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An analysis of 6 decades of hygiene-related advertising: 1940-2000.

OBJECTIVES: To describe and analyze trends in hygiene-related advertisements and examine potential social and regulatory changes that might be associated with these trends. METHODS: From 1940 to 2000, advertisements in January issues of 2 widely read magazines were analyzed every fifth year, and 2 additional magazines only available from 1960 to 2000 were also analyzed every fifth year. In a content analysis, the total number of advertisements were determined and specific advertisements were grouped into categories (personal hygiene, dishwashing, laundry, and house cleaning) and further examined for the presence of 4 key claims (aesthetics, health effects, time-saving, and microbial effects). RESULTS: From 1940 to 2000 for all magazines combined, 10.4% of the advertisements were devoted to hygiene products. After 1960 there were significantly fewer hygiene advertisements as compared with 1940 to 1955, and there was a significant increase after 1980 (P <.00001). Throughout all 6 decades, most advertisements related to personal hygiene. There were no significant differences over time in the proportion of advertisements that made claims related to health, microbial effects, or aesthetics, but significantly more advertisements before 1960 made time-savings claims (P =.009). CONCLUSIONS: This content analysis reflects a cyclical attention in consumer advertising to personal and home hygiene products during the past 6 decades, with a waning of interest in the decades from 1960 to 1980 and an apparent resurgence of advertisements from 1985 to 2000. The potential contributions of federal regulatory bodies and societal changes (e.g., new marketing strategies and options, product development, new and re-emerging infectious diseases, increasing concern about antimicrobial resistance, and increasing recognition that infectious diseases are unlikely to be eradicated) to these marketing trends are discussed.

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Smokers' responses to advertisements for regular and light cigarettes and potential reduced-exposure tobacco products.

This study examines smokers' responses to advertisements for potentially reduced exposure tobacco products (PREP), light cigarettes, and regular cigarettes. A convenience sample of 600 adult smokers reviewed one actual advertisement for each type of product. Smokers ranked the products on health risk, amount of tar, and carcinogenicity, and identified the messages they perceived the advertisements to convey. Smokers perceived PREP products as having lower health risks (mean = 5.4 on a scale of 1-10) and carcinogens (6.6) than light cigarettes (5.8 and 6.9, respectively, p < .001), and lights as having lower health risks and carcinogen levels than regular cigarettes (8.2 and 8.8, respectively, p <.001). The average PREP rating for level of tar (5.3) was not significantly less than the light mean of 5.4, but both were significantly less than the regular mean of 8.4 (p <.001). Although no advertisements explicitly said that the products were healthy or safe, advertisements for PREP products and light cigarettes were interpreted as conveying positive messages about health and safety. Most smokers believed that claims made in cigarette advertisements must be approved by a government agency. The results indicate that advertisements can and do leave consumers with perceptions of the health and safety of tobacco products that are contrary to the scientific evidence. Explicit and implicit advertising messages may be strengthened by the perceived government endorsement. This supports the Institute of Medicine's recommendation to regulate the promotion, advertising, and labeling of PREP tobacco products and light cigarettes. Effective regulation may need to focus on consumer perceptions resulting from advertisements rather than the explicit content of advertising text.

Adult↗

Health-related quality-of-life claims in prescription drug advertisements.

Health-related quality-of-life (HRQOL) claims in drug advertisements and HRQOL advertisements' compliance with FDA regulations were studied. HRQOL advertisements from three medical journals from the years 1984, 1988, and 1992 were analyzed. Information was collected on the drug products and classes for which HRQOL claims were made and (1) whether the claims were explicit or implied, (2) how the products were claimed to affect HRQOL, and (3) whether claims related to overall well-being, a specific physiological aspect, or functional ability. For 1992 only, the compliance of HRQOL advertisements with FDA regulations was assessed. Ninety-four HRQOL advertisements were identified: 27 for 1984, 41 for 1988, and 26 for 1992. The drug classes for which HRQOL advertisements were most commonly used were diuretics (1984), nonsteroidal anti-inflammatory drugs (all three years), antianginals (1984 and 1988), antihypertensives (1988 and 1992), and anti-depressants (1992). Almost all the advertisements contained a claim (usually implicit) related to a specific physiological aspect of HRQOL, and claims concerning physical functioning outnumbered other function-related claims. In 1992, 42% of the HRQOL advertisements appeared out of compliance with at least one FDA regulation. In 1984, 1988, and 1992, HRQOL claims in prescription drug advertisements in three medical journals were mainly implicit and related mainly to specific physiological aspects of HRQOL. Over 40% of the HRQOL advertisements reviewed for compliance with FDA regulations for prescription drug advertising appeared not to comply.

