Advertising 2008: Comm 3006 Week 7 lecture - Health & well-being oh no, toenail fungus! promotion
Broad areas of interest: <ul><li>Cigarette and alcohol advertising </li></ul><ul><li>Government ‘social marketing’ health campaigns </li></ul><ul><li>Health food and nutritional supplement advertising </li></ul><ul><li>‘ Lifestyle drug’ advertising </li></ul><ul><li>Cosmetics and cosmetic surgery advertising </li></ul><ul><li>Ethical issues and ‘stealth’ marketing techniques </li></ul><ul><li>Conclusion and questions raised </li></ul>
First, some quick revision: <ul><li>Health is an area that used to largely stand outside a commodity relationship. Not that long ago, health was managed by the family, who grew their own food or purchased it in bulk for the corner store. Cooking was done at home. Ailments were dealt with using herbal remedies or by the local GP who had a ‘special relationship’ with the community that didn’t involve advertising </li></ul><ul><li>Today we are increasingly obsessed with and fearful about our health. Why? Maybe it’s because our perception of health has been ‘outsourced’ to the promotional / entertainment complex. We eat fast food because we are time-starved, but are exposed to media health scares about junk food and eating ‘disorders’. We don’t exercise, yet we are exposed to images of youthful, super-fit people on TV. Young boys are no longer just ‘full of energy’ - they have ADHD. Impotence is no longer a part of getting older - it’s a disease . People are no longer just sad - they are clinically depressed </li></ul><ul><li>There are large gaps developing between what we hope to look like, and what we actually look like. That gap has been filled by a ‘beauty’ industry that tries to sell us back our youth using ever more expensive and invasive procedures </li></ul><ul><li>Even ads for health products as basic as Paracetemol are now often quite sophisticated at a sign value level, and may raise ethical, not just marketing, issues that we need to think about </li></ul>
Broadly, campaigns come in these areas: <ul><li>Behaviour modification promotions - often government sponsored, trying to convince us to stop using certain products, stop certain ‘dangerous’ behaviours, or to increase tolerance and understanding of certain disability groups. In this group we have anti-cigarette advertising (Quit, Nicorette) ads, anti-drink driving, anti-binge drinking ads – more about this ‘social marketing’ in the political advertising lecture </li></ul><ul><li>‘ Health(ier) food’ promotions - include vitamins, herbal remedies, dietary supplements (a huge and growing industry), promotions from primary producers trying to persuade us about the health benefits of their foodstuffs (fruit, dairy), and ads from mainstream food producers trying to counteract community notions that their products are unhealthy (breakfast cereals, red meat, dairy). More recently we have seen the fast food industry respond to criticism of the un-healthiness of their food (‘Super Size Me’, McDonald’s ‘salad bars’, Subway’s ‘Jarrod’ campaign) </li></ul><ul><li>Multinational drug company drug promotions - developed specifically for high-value target demographics and often specifically dealing with ‘lifestyle problems’ of aging, stressed lifestyles or childrearing. Examples are Ritalin for ADHD children, HRT therapies for menopause, SSRIs for depression, anti-inflammatories for arthritis (Vioxx) and Viagra for ‘erectile dysfunction’. The role played by the drug companies. Direct marketing of prescription drugs is outlawed in Australia (but not in the US) </li></ul><ul><li>‘ Cosmetic’ problem ads - poor eyesight, crooked teeth, bad skin, wrinkles, baldness, body image problems etc. Advertising has played a role in turning many of them into ‘diseases’ as has ‘stealthier’ promotion via ‘reality TV’ shows about cosmetic surgery </li></ul>
