Click It or Ticket - North Carolina, USA

The first step was to re-define the product benefits - set belt usage is important not to save your life, but to keep you from getting "busted" by the police. A new law was passed by the North Carolina legislature that made it possible for police to stop and ticket motorists who were not wearing their seat belt, penalising them with a fine (US $25) and jail time. Checkpoints were established throughout the state. Marketing and media campaigns advertised the new law and the consequences of violating it. These efforts included television and radio advertisements, billboards, posters, political and celebrity events, and media outreach through press releases, op-eds, and programme statistics for each county published in local newspapers. The internet was also utilised to publicize the campaign message and to illustrate the programme's results.

Health

Prior to 1980, seat belt use in the United States hovered around 11 percent, even after numerous volunteer and educational campaigns at the local, county, and state levels. Between 1980 and 1984 additional efforts were made to increase use through individual organisations, public education programmes, incentives, and policy changes. These efforts did not have any significant impact in large, metropolitan areas; by the end of that term, national seat belt usage had reached only 15 percent.

In 1984, New York became the first state to enact a mandatory seat belt use law, and by 1990, 37 other states had followed suit. While the vast majority of these laws were secondary enforcement statutes that required an officer to observe another traffic violation before citing a seat belt infraction, the national usage rate climbed from 15 to 50 percent. Even with this success, it was clear from results in Canada that laws themselves would not be sufficient to achieve high seat belt usage. Truly successful rate increases had been achieved in Canada and individual jurisdictions in the US only through highly visible "waves" of enforcement. These results prompted the National Highway Traffic Safety Administration (NHTSA) to implement Operation Buckle Down in 1991, a two-year Special Traffic Enforcement Program (STEP) to increase seat-belt use. Though there was no uniformity in the level of enforcement or visibility within each state, the programme saw the usage rate increase from 53 to 62 percent by the end of 1992.

By 1993, North Carolina was one of only a handful of states with a primary seat belt law in place, one in which officers can make a citation without having to observe another traffic violation. Implementation of the primary law itself resulted in a significant increase in belt usage to 78%. As had been observed in Canada, however, the rate decreased shortly thereafter to around 65% where it remained. It was clear to state officials that a long-term approach was needed to achieve and sustain a high usage rate.