The Inoculating Effect of Message Sidedness on Adolescents’ Binge Drinking Intentions

Abstract

In this study, we assess an alternative strategy for health interventions, namely, two-sided messages. A 3 × 2 between-subjects factorial experimental design investigates the effect of three different anti-binge drinking messages (i.e., one-sided, two-sided non-refutational, and two-sided refutational) on strongly and weakly issue-involved adolescents’ binge drinking intentions after exposure to peer pressure. A sample of 185 adolescents between the age of 15 and 19 participated in the experiment. The results show that when adolescents’ involvement with binge drinking is strong, a two-sided refutational as well as non-refutational message result in lower binge drinking intentions than a one-sided message. When adolescents’ involvement with binge drinking is weak, binge drinking intentions are not influenced by message sidedness.

Keywords

binge drinking two-sided messages involvement peer pressure

Introduction

Ample studies demonstrate the dire effects of binge drinking, which is the episodic or irregular consumption of excessive amounts of alcohol (Dufur, Parcel, & McKune, 2013; Faulkner, Hendry, Roderique, & Thomson, 2006; Ragsdale et al., 2012; Vik, Cellucci, & Ivers, 2003). There is a strong need for prevention programs to reduce alcohol use, especially among adolescents (Swahn, Simon, Hammig, & Guerrero, 2004). Previously, academic health communication research mainly focused on the negative side of certain unhealthy behavior by emphasizing how unhealthy, dangerous, or damaging the behavior is (Reynolds & Seeger, 2005). As many health prevention organizations apply such one-sided (i.e., negative) messages, individuals might get used to this type of persuasive appeal, possibly leading to a saturation effect (Ahn, Wu, Kelly, & Haley, 2011; Devlin, Eadie, Stead, & Evans, 2007), a boomerang effect leading to aversive reactions such as denial and defensive avoidance (Quick & Bates, 2010). Consequently, the effectiveness of these traditional, one-sided negative health communication messages is limited (Dufur et al., 2013; West & O’Neal, 2004).

In this study, we assess an alternative form of health communication messages, namely, two-sided messages in which the communicator takes into account both sides of an issue, but actually still favors one side (Hovland, 1954). A variety of advertising studies suggest that (commercial) messages can include some negative information along with the positive product information, and still be more effective than when only positive information is provided (e.g., Crowley & Hoyer, 1994). However, the use of the two-sided message strategy has mainly been limited to commercial product advertising (e.g., Bohner, Einwiller, Erb, & Siebler, 2003; Eisend, 2006). Eisend’s (2006) meta-analysis underscores the need for empirical research assessing the effectiveness of two-sided messages for issues other than commercial products. A few studies applied two-sided messages to health communication (e.g., Belch, 1981, promoting toothpaste; Ley, Witworth, Woodward, & Yorke, 1977, promoting weight loss), but only in the conventional way of selling a health product or promoting healthy behavior, not discouraging unhealthy behavior. The present study investigates two-sided messages in a reversed way by focusing on the negative consequences of certain unhealthy behavior while adding some minor positive points of that behavior (instead of adding some minor negative elements in a message that generally emphasizes the positive characteristics of a product, as done in previous studies on message sidedness). Most unhealthy behavior is not exclusively negative, but often also entails some benefits for the individual (e.g., binge drinking for emotional or social reasons, smoking to reduce stress), making behavior change more difficult. Experimenting with risky behavior can be a necessary, constructive component of identity formation for adolescents. This is called the “paradox of risk taking” (Dworkin, 2005): An individual may experience positive and negative precursors and consequences of risk taking (Dworkin, 2005). Hence, in our study, we aim to avoid a one-sided, negative-only approach of risky behavior, by also acknowledging the perceived arguments in favor of the risky behavior.

