Short wordless animation modestly reduced addiction stigma in three-country trial

Stigma means negative judgments, blame, or social distancing toward a group of people. For people with addiction, stigma can shape how they are treated by others and may make it harder to seek support. Researchers tested whether a very short animated story could shift those attitudes.

The study was a three-arm online randomized controlled trial, a design that assigns participants by chance to different groups. This helps researchers compare the effects of an intervention more fairly. Adults aged 18 to 49 in the United Kingdom, United States, and South Africa were recruited through the Prolific Academic online research platform between July 10 and July 24, 2025.

Participants were assigned in equal proportions to one of three groups. One watched a 2-minute, 40-second wordless animated storytelling video with a soundtrack. Another watched the same video without sound. The comparison group received written information about substance use disorders through the survey platform.

The animation used a story intended to create a form of social contact: an encounter with another person’s lived experience. It did not use spoken dialogue, which the researchers said could make it easier to share across language settings.

Of 13,500 people recruited, 13,397 completed the first assessment immediately after the material they were assigned to see or read. Ninety-two percent completed a second assessment two weeks later. The main outcome was participants’ score on the 18-item Attribution Questionnaire, called the AQ-18, a validated survey that measures stigma toward people with addiction.

Immediately after exposure, average stigma scores were 9% lower in the group that watched the video with a soundtrack than in the informational control group. The estimated ratio of average scores was 0.91, with a 95% confidence interval of 0.90 to 0.93. A ratio below 1 here indicates lower stigma scores than the comparison group.

People who watched the silent version also had lower stigma scores immediately afterward, though the difference was smaller: 6% lower than the control group. The ratio of average scores was 0.94, with a 95% confidence interval from 0.93 to 0.95.

At the two-week follow-up, the differences had narrowed. Stigma scores remained 4% lower in the soundtrack group, with a ratio of 0.96, and 2% lower in the silent-video group, with a ratio of 0.98. The confidence intervals were 0.95 to 0.97 and 0.97 to 0.99, respectively.

The researchers also measured optimism, hopefulness, and warmth toward people with addiction. Both video groups improved on these secondary measures right after exposure. At two weeks, warmth remained higher, although the effect had weakened over time. The abstract does not provide numerical results for all of these secondary outcomes.

The results are encouraging, but they do not show that one short video changes behavior, improves access to care, or affects recovery. The study measured survey responses over two weeks, not treatment seeking, clinical outcomes, or longer-term attitudes. It also studied adults recruited through one online platform, so the findings may not apply in the same way to every community or setting.

The soundtrack version had the larger and more lasting effect in this trial. Future research could test whether repeated exposure works better, whether the approach changes behavior outside surveys, and how well it performs over longer periods and in other populations. The trial was registered before the study began, and its results were published in eClinicalMedicine.