PERCEPTION OR REALITY?

Palo Alto's New Anti-Drug Campaign Wants to Show That "Everyone Is Not
Doing It," but Is It Putting Rose-Colored Glasses on a Community Problem?

Palo Alto teen Raquel Lara doesn't drink.

"But I know a lot of my friends do," Raquel, a junior at Gunn High
School, said.

During a recent afternoon, Raquel briefly studied new student survey
results on substance abuse in Palo Alto and saw that no, not everyone
in Palo Alto is doing it. She learned that more than 90 percent of
Gunn students reported not drinking alcohol in a typical week.
Three-quarters said they don't in a typical month.

"It's pretty surprising," Raquel said.

That "Ah-ha!" moment is exactly what a committee of local parents,
school administrators and health experts is hoping for when students
and parents ponder the newly released data. In fact, the Community
Drug and Alcohol Committee hired a Montana consultant, "Most of Us,"
to create a local marketing campaign to challenge student perceptions
of peer drug use.

But is the survey giving local teens accurate information?

Some drug policy experts question whether such survey data can be
trusted, since it asked teens to essentially admit illegal behavior.
Also, the answers to some questions aren't being reported because they
don't fit the group's intended message. And a Harvard study published
last year found that similar programs on college campuses were
ineffective.

The task force plans to use the survey's results to implement a
debated method for reducing drug and alcohol use among teens, at a
total cost of more than $50,000.

Much of the money comes from the Palo Alto Medical Foundation and the
PTA. The Palo Alto Weekly's Holiday Fund also contributed $5,000
towards the project.

The theory behind the controversial technique -- known as social
norming -- goes like this: Most teens misperceive how often their
peers use drugs and alcohol. That view is one of the biggest factors
influencing kids' decisions to drink or use drugs. Change the belief,
through a carefully designed multimedia campaign, and you change the
behavior.

"Misperceptions can actually suppress positive behaviors," said Becky
Beacom, the manager of health education with the Palo Alto Medical
Foundation, who is spearheading the campaign.

The point is to transform the language that the entire Palo Alto
community uses when discussing teens and drugs to remove the myth that
it is normal to try drugs and alcohol.

"We're looking to, in effect, change a culture," said Deborah Kurland,
an activist mother of three who works on the committee.

The 37-question survey was administered in February to every Palo Alto
middle and high school student. Taken in school over the Internet, it
took approximately 15 minutes for students to complete.

Questions ranged from how often kids smoked and used drugs to their
thoughts on drug and alcohol use. They were also polled on how they
thought "most" other students behaved and thought, to measure their
perceptions (see sidebar).

Students were promised anonymity. At most schools, at least 70 percent
of students chose to take the survey, even though they had the option
not to. Terman Middle School was the exception -- only 53 percent of
students took the survey.

The overall non-response rate raises questions about how statistically
representational the responses are, but the school's consultant
insists the data should be trusted.

"We don't know who is opting out," but the numbers closely match
national averages, said Jeffrey Linkenbach, the director of the "Most
of Us" Montana Social Norms Project, based at Montana State University.

The results show that a majority of Palo Alto students said they don't
smoke, use drugs or regularly drink.

Approximately 80 percent of high school students said they never used
tobacco. According to the statistics, more than 70 percent have not
smoked marijuana. More than 90 percent said they don't drink alcohol
in a typical week. More than 70 percent said they don't drink in a
typical month.

Those numbers are even higher for middle school students. More than 96
percent said they never smoked marijuana. Approximately 96 percent
said they haven't used tobacco. More than 94 percent said they don't
drink alcohol in a typical month.

Of course, that's just one way to look at the numbers.

It would also be fair to say out of approximately 3,300 high school
students:

*Nearly 1,000 high school students have used marijuana (more than 30
percent);

*More than 900 drink in a typical month (approximately 30
percent);

*Approximately 700 have used tobacco (approximately 20 percent);
and

*Around 200 have used cocaine (around 5 percent).

As for middle school students, the numbers show that more than 700
students -- out of approximately 2,300 -- have consumed alcohol (more
than 30 percent), and approximately 150 (approximately 6 percent) have
used over-the-counter medicines "for the purposes of getting high."

Plus, the answers to some questions are being withheld because they
don't jibe with the "positive" message the committee hopes to
disseminate in Palo Alto. For instance, high school students were
asked if they had ever consumed alcohol, but that percentage was not
noted in the consultant's report. It's likely that number is above 50
percent, showing that most Palo Alto high school students have taken a
drink.

Also, the numbers are not broken down by grade level. National
statistics consistently demonstrate that the older students are, the
more likely they are to use drugs and alcohol.

So while only 25 percent of the student body of Paly might drink
monthly and only 31 percent of high school students have tried
marijuana, by the end of senior year, both numbers are likely to be
more than 50 percent.

The anti-drug committee would rather the community -- and the media --
accentuate the positive numbers since that's the point of its coming
marketing campaign.

"The purpose of this was not to do a reporting out of data. We got the
data to do the certain thing and that's a social-norms approach ..
because that's the thing that's supposed to work," Beacom said.

For instance, rather than stating that more than 30 percent of Palo
Alto High School kids have tried marijuana, the anti-drug group will
point out that 69 percent haven't.

The message is already getting out. A new poster at Palo Alto High
School, designed by students using the survey's numbers, proclaims
that nine out of 10 Palo Alto High School students don't drink in a
typical week. The headline announces, "This is who we REALLY are." The
poster features a photo of a teenage girl's bare navel with a ringed
finger across it. (At a recent committee meeting, Paly Principal
Sandra Pearson joked that because of the picture, no one would read
the text.)