Advertising↗

Relationship between direct-to-consumer advertising and physician diagnosing and prescribing.

The relationships between direct-to-consumer advertising expenditures and the monthly frequencies of diagnoses and prescriptions written associated with the products advertised are examined. The analyses utilized quasi-experimental time-series techniques. Data from the National Ambulatory Medical Care Survey and Competitive Media Reporting were used to calculate monthly levels of the dependent and independent variables. The dependent variables included monthly frequencies of diagnoses for the products' FDA-approved indications, medications prescribed within the advertised pharmaceutical class, and medications prescribed for the specific advertised agent. The independent variables included monthly expenditures for advertising each pharmaceutical class and each specific agent. Several significant monthly relationships were found. The diagnoses of hyperlipidemia (p = 0.008) and the number of prescriptions written for antilipemics (p = 0.003) were positively associated with the advertising expenditure for antilipemics. The number of prescriptions written for Claritin (p = 0.004) and Zocor (p < 0.001) was positively related to the advertising expenditure for their respective pharmaceutical classes; the amount of prescriptions written for Hismanal (p = 0.007), Seldane (p < 0.001), and Zantac (p = 0.004) was negatively related to the advertising expenditure for their respective pharmaceutical classes. The number of prescriptions written for Claritin (p = 0.005) and Zocor (p < 0.001) was positively related to the advertising expenditure for each specific product; the amount of prescriptions written for Hismanal (p = 0.049) was negatively associated with the amount of money spent specifically advertising the agent. No significant associations were found in antihypertensive drugs and drugs to treat benign prostatic hypertrophy. The results of the analyses suggest that the direct-to-consumer advertising expenditure is associated with physician diagnosing and physician prescribing for certain drugs and drug classes.

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Physician advertising revisited.

This article examines the determinants of physician advertising using a nationally representative sample of 2,573 self-employed physicians. In contrast to a previous study by Folland, this article identifies a number of physician characteristics that are strongly related to the advertising decision. In particular, female physicians and foreign medical graduates (FMGs) are significantly less likely to advertise than are males and non-FMGs, respectively. Board certified physicians are less likely to advertise than are uncertified physicians. Also in contrast to previous results, primary care physicians are not necessarily more likely to advertise than nonprimary care physicians. For example, advertising propensity is strongest among plastic surgeons, whereas the propensity to advertise in such primary care specialties as internal medicine and pediatrics are quite close to advertising propensities for general surgeons. Furthermore, the relationship between practice size and advertising propensity is shown to be much stronger than previous research in this area has indicated. Finally, the results suggest that a number of physician characteristics associated with advertising through written media (newspapers or magazines) are also associated with advertising through audiovisual media (television or radio).

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The effects of television food advertisement on children's food purchasing requests.

BACKGROUND: Children's eating habits and their food consumption have direct relations with obesity, diabetes, cancers, hypertension and coronary heart disease. Television advertisements directly affect children's eating habits and their food consumption. This study was conducted in order to examine television advertisements and children's food consumption while watching television and their desire to purchase goods that they see on television advertisements. METHODS: In the first stage of the study, content analysis of the television advertisements was conducted. In the second stage of the study, a questionnaire (check list) was developed in order to examine children's food consumption while watching television and their purchasing requests while shopping in the supermarket. It was given to 347 mothers who have children aged between 3 and 8 years. RESULTS: When the results of the study were examined it was found that the time devoted to children's programs was approximately 121 min and the advertisements during this period were approximately 35 min. A total of 344 of the 775 television advertisements shown were related to food. It was also found that most of the food advertisements were about candy/chocolate, chips, milk and milk products such as cheese, yoghurt, and breakfast cereals. The results also revealed that 89.6% of the children either drank or ate something while watching television and the food they consumed most while watching television were fruits, soft drinks, popcorn/nuts, cake, chips and candy/chocolate. The results also revealed that 40.3% of the children asked their parents to purchase the goods that they saw on the television advertisements and that 8.9% of them argued with their parents and/or cried in order for their parents to buy that particular product. It was found that the children tended to request more sweetened products such as candy, ice-cream, biscuit, cake or soft drinks. CONCLUSION: More than half of the food presented in television advertisements were rich in fat and sugar. Children ask their parents to buy the goods they see on television advertisements both while watching television and while shopping. Television advertisements especially affect young children's unhealthy food consumption.

