Examining school nutrition policies and their effect on the promotion of low-nutrient foods in the context of sports advertising

OBJECTIVES

Despite recommendations to implement nutrition standards in schools, low-nutrient foods and high-energy drinks are still some of the most important challenges for school management and students' purchasing and consumption behavior. In this regard, the aim of the present study is to examine school nutrition policies and their effect on the promotion of low-nutrient foods in the context of sports advertising.

METHODS

A partial least square technique with SmartPLS 3.0 and bootstrapping with 500 resamples was used to examine the effect of food marketing on school nutrition policies and students' nutritional involvement. Online surveys were done through The Iranian Educational Network of students and measured on a 5-point Likert scale. The survey questionnaire consisted of 3 scales to measure the following: school nutrition policies, advertising of low-nutrient foods, and student nutritional involvement.

RESULTS

Results from a sample of 382 Iranian high school students revealed that low-nutrient food advertising has a significant effect on student consumption, and the greatest overall effect on students' nutritional involvement. School nutrition policies were affected by media, endorsement, and the environmental advertising, whereas school financial capabilities had the greatest direct effect on students' nutritional involvement.

CONCLUSIONS

These findings suggest that advertising through sports media plays a mediating role in school nutrition policies and student nutritional involvement. Policy changes to restrict food marketing for young people must include both television and non-broadcast media.

Analysis of green word-of-mouth advertising behavior of organic food consumers

The word-of-mouth (WOM) marketing process is one of the main means by which consumers obtain information. As a communication channel between consumers in economically developing countries, WOM may contribute to the development of the organic food market. The primary objective of this study is to segment organic saffron consumers in Mashhad, Iran, and determine how they engage in WOM marketing. Data were collected through questionnaires from 13 districts of Mashhad using a stratified sampling method. In this study, 400 organic saffron consumers were grouped using a self-organizing map (SOM) neural network based on consumer neobehavioristic theory, and then, using decision trees, consumer behavior rules were extracted for participating in the WOM for each group. According to the results, less than fifty percent of consumers in each of the four market segments are willing to participate in WOM advertising for organic saffron. A lack of awareness of the characteristics of organic saffron is also found to be the main reason for consumers' reluctance to recommend organic saffron to others. Mass-media advertising is an effective way to raise consumer awareness and influence opinion leaders, ultimately resulting in WOM recommendations.

Using an epidemiological model to explore the interplay between sharing and advertising in viral videos

How to exploit social networks to make internet content spread rapidly and consistently is an interesting question in marketing management. Although epidemic models have been employed to comprehend the spread dynamics of internet content, such as viral videos, the effects of advertising and individual sharing on information dissemination are difficult to distinguish. This gap forbids us to evaluate the efficiency of marketing strategies. In this paper, we modify a classic mean-field SIR (susceptible-infected-recovered) model, incorporating the influences of sharing and advertising in viral videos. We mathematically analyze the global stability of the system and propose an agent-based modeling approach to evaluate the efficiency of sharing and advertising. We further provide a case study of music videos on YouTube to show the validity of our model.

Culturally Tailored Anti-Smoking Messages: A Randomized Trial With U.S. Sexual Minority Young Women

INTRODUCTION

This study evaluated effects of exposure to culturally tailored anti-smoking ads versus control ads on quitting intentions, cigarette purchase intentions, and tobacco industry perceptions among young adult, cisgender and transgender, sexual minority women (SMW).

STUDY DESIGN

An online randomized controlled experiment with 1-month longitudinal follow-up was conducted.

SETTING AND PARTICIPANTS

About 2,214 U.S. SMW ages 18-30 were recruited via online survey panels (The PRIDE Study and Prolific), social media ads and posts, and HER dating app ads. Data were collected in 2021-2022.

INTERVENTION

Participants were randomly assigned to receive up to 20 tailored ads containing LGBTQ+ branding versus 20 control ads without LGBTQ+ branding over 4 weeks. Both conditions used identical anti-smoking statements and photographs (including several photographs of individuals who self-identified as SMW).

MAIN OUTCOME MEASURES

One-month follow-up intention to purchase cigarettes, intention to quit, marketing receptivity, pro-industry attitudes, and pro-industry beliefs were measured. Analyses were conducted in 2022-2023. Linear regression models predicted outcomes at 1-month follow-up with the randomized arm, adjusted for baseline measures of each outcome and stratified by smoking status (those who currently smoked and those who did not smoke).

RESULTS

Among those who smoked, follow-up intention to quit increased and intention to purchase cigarettes, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up pro-industry beliefs were significantly lower (B=-0.331, 95% CI -0.652, -0.010, p=0.043) in the tailored versus control arm, adjusted for baseline beliefs. Among those who did not smoke, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up outcomes did not differ significantly between arms.

CONCLUSIONS

These findings can inform future anti-smoking campaign development to reduce cigarette smoking-related disparities among young adult, cisgender and transgender, sexual minority women and serve as the basis for developing similar ads for other LGBTQ+ audiences.

TRIAL REGISTRATION

This study was registered in ClinicalTrials.gov (NCT04812795).

Managing Disruption: A Case Study of Boundary Work Around Alcohol Industry-Sponsored Scientific Interventions

OBJECTIVE

Following recent work examining alcohol industry involvements in science, this is a case study that examines the ways in which the alcohol research community engages in "boundary work"--in which scientists define and defend the demarcation between their community of knowledge makers and others, justifying their claim to legitimacy and authority--in response to alcohol industry-sponsored interventions. The case here involves an economist who disputes the research consensus positions and policy recommendations of the field, having been funded by the key global alcohol industry political organization.

METHOD

We examine the "functional" statements of both sides of this issue to show the ways in which the scientific and policy consensus of the field is disputed. Three examples of the responses of the alcohol research community, presenting different types of responses, are interrogated.

RESULTS

In late career and retirement, this economist published extensively in alcohol and health economics journals within the peer-reviewed literature on two key topics in alcohol policy: pricing/taxation measures and advertising restrictions. These commentaries, reviews, and correspondence propose alternative policies favored by the alcohol industry, which are at odds with the alcohol public health evidence base. The three examples examined of boundary work performed by alcohol public health researchers illustrate the variety of ways in which the legitimacy of these interventions has been questioned: on technical grounds, on explicitly normative grounds, and as a body of work as a whole.

CONCLUSIONS

Interventions in the scientific literature create important resources for alcohol industry actors to oppose alcohol policy measures globally. The alcohol research field may benefit from discussion about how to respond to these kinds of interventions.

The Role of Social Media Advertisement and Physical Activity on Eating Behaviors among the General Population in Saudi Arabia

Over the past few decades, people in Saudi Arabia have become less inclined to adopt active lifestyles and healthy eating habits due to the increasing use of digital technologies such as social media. The objective of this online-based cross-sectional study was to assess the role of social media food advertisements and physical activity on eating behaviors among the general population in Saudi Arabia (n = 471). Data were collected through a structured questionnaire, which consisted of four parts: (i) sociodemographic information, (ii) attitude towards social media, (iii) eating behaviors-related information, and (iv) exposure to and engagement with social media advertisements. The study's outcome variable, eating behaviors (healthy vs. unhealthy), was assessed using the following question: "Are you on a healthy diet (such as a balanced diet, keto, or low carb)?" A multiple binary logistic regression analysis was performed to investigate the factors that influence unhealthy eating behaviors. Approximately 79.6% of the participants had unhealthy eating behaviors. Participants who were not involved in daily physical activity were more likely to have unhealthy eating behaviors compared to their counterparts (adjusted odds ratio, AOR = 4.86). Participants who watched food ads on social media channels 1-3 times a week (AOR = 2.58) or daily (AOR = 3.49) were more likely to have unhealthy eating behaviors than their counterparts. Participants whose appetite to try foods increases always (AOR = 1.42) or usually (AOR = 2.88) after viewing ads on social media were more likely to have unhealthy eating behaviors. These findings suggest that policymakers should take immediate action to regulate food advertising policy to promote a healthy food environment across the country. Saudis should be encouraged to engage in more physical activity, which could support the maintenance of healthy eating patterns and lifestyles.

Ethical judgments of poverty depictions in the context of charity advertising

Aid organizations, activists, and the media often use graphic depictions of human suffering to elicit sympathy and aid. While effective, critics have condemned these practices as exploitative, objectifying, and deceptive, ultimately labeling them 'poverty porn.' This paper examines people's ethical judgments of portrayals of poverty and the criticisms surrounding them, focusing on the context of charity advertising. In Studies 1 and 2, we find that tactics that have been decried as deceptive (i.e., using an actor or staging a photograph) are judged to be less acceptable than those that have been decried as exploitative and objectifying (i.e., depicting an aid recipient's worst moments). This pattern occurs both when evaluating the tactics themselves (Studies 1a-1c) and when directly evaluating critics' arguments about them (Study 2). Studies 3 and 4 unpack the objection to deceptive tactics and find that participants' chief concern is not about manipulating the audience's responses or about distorting perceptions of reality. Participants report less concern about non-deceptive manipulation (using emotion to compel donations) and 'cherry-picked' portrayals of poverty (an ad showing an extreme, but real image) so long as there is some truth to the portrayal. Yet they are more sensitive to artificial images (e.g., an actor posing as poor), even when the image resembles reality. Thus, ethical judgments hinge more on whether poverty portrayals are genuine than whether they are representative. This work represents the first empirical investigation into ethical judgments of poverty portrayals. In doing so, this work sheds light on how people make sense of morally questionable tactics that are used to promote social welfare and deepens our understanding of reactions to deception.