Ample commercial communication studies (e.g., Crowley & Hoyer, 1994; Eisend, 2006; Hastak & Park, 1990) found that two-sided messages are superior over one-sided messages, but only a few studies investigate two-sided messages more deeply by comparing two specific subtypes of two-sided messages, that is, non-refutational and refutational messages. In two-sided non-refutational messages, advertisers simply present positive and negative information. In refutational two-sided (commercial) messages, they subsequently refute or discount the negative information in an attempt to “inoculate” the audience against possible counterclaims or opposing messages by competitors afterward (Eisend, 2007). So far, only a few commercial studies in two-sided persuasion research incorporate refutational appeals (e.g., Etgar & Goodwin, 1982; Kamins & Assael, 1987). Those few studies delivered mixed results on which subtype of two-sided message is most effective, indicating the need for further research assessing the role of possible moderating variables (Crowley & Hoyer, 1994). Specifically, Eisend (2006, 2007) stresses the potential moderating impact of issue involvement on the effectiveness of message sidedness.

Hence, the present anti-binge drinking study investigates the moderating role of issue involvement on the effectiveness of message sidedness (i.e., one-sided vs. two-sided) and the presence or absence of refutation (i.e., refutational vs. non-refutational) on adolescents’ binge drinking intentions after exposure to peer pressure. Peer pressure can be defined as the influence that (one or more) peers exert over one (or more) individual(s), in an attempt to change their attitudes, values, or behavior to fit the peer group. The operation of peer pressure on adolescents can be explained by the “identity shift effect” (Treynor, 2009). When an individual (in this case, an adolescent) is faced with a threat of external conflict (social rejection) for failing to conform to a group standard, he or she will feel the need to resolve this conflict (Treynor, 2009). This can be done by conforming to the group standard, but this brings along an internal conflict (because one has violated one’s own standards). Subsequently, to resolve this internal conflict (self-rejection), an “identity shift” is made: he or she adopts the group’s standards as one’s own, thereby eliminating the internal conflict (Treynor, 2009). As a result of this conflict resolution process, the individual forms a new identity (that is, a new set of internalized standards; Treynor, 2009). The peer pressure component is essential to our study, because our study aims to test the inoculating effect of message sidedness and refutation. To test the inoculation theory, a form of counterpersuasion is assumed. In this study, counterpersuasion takes the form of peer pressure. The intended effect of the peer pressure is to expose the respondents to information in favor of binge drinking, which they are likely to be exposed to in reality as well (e.g., after school, at parties, etc.). This way, we aim to test the inoculating effect of two-sided messages, that is, which type of two-sided message (i.e., refutational versus non-refutational) makes our participants more resistant to this kind of peer pressure.

Literature

Most commercial advertising studies have found that—in comparison with one-sided messages—two-sided messages are a more effective communication strategy, especially in difficult communication situations. For instance, when consumers are exposed to counterarguments against an advertising message afterward, two-sided messages lead to better defense mechanisms than one-sided messages (e.g., Crowley & Hoyer, 1994). Based on McGuire’s (1961) inoculation theory, empirical findings support that two-sided messages can generate resistance to counterpersuasion afterward (cf. peer pressure; for example, Crowley & Hoyer, 1994; Kamins & Assael, 1987). Most studies in a commercial context indeed show that two-sided messages are more effective than one-sided ones (Eisend, 2006, 2007).

Using a physiological analogy, inoculation theory (McGuire, 1961) states that offering mild counterarguments and afterward refuting them within the same message can bolster individuals against possible counterpersuasion afterward (Eisend, 2007). In immunology, to build resistance to a disease, people are injected with a solution that contains a mild form of the disease itself (Etgar & Goodwin, 1982). In other words, by preexposing subjects to weakened counterarguments (and immediately refuting them within the same message), their defense mechanism is heightened. Contrary to non-refutational two-sided messages, in refutational two-sided messages advertisers present positive and negative information, but then refute or discount the negative information, to inoculate the audience against possible counterclaims (Eisend, 2007). One of the principle tenets of inoculation theory is the need to include this refutation within the message itself (Crowley & Hoyer, 1994). Therefore, on the basis of the inoculation theory (McGuire, 1961), it could be expected that refutational two-sided messages are more effective against counterpersuasion than non-refutational ones. However, many researchers have also obtained beneficial effects for two-sided advertising without refutation (Crowley & Hoyer, 1994). In a commercial advertising context, several studies (e.g., Golden & Alpert, 1987; Kamins & Assael, 1987; Smith & Hunt, 1978) demonstrate beneficial effects of two-sided messages without refutation of the negative claims, indicating that the presence or absence of refutation has little impact. For instance, Kamins and Assael (1987) found that a one-sided message is less effective than either type of two-sided message, but similar results were obtained for both types (refutational and non-refutational) of two-sided messages. These empirical results suggest that, in some cases, refutation within the message is not necessary (Crowley & Hoyer, 1994). Hence, the cases in which refutation is needed and those in which refutation is redundant might be moderated by certain variables.

