Harvard Alcohol Project

driverLaunched in 1988, the Harvard Alcohol Project sought to demonstrate how a new social concept, the “designated driver,” could be rapidly diffused through American society via mass communication, catalyzing a fundamental shift in social norms relating to driving-after-drinking. Such a shift was essential for curbing alcohol-related traffic fatalities, the leading cause of death among young adults aged 15-24. Through this Project, the Center became the architect of the “designated driver” campaign in the United States, importing the concept from Scandinavia.

The Harvard Alcohol Project represented a genuine breakthrough for public health. It marked the first time that a health institution joined forces with the communications industry on a project of this magnitude. All major Hollywood studios participated along with the ABC, CBS, and NBC television networks. Channels, a respected trade journal, called the extent of this industry involvement “unparalleled,” and The New York Times lauded the initiative in an editorial.

The Project broke important new ground when TV writers agreed to insert drunk driving prevention messages, including references to designated drivers, into scripts of top-rated television programs, such as “Cheers,” “L.A. Law,” and “The Cosby Show.” Entertainment not only mirrors social reality, but also helps shape it by depicting what constitutes popular opinion, by influencing people’s perceptions of the roles and behaviors that are appropriate to members of a culture, and by modeling specific behaviors. The strength of this approach is that short messages, embedded within dialogue, are casually presented by characters who serve as role models within a dramatic context, facilitating social learning. The Project’s strategy was strongly endorsed in a unanimous resolution of the board of directors of the Writers Guild of America, West. Harvard served as catalyst and information source; television writers retained full creative control. Prior to the Center’s work, no one had successfully organized the creative community for such a large-scale effort. Over a four-year period, more than 160 prime-time programs incorporated sub-plots, scenes, and dialogue on the subject, including frequent references to the use of the designated driver.

At Harvard’s request, ABC, CBS, and NBC also aired frequent public service announcements (PSAs) during prime time encouraging the use of designated drivers. This was the first time that the three networks produced and sponsored simultaneous campaigns with the same message. The Center’s public relations activities further reinforced the campaign, generating extensive news coverage.

The Project received extensive national attention, including a special report on “ABC’s World News Tonight with Peter Jennings” and a front-page article in The New York Times. Another significant aspect of the Project was its cost-effectiveness. According to industry estimates, the Project received over $100 million annually in network air time, utilizing under $300,000 in annual grants.

The designated driver campaign soon became transformed into a national movement as a broad range of prominent individuals (e.g., President George Bush, President Bill Clinton, former Surgeon General C. Everett Koop); government agencies (e.g., the National Highway Traffic Safety Administration, the federal Center for Substance Abuse Prevention); national organizations and advocacy groups (e.g., Mothers Against Drunk Driving); professional sports leagues (e.g., Major League Baseball, National Basketball Association); major corporations (e.g., State Farm Insurance); leading police departments; and brewers and distillers endorsed and promoted the designated driver concept.

“Designated driver” became a household phrase in the U.S. to such an extent that the term appeared in the 1991 Random House Webster’s College Dictionary. Public opinion polls documented the rapid, wide acceptance and strong popularity of the designated driver concept. According to the Roper Poll, the proportion of Americans serving as a designated driver reached 37% in 1991. Among Americans under the age of 30, 52% had actually been a designated driver. Among frequent drinkers, 54% had been driven home by a designated driver. The Wirthlin Group reported that nearly 9 out of 10 respondents in the country were familiar with the designated driver program and they gave it a favorability rating of 81 on a 100-point scale; the designated driver program rated higher than all other programs or industries rated.

In June 1993, the U.S. Center for Substance Abuse Prevention joined with the National Highway Traffic Safety Administration to issue an official policy statement endorsing the designated driver concept within a comprehensive framework for addressing alcohol-related problems. The agencies’ Statement on Designated Drivers observed, “By encouraging drivers to remain alcohol-free, the designated driver [concept] both promotes a social norm of not mixing alcohol with driving and fosters the legitimacy of the non-drinking role. Moreover, the concept of no alcohol for the driver is more stringent than current state driving under the influence (DUI) laws permitting some alcohol for drivers.” The joint statement stressed the need to promote moderation for the driver’s companions, and concluded as follows: “Policy: The use of designated drivers by the public and designated driver programs by servers of alcoholic beverages is encouraged for those over age 21.”

By 1998, according to the Roper Poll, a majority of adults who drink had served as a designated driver and/or been driven home by one. Among frequent drinkers who consumed five or more drinks in the past seven days, 62% had served as a designated driver and/or been driven home by one. The following is a breakdown of usage of the concept among adults who ever drink and among frequent drinkers:

Percentage of people surveyed who have been a designated driver and/or been driven home by one

Ever Drinkers Frequent Drinkers
Total 53% 62%
Men 55% 63%
Women 52% 61%
Adults aged 18-29 64% 65%
Adults aged 30-44 60% 67%
Adults aged 45-59 48% 62%
Adults aged 60+ 29% 43%
Executives/Professionals 60% 70%
White collar workers 58% 66%
Blue collar workers 55% 63%
Influentials * 66% 75%

* First identified by Roper in the early 1940s, the Influential Americans are the opinion leaders of society, the approximately ten percent of the U.S. population who are most active in the affairs of their communities and the nation.

Source:Roper Starch Worldwide Inc., Roper Reports 98-3, 1998. Results of a survey conducted in March 1998 of 2,009 Americans aged 18 years and older.

What was the Campaign’s impact on alcohol-related traffic fatalities?

When the Campaign began in late 1988, annual fatalities stood at 23,626. By 1992, annual fatalities had dropped sharply to 17,858. This represented a four-year decline of 24%, compared to 0% change in the three years just prior to the Campaign. By 1994, annual fatalities reached a low of 16,580 (a six-year decline of 30%), before leveling off. Using 1988 as a baseline, more than 50,000 lives had been saved by the end of 1998. A variety of factors have been responsible for this striking progress, including intensive publicity, new laws, and strict enforcement. Based on the extensive polling data presented above, the Center concludes that the designated driver campaign made an important contribution to the sharp downward trend in alcohol-related traffic fatalities.

The Harvard Alcohol Project, the first successful, large-scale effort to use dialogue in network entertainment as a health promotion “technology,” stimulated similar efforts by others. The New York Times reported that senior television executives “embraced Winsten’s concept of sending a message through their medium” to create a highly successful environmental project. Harvard’s work, the Times said, also “paved the way for anti-drug messages in Hollywood.”