From November 17 to 23, 1999, Peter D. Hart Research Associates conducted a poll among 506 New Jersey voters and 503 Oregon voters to assess their awareness of and familiarity with emergency contraception, their feelings about emergency contraceptive pills? being widely available to women, and their attitudes toward collaborative drug therapy agreements and so-called ?conscience clauses.?  The margin of error for each poll is ±4.5%.  The following memo presents the key findings of these polls.

 

 

 

The research findings provide valuable insight into voters? approach to the topic of emergency contraception (EC).  As the results of both polls demonstrate, emergency contraception is not a subject with which most voters are familiar; however, once they learn more about the subject, they are generally positive to the idea of emergency contraception and its being widely available to women. 

Perhaps somewhat surprisingly, voters have mixed reactions to the concept of collaborative drug therapy agreements between doctors and pharmacists, and their reservations about these arrangements significantly affect their feelings about making EC available through these types of agreements.  Finally, while voters are largely unaware of the discussion of so-called ?conscience-clause? legislation in their states, they express strong opposition to these exemptions.

 

 

Many voters have a general sense that a medical treatment exists for preventing pregnancy after unprotected sex, but almost unanimously, voters know very little about emergency contraceptive pills?from whether EC is even available in the United States to how long EC pills are considered effective in preventing pregnancy.  About half (47% in New Jersey, 51% in Oregon) of voters in each state say that they know of a product or drug that has been proven effective in preventing pregnancy after unprotected sex, but they admit that they are not particularly familiar with the particular drugs.  A slightly higher proportion of voters in each state believe that they are very or fairly familiar with the term ?morning-after pill? (23% NJ, 25% OR) than with the term ?emergency contraceptive pills? (14% NJ, 17% OR). 

Voters? lack of knowledge of emergency contraception stems from their lack of personal experience with EC:  just one in 20 (5%) New Jersey voters and one in ten (9%) Oregon voters know of a family member or friend who has taken emergency contraceptive pills.  Even among the population whom one might expect would have the most personal experience with EC?women age 18 to 44?only about one in ten (8% NJ, 11% OR) say that they know someone who has taken emergency contraceptive pills.  In both states, barely one in ten (7% NJ, 9% OR) 18- to 50-year-old women say that they have discussed EC with their doctors or other health care professionals. 

In fact, emergency contraception remains such a remote topic to most of the general public that a majority of voters are not even aware that emergency contraceptive pills are available in the United States:  just about one in three (30% NJ, 33% OR) voters in each state know that EC is available in this country, compared with one in four (28% NJ, 25% OR) who do not; the remainder admit that they simply do not know whether the drug is available in America.  Even among voters who know that emergency contraceptive pills are available in America, one in four (25%) New Jersey voters and one in three (34%) Oregon voters do not know that these pills are available only by prescription. 

 

 

Despite their lack of familiarity with and knowledge of emergency contraception, voters generally react favorably to the idea of emergency contraception?s being widely accessible to all women.  After hearing a short description of emergency contraceptive pills, to clarify voters? misperceptions and provide them with some context, approximately six in ten (62% NJ, 64% OR) voters say that they feel very or fairly positive toward the idea of EC?s being widely available.  In fact, this sentiment is so widespread that a majority of voters in almost all demographic groups?including Catholics?describe their reaction to the idea as positive; Oregon Republicans are the exception, and even a large plurality (49%) of them feel positive toward the idea.

 

 

 

 

 

 

The positive aspects of emergency contraceptive pills? being widely accessible are similar to many of the values that voters bring to the debate surrounding other reproductive rights issues; for example, about one in five (23% NJ, 19% OR) voters talk about EC as a ?personal decision? and a ?woman?s choice.?  They also volunteer that emergency contraceptive pills would prevent unwanted pregnancy (12% NJ, 14% OR) and that the pills are a better alternative to abortion (6% in both states).  In fact, when read a series of statements about why emergency contraceptive pills should be widely available to women, voters in both states identify reducing the number of abortions as the most convincing reason to support the accessibility of EC.

 

While voters have a generally positive reaction to emergency contraception, they do express concern about two distinct aspects of EC?s being widely available:  the potentials for encouraging risky, unprotected sex, and abusing EC as a regular, ongoing method of birth control.  More than four in ten voters in each state?including a significant proportion of voters who describe themselves as being positive toward EC?say that these concerns are very or fairly convincing reasons why EC should not be widely available to women.

 

 

Voters are ambivalent toward the idea of collaborative drug therapy agreements between pharmacists and doctors.  In New Jersey, 47% of voters describe these agreements as a bad idea, while only 33% describe them as a very or fairly good idea; in Oregon, reactions are more evenly divided?40% think the agreements are a bad idea, as opposed to 38% who believe they are a very or fairly good idea.  While men in both states are more likely than women to see these arrangements as a positive step, New Jersey and Oregon voters both seem reluctant to diminish the role of doctors in prescribing drugs.  And because voters have mixed reactions to the pros and cons of collaborative drug therapy agreements, they are not particularly enthusiastic about adding emergency contraceptive pills to the protocol of drugs that fall under these arrangements.  In New Jersey, 39% support adding EC to the list of medications that pharmacists could prescribe directly to patients; 56% oppose this measure.  In Oregon, however, 51% favor adding EC to collaborative drug therapy agreements, while 44% oppose this extension.

 

 

Legislative proposals in New Jersey and Oregon that would allow pharmacists to refuse to fill prescriptions or provide medications because of religious or moral objections?so-called ?conscience clauses??are not a topic with which voters are familiar.  In Oregon, about half (52%) of voters say that they have heard nothing at all about these proposals, whereas in New Jersey, three in four (74%) say the same.  Despite their low levels of awareness of these legislative initiatives, voters express strong and consistent opposition to these measures:  eight in ten (79%) in New Jersey oppose this type of legislation, while seven in ten (69%) in Oregon feel similarly.  Conscience-clause legislation is rejected by sizeable majorities of every demographic group of voters in both states.

 

 

 

 

 

 

 

 

 

 

In explaining their opposition to these legislative measures, voters cite pharmacists? ?professional obligation to provide patients with any drug or medication that has been legally prescribed for them? as the most compelling reason to reject these measures:  70% of voters in New Jersey and 62% of voters in Oregon rate this as a very convincing reason to oppose conscience-clause legislation.  At the same time, just about one in three (33% NJ, 35% OR) say that the argument ? . . . it is the responsibility of the pharmacy?not the pharmacist?to make sure that patients have access . . . to the drugs and medications that they need? is a very convincing reason to support the legislation.

In the end, a majority (60% NJ, 53% OR) of voters maintain that pharmacists should never be allowed to refuse medications to patients because of their own religious or moral objectives?even when they are presented with the alternative of allowing pharmacists to refuse prescriptions as long as the pharmacy has a procedure for ensuring that patients are not denied care.