In his meta-analysis, Eisend (2006) included the impact of a number of moderating variables. However, the moderators studied to date have not been able to explain some of the inconsistent effects of message sidedness and the (non)refutational character of two-sided messages. In the context of (commercial) two-sided messages, issue (or product) involvement has been suggested as a potentially important moderating variable (e.g., Chebat & Picard, 1985; Eisend, 2006; Hastak & Park, 1990; Stayman, Hoyer, & Leon, 1987). Involvement can be defined as the extent to which the attitudinal issue under consideration is of personal importance (Petty & Cacioppo, 1979). Involvement has been an important concept in studying advertising effectiveness (Petty & Cacioppo, 1986), as marketers can segment markets according to individuals’ involvement with an issue. However, previous research investigating the role of involvement on message sidedness’ effects has delivered mixed results. For instance, Chebat and Picard (1985) found a significant interaction effect between issue involvement and message sidedness (one- versus two-sided). Two-sided messages were more effective for strongly involved individuals, but not for weakly involved individuals (Chebat & Picard, 1985). Similar results were obtained by Hastak and Park (1990). Yet, to our knowledge, the impact of issue involvement has not been tested concerning the (non)refutational character of two-sided messages. It is important to fill this research void, because involvement can influence processing depth (Eisend, 2007). Individuals differing in involvement tend to process information differently (Petty & Cacioppo, 1986), which, in his turn, could influence the impact of different message formats, such as the presence or absence of a refutational statement in a two-sided message.

When issue involvement, and thus personal relevance, is weak, message processing is rather limited (Hastak & Park, 1990). Individuals who are weakly involved with the issue will be less motivated to process the message about that issue, resulting in little or no impact of different message formats. Therefore, in line with previous empirical studies (e.g., Chebat & Picard, 1985), we only expect to find an effect of message sidedness when issue involvement is sufficiently strong.

When individuals’ issue involvement is strong, the two-sided nature of the message is more likely to be influential (Hastak & Park, 1990). Strong involvement is necessary to motivate an individual to evaluate different message arguments (Gotlieb & Sarel, 1991). Furthermore, strong involvement enhances the importance of message content in persuasion (Chebat & Picard, 1985; Petty & Cacioppo, 1979). For instance, Leippe and Elkin (1987) found that strong issue involvement encourages sensitivity to how well message arguments concur with personal standards and opinions. We therefore expect that, for strongly involved individuals, two-sided messages will be more effective in generating resistance to counterpersuasion (i.e., peer pressure) than one-sided ones, as two-sided messages offer a more nuanced view that might better represent their knowledge about the positive and negative aspects of the issue.

The positive impact of two-sided messages is expected regardless of whether the argument is refuted or not, as both subtypes of two-sided messages offer pro and contra arguments about the issue. Ahn et al. (2011) suggest the mere mentioning of positive (pro drinking) arguments can be sufficient to make the recipients realize that the benefits do not outweigh the negative consequences. In other words, refuting the opposing argument will be relatively easy to do themselves. Hence, to the strongly involved, refutation within the message itself might be unnecessary and is expected not to make a difference in terms of inoculating them against counterpersuasion (peer pressure) afterward. We therefore expect an equally beneficial effect on strongly involved subjects’ binge drinking intentions following exposure to peer pressure for a two-sided non-refutational and a two-sided refutational message.

Hypothesis 1a (H1a): For weakly issue-involved adolescents, message sidedness does not affect binge drinking intentions.

Hypothesis 1b (H1b): Strongly issue-involved individuals show lower binge drinking intentions following exposure to a two-sided message compared with a one-sided message.

Hypothesis 1c (H1c): For strongly issue-involved individuals, an additional refutational statement in the two-sided message will not impact binge drinking intentions.

