Counter-advertising uses commercial marketing tactics, including branding of messages, images, and warning labels, to refute pro-substance influences and increase pro-health messages and influences. Counter-advertising is commonly used to balance the potential effects of alcohol advertising on consumption and alcohol-related problems.


To educate youth on the potential negative consequences of alcohol use

Typical Elements

  • Partnerships with advertising agencies that have (Miller, 1998):
    • A strong track record in formulating and sustaining comprehensive prevention campaigns
    • A clear understanding of  local context (e.g., knowledge of local media outlets, state prevention efforts)
    • Appropriate infrastructure, staffing, and expertise to implement and sustain counter-advertising efforts
    • No conflicts of interest with alcohol advertisers
  • Specific focus population and targeted alcohol-related behavior. Marketing requires a high level of specificity, or market segmentation, to be effective. Research suggests considering the following factors (Agostinelli & Grube, 2002):
    • Drinking behavior: Moderate or light drinkers can be more receptive to counter-advertising than heavy or problematic drinkers. For example: Negative-restrictive messages (e.g., “Don’t drink”) are associated with increased perceptions of excessive drinking risks and intentions to change drinking behavior among underage moderate drinkers, but have the opposite effect on underage binge drinkers (Lee, 2013).
    • Personality type: Impulsive or sensation-seeking personalities are more responsive than less sensation-seeking personalities to upbeat, fast-paced, and suspenseful messages.
    • Readiness to change: People who recognize their drinking as problematic (versus those who don’t) are more receptive to messages that require them to think about their problematic drinking.
  • Understanding of focus population’s exposure to pro-substance use messages and their perceptions about the costs and benefits of engaging in or abstaining from the alcohol-related behavior that should change.
  • Key counter-advertising messages that resonate with youth in the focus population. Behavior change theory and research indicate that it is critical for counter-advertising to include content with (Slater, 1999a and b):
    • Emotional factors: Use of celebrity endorsements, positive appeals, alcohol-related fears, empathy evocations, or sensational content encourage youth to process messages.
      • ​Note: Tobacco prevention efforts found that sensational messages about manipulation by the tobacco industry elicited strong emotional reactions from sensation-seeking teens (Stevens, 1998).
    • ​Logic and modeling: Strong logical arguments and modeling of appropriate behavior help youth integrate messages into their belief structures, increasing the potential for a lasting effect.
  • Delivery of counter-advertising messages so they reach the focus population. One of the most common delivery methods has been to use warning labels on alcohol. Labels are most effective when they (Agostinelli & Grube, 2002):
    • Are placed where audience members can see them
    • Highlight specific risks
    • Include qualifier words (e.g., may cause cancer)
  • Delivery that (adapted from CDC, 2003):
    • Is long-term: A campaign that occurs over the course of a month is not as likely to reach as many people as one that lasts a year or more.
    • Is comprehensive: A campaign should consist of many different components that support one another and are coordinated.
    • Uses multiple strategies: Campaigns implemented in conjunction with other environmental prevention strategies (e.g., enforcement and policy) are more likely to be effectivene.
    • Uses multiple media outlets: When possible, mass media campaigns should comprise television, radio, billboards, social media, and print media, including leaflets, magazines, and newspapers.
    • Demonstrates cultural competence: The audience will be more likely to understand and related to culturally appropriate communication strategies.
    • Is strategic: The campaign should be delivered in places and at times when the audience is most likely to see and absorb your messages.
    • Is adequately funded: Adequate funding will maximize campaign effectiveness.


Youth under age 21


No outcome data found for role of counter-advertising in preventing underage drinking and/or its consequences.


Alcohol Counter-Advertising and the Media: A Review of Recent Research

Designing an Effective Counteradvertising Campaign-California

Designing an Effective Counteradvertising Campaign-Massachusetts

Designing and Implementing an Effective Tobacco Counter-Marketing Campaign

Drinking and Driving PSAs: A Content Analysis of Behavioral Influence Strategies

Integrating Application of Media Effects, Persuasion, and Behavior Change Theories to Communication Campaigns: A Stages-of-Change Framework


No recognition found for role of counter-advertising in preventing underage drinking and/or its consequences.


Agostinelli, G., & Grube, J. W. (2002). Alcohol counter-advertising and the media: A review of recent research. Alcohol Research and Health, 26(1), 15–21.

Centers for Disease Control and Prevention. (2003). Designing and implementing an effective tobacco counter-marketing campaign. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Promotion, Office on Smoking and Health. Retrieved from:

Lee, M. J. (2013). Underage drinkers’ responses to negative-restrictive versus proactive –nonrestrictive slogans in humorous anti-alcohol abuse messages: Are humorous responsible drinking campaign messages effective? Journal of Health Communication, 18(3), 354–368.

Miller, A. (1998). Designing an effective counteradvertising campaign—Massachusetts. CANCER Supplement, 83(12), 2742–2745.

Slater, M. D. (1999a). A content analysis of behavioral influence strategies. Journal of Alcohol and Drug Education, 44(3), 68–81.

Slater, M. D. (1999b). Integrating application of media effects, persuasion and behavior change theories to communication campaigns: A states-of-change framework. Health Communication, 11(4), 335–354.

Stevens, C. (1998). Designing an effective counteradvertising campaign—California. CANCER Supplement, 83(12), 2736–2741.