx>rts of risky behavior: (1) If you did this activity, to what extent do you believe that you would be personally at risk for getting hurl or sick^ (Personal Risk), (2) If someone your age did this activity, to what extent do you believe that he/she would be at risk ofgetting hurt or sicl (Risk to Others), (3) If you did this activity, to what extent would it provide you wixhpleasure or other ben^it^ (Benefits), (4) f someone your age did this activity, to what extera could he or she control the risks associated with if! (Controllability), (5) To what extent do you feel pressure from your friends to do this activity? (Peer Pressure), (6) To what extent are people who do this activity admired by their friend^ (Pea- Admiration), (7) To what extent can a person your age avoid doing this activity! ( Avoidability), (8) If you wanted to participate in this activity, haw easy would it be to do so7 (Ease of Doing), {9) Would your parents approve or disapprove of your doing thist (Paraital Approval). Scale 10 asked how often close friends did the activity (never, sometimes, often), scale 11 asked what percentage of same-age peers do this activity, and scale 12 asked for a self-reported frequency of involvement with the activity over the past six months (O=zero, 1=1 or 2 times, 2=3 to 5 times, 3=6 to 10 times, 4=11 or more times).

INTRODUCTION
Although alcohol use by high-school students has shown an encouraging decline in recent years, teenage alcohol consumption remains at high levels. A 1991 national survey of high school s ^ o r s (Johnston. 1992) indicated that 88% of seniors had tried drinking at least oiKe, 54% had tried drinking in the last thirty days, and 30% report drinking 5 or more drinks at a time within the last two weeks. Particularly disturbing was the fact that almost one third did not perceive drinking four or flve drinks on a nearly daily basis as a great risk. According to the U.S. Department of Education (1988) drinking and driving is common among teenagers and is the leading cause of death among people aged 16-24 years. In this paper we begin by investigating a model of alcoholrelated risk taking, in which we hypothesize that personality traits, social influences, and grade level contribute to adolescent risk taking largely through their effect on risk perceptions. We then discuss how our findings together with those of other researchers can be tised to reduce alcohol-related risk taking by employing basic marketing principles. METHOD Subjects and Procedures We administered our measures to an entire high school located in rural Oregon. The experimenters emphasized that the questionnaires were to be completed anonymously, and encouraged the participants to be completely honest in their responses. The experimenter remained in the classroom to answer questions and to ensure iatthestudents worked independently. However, to protect the confidentiality of subjects' responses, experimenters did not patrol the room. Across the two days, 323 students were assessed, which is 84% of the high school's enrollment of 382 students. Risk Perception, Social Influence, and Risk Behavior Scales These three constructs called for ratings of 16 different activities on 12 scales. There were seven activities involving alcohol: drinking wine or wine coolers, drinking beer, drinking hard liquor.

Personality Variables Personality scales were administered immediately after con:q)letion of the risk-pra-ception, social influence, and risk behavior scales. Sensation seeking, which peaks in adolescence, is associated with participation in a range of risky activities including using alcohol (Zuckerman, 1979). It was assessedby eight items from the Saisation Seeking Scale (Zuckerman, Kolin, Price, & Zoob, 1964). Two items from each of four subscales (thrill and adventure seeking, experience seeking, disinhibition, and boredom susceptibility) were used (alpha = .69). Frequraii drug use is associated with poor impulse control (Shedler & Block, 1990) which was assessed by 20 itrans from Block's Ego Control Scale (alpha = .74). Adolescent problem behavior, including alcohol use, has been associated with low values for academic achievement and high values for independence (Jessor, 1984; lessor and lessor, 1977). These variables were assessed using five items each from lessor's A and I scales (alpha = .88 and .77 respectively). Structural Model of Aicohol-Related Risk Taking To investigate how persoiudi^ characteristics, social influence and risk perceptioncontribute to alcohol-related risk taking we constructed the structural model shown in Figtire 1 (the results from this figure are discussed in the next section). We hypothesized diat Alcohol-Related Risk Taking could be explained by a combination of constructs representing risk perception, social influence, and Advances in Consumer Research Volume 20, & 1993

183

184 / Alcohol-Related Risk Taking Among Teenagers FIGURE 1 A Proposed Structural Model Depicting Factors That Contribute to Alcohol-Related Risk Taking^

Grade Level

.08

-.10 Sensation Seeking

-.34

Perceived Benefits vs.

