Socio-economic patterning of food and drink advertising at public transport stops in Edinburgh, UK

OBJECTIVE

Outdoor advertisements for food and drink products form a large part of the food environment and they disproportionately promote unhealthy products. However, less is known about the social patterning of such advertisements. The main aim of this study was to explore the socio-economic patterning of food and drink advertising at bus stops in Scotland's capital city, Edinburgh.

DESIGN

Bus stop advertisements were audited to identify food/drink adverts and classify them by food/drink category (i.e. 'advert category'). This data were then linked to area-based deprivation and proximity measures. Neighbourhood deprivation was measured using the bus stop x/y co-ordinates, which were converted to postcodes to identify the matching 2012 deprivation level via the Scottish Index of Multiple Deprivation. Distance to schools and leisure centres were also collected using location data. Generalised estimating equations and linear regression analyses were used to assess associations between the promotion of advert categories and deprivation and proximity to schools/leisure centres, respectively.

SETTING

Edinburgh city, United Kingdom.

RESULTS

561 food/drink advertisements were identified across 349 bus stops, with 8 advertisement categories noted and included in the final analysis, including alcohol, fast food outlets and confectionary. The majority of adverts were for 'unhealthy' food and drink categories, however there was no evidence for any socio-economic patterning of these advertisements. There was no evidence of a relationship between advertisements and proximity to schools and leisure centres.

CONCLUSIONS

While there is no evidence for food and drink advertising being patterned by neighbourhood deprivation, the scale of unhealthy advertising is an area for policy evaluations and interventions on the control of such outdoor advertising.

Impact of a voluntary industry code for advertising food to children and young people: an analysis of New Zealand television data

OBJECTIVE

To evaluate the impact of the 2017 update to the voluntary Advertising Standards Authority (ASA) code for advertising food on children and young people's exposure to unhealthy food advertisements on New Zealand television.

DESIGN

Audience ratings data were analysed for New Zealand children and young people's television viewing for eight random days prior to (June to August 2015) and following (October to December 2018) the code update, from 06.00 to midnight (864 h). Food advertisements were coded using three nutrient profiling models. The number of children and young people watching television each year was compared.

SETTING

Three free-to-air New Zealand television channels.

PARTICIPANTS

New Zealand children aged 5-18 years.

RESULTS

Television viewer numbers decreased over the 3 years (P < 0·0001). The mean rate of unhealthy food advertising on weekdays was 10·4 advertisements/h (2015) and 9·5 advertisements/h (2018). Corresponding rates for weekend days were 8·1 and 7·3 advertisements/h, respectively. The percentage of food advertisements which were for unhealthy foods remained high (63·7 % on weekdays and 65·9 % on weekends) in 2018. The ASA definition of children's 'peak viewing time' (when 25 % of the audience are children) did not correspond to any broadcast times across weekdays and weekend days.

CONCLUSIONS

Between 2015 and 2018, children and young people's television exposure to unhealthy food advertising decreased. However, almost two-thirds of all food advertisements were still unhealthy, and the updated ASA code excluded the times when the greatest number of children was watching television. Consequently, government regulation and regular monitoring should reflect the evolving food marketing environment.

[Spanish adaptation of the Gambling Advertising Impact Scale for adolescents]

La presión mediática de publicidad de apuestas ha alcanzado niveles preocupantes. Constituye un riesgo para la salud mental de los jóvenes y adolescentes al promover una actitud favorable hacia las apuestas, una mayor frecuencia de juego y una percepción de mayor accesibilidad. En la actualidad no se dispone de un instrumento capaz de evaluar el impacto de la publicidad de apuestas.

Objetivo

Adaptar y validar la Escala de Impacto de Publicidad de Apuestas (IGAS, Impact of Gambling Advertising Scale).

Diseño

Investigación instrumental. La escala IGAS fue traducida del inglés garantizando su equivalencia lingüística, conceptual y métrica. A continuación, se comprobaron las propiedades psicométricas.

Emplazamiento

Comunidad Valenciana (España).

Participantes

1.724 adolescentes con una media de 16,52 años (DT = 0,759).

Intervención Se administró un cuestionario autoaplicado en formato de papel en una única medida.

Principales medidas

Impacto de la publicidad, severidad e intención de apostar, y accesibilidad.

Resultados

La consistencia interna y la fiabilidad dos mitades fueron buenas, α de Cronbach = 0,782 y 0,70, respectivamente. El análisis factorial confirmatorio concluyó que la versión española reproduce la original de tres dimensiones. Los análisis de la validez convergente mostraron relaciones directas y significativas con diferentes aspectos de la conducta de juego, y otros factores predictores.