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Cigarette advertising in Mumbai, India: targeting different socioeconomic groups, women, and youth.

BACKGROUND: Despite a recent surge in tobacco advertising and the recent advertising ban (pending enforcement at the time of this study), there are few studies describing current cigarette marketing in India. This study sought to assess cigarette companies' marketing strategies in Mumbai, India. METHODS: A two week field study was conducted in Mumbai in September 2003, observing, documenting, and collecting cigarette advertising on billboards, storefronts and at point of sale along two major thoroughfares, and performing a content analysis of news, film industry, and women's magazines and three newspapers. RESULTS: Cigarette advertising was ubiquitous in the environment, present in news and in film magazines, but not in women's magazines or the newspapers. The four major advertising campaigns all associated smoking with aspiration; the premium brands targeting the higher socioeconomic status market utilised tangible images of westernization and affluence whereas the "bingo" (low priced) segment advertisements invited smokers to belong to a league of their own and "rise to the taste" using intangible images. Women were not depicted smoking, but were present in cigarette advertisements--for example, a woman almost always accompanied a man in "the man with the smooth edge" Four Square campaign. Advertisements and product placements at low heights and next to candies at point of sale were easily accessible by children. In view of the imminent enforcement of the ban on tobacco advertisements, cigarette companies are increasing advertising for the existing brand images, launching brand extensions, and brand stretching. CONCLUSION: Cigarette companies have developed sophisticated campaigns targeting men, women, and children in different socioeconomic groups. Many of these strategies circumvent the Indian tobacco advertising ban. Understanding these marketing strategies is critical to minimise the exploitation of loopholes in tobacco control legislation.

Adolescent↗

Anti-smoking advertising campaigns targeting youth: case studies from USA and Canada.

OBJECTIVE: To assist in planning anti-smoking advertising that targets youth. Using five US state campaigns, one US research study, and a Canadian initiative as exemplars, an attempt is made to explain why certain advertising campaigns have been more cost effective than others in terms of reducing adolescent smoking prevalence. Several factors which prior research and theory suggest may be important to cost effectiveness are examined. Specifically, three variables pertaining to the advertising message (content, consistency, and clarity) and two variables related to the advertising execution or style (age of spokesperson and depiction of smoking behaviour) are studied. DESIGN: A case study approach has been combined with supplemental data collection and analysis. To assess campaign effects, published articles and surveys of adolescent smoking prevalence in campaign versus control (non-campaign) locations were utilised. Adolescent subjects provided supplemental data on the advertising message variables. Trained adults content analysed each advertisement to assess the executional variables. SUBJECTS: A total of 1128 seventh grade (age 12-13 years) and 10th grade (age 15-16 years) students participated in the supplemental data collection effort. RESULTS: An anti-smoking advertising campaign initiated by Vermont researchers was found to be the most cost effective in that it significantly reduced adolescent smoking prevalence at a low per capita cost. Next in order of cost effectiveness were California, Massachusetts, and Florida because behavioural outcomes were inconsistent across time and/or grades. California was ranked higher than the other two because it spent less per capita. Minnesota and Canada were ineffective at reducing adolescent smoking prevalence, and no comparison outcome data were available for Arizona. Four factors were found to be associated with increased cost effectiveness: (1) a greater use of message content that prior research suggests is efficacious with youth; (2) a more concentrated use of a single efficacious message; (3) an avoidance of unclear messages; and (4) an increased use of youthful spokespeople that adolescents could more readily identify with. No indication was found that depictions of smoking undermined campaign effectiveness by inadvertently implying that smoking was prevalent. CONCLUSIONS: The highly cost effective Vermont campaign can be used as a model for future efforts. It is estimated that 79% of the Vermont advertisements conveyed efficacious messages, 58% concentrated on a single efficacious message, 70% showed youthful spokespeople, and only 4% contained unclear messages. The results suggest that, in the less effective campaigns, as few as 25% of the advertisements contained messages that prior research indicates should be efficacious with youth, as few as 10% of the advertisements focused on one efficacious message, and up to 32% of the advertisements lacked clearcut messages.