Risks

Frequency of Alcohol Use

Ego Control
-.12

Alcohol-Relat Risk Taking

Drinking fit Driving Behavior

Independence

Achievement

Peer Pressure

I Peer Admiration

Avoldabllity

Figures 1 and 2 are taken from Hampson, Sarah, E., William J. Bums, Herbert H. Severson, and Paul Slovic (1992), "Adolescent AlcoholRelated Risk Taking: Exploring Structural Relations Among Risk Percqtions, Personality, and Risk Taking" which is cuireny under review at the Journal of Studies on Alcohol.

personality characteristics. Specifically, Perceived Benefits vs. Risks is thought to positively influence Alcohol-Related Risk Taking. Perceived Benefits vs. Risks was measured by perceptions of persona] risk, risk to others, controllability of the risk, parental approval for the activity, and benefits. Those scoring high in terms of Perceived Benefits vs. Risks tend to believe the activity to be controllable, beneficial, and approved of by parents, and also to be of low risk to themselves and others. Thus teenagers scoring higher on this factor should be more likely engage in risky behavior. Tliis construct represents the combination of risks and benefits thai Slovic has found typical of intuitive assessments of risk (Slovic, Fischoff, & Lichtenstein, 1986). Likewise, Perceived Social Influence affects positively both Perceived Benefits vs. Risks and Alcohol-Related Risk Taking. Perceived Social Influence was measured by perceptions of peer pressure, peer admiration, avoidabitity, and ease of doing the activity. As such Perceived Social Infiuence captttres the various perceived contextual factors that favor engagement in risk taking. High scores on this construct perceive the activity to be admired by their peers, feel under pressure to engage in the activity, see it as difficult to avoid, and easy to do. Hence, adolescents perceiving greater social pressures should be more inclined to view these activities as less risky and to participate more frequently. Four personality variables and a student's grade level are hypothesized to affect participiuion in alcohol-related risk taking. Grade Level, and Sraisation Seeking are thought to have a direct positive effect on Alcohol-Related Risk Taking while Ego Control (low impulsiveness) is hypothesized to exert a direct negative influraice on such bdiavior. For example, those in higher grades face more opportunities to engage in such risks, those possessing greater sensation seeking needs more often pursue such opportuni-

ties, and those exhibiting greater impulsiveness more frequently participate in risky activities without proper reflection. Personality characteristics and grade level are also hypothesized to have indirect effects on Alcohol-Related Risk Taking. Sensation Seeking positively affects Alcohol-Related Risk Taking through its positive effect on Perceived Benefits vs. Risks. For instance, high sensation seeking needs may encourage teenagers to focus more on the benefits of risky activities than on the dangers. Ego Control affects Alcohol-Related Risk Taking negatively because of its negative influence on Perceived Benefits vs. Risks. Less impulsive individuals for example, are more tqit to consider long-run consequences and thus should perceive fewer benefits (short-lived) and more long term risks. Achievement negatively affects Alcohol-Related Risk Taking through its negative infiuoice onPerceivedSociallnfiuence. Students who place greatervalueon academic achievementterKlto gravitate more readily toward scholastic activities and receive greater encouragement from teachers and other academically-oriented students. Hence, t h ^ should be perceive less social influence to participate in risky activities. Independice positively influences Alcohol-Related Risk Taking through its positive effect on Perceived Boiefits vs. Risks. Those with higher values for Indepraidence (i.e., independence from adult authority) are more inclined to view "adult" activities positively, and to reject warnings coming from authorities. Thus, they should perceive more benefits and less risks associated with risk taking activities. Finally, Grade Level exerts a positive influence on Alcohol-Related Risk Taking through its positive effect on Perceived Benefits vs. Risks. As mentioned, students in higher grades have greater opportunities to engage in risky activities. As a result, older students are exposed (in the short term) to more information regarding the benefits than the dangers of such activities. Thus,

