Social marketing defined by Kotler: “Social marketing is the use of marketing principles and techniques to influence a target audience to voluntarily accept, reject, modify or abandon a behavior for the benefit of individuals, groups, or society as a whole. Since Kotler created this definition more than 25 years ago, it has been associated with selling a new and “better” behavior and the competition has been the current or preferred behavior of the target market. An aberration to this concept was noted in this week’s edition of the Economist in an article about Vancouver’s struggle with its swelling drug problem.
During the past decade, Vancouverites have lived with open drug dealing on their streets, deaths from drug overdoses, and disease spread from dirty syringes. All types of crime associated with drug dealing have been on the rise. In the past we have seen social marketing campaigns based on the premise of “Just say NO to drugs”. Remember the “This is your brain on drugs” with the woman swinging an iron skillet filled with scrambled eggs? As most of us in the health care field have experienced, this message carries little credence. Five years ago the Vancouver city council adopted a “four pillars” strategy which included harm reduction, prevention, treatment, and enforcement. This has led to a more lenient European-style approach to their city’s drug problem. Since then, two programs unique to North America have been started: a safe injection site for heroin addicts where nurses are instructing intravenous drug users on the proper usage of IV needles and a clinic prescribing free heroin to hard core addicts. The people promoting these programs hope to see a decrease in blood borne diseases like HIV and hepatitis, a decrease in overdoses, and a decrease in public drug use and problems stemming from discarded needles. There are supervised injection sites (SISs) in 27 cities around the world where there has been a documented reduction in the aforementioned problems.
Traditionally, social marketing has tried to “sell” healthy behavior. It starts out by conducting research and then segmenting the audience into groups with common risk behaviors, motivations, and information channel preferences. Then, attractive intervention strategies are designed, informed by the “4 Ps” of marketing – product, price, place, promotion. We can look at SISs in this framework. The product: heroin, probably a cleaner more consistent product than what is found on the streets. This is probably the main difference from the traditional social marketing product which has been a behavior. Price: you can’t beat the price, free. This may help decrease the crime related to drug use. Place: a clinic where clean needles are provided and nurses that teach you how to use them properly. Promotion: my guess is from word of mouth. Although this version of social marketing may not be what Philip Kotler had in mind, it may work better than the previous efforts when it comes to treating public health problems associated with intravenous drug use.