Method

Design and Stimuli

To test the hypotheses, we set up a between-subjects factorial experimental design, in which one factor was manipulated on three levels (one-sided vs. two-sided non-refutational vs. two-sided refutational). Issue involvement was measured and subsequently dichotomized into two levels (weak vs. strong involvement with binge drinking). The criterion we used to dichotomize involvement was the median. A median split has some important advantages over other methods of dichotomizing variables (such as, for instance, conducting an extreme split in which the less outspoken “middle group” around the median is left out of the analyses). The median split method allows us to use all data (whereas, with some other approaches, part of the sample can be lost). Second, in reality, not many people have an extremely outspoken score on involvement. Using an extreme split would therefore not enhance the external validity. Hence our choice for a median split.

Respondents’ involvement with the issue of binge drinking was measured prior to the exposure to the experimental stimuli and completing the questionnaire. Message sidedness and refutation were manipulated into three different messages, as follows: (a) the one-sided message contained one argument against binge drinking, that is, “Because of binge drinking, Thomas, 16 years old, got alcohol poisoning”; (b) the two-sided non-refutational message used the same anti-binge drinking argument, but also added one argument in favor of binge drinking, that is, “Thanks to the alcohol, he was very popular that night”; (c) the two-sided refutational message contained the same contra and pro arguments, but refuted the pro binge drinking argument by means of a refutation statement, that is, “But how important is popularity in the end?”. The anti-binge drinking messages used in the current study contain emotional, social arguments, as previous studies have shown that adolescents consume alcohol chiefly for social motives (e.g., Wicki, Kuntsche, & Gmel, 2010).

The peer pressure (as a form of counterpersuasion) was conceptualized as a printed online chat conversation between two peers, slightly older than the participants in the experiment (i.e., aspiration group). In this virtual chat conversation, the teenagers talk to each other about how much fun their last night out was, thanks to binge drinking. They explicitly promoted binge drinking in a very informal way (e.g., “Last night was awesome!! So much booze! Binge drinking is so cool, you gotta do it!!”). To test whether the chat conversation was indeed perceived as being “in favor of binge drinking,” we conducted a pretest (cf. infra).

Pretests

The three experimental stimuli were pretested between subjects among 60 respondents. For message sidedness and refutation, the same measurement scales as in the main study were used (see hereafter). The results show that the respondents rated the two-sided messages (M = 5.97) as more two-sided than the one-sided message on a 7-point semantic differential scale (M = 1.30), t(58) = 17.19, p < .001. The two-sided refutational message (M = 5.95) scored significantly higher on the 7-point refutation scale than the two-sided non-refutational message (M = 2.45), t(38) = 7.73, p < .001. In addition, the pro binge drinking peer pressure message was pretested among 15 respondents, indicating that the direction of the peer pressure message was very pro binge drinking (M = 6.40, SD = 1.12) on a 7-point semantic differential scale (i.e., “The chat conversation is against vs. in favor of binge drinking”). The results of this pretest show that the chat conversation is indeed perceived as very pro binge drinking.

Participants and Procedures

The data for the main study were collected from 185 participants by means of a printed questionnaire in two secondary schools in Flanders, Belgium. The sample consisted of 67.6% females, and the age range was 15 to 19 years (M_age = 16.49, SD = .82). The study focuses on adolescents because the prevalence of binge drinking is high within this target group. After a short introductory briefing to the study, and on the participants’ agreement to participate, the participants were gathered in a classroom under supervision. First, each participant’s involvement with the issue of binge drinking was measured. Next, the participants were randomly assigned to one of the three experimental conditions. Subsequently, they were exposed to the peer pressure (i.e., the virtual chat conversation promoting binge drinking). Finally, they completed the questionnaire containing measures for behavioral intentions to binge drink. They were debriefed and thanked for their cooperation.

