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PubMed2006

What are the public health effects of direct-to-consumer drug advertising?

BACKGROUND TO THE DEBATE: Only two industrialized countries, the United States and New Zealand, allow direct-to-consumer advertising (DTCA) of prescription medicines, although New Zealand is planning a ban. The challenge for these governments is ensuring that DTCA is more beneficial than harmful. Proponents of DTCA argue that it helps to inform the public about available treatments and stimulates appropriate use of drugs for high-priority illnesses (such as statin use in people with ischemic heart disease). Critics argue that the information in the adverts is often biased and misleading, and that DTCA raises prescribing costs without net evidence of health benefits.

Advertising↗
PubMedDate not supplied

Pharmaceutical promotion, advertising, and consumers.

Proponents of drug promotion and advertising claim that it is informative and educational; opponents are concerned that the information conveyed encourages inappropriate and unnecessary use. Health Affairs papers by Joel Weissman and colleagues and by Robert Dubois provide some validation for the views of both sides of this debate but do not allow us to draw definitive conclusions about key issues involving inappropriate use of expensive medications and their substitution for cheaper medications that are just as effective. The extent to which consumers have been protected from the rising cost of pharmaceuticals further muddles the picture. However, new insurance benefit designs that threaten to shift more costs to consumers may fuel demand for more comprehensive and balanced information.

Advertising↗
PubMedDate not supplied

DTC advertising's benefits far outweigh its imperfections.

Direct-to-consumer (DTC) communication about pharmaceutical products enables consumers to take a hands-on interest in their own health care. A growing body of research and expert opinion supports the view that the information presented in DTC communications informs patients' decision making and leads to more productive physician/patient encounters. Arguments that DTC advertising leads doctors to write unnecessary prescriptions and increases costs are unfounded. Criticism of the practice may also be shortsighted, because outpatient drug treatment can substitute for more costly therapies and hospitalizations. Public debate should focus on making information clear and comprehensible so that consumers can get maximum value.

Advertising↗
PubMedDate not supplied

Turning point or tipping point: new FDA draft guidances and the future of DTC advertising.

According to Food and Drug Administration (FDA) research, direct-to-consumer (DTC) drug ads are not as empowering as they were even three years ago. How will the FDA's new draft guidances reverse this trend and affect the future of DTC advertising? Will they be a turning point, resulting in pharmaceutical companies' embracing an educational public health imperative, or a tipping point with politicians and the public zeroing in on aggressively targeted DTC ads as the postimportation pharmaceutical bête noire? The FDA believes that its new guidances strengthen the strategic argument that a better-informed consumer lays the groundwork for a better potential customer.

Advertising↗
PubMed2005

The availability of references and the sponsorship of original research cited in pharmaceutical advertisements.

BACKGROUND: The primary goal of pharmaceutical advertisements is to convince physicians to prescribe the manufacturer's product. We sought to determine what materials are cited in support of claims in pharmaceutical ads and medical research articles, and whether health care professionals seeking to verify the claims could obtain these references. METHODS: We reviewed 438 unique ads from the 1999 issues of 10 American medical journals, and a random sample of 400 references in medical research articles selected from the same journals. We classified references as journal article, data on file, meeting abstract or presentation, book or monograph, marketing report, prescribing information, government document or Internet site. We attempted to confirm or obtain each reference through library and Internet searches or by direct request from the manufacturer. The main outcome we sought to determine was the availability of the reference to a clinician. We also ascertained the source of funding for original research cited in the ads and the research articles. RESULTS: In the 438 ads with medical claims, 126 contained no references and 312 contained 721 unique references. Of these ad references, 55% (396/721) cited journal articles and 19% (135/721) cited data on file. In contrast, in the sample of research article references, 88% (351/400) cited journal articles and 8% (33/400) cited books. Overall, 84% of the citations from the ads were available: 98% of journal articles, 86% of books, 71% of meeting abstracts or presentations and 20% of data-on-file references. In all, 99% of the sample of research article references were available. We determined that 58% of the original research cited in the pharmaceutical ads was sponsored by or had an author affiliated with the product's manufacturer, as compared with 8% of the articles cited in the research articles. INTERPRETATION: Many pharmaceutical ads contain no references for medical claims. Although references to journal articles were usually obtainable, other published sources were not as easily acquired. The majority of unpublished data-on-file references were not available, and the majority of original research cited to substantiate claims in the pharmaceutical ads was funded by or had authors affiliated with the product's manufacturer.

Advertising↗
PubMed2005

Effects of cautionary messages and vulnerability factors on viewers' perceptions of alcohol advertisements.

OBJECTIVE: This study examined how individual difference vulnerability factors affect college students' perceptions of beer commercial actors' age, attractiveness and drinking. We were also interested in whether viewers' exposure to a cautionary message would affect their perceptions of the actors' drinking behavior. METHOD: Three groups of college students were exposed to the same set of two alcohol advertisements. After watching the ads, each group received a different cautionary message prior to answering questions about the ad's content: (1) a neutral message (viewed by 42% [n = 119] of the sample), (2) a U.S. federal warning (viewed by 31% [n = 89]) and (3) an industry message (viewed by 27% [n = 76]). We also examined three putative vulnerability factors: age (underage 21 or not), gender and family history of alcohol problems (yes or no) as well as the effects of quantity-frequency of alcohol consumption, episodic heavy drinking, severity of alcohol dependence, disinhibition sensation seeking and the eight factors of the Alcohol Expectancy Scale. RESULTS: The cautionary messages had no effect on viewers' perceptions of characters' age, attractiveness and drinking behavior. Although neither of the commercials depicted the physical act of drinking, the student raters nevertheless perceived the characters to be heavy episodic drinkers. Those reporting more alcohol dependence symptoms perceived increased drinking for the male characters, as did females and viewers with expectancies for social and physical pleasure. CONCLUSIONS: Perceptions of the drinking in beer commercials are based in part on the character depicted in the ad and in part on the demographic and personal vulnerability factors of the viewer.

Adolescent↗
PubMed2002

A case of suffocation by an advertising balloon filled with pure helium gas.

We encountered a rare case of suffocation by an advertising balloon filled with pure helium gas. Suffocation caused by inhalation of atmosphere lacking in oxygen is not exceptional, but reports of death by suffocation due to a pure inert gas such as helium are very rare. In this case, the balloon mooring on the ground was enclosed, warning signs were displayed, and it was clear that entering the balloon filled with an atmosphere lacking in oxygen was extremely dangerous and should not be done; the accident did, however, occur. Accidents of this kind may occur in the future unless appropriate education and countermeasures are taken.

Accidents↗
PubMed2006

Antismoking advertisements for youths: an independent evaluation of health, counter-industry, and industry approaches.

OBJECTIVES: We used a validated copy test method to examine the effectiveness of 8 types of antismoking advertisements representing health, counterindustry, and industry approaches. We tested the hypothesis that health ads about tobacco victims can lower most adolescents' intent to smoke if the ads elicit disgust and anti-industry feelings rather than fear. We hypothesized null effects for adolescents with conduct disorder because of their abnormally low empathy. METHODS: Ninth-grade students from 8 California public schools (n=1725) were randomly assigned to view 1 of 9 videotapes containing a TV show with ads that included either a set of antismoking ads or a set of control ads. Participants completed baseline measures assessing personality traits and postexposure measures assessing smoking intent, feelings, beliefs, and ad evaluations. RESULTS: Ads focusing on young victims suffering from serious tobacco-related diseases elicited disgust, enhanced anti-industry motivation, and reduced intent to smoke among all but conduct-disordered adolescents. Counterindustry and industry ads did not significantly lower smoking intention. CONCLUSIONS: Sponsors of tobacco use prevention ad campaigns should consider using ads showing tobacco-related disease and suffering, not just counterindustry ads. Ads should be copy tested before airing.

Adolescent↗
PubMed1988

Tobacco advertisements in physicians' offices: a pilot study of physician attitudes.

A pilot study evaluated the feasibility of a campaign to eliminate magazines advertising cigarettes from doctors' office waiting rooms. Only six of 51 waiting rooms visited did not contain cigarette ads. Only 25 per cent of physicians interviewed would participate in a subscription-cancellation campaign; they expressed doubt that this would influence patients' smoking behavior. This suggests that such a campaign will fail unless it is possible to change physicians' beliefs in its effectiveness.

Advertising↗
PubMed1996

Smokers' knowledge and understanding of advertised tar numbers: health policy implications.

OBJECTIVES: This article examines health policy implications of providing smokers with numerical tar yield information in cigarette advertising. METHODS: Results of a national probability telephone survey regarding smokers' knowledge and understanding of numerical tar yields and deliveries are reported. RESULTS: Few smokers knew the tar level of their own cigarettes (the exception being smokers of 1- to 5-mg tar cigarettes), and a majority could not correctly judge the relative tar levels of cigarettes. Smokers were unsure whether switching to lower-tar cigarettes would reduce their personal health risks. Many smokers relied on absolute numbers in making trade-offs between number of cigarettes smoked and their tar levels, thus confusion machine-rated tar-yields with actual amounts ingested. CONCLUSIONS: The wisdom of the present method of providing tar and nicotine numbers in ads and recommendations for modifying the test protocol are now under discussion. This research indicates that these tar numbers and their implications are poorly understood. The paper recommends revisions in tar ratings to make them more useful and a required statement on cigarette packages to more explicitly relate tar levels to major health risks.

Adult↗
PubMed2002

Tobacco, commercial speech, and libertarian values: the end of the line for restrictions on advertising?

In June of 2001, the Supreme Court overturned a set of antitobacco measures adopted by the state of Massachusetts designed to protect young people from advertising. Once again, the court expressed its hostility toward measures designed to restrict commercial speech in the name of the social good. In so doing, the court underscored the enduring tension between the libertarian and social welfare dimensions of contemporary democracy and placed into relief the divisions within the American liberal tradition.

Adolescent↗
PubMed2002

Expressive freedom and tobacco advertising: a Canadian perspective.

In 1989, Canada enacted the Tobacco Products Control Act (TPCA), which prohibited tobacco advertising, required health warnings on tobacco packaging, and restricted promotional activities. Canada's tobacco companies challenged the TPCA's constitutionality, arguing that it infringed on freedom of expression. Although it seemed likely that the Canadian Supreme Court would uphold the legislation, in 1995 the court declared the impugned provisions to be unconstitutional. The decision is testimony to the constraining force of liberalism on tobacco regulation, but it is also evidence of the power of political will. While the Canadian government could have used the decision to justify withdrawing from further confrontations with powerful commercial interests, it chose instead to enact new tobacco control legislation in 1997.

Adolescent↗
PubMed2003

The outing of Philip Morris: advertising tobacco to gay men.

OBJECTIVES: This case study describes the events surrounding the first time a major tobacco company advertised in gay media. METHODS: We analyzed internal tobacco company documents, mainstream newspapers, and the gay press. RESULTS: Philip Morris was unprepared for the attention its entry into the gay market received. The company's reaction to this incident demonstrates that its approach to the gay community both parallels and diverges from industry strategies toward other marginalized communities. CONCLUSIONS: The tobacco industry's relationship to the gay community is relatively undeveloped, a fact that may provide tobacco control advocates an opportunity for early intervention. The gay community's particular vulnerabilities to the industry make development of gay tobacco control programs crucial to reducing gay smoking prevalence and industry presence in the community.

Adult↗
PubMed1997

Informational and symbolic content of over-the-counter drug advertising on television.

The informational and symbolic content of 150 over-the-counter drug commercials on television are empirically analyzed in this study. Results on the informational content suggest that over-the-counter drug ads tend to focus on the concern of what the drug will do for the consumer, rather than on the reasons why the drug should be ingested. Accordingly, advertising strategy is centered on consumer awareness of the product as the primary goal. Educational commitment, however, did not seem to be blended into the promotional efforts for over-the-counter drugs. Findings on the symbolic content of over-the-counter drug ads reveal that drug images have been distorted. Performance of most drugs has been portrayed to be simple resolutions to relieve the symptom. Moreover, a casual attitude toward drug usage is encouraged in the commercials, while time lapse of drug effects is overlooked.

Advertising↗
PubMed1999

Stereotypes of the elderly in magazine advertisements 1956-1996.

The globalization of American culture is increasing as various media target an international market. This article reports the results of a study examining trends in the stereotyping of the elderly in print advertisements appearing from 1956 to 1996 in U.S. magazines. Results show that the percentage of elderly portrayals in print ads has decreased. There has been relatively little overall stereotyping of elderly, with only 4 percent of the sample depicting negative stereotypes. Nevertheless, there has been an increasing percentage of negative stereotypes and a decreasing percentage of positive stereotypes. Results are analyzed in relationship to marketing trends and the social impact on aging.

Advertising↗
PubMed2000

The influences of drug companies' advertising programs on physicians.

This study investigates the influences of drug companies' advertising programs on physicians. Of the 446 physicians interviewed, 53.9 percent were visited by pharmaceutical company representatives at least once a day, and 43.5 percent spent 15 minutes or more per day on these visits. With respect to the information delivered by the pharmaceutical company representatives, 67.7 percent of physicians thought it was not reliable, and 62.8 percent reported that it had no effect on their prescription writing. The promotional gifts had little effect on prescriptions for 43.9 percent of physicians, and 80.3 percent reported that these gifts were distributed unequally among doctors according to the drugs they prescribed. Only 23.5 percent of physicians supported the prohibition of promotion programs; 90.6 percent of physicians agreed that drugs are too expensive, and 82.9 percent agreed on the presence of overprescription. The authors evaluate these results and provide some suggestions for improving the sources of information for drug prescribing.

Advertising↗
PubMed1998

Influence of female body images in printed advertising on self-ratings of physical attractiveness by adolescent girls.

In contrast to earlier studies suggesting that self-concept is stable by late adolescence and therefore resistant to change, this study found that adolescent girls' ratings of self-attractiveness were significantly higher following exposure to printed advertisements employing attractive models who were overweight compared to those exposed to models who were not overweight. Implications for further research are discussed.

Adolescent↗