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Sexual content of advertisements and the smoking process in adolescents.

STUDY OBJECTIVE: s: To analyze the perception of sexual content (PSC) of tobacco advertisements and its potential impact on the process of smoking in adolescents. DESIGN, PARTICIPANTS, AND SETTING: A questionnaire was administered to 1,186 adolescents at the National Institute of Respiratory Diseases in Mexico City to determine the PSC. In addition, age, gender, susceptibility, receptivity, parental smoking and education, anxiety, depressive symptoms, school category, and grade were determined. INTERVENTIONS AND MEASUREMENTS: The images of two advertisements were projected in color onto a screen. One of the images had unquestionable sexual content. The impact of the images was evaluated at the same time in the questionnaire. RESULTS: Forty-one percent of participants were nonsmokers (25% nonsusceptible and 16% susceptible), whereas 59% were smokers (47% experimenters and 12% established). Sixty-six percent were receptive to promotions of the tobacco companies. Seventy-two percent perceived sexual contents in the advertisements. A logistic regression model showed that receptivity (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.3 to 3.4), minimal PSC (OR, 2.6; 95% CI, 1.7 to 4.0), and high PSC (OR, 4.4; 95% CI, 2.4 to 8.0) were significantly associated with the status of smokers, whether experimenters or established. The strongest association was found with established smokers. Further analysis showed that male gender was significantly associated with high levels of PSC. CONCLUSIONS: These results show that a high percentage of adolescents perceived sexual content in the tobacco advertisement, which, independent of the subject's receptivity, plays a role in the process of smoking, especially in male adolescents.

Adolescent↗

Effect of television programming and advertising on alcohol consumption in normal drinkers.

The drinking behavior of 96 male normal drinking college students was assessed after they viewed a videotape of a popular prime-time television program complete with advertisements. Different versions of the videotape were used to evaluate the effects of a television program with and without alcohol scenes as crossed with the effects of three different types of advertisements (i.e., beer, nonalcoholic beverages and food). After viewing the videotape, the subjects, who were led to believe that they were participating in two separate and unrelated sets of experimental procedures, were asked to perform a taste rating of light beers, which actually provided an unobtrusive measure of their alcohol consumption. The results provided no support for the widely held assumption that drinking scenes in television programs or televised advertisements for alcoholic beverages precipitate increased drinking by viewers. This finding, however, must be considered in the context of the laboratory setting of the study, and thus may not generalize to real-life television viewing. Further research in this area is clearly needed, including an evaluation of the effects of television program content and advertisements on other populations (e.g., alcohol abusers).

Adult↗

Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers.

OBJECTIVE: Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality. METHOD: We first estimated the effect of public health interventions to decrease harmful drinking among youth from literature reviews and used life table methods to estimate alcohol-attributable years of life lost by age 80 years among the cohort of approximately 4 million U.S. residents aged 20 in the year 2000. Then, from national survey data on transitions in drinking habits by age, we modeled the impact of interventions on alcohol-attributable mortality. RESULTS: A tax increase and an advertising ban were the most effective interventions identified. In the absence of intervention, there would be 55,259 alcohol-attributable deaths over the lifetime of the cohort. A tax-based 17% increase in the price of alcohol of dollar 1 per six pack of beer could reduce deaths from harmful drinking by 1,490, equivalent to 31,130 discounted years of potential life saved or 3.3% of current alcohol-attributable mortality. A complete ban on alcohol advertising would reduce deaths from harmful drinking by 7,609 and result in a 16.4% decrease in alcohol-related life-years lost. A partial advertising ban would result in a 4% reduction in alcohol-related life-years lost. CONCLUSIONS: Interventions to prevent harmful drinking by youth can result in reductions in adult mortality. Among interventions shown to be successful in reducing youthful drinking prevalence, advertising bans appear to have the greatest potential for premature mortality reduction.

Adult↗

Direct-to-consumer advertising in oncology.