Case study - cigarette advertising: <ul><li>The cigarette industry claimed for years that advertising didn’t recruit new smokers or attract children to smoking, it simply persuaded people to change brand. Careful thinking will reveal this as nonsense, because new smokers always had to be ‘recruited’ to replace those that died of old age or disease </li></ul><ul><li>In spite of decades of accumulating medical evidence about the dangers of smoking addiction, it took decades to ban its advertising in Australia (the Tobacco Advertising Prohibition Act in 1992) and further decades of ‘social marketing’ to reduce smoking rates. Smoking is now banned in most public places and health warnings must be displayed on cigarette packs. However, it is still legal to purchase cigarettes </li></ul><ul><li>Many old ads now seem outrageous </li></ul><ul><li>and fraudulent, yet much of the world </li></ul><ul><li>is still open to this type of highly </li></ul><ul><li>emotive cigarette advertising. In the first </li></ul><ul><li>world the cigarette industry has become </li></ul><ul><li>involved in ‘stealthy’ forms of </li></ul><ul><li>advertising such as the sponsoring of </li></ul><ul><li>sporting events and use of celebrities in TV </li></ul><ul><li>and film which attempt to making smoking </li></ul><ul><li>‘ cool’ to young female smokers </li></ul>
Case study - alcohol advertising: <ul><li>Because cigarette advertising is basically a thing of the past in Australia, a more interesting debate for us here is the alcohol advertising debate. Here is another legal product, almost universally used, but which is also potentially harmful, especially when consumed by children </li></ul><ul><li>There is a continuing ongoing debate in Australia and other places about whether the alcohol industry is deliberately pitching certain products and the ads that promote them at the underage market (mainly premixed spirits – ‘ alcypops’ - but certain wine and beer lines as well), again particularly at young women, in an effort to recruit new drinkers. Once again these ads generally highlight the ‘cool’, ‘liberating’ or ‘rebellious’ nature of these products </li></ul><ul><li>This has again bought a response from </li></ul><ul><li>governments who spend large amounts </li></ul><ul><li>of money on anti drink driving and </li></ul><ul><li>underage binge drinking promotions </li></ul><ul><li>A study of the impact and effectiveness </li></ul><ul><li>of one or more of these campaigns would </li></ul><ul><li>make an excellent essay topic, as would </li></ul><ul><li>consideration of the ethical implications </li></ul><ul><li>of a product that is legal, but which is also medically dangerous </li></ul>
Case study - ‘health food’ advertising: <ul><li>We live in a world increasingly ‘apart’ from nature. For most of the 20th century, advertising reflected the growing belief in science and technology - including in ads for food and medicine. The scientific ‘conquest’ of nature would make life better, easier and cheaper and healthier for all of us these ads claimed. People believed them </li></ul><ul><li>Nuclear accidents, pollution, the environmental movement, and a growing fear of modern life have produced a backlash against this kind of advertising. Nature has become, not the enemy, but the refuge we wish to return to. Nature has come to symbolise the romantic past, freedom, and safety from pollution, city life and rampant consumerism </li></ul><ul><li>Dissatisfaction with processed foods we eat coincides with a reduction is trust in science and corporations to supply us with healthy lifestyles. Ironically we rely on both of these for almost all our food and medicine even as we romantically long for ‘the good old days’. Hence the tremendous rise of the health food and industry, and their advertising campaigns </li></ul><ul><li>Many ads highlight the connection between product and nature, point out the inadequacy of the modern diet and lifestyle, and yet hide the role science and industry almost always plays in manufacturing the product. Sugar may be a ‘natural’ chemical, but the way it is produced is anything but natural, in spite of what the advertising suggests </li></ul><ul><li>An extreme case of symbolic transference is the alliance of natural imagery with vitamins. Almost all are made via an industrial manufacturing process, yet the word ‘chemical’ is avoided at all costs in advertising because vitamins are ‘health foods’! </li></ul>
Case study - ‘lifestyle drugs’ 1: <ul><li>Multinational corporations exist to make profits for shareholders. They spend millions of dollars bringing new drugs to the market. Obviously, they will want to develop drugs that will bring in the greatest profit for their shareholders, not necessarily the drugs that might result in the greatest alleviation of suffering. Malaria and AIDS kill millions of people in the third world, yet most research goes to drugs that can be sold to wealthy ‘lifestyle’ markets </li></ul><ul><li>It is in the interests of these drug companies to ‘invent’ medical syndromes, and respond to moral panics in popular culture that surround health issues. Why? Because