How to Curb Marketing From Health-Harming Industries

Harmful Marketing: An Overlooked Social Determinant of Health

Research paper

Abstract

This paper reviews evidence about the impact of marketing on ill health.

The researchers summarize evidence that marketing practices in six industries (tobacco, alcohol, pharmaceutical, processed food, firearm, and fossil fuel) are causal influences on the occurrence of injury, disease, and premature death.

For each industry, the researchers provide a brief overview on the extent of harmful marketing, efforts from each industry to obscure or otherwise conceal the impact of their marketing strategies, and efforts to counter the impact of harmful marketing in these industries. However, considering the ubiquitous belief that regulation is harmful to society, little headway has been made in reducing harmful marketing.

The researchers propose the substitution of a public health framework for the currently dominant free market ideology. Doing so would situate harmful marketing as a social determinant of health and consolidate the disparate efforts to regulate marketing of harmful products. Implications for future policy and research efforts are discussed.

Harmful Marketing: An Overlooked Social Determinant of Health

This paper examines the impact of marketing on health in the USA, as commercial determinants of health have received far less attention in the literature on social determinants of health, despite their significant impact.

The researchers review evidence showing that marketing practices in six industries – tobacco, alcohol, pharmaceuticals/opioids, processed food, firearms, and fossil fuels – causally influence the incidence of injury, disease, and premature death. These industries not only promote harmful products but also obscure their negative health impacts to avoid regulatory scrutiny.

The researchers selected these six industries to represent some of the most egregious examples of industries that utilize marketing to sell products that harm health. For these six industries, the researchers describe the epidemiological and economic aspects of associated health outcomes, the marketing strategies of these industries, their resistance to regulation, and efforts to mitigate the effects of harmful marketing.

However, in the context of a widespread belief that the regulation of industries is harmful to society, achieving regulation that would decrease the public health impact of these products is challenging.

The researchers propose adopting a public health framework in place of the prevailing free market approach. This shift would recognize harmful marketing as a critical social determinant of health and unify various regulatory efforts into a comprehensive public health strategy to control marketing practices that endanger significant portions of the population.

The Alcohol Industry

Deaths due to the products of alcohol companies

Alcohol marketing to young people

Spending on alcohol marketing was projected to increase from $6.7 billion in 2020 to $7.7 billion in 2023, with 30% of that spent on digital advertising (Zenith Media, 2021).

Minoritized youth are exposed to more alcohol marketing than white youth, and minoritized and lower income groups are disproportionately impacted by alcohol use, both by health effects and punitive outcomes.

A growing body of research suggests that exposure to alcohol marketing increases the onset and severity of alcohol consumption by youth. Much of this work is cross-sectional, but several systematic reviews, commissioned to assess the link between exposure to alcohol marketing and use by youth, support a causal link.

Three ways alcohol marketing causes harm and one effective solution

Alcohol marketing causes harm to children and youth. Alcohol marketing saturates society with alcohol, and perpetuates the harmful alcohol norm. And alcohol marketing prevents evidence-based alcohol industry regulation.
These are the three ways how alcohol marketing causes harm.
In this blog post, Maik provides state of the art analysis of how exactly, using a concrete Heineken example, and the best available scientific evidence.
And he explores the question of what can be done about it. There is a solution and it turns out most people support it.

Efforts of the alcohol industry to conceal their impact

Unlike the regulations on tobacco marketing to youth, there are few limits on alcohol marketing in the United States.

The alcohol industry has a voluntary, self-regulatory code to not advertise in magazines, in newspapers, on television, on radio, or in digital media in which underage youth comprise more than 28.4% of the audience. The code also promises to not depict “excessive” alcohol use or acceptability of alcohol-impaired behavior in ads and to not associate the consumption of alcohol with status or success (Beer Institute, 2018; Distilled Spirits Council of the United States, 2021; Wine Institute, 2011).

However, there is no independent oversight, monitoring, or enforcement of these alcohol industry codes. As a result, they are often disregarded (Federal Trade Commission, 1999). Like the tobacco industry, these alcohol industry-imposed self-regulations for alcohol were established to avoid governmental regulation.

Limited Impact of Efforts to Reduce Marketing to Youth

In 2002, the Center on Alcohol Marketing and Youth (CAMY) was established to monitor alcohol marketing practices in the US, with a focus on youth exposure to advertisements in magazines, on television, and on the radio.

CAMY analyses found that, between 2001 and 2005, alcohol companies were routinely advertising to audiences with a high number of youths aged between 12 and 20.

From 2005 to 2012, youth under age 21 were exposed to $15.1 billion of alcohol advertisements that did not comply with the self-imposed alcohol industry audience composition guidelines (i.e., over 28.4% of the audience was underage), primarily via cable television.

A recent study found that, between 2013 and 2018, alcohol ads were appearing more frequently during shows in which 28.4% or more of the audience were under-age viewers.

In sum, the lack of governmental oversight, regulation, or enforcement of self-imposed industry regulations for alcohol marketing is ineffective tools for reducing exposure of alcohol marketing to youth.

Discussion

Reducing such marketing should be a top priority for public health research and practice.

In each case, these industries are engaging in marketing and public relations practices designed to obscure the impact of their product on disability and death, and to prevent regulation that might reduce their profits. Efforts are underway to stop these harmful practices, but they have had limited success, largely because of the skill and resources these industries put toward preventing regulation of their practices.

The fact that excess deaths continue to occur and are in some cases increasing because of these practices constitutes empirical evidence that US society does not have policies and practices effective at preventing or ameliorating these harms. On that basis, the researchers describe the steps necessary.

A registry of marketing-related deaths

In the same way that the public health system monitors deaths due to chronic and infectious illness and injuries, a system is needed that provides annual data on deaths attributable to marketing. For example, a study by Pierce et al. estimated that 34% of new smokers begin smoking as a result the advertising and promotion of cigarettes. Based on the number of new smokers who began smoking Camel or Marlboro cigarettes between 1988 and 1998 and the proportion of smokers who die due to smoking, the study estimated that 520,000 people would die due to Camel marketing and 300,000 would die due to Marlboro marketing.

Having annual estimates of the deaths due to the marketing of various harmful products would drive policymaking that regulates such marketing. However, before such a registry could be created, there would need to be widely accepted standards for concluding that a marketing practice contributed to premature deaths. To that end, experimental evidence would be needed.

Experimental evidence of the impact of marketing

Research and litigation on the harm of cigarette marketing suggest general standards for concluding that marketing is harmful to health. There must be experimental evidence that this marketing contributes to the use of a product that causes premature death.

In the USA vs Philip Morris et al., the tobacco industry argued that the correlation between adolescents’ exposure to cigarette advertising and their subsequent smoking was simply due to a pre-existing interest in cigarettes. However, experimental studies that randomized young people to be exposed to marketing, while others were not, showed that exposure to marketing increased favorable attitudes toward smoking and intentions to take up smoking, two well-established predictors of subsequent smoking.

Making public health the criterion for the regulation of marketing

Each of the marketing practices this study identifies has been opposed by groups seeking to reduce these harms. But these efforts have had limited success because of the widespread belief that the regulation of industry is harmful.

Overcoming this default assumption is essential for increasing a society’s ability to prevent the premature deaths that result from harmful marketing. That assumption has been promoted by advocates for free market economics who cite Adam Smith’s description of the benefit of unfettered markets. However, their advocacy ignores the fact that Smith actually favored the need for government to restrain harmful commercial practices.

An alternative principle should be the public health principle: regulation of practices that contribute to premature death. Economists and the public health community are quite capable of assessing the harms of products to public health. The principle is that when the harm of marketing a product exceeds its benefit, that marketing should be subject to regulation to ensure that the marketing is not profitable. This principle would supplant the widely accepted principle that regulation of business should be limited.

Government efforts to tackle harmful marketing have generally failed because they rely on fines that are merely a cost of doing business. In 2007, for example, three executives at Purdue Pharma paid $634.5 million in fines for the fraudulent marketing of OxyContin. Yet, the company continued to market the drug quite profitably and overdose deaths continued to rise.

The practices of corporations are selected by their consequences. Companies continue to engage in harmful marketing because it is profitable. They will discontinue practices that are losing them money, but fines that are less than the total profits are simply the cost of doing business. Harmful marketing will stop when it is unprofitable.

Reducing the power of corporations

The power of corporations to profit from harmful practices goes well beyond their ability to market harmful products with impunity. For this reason, the problem of reducing harmful marketing needs to be seen in the context of the power that corporations have attained over the past forty years. In their pursuit of maximizing profits, they have eroded the enforcement of anti-trust laws, gained the ability to fund political candidates, reduced the regulatory authority of government agencies, and learned to influence public opinion through disinformation campaigns.

In 2023, Wood et al. provided an extensive review of the strategies that have been reported for reducing corporate power. Supplemental Table 2 lists the strategies they identified and provides two examples of each strategy. Strengthening these efforts will contribute not only to a society’s ability to prevent harmful marketing, but to the more general effort to prevent harmful corporate practices.

Supplemental Table 2

References

Meagher, M. (2020a). Competition is killing us: how big business is harming our society and planet-and what to do about it. Penguin Business. 

Meagher, M. (2020b). Winner takes all. Royal Society for Arts, 166(3), 32-34.

Wood, B., Lacy-Nichols, J., & Sacks, G. (2023). Taking on the Corporate Determinants of Ill-health and Health Inequity: A Scoping Review of Actions to Address Excessive Corporate Power to Protect and Promote the Public’s Health. International Journal of Health Policy and Management, 12(Issue 1), 1-17. https://doi.org/10.34172/ijhpm.2023.7304

Source Website: Springer Nature Link