Persuasive linguistic tricks in social media marketing communication-The memetic approach.

The paper reports the results of a study into the use of linguistic cues defined as Persuasive Linguistic Tricks (PLT) in social media (SM) marketing communication. It was assumed that the content shared on Social Networking Sites (SNS) could be perceived as specific sets of meanings (memeplexes), where a single component, also PLT, may function as their part. Following an original typology of PLT, created based on an emotional factor, the research focused on whether and how the number of positive, neutral and negative PLT used in Facebook posts impacted the behaviour of content recipients. These activities, including liking, commenting and sharing, are strictly connected with post spreading and range. The data analysis focused on 167 Facebook posts shared by five leading Polish travel agencies and 1911 responding comments. The quantitative content analysis method and Spearman's correlation tests were used. A relationship was observed between the number of emotionally positive and neutral PLT and the increase in the range of content with these PLT. The use of PLT by post recipients was also observed in their comments. This phenomenon is possibly related to the memetic nature of PLT. From the perspective of marketing messages, the obtained results contribute to and guide the textual content-building with a high spreading potential owing to the memetic capability of PLT. Further elaborations were made on the assumption for the evolutionary approach in social media content transfer and its processing.

Audit of NZ COVID Tracer QR poster display and use in Dunedin.

AIMS: To assess how well the NZ COVID Tracer QR (Quick Response) code poster is displayed by Dunedin businesses and other venues in which groups of people gather indoors, and to calculate the proportions of visitors to those venues who scan the QR code poster. METHODS: We randomly selected 10 cafes, 10 restaurants, 10 bars, five churches, and five supermarkets and visited them at their busiest times. We evaluated the display of QR code posters using a six-item assessment tool that was based on guidance provided to businesses and services by the Ministry of Health, and we counted the number of people who entered each venue during a one-hour period and the number who scanned the QR code poster. RESULTS: All six criteria for displaying QR code posters were met at half of the hospitality venues, four of five churches, and all supermarkets. Scanning proportions were low at all venues (median 10.2%), and at 12 (30%) no visitors scanned; eight of these venues were bars. CONCLUSION: This audit provides a snapshot of the display and scanning of QR code posters in a city with no managed isolation and quarantine facilities and where no COVID-19 cases have been detected for 10 months.

Violations of the International Code of Marketing of Breastmilk Substitutes (WHO Code) in two Ecuadorian cities.

OBJECTIVE: The aim of this study was to estimate the prevalence of violations of the International Code of Marketing of Breastmilk Substitutes (World Health Organization [WHO] Code) in Ecuador's two main cities, Quito and Guayaquil. METHODS: The WHO Net Code Protocol was applied. It examines compliance with the WHO Code by: (1) Interviews with health professionals and mothers of children <24 mo in randomly selected health facilities (HFs); (2) Surveillance of breastmilk substitutes (BMS) points of sale (POS); (3) Assessment of BMS labels; and (4) Mass media monitoring. RESULTS: Most HFs were contacted by BMS company representatives. BMS promotional materials were found in one of every four HFs. Almost 50% of health personnel knew about the WHO Code. At least 48.5% of mothers received advice on feeding their children BMS. The varied advice came from several sources. Of POS, 68% failed to comply with the WHO Code in several ways (e.g., giving gifts, promotional packaging, and informational materials) and by reducing the price of BMS. More than half of the BMS labels contained texts or images that idealized their use. More than $1 million of BMS advertising expenses were identified in the media. CONCLUSION: The fact that the WHO Code was violated many times in Quito and Guayaquil strengthens the need for regulatory mechanisms and for the promotion of breastfeeding by multiple sectors.

Smokers' Exposure to Perceived Modified Risk Claims for E-Cigarettes, Snus, and Smokeless Tobacco in the United States.