Exposure to and Appeal of Tobacco Ads and Displays in China: A Qualitative Exploration of Chinese Youth Perceptions

INTRODUCTION

Adolescents are uniquely vulnerable to nicotine addiction, and smoking is common among male adolescents in China. Although China implemented a ban on cigarette and e-cigarette advertising in public places, Chinese youth remain exposed to this marketing, which may contribute to future use.

AIMS AND METHODS

From December 2021 to January 2022, we conducted 20 online focus group discussions with 119 adolescents in 10 Chinese cities to explore sources of tobacco marketing exposure, defined as exposure to cigarette and e-cigarette ads and product displays, and what features made marketing attractive.

RESULTS

All groups discussed exposure to tobacco ads/displays in public places, including locations near their home or school. Nearly all groups discussed that exposure to online tobacco ads was common, particularly exposure to e-cigarette commercial ads and posts made by classmates or friends selling e-cigarettes. Most groups identified how eye-catching colors, imagery, product packaging, and price promotions featured in e-cigarette ads/displays attracted their attention.

CONCLUSIONS

Results suggest Chinese adolescents are exposed to cigarette and e-cigarette ads and displays, many of which are placed in youth-friendly locations and contain youth-appealing features.

IMPLICATIONS

Only a handful of studies have examined the influence of cigarette and e-cigarette advertising on youth in the context of China. Prior research has established the relationship between youth exposure to tobacco marketing and increased susceptibility to future use. Our findings emphasize the importance of effectively enforcing and expanding restrictions on cigarette and e-cigarette marketing in order to protect youth from exposure and future smoking/vaping initiation.

Picture analysis of billboards and infographic graphics advertising COVID-19 on promoting preventive behaviors and taking vaccination against the Coronavirus disease pandemic

Today, advertising science is a tool that helps advertisers to design their advertising to meet the needs of the audience. In this regard, knowing and understanding the audience is one of the most important points that advertisers should pay attention to before advertising in order to better attract the audience. This study has been done with the aim of billboards and infographics analysis related to promoting preventive behaviors and vaccination against the Coronavirus disease pandemic and investigating the opinion of the general adult population of Iran. The method used in this research is the qualitative method. In this research, according to the type of data and research goals, Kress and Van Leeuwen's discourse theory method has been used. The sample size includes 36 advertising billboards and infographics. Data collection has been done through searching the sites and websites of health networks and medical education centers in Iran, taking pictures of infographics and billboards in public places, and also receiving archive files of pictures from the public relations of health networks and medical services. The data was collected from February 19, 2020 to December 30, 2022 (the time frame of the pandemic and public vaccination program in Iran). Then, an online survey about promoting preventive behaviors and taking vaccination against the Coronavirus disease pandemic was designed in SurveyMonkey and its link was provided to the audience through virtual networks and other platforms. The assessment of validity involved experts in infection control and linguistics. The reliability of the measurement, determined through the Cronbach's alpha internal consistency coefficient, yielded a coefficient of 0.968. In this study, data analysis was conducted using IBM SPSS Statistics software, version 15.0 (IBM Corp., Armonk, NY, USA). Finally, users' opinions about of billboards and infographics were analyzed using descriptive statistics. The results of component analysis and surveys show that visual components such as «The staring look at the spectator (Demand)», «Head-on Shot (inclusion)», «Down Shot (Creating a sense of participation for the represented person)», «Close-up (intimate/individual relationship)», «Level Shot (equality)» and «High-Angle Shot (Presenting power)» in medical advertising has had a great impact in arousing public opinion to create a positive attitude towards preventive measures and vaccination during the Coronavirus disease epidemic. The results of this research show that in visual communication, visual components play a significant role in creating and maintaining target ideologies. Also, advertising in the field of preventive measures in medical sciences requires certain rules that determine people's culture and the main foundation of their attitude and thinking. Therefore, it is necessary to know such knowledge and learn it by the medical staff to deal with critical situations.

The influence of recommendation algorithm's information flow on targeted advertising audience's coping behavior

Targeted advertising equipped with a recommendation algorithm can achieve accurate matching between users and recommended content, but overly precise recommendations may exacerbate negative audience reactions or behaviors. Improving the transparency of algorithm recommendation is one of the ways to address audience concerns or skepticism, and transparency guarantees the audience's right to know and thus brings more trust, which will reduce the audience's negative behavior. But increased transparency may also make the audience feel pressured or threatened, and requiring more cognitive and behavioral effort, which was called coping behavior. In order to clarify the relationship between the transparency of the algorithm recommendation and the audience's coping behavior, based on the persuasion theory, this study discusses the mechanism of the influence of the characteristics of the algorithm recommendation information flow on the audience's coping behavior of targeted advertising from the perspective of the flow mode and transmission principle of information. Based on the data of 120 online pretests and 297 formal tests, the results show that the perceived trust and perceived threat caused by the information flow characteristics of the algorithm recommendation jointly determine the possible coping behaviors of targeted advertising audiences. Additionally, users' self-efficacy regulates the relationship between mental process and coping behavior. Different from previous studies on audience coping behaviors of targeted ads, which mainly start from the perspective of participants and advertising content, this research tries to start from the perspective of information flow. The research results demystify the relationship between recommendation algorithm information flow and the audience's coping behavior, and enrich the algorithmic persuasion framework. The research results have reference value for the improvement of personalized recommendation effect, and provide a new way to further study the transparency of algorithm recommendation in the field of consumer behavior. Meanwhile, it also provides suggestions for the practices of platforms and advertisers in practice.

Nicotine pouch marketing strategies in the USA: an analysis of Zyn, On! and Velo

INTRODUCTION

Nicotine pouches are gaining popularity, yet their marketing is understudied.

METHODS

Using Numerator advertising data from January 2019 to September 2021 regarding three popular brands of nicotine pouch in the USA-Zyn (by Swedish Match, introduced in the USA in July 2016), On! (Altria, August 2016) and Velo (RJ Reynolds, July 2019)-we examined (1) general advertising characteristics (eg, media type, year); (2) ad content (ie, headlines and imagery themes); (3) prominent media channels (ie, specific websites, magazines, etc); and (4) ad expenditures.

RESULTS

There were 286 unique ads (Zyn: 44.4%; On!: 2.8%; Velo: 52.8%), 119 143 occurrences (Zyn: 3.5%; On!: 0.5%; Velo: 96.0%) and $24 774 650 total expenditures (Zyn: 4.7%; On!: 0.6%; Velo: 94.7%). The greatest proportion of ad occurrences and expenditures were accounted for by radio (75.9% and 28.2%, respectively) and television (16.2% and 56.5%), followed by mobile (0.5% and 7.2%) and online display (6.7% and 3.6%). Across ad occurrences and expenditures, prominent headline themes included 'freedom' (26.0% and 17.1%, respectively), 'brand' (9.6% and 18.6%) and 'flavour' (16.4% and 7.6%); images mainly featured the product alone (61.4% and 56.1%), text (16.2% and 24.6%) or men (8.7% and 8.6%); and prominent channel themes were entertainment (34.7% and 37.3%), news/weather (14.3% and 21.7%), business/finance (12.9% and 9.0%) and sports (9.5% and 1.0%). Zyn and On! prioritised online display and print; Velo prioritised radio and television. Zyn's and Velo's headlines focused on 'freedom', with Zyn also emphasising 'brand' and Velo 'innovation'; On!'s headlines emphasised 'flavour'.

CONCLUSIONS

Regulatory efforts must be informed by surveillance of nicotine pouch marketing and impacts on consumer subgroups (eg, young people).

Organic, Earth-Friendly Tobacco With a Charcoal Filter and Smooth Taste: A Randomized Experiment Testing Effects of Natural American Spirit's "Sky" Cigarette Advertising on Consumer Perceptions

INTRODUCTION

The Natural American Spirit (NAS) brand has a history of marketing tactics that may convey reduced harm. While no longer allowed to use "additive-free" or natural descriptors (except in the brand name), it continues promoting potentially misleading attributes. This study examined perceptions of NAS's newer "Sky" style, promoted as organic tobacco with a charcoal filter.

AIMS AND METHODS

In an online experiment, we randomized 1927 adult past 30-day tobacco or nicotine product users to one of six conditions showing Sky ads with different descriptors: (1) charcoal filter, (2) charcoal + organic, (3) charcoal + earth-friendly, (4) charcoal + smooth taste, (5) charcoal + all other descriptors, and (6) no-descriptor control (Sky ads without target descriptors). Product perceptions were compared by condition. Participants also reported perceived benefits of charcoal filters.