Adolescent↗

[The interactive effects of comparative advertising on brand and company image change].

The purpose of the present study was: 1) to investigate the effects of two types of comparative advertising--Merit-type (emphasizing positive aspects of their own brand) and Demerit-type (pointing out negative aspects of the rival brand); and 2) to find an effective strategy against comparative advertising of a rival company. Subjects were shown advertisements, and were then asked to evaluate those advertisements (17 items), the brands and company images (3 items) for these two companies. The results are as follows: Comparative advertising, especially of the Demerit-type, was the most conspicuous type of advertising, which also had a significant negative effect on the perception of rival brands. However, this type of advertising also had a negative effect on his own advertising, the brands advertised, and the company itself. Furthermore, it was found that when a rival company uses Demerit-type advertising, it is better not to respond by the same type, but to respond by Merit-type advertising. In such a situation, positive image of his own brand and company become significantly higher.

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Physicians and advertising.

In this study, although the majority of responding physicians seemed to perceive advertising as not having an impact on the medical marketplace, the results concerning the medical profession appear quite different. In addition to soundly rejecting advertising as a communication mode in their profession, the physicians felt strongly that it would damage the profession's public image, plus promote fraud and hucksterism. A majority of respondents even went so far as to state that advertising would cause the quality of care to deteriorate. A majority also felt that advertising is ethically wrong for physicians. From these results, it seems that these physicians were not as concerned about the evils of advertising, per se, as the manner in which advertising would be applied by their colleagues to undermine the profession. It is very clear from the factor analysis that the major dimension of these physicians' attitudes toward advertising pertained to concern for the image of the profession, although economic and media communications aspects were of some importance. The question items loading most heavily on the IMAGE factor reflect perceptions that advertising will impact on the quality of care, promote fraud and hucksterism, convey a negative public image, etc. Thus, the primary focus of the physicians' negative attitudes does not seem to be toward the economic consequences, nor toward advertising as a societal entity. But, the major element for negativity is the way in which advertising would be applied by medical practitioners. More specifically, physicians believed that it would be applied in an unprofessional, unethical manner. Results of the factor analysis imply that the negativity focused upon advertising is really directed toward uncertainty pertaining to the ethics of medical practitioners and the way in which these ethics would be projected through media and other communications vehicles.

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Direct-to-consumer prescription drug advertising, 1989-1998. A content analysis of conditions, targets, inducements, and appeals.

BACKGROUND: We conducted a content analysis of consumer-targeted prescription drug advertisements to explore trends in prevalence, shifts in the medical conditions for which drugs are promoted, reliance on financial and nonmonetary inducements, and appeals used to attract public interest. METHODS: We collected the drug advertisements appearing in 18 consumer magazines from 1989 through 1998. Two judges independently coded each advertisement and placed it in a category pertaining to the target audience, use of inducements, and product benefits (mean kappa=0.93). We employed descriptive statistics, cross-tabulations, and curve estimation procedures. RESULTS: A total of 320 distinct advertisements were identified, representing 101 brands and 14 medical conditions. New advertisement and brand introductions increased dramatically during this decade. Advertisements for drugs used for dermatologic, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and obstetric/gynecologic conditions were most common. Almost all of the advertisements were aimed at the potential user of the drug, not third-party intermediaries such as parents and spouses. Although most advertisements were gender-neutral, women were more likely to be exclusively targeted. One eighth of the advertisements offered a monetary incentive (eg, a rebate or money-back guarantee), and one third made an offer of additional information in printed or audio/video form. The most common appeals used were effectiveness, symptom control, innovativeness, and convenience. CONCLUSIONS: Consumer-directed prescription drug advertising has increased dramatically during the past decade. The pharmaceutical industry is turning to this type of advertising to generate interest in its products. Our data may be useful to physicians who want to stay abreast of the treatments that are being directly marketed to their patients.

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Evidence-based advertising? A survey of four major journals.

