Page 266 - The Handbook of Persuasion and Social Marketing

242 The Handbook of Persuasion and Social Marketing

The Remedy Revolution

The old paradigm that shaped public opinion and policy making on to-
bacco control efforts tended to emphasize consumer freedom of choice and
to decry all government intervention as paternalistic. . . . A widespread
popular consensus in favor of aggressive policy initiatives is now emerging,
and this shift in popular sentiment has also been accompanied by support
across most of the political spectrum. (Institute of Medicine, 2007, pp. 7–8)

An Upstream Movement Emerges

As the above quote illustrates, a fundamental shift is occurring in how
social change agents (e.g., public health officials, environmental groups)
pursue the promotion of pro-social behaviors. This trend entails a move-
ment away from remedies that rely on persuasive or informative commu-
nications produced and disseminated by “good behavior” advocates within
government and NGOs. Simultaneously, greater efforts and resources are
being placed on advocating policy change that is likely to have a collective
impact on large numbers of consumers rather than focusing efforts solely
on individual change through personal choice. Our argument that these
trends exist is based on three observations: the sheer number of new rem-
edies that entail a degree of policy restriction; the writings of leading
scholars (primarily in public health and, to a lesser degree, in marketing);
and the positions taken by leading national and international agencies.
The intersection of these two trends roughly corresponds to what pub-
lic health scholars and practitioners have in mind when they speak of the
movement from downstream to upstream marketing. Table 9.1 outlines
some important differences that have been the basis for understanding
these two perspectives. While in practice, upstream and downstream ef-
forts are often used simultaneously to improve public health, they do in-
volve different philosophical and strategic approaches, including distinct
goals, targets, and activities.
While traditional social marketing approaches have focused on a psy-
chological perspective, with individual choice and behavior change as
their main premises, upstream remedies are embedded in a different phi-
losophy. Drawing heavily from sociology and a social construction per-
spective, the public health community increasingly believes self-destructive
behavior to be a product of social and environmental conditions rather
than free choice. In other words, people do not so much freely choose
their actions as have their potential actions—and the meaning of those ac-
tions—shaped by their social environment. Given this perspective, Winett