INTRODUCTION: Based on arguments for harm reduction and health benefits, tobacco companies in the United States can apply for regulatory authorization to make "modified risk tobacco product" (MRTP) marketing claims. The impact of future MRTP claims may depend on whether they are noticed, believed, and lead to smokers switching products. This study provides baseline data about smokers' exposure to perceived MRTP claims ahead of any MRTP authorizations. AIMS AND METHODS: We analyzed measures from Wave 3 of the US-based Population Assessment of Tobacco and Health (PATH) study which asked smokers to indicate if they had seen any e-cigarettes, snus, or other smokeless tobacco (SLT) products that claim to be "less harmful" in the past 12 months, and their likelihood of using products with these claims in the next 30 days. RESULTS: Significantly fewer smokers noted having seen snus (5.1%) or other SLT (5.6%) with "less harmful" claims compared with e-cigarettes (29.1%). For each product, the prevalence of MRTP claim exposure was higher among smokers who perceived the product to be less harmful than smoking, who currently used the product, and who had higher rates of tobacco advertising exposure at the point of sale. Among smokers who noticed products with "less harmful" claims, about one-quarter said they would use them in the future (24%-27%). CONCLUSIONS: Ahead of any Food & Drug Administration (FDA) authorization for MRTP claims, some smokers already perceive exposure to "less harmful" claims for e-cigarettes, but few do for SLT. MRTP claims may motivate some smokers to use these products. IMPLICATIONS: This study provides new baseline data about smokers' perceived exposure to MRTP claims in the United States ahead of any regulatory claim authorization. Using data from Wave 3 of the US PATH study, we found that some smokers already perceive exposure to "less harmful" claims for e-cigarettes (29%), but few do for SLT (5%-6%). Among smokers who noticed products with "less harmful" claims, about one-quarter said they would use them in the future (24%-27%), suggesting MRTP claims may motivate some smokers to use products described as "less harmful."

Advocacy, Strategy and Tactics Used to Confront Corporate Power: The Nestlé Boycott and International Code of Marketing of Breast-milk Substitutes.

Douglas A. Johnson began his career as a human rights activist while earning his undergraduate degree in philosophy (1975) at Macalester College in the United States. He lived at Gandhi's ashram in India to study nonviolent organizing (1969 to 1970). He served as the director of the Third World Institute in Minneapolis, MN, USA (1973-1979), which functioned as the international social justice program of the Archdiocese of Minneapolis and St. Paul. Johnson's work included creating and running a political collective; leading development study tours into villages in Guatemala and Honduras; and investigating how transnational companies (e.g., Nestlé) were penetrating the developing world. He was the co-founder of the Infant Formula Action Coalition (INFACT), elected national chairperson (1977-1985), and appointed as Executive Director (1978-1984). His role included representing INFACT before national and international organizations, the human milk substitute industry, the US Congress and Executive Branch, and the press. He initiated and coordinated the first international grass-roots consumer boycott (against Nestlé) in ten nations. He was also a co-founder of the International Nestlé Boycott Committee and the International Baby Food Action Network (IBFAN). He earned a Master's in Public and Private Management at Yale University (1988). Then he became the first Executive Director of the Center for Victims of Torture, in Minneapolis (1988-2012), the first treatment center for torture victims in the US. Since 2013, he has been teaching human rights theory and practice, and sharing lessons he has learned, as a Lecturer in Public Policy at the Harvard Kennedy School, Harvard University (US). (This interview was conducted via Zoom and transcribed verbatim. It has been edited for ease of readability. DJ refers to Doug Johnson and LD refers to Laura Duckett.).

The Potential of Smartphone Apps in Informing Protobacco and Antitobacco Messaging Efforts Among Underserved Communities: Longitudinal Observational Study.