BACKGROUND: Pharmaceutical advertisements are an important means of bringing drug information to physicians. Most advertisements are intended only to raise awareness, though there are those that do seek to persuade through presentation of research findings. Researchers have questioned the quality of the research reported in advertisements and wonder whether these advertisements would lead to improper prescribing. METHODS: A consecutive 6-month sample of advertisements in 4 general medical journals, 3 from the United States and 1 from Canada, were reviewed to determine how research results are presented in pharmaceutical advertisements. RESULTS: During this time there were 187 distinctive advertisements, with 43 data presentations in the 33 advertisements that contained quantitative research results. These results were examined using a critical appraisal worksheet. References to randomization and blinding were found in less than one half of the 43 data presentations. P values were frequently provided, but confidence intervals and references to power and number needed to treat were not provided in any of the advertisements. CONCLUSIONS: Descriptions of research in pharmaceutical advertisements were brief and incomplete, and they inconsistently provided the basic design and statistical information needed to judge the results reported. More detail could make these advertisements more meaningful to critical readers.

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Smoking status of 132,176 people advertising on a dating website. Are smokers more "desperate and dateless"?

OBJECTIVE: To determine (i) whether people advertising themselves on a dating website were more likely to be smokers than members of the general population; and (ii) whether attractive advertisers (those whose ads were viewed most often) were less likely to smoke than all advertisers. DESIGN: Comparison of the number of advertisers who smoke with survey data on national smoking status. SETTING: "RSVP", Australia's largest web-based dating site (455,196 members on 12 October 2004). PARTICIPANTS: 132,176 advertisements accessed on 10 February 2004. MAIN OUTCOME MEASURES: Smoking status; and "votes" for advertisers' attractiveness based on how often visitors to the site accessed individual advertisements. RESULTS: In every age group, there were higher proportions of women smokers among the advertisers than in the general population (P < 0.05), and this was also the case for men aged 50 years and over. There was a higher proportion of non-smokers in the "Top 100" men or women advertisers aged 20-29 years (82%) compared with total RSVP advertisers in this age group (67%) (P < 0.001). 85% of the men and 78% of the women in the two "Top 100" groups were non-smokers, with only 2% of both sexes claiming to be regular smokers. CONCLUSIONS: Compared with the general population, a higher proportion of women and older men who advertise themselves on a dating website are smokers. Smokers may be perceived as less attractive.

Adult↗

Advertising of medicines on New Zealand television.

AIMS: To measure the frequency of advertising of medicines on New Zealand television and to describe the distribution of advertising. METHODS: A stratified random sample of 35 days (577.5 hours) of television was video-recorded, including five free to air channels for each day of the week. Videotapes were watched, then advertisements were recorded on a pre-designed form. RESULTS: 340 advertisements for medicines were identified, an average of 1 per 102 minutes; 37% of advertisements were for medicines available for general sale, 24% for dietary supplements, 21% for pharmacy- or pharmacist-only medicines, and 18% for prescription-only medicines. Four channels had similar amounts of advertising. Channels varied in the kind of medicines they had advertisements for. There were more advertisements per hour in the afternoon than in the morning or evening. Advertisements for medicines were found in a wide range of programmes, including children's programmes. CONCLUSIONS: People who watch particular programmes, or who watch television at some times of days may be exposed to considerably more than one medicine's advertisement per 102 minutes. While this study does not examine the effect of medicines advertisements on consumer behaviour, previous research suggests this may be significant.

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Accuracy of pharmaceutical advertisements in medical journals.

BACKGROUND: Because of the effect of the ever-growing evidence-based medicine movement on prescribing behaviour of doctors, the pharmaceutical industry incorporates bibliographical references to clinical trials that endorse their products in their advertisements. We aimed to assess whether the references about efficacy, safety, convenience, or cost of antihypertensive and lipid-lowering drugs included in advertisements supported the promotional claims. METHODS: We assessed all advertisements for antihypertensive and lipid-lowering drugs published in six Spanish medical journals in 1997 that had at least one bibliographical reference. Two pairs of investigators independently reviewed the advertisements to see whether the studies quoted to endorse the advertising messages supported the corresponding claims. FINDINGS: We identified 264 different advertisements for antihypertensive drugs and 23 different advertisements for lipid-lowering drugs. We recorded at least one reference in 31 advertisements in the antihypertensive group and at least one reference in every seven advertisements in the lipid-lowering group, providing a total of 125 promotional claims with references. We could not retrieve 23 (18%) references from monographic works and non-published data on file. 79 (63%) of the 125 references were from journals with a high impact factor; 84 (82%) of the 102 references retrieved were from randomised clinical trials. In 45 claims (44.1%; 95% CI 34.3-54.3) the promotional statement was not supported by the reference, most frequently because the slogan recommended the drug in a patient group other than that assessed in the study. INTERPRETATION: Doctors should be cautious in assessment of advertisements that claim a drug has greater efficacy, safety, or convenience, even though these claims are accompanied by bibliographical references to randomised clinical trials published in reputable medical journals and seem to be evidence-based.