wealthy people in developed countries are time poor but financially rich. When something goes ‘wrong’ with their health their consumer instinct is to pop a pill to fix it. If something causes inconvenience to people then that constitutes a marketing opportunity for drug companies </li></ul><ul><li>There are several health ‘panics’ and drug classes where multinationals are currently using sophisticated advertising in a way that might almost amount to ‘emotional blackmail’. These include advertising for antidepressants, hormone replacement therapy, erectile dysfunction, hair and weight loss, ADHD, and cosmetic surgery </li></ul><ul><li>An example - ‘Depression’ is a clinical disorder this is exploding in the developed world. Why? Medically the jury is still out, but ever since the discovery of SSRIs (selective serotonin re-uptake inhibitors) new branded drugs, all with ‘up’ sounding names - Prozac, Effexor, Zoloft, Paxil - have flooded the market. These drugs have been aggressively marketed to stressed populations as ‘instant happiness’. In 2003 over 10 million antidepressant prescriptions were handed to Australians alone </li></ul>
Case study - lifestyle drugs 2: <ul><li>More examples of ‘disorder classes’ include: </li></ul><ul><li>Menopause is something that is ‘natural’ that happens to half the population, yet in recent years it has been increasingly pathologised as a ‘disease’ that can be overcome with Hormone Replacement Therapy. HRT has been marketed as an elixir of youth, a lowerer of cholesterol, ridder of osteoarthritis and an aphrodisiac. Promensil is just one of many </li></ul><ul><li>Impotence goes to the heart of a man’s self-image. While some cases of impotence are due to genuine medical conditions, most are psychological and related to insecurity, fear, exhaustion and work stress. However, Pfizer has Viagra (sildenafil citrate) on the market. This drug has been one of the most rapid sellers in history, and been marketed using a variety of clever, highly persuasive techniques </li></ul><ul><li>ADHD We are now living in a world where two income parents have very little time to parent their children. Added to this is a wave of concern about the behavioural effects of diet, food additives and pollution on children. We now have an ‘epidemic’ of what has come to be known as ADHD, or Attention Deficit Hyperactivity Disorder, especially in boys. Is this a ‘real’ disease, or does it reflect a change in lifestyles? Drug companies have done all they can to promote stimulants like Ritalin, Concerta and Adderall as ‘cures’ for ADHD </li></ul><ul><li>One consistent theme in direct-to-consumer </li></ul><ul><li>advertisements in the US is that consumers </li></ul><ul><li>need to be anxious - serious illness is lurking </li></ul><ul><li>around the corner - and drug treatment is all that is needed to allay this anxiety </li></ul>
Case study - ‘cosmetic enhancement’: <ul><li>There are big profits waiting to be made in a wealthy population that is terrified of growing old in a youth obsessed culture . Over the past decade our insecurity about our body image, first with women then with men, has risen enormously. We are saturated with images of beauty and youth. Cosmetic appearance is increasingly tied to romantic and professional success, and beauty industry advertising has gone way beyond traditional cosmetics advertising into the realm of medicine and surgery </li></ul><ul><li>Is having crooked teeth a disease? If you can promote the idea that you won’t get friends at school without expensive veneers it is! Is Botox essential to get that good job? Do you need a breast enhancement or a hair transplant for that self-confidence lift or maybe to save that relationship? Ads like this are now common - most procedures are not covered by Medicare, and are enormously expensive and profitable for the beauty industry </li></ul><ul><li>Anxiety about appearance is most effectively utilised when advertising and pop culture entertainment come together in ‘reality-TV’. These shows are presented in a ‘serious medicine’ format but with the added emotional appeal of ‘real life’ stories of the ‘ugly duckling to beautiful swan’ transformation revealed to loved ones at the end of the show. These ‘extreme makeovers’ are powerful indirect forms of advertising for the medicalisation and normalisation of ‘problems’ that often have little to do with physical health </li></ul>
