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Diffusion of innovations theory for alcohol, tobacco, and drugs.

More than hundred years have passed since the diffusion of innovations The study of the diffusion of innovation is the study of how, why, and at what rate new ideas and technology spread through cultures.

This research topic began in the 1950s at the University of Chicago with funding from television producers who sought a way to measure the
 theory originated. But it still remains a popular theory. As of 2002, over 5,200 applications of this theory in various fields have been published (Rogers, 2003). The hallmark of diffusion of innovations theory is that it deals with dissemination of new ideas and adoption by people in a systematic manner. Diffusion of innovations theory is an effective tool for social change. The diffusion of innovations theory deals with dissemination of an innovation is an idea, practice, or product (including services) perceived as new by an individual or other unit of adoption. Communication channels serve as the link between those who have the know-how of the innovation and those who have not yet adopted it. The innovation-decision process (Rogers, 2003) is a five step process: (1) gaining knowledge about the innovation; (2) becoming persuaded about the innovation; (3) decision step of adopting or rejecting the innovation; (4) implementation step of putting the innovation to use; and (5) confirmation step of either reversing the decision or adopting the new innovation.

The applications of the diffusion of innovations theory in public health, health promotion, and health education began with immunization immunization: see immunity; vaccination.  campaigns and family planning family planning

Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources.
 programs. Its application in alcohol, tobacco, and drugs can be seen at two levels. The first level pertains to adoption and diffusion of the habit of using alcohol, tobacco, and drugs. The second level pertains to diffusion of successful interventions pertaining per·tain  
intr.v. per·tained, per·tain·ing, per·tains
1. To have reference; relate: evidence that pertains to the accident.

 to prevention and control of alcohol, tobacco, and drugs. Ferrence (2001) calls these two levels "natural" or spontaneous as in the unplanned diffusion of drugs in a given population and "planned" as in the case of interventions. It is the latter level that our readers would be especially interested. Ebrahim and colleagues (2007) advocate in present times the need for faster diffusion of interventions at a global level with regard to five modifiable risk behaviors of alcohol consumption, tobacco use, overweight and obesity, low fruit and vegetable consumption, and physical inactivity physical inactivity A sedentary state. Cf Physical activity. .

Simons-Morton and colleagues (1997) have advocated the use of diffusion of innovations theory in prevention of alcohol, tobacco and drug use. Several interventions in the area of alcohol, tobacco, and drugs have used diffusion of innovations theory for their dissemination. One intervention is the Smart Choices, a school-based tobacco prevention program (Brink, Basen-Engquist, O'Hara-Tompkins, Parcel, Gottlieb, Lovato, 1995; Parcel et al., 1995). It was found that adoption of the program was increased in the intervention districts, and teacher attitudes and organizational factors were responsible for adoption. A unique feature of this study is that it combined social cognitive theory Social Cognitive Theory utilized both in Psychology and Communications posits that portions of an individual's knowledge acquisition can be directly related to observing others within the context of social interactions, experiences, and outside media influences.  (Bandura ban`dur´a   

n. 1. A traditional Ukrainian stringed musical instrument shaped like a lute, having many strings.
, 1986) with diffusion of innovations theory.

Another example of application of diffusion of innovations theory is the dissemination of Centers for Disease Control and Prevention's school guidelines to prevent tobacco use and addiction to state education agencies (McCormick & Tompkins, 1998). It was found that diffusion process Diffusion process

A conception of the way a stock's price changes that assumes that the price takes on all intermediate values.
 requires planned change One of the foundational definitions in the field of organizational development (aka OD) is planned change:

“Organization Development is an effort planned, organization-wide, and managed from the top, to increase organization effectiveness and health through planned
 over time through several communication channels.

In North Carolina North Carolina, state in the SE United States. It is bordered by the Atlantic Ocean (E), South Carolina and Georgia (S), Tennessee (W), and Virginia (N). Facts and Figures

Area, 52,586 sq mi (136,198 sq km). Pop.
 an experimental study was done in 22 school districts to ascertain the extent of implementation of school-based tobacco prevention curricula being disseminated based on diffusion of innovations model (McCormick, Steckler, & McLeroy, 1995). The study found that larger organizational size and teacher training were strongest predictors of curricula implementation.

Ferrence (1996) notes several applications of diffusion of innovations theory in tobacco prevention such as limiting exposure to environmental tobacco smoke environmental tobacco smoke (ETS/passive smoke),
n the gaseous by-product of burning tobacco products, including but not limited to commercially manufactured cigarettes and cigars; contains toxic elements harmful to the health of adults and children
, diffusion of smoking cessation smoking cessation Public health Temporary or permanent halting of habitual cigarette smoking; withdrawal therapies–eg, hypnosis, psychotherapy, group counseling, exposing smokers to Pts with terminal lung CA and nicotine chewing gum are often ineffective.  programs among physicians, and diffusion of policies regarding tobacco control among public health agencies. Rohrbach and colleagues (1996) also advocate use of diffusion of innovations theory to adoption and implementation of alcohol, tobacco, and drugs prevention programs in schools

However, there are some limitations to the diffusion of innovations theory that researchers must consider. First, public health interventions are preventive in nature where the individual has to adopt the new idea today to avoid the likelihood of a negative consequence at a later date. For example, a smoker would need to quit smoking today to prevent development of lung cancer lung cancer, cancer that originates in the tissues of the lungs. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell.  20 or so years later. Such a long interval poses special challenges and diffusion occurs more slowly (Rogers, 2002). It needs to be kept in mind that diffusion of innovations in health is a complex process that occurs at multiple levels, across many different settings, and utilizes different strategies (Parcel, Perry, & Taylor, 1990).