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Responses to televised alcohol advertisements associated with drinking behaviour of 10-17-year-olds.

AIMS: To examine the nature of the relationships between 10-17-year-old New Zealanders' responses to alcohol advertisements and their drinking behaviour and future drinking expectations, with consideration also being given to the role of positive and negative beliefs about drinking. DESIGN: Survey involving 500 face-to-face interviews, with selection based on random cluster sampling. SETTING: In respondents' homes in New Zealand's three largest urban areas. PARTICIPANTS: Ten-17-year-old New Zealanders. MEASUREMENTS: Response to specific alcohol advertisements was measured by recalled exposure (how often they recalled having seen the advertisements) and liking (a measure of positive response). FINDINGS: An exploratory structural equation model provided tentative support for the theory-based hypothesis that positive responses to beer advertisements increased the frequency of current drinking and expected future drinking, among this age group. There was no evidence for the hypothesized reciprocal effects; the frequency of drinking (including non-drinking) did not significantly affect the respondent's liking of beer advertisements. There was also no support for a hypothesis that linking of the beer advertisements was a product of a general liking for alcohol. Many of the young people themselves felt that alcohol advertising encouraged teenagers to drink. This was especially the case among 10-13-year-old males, who were the most likely to accept the portrayals in alcohol advertising as realistic. CONCLUSIONS: Although there are limitations on the confidence with which conclusions can be drawn, the findings are consistent with qualitative and quantitative research and different theoretical perspectives on advertising processes which suggest alcohol advertising is likely to have some influence on young people.

Adolescent↗

Alcohol advertising in college newspapers: a 7-year follow-up.

The authors report on the frequency and nature of alcohol advertisements in a representative sample of college newspapers from 1984/85 and compare these with results of a similar study conducted 7 years earlier, in 1977/78. On average, nearly 24 column inches of space per issue were devoted to national alcohol advertisements in 1984/85. This represents a significant decrease from an earlier period. The space devoted to national alcohol advertisements, however, still far exceeded that for comparison products (books, soft drinks). Local alcohol advertisements averaged 20 column inches per issue and were somewhat more frequent than in the previous study. The content of the advertisements differed markedly from the messages presented 7 years earlier. Although national alcohol advertisements in 1977/78 frequently ridiculed education and study, none did so in 1984/85, when appeals were to taste and product quality instead. Fantasy themes also were relatively common. Very few national alcohol advertisements featured athletes or group drinking. Sponsorship of campus activities by the alcohol industry, however, had increased since the earlier study. In contrast to national advertisements, many local advertisements consisted of inducements to drink through special offers and happy hours. Some encouraged irresponsible and heavy drinking. Interestingly, alcohol advertisements were just as frequent in papers from states with higher minimum drinking ages and were more frequent in papers from campuses with higher proportions of women students.

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How evidence-based are advertisements in journals regarding the subspecialty of rheumatology?

OBJECTIVES: In rheumatology, five different billion-dollar drugs have emerged in recent years, making this subspecialty the focus of extensive advertising campaigns. Considering this development and the fact that the scientific content of advertisements has been questioned, we initiated a study to determine how evidence-based advertisements are in four leading journals of rheumatology. METHODS: Advertisements were extracted from the journals Arthritis and Rheumatism, Rheumatology, Seminars in Arthritis and Rheumatism and the Journal of Rheumatology, and were evaluated using a standardized score form. RESULTS: In total, 353 advertisements were obtained, of which 84 were unique. Of the 300 references provided by these unique advertisements, 53 (18%) were considered 'supporting'. In addition, 87 (29%) of the 300 references referred to randomized controlled trials (RCTs), of which 49% supported the claim. The vast majority of RCTs (97%) were sponsored by the advertising company. In the 84 unique advertisements 288 claims were made, of which 190 provided one or more references. Of these 190 claims, 33 (17%) were judged 'well supported'. In total, only four (5%) of the 84 different advertisements were judged 'well supported' and 11 (13%) of the 84 were judged 'misleading' because they contained one or more misleading claims, i.e. claims with references to articles contradicting the claim. CONCLUSIONS: This study indicates that few advertisements in rheumatology journals are entirely evidence-based.

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