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to patients and support to caregivers while encouraging the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum in which caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Increasingly, cancer patients are subjected to advertisements related to oncologic therapies and other cancer-related products in the popular media. Such direct-to-consumer advertising is controversial: while it may inform, educate, and perhaps even empower patients, it also has the ability to misinform patients, and strain their relationships with oncology providers. The U.S. Food and Drug Administration requires that direct-to-consumer advertising provide a balanced presentation of a product's benefits, risks, and side effects, but this can be difficult to achieve. Through a discussion of this topic by an oncology fellow, ethicist, cancer survivor, and senior oncologist, the role of direct-to-consumer advertising and its often subtle effects on clinical practice in oncology are explored. Although sparse, the medical literature on this increasingly prevalent type of medical communication is also reviewed.

Academic Medical Centers↗

Health advertising: prevention for profit.

The National Cancer Institute (NCI) estimates on the basis of current knowledge alone that, at a minimum, 30,000 lives could be saved in the year 2000 if Americans would modify their dietary habits. A recent innovative way of responding to this challenge was the Kellogg Company/NCI All-Bran advertising campaign. This paper will describe the campaign, and its impact on consumers, cereal industry sales, food industry advertising practices, health regulatory policy, and the organizational credibility of both NCI and Kellogg. For the past three years, Kellogg has included NCI's cancer prevention messages in their advertisements for All-Bran cereal and on their bran cereal boxes. This collaborative effort has stimulated considerable controversy over whether the health claims made on the cereal label are in violation of federal food labeling regulations. Meanwhile, research has demonstrated the positive impact of the campaign on consumer's knowledge and behavior regarding fiber as well as on Kellogg's profits. Other manufacturers are anxious to jump on the "branwagon"; however, many unanswered questions remain about this new approach to health advertising.

Advertising↗

Subjects and accomplices: regulation and the ethics of cigarette advertising.

In debates on the regulation of cigarette advertising, opposition to regulation is based on a perceived threat to individual autonomy and choice. Advocates of regulation have sought to combat such arguments by focusing on the unique characteristics of tobacco: the absence of a "safe" level of consumption; that the habit is often acquired by children or young persons; that smokers are unaware of the extent of the risks involved; and that smoking is "addictive." The authors discuss the implications of these characteristics for regulation and the difficulties with such arguments. The focus on characteristics of the product means that little attention is given to the implications of the content and techniques of advertising. The dominant forms of cigarette advertising involve the communication of little product information and the use of persuasive mechanisms of which the consumer is either unaware or not fully aware. The authors explore the implications of such advertising strategies for regulation and public policy.

Adolescent↗

Adolescent counterarguing of TV beer advertisements: evidence for effectiveness of alcohol education and critical viewing discussions.

The pervasiveness of American youth's exposure to alcohol advertising is well-documented, as is the correlational evidence linking such exposure to alcohol-related attitudes, use, and expectancies. While efforts to train young people to resist persuasive appeals are often made in alcohol education programs, little evidence exists concerning the effectiveness of such efforts. The present study (N = 83) found that recency of exposure to alcohol education classes and discussion of alcohol advertising in such classes predicts cognitive resistance (counterarguing) of such advertisements months or even years after class exposure. Age, gender, and ethnicity were statistically controlled. While females tended to counterargue the alcohol advertisements more than did males, there was no statistically significant difference in the impact of education on males and females.

Adolescent↗

The effect of top-level domains and advertisements on health web-site credibility.

BACKGROUND: Concerns over health information on the Internet have generated efforts to enhance credibility markers; yet how users actually assess the credibility of online health information is largely unknown. OBJECTIVE: This study set out to (1) establish a parsimonious and valid questionnaire instrument to measure credibility of Internet health information by drawing on various previous measures of source, news, and other credibility scales; and (2) to identify the effects of Web-site domains and advertising on credibility perceptions. METHODS: Respondents (N = 156) examined one of 12 Web-site mock-ups and completed credibility scales in a 3 x 2 x 2 between-subjects experimental design. Factor analysis and validity checks were used for item reduction, and analysis of variance was employed for hypothesis testing of Web-site features' effects. RESULTS: In an attempt to construct a credibility instrument, three dimensions of credibility (safety, trustworthiness, and dynamism) were retained, reflecting traditional credibility sub-themes, but composed of items from disparate sources. When testing the effect of the presence or absence of advertising on a Web site on credibility, we found that this depends on the site's domain, with a trend for advertisements having deleterious effects on the credibility of sites with .org domain, but positive effects on sites with .com or .edu domains. CONCLUSIONS: Health-information Web-site providers should select domains purposefully when they can, especially if they must accept on-site advertising. Credibility perceptions may not be invariant or stable, but rather are sensitive to topic and context. Future research may employ these findings in order to compare other forms of health-information delivery to optimal Web-site features.

