Drug Education and Its Publics in 1980S Britain

International Journal of Drug Policy 88 (2021) 103029 Contents lists available at ScienceDirect International Journal of Drug Policy journal homepage: www.elsevier.com/locate/drugpo Policy Analysis Just say know: Drug education and its publics in 1980s Britain Alex Mold Centre for History in Public Health, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom ARTICLE INFO ABSTRACT Keywords: Until the 1980s, anti-drug education campaigns in the UK were rare. This article examines the reasons behind a Heroin policy shift that led to the introduction of mass media drug education in the mid 1980s. It focuses on two Drug education campaigns. ‘Heroin Screws You Up’ ran in England, and ‘Choose Life Not Drugs’ ran in Scotland. The campaigns Health education were different in tone, with ‘Heroin Screws You Up’ making use of fear and ‘shock horror’ tactics, whereas History of drug use ‘Choose Life Not Drugs’ attempted to deliver a more positive health message. ‘Heroin Screws You Up’ was criticised by many experts for its stigmatising approach. ‘Choose Life Not Drugs’ was more favourably received, but both campaigns ran into difficulties with the wider public. The messages of these campaigns were appro priated and deliberately subverted by some audiences. This historical policy analysis points towards a complex and nuanced relationship between drug education campaigns and their audiences, which raises wider questions about health education and its ‘publics’. In April 1986, the cast of teen TV soap, Grange Hill, released a song wanted to be seen to take action on drugs, leading to the introduction of titled ‘Just say no’. The single reached number five in the charts and mass-media campaigns, even though this went against expert advice. remained in the Top 100 for fiveweeks. It delivered a clear anti-drug use The ‘Heroin Screws You Up’ campaign, which ran in England from 1985 message, telling listeners to ‘just say no’ to drugs. The song built on a until 1986 and the ‘Choose Life Not Drugs’ campaign which ran in recent storyline in which one of the characters, Zammo McGuire, Scotland over the same period, were very different in tone. The ‘Heroin became addicted to heroin. ‘Just say no’ also echoed American First Screws You Up’ campaign made use of fear and ‘shock horror’ tactics; in Lady Nancy Reagan’s campaign of the same name, and an anti-drug use contrast the ‘Choose Life Not Drugs’ campaign situated its anti-drug TV advertisement made by the Scottish Health Education Group in 1985. message within a broader positive health agenda. ‘Heroin Screws You The premise of such ‘just say no’ messages was that telling children and Up’ was widely criticised at the time, whereas ‘Choose Life Not Drugs’ young people about the dangers of drugs would dissuade them from was received more warmly, but both campaigns were open to alternative substance use. Like other health education programmes during the readings and re-appropriation by their audiences. Anti-drug use mes 1980s, the intention behind drug education was to increase knowledge sages were interpreted in a variety of ways by different ‘publics’. These about drugs, provoke behaviour change and encourage individuals to readings were shaped by the beliefs and behaviours of groups and in make healthier choices. The use of such campaigns to prevent drug use dividuals, but also influenced by social structures, economic circum was, however, controversial. Health educators and experts on drug use stances and political framings. had long advised against mass drug education efforts, for fear that these To address such issues, this article focuses on some of the visual would have the opposite effect. Many authorities believed that drug materials produced as part of these campaigns and how they were education campaigns would provide information about drugs to young received. Such an approach has provided a fruitful line of analysis for people that they were previously unaware of, increasing the likelihood historians of other public health issues (Cooter & Stein, 2010; Hand, that they would take drugs. Concerns about the so-called ‘boomerang 2017; Medcalf & Nunes, 2018). It is especially pertinent here for two effect’ meant that there were very few anti-drug campaigns in Britain reasons. Firstly, there is a lack of archival material relating to the until the 1980s (Manning, 2013). development of the anti-heroin campaigns and the strategies behind This article explores the reasons behind the change in drug education them. This is not that unusual; campaign materials may survive but policy during the 1980s and examines two campaigns to tease out some documents relating to their production often does not. Secondly, the wider issues around drug education and its publics. An increase in visual materials facilitate an exploration of the relationship between heroin use and growing media attention meant that the government intention and reception, between public health actors and their publics. E-mail address: [email protected]. https://doi.org/10.1016/j.drugpo.2020.103029 0955-3959/© 2020 The Author. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). A. Mold International Journal of Drug Policy 88 (2021) 103029 This is important, as it broadens the focus away from the issue of an ‘ill-advised approach by feeding interest in drugs in the wrong way, whether or not such campaigns ‘work’. Since the late 1970s, health may actually encourage experimentation’ (Central Office of Informa- educators and their paymasters questioned the effectiveness of their tion, 1979, p. 17). efforts in changing individual behaviour and generating healthier out- However, when heroin use started to increase, the value of drug comes. A more recent meta-analysis of health education campaigns education was re-evaluated. In 1977, there were 2016 ‘known heroin suggests that whilst there is evidence of some successes, especially addicts’, by 1982 there were 4371 (Advisory Council on the Misuse of around smoking, most only produce a moderate effect (Wakefield,Loken Drugs, 1983). In 1984, the government’s expert body on drugs, the & Hornik, 2010). That does not mean however, that such campaigns are Advisory Council on the Misuse of Drugs (ACMD), examined the issue of unworthy of study. A ‘failed’ campaign can tell us as much, if not more, health education campaigns. They asserted that ‘education aimed spe- than a successful one. By looking at two such campaigns this article cificallyat preventing drug misuse is not yet common because of the fear draws out a set of wider issues about how these materials were read and that it will promote experimentation’ (Advisory Council on the Misuse of interpreted by different audiences, the relationship between experts and Drugs, 1984, p. 20). The ACMD warned against ‘shock and horror’ policy makers, and the political and symbolic value of health education tactics, noting that campaigns ‘based on such measures on their own are efforts even when these do not achieve their putative goals. likely to be ineffective or, at worst, positively harmful’ (Advisory Council on the Misuse of Drugs, 1984, pp. 35–36). The Council also Drug use and health education, 1960s–1980s raised questions about the whole premise of drug education, noting that ‘we do not accept that educational programmes based only on the pro- Educating people about dangers to health had long been part of vision of accurate factual information about drugs and their potential public health practice, but this took on a new level of importance in the dangers are sufficient to prevent drug misuse. It is now generally second half of the twentieth century. As chronic disease linked to life- accepted that knowledge of itself does not usually change attitudes, far style became the leading cause of morbidity and mortality, emphasis less alter behaviour’ (Advisory Council on the Misuse of Drugs, 1984, p. was placed on informing people about health risks and persuading them 36). Instead, the ACMD argued that drug education was better placed to change their behaviour. Mass media health education campaigns within a broader programme of health education messaging aimed at were increasingly common from the 1960s onwards. In 1964, the Cohen promoting a healthy lifestyle – taking exercise, not smoking, eating a committee on health education recommended that greater use be made good diet, and so on. of the mass media not only to provide health information, but also to By the early 1980s, the rising number of people using heroin, and a change behaviour (Ministry of Health, 1964). In the wake of the Cohen growing moral and media panic around heroin use, made a health ed- committee the Health Education Council (HEC) was set up in 1968 in ucation campaign politically expedient, even if it was not well- England and Wales, and the Scottish Health Education Group (SHEG) in supported amongst experts. In 1983 there were 5079 ‘known heroin Scotland. Numerous campaigns on various issues were launched by addicts’, by 1987 there were 10,389, with many thousands more going these groups, on topics including obesity, alcohol and the dangers posed undetected. At the same time, social and economic conditions facilitated by smoking (Berridge, 2007; Berridge & Loughlin, 2005; Hand, 2020; the development of problematic drug use and heightened the sense of Mold, 2017). By the early 1980s, however, doubts about the ability of fear that surrounded this. Mass unemployment, particularly amongst such campaigns to change behaviour and reduce harmful outcomes were young people, and high levels of deprivation were linked to rising levels beginning to arise. An editorial published in the British Medical Journal of drug use, especially in urban areas (MacGregor, 1989). Popular and in 1982 argued that the HEC had achieved little (Anon, 1982).

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