RESULTS

Overall, 28% of participants indicated Sky is less harmful and 38% believed it exposes users to fewer chemicals. Participants in the "charcoal + organic," "charcoal + earth-friendly," and the all-descriptor conditions had higher odds of believing Sky reduces chemical exposure (respectively, 43%, 40%, and 42%), relative to the no-descriptor control. Fewer control participants endorsed beliefs that Sky has a "better filter" and is "more environmentally friendly". Many believed cigarettes with charcoal filters could confer benefits relative to other cigarettes, such as reducing chemical exposure, or being cleaner, purer or safer (though research on relative safety of charcoal filters in cigarettes is inconclusive).

CONCLUSIONS

Sky marketing may promote misperceptions about product safety and composition, and ads using both charcoal and organic text may particularly reinforce them.

IMPLICATIONS

This study examined the impact of new cigarette advertising promoting the use of charcoal filters and organic tobacco along with other suggestive claims ("environmentally friendly," "smooth taste") on tobacco users' perceptions of the advertised product-NAS Sky cigarettes. Our study provides new data about positive consumer perceptions of charcoal-filtered cigarettes, and results suggest that combinations of these marketing terms evoke perceptions about reduced harm and reduced exposure to harmful chemicals that may be misleading to the public. Our findings underscore a need for additional regulatory action regarding tobacco marketing that makes use of natural-themed marketing.

Noticing people, discounts and non-tobacco flavours in e-cigarette ads may increase e-cigarette product appeal among non-tobacco-using young adults

INTRODUCTION

Young adults new to tobacco (including e-cigarettes) are at an increased risk of e-cigarette use after e-cigarette exposure. This study examined the association between noticing e-cigarette advertising features and perceived product appeal among non-tobacco-using young adults.

METHODS

A sample of non-tobacco-using young adults (ages 18-29 years; n=1993) completed an online survey in 2021. We content analysed visible features from 12 e-cigarette ads that represented commonly used e-cigarette brands. Participants viewed the ads and clicked on the areas of the ads that drew their attention. Participants reported e-cigarette product appeal for each ad, including ad liking, product curiosity and use interest. We used generalised estimating equations to examine within-person associations between noticing specific ad features and reporting each and any type of product appeal, adjusting for noticing other features and participant characteristics.

RESULTS

Noticing people, discounts, non-tobacco (menthol and mint/fruit) flavours, positive experience claims or product images was positively associated with having any e-cigarette product appeal. Noticing discounts or mint/fruit flavours was also positively associated with e-cigarette use interest. In contrast, noticing nicotine warnings or smoking cessation claims was negatively associated with ad liking and product curiosity.

CONCLUSIONS

Attention to several e-cigarette ad features (eg, people, discounts, non-tobacco flavours) was associated with increased e-cigarette product appeal, whereas attention to nicotine warnings and smoking cessation claims was associated with reduced appeal among non-tobacco-using young adults. Restricting appeal-promoting features while strengthening the effects of nicotine warnings and smoker-targeted claims in e-cigarette ads may potentially reduce e-cigarettes' overall appeal among this priority population.

Experimental research on non-idealized models: A systematic literature review

Current literature on non-idealized models seems to offer mixed evidence on whether such models generate a positive body image and increase advertising effectiveness. To closely investigate this claim, we conducted a systematic review to summarize the empirical findings on the effects of non-idealized models on body image, well-being, and advertising outcomes among men and women. To contextualize these results, we also synthesized (1) the conceptualization of a non-idealized body size (i.e., labelling and operationalization), (2) the message accompanying the model (i.e., medium type and marketing intent), and (3) individual traits of participants tested as potential moderators. Three databases in different disciplines (i.e., ProQuest Psychology, Communication and Mass Media Complete, and Web of Science) were searched, and 86 unique studies were included in the review. While most studies found positive or null effects of non-idealized models on body image, well-being, and advertising outcomes, a small number of studies obtained negative results. These inconsistent findings could be explained by the large variety of labels and unclear operationalizations identified within our review. The conclusions of this review call for a clearer definition and measurement of non-idealized models.

A systematic review and meta-analysis of the effect of digital game-based or influencer food and non-alcoholic beverage marketing on children and adolescents: Exploring hierarchy of effects outcomes

Videogame livestreaming platforms are an emerging form of digital media, popular with young people, where users watch gaming influencers play videogames. Food and non-alcoholic beverage (hereafter: food) brands have a substantial presence on these platforms, yet no studies have examined the impact of this food marketing on young people. This systematic review and meta-analysis examined the evidence (quantitative or mixed-method) for a relationship between exposure to digital game-based or influencer food marketing, and food-related (brand awareness, attitudes, preferences, purchase, and consumption), and post-consumption (weight, body mass index [BMI], and dental caries) outcomes in young people (≤18 years). Twenty-three databases were searched in March 2021. Twenty-two studies met the inclusion criteria, of which 20 were included in the quantitative synthesis. Meta-analyses indicated food marketing was associated with more positive attitudes and greater preferences (OR = 1.74, p < 0.001 [95%CI: 1.355, 2.232]), and increased consumption (SMD = 0.37, p < 0.001 [95%CI: 0.219, 0.529]). Narrative synthesis indicated that food marketing may increase brand awareness but not pester intent, although data were limited. Evidence suggests that there is a relationship between exposure to food marketing via influencers and digital gaming media, and several food-related outcomes. This is the first quantitative synthesis to demonstrate these relationships; this work has implications for food marketing policy.

Effect of Gender and Celebrity Status of Models in Printed Advertisements Promoting Physical Activity

Public health organizations have embarked on various campaigns to increase the level of physical activity in the population. The aim of this study is to examine whether printed advertisements promoting physical activity can be made more effective by manipulating the model used in advertisements. Two experiments were conducted. The aim of the first experiment was to examine whether the gender of the model affects the effectiveness of the advertisement. Seventy-five respondents were randomly split into a control group featuring no model, experimental group 1 featuring a female model, and experimental group 2 featuring a male model. The study found that while respondents spend more time looking at advertisements with models, male respondents in the male model group reported an intent to participate in higher levels of physical activity compared with the other 2 groups. The aim of the second experiment was to examine whether the celebrity status of the model affects the effectiveness of the advertisement. Fifty-nine respondents were randomly split either into a group featuring a sports celebrity or an unknown athlete. The results show that while the sports celebrity was more attractive, it was respondents in the noncelebrity group that reported an intent to participate in higher levels of physical activity. The findings from this study suggest that noncelebrity male models in printed advertisements promoting physical activity are more effective.

Philip Morris International's Formula 1 Sponsorship-Linked Marketing: Transformation From Marlboro to Mission Winnow

INTRODUCTION

Transformation describes a dramatic modification in appearance or character. Philip Morris International (PMI)'s sponsorship-linked marketing of Formula 1 auto racing is illustrative of transformation. The company's flagship cigarette brand, Marlboro has been replaced as the identified partner by their newly developed brand, Mission Winnow. This study examines the tobacco company's marketing objectives for transforming the brand identity of its Formula 1 Ferrari race team partnership.

AIMS AND METHODS

We provide a case study, and our method of qualitative enquiry is textual analysis. We review marketing planning documents from Philip Morris, which would normally be proprietary, but are publicly accessible because of litigation. Additionally, we review Mission Winnow's social media posts, over a 3-year span, from the brand's Facebook, Instagram, and Twitter accounts.

RESULTS

PMI initiated its Formula 1 sponsorship in 1972. Through Marlboro, the company's sponsorship-linked marketing was largely centered on building brand image and reinforcing Marlboro's brand identity of rugged masculinity, independence, heroism, and adventure. When Mission Winnow replaced Marlboro as the identified brand sponsor in 2018, the company's marketing communication shifted to highlighting transformation, progress, open dialogue, teamwork, innovation, technology, and science.

CONCLUSIONS

Despite Article 5.3 of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC) calling for Parties to protect public health policies from the commercial and vested interests of tobacco companies, PMI still seeks to be an important stakeholder in such consultations, including those pertaining to harm reduction. Mission Winnow's sponsorship-linked marketing points to a larger company narrative about trying to gain or reclaim legitimacy and credibility.

IMPLICATIONS

PMI's continued sponsorship of Formula 1 is a strategic means of drawing attention to the company's "next-generation products" and communicating their supposed "transformation." The company's sponsorship-linked marketing initiatives point to a need for Parties to enforce Article 13 of the WHO FCTC, which calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship.

Exploring the Dunning-Kruger Effect in Health Communication: How Perceived Food and Media Literacy and Actual Knowledge Drift Apart When Evaluating Misleading Food Advertising

Marketers often advertise products high in sugar, fat or calories as healthy products. With this potentially misleading information, they can influence eating decisions with negative consequences for human health. Consumers need the ability to uncover misleading food advertising. However, individuals' perceived knowledge and their actual objective abilities often drift apart - a phenomenon which has come to be known as the Dunning-Kruger Effect. Thus, this study set out to uncover the phenomenon's potential existence in health communication, more precisely in the area of food and media literacy. In a quantitative survey representative of the Austrian population (n = 1000) the Dunning-Kruger Effect (DKE) could be detected: Individuals who were most knowledgeable underestimated their food and media literacy, but - on the positive side - they acted as opinion leaders. Individuals who were least knowledgeable about advertising strategies used to market an unhealthy product as healthy and about the actual nutrition score of the advertised product were most likely to overestimate their own food and media literacy. Worryingly, further concerning consequences emerged, especially for least knowledgeable individuals. The study's results provide important implications for public health campaigns.

Let it out: A digital communication campaign to reduce suicide and mental health stigma in Kentucky farmers

Given the disproportionately high suicide rate of farmers in Kentucky and the unique cultural needs of farmers, a coalition was created to reduce the stigma of seeking help for mental health. A targeted communications campaign was developed to provide information to farmers at risk. This paper describes the development and launch of the campaign, including formative research, message development, campaign concepts, deployment of the campaign, and initial results. Events, traditional advertising, and social and digital media campaigns provided targeted brand awareness. Initial reception to the campaign was positive, especially with TV and radio watch- and listen-through rates and website traffic. The campaign requires expanded messaging and tactics and new partnerships to influence farmers. Practical and theoretical implications include the future use of paid digital strategies to confidentially influence farmers, additional research about culturally competent approaches toward subsets of farmers, and the amount of detail to provide about mental health conditions.

Adolescent Advertising Exposure to Cannabis Products in Rural Oklahoma via Medical Dispensaries

OBJECTIVE

We assess cannabis advertising exposure among adolescents in rural Oklahoma from medical dispensaries.

METHOD

Our mixed-methods study identified medical dispensaries within a 15-minute drive time of rural Oklahoma high schools. Study staff completed observational data collection forms and took photographs of each dispensary. Quantitative data from the forms and qualitative coding of photographs were used to describe dispensary characteristics and likely advertising exposure for adolescents.

RESULTS

Ninety-two dispensaries were identified across 20 rural communities. The majority presented as retail spaces (n = 71). Product (n = 22) and price promotions (n = 27) were common. Coding of dispensary photographs found that product promotions advertised cannabis use modalities, with cannabis flower being the most common (n = 15), followed by edibles (n = 9) and concentrates (n = 9). Among dispensaries with price promotions, discounts (n = 19) and prices under $10 (n = 14) were common.

CONCLUSIONS

Sampled rural medical dispensaries present as retail spaces and are a likely source of adolescent cannabis advertising exposure.

Tobacco company agreements with tobacco retailers for price discounts and prime placement of products and advertising: a scoping review

OBJECTIVE

The objectives of this scoping review are to examine existing research on the often-secretive contracts between tobacco manufacturers and retailers, to identify contract requirements and incentives, and to assess the impact of contracts on the sales and marketing of tobacco products in the retail setting.

DATA SOURCES

The systematic search was conducted in PubMed/MEDLINE, Web of Science, Scopus, ProQuest Political Science Database, Business Source Premier, ProQuest Agricultural & Environmental Science Collection, and Global Health through December 2020.

STUDY SELECTION

We included studies that collected and analysed empirical data related to tobacco contracts, tobacco manufacturers, and tobacco retailers. Two reviewers independently screened all 2786 studies, excluding 2694 titles and abstracts and 65 full texts resulting in 27 (0.97%) included studies.

DATA EXTRACTION

Study characteristics, contract prevalence, contract requirements and incentives, and the influence of contracts on the retail environment were extracted from each study.

DATA SYNTHESIS

We created an evidence table and conducted a narrative review of included studies.

CONCLUSIONS

Contracts are prevalent around the world and handsomely incentivise tobacco retailers in exchange for substantial manufacturer control of tobacco product availability, placement, pricing and promotion in the retail setting. Contracts allow tobacco companies to promote their products and undermine tobacco control efforts in the retail setting through discounted prices, promotions and highly visible placement of marketing materials and products. Policy recommendations include banning tobacco manufacturer contracts and retailer incentives along with more transparent reporting of contract incentives given to retailers.

Naturally leading: a content analysis of terms, themes and word associations in Natural American Spirit advertising, 2000-2020

BACKGROUND

Natural American Spirit (NAS) is a cigarette brand distinguished by supposed 'natural', 'additive-free' characteristics, marketing of which is tied to misperceptions of reduced harm. In 2017, NAS's manufacturer agreed (with the Food and Drug Administration) to remove 'natural'/'additive-free' from US marketing. Prior research has explored NAS marketing immediately post-agreement. This study sought to identify prominent post-agreement terms and themes and analyse how they had been used in pre-agreement ads.

METHODS

We conducted a content analysis of NAS ads from 2000 to 2020 (N=176), documenting prominent pre-agreement and post-agreement terms/themes and examining how they are used in NAS ads. We coded for descriptors, themes, imagery and promotions, and extended prior research by analysing how leading post-agreement terms were used in conjunction and thematically associated with 'additive-free' and 'natural' before the agreement.

RESULTS

Results indicated 'tobacco and water' and 'Real. Simple. Different.' increased post-agreement, as did environmental imagery. 'Organic' was prominent pre-agreement and post-agreement. The descriptors used most often in post-agreement ads almost always appeared in conjunction with (and were thematically linked to) 'natural' and 'additive-free' in pre-agreement ads.

CONCLUSIONS

In the years since the agreement, NAS ads have heavily relied on still-allowable descriptors that may invite reduced risk misperceptions. Notably, these descriptors were consistently used alongside the banned terminology before the agreement and presented as if affiliated conceptually, possibly prompting similar connotations. Findings indicate a continuing need for research into NAS advertising effects and a potential role for additional regulatory action.

Effects of banner ad type, web content type and theme consistency on banner blindness: an eye movement study

During the epidemic, online advertising became more important, and several studies have suggested that internet users tend to avoid viewing online ads, such as banner ads. Previous studies have shown that product items that use animation lead to increased visual attention to all items on a webpage at the expense of attention to nonanimated items on the same webpage. However, few studies have compared the impact of the picture and text forms taken by static banners on the effectiveness of banner ads. At the same time, whether semantic factors (theme consistency) moderate the influence of structural factors (picture and text forms) on banner advertising remains unknown. The aim of this paper is to examine the influence of structural factors and semantic factors of ads on participants' visual attention to and memory of banner ads. The participants (twenty-seven males and forty females aged 18-26 years) were divided into two groups, one for consistent ad-web content themes and the other for inconsistent ad-web content themes. Then, the participants were asked to browse 16 complete pages (4 pages each of text-type web content and text-type banner ads, picture-type web content and picture-type banner ads, text-type web content and picture-type banner ads, and picture-type web content and text-type banner ads), and their eye movements were recorded to measure the participants' level of attention to the banner ads. A recognition task was used to measure the participants' memories of the banner ads. The results showed that the text-type banner ad had a lower blindness rate and exerted better attention and memory effects than the picture-type banner ad, and the text-type banner ad had a lower blindness rate and better attention and memory effects when positioned in the background of picture-type web content than when positioned in the background of text-type web content. A significant interaction effect among banner ad type, web content type and theme consistency showed that ad-web content theme consistency moderated the effect of web content type and banner ad type on ad effectiveness. Taken together, the results of these tasks demonstrate that theme consistency moderates the effect of web content type and banner ad type on ad effectiveness in a top-down manner. To reduce the negative effect of banner blindness, placing text-type banner ads in picture-type web content and setting a consistent theme between the banner ad and the web content is the more effective choice. The findings from this study can be used to assist advertising agencies in designing more effective and efficient banner ads from the perspective of basic psychology.

Evaluation of a Road Safety Awareness Campaign Deployed along the Roadside in Saguenay (Québec, Canada)

For the past few years, police officers from the City of Saguenay have been installing a billboard combined with a damaged car along roadsides to make drivers aware of the road risks related to dangerous behaviors at the wheel. To assess the short-term effect of this device, evaluative research with a quasi-experimental design with pre-exposure, during, and post-exposure. The results show a significant decrease (p < 0.001) of 0.637 km/h for the first site (a 70 km/h zone) and 0.269 km/h for the second site (a 50 km/h zone) when the device is exposed. At the time of this last evaluation, a reduction of 1.255 km/h remained even after the advertising panel was removed. Although minimal, this speed reduction where the billboards are placed shows the police that this awareness-raising approach works since it reduces the speed of motorists at very low cost.