Advances in Consumer Research (Volume 20) 1185 they should perceive more benefits than risks connected with risky activities such as alcohol use. with a direct effect of .8 (i.e., a one standard deviation change in Perceived Benefits vs. Risks produces a .8 standard deviation change in Alcohol-Related Risk Taking). As expected. Grade Level displayed a direct effect on Alcohol-Related Risk Activities. RESULTS Independaice was originally thought to operate on this construct The self-reports of alcohol use indicated that 61% of the younger students (i.e., 9th and 10th grades) and 81% of the older only indirectly through Perceived Benefits vs. Risks but appeared students (i.e., 11th and 12th grades) had drunk beer on at least one to exCTt a direct influence as well. However, there were no other occasion during the past six months. Similarly, 59% of the younger direct effects on Alcohol-Related Risk Taking. Together these studraits and 78% of the older students rqxnted drinking wine, and three factors (Grade Level, Independence, and Perceived Benefits 46% of the younger students and 70% of the older students rqrorted vs. Risks) accounted for 72% of the variance of Alcohol-Related drinking hard liquor at least once. Moreover, 43% of the younger Risk Taking. Grade Level, Sensation Seeking, Ego Control, students and 61% of the older students reported at least one recent Independence, Achievement, Peer Admiration, and Avoidability incidence of drinking flve or more drinks on one occasion. These appear to indirectly affect Alcohol-Related Risk Taking through levels of alcohol involvement are comparable to levels reported in their direct influence on Perceived Beneflts vs. Risks . However, other studies. The correlations between these four alcohol-related these seven factors explain only amoderate portion of the variance activities were high (ranging from .73 to .82) with an alpha value of of Perceived Benefits vs. Risks (R2 =: .46). .93. Hraice, these four items w ^ e summed to produce an index To determine whether the model in Figure 2 qjplied equally reflecting a students's fr^uency and quantity of alcohol use. well to either sex, the sample was divided into girls (i^l44) and For drinking and driving, 31% of the younger students and boys (n=148) and a two-group model was estimated under the 44% of theolder students reported riding with an intoxicated driver, constraint that corresponding parameters were set equal to each and 1% of the younger students and 28% of the older students other. Overall the two models behaved in a similar fashion. The model has limitations that should be mentioned. First, reported having driven while intoxicated. The correlations between these two activities was moderately high (.69). Hence, these two model respecification was guided in part by considerations of fit items were summed to form a Drinking & Driving index reflecting which limits the generalizability of our findings. Replication of our the amount of drinking and driving. The two measures of Alcohol- fmdings on an independent sample is clearly needed. Second, Related Risk Taking were positively skewed because of the rela- failing to include factors represeiuing the roles of social and tively high numbCTs of students reporting little or no alcohol-related parental influence probably inflated the effect of Perceived Benrisk taking. Accordingly, they were transformed to a natural log efits vs. Risks on Alcohol-Related Risk Taking. Lastly, a longituscale. dinal model would better serve to capnire the reciprocal relationThe model in Figure 1 was examined using a covariance ship between perceived risks and teenage involvement with alcostructure modeling program called EQS (Bentler, 1989) and esti- hol. For example, it appears reasonable that frequent involvnnent mates were based on elliptical rather than normal distribution with alcohol may contribute to faulty perceptions of the risks that theory. The chi-square statistic (x'=185.98, df=89, p<.001) indi- accompany this behavior. cated that the model statistically did not fit very well. However, the Bentler-Bonnet Normed Fit Index (BBNFI) was .98 (.90 or higher DISCUSSION is considered acceptable) indicating that the model performed well Despite its preliminary nature, our model has sevrai implicain accounting for covariances among model variables. The largest tions for interventions to reduce alcohol-related risk taking. It contribution to the poor model fit appeared to come from improper suggests that if we wish to decrease adolescent's involvement in measurement of the latent constructs Perceived Benefits vs. Risks such activities we need, among other things, to influence their and Perceived Social Influence. Examining measurement coeffi- perceptions of the risks and benefits associated with alcohol use. cients (all path estimates represent standardized regression coeffi- Our findings indicate that teaching adolescents to gain control over cients) indicated that only Personal Risk. Risk to Others, and their impulses, encouraging their willingness to communicate with Benefits were good indicators of Perceived Benefits vs. Risks. authority figures (aided by our own willingness and ability to Likewise, these coefficients suggested that the variables used to communicate with teenagers), and heightening their motivation to measure Perceived Social Influence did not sean to share a comdo well in school may alter their perceptions of therisksand boiefits mon factor. As a result, the model proposed in Figure 1 was of drinking. Likewise, helping teenagers to develop the social skills modified to bett^ conform U) the data but still address the original necessary to realize that such activities are not only avoidable but theoretical propositions. that such behavior is not admirable also may influence their The revised model in Figure 2 retained the construct of perceptions of the risks and benefits. Lastly, while grade level and Perceived Beneflts vs. Risk, measured now by Personal Risk. Risk sensation seeking are typically not susceptible to intovention they to Otho's, and Benefts. The construct Perceived Social Influence do help indicate which adolescents are at highest risk and how we was dropped but two of its measures. Peer Admiration and might best communicate with them. Avoidability, were retained because of their significant contribuThe marketing challenge is to implement cost effective protion to Perceived Benefits vs. Risks. The model shown in Figure 2 grams that influence risk attitudes towards drinking and affect was the product of removing variables and paths that did not make behavioral change. Social marketing provides a frameworic in a statistically significant contribution to the prediction of Perceived which marketing principles can be integrated with social-psydioBenefits vs. Risks or Alcohol-Related Risk Taking. TheX2 statistic logical theory and empirical findings to accomplish goals involving C'=66.22, d=40, p=.Ol) indicated that at best the model fit only attitudinal or behavior change (Kotier & Roberto, 1989). What the marginally well. However, the %Vdf ratio was 1.7 (2 or less is marketing qiproach brings to the adoption of social change is the considered acceptable) and BBNFI was .99 indicated that the model ability to plan in terms of the needs of speciflc target groups. This was reasonably consistent with the data. framework allows efforts to be trained on the needs of particular As anticipated. Perceived Benefits vs. Risks played a central market segments and goals to be represented in terms of variables role in explaining the behavior of Alcohol-Related Risk Taking that are under our control: designing programs to encourage