‘ Stealth’ marketing techniques: <ul><li>‘ Ask your doctor’ ads. Ads that highlight a ‘condition’ so the target market feels humiliated and vulnerable. Often no treatment or brand is specifically mentioned, the target consumer is encouraged to see their doctor. It’s the doctor that gets hit with the ‘hard sell’ promotional material (this is legal) </li></ul><ul><li>‘ Medical breakthrough’ stories in the media, especially on shows like ACA and morning TV, but even sometimes on the TV news. If people see stories about ‘wonder drugs’ in the media, they are inclined to treat it as ‘factual news’, not as the result of sensational press releases from drug companies. This is essentially free advertising posing as journalism. The drugs may not be new, they may not be breakthroughs, they may not even be effective </li></ul><ul><li>‘ Support Groups’. In the US as well as Australia, all sorts of support groups have sprung up around the communities that use, and often become dependent upon, drugs like Ritalin, Viagra and Celebrex (an arthritis drug). This seems harmless until one discovers that in many cases these groups are ‘sponsored’ by the drug companies themselves </li></ul><ul><li>‘ Patient Groups’. Non-profit societies professing to be concerned with the sufferers or patients of certain ‘diseases’ may well turn out to be funded by the drug companies that have a direct commercial interest in the treatment of these ‘diseases’ </li></ul><ul><li>Incentive schemes tied to things like credit cards. Just like your flybys, Virgin Visa or Woollies petrol cards, except for drugs! </li></ul><ul><li>The ‘invention of new diseases’. Did you know that ‘toe fungus’ is a disease, and that a new wonder drug can help? Is being short a disease? It might be if you are a company producing human growth hormone </li></ul>
Ethical issues?: <ul><li>Should drug companies be allowed to market whatever they want, however they want, to who ever they want, as long as the product isn’t ‘harmful’? Certainly the drug companies would claim this </li></ul><ul><li>However one can make the argument that the health area is special. Selling health is not like selling shoes - our lives are at stake here. People are especially vulnerable to exploitation and over-servicing in an industry where there is a tremendous power imbalance between producer and consumer - an imbalance that advertisers exploit. Advertisers also exploit our trust in our family GP, often considered to be trustworthy and not affected by marketing </li></ul><ul><li>Australian governments have traditionally limited the type of medications that can be advertised direct to the public. However, medical manufacturers and their ad companies use several ‘stealth’ advertising techniques to get around these limitations… </li></ul><ul><li>In the US the spend on health promotion in 1996 was US$12.3 billion! The largest percentage of that money was spent on sales teams targeting doctors. Studies in several countries have demonstrated that doctors who rely heavily on commercial sources of information are less likely to prescribe appropriately </li></ul><ul><li>For an example of stealth medical marketing in Australia go here: </li></ul><ul><li>http://www.abc.net.au/rn/backgroundbriefing/stories/2008/2166307.htm </li></ul>
Conclusion: <ul><li>High-end ‘sign value rich’ advertising is extending to areas of our lives that were formerly not based on a commodity relationship. This applies especially to ‘prestige’ products where demand can be enhanced by clever marketing </li></ul><ul><li>Drug, health food and cosmetic advertising plays on existing fears and is not adverse to creating new ones. It is not surprising that they do, after all pharmaceutical companies are in the business of making a profit. However, this is an area where a collision between what is safe, what is profitable, and what is socially ethical, is inevitable </li></ul><ul><li>This is paradoxically, a culture where romantic longings for holistic ‘natural’ medicines co-exist with a pragmatic reality of time-stressed individuals needing ‘instant fixes’ from the high-tech science so often a part of ‘miracle cure’ advertising </li></ul><ul><li>Where do you stand on this? Have you felt ‘pressured’ by health marketing? Is selling ‘health’ just like selling underpants? Should health advertising be ‘open slather’? Are diseases being ‘created’ by drug companies? What should the role of government in health promotion be? What would you do if you were in charge of the health portfolio? </li></ul>
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