The impact of racially-targeted food marketing and attentional biases on consumption in Black adolescent females with and without obesity: Pilot data from the Black Adolescent & Entertainment (BAE) study

Unhealthy food advertisements ("advertisements" hereafter referred to as "ads") are linked to poor diet and obesity, and food companies disproportionally target Black youth. Little is known about the mechanisms whereby food ads influence diet. One possibility may be racially-targeted ads that appeal to Black youth. Those with food-related attentional biases may be especially vulnerable. The objective of this project was to assess the feasibility and initial effects of a pilot study testing the influence of racially-targeted food ads and food-related attentional biases on eating behaviors among a sample of Black adolescent females. Feasibility of recruitment, retention, and procedures were examined. Participants (N = 41, 12-17y) were randomized to view a television episode clip of the Big Bang Theory embedded with either four 30-second racially-targeted food ads or neutral ads. A computer dot probe task assessed food-related attentional biases. The primary outcome was caloric consumption from a laboratory test meal. Interactions based on weight and ethnic identity were also examined. Analyses of variance and regressions were used to assess main and interaction effects. Exposure to racially-targeted food ads (versus neutral ads) did not affect energy consumption (p > .99). Although not statistically significant, adolescents with obesity consumed nearly 240 kcal more than non-overweight adolescents (p = 0.10). There were no significant preliminary effects related to food-related attentional biases or ethnic identity (ps = 0.22-0.79). Despite a non-significant interaction, these data provide preliminary support that adolescents with obesity may be particularly vulnerable to racially-targeted food ads. An adequately powered trial is necessary to further elucidate the associations among racially-targeted food ads among Black adolescent girls with obesity.

Presence of Nicotine Warning Statement on US Electronic Nicotine Delivery Systems (ENDS) Advertisements 6 Months Before and After the August 10, 2018 Effective Date

INTRODUCTION

Effective in August 10, 2018, FDA requires advertisements for electronic nicotine delivery systems (ENDS) that meet the definition of a "covered tobacco product" to feature a standard nicotine warning statement. To date, limited data exist on the presence of warning statements in ENDS advertising.

METHODS

We acquired ENDS ads (n = 459) that first ran six months before (February 10, 2018-August 9, 2018) and after (August 10, 2018-February 9, 2019) the effective date. The sample included online, print, and outdoor static ads (ie, without video or animated graphics) (n = 166 before, n = 198 after), online and television video ads (n = 16 before, n = 49 after), and radio ads (n = 9 before, n = 21 after). We coded ads for the presence of the verbatim FDA warning. Ads with verbatim warnings were coded for required formatting and additional features.

RESULTS

Overall, 28% of static (n = 46/166), 62% of video (n = 10/16), and 67% of radio (n = 6/9) ads that ran before the effective date contained the verbatim warning versus 84% (n = 167/198, p < .001), 96% (n = 47/49, p = .002), and 86% (n = 18/21, p =.329) of ads that ran after, respectively. Following the effective date, nearly all static ads placed the warning as required at the top of the ad (76% [n = 35/46] before, 97% [n = 162/167] after, p < .001), and many video ads featured the warning statement for the entire ad duration (0% [n = 0/10] before, 60% [n = 28/47] after, p < .001). Half (n = 9/18) of radio warnings running after the effective date were read faster than the other promotional content.

CONCLUSIONS

The presence of the nicotine warning statement on paid promotional static, video, and radio ENDS ads in this sample increased after August 10, 2018, but a notable number still lacked the warning.

IMPLICATIONS

Results from this study provide initial insights into the extent to which required nicotine warning statements appear in ENDS ads in the study sample across traditional (eg, magazines, television, radio) and digital (eg, online/mobile ads) advertising mediums. Following the August 10, 2018, effective date, we observed a substantial increase in the presence of the required FDA warning statement on the ENDS ads in this sample. However, a notable number of ads in the study lacked the required warning and warnings did not always include the required formatting displays.

Strategies for Recruiting Migrants to Participate in a Sexual Health Survey: Methods, Results, and Lessons

In this article, we describe the approaches taken to recruit adult migrants living in Australia for a sexual health and blood-borne virus survey (paper and online) and present data detailing the outcomes of these approaches. The purpose was to offer guidance to redress the under-representation of migrants in public health research. Methods of recruitment included directly contacting people in individual/organizational networks, social media posts/advertising, promotion on websites, and face-to-face recruitment at public events/venues. Search query strings were used to provide information about an online referral source, and project officers kept records of activities and outcomes. Descriptive statistical analyses were used to determine respondent demographic characteristics, proportions recruited to complete the paper and online surveys, and sources of referral. Logistic regression analyses were run to predict online participation according to demographic characteristics. The total sample comprised 1454 African and Asian migrants, with 59% identifying as female. Most respondents (72%) were recruited to complete the paper version of the survey. Face-to-face invitations resulted in the highest number of completions. Facebook advertising did not recruit large numbers of respondents. Same-sex attraction and age (40-49 years) were statistically significant predictors of online completion. We encourage more researchers to build the evidence base on ways to produce research that reflects the needs and perspectives of minority populations who often bear the greatest burden of disease.

Advertising of unhealthy foods and beverages around primary and junior high schools in Ghana's most urbanized and populous region

Introduction

The advertising of energy-dense, nutrient-poor foods and beverages is a common feature in obesogenic food environments. Such advertising, within and around settings where children live, learn, and play, negatively affects their food acquisition and consumption. We examined the extent and nature of food and beverage advertising around primary and junior high schools in Ghana's most populous and urbanized region, Greater Accra.

Materials and methods

Outdoor advertisements for foods and beverages within a 250 m road network distance of 200 randomly sampled schools were geocoded. For each food and beverage advertisement, information was collected on the setting, type, size, and number of product types featured in the advertisement. Promotional techniques (promotional characters and premium offers) used in advertisements were documented. Advertised foods and beverages were classified using the INFORMAS and NOVA food classification systems.

Results

A total of 5,887 advertisements were identified around the schools surveyed, 42% of which were for foods and beverages. Advertisements were most prevalent at food outlets (78% of all food advertisements), but also along roads and on non-food structures. Overall, 70% of food advertisements featured non-core/unhealthy products, while 12 and 14% had core/healthy and miscellaneous (including soup cubes, seasonings, and tea) products. About 4% of food advertisements had only a product/brand name or logo displayed. One out of two of the foods and beverages advertised were ultra-processed foods, 30% processed, 3% processed culinary ingredients, and 17% unprocessed or minimally processed foods. Sugar-sweetened beverages were the most advertised food product type (32%). Promotional characters were found on 14% of all food advertisements (most-69% were cartoons or manufacturer's characters), while 8% of all food advertisements had premium offers (including price discounts and gift/collectables).

Conclusions

There is an abundance of unhealthy food advertisements around primary and junior high schools in the Greater Accra Region. Policy actions such as restricting the promotion of unhealthy foods in children's settings are needed to protect pupils from such advertising practices.

Social Media Use and Alcohol Consumption: A 10-Year Systematic Review

Many studies have looked at the relationship between social media and alcohol consumption. There is a need for a comprehensive review that synthesizes the results of past research to systematically understand the relationship between social media use and alcohol consumption. The present systematic literature review synthesizes the findings from global social media and alcohol use studies (n = 206, 204 retained for analysis) between 2009 and 2019. Codes included type of study, methods, use of theory, and whether and how the relationship between social media and alcohol use was tested, among others. In addition to providing descriptive findings, the current study compared the findings across studies that primarily focused on advertising and marketing, self-generated user-generated content (UGC), other-generated UGC, social media uses and affordances, and a mixture of more than one type of content/focus. Most articles used quantitative methods (77.94%), which is followed by qualitative methods (15.20%), mixed methods (6.37%), and 0.49% that did not fit in any of the methods categories. Of the studies that tested the relationship between social media use and alcohol consumption, an overwhelming majority found that relationship to be positive (93.10%). The results of the present study provide a comprehensive understanding of past findings regarding social media and alcohol consumption and provide important future research suggestions.

Oral nicotine marketing claims in direct-mail advertising

BACKGROUND

Little is known regarding how oral nicotine products (eg, nicotine pouches, lozenges) are marketed to consumers, including whether potential implicit reduced harm claims are used. In the current study, we explored the marketing claims present in a sample of direct-mail oral nicotine advertisements sent to US consumers (March 2018-August 2020).

METHODS

Direct-mail ads (n=50) were acquired from Mintel and dual-coded for the following claims: alternative to other tobacco products, ability to use anywhere, spit-free, smoke-free and product does not contain tobacco leaf. We merged the coded data with Mintel's volume estimate (number of mail pieces sent to consumers) and calculated the proportion of oral nicotine advertisements containing claims by category.

RESULTS

Of the 38 million pieces of oral nicotine direct-mail sent to US consumers, most featured claims that the product could be used anywhere (84%, 31.8 million pieces); was an alternative to other tobacco products (69%, 26.1 million pieces); and did not contain tobacco leaf (eg, 'tobacco leaf-free', 'simple' approach of extracting nicotine from tobacco; 55%, 20.7 million pieces). A slightly smaller proportion contained claims that oral nicotine was 'spit-free' (52%, 19.8 million pieces) or 'smoke-free' (31%, 11.7 million pieces).

CONCLUSION

Our results provide an early indication of marketing claims used to promote oral nicotine. The strategies documented, particularly the use of language to highlight oral nicotine is tobacco-free, may covey these products as lower-risk to consumers despite the lack of evidence or proper federal authorisation that oral nicotine products are a modified-risk tobacco product. Future research is needed to examine consumer perceptions of such claims.

