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Citizen Behavior Change: The Social Marketing Approach

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nancy Lee
September 6, 2019

In a PA Times Column this past Spring, I described three major approaches that policy makers, agency directors and program managers typically rely on for citizen behavior change for social good: Education, Social Marketing and Law (See Figure 1). The column encouraged more consideration of the social marketing approach, as it is often the most efficient and effective strategy for achieving higher rates of behavior change, as well as producing greater returns on investment of resources. This column, and one that will appear later in 2020, will discuss success stories highlighting, “Wicked problems,” that social marketing addresses. For this article, the focus is on improving health and preventing injuries.



Reducing Opioid Overdoses

The Problem: According to the CDC’s 2015 Vital Signs report, the rate of heroin-related overdose deaths nearly quadrupled between 2002 and 2013, with more than 8,200 people in the United States dying in 2013. Of special focus in the report was the fact that 45% of people who used heroin were also addicted to prescription opioid painkillers.

In May 2015, the City of Gloucester, Massachusetts, with a population of only 30,000, had its fourth fatal drug overdose, surpassing the prior year’s total. The police chief, Leonard Campanello, declared he had, “Had enough,” trying to fight the drug war the old-fashioned way, putting pushers and addicts in jail, only to have them reoffend. His revolutionary approach, branded by some as Help Not Handcuffs, clearly illustrates the social marketing option.

The Priority Audience: Gloucester’s sheriff’s strategy was one focused on heroin addicts in the town and region who were also using opiates.

Desired Behavior and Audience Insights: The department wanted addicts to come to the police station and ask for help with their addiction. He further proclaimed that he believed the stigma attached to heroin addiction was keeping them from seeking help.

Social Marketing Intervention Mix: The 4Ps: The message offered was that the department would help them get medical care and reduce the red tape to get treatment (product). They developed an agreement with local drug stores to give people struggling with an addiction access to free Narcan without a prescription (price); partnered with local hospitals to fast-track those seeking detox treatment; and posted (promotion) on the Police Department’s Facebook account that, “Any addict who walks into the police station with the remainder of their drug equipment (needles, etc.) or drugs and asks for help will NOT be charged.”

Results: Six months after the Facebook posting, 300 people had come through the door and were in treatment.

The above case is an edited case from my book, Policymaking for Citizen Behavior Change.



Reducing Drownings

The Problem: In 2016, the U.S. Coast Guard reported that alcohol use was the leading contributing factor in fatal boating accidents, and that 17% of all fatal boating accidents were the result of boat operators using alcohol.

The Priority Audience: In 2015, the Sea Tow Foundation, in partnership with the Washington State Parks Department, developed a social marketing plan launched in 2016 to reduce the number of skippers driving boats while under the influence of alcohol and drugs.

Desired Behavior and Audience Insights: The campaign focused on designating someone before leaving the dock to be the Designated Skipper for the trip. Intervention strategies were chosen to address major audience barriers including the belief that it’s safer to drink on the water than on the land, and remembering to do it.

Social Marketing Intervention Mix: The 4Ps: Designated sober skippers were provided yellow wristbands and floating key tags (product); discounts were provided at select marinas and restaurants to skippers wearing a Sober Skipper wristband (price); wristbands and floating key tags were made available at a variety of stores, marinas, restaurants, and fuel docks (place); and key messages (promotion) emphasized that, “Designating a sober skipper on the water is just like designating a sober driver on land.” 

Results: After the launch of the Designated Skipper program at the 2015 Seafair on Lake Washington, results for the pilot were indeed encouraging, with Seafair having its first zero fatality or major injury since its beginning in the early 1950s.

The above case is from Social Marketing: Behavior Change for Social Good 6th Edition, co-authored by myself and Philip Kotler.


It is hoped that these more in-depth case stories increase consideration of the social marketing option versus education and law, and that the examples of the social marketing intervention mix help distinguish this approach from Behavioral Economics and Nudge, which are primarily theories and frameworks that inspire social marketing strategies.

Author: Nancy Lee is a Teaching Associate at the University of Washington where she teaches social marketing in the MPA program. She has coauthored 13 books, 11 with Philip Kotler. She has a small consulting firm in Seattle, Social Marketing Services, has consulted on more than 100 social marketing campaigns, and has conducted workshops on Social Marketing in 12 countries

Email: [email protected]


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