Measures

In line with previous studies (e.g., Eisend, 2006), the manipulation check variable message sidedness was measured by means of one single item on a 7-point semantic differential scale (“This message only gives an argument against binge drinking” vs. “This message gives an argument against binge drinking, but also considers an argument in favor of binge drinking”). The manipulation check variable refutation of the message arguments was measured by one single item on a 7-point Likert-type scale (“The argument in favor of binge drinking was subsequently refuted in the message”). The moderator variable involvement with binge drinking was measured by five items on a 7-point Likert-type scale (Beatty & Talpade, 1994; that is, “The issue of binge drinking is very important to me,” “In general, I have a strong interest in binge drinking,” “Binge drinking matters a lot to me,” “I get bored when other people talk to me about binge drinking [reversed item]”, “binge drinking is very relevant to me”; α = .82). The outcome variable behavioral intentions to binge drink were assessed by three bipolar items on a 7-point scale (Zhang & Buda, 1999; that is, “The chances that I will binge drink are improbable vs. probable,” “unlikely vs. likely”, “impossible vs. possible”; α = .96). Information on the distribution of our main variables (i.e., involvement and binge drinking intentions) can be found in the appendix. The concept of “involvement” differs from “binge drinking intentions” in multiple ways. First of all, respondents’ involvement with binge drinking is measured as an independent variable (i.e., prior to exposure to the actual experimental stimuli) and thus, is not influenced by the experimental manipulation. Binge drinking intentions, on the other hand, were measured as a dependent variable, that is, after exposure to the experimental stimuli. Second, involvement refers to the degree to which individuals are interested in the phenomenon of binge drinking, not per se having the intention to binge drink themselves. Although strongly involved teenagers are indeed often also the ones who are most at risk of binge drinking, the concept of involvement cannot automatically be considered as identical to binge drinking intentions. For instance, a teenager could give very limited thought to the idea of binge drinking, and not really be “interested” in the phenomenon, but still have greater intentions to binge drink than a teenager who does have a strong interest in binge drinking. Hence, both concepts are different, theoretically as well as in terms of their role (independent vs. dependent variable) in the current study.

Results

Manipulation Checks

The manipulation checks revealed that the two-sided messages (M = 4.56) were perceived as more two-sided than the one-sided message (M = 1.95, t(183) = 10.29, p < .001. The two-sided refutational message (M = 4.76) was considered more refutational than the two-sided non-refutational message (M = 3.68), t(119) = 3.09, p < .001. The pro binge drinking peer pressure message was rated as very pro binge drinking (M = 6.28, SD = 1.22).

Test of the Hypotheses

The hypotheses were tested by means of a two-way analysis of variance (ANOVA). The results showed a significant interaction effect between message sidedness and involvement with binge drinking on binge drinking intentions, F(2, 178) = 5.99, p = .003 (see Figure 1). Simple effect tests showed that, when adolescents’ involvement with binge drinking was weak, their binge drinking intentions were not significantly different (i.e., equally low) for a one-sided (M = 1.59), a two-sided non-refutational (M = 1.72), and a two-sided refutational (M = 1.84) message, t(72) = .41, p = .69, t(70) = .49, p = .63, and t(74) = 1.19, p = .24. These results support H1a.

Figure 1.

The interaction effect between message sidedness and involvement with binge drinking on binge drinking intentions after exposure to peer pressure.

When adolescents’ involvement with binge drinking was strong, a two-sided non-refutational message (M = 2.58) and a two-sided refutational message (M = 2.76) both resulted in significantly lower binge drinking intentions than a one-sided message (M = 4.12), t(49) = 2.67, p = .01 and t(46) = 2.35, p = .02. This confirms H1b.

As expected, for strongly issue-involved individuals, no significant difference in binge drinking intentions following exposure to a refutational (M = 2.76) or a non-refutational (M = 2.59) two-sided message was found, t(45) = .32, p = .75, supporting H1c.

In addition, we addressed possible confounding factors such as age or gender. When including gender as a covariate in the analysis, we found the same results, F(2, 177) = 5.96, p = .003, in the same direction, indicating the absence of a confounding effect of gender.

Similarly, when repeating the analysis including age as a covariate, we obtained the same results, F(2, 177) = 5.70, p = .004, in the same direction, indicating the absence of a confounding effect of age.

In addition, to test if there is a relation between gender and involvement with binge drinking, and between gender and binge drinking intentions, we conducted two separate t tests with gender as the independent variable, and involvement with binge drinking and binge drinking intentions each as a dependent variable. The results showed that there is no significant effect of gender on involvement with binge drinking, t(183) = 2.197, p = .054, and no significant effect of gender on binge drinking intentions, t(182) = 1.49, p = .138. Therefore, in combination with the covariate test (cf. supra), we can conclude that the distribution of gender does not have a confounding effect on the results of our study.