Youth and Young Adult-targeted E-cigarette Warnings and Advertising Messages: An Experiment with Young Adults in the US

Warnings specifically focused on harm to younger users have been understudied in vaping warning research, even while vaping products may appeal specifically to a younger population through implicit advertising strategies. This study examined how youth and young adult-focused e-cigarette health warning messages and implicit advertising strategies influence affective responses, risk perceptions, cognitive elaboration about e-cigarette harms, and willingness to vape in the future. We recruited young adults (who, at the time, were not smoking combustible cigarettes) aged 18-25 to participate in an online survey experiment with a 3 (warning label type: current FDA/youth and young adult risk-focused/none) × 3 (advertising health message strategy: explicit/implicit/none) + 3 (non-vaping products control) design. The results show a main effect for warning such that both FDA and targeted warnings increased negative affect and decreased positive affect compared to no warning. Moreover, the youth and young adult-focused warning boosted youth-specific harm beliefs and cognitive elaboration relative to control and the FDA warning, which did not differ from one another. Implicit health messages produced greater positive affect relative to explicit messages and no message, but the ad strategy manipulations did not influence other outcomes. While the population studied here with a single exposure reported no effects of either manipulation on willingness to vape, previous research has associated similar emotions and cognitions with lowered intentions to vape. Regulatory bodies should consider further exploration of vaping warnings that emphasize youth and young adult-specific harms to educate young people about relevant risks.

Food Marketing and Power: Teen-Identified Indicators of Targeted Food Marketing

Food marketing is powerful and prevalent, influencing young people’s food attitudes, preferences, and dietary habits. Teenagers are aggressively targeted by unhealthy food marketing messages across a range of platforms, prompting recognition of the need to monitor such marketing. To monitor, criteria for what counts as teen-targeted food marketing content (i.e., persuasive techniques) must first be established. This exploratory study engaged teenagers to explore the “power” of food marketing by identifying what they consider to be teen-targeted marketing techniques within various food marketing examples. Fifty-four teenagers (ages 13–17) participated in a tagging exercise of 19 pre-selected food/beverage advertisements. Assessed in light of age and gender, the results showed clear consistency with what indicators the participants identified when it comes to selecting “teen-targeted” ads—with advertisements most frequently chosen as “teen-targeted” containing humor (particularly irony) and celebrities. When it comes to specific indicators used by teenagers, visual style dominated, standing as the marketing technique with the most “power” for teenagers. The findings shed much needed insight into the elements of power—and more precisely, the specific marketing techniques persuasive to teenagers—which are necessary to inform monitoring efforts and to create evidence-based policy.

Global COVID-19 Advertisements: Use of Informational, Transformational and Narrative Advertising Strategies

This study employs the informational and transformational approaches from Taylor's Six-Segment Message Strategy Wheel and narrative transportation theory to understand the use of different advertising message strategies in COVID-19 advertisements on a global scale. Understanding how advertisers constructed their public messages during a global pandemic is a necessary first step before follow-up research can be done to assess which message strategies were most effective. Content analysis was performed on the entire COVID-19 video ad library (N = 354) from Ads of the World website that were published from March to September 2020 from 49 countries. Results suggested that most of the ads used a transformational strategy with a focus on the social aspect of limiting community spread instead of an informational approach. Many of the ads also employed a narrative message strategy that used storytelling to transport and persuade viewers. Perhaps the most interesting finding is that the use of narrative message strategy was related to storytelling, ad length, music, and humor, but independent from the use of informational strategies.

A branch and bound algorithm for optimal television commercial scheduling

In the current era of multimedia, television (TV) plays an important role in transmitting advertising messages. In addition, advertising is the primary source of revenue for the TV industry. Thus, a critical issue for TV stations is the scheduling of commercials in suitable advertising breaks on different TV channels to maximize revenue and minimize penalties. This type of TV commercial scheduling problem is similar to the machine scheduling problem, and both have availability constraints. However, the literature on TV commercial scheduling has not considered this perspective. Motivated by this, we consider the problem of scheduling commercials with specific service-level requirements on TV channels while minimizing the maximum lateness. The lateness of a commercial is defined to be its completion time minus its due date, and the maximum lateness is the maximum value of lateness among all commercials. We propose an exact branch and bound algorithm based on the LFJ (least flexible job first)/EDD (earliest due date first) rules and network flow methods, which were developed to solve the machine scheduling problem with availability constraints. Computational analysis shows that the bounding scheme proposed is highly effective, and a very low percentage of nodes is generated by the branch and bound algorithm. The algorithm can obtain an optimal solution for the problem.

I'm Lovin' It: How Fast Food Advertising Influences Meat-Eating Preferences

Overconsumption of red and processed meat is associated with a multitude of negative health outcomes. Previous research shows exposure to advertising messaging can influence dietary behaviors but research on the influence of meat advertising on diet, specifically, is scant. Theoretically informed by the Reasoned Action Approach, the present experiment randomly assigned participants to view a version of a print McDonald's advertisement that included meat imagery (a Big Mac), non-meat imagery (French fries), or no food (just the McDonalds' logo and slogan), which acted as a control. An online survey in the United States included 514 U.S. adults (M_age = 51 years). Participants exposed to meat imagery compared to the non-meat imagery reported a higher desire to eat meat. The meat imagery and control conditions were also significantly associated with increased cognitive accessibility of meat concepts, compared to when respondents were shown the no-meat condition. Desire to eat meat, but not the cognitive accessibility of meat concepts, was significantly associated with attitude, normative pressure, and perceived behavioral control for avoiding eating meat one day per week; these constructs predicted intention and willingness to avoid meat. Results indicate that exposure to meat imagery in advertising does have the potential to influence meat consumption behavior and also has implications for the use of meat imagery in persuasive messaging for public health campaigns.

Does the French Évin Law on Alcohol Advertising Content Reduce the Attractiveness of Alcohol for Young People? An Online Experimental Survey

OBJECTIVE

France's Évin law limits the content of alcohol advertising to purely factual product information. Little research to date has examined the effectiveness of this measure. To address this gap, we investigated the effect on young people of (a) content restrictions in general, (b) more or less strict content regulations, and (c) whether different youth profiles are more or less susceptible to content regulations.

METHOD

An online experimental survey on 18- to 25-year-olds in France was conducted (n = 2,163). Participants were exposed to three advertising conditions for four alcohol brands: (a) neutral ads with only bottles and logos (in line with Évin law restrictions); (b) contextual ads (partying and sport iconography) without characters; and (c) contextual ads featuring characters. Participants self-reported their reactions on attention, appeal, product, alcohol consumption perception, image benefits, and perceived behavioral impact. Demographics and alcohol use measures were also collected.

RESULTS

For almost all reactions, ads that featured sport or party contexts (with/without characters) generated more positive reactions and more perceived behavioral impact compared with neutral ads. Ads that featured characters had more positive reactions than ads without characters. Women and the youngest segment (18-21 years old) emerged as the most sensitive to contextual ads.

CONCLUSIONS

Regulating alcohol advertising content via strongly prohibitive measures, as per France's Évin law in 1991 or similar measures in other countries, is an effective policy direction for protecting vulnerable young people. This approach should be considered by countries that currently have only partial bans on alcohol advertising placement.

Constructing the Gendered Risk of Illness in Lyrica Ads for Fibromyalgia: Fear of Isolation as a Motivating Narrative for Consumer Demand

Direct-to-consumer television advertisements for Lyrica in the United States create narratives of gendered domestic normalcy to which women with fibromyalgia are encouraged to aspire through pharmaceutical intervention. This paper unpacks images and narratives within these advertisements to demonstrate that they rely on metaphors that represent gendered expectations in order to evoke guilt and provoke a desire for what Joseph Dumit calls "health as risk reduction," and what I argue is an attempt to show disability being erased. Following Stuart Hall's Encoding/Decoding model of communication, viewers play a role in constructing societal expectations for women with chronic pain and for themselves.

An evaluation of the evidence submitted to Australian alcohol advertising policy consultations

BACKGROUND

Industry self-regulation is the dominant approach to managing alcohol advertising in Australia and many other countries. There is a need to explore the barriers to government adoption of more effective regulatory approaches. This study examined relevance and quality features of evidence cited by industry and non-industry actors in their submissions to Australian alcohol advertising policy consultations.

METHODS

Submissions to two public consultations with a primary focus on alcohol advertising policy were analysed. Submissions (n = 71) were classified into their actor type (industry or non-industry) and according to their expressed support for, or opposition to, increased regulation of alcohol advertising. Details of cited evidence were extracted and coded against a framework adapted from previous research (primary codes: subject matter relevance, type of publication, time since publication, and independence from industry). Evidence was also classified as featuring indicators of higher quality if it was either published in a peer-reviewed journal or academic source, published within 10 years of the consultation, and/or had no apparent industry connection.