BACKGROUND: People from underserved communities such as those from lower socioeconomic positions or racial and ethnic minority groups are often disproportionately targeted by the tobacco industry, through the relatively high levels of tobacco retail outlets (TROs) located in their neighborhood or protobacco marketing and promotional strategies. It is difficult to capture the smoking behaviors of individuals in actual locations as well as the extent of exposure to tobacco promotional efforts. With the high ownership of smartphones in the United States-when used alongside data sources on TRO locations-apps could potentially improve tobacco control efforts. Health apps could be used to assess individual-level exposure to tobacco marketing, particularly in relation to the locations of TROs as well as locations where they were most likely to smoke. To date, it remains unclear how health apps could be used practically by health promotion organizations to better reach underserved communities in their tobacco control efforts. OBJECTIVE: This study aimed to demonstrate how smartphone apps could augment existing data on locations of TROs within underserved communities in Massachusetts and Texas to help inform tobacco control efforts. METHODS: Data for this study were collected from 2 sources: (1) geolocations of TROs from the North American Industry Classification System 2016 and (2) 95 participants (aged 18 to 34 years) from underserved communities who resided in Massachusetts and Texas and took part in an 8-week study using location tracking on their smartphones. We analyzed the data using spatial autocorrelation, optimized hot spot analysis, and fitted power-law distribution to identify the TROs that attracted the most human traffic using mobility data. RESULTS: Participants reported encountering protobacco messages mostly from store signs and displays and antitobacco messages predominantly through television. In Massachusetts, clusters of TROs (Dorchester Center and Jamaica Plain) and reported smoking behaviors (Dorchester Center, Roxbury Crossing, Lawrence) were found in economically disadvantaged neighborhoods. Despite the widespread distribution of TROs throughout the communities, participants overwhelmingly visited a relatively small number of TROs in Roxbury and Methuen. In Texas, clusters of TROs (Spring, Jersey Village, Bunker Hill Village, Sugar Land, and Missouri City) were found primarily in Houston, whereas clusters of reported smoking behaviors were concentrated in West University Place, Aldine, Jersey Village, Spring, and Baytown. CONCLUSIONS: Smartphone apps could be used to pair geolocation data with self-reported smoking behavior in order to gain a better understanding of how tobacco product marketing and promotion influence smoking behavior within vulnerable communities. Public health officials could take advantage of smartphone data collection capabilities to implement targeted tobacco control efforts in these strategic locations to reach underserved communities in their built environment.

Medicine's collision with false hope: The False Hope Harms (FHH) argument.

The goal of this paper is to introduce the false hope harms (FHH) argument, as a new concept in healthcare. The FHH argument embodies a conglomerate of specific harms that have not convinced providers to stop endorsing false hope. In this paper, it is submitted that the healthcare profession has an obligation to avoid collaborating or participating in, propagating or augmenting false hope in medicine. Although hope serves important functions-it can be 'therapeutic' and important for patients' 'self-identity as active agents'- the presentation of false hope along the hope continuum entails a misconstrued balancing act. By not speaking up against unrealistic patient and family requests-including some requests for rights to try, resuscitative efforts in terminally ill patients, or other demands for non-beneficial treatments-healthcare providers precipitate harms, i.e., the FHH. These harms arise on both individual and communal levels and cannot be ignored. The goal of this paper is not to offer a definition of false hope, because the phenomenon of false hope is too complex for any simple definition. Instead, this paper seeks to make four points while outlining the FHH argument: consumer medicine and false hope are connected; providers and patients are very vulnerable in the system of consumer medicine; providers have a responsibility to stand up against false hope; and how the FHH argument could perhaps offer a footing to resist giving in to false hope.

Regulating Alcohol Marketing on Social Media: Outcomes and Limitations of Marketing Restrictions of Finland's 2015 Alcohol Act.

OBJECTIVE: The aim of this study was to assess the effectiveness of the 2015 law restricting alcohol marketing on social media in Finland. METHOD: The study compared posts that market alcohol on Finnish and Swedish social media in terms of number, content, and user engagement during the month of January in three separate years: 1 year before, 1 year after, and 2 years after the 2015 Alcohol Act came into effect in Finland. The data consisted of all posts (Finland, N = 1,536; Sweden, N = 1,204) published during the selected months by alcohol brands that had active national social media accounts at the time of data collection. The coding protocol included numbers of posts and measures of consumer engagement, as well as content restricted by the law. RESULTS: Social media posting increased between the 2014 and 2016 samples in both countries. In Finland, the number of posts decreased in 2017. The proportion of posts with content restricted by the 2015 law increased in both countries between the 2014 and 2016 samples. However, in Finland, the amount of restricted content decreased in the 2017 sample, whereas in Sweden it increased, Pearson χ2(1) = 29.273, p < .001. The level of user engagement increased in both countries between the 2014 and 2017 samples. CONCLUSIONS: The social media regulation in the Finnish 2015 amendment has had an impact on alcohol brands' social media content, but it has not affected marketers' ability to increase consumer engagement.