Discussion

In a commercial context, empirical studies produced mixed results regarding the impact of two-sided messages on behavioral intentions (Crowley & Hoyer, 1994; Eisend, 2006). In the present health risk prevention context, we found that behavioral intentions to indulge in binge drinking after exposure to peer pressure are significantly influenced by message sidedness, but only when subjects’ issue involvement is sufficiently strong. When involvement with binge drinking is weak, subjects’ binge drinking intentions after peer pressure are low, irrespective of the type of communication. If an individual is weakly involved with binge drinking, he or she will put less effort in processing a message about binge drinking, simply because they do not care about it. As a result, they are not affected by any message at all. So regardless of the message sidedness, they remain disinterested in binge drinking. However, adolescents who are strongly involved with binge drinking are more open to persuasive influence: They express lower binge drinking intentions after peer pressure when they were previously exposed to a two-sided (refutational or non-refutational) anti-binge drinking message instead of a one-sided anti-binge drinking message. No different effect for a refutational and a non-refutational two-sided message was found. Following the inoculation theory (McGuire, 1961), one would expect a two-sided refutational message to be more effective in bolstering individuals against peer pressure, as the refutation statement in the message would serve as a bolstering mechanism. On the other hand, ample empirical studies show that refutation is not always necessary (e.g., Golden & Alpert, 1987; Kamins & Assael, 1987; Smith & Hunt, 1978). In other words, two-sidedness as such can be persuasive, regardless of whether the two-sided argument was subsequently refuted in the message or not. The results of the present study demonstrate the moderating role of issue involvement: In the case of strongly issue-involved individuals, refutation in the message has no impact, as long as the message is two-sided instead of one-sided. Two-sided messages offer a more nuanced view on the issue, by recognizing that an individual may experience positive and negative precursors and consequences of risky behavior (Dworkin, 2005). Hence, in our study, we aim to avoid a one-sided, negative-only approach of risky behavior, by also acknowledging the perceived arguments in favor of the risky behavior. This two-sided, more nuanced approach is likely to be more appreciated by strongly issue-involved individuals, as involvement encourages sensitivity to how well message arguments concur with personal standards and opinions (Leippe & Elkin, 1987). As strongly issue-involved individuals are expected to have elaborated on the pros and cons of binge drinking before, refutation does not add any relevant argument they did not consider before. Hence, a refutation statement within the message might be redundant in this case, as the mere two-sidedness of the message drives the effect. This finding aligns with the suggestions made by Ahn et al. (2011), in that public service announcements (PSAs) disclosing the positive aspects of drinking (alongside the negative ones) could help adolescents to relate these situations to their own life, and understand that the benefits of excessive drinking are negligible compared with the negative consequences (Ahn et al., 2011). However, Ahn et al. (2011) did not actually test this assumption. Our study goes beyond prior research (e.g., Ahn et al., 2011) by testing the effectiveness of different two-sided message formats in an experimental setting. Moreover, our study includes a moderating variable (i.e., issue involvement) that has been put forward by previous research, but has not been actually tested yet.

Besides our main analyses testing our hypotheses, we verified our results for a possible confounding influence of gender. The results of this additional test showed that the distribution of gender in our sample did not influence the effects of our study. In other words, no confounding effect due to gender was found. Furthermore, we tested whether there was a correlation between gender and binge drinking intentions in our sample. The results of this correlation analysis showed that—in our sample—gender was not correlated with binge drinking intentions. Therefore, we conclude that gender was not a confounding factor in this study. This finding, however, does not align with most previous research on binge drinking, which has often indicated a relation between binge drinking and gender. We acknowledge that ample research identifies gender differences regarding binge drinking behaviors (Holmila & Raitasalo, 2005). Yet, in our study, these gender differences were not found.

Theoretical Contributions

The present study contributes to the health risk prevention literature, as well as to the research stream on message sidedness. First of all, this study offers valuable new theoretical insights into health risk prevention strategies, as it proposes an alternative way of communicating health risks. While, to date, most health campaigns consisted of one-sided appeals, we demonstrate that two-sided messages can be more effective in terms of health risk prevention. More specifically, when the aim is to increase individuals’ resistance to counterpersuasion (which was operationalized in the form of peer pressure), two-sided messages prove to be more effective than one-sided messages.