Adult↗

Fashion advertisements: a comparison of viewers' perceptual and affective responses to illustrated and photographed stimuli.

The perceptual and affective responses of 44 women to actual illustrated and photographed fashion advertisements during focused interviews were explored. Content analysis methods identified categories of response; frequency of response categories for the two media were compared using Fisher's z tests. Significant differences in perceptual responses included greater visual interest created by the use of color in photographs, greater interest in layout and design features of the illustrations, and interest in characteristics of the models in the photographs. Affective response differences included greater preference for photographic advertisements and the garments in them. Contrary to suggestions from professionals in fashion advertising, no significant differences were found in viewers' perceptions of information about the products in the advertisements or perceptions of meaning and aesthetic response.

Adult↗

Emotion and style in 30-second television advertisements targeted at men, women, boys, and girls.

A program for objective textual analysis which incorporated measures of style, word emotionality, and word imagery, was used to score the verbal portion of 152 30-sec. television advertisements. This analysis indicated that advertisements directed at children were more active, longer, and less negative than those directed at adults. A comparison of advertisements directed at males and females regardless of age showed greater linguistic complexity (more words, fewer common words) when their text was directed at women and girls. Each of the 13 stylistic and emotional measures used to describe advertisements produced at least one significant difference associated with the age or the sex of the target population or their interaction.

Adult↗

Note on guilt appeals in advertising: covariate effects of self-esteem and locus of control.

A 1991 study by Pinto and Priest demonstrated the effectiveness of advertisements employing moderate levels of guilt in inducing guilt responses in subjects. Because individuals' responses to guilt are often influenced by their specific personality characteristics, researchers have pointed to the potential moderating effects of individual difference variables such as level of self-esteem and locus of control on individuals' susceptibility to guilt appeals. A study was conducted to evaluate the possibility that self-esteem and locus of control can act as covariates across three treatment levels of guilt advertising. From a sample of 57 working mothers, advertisements stimulating medium and high levels of guilt elicited significantly greater feelings of guilt in subjects than the control advertisement stimulating low guilt. However, the relationship between susceptibility to guilt appeals and self-esteem and locus of control was not observed to covary.

Adult↗

Drama advertisements: moderating effects of self-relevance on the relations among empathy, information processing, and attitudes.

The effects of drama versus lecture format in public service advertisements are studied in a 2 (format) x 2 (malaria vs AIDS) factorial design. Two structural equation models are built (one for each level of self-relevance), showing two distinct patterns. In both low and high self-relevant situations, empathy plays a key role. Under low self-relevance conditions, drama enhances information processing through empathy. Under high self-relevant conditions, the advertisement format has neither significant cognitive or empathetic effects. The information processing generated by the highly relevant topic affects viewers' empathy, which in turn affects the attitude the advertisement and the behavioral intent. As predicted by the Elaboration Likelihood Model, the advertisement format enhances the attitudes and information processing mostly under low self-relevant conditions. Under low self-relevant conditions, empathy enhances information processing while under high self-relevance, the converse relation holds.

Adolescent↗

Advertising content in physical activity print materials.

Copies of 80 sets of print materials available free of charge to the general public were analyzed to determine the relationship between the developer and advertising-related material. Almost all of the materials had some form of advertising content. Materials from commercial product vendors were most likely to have product logos, references to specific brands, and had the greatest number of logos, and the greatest number of references to specific brands. They were the second most likely to have advertising slogans, and had the second greatest number of advertising slogans.

Advertising↗

Prescription drug advertising: medical journal practices under different types of control.