Second, oftentimes in health promotion and health education the interventions have to be designed for lower socio-economic groups, people with low literacy levels and other vulnerable sections of the community. The adoption and diffusion process occurs easier and smoother in the wealthier and highly educated while in the vulnerable sections it is not as smooth and offers a number of challenges and barriers. As a consequence the gap between those who have and those who do not have widens even farther.

Finally, an issue with the diffusion of innovations theory is what is called pro-innovation bias (Rogers, 2003). This refers to the connotation con·no·ta·tion  
1. The act or process of connoting.

a. An idea or meaning suggested by or associated with a word or thing:
 that an innovation should be diffused and adopted by all members and in a rapid manner without rejection or reinvention. This is often not possible with many of the health promotion and education objectives. For example, with quitting smoking it is virtually impossible at present to think that no one will smoke. Rogers (2003) suggests conducting research while the innovation is still being adopted rather than waiting for it to be completely adopted, studying unsuccessful innovations, and examining the broader context in which an innovation diffuses.

On the whole the diffusion of innovations is a robust theory. More researchers must utilize it in prevention of alcohol, tobacco and drug use.


Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice Hall Prentice Hall is a leading educational publisher. It is an imprint of Pearson Education, Inc., based in Upper Saddle River, New Jersey, USA. Prentice Hall publishes print and digital content for the 6-12 and higher education market. History
In 1913, law professor Dr.

Brink, S. G., Basen-Engquist, K. M., O'Hara-Tompkins, N. M., Parcel, G. S., Gottlieb, N. H., Lovato, C. Y. (1995). Diffusion of an effective tobacco prevention program. Part I: Evaluation of the dissemination phase. Health Education Research, 10(3), 283-295.

Ebrahim, S., Garcia, J., Sujudi, A., & Atrash, H. (2007). Globalization globalization

Process by which the experience of everyday life, marked by the diffusion of commodities and ideas, is becoming standardized around the world. Factors that have contributed to globalization include increasingly sophisticated communications and transportation
 of behavioral risks needs faster diffusion of interventions. Preventing Chronic Disease. Retrieved September 4, 2007, from

Ferrence, R. (2001). Diffusion theory and drug use. Addiction, 96(1), 165-173.

Ferrence, R. (1996). Using diffusion theory in health promotion: The case of tobacco. Canadian Journal of Public Health, 87 (Suppl. 2), S24-27.

McCormick, L. K., Steckler, A. B., McLeroy, K. R. (1995). Diffusion of innovations in schools: A study of adoption and implementation of school-based tobacco prevention curricula. American Journal of Health Promotion, 9(3), 210-219.

McCormick, L., & Tompkins, N. O. (1998). Diffusion of CDC's guidelines to prevent tobacco use and addiction. Journal of School Health, 68(2), 43-45.

Parcel, G. S., O'Hara-Tompkins, N. M., Harrist, R. B., Basen-Engquist, K.M., McCormick, L. K., Gottlieb, N. H., & Eriksen, M. P. (1995). Diffusion of an effective tobacco prevention program. Part II: Evaluation of the adoption phase. Health Education Research, 10(3), 297-307.

Parcel, G. S., Perry, C. L., & Taylor, W.C. (1990). Beyond demonstration: Diffusion of health promotion interventions. In N. Bracht (ed.), Health promotion at the community level. Thousand Oaks Thousand Oaks, residential city (1990 pop. 104,352), Ventura co., S Calif., in a farm area; inc. 1964. Avocados, citrus, vegetables, strawberries, and nursery products are grown. , CA: Sage Publishers.

Rohrbach, L. A. D'Onofrio, C. N., Backer, T. E., & Montgomery, S. B. (1996). Diffusion of school-based substance abuse prevention programs. American Behavioral Scientist, 39, 919-934.

Rogers, E. M. (2002). Diffusion of preventive interventions. Addictive Behaviors, 27, 989-993.

Rogers, E. M. (2003). Diffusion of innovations. (5th ed.). New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of
: Free Press.

Simons-Morton, B. G., Donohew, L., & Crump crump  
v. crumped, crump·ing, crumps
1. To crush or crunch with the teeth.

2. To strike heavily with a crunching sound.

, A. D. (1997). Health communication in the prevention of alcohol, tobacco, and drug use. Health Education & Behavior, 24(5), 544-554.

Manoj Sharma, MBBS MBBS, MBChB n abbr (BRIT) (= Bachelor of Medicine and Surgery) → título universitario

MBBS, MBChB n abbr (Brit) (= Bachelor of Medicine and Surgery) →
, CHES, Ph.D.

Editor, Journal of Alcohol & Drug Education & Amar Kanekar, MBBS, MPH

University of Cincinnati The University of Cincinnati is a coeducational public research university in Cincinnati, Ohio. Ranked as one of America’s top 25 public research universities and in the top 50 of all American research universities,[2]  

526 Teachers College

PO Box 210068

Cincinnati, OH 45221-0068
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Author:Sharma, Manoj; Kanekar, Amar
Publication:Journal of Alcohol & Drug Education
Article Type:Editorial
Geographic Code:1U3OH
Date:Apr 1, 2008
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