RESULTS

Almost two-thirds of submissions were from industry actors (n = 45 submissions from alcohol, advertising, or sporting industries). With few exceptions, industry actor submissions opposed increased regulation of alcohol advertising and non-industry actor submissions supported increased regulation. Industry actors cited substantially less evidence than non-industry actors, both per submission and in total. Only 27% of evidence cited by industry actors was highly relevant and featured at least two indicators of higher quality compared to 58% of evidence cited by non-industry actors.

CONCLUSIONS

Evaluation of the value of the evidentiary contribution of industry actors to consultations on alcohol advertising policy appears to be limited. Modifications to consultation processes, such as exclusion of industry actors, quality requirements for submitted evidence, minimum standards for referencing evidence, and requirements to declare potential conflicts, may improve the public health outcomes of policy consultations.

Themes, communities and influencers of online probiotics chatter: A retrospective analysis from 2009-2017

We build on recent examinations questioning the quality of online information about probiotic products by studying the themes of content, detecting virtual communities and identifying key influencers in social media using data science techniques. We conducted topic modelling (n = 36,715 tweets) and longitudinal social network analysis (n = 17,834 tweets) of probiotic chatter on Twitter from 2009–17. We used Latent Dirichlet Allocation (LDA) to build the topic models and network analysis tool Gephi for building yearly graphs. We identified the top 10 topics of probiotics-related communication on Twitter and a constant rise in communication activity. However the number of communities grew consistently to peak in 2014 before dipping and levelling off by 2017. While several probiotics industry actors appeared and disappeared during this period, the influence of one specific actor rose from a hub initially to an authority in the latter years. With multi-brand advertising and probiotics promotions mostly occupying the Twitter chatter, scientists, journalists, or policymakers exerted minimal influence in these communities. Consistent with previous research, we find that probiotics-related content on social media veers towards promotions and benefits. Probiotic industry actors maintain consistent presence on Twitter while transitioning from hubs to authorities over time; scientific entities assume an authoritative role without much engagement. The involvement of scientific, journalistic or regulatory stakeholders will help create a balanced informational environment surrounding probiotic products.

Analysis of social media use by European plastic surgery societies: A missing link for #PlasticSurgery

PURPOSE

The field of Plastic Surgery is prominent on social media around the world. Board certified plastic surgeons and societies of plastic surgery play a role in providing accurate, evidence-based information to the public, patients, and colleagues. The aim of this study was to explore the use of social media by European Plastic Surgery Societies.

METHODS AND MATERIALS

A retrospective analysis of the presence and activity of European Plastic Surgery Societies on Facebook, Twitter and Instagram was conducted between December 12th 2018 and December 12th 2019. The results have been compared to the American Society of Plastic Surgeons.

RESULTS

Twenty, eleven and nine European societies yielded an active account on Facebook, Twitter and Instagram respectively. Only seven European societies had an account on all three platforms and were therefore considered polypresent. The amount of followers of those seven societies was significantly higher than of the others (p-value = 0.02). Their activity yielded significantly more posts on Facebook (p-value = 0.02). The American Society of Plastic Surgeons had more followers on all three platforms than all European societies combined.

CONCLUSION

Social media are still rather unexploited by European Plastic Surgery Societies. A tendency towards increased visibility can be observed, yet a higher penetration is required to further educate and engage through social media. The quantitative data provided serve as reasonable foundation for further studies and a guide for growth of #PlasticSurgery.

Novel approach to delivering pro-environmental messages significantly shifts norms and motivation, but children are not more effective spokespeople than adults

Three studies provided initial laboratory tests of the effectiveness of a novel form of community-based environmental messaging intended to be deployed on public digital signs. In all studies, adult participants watched a slideshow of “Community Voices,” a display that combines community images and quotes to celebrate and empower pro-environmental and pro-community thought and action. In addition to assessing the general efficacy of the approach, a central goal was to assess the impact of alternative messengers by comparing identical text associated with either adult or child messengers (Studies 1, 2, and 3). We also assessed the impact of alternative framing of the message itself by comparing: injunctive vs non-injunctive wording (Study 1), political vs non-political content (Study 1), and future vs. present-oriented framing (Study 2). Studies 1 and 2 were conducted on a national sample. In addition, to assess the impact of local vs. non-local messengers, Study 3 compared the response of a non-local sample to a local population in which subjects had personal connections with the people and places featured in the message content. Exposure to Community Voices messages resulted in significant increases in social norm perception, concern about environmental issues, commitment to action, and optimism, suggesting that this approach to messaging is potentially valuable for stimulating cultural change. However, messages attributed to child messengers were generally not more effective, and in some cases were less effective than the same message attributed to adults. We also found no significant difference in the impact of the alternative message frames studied.

I am afraid, so I buy it! The effects of anxiety on consumer assimilation and differentiation needs amongst individuals primed with independent and interdependent self-construal

Individuals tend to satisfy their assimilation needs by purchasing products that bear a specific group identity. Such products might be preferred when an individual is threatened because anxiety increases affiliative needs. In contrast, individuals might be more attracted to unique-design products when they feel less anxious. We examined the impact of anxiety on assimilation and differentiation needs amongst consumers primed with independent and interdependent self-construal. We expected that anxiety would produce stronger assimilation needs and show a weaker preference for unique products. In Study 1 (N = 110), we found that individuals in the anxiety-inducing condition decreased their evaluation of unique products and exhibited stronger assimilation needs. Independents who felt anxiety reacted with a reduced preference for group-linked products. Study 2 (N = 102) found that introducing an anxiety-decreasing agent (vanilla scent) after a social identity threat reduced differentiation needs and preference for unique products. Physiological data showed that the social identity threat increased sympathetic arousal, but the vanilla scent did not have a soothing effect on physiological reactivity. Overall, this work showed that both anxiety and vanilla scent reduced consumer need for differentiation. Furthermore, for independents, anxiety reduced assimilation needs. We found novel determinants of assimilation/differentiation needs with implications for advertising and retailing products with a unique design.

Research on the cooperative mechanism of government and enterprise for basin ecological compensation based on differential game

Ecological compensation is an important means of basin pollution control, the existing researches mainly focus on the government level ignoring the important role of enterprises. Therefore, this paper introduces enterprises into the process of ecological compensation. Firstly, suppose the ecological compensation system composed of government and enterprises, the government is in the dominant position. The ecological compensation input of the government and enterprise will produce social reputation, and the ecological compensation of enterprise will also produce advertising effect. Consumer demand will be affected by social reputation and advertising effect. Then, the compensation strategies of the government and enterprise are analyzed by constructing the differential game model. The research shows that under certain conditions, the cost-sharing mechanism can realize the Pareto improvement of the benefits of government, enterprise and the whole system. Under the cooperative mechanism, the benefit of the government, enterprise and the whole system is optimal. Finally, the validity of the conclusion is verified by case analysis, and the sensitivity analysis of the relevant parameters is carried out. The conclusion can provide reference for government to establish sustainable watershed ecological compensation mechanism.

Characterization of US Hospital Advertising and Association With Hospital Performance, 2008-2016

IMPORTANCE

Hospital advertising has been touted as a tool to improve consumer decision-making, but little is known about its association with objective measures of hospital quality.

OBJECTIVE

To document recent trends in hospital advertising in the US and examine the association between concurrent measures of hospital advertising and quality.

DESIGN, SETTING, AND PARTICIPANTS

Retrospective cross-sectional study of all general acute care hospitals operating in the US between January 2008 and December 2016. Data were analyzed from December 6, 2019, to July 15, 2020.

EXPOSURE

Annualized advertising spending for each hospital as measured by a market research firm.

MAIN OUTCOMES AND MEASURES

Four composites of hospital performance from the Centers for Medicare & Medicaid Services Hospital Compare database were used: risk-standardized mortality rate, risk-standardized readmission rate, Consumer Assessment of Healthcare Providers & Systems (CAHPS) Overall Patient Experience Rating (scale of 1-5; higher scores indicate a more positive patient experience rating), and overall 5-star rating. Linear models adjusted for hospital bed size, hospital revenue, and geographic census region.

RESULTS

The study sample included, on average, 4569 general acute care hospitals per year between 2008 and 2016. During this time, approximately half of acute care hospitals (2239 of 4569 [49%]) advertised their services to consumers and spent a total of $3.39 billion. Relative to hospitals that never advertised, advertising hospitals were more likely to be nonprofit facilities (mean [SD], 66% [47%] vs 51% [50%]; P < .001), had larger bed sizes (mean [SD], 234.3 [210.7] beds vs 84.8 [110.6] beds; P < .001), and had higher net incomes (mean [SD], $17 800 000 [$49 000 000] vs $134 099 [$51 600 000]; P < .001). There was no observed association between hospital advertising and performance. For example, hospitals that advertised had a mean (SD) CAHPS 5-star rating of 3.2 (0.9) stars compared with 3.3 (1.0) stars among hospitals that did not advertise, an insignificant difference (P = .92). We observed no difference in performance between advertising and nonadvertising hospitals in 30-day readmission rates (mean [SD], 15.5% [0.8%] vs 15.6% [1.0%]; P = .25), mortality rates (mean [SD], 12.7% [4.0%] vs 12.0% [4.1%]; P = .46), and overall 5-star hospital ratings (mean [SD], 3.1 [0.8] stars vs 3.0 [0.9] stars; P = .50). A significant difference was observed in adjusted mortality rates across terciles of advertising spending, with lower mortality rates for the hospitals with higher ad spending (2016, mean [SD] mortality composite for hospitals in the highest tercile, 11.2% [4.2%] vs hospitals in the middle tercile, 12.0% [3.8%], and for hospitals in the lowest tercile, 12.7% [4.1%]; P = .003).

CONCLUSIONS AND RELEVANCE

The results of this cross-sectional study suggest that the amount hospitals spent on direct-to-consumer advertising was not associated with publicly reported measures of hospital quality; instead, hospital advertising spending was higher for financially stable hospitals with higher net incomes.

Neighborhood Disparities in the Availability, Advertising, Promotion, and Youth Appeal of Little Cigars and Cigarillos, United States, 2015

INTRODUCTION

Between 2012 and 2016, sales of cigars increased by 29% in the United States. In small local studies, greater little cigar and cigarillo (LCC) availability and marketing has been documented in neighborhoods with a greater proportion of Hispanic or Latino and black residents, and near schools. This national study of cigarette retailers assesses whether LCC availability and marketing at the point of sale is associated with neighborhood racial, ethnic, income, and percent youth demographics.

METHODS

In 2015, we collected LCC availability and marketing data through retailer audits of a nationally representative sample of 2128 cigarette retailers. Using 2011-2015 American Community Survey census tract estimates, we modeled associations of neighborhood demographics (in quartiles) with availability of LCC-flavored products, and presence of exterior advertisements, youth marketing, and promotions.

RESULTS

Nearly 90% of retailers sold LCCs, 83.0% sold flavored LCCs, and 30.9% had youth marketing. Controlling for retailer type and other neighborhood characteristics, neighborhoods with the highest proportion of black residents had significantly higher odds of flavored LCC availability (adjusted odds ratio [AOR] = 2.24, 95% confidence interval [CI] = 1.52, 3.30); exterior advertisements (AOR = 2.84, 95% CI = 1.94, 4.16); price promotions (AOR = 1.62; 95% CI = 1.07-2.45), and youth appeal (AOR = 1.49, 95% CI 1.08-2.08) compared to the lowest. Disparities in flavored LCC availability, exterior advertising, and youth appeal were also present for lower income neighborhoods.

CONCLUSION

Neighborhoods with a greater proportion of black or lower income residents have greater flavored LCCs availability and LCC marketing. Without stronger LCC regulation, residents of these neighborhoods may be at a greater risk of LCC use.

IMPLICATIONS

LCCs are harmful combustible tobacco products that are less regulated than cigarettes (eg, lower taxation, cheaper outlay due to small package sizes, availability of flavors), which makes them an affordable and appealing product to youth. This study documents greater availability, advertising, and marketing of LCCs in neighborhoods with a higher proportion of black or lower-income residents, potentially putting these populations at a greater risk of using or switching to these products in the face of increasing cigarette regulations. These findings underscore the need for local, state, and federal LCC regulatory action.

Designing Effective Digital Advertisements to Prevent Online Consumption of Child Sexual Exploitation Material

The necessity of developing effective and innovative primary prevention strategies is a pressing objective in stemming the harm caused by the production and consumption of child sexual exploitation material (CSEM). Digital media interventions - including search engine advertisements - hold promise as prevention tools to deflect potential users away from CSEM and redirect them to therapeutic services. This study aimed to establish an evidence base for effective advertising in this context by creating mock-up helpline advertisements and testing them in focus groups and interviews with staff and clients of New Zealand's major treatment service providers for harmful sexual behavior. Prior to testing these advertisements in situ (on online platforms), this paper reports on a foundational creative and qualitative investigation of effective advertisements - what imagery, text, and design features are most likely to succeed in diverting people away from seeking CSEM and encouraging them to reach out to a helpline? The findings of this study offer deeper understanding of the mindset, emotions, and barriers to reaching out that are experienced by onset CSEM users, as well as suitability of certain imagery and text for advertising in this context, and thereby contribute to strengthening primary prevention efforts in combatting CSEM consumption.

Alcohol Advertising, Promotion, and Sponsorship: A Review of Regulatory Policies in the Association of Southeast Asian Nations

OBJECTIVE

The expansion of transnational alcohol corporations (TACs) in Southeast Asia has been suggested as a possible contributor to increased alcohol advertising, promotion, and sponsorship (AAPS), which in turn may have contributed to increasing rates of alcohol consumption and alcohol-related problems. The aim of this scoping review is to document the growth of TACs in the region and to critically evaluate the development of alcohol policies to regulate AAPS in 10 Southeast Asian nations.

METHOD

National policies related to AAPS were reviewed using data from the Global Information System on Alcohol and Health, following the framework of the WHO Global Strategy to reduce the harmful use of alcohol. The policy review was supplemented with data from corporate annual reports, press releases, four databases of academic literature, market research from Euromonitor International, and news articles.

RESULTS

Four TACs--Carlsberg, Diageo, Heineken, and San Miguel--have been expanding operations in Southeast Asia by setting up new breweries, acquiring local alcohol companies as subsidiaries, and entering into joint ventures. In contrast, policies for regulating AAPS vary across Southeast Asia and range from nonexistent to strong control of AAPS. There is strong control of AAPS in countries with existing legislation ranging from a complete ban (Brunei) to almost comprehensive bans (Indonesia, Myanmar, Laos) and partial bans (Thailand). Nonexistent to weak control of AAPS is observed in the Philippines, Singapore, Cambodia, Malaysia, and Vietnam, which mostly rely on voluntary regulation.

CONCLUSIONS

The study's findings point to the growing power of TACs in the region and call for the need for stronger measures based on scientific evidence of effectiveness that are implemented without interference from commercial interests.

How Is Functional Food Advertising Understood? An Approximation in University Students

In functional food advertising, messages are not always easily understandable for the target audience. Current European legislation, enforced through Regulation 1924/2006, specifies that such messages should be clear and precise so as not to mislead the consumer. The objective of this study was to observe consumers' understanding of messages in functional food advertisements. The methodology used was a self-administered survey filled out by 191 students enrolled in a Degree in Advertising and Public Relations at the University of Alicante (Spain). The results suggest that a large number of students do not know what functional food is and obtain information about these products mainly from labelling/packaging. The major means of communication through which they learn about health benefits via advertising is the internet, followed by television. Most respondents indicated that they understood related advertisements and found it helpful to be given additional information on health benefits. Worthy of note, the greater their level of understanding of the messages, the higher their level of distrust of advertising messages, which they considered to be deceptive or misleading.

Obesity and food-related content aimed at children on YouTube

This article explores the intersection between advertising by food brands, practices on YouTube and child obesity. The objective is to analyse the communication features of marketing content by food brands targeting children on YouTube. The existing literature confirming the relationship between exposure to food advertising and actual consumption prioritizes television while largely ignoring the digital world. When children connect to the internet, watching videos on YouTube is their most common activity. We analyse and compare the advertising by food brands on regular TV networks (traditional advertising) with videos by child YouTubers (influencing) in Spanish. An exploratory study is conducted by means of a content analysis of 304 videos, with 12 variables grouped into 2 categories: prevalence of ultra-processed vs healthy products in advertising, and marketing style. The results reveal marked differences in practices between brands and child YouTubers, along with the rise of hybrid media forms. The conclusions highlight the absence of advertising warnings in content targeting children. Changes are recommended to increase the responsibility assumed by these media spaces that exert such a huge influence on an audience as vulnerable as children.

Advertising techniques increase biologic treatment willingness in patients with psoriasis

BACKGROUND

Although biologics have revolutionized psoriasis care, some patients may be reluctant to consider implementing biologic therapy.

OBJECTIVE

To determine whether willingness to take a biologic is increased by commonly used advertising techniques.

METHODS

An online survey was used to assess subjects with a self-reported diagnosis of psoriasis and their willingness to initiate biologic treatment (N=400). Subjects were randomized to receive one of the following surveys: clinical data with positive framing (N=80), bandwagon-based statement (N=80), testimonial-based statement (N=80), comparative advertising (N=80), and negative framing (N=80). Willingness to take treatment was recorded on a 10-point Likert scale and evaluated using one-way ANOVA, two-group t-tests, and chi-squared tests.

RESULTS

Compared to subjects presented with positive framing (M=5.5, SD=3.2), subjects presented with a bandwagon-based statement (M=6.5, SD=2.7; P=0.04) and testimonial-based statement (M=7.0, SD=2.7; P=0.01) reported a greater willingness to take treatment, whereas negative framing (M=4.5, SD=3.0; P=0.03) decreased willingness and comparative advertising (M=5.5, SD=2.7; P=0.96) yielded the same willingness as positive framing.

CONCLUSION

Providers might be able to enhance biologic acceptance by utilizing commonly used advertising techniques, such as the bandwagon effect, testimonial effect, and positive framing.