186 / Akohol'Rebted Risk Taking Among Teetiagers

nGURE 2 A Modified Model Depicting Factors That Contribute to Alcohol-Related Risk Taking^ Grade Level
Beneflts

Sensation Seeking
-.42

Quantity & Frequency of Alcohol Use .82

Ego Control
-.20

Independence
.41

Perceived Benefits vs. Risks

Alcohol-Relate Risk Taking

.64 Drinking & Driving BehaviOT

Achievement AvoldablUty
-.32

Peer Admiration

responsible alcohol consumption (Product), reducing psychological, social, economic, and convenience costs associated with the change of behavior (Price), providing accessible opportunities to leam about and behave in a responsible fashion (Place), and developing messages that communicate the benefits over the costs stjch as improved health and self-esteem (Promotion). Product Programs designed to inuence alcohol-related risk taking need to be comprdiensive in their scope and tailored to the needs of specific target groups. Comprdiensiveness requires involving multiple publics (e.g., adolescents, parents, school and health officials) and addressing multiple behaviors (e.g., alcohol and drug use, smoking, unsafe sex, poor school performance). Tailoring programs requires recognizing that adolescents daffet in their level of risk information, peer pressures, and psychological and social maturity. For example, adolescents at highest risk tend to have greater needs for thrill seeking, lower needs for academic achievement, associate with more deviate peer groups, possess less developed social skiUs, and often come from families with poorer parenting skills. Hence, media campaigns that focus only on the dangers of substance abuse (e.g., 'This is your brain on drugs...") or social intwaction (e.g., "Just say no!") ignore the fact that this group often seeks risky activities and saying no to substance abuse may spell rejection from their peer group. Likewise, educational programs that merely provide risk information without providing training and support for behavioral change are likely to produce only short lived results.

Prke and Place Programs must also make it as easy as possible to participate, being mindful of the psychological, social, and time commitments involved with such activities. This is especially true of high-risk adolescents and their parents. For example, these parents may be reluctant to participate because of time confficts, apprehension about what to expect or failing to see the relevance to their lives. Programs designed to improve parenting skills not only require time and effort but may be psychologically threatening. Often the parents of adolescents having problems in school are not actively involved in school functions and hence may require they develop new relations with teachers and other school officials. Moreover, high-risk adolescents most likely have begun alienating themselves from teachers and associating with peers exhibiting risky behaviors. Their peer groups often condone and even encourage substance abuse. Hence, the physical, psychological, and social costs of quitting addictive behaviors is likely to be very high. Programs must seek to reduce these costs for parents and adolescents by not only facilitating behavioral change but by providing social support for the formation of new reference groups. Promotion Lastly, promotional efforts must convince adolescents, parents, and community monbers that high risk behavior presents a real danger to teenagers and a high cost to families and conununities. Promotional messages must also offer definite measures to reduce such risk-related costs. These messages should be crafted to address the individual concems of the community, parents and

Advances in Consumer Research (Volume 20) 1187

teenagers. To motivate adolescents it is especially important to not only present accurate information about such risks but to focus specifically on increasing their sense of personal threat. Adolescents already exhibiting risky behavior may be resistant to this message for anumber of reasons. First, members of this group tend to be sensation seekers and haice they typically focus more on the baiefits of risk taking than other teenagers. Second, they and their peers frequently engage in high risk activities without any apparent problems thus providing evidence that such behavior is at once exiting, not overly dangerous, and has consequences that are largely controllable. Finally, because substance abuse is physically and psychologically addicting prolonged involvement tends to promote denial of the inherent dangers cormected with such activities. Research is needed to determine effective means to counter resistant beliefs concerning the persona]riskof alcohol-related risk taking. Investigators involved with AIDS intervention research have found (Kelly et al.. 1991) that getting individuals to acknowledge that high risk behavior places them in genuine danger is accomplished more easily when this message comes from individuals that are highly regarded by their peer group, when they are repeatedly reminded of the value of changing their behavior, and when they have easy access to a social support system promoting behavioral change. Hence, at the national level messages concerning ihe dangers of substance abuse must come from highly credible sources (e.g., musicians that have used drugs and have quit), must convey personal hardship, must present a realistic way out of the problem, and must be repeated often. Likewise, at the local level peers that are in the process of changing their highriskactivities can be effective role models. They can also serve to generate discussion and encouragement among their friends to seek help in changing their high risk activities. Slovic, Paul, Baruch Fischoff, & Sarah Lichtenstein (1986), "The Psychometric Study of Risk Perception." In V.T. Covello, J. Menkes, & J. Mumpower (Eds.), Risk Evaluation and Management, ficw York: Plenum. Shedler, Jonathan, &. Jack Block (1990), "Adolescent Drug Use and Psychological Health: A Longitudinal Perspective." American Psychologist, 45, 612-629. U. S. Departmoit of the Health and Human Services (1990), Seventh Special Report to the U. S. Congress on Alcohol and Health. Zuckerman. Marvin (1979), Sensation Seeking: Beyond the Optimal Level of Arousal. New York, NY: John Wiley & Sons. Zuckerman. Marvin. Elizabeth L. Kolin. Leah Price. & Ina Zoob (1964). "Developmrait of a Sensation-Seeking Scale." Journal of Consulting Psychology, 28,477-482.

REFERENCES
Bentler, Peter M. (1989), EQS Structural Equations Program Manual. Los Angeles, CA: BMDP Statistical Software. Jessor, Richard & Shirley L. Jessor (1977), Problem Behavior and Psychosocial Sevelopment: A Longitudinal Study of Youth. New York, NY: Academic Press. Jessor, Richard (1984), "Adolescent Development and Behavioral Health," in J. D. Matarazzo, S. M. Weiss, J. A. Herd, & N. E. MUler (Eds.). Behavioral Health: A Handbook of Health Enhancement and Disease Prevention. New York, NY: J. Wiley & Sons. Johnston, Lloyd (1992), Report Issued by the University of Michigan's News and Information Services Regarding Teenage Substance Abuse on January 27, 1992. Kelly, Jeffrey, Janet S. St. Lawrence, Yolanda E. Diaz, L. Yvonne Stevenson, Allan C. Hauth, Ted L. Brasfield, Seih C. Kalichman, Joseph E. Smith, & Michael E. Andrew (1991), "HTV Risk Behavior Reduction Following Intervention with Key Opinion Leaders of Population: An Experimental Anlys," Amecan Journal of Public Health, 81, 2 168171. Koer. Philip, & Eduardo L. Roberto (1989). Social Marketing: Strcaegies for Changing Public Behavior. New York: The Free Press. Severson, Herbert H., Paul Slovic. Sarah E. Hampson. & Linda Schrader (1990), "Adolescent Risk Perception: A Measure to Further our Understanding of Tobacco and Drug Use." Hygie, 9, 27-29. Slovic, Paul (1987), "Perceptions of Risk." Science, 236, 280285.

Copyright of Advances in Consumer Research is the property of Association for Consumer Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.