Second, this study contributes to the existing theoretical framework on two-sided messages in two different ways. One the one hand, the present study goes beyond most prior message sidedness studies by incorporating refutational appeals as well. So far, a relatively limited amount of commercial studies in two-sided persuasion research incorporate refutational appeals (e.g., Etgar & Goodwin, 1982; Kamins & Assael, 1987). Our study fills this research void by comparing the three types of messages sidedness, that are, one-sided, two-sided non-refutational, and two-sided refutational. On the other hand, our study contributes to message sidedness theory by assessing the moderating impact of issue involvement. Issue involvement has been suggested by previous literature (Eisend, 2006, 2007) as a potentially important moderator of message sidedness’ effects, but has not been investigated so far. Hence, our study provides new insights into the moderating role of issue involvement on the effectiveness of message sidedness.

Implications for Health Practitioners

The present study provides useful insights for health practitioners who develop campaigns to prevent binge drinking (or other health risk behavior) among adolescents. First of all, this study has broadened the spectrum of communication strategies available for public health communication. By applying a communication strategy previously mainly associated with commercial product marketing (i.e., two-sided messages) new possibilities are created for the social marketing domain.

In summary, the results of this study recommend the use of two-sided messages in campaigns aimed at preventing binge drinking among adolescents, especially strongly issue-involved adolescents, when they have previously been exposed to peer pressure. Two-sided messages (with or without refutation) are effective in inoculating strongly issue-involved adolescents against peer pressure later on. This is relevant given the high chances that adolescents are, in reality, confronted with peer pressure trying to convince them to binge drink. Moreover, strongly issue-involved subjects are the main target group for substance abuse prevention programs, as greater involvement with one substance (e.g., alcohol) is generally associated with greater involvement in another substance (e.g., smoking; Johnson, Boles, Vaughan, & Kleber, 2000). Compared with the traditional one-sided (negative-only) anti-binge drinking messages, two-sided anti-binge drinking messages generate lower binge drinking intentions among this target group, regardless of whether the pro binge drinking argument was refuted in the message or not.

Personalization and targeting of anti-drinking interventions can increase the interventions’ effectiveness (Craigs, Bewick, Gill, O’May, & Radley, 2011). Health practitioners should therefore obtain profound knowledge of the target group (i.e., to what extent they are involved with the issue), as strongly issue-involved adolescents require a two-sided approach. Hence, qualitative pre-research can help health practitioners to gain the necessary insights prior to the actual message design, to create optimal resistance against possible peer pressure later on.

Further Research

In line with previous studies assessing refutational and non-refutational two-sided messages (e.g., Kamins & Assael, 1987), this study did not find a different effect for both subtypes of two-sided messages when including issue involvement as a moderator. Perhaps, when including other moderating variables (e.g., prior knowledge of the issue) and/or different situational contexts (e.g., induced central versus peripheral processing), different results might be found between both subtypes of two-sided messages.

Further studies could also consider different issues when investigating the effect of two-sided non-refutational versus two-sided refutational messages. Binge drinking is not a very ambivalent issue in that most people would consider it as undesirable behavior. Consequently, the issue of binge drinking has relatively weak pro arguments (“cool”) compared with the (strong) contra arguments (“alcohol poisoning”). When the opposing argument (i.e., the pro binge drinking argument) is considerably weak, it might be more easily mentally refuted by the recipients themselves. For a more ambivalent topic (e.g., the use of antibiotics)—which is inherently more “dual” because it is characterized by stronger pro and contra arguments—a difference between the two-sided non-refutational and the two-sided refutational message could be expected, as it might be more difficult for subjects to mentally refute the argument themselves. Hence, in the case of more ambivalent issues, the presence of a refutational statement within the message might be necessary.

A limitation of this study is that the counterpersuasion (i.e., the peer pressure stimulus) was constant for all participants. Further research should manipulate counterpersuasion as an experimental treatment to compare the effects of two-sided messages for conditions with versus without counterpersuasion.