An Experimental Study of Nicotine Warning Statements in E-cigarette Tweets.

INTRODUCTION: It is unclear whether warnings on electronic cigarette (e-cigarette) advertisements required by the US Food and Drug Administration (FDA) will apply to social media. Given the key role of social media in marketing e-cigarettes, we seek to inform FDA decision making by exploring how warnings on various tweet content influence perceived healthiness, nicotine harm, likelihood to try e-cigarettes, and warning recall. METHODS: In this 2 × 4 between-subjects experiment participants viewed a tweet from a fictitious e-cigarette brand. Four tweet content versions (e-cigarette product, e-cigarette use, e-cigarette in social context, unrelated content) were crossed with two warning versions (absent, present). Adult e-cigarette users (N = 994) were recruited via social media ads to complete a survey and randomized to view one of eight tweets. Multivariable regressions explored effects of tweet content and warning on perceived healthiness, perceived harm, and likelihood to try e-cigarettes, and tweet content on warning recall. Covariates were tobacco and social media use and demographics. RESULTS: Tweets with warnings elicited more negative health perceptions of the e-cigarette brand than tweets without warnings (p < .05). Tweets featuring e-cigarette products (p < .05) or use (p < .001) elicited higher warning recall than tweets featuring unrelated content. CONCLUSIONS: This is the first study to examine warning effects on perceptions of e-cigarette social media marketing. Warnings led to more negative e-cigarette health perceptions, but no effect on perceived nicotine harm or likelihood to try e-cigarettes. There were differences in warning recall by tweet content. Research should explore how varying warning content (text, size, placement) on tweets from e-cigarette brands influences health risk perceptions. IMPLICATIONS: FDA's 2016 ruling requires warnings on advertisements for nicotine-containing e-cigarettes, but does not specify whether this applies to social media. This study is the first to examine how e-cigarette warnings in tweets influence perceived healthiness and harm of e-cigarettes, which is important because e-cigarette brands are voluntarily including warnings on Twitter and Instagram. Warnings influenced perceived healthiness of the e-cigarette brand, but not perceived nicotine harm or likelihood to try e-cigarettes. We also saw higher recall of warning statements for tweets featuring e-cigarettes. Findings suggest that expanding warning requirements to e-cigarette social media marketing warrants further exploration and FDA consideration.

Flavor Capsule Variants' Performance in a "Dark Market": Implications for Standardized Packaging.

BACKGROUND: By increasing excise taxes, eliminating tobacco marketing, and requiring standardized (plain) packaging of tobacco products, governments internationally have reduced smoking's allure. Yet product innovations, such as flavor capsule variants (FCVs), remain unregulated and may appeal to non-smokers. We examined the growth of FCVs in a country with a progressive policy environment. METHODS: Each year, New Zealand tobacco companies must provide details of the number of cigarette sticks released for each brand and variant to the Ministry of Health. We used this information to analyze FCVs' performance for British American Tobacco (BAT) and Philip Morris International (PMI), which account for a large proportion of New Zealand tobacco sales. We report the quantity released of each variant and share of parent brand portfolio, and examine growth patterns within the premium, everyday, and value market subsections. RESULTS: BAT introduced FCVs in 2012 and by 2014 offered FCVs in all market subsections; PMI introduced a Marlboro FCV in 2014. FCVs grew rapidly relative to unflavored variants and, by 2017, represented nearly 10% of BAT's product portfolio and more than 3% of PMI's product portfolio. By 2017, FCVs accounted for more than a third of the Dunhill sticks released, 14% of Holiday, and 17% of Pall Mall. CONCLUSIONS: FCVs' rapid growth may have reduced declines in the numbers of sticks released. Policy makers should disallow FCV innovations, which offer no health benefits to smokers and may instead attract non-smokers to smoking. Where timely, these regulations could be incorporated into standardized packaging policies. IMPLICATIONS: FCVs have grown quickly in countries with comprehensive tobacco marketing restrictions, which suggests tobacco companies are now focusing on novel product designs to attract new smokers. Standardized packaging regulations could address both external packaging and stick design innovