It was early 2016 and we were in Hong Kong. A short holiday break during the process of finding my first job. I had just spent my last internship in public health, 8 months during which I heard all about the advantages of empowerment of communities and health promotion and education over prevention campaigns. My social psychology background also kicked in when I saw that little sign during one of our hikes.
If you ever have been to Hong Kong, you probably have seen a lot of public campaigns about what to do and how to do it well (according to the government) on almost every subject. From how to take the escalator to how you should not forget you have a child during your divorce. Most of them feel quite convincing and logical even if they’re often infantilizing as we all have experienced during Covid times.
This sign is from the 80s and public health campaigns and researches have evolved a lot since then. Now we know that these messages don’t have a real impact on people’s behaviour. However, this kind of slogan is still used. Especially in Europe, where you can find them combined with graphic pictures on all tobacco products. So does fear of cancer cures smoking and why do we keep using fear appeal in public health campaigns ?
Reading marketing and social psychology papers, I found that there are methodology errors, results misinterpretations combined with the systemic issue of publishing selection. Making it difficult to conclude on the efficacy of fear appeal in public health campaigns.
Meta-analysis researchers struggle with defining selection criteria to test theories. To test the impact of one variable on another one, you need it to be variable in your experiment. For example, you need to have several levels of fear, or at least one control condition, to be able to make comparisons and to conclude that fear has an impact on people’s behaviour. In this case you also need to measure people’s behaviours to be able to make that conclusion. It is not the case in many studies where intention of change is preferred to actual behaviour change.
The need for fast publication, funding difficulties, and thus fast experimentation, ethical dimension and risks of longer studies alongside many other reasons explain those choices, which are not only restricted to these researches.
One thing seems to make consensus though. Fear of cancer won’t cure smoking, behaviours have more chances to change if solutions are perceived as effective and reachable. And this specific knowledge has been there at least since the 80’s, but not really used, in Europe, before the 2010’s.
Legislation on public health is notoriously more resistant to change than scientific findings. Recent events showed us that if they do too quickly they often follow the most persuasive and good speaker, as we all tend to do. It is probably what happened in that case. Fear appeal in marketing had a great track record on sales. Combined with some quick studies and a low cost for public administration, why not try ?
We know that peer influence is a strong tool for changing behaviour since Asch’s experimentations on conformity in the early 50’s. Researchers have been developing, testing and finding great results with group interventions especially on adolescents since then. But a public campaign is cheaper than community work, school interventions, especially when you can transfer responsibility and cost of a campaign to the tobacco industry.
As I mentioned, things are evolving and the need for reachable solutions is better understood and included in public communications with support call centers being advertised on tobacco products.
Behaviour change and motivation was a great interest of mine during my college years. It was then that I heard for the first time that fear appeal was not efficient in health public campaigns but I didn’t manage to do my own research at the time.
Once again, from a trip to the other side of the planet, I got back with a picture that, today, gave me a chance to look for some answers to a question that has been in my head for all these years !
I am only taking a quick look on the subject, if you want to share your own findings and thoughts, please, comment below !
- Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory, Peters, G. J., Ruiter, R. A., & Kok, G. (2013).
- Effective and ineffective use of fear in health promotion campaigns. Soames Job RF (1988)
- Fear appeal – Wikipedia
Leave a Reply