Another limitation of this study is that subjects’ cognitions and counterargumentations after exposure to a two-sided message were not measured. McGuire’s inoculation theory (1961) states that two-sided refutational messages reduce the amount of counterarguments and strengthen cognitions. Future research could also measure these cognitions and counterarguments to study the cognitive processing of different types of one- and two-sided messages more in depth.

Furthermore, another limitation of this study is the fact that, in general, individuals’ involvement with the issue of binge drinking is relatively low. Therefore, it could be argued that our labels of “weak” and “strong” involvement are rather “not at all” versus “a little bit” involved, respectively. The general low level of involvement with binge drinking could be explained by the nature of the issue itself: Binge drinking is a relatively univalent negative issue, in that not many individuals hold positive attitudes toward the issue, and not many individuals are strongly involved with it. Perhaps, for more ambivalent issues, more variation in issue involvement could be observed and the effect of involvement could be studied in more detail.

We acknowledge that our manipulation of peer pressure could have been stronger by using the participants’ actual peers (i.e., their real friends instead of two teenagers they do not personally know), but this was not feasible for several reasons. First of all, it would be unethical to expose teenagers to very strong peer pressure for the sake of an experiment. Second of all, it is practically unfeasible to force real teenagers (i.e., friends of the participants) to “act” peer pressure. This would seem unrealistic, which would hamper the external validity of our study. However—in addition to the manipulation check we conducted on the manipulation of peer pressure in the present study—further research could also measure the perceived strength of the peer pressure, and perhaps, compare different levels of strength in peer pressure.

A final suggestion for further research is to offer alternative behavior when discouraging certain risky behavior through two-sided messages. Although two-sided messages acknowledge the perceived pro arguments alongside the con arguments, they omit to propose an alternative behavior that might offer equal benefits to the target group, while—at the same time—having less or no dire effects. For instance, instead of merely discouraging binge drinking, it might be more beneficial to offer an alternative behavior, such as moderate alcohol consumption. This way, the target group is provided with a useful alternative that circumvents the dangerous aspects of the unwanted behavior, while still offering the positive aspects of alcohol consumption (e.g., experimentation, maturation, etc.). Further research could also investigate the effectiveness of promoting alternative behaviors in two-sided messages. According to the theory of alternative behavior (Jaccard, 1981), attitude changes are optimal when alternatives are given for the discouraged behavior. This can be linked with the efficacy aspect in threat appeal literature (Witte, 1992). Traditionally, a threat appeal consists of a threatening message combined with a relief aspect, which is a solution or recommended behavior to deal with the threat. Thus, offering alternative behavior might help individuals to actually change their behavior while not making them feel as if they “missed” something.

End Conclusion

In sum, this study found the beneficiary impact of two-sided messages over one-sided messages in terms of bolstering adolescents’ binge drinking intentions against peer pressure. This effect was only found for strongly issue-involved adolescents. Weakly issue-involved adolescents have low intentions to binge drink, irrespective of the type of communication used. For strongly issue-involved adolescents, two-sided messages lead to significantly lower binge drinking intentions after peer pressure than one-sided messages. No different effect was found due to refutation of the pro binge drinking argument. Hence, both subtypes of two-sided messages (refutational as well as non-refutational) are equally effective in generating low binge drinking intentions among strongly involved adolescents who were confronted with peer pressure.

Footnotes

Appendix

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Erlinde Cornelis is a PhD student at the Department of Communication Sciences at Ghent University (Belgium). She obtained her master’s degree in communication sciences–communication management with the greatest distinction at Ghent University. Her research focuses on the effectiveness of two-sided messages for nonprofit communication, such as health and science issues.

Veroline Cauberghe is a professor of marketing communications at the Department of Communication Sciences at Ghent University (Belgium). She obtained her master’s degree at the University of Antwerp (Belgium). Her research interests are the effectiveness of new advertising formats, social marketing, health communication, and crisis communication.

Patrick De Pelsmacker is a professor of marketing at the University of Antwerp and Ghent University (Belgium) where he teaches marketing research, marketing communications, and consumer behavior. His research interests relate to advertising effectiveness, advertising in new media and new formats, ethical consumer behavior, and social marketing.

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