Conclusión

La versión adaptada de la IGAS es una medida fiable y válida para la evaluación del impacto de la publicidad en adolescentes. La escala es un instrumento útil para el diagnóstico del nivel de riesgo y la evaluación de intervenciones preventivas.

Food-Focused Media Literacy for Remotely Acculturating Adolescents and Mothers: A Randomized Controlled Trial of the "JUS Media? Programme"

PURPOSE

Unhealthy eating is a major modifiable risk factor for noncommunicable diseases and obesity, and remote acculturation to U.S. culture is a recently identified cultural determinant of unhealthy eating among adolescents and families in low/middle-income countries. This small-scale randomized controlled trial evaluated the efficacy of the "JUS Media? Programme," a food-focused media literacy intervention promoting healthier eating among remotely acculturating adolescents and mothers in Jamaica.

METHODS

Gender-stratified randomization of 184 eligible early adolescents and mothers in Kingston, Jamaica (i.e., 92 dyads: M_{adolescent.age} = 12.79 years, 51% girls) determined 31 "Workshops-Only" dyads, 30 "Workshops + SMS/texting" dyads, and 31 "No-Intervention-Control" dyads. Nutrition knowledge (food group knowledge), nutrition attitudes (stage of nutritional change), and nutrition behavior (24-hour recall) were primary outcomes assessed at four time points (T1/baseline, T2, T3, T4) across 5 months using repeated measures analysis of covariances.

RESULTS

Compared to control, families in one or both intervention groups demonstrated significantly higher nutrition knowledge (T3 adolescents, T4 mothers: mean differences .79-1.08 on a 0-6 scale, 95% confidence interval [CI] .12-1.95, Cohen's ds = .438-.630); were more prepared to eat fruit daily (T3 adolescents and mothers: .36-.41 on a 1-5 scale, 95% CI .02-.77, ds = .431-.493); and were eating more cooked vegetables (T4 adolescents and T2 and T4 mothers: .20-.26 on a 0-1 scale, 95% CI -.03-.50, ds = .406-.607). Postintervention focus groups (6-month-delay) revealed major positive impacts on participants' health and lives more broadly.

CONCLUSIONS

A food-focused media literacy intervention for remotely acculturating adolescents and mothers can improve nutrition. Replication in Jamaica and extension to the Jamaican diaspora would be useful.

Tobacco messages encountered in real-time among low socio-economic position groups: a descriptive study

BACKGROUND

Tobacco advertising disproportionately targets low socio-economic position (SEP) groups, causing higher rates of tobacco use in this population. Anti-tobacco public health education campaigns persuade against use. This study measured real-time exposure of pro- and anti-tobacco messages from low SEP groups in two American cities.

METHODS

Individuals in low SEP groups (N = 95), aged 18-34 years old, who were smokers and non-smokers, from the Boston and Houston areas, took part in a mobile health study. They submitted images of tobacco-related messages they encountered via a mobile application for a 7-week period. Two coders analyzed the images for message characteristics. Intercoder reliability was established using Krippendorff's alpha and data were analyzed descriptively.

RESULTS

Of the submitted images (N = 131), 83 were pro-tobacco and 53 were anti-tobacco. Of the pro-tobacco messages, the majority were cigarette ads (80.7%) seen outside (36.1%) or inside (30.1%) a convenience store or gas station and used conventional themes (e.g., price promotion; 53.2%). Of the anti-tobacco messages, 56.6% were sponsored by public health campaigns or were signage prohibiting smoking in a public area (39.6%). Most focused on the health harms of smoking (28.3%).

CONCLUSION

Low SEP groups in this study encountered more pro-tobacco than anti-tobacco messages at places that were point-of-sale using price promotions to appeal to this group. Anti-tobacco messages at point-of-sale and/or advertising regulations may help combat tobacco use.

Perceived financial constraints and normative influence: discretionary purchase decisions across cultures

Five studies examine how perceived financial constraints and abundance determine when consumers will engage in solitary or social purchases. When financially constrained, consumers prefer solitary (vs. social) purchases. We also identify self-construal as a moderator of how consumers spend their discretionary income. While independent consumers prefer solitary (vs. social) purchases, interdependent consumers prefer social (vs. solitary) purchases. Interestingly, when consumers have adequate discretionary income, independent as well as interdependent consumers have similar preferences for solitary and social purchases. In addition, for interdependent consumers, communal norms mediate the preference for social purchases. Finally, for independent consumers, making the communal norm salient reverses their preference for solitary purchases, resulting in a preference for social purchases. Our findings suggest how managers can effectively promote different types of purchases under varying financial resource conditions in their global communication strategy.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11747-021-00814-x.

The effect of priming on food choice: A field and laboratory study

Priming involves the activation of a mental concept in memory which increases the likelihood that it will be assimilated into subsequent information processing. The present study investigates whether exposure to prime stimuli can increase the selection of unhealthy foods, which is an important topic as priming has been found to influence judgements, decisions, and behaviour outside of awareness. Study one was a between-subjects field study which examined the effect of brief exposure to food-related logos on subsequent snack choice. Study two took this further by examining food choice following exposure to unhealthy food-related logos in a laboratory setting. No main effect of priming was found by either the field study or the laboratory study; the participants in both studies made similar food choices regardless of condition. However, the results of study two showed a significant main effect of trait mindfulness on food choice, whereby participants higher in trait mindfulness selected fewer unhealthy foods. In conclusion, further research is required to determine whether exposure to unhealthy food-related logos can increase the selection of unhealthy foods. Although the potential for mindfulness to reduce the selection of unhealthy foods looks promising, this also requires further investigation through experimental research.

Society for Assisted Reproductive Technology advertising guidelines: How likely are member clinics to maintain compliance after resolving their violations?

Objective

To evaluate the Society for Assisted Reproductive Technology (SART) member in vitro fertilization centers' compliance with SART’s advertising guidelines after delayed correction of previous violations.

Design

Retrospective cohort study.

Setting

Internet.

Patient(s)

None.

Intervention(s)

None.

Main Outcome Measure(s)

Clinics that were cited for noncompliance with SART advertising guidelines in 2019 and exceeded the two-week grace period in correcting their violations were studied. These clinics were rereviewed in 2020, at least 6 months after their initial citation, for violations of SART advertising guidelines in all six categories: supplemental data noncompliance, link to SART Clinical Summary Report and disclaimer statement missing, unsubstantiated claims, statements denigrating other clinics, and claims of superiority.

Result(s)

In 2019, 44 (27%) of 161 of clinics reviewed by the SART advertising committee had at least one violation that was eventually resolved but not within the two-week grace period. On rereview in 2020, one clinic had not renewed its SART membership and 10 (23%) of the remaining 43 clinics were noted to have violations at the subsequent review. Improper presentation of supplemental data was the most common violation category in both the initial review, 32 (73%) of 44 clinics, and on rereview, 7 (70%) of 10 clinics cited a second time for violations.

Conclusion(s)

Of the in vitro fertilization clinics with previous violations with delayed correction in 2019, 77% were subsequently compliant when reevaluated in 2020, indicating that advertising committee disciplinary and educational measures were largely effective. The most common citation for both years was maintaining consistent and transparent supplemental data on their websites.

Chiropractic website claims related to non-musculoskeletal conditions: a cross-sectional study

BACKGROUND

Chiropractors frequently use spinal manipulation therapy as a treatment modality in the management of musculoskeletal (MSK) conditions such as spinal pain and sometimes in the treatment of non-MSK disorders. The latter is not supported by evidence. This study aimed to investigate the extent of non-MSK website claims from French chiropractors to assess if websites were aligned with current recommendations on evidence-based practice.

METHODS

This was a cross-sectional study of a representative sample of French chiropractors. Information on non-MSK conditions was collected from chiropractic professional websites by two independent observers in June 2020. For each non-MSK condition, it was noted whether a clarifying explanation justifying the mentioning of the condition was available. In addition, data on professional association affiliation status, country of education, years since graduation, and special clinical focus (e.g., seniors, children) were collected.

RESULTS

A total of 287 randomly selected websites were included in the study corresponding to 22% of all chiropractors registered in France. One or more of 42 different non-MSK conditions were identified on 231 websites, of which 5 (2.2%) provided a clarifying explanation. 226 (79%) websites mentioned a non-MSK condition without a clarifying explanation. The non-MSK conditions most often mentioned were sleep problems, constipation/digestive problems, unease/discontent in children and menstrual cramps/pains. A larger proportion of the websites advertising treatment for non-MSK disorders was found among those claiming a special clinical focus on infants/children, seniors, pregnant women or athletes compared to those that did not. Also, a larger proportion of chiropractors who were affiliated with a professional association were advertising treatment for non-MSK disorders compared to those who were not affiliated.

CONCLUSIONS

Eight out of ten chiropractic websites mentioned one or more non-MSK diagnoses or symptoms. It is unclear if this reflects inaccurate communication or if treatments for non-MSK conditions are provided by the chiropractors.

Disparities in exposure to television advertising of sugar-sweetened and non-nutritive sweetened beverages among U.S. adults and teens, 2007-2013

The objective of this study was to estimate disparities in exposure to television advertising of sugar-sweetened and non-nutritive sweetened beverages among U.S. adults and teens. Data (2007-2013) came from the National Consumer Survey and included 115,510 adult respondents (age 18+) and 8635 teen respondents (age 12-17). The data was originally accessed in 2018 and analyzed in 2019-2020. The main outcomes were individual-level estimated exposure to advertisements for regular soda, diet soda, and energy/sport drinks. The main exposures were by race/ethnicity, household income, and educational attainment. Non-white adults (teens) were exposed to an estimated (per year) 101.5 (190.1) regular soda ads, 49.5 (61.2) diet soda ads, and 157.1 (279.6) energy/sport ads per year while white respondents were exposed to 97.5 (127.7) regular soda ads, 45.8 (44.2) diet soda ads, and 123.9 (192.0) energy/sport ads per year. Adult (teen) respondents who were non-white with low incomes and with low educational attainment were exposed to 4.7% (53.7%) more regular soda ads, 6.6% (43.8%) more diet ads, and 23.2% (56.2%) more energy/sport ads than respondents who were white with high incomes and high educational attainment. Demographic and socio-economic groups with a higher prevalence of obesity were exposed to significantly more advertisements for sugar-sweetened beverages. When evaluating potential policies to regulate marketing of sugar-sweetened and non-nutritive sweetened beverages, policymakers should consider the disparate exposure of at-risk populations to advertising of sugar-sweetened and non-nutritive sweetened beverages.

Media representations of opposition to the 'junk food advertising ban' on the Transport for London (TfL) network: A thematic content analysis of UK news and trade press

BACKGROUND

Advertising of less healthy foods and drinks is hypothesised to be associated with obesity in adults and children. In February 2019, Transport for London implemented restrictions on advertisements for foods and beverages high in fat, salt or sugar across its network as part of a city-wide strategy to tackle childhood obesity. The policy was extensively debated in the press. This paper identifies arguments for and against the restrictions. Focusing on arguments against the restrictions, it then goes on to deconstruct the discursive strategies underpinning them.

METHODS

A qualitative thematic content analysis of media coverage of the restrictions (the 'ban') in UK newspapers and trade press was followed by a document analysis of arguments against the ban. A search period of March 1, 2018 to May 31, 2019 covered: (i) the launch of the public consultation on the ban in May 2018; (ii) the announcement of the ban in November 2018; and (iii) its implementation in February 2019. A systematic search of printed and online publications in English distributed in the UK or published on UK-specific websites identified 152 articles.

RESULTS

Arguments in favour of the ban focused on inequalities and childhood obesity. Arguments against the ban centred on two claims: that childhood obesity was not the 'right' priority; and that an advertising ban was not an effective way to address childhood obesity. These claims were justified via three discursive approaches: (i) claiming more 'important' priorities for action; (ii) disputing the science behind the ban; (iii) emphasising potential financial costs of the ban.

CONCLUSION

The discursive tactics used in media sources to argue against the ban draw on frames widely used by unhealthy commodities industries in response to structural public health interventions. Our analyses highlight the need for interventions to be framed in ways that can pre-emptively counter common criticisms.

Visual images of prescription drug benefits in direct-to-consumer television advertisements

OBJECTIVE

Images demonstrating a prescription drug's efficacy are often included in direct-to-consumer television advertisements. The current research assessed whether exaggerated efficacy images can mislead individuals, and whether providing accurate quantitative information can reduce these misperceptions.

METHODS

We conducted two experimental studies with internet panelists 60 years and older testing drug efficacy images in television ads for wet age-related macular degeneration (N = 901) and plaque psoriasis (N = 902). In each study, participants viewed one of six ads that varied in the efficacy images included (no image, accurate image, exaggerated image) and the presentation of quantitative information (absent, present). Measures included recall, perceptions, and numeracy.

RESULTS

In both studies, participants who saw exaggerated images were more likely than those who saw no image or accurate images to overestimate efficacy. Presenting quantitative information increased participants' gist and verbatim recall of drug efficacy, and in some cases, led participants to have more accurate perceptions of the drug's efficacy even in the presence of exaggerated images. Higher numeracy was associated with better gist and verbatim recall.

CONCLUSIONS

These results support visual persuasion theory. Moreover, they show that exaggerating benefits visually can mislead viewers.

PRACTICE IMPLICATIONS

Stakeholders should ensure that images in direct-to-consumer promotion are accurate and non-misleading.

Indirect tobacco advertising, promotion and sponsorships in the Indian Premier League 2020: Tobacco Industry's continuous presence in Indian cricket

BACKGROUND

Indian Premier League (IPL) cricket tournament - a shorter version of the sport which is played between assorted company-owned or individual owner teams - has grown immensely popular over the last decade. There is long history of tobacco advertisement, promotion and sponsorship (TAPS) in cricket. While direct and indirect TAPS is completely prohibited under the Cigarettes and Other Tobacco Products Act (COTPA), 2003 the nexus between tobacco industry and cricket in India continues. We monitored any tobacco product and allied brand or surrogate advertisement, promotion, sponsorship (TAPS) or placement during every match played in the IPL-13 season in the year 2020.

METHODS

Using an investigative approach, 60 match highlights during IPL-13 (during September 19 to November 10, 2020) were monitored for TAPS (both on-site i.e. sportswear and/or in stadia) shown on the official website (www.iplt20.com). All sponsors and advertisers were validated using brand names or logos from their respective official website.

RESULTS

Two IPL teams (Rajasthan Royals and Royal Challengers Bangalore) were sponsored by major tobacco industry owned brands. Violations by a major smokeless tobacco company promoting their brand extension product i.e. Vimal Elaichi, on the official telecast websites (www.espncricinfo.com and www.cricbuzz.com) and television channels (www.Zeenews.india.com/Gujarati) was observed. Tobacco companies i.e. Kamla Pasand and ITC Limited were also listed as associate sponsors for the 2020 championship.

CONCLUSION

Despite comprehensive ban under India's tobacco control law (COTPA, 2003), sponsorship by tobacco industry was found widespread in IPL-13. Advertisement and logos of tobacco companies are persistent during the telecast and promotion of the IPL events, in clear violation of India's tobacco control legislation and Article 13 of WHO's Framework Convention on Tobacco Control (WHO-FCTC) and its guidelines. Given that India and South Asia comprise the largest audience for televised cricket, strong exclusion criteria is needed by the international cricket authority and national cricket associations to ensure compliance with the national law and global good practice, making the cricketing world truly tobacco free.

Source memory for advertisements: The role of advertising message credibility

Advertising is seen as an untrustworthy source because of the perceived self-interest of the advertisers in presenting product information in a biased or misleading way. Regulations require advertising messages in print and online media to be labeled as advertisements to allow recipients to take source information into account when judging the credibility of the messages. To date, little is known about how these source tags are remembered. Research within the source-monitoring framework suggests that source attributions are not only based on veridical source memory but are often reconstructed through schematic guessing. In two experiments, we examined how the credibility of advertising messages affects these source attribution processes. The source of the messages affected judgments of credibility at the time of encoding, but the source tags were forgotten after a short period of time. Retrospective source attributions in the absence of memory for the source tags were strongly influenced by the a priori credibility of the messages: Statements with a low a priori credibility were more likely to be (mis)attributed to advertising than statements with high a priori credibility. These findings suggest that the mere labeling of untrustworthy sources is of limited use because source information is quickly forgotten and memory-based source attributions are strongly biased by schematic influences.

#SupportLocal: how online food delivery services leveraged the COVID-19 pandemic to promote food and beverages on Instagram

Objective:

To explore the promotion of discretionary foods/beverages and marketing strategies employed by the top three online food delivery services’ (OFDS) Instagram accounts in three countries before and during the coronavirus disease 2019 (COVID-19) pandemic.

Design:

Publicly available data were extracted for the top three OFDS Instagram accounts for Australia, United Kingdom (UK) and the United States of America (USA) from March to May 2019 and 2020. Food/beverage items from posts were classified as ‘discretionary’ or from the five food groups (FFG) according to the Australian Dietary Guidelines. Marketing strategies were coded using an existing framework. Posts referring to COVID-19 were coded under four marketing strategies: (i) appropriating frontline workers; (ii) combatting the pandemic; (iii) selling social distancing; and (iv) accelerating digitalisation.

Results:

From 581 posts, 618 food/beverage items were shown, of which 69 % (427/618) were classified as discretionary. In 2019, the most used marketing strategies were product imagery (unbranded) (137/195, 70 %), links (111/195, 57 %) and sponsorships/partnerships (58/195, 30 %). In 2020, the most used were links (252/386, 68 %), product imagery (unbranded) (179/386, 49 %) and branding elements (175/386, 45 %). The most common COVID-19 marketing strategy was combatting the pandemic (76/123, 62 %) followed by selling social distancing (53/123, 43 %), appropriating frontline workers (34/123, 28 %) and accelerating digitalisation (32/123, 26 %).

Conclusions:

Following the COVID-19 pandemic, OFDS adapted their marketing, creating content with the theme of ‘combatting the pandemic’. Due to the growing number of discretionary foods/beverages promoted on Instagram, this highlights the need for policy action to counter the potential influence social media platforms have on dietary behaviours.

Advertising, incentives, and the upsell: how advertising differentially moderates customer- vs. retailer-directed price incentives' impact on consumers' preferences for premium products

Many durable goods firms use price promotion strategies and advertising simultaneously to impact consumer preferences among vertically differentiated product offerings. In this research, we use a large secondary dataset of automotive purchases (N = 323,959) to investigate how advertising spending differentially moderates the positive impact of both customer- and retailer-directed price incentives on consumers' premium level of purchase for vertically differentiated products. We find that higher advertising spending magnifies the positive impact of customer-directed price incentives on consumers' preference for more premium purchases. In contrast, higher advertising spending attenuates the positive impact of retailer-directed price incentives on consumers' preference for more premium purchases. Our work is distinct from previous research, which has almost exclusively focused on the CPG industry and the effects of advertising and price promotions on general demand metrics-instead of consumers' preferences for premium products. Our work has important implications for practitioners and consumer welfare.

Framing real beauty: A framing approach to the effects of beauty advertisements on body image and advertising effectiveness

Current literature is inconsistent about the effects of idealized (i.e., thin) vs. non-idealized (i.e., average or plus-size) models on young women's well-being. This inconsistency may be explained by different frames (i.e., passive body, active body, and subject) surrounding beauty ad models. The current experimental study among 568 women aged 18-30 years (M = 21.45, SD = 1.84) tested the effects of differently framed ads featuring idealized vs. non-idealized models on well-being and ad effectiveness while taking into account the mediating role of cognitive schemas and moderating role of thin-ideal internalization. Results showed that a passive body frame generated more appearance schemas compared to a subject frame. The effects of framing on body functionality schemas operated differently for idealized vs. non-idealized models. The passive body frame also induced inferior ad outcomes (i.e., lower attitudes to the advertisement and brand and lower purchase intent) compared to an active body frame. No other main framing effects nor moderating effects of thin-ideal internalization were found. These results for advertising outcomes can encourage beauty brands to stop using typical objectifying ads.

Food and drink marketing on social media and dietary intake in Australian adolescents: Findings from a cross-sectional survey

Unhealthy food and drink marketing is prominent on social media and use of such platforms is widespread among adolescents. This study aims to examine the association between exposure to and engagement with food or drink advertisements on social media and unhealthy food and drink intake in Australian adolescents. In 2018, a representative sample of secondary school students aged 12-17 years (N = 8708) self-reported how frequently they saw food or drink advertisements on social media (exposure), 'liked' or 'shared' food or drink posts (engagement), and consumption of various unhealthy food and drinks. Multilevel logistic regression assessed the association between exposure to and engagement with food marketing on social media and high intake of unhealthy food and drinks. Fifty-five percent of students reported seeing a food or drink advertisement on social media at least weekly, while engagement was less frequent. Exposure to a food or drink advertisement on social media at least once in the last week was associated with a high intake of unhealthy drinks, while liking or sharing a food or drink post at least once in the last month was associated with a high intake of unhealthy food and drinks (all p < 0.01). As frequency of engagement with this type of marketing increased, so too did the likelihood of a high intake of unhealthy food and drinks. The association between exposure to and engagement with food or drink marketing and high unhealthy drink intake was driven by males, while all associations persisted irrespective of age. Holding manufacturers to higher standards in their digital marketing of unhealthy food and drink products through improved policy design and enforcement capability may be crucial in enabling young individuals to maintain a healthy diet.

An exploratory study on the sociocultural consequences of food consumption patterns among African American girls

African American women, in particular, have learned to navigate through a food consumption landscape that purposefully, and often aggressively, limits their choices and stigmatizes their resulting physical appearance, and renders them collectively unattractive and unworthy. While American women are challenged to subscribe to traditional slim body standards, a faction of Americans have differing opinions. African American (AA) women celebrate larger body types and defy weight stigma. When African Americans make food choices, taste and cost are not the only factors influencing those choices; the cultural role of food is also considered. We conducted semi-structured interviews with 12 African American girls to identify some of the consequences of this consumption practice that challenges what we argue is a hegemonic taste regime surrounding body size. This work further elucidates the ways in which the African American community has operationalized the concept of cultural capital around the issues of body image to create what we suggest is a type of emotional well-being. In addition to uncovering marketing channels promoting anti-obesity campaigns that would be more likely to capture their attention, our findings also reveal that AA girls embrace shapely bodies, despite not necessarily having one themselves, and overall possess a more positive body image than their Caucasian peers. Having shapely bodies was deemed more attractive among romantic interests and acceptable overall in the AA community regardless of the associated health risks associated with consuming unhealthy foods.

Prevalence of violent advertisements in New York City subways

Background: Media advertisements displaying aggression and violence in public transit spaces represent a public health concern. The high visibility of ads likely contributes to increased levels of aggression among New York City (NYC) youths traveling across boroughs. Given the importance of the physical, psychological and social environment in shaping the lives of youth, additional attention is warranted regarding how media advertisements are promoted within public transit spaces across America. The aim of this study was to document quantity and placement of advertisements illustrating aggressive and violent content throughout the NYC public transit subway system. Methods: This cross-sectional study was conducted over a five-day period in June 2017. Direct observation was used to document all advertisements within every NYC Metropolitan Transit Authority (MTA) subway station (N = 472) in four NYC boroughs: Bronx, Brooklyn, Manhattan and Queens. Static media advertisements with/without aggressive and violent content displayed on subway platform wall panels above and underground were counted, photographed and described with a mobile app. Results: Aggressive and violent ads in the MTA were pervasive. Subway platforms displayed advertising consisting of guns, individuals fighting and attacking, and words with aggressive language. Conclusion: Public transit spaces provide unregulated visual and verbal messages without citizen participation. Subway stations in NYC and across the country prohibition stance could be a model for violent content reduction. Given the pervasive and tragic effects of aggression and violence on youth and adults, transit agencies could inundate passengers with positive advertising content. Dialogue between citizens and transit agencies to remove noxious messages from public transit spaces warrants the same discussion given to banning alcohol advertisements.

Emergent gambling advertising; a rapid review of marketing content, delivery and structural features

BACKGROUND

Gambling advertising is well-funded and has become increasingly sophisticated in recent years. As the presence and pervasiveness of gambling advertising increases, there is a corresponding need for empirical understanding of the characteristics and trends associated with emergent gambling advertisements and marketing. However, there is limited data on this rapidly evolving phenomenon.

METHODS

A rapid review was undertaken of the empirical research (2015-2020) that focused upon the content, delivery and structural features incorporated within emerging gambling advertising.

RESULTS

Twenty-five studies were included in the review. The majority of these studies were conducted in either the UK or Australia; two jurisdictions that have unique and particularly liberal gambling environments. The literature suggests that emergent gambling advertising content is targeted, positively framed and in some instances, may overrepresent riskier bets. The sporting and social media spheres are densely populated with such advertisements that involve both direct and indirect marketing strategies. In relation to the online environment, there is evidence to suggest the emergence of more interactive advertisements that prompt user engagement. In addition, financial incentivisation has diversified and is often subject to strict and esoteric conditions. Despite these emergent trends, little provision is devoted to adequately displaying harm reductive or responsible gambling content within gambling advertising.

CONCLUSIONS

Overall, there is a paucity of research and lack of methodological diversity concerning the characteristics of advertising within the literature. The barriers to investigating emerging gambling advertising are discussed alongside future research priorities. It is important for this research area to expand in order to appropriately inform ethical industry marketing and effective harm-reduction strategies. [Pre-registered online via Prospero: CRD42020184349].

Estimated televised alcohol advertising exposure in the past year and associations with past 30-day drinking behavior among American adults: results from a secondary analysis of large-scale advertising and survey data

AIMS

To estimate the volume of past-year televised alcohol advertising exposure by product category and demographic group among adults living in the United States and test associations between estimated alcohol advertising exposure and past 30-day drinking behavior.

DESIGN

Secondary analysis of data from two national-level US data sets: Kantar data on appearances of televised alcohol advertisements and data from the Simmons National Consumer Survey (NCS), a large national mail survey on television viewing patterns and consumer behavior.

SETTING

United States.

PARTICIPANTS

A total of 54 671 adults, aged 21 years and older, who were randomly selected to participate in the Simmons NCS.

MEASUREMENTS

Estimated exposure to televised advertisements for beer, wine and spirits, self-reported alcohol use in the past year and number of drinks consumed in the past 30 days.

FINDINGS

The average respondent was exposed to an estimated 576 [95% confidence interval (CI) = 570-582] televised alcohol advertisements in the year preceding their survey. Exposure was higher among males versus females and African Americans versus whites. A 1% increase in the estimated volume of advertisement exposure was associated with a 0.11 (95% CI = 0.08-0.13) percentage point increase in the odds of having at least one drink in the last 30 days and, among past 30-day drinkers, a 0.05 (95% CI = 0.04-0.07) per cent increase in the number of alcoholic drinks consumed. Associations were consistent across product categories and demographics.

CONCLUSIONS

There appears to be a small but consistent positive association between alcohol advertising exposure and drinking behavior among American adults.

Geospatial spread of e-cigarette vape shops in South Africa and the relationship with tobacco product use among adults

We estimated the spatial distribution of e-cigarette vape shops in South Africa and measured associations with tobacco use among adults. We linked geocoordinates of identified vape shops to internet protocol addresses of individual participants in the 2018 Health 24 survey (n = 18,208). We used logistic regression to measure the associations between proximity to vape shops and tobacco-related behaviors. In total, we identified 240 vape shops; 49.6% of these were within a 5 km radius of a higher educational institution. Proximity to vape shops was associated with ever e-cigarette use among young adults aged 18-29 years (AOR = 1.33, 95%CI = 1.16-1.54). Efforts to regulate e-cigarette marketing can benefit public health.

Direct-to-consumer dermatology-related advertising differs in magazines targeted to women of color: A cross-sectional analysis of top-circulating consumer magazines

Background

Advertisements for dermatology-related products in consumer magazines serve as a potential source of health literacy, which varies by demographic group.

Objective

This study sought to examine differences in advertisements for dermatology-related products in the top U.S. consumer magazines targeted at women of color compared with three other demographic groups: teenagers, adult women, and adult men.

Methods

Dermatology advertisements in the most circulated U.S. consumer magazines targeting these four demographic groups were analyzed. Descriptive statistics were obtained. Simple logistic regressions were used to compare the product indications, language used, and the sex, age, ethnicity, and skin type of models between magazine categories. Limitations of this study included that certain magazines could not be included due to a lack of accessibility, and subjective assessments were made when necessary because not all data collected were explicitly stated.

Results

Significant differences exist in print media advertising for women of color in comparison with other demographic groups, including skin-of-color magazines having an increased number of darker-skin models, more advertisements related to products that target pigmentation, and differences in advertisement word choices.

Conclusion

The differences in print media advertising for women of color in comparison with other demographic groups may influence the dermatologic concerns of this population, including their dermatology-related knowledge base, grooming practices, beauty perceptions, and utilization of dermatology as a specialty.

What do Australian health consumers believe about commercial advertisements and testimonials? a survey on health service advertising

Background

There has been little examination of consumer attitudes towards the commercial advertising of healthcare services in Australia and how marketing is used by consumers in their health decision-making. In this research, we examined how consumers reported commercial advertising helped them to understand the health services available to them and the influence that marketing had upon their choices.

Methods

A survey instrument using a Likert scale to indicate agreement or disagreement with 21 questions was developed using qualitative interviews before being distributed online within Australia. Sampling of participants was stratified by age, gender and location. The results were subjected to statistical analysis with Spearman Rank Correlation test being used for bivariate analysis.

Results

One thousand five hundred sixty-four complete surveys were collected. The results revealed certain consumer beliefs, for example; the title of ‘Dr’ was believed to indicate skill and high levels of training (81.0%), with 80.3% agreeing incorrectly that use of the title was strictly regulated. Participants reported to have a higher confidence in their own abilities (71.2%) than the public (52.8%) in assessing health advertising. The level of self-confidence increased with higher education level and decreased by age (p < 0.05). Testimonials were reported to be lacking in reliability (67.7%) and that they should not be used in healthcare in the same manner as they are used in other industries. Only 44.8% of participants reported that they felt confident to spot a review that was not written by a genuine user of a service.

Conclusions

The data demonstrated that many health consumers felt that while commercial health advertising was helpful, it was also confusing, with many participants also holding mistaken beliefs around other elements of commercial health advertising. While the advertising of healthcare services might have educational effects and be superficially empowering, advertising is primarily intended to sell, not educate. This research demonstrates that there is significant potential for healthcare advertising to mislead. Future developments in regulatory health advertising policy, and the related ethical frameworks developed by professional healthcare associations, need to consider how the consumers of healthcare services might be better protected from misleading and predatory advertising practices.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-10078-9.