In addition to posters, daily video announcements and class projects
will be built around the survey results.

Students who've seen the numbers, however, doubt their
validity.

"We had a debate about that at lunch, and everybody thought it seemed
a little low," Paly junior Johanna Kenrick said. "But maybe people
talk about drinking more then they do [actually drink]."

Even some police officers are wary of the numbers. Palo Alto Detective
Wayne Benitez, who has been running a campaign to fight kids' abuse of
over-the-counter drugs (see sidebar), felt the results underestimated
high school use of such drugs. "I thought it would be higher," he said.

Committee members say that doubt reinforces the need for the project,
since the point is to correct misperceptions. "It's good news, at the
same time it reveals we have something to deal with," Beacom said.

After they see the figures, kids are freed up to be themselves, Beacom
said. "The kids that don't use drugs and alcohol will be bolstered,
knowing that they're not geeks, they're the norms," she said.

Palo Alto school administrators said that the numbers appear
accurate.

"It fits the perspective of the administration -- of what we see and
what we hear about," Gunn High School Principal Scott Laurence said.

But is the group worried that the numbers will fuel denial -- that a
parent whose kid is an alcoholic, for instance, will see the data and
think, "90 percent of kids don't drink; My kid must not"?

"I think it will be the opposite, actually," said Philippe Rey, the
associate director of Adolescent Counseling Services, which has drug
analysts available to Palo Alto students at school.

"If you, as a parent, know that your kid is having a problem but you
believe that 90 percent of kids have a problem, you may tend to say,
'Oh, it's part of being a teen, we won't look into that, he doesn't
need treatment."

But if a parent sees that his or her kid "is the only one having a
problem," he or she will think, "'I better wake up,'" Rey added.

The committee's parent leaders also believe the data -- and the new
way of expressing their results -- can be used to encourage kids to do
more productive things with their time.

"It's another tool in your toolkit," PTA President Kate Hill said. "If
your child says to you, 'I can't go to the dance because everyone who
goes to the dance is drunk,' you can say, 'Actually the statistics
don't bear that out. Go to the dance and have a good time.'"

Next year, the committee will resurvey the students, hoping to find a
decrease in the perception about the amount of drug and alcohol use,
like other schools have found. The committee hopes that perception
change will alter drug use.

Although it has created a buzz in academic circles, social norming has
also become extremely controversial.

In a widely reported 2003 study, Harvard researchers examined more
than 60 colleges and found that similar programs had no effect, or
caused a slight surge in alcohol consumption among students. College
campaigns differ in that they promote drinking in moderation versus
complete abstinence.

While social-norms marketing has been able to change misperceptions
among students, "there's a lot of other factors that go into
ultimately changing a behavior," said Toren Nelson, assistant director
at Harvard University's College Alcohol Study.

Likewise, some Palo Alto teenagers don't believe the local campaign
will influence their behavior.

"That's what other people do," Gunn senior Kui Mwaniki said after
reading some of the results. "I'll do what I want to do."

The Harvard researchers believe factors other than overall perception
are more important to whether young adults drink or use drug,
including the actions of a student's closest friends and the
availability of alcohol in a community.

Other drug-policy leaders question social-norming methods.

"I'm skeptical of surveys. I'm particularly skeptical of surveys where
you are asking someone whether they've participated in illegal
behavior," said Marsha Rosenbaum, the director of San Francisco's Drug
Policy Alliance. "You're likely to get low estimates there."

Also, kids whose social circles drink are likely to discount the data,
taking away its effectiveness, Rosenbaum added.

For keeping kids away from drugs, Rosenbaum said, "there is no
substitute for the facts, for good drug education and for keeping kids
busy."

School officials' time would be better spent using their "political
muscle" to limit kids' access to drugs and alcohol, Nelson argued.

Palo Alto students also might be too media savvy to be influenced by
such a campaign. With all the anti-drug messages swirling around,
"after a while you start to tune this stuff out," Paly junior Kim
Thacker said.

Social-norming proponents have criticize the Harvard study, noting
that it failed to check how effectively the campaigns at the colleges
were implemented.

The researchers "didn't collect any data about the content of what
students were seeing," said H. Wesley Perkins, a Professor of
Sociology at Hobart and William Smith Colleges in New York, and a
social-norms pioneer.

Perkins is also the editor of "The Social Norms Approach to Preventing
School and College Age Substance Abuse," a collection of studies by
various researchers.

One study published in the book found that at two unnamed "Midwestern"
high schools, drinking and smoking went down 20 to 30 percent two
years after they started social-norming projects in 1999.

The researchers of that study, unlike at Harvard, did not research and
report upon similar groups of high schools that did not have
social-norming projects, to have a scientific control.

Palo Alto officials are quick to point out that social norming is just
one way they are trying to limit drug and alcohol use. For instance,
counselors are available on campus, schools have a close relationship
with local police officers, and schools require students to be driven
to off-site dances.

The committee members also insist they are not trying to gloss over or
minimize a serious community issue.

"The real message is we have good news, but we have a problem here,"
Beacom said. She later added: "I just think that kids deserve to know
the truth."

Still, part of what initially appealed to the committee in the
beginning about social norming was its positive messages.

"If I really believed that everyone was doing it, then I wouldn't get
out of bed in the morning and come to this job, because it would be
too depressing," Paly Student Activities Director Joann Vaars said.

But if only 10 percent of kids are drinking regularly, she said, "I
can work with that. I know who those 10 percent are."