Medication is one important aspect of health care delivery. The sources of information used to select appropriate medication include drug advertisements which appear in professional journals. There is a need to monitor the quality of these advertisements. The study reported in this paper includes a longitudinal (1961 to 1977) and cross-societal (Britain, United States and Australia) content analysis of drug advertisements. Such a comparison contributes to the debate concerning the type of regulation likely to be effective for this form of advertising.

Advertising↗

Influence of education and advertising on the uptake of smoking by children.

How effective are peer-led programmes in preventing the uptake of smoking by children? In 1981, we conducted a randomized controlled trial of a school-based educational programme for the prevention of smoking in children who were in their seventh year at school. In this article, the reported results of two years of follow-up confirm an earlier report that both teacher-led and peer-led programmes resulted in a reduction, to about the same degree, in the uptake of smoking by girls, while only the teacher-led programme appeared to be effective in boys. In girls, both the teacher-led and peer-led programmes maintained their effects over the two years of follow-up with adjusted differences in prevalence rates of the uptake of smoking relative to the control group of -6.6% (95% CL, -17.3%, 4.0%) and -8.1% (95% CL, -18.9%, 2.7%), respectively, after two years. In boys, the effect of the teacher-led programme was reduced substantially by the second year with a difference in the prevalence rate of -2.8% (95% CL, -11.2%, 5.6%); for the peer-led programme the difference in the prevalence rate was +6.4% (95% CL, -3.6%, 16.4%). Other variables which had a significant effect on the smoking behaviour were the perceived response to cigarette advertising, parental and sibling smoking status, the perceived parental sanctions on smoking behaviour, selected peer influences and the intention to smoke. The children's perceived responses to cigarette advertising showed the strongest and most consistent evidence of an effect on the uptake of smoking by children who initially were non-smokers. After adjustment for the effects of other variables there was an excess of 15.0% (95% CL, 2.1%, 27.9%) in the prevalence rate of smoking after two years for girls who thought that they were influenced by advertising compared with those who did not. The corresponding difference for boys was 15.3% (95% CL, 4.0%, 26.6%). As smoking-prevention programmes only may delay the onset of smoking in children, it is important that legislative measures be introduced to reduce the effects of cigarette advertising.

Advertising↗

The effects of exercise advertising on self-efficacy and decisional balance.

OBJECTIVES: To investigate the effects of exercise advertising on self-efficacy and decisional balance for changing exercise behavior. METHODS: One hundred seventy-four university students (females = 108; males = 66) watched a video that contained health, appearance, or control advertising and completed stage of change, exercise self-efficacy, and decisional balance questionnaires. RESULTS: There was a significant condition by gender interaction indicating that men in the appearance condition had lower self-efficacy than did females. Health promotion advertising did not have any effect. CONCLUSIONS: This study provides evidence that the message in appearance-based advertising that men should be muscular may be detrimental.

Adult↗

Hospital advertising: does it influence consumers?

Though consumers generally favor hospital advertising, it has not emerged as a major factor in hospital choice research. A survey examined the effectiveness of hospital advertising and its strength as a factor in hospital choice. The majority of the respondents approved of hospital advertising and showed knowledge of hospital specialties. However, hospital choice was influenced primarily by physician recommendation and location, rather than advertising.

Advertising↗

Direct-to-consumer ads can influence behavior. Advertising increases consumer knowledge and prescription drug requests.

This study examines the impact of direct-to-consumer (DTC) pharmaceutical advertising on prescription drug knowledge and the requesting behavior of consumers. The authors developed and tested a conceptual model of prescription drug knowledge and requests. Consumers' belief that drug advertising can educate them was associated with a greater amount of drug knowledge, and the belief they would upset physicians by asking for specific drugs was associated with less knowledge. The belief that drug advertising reduces prices was associated with greater probability of drug requests, and the belief that physicians should be the sole source of drug information was associated with lesser probability of request. Preference for generic drugs was associated with a lesser likelihood of requesting a specific drug. Media exposure and drug advertising awareness were associated with higher drug knowledge and a greater probability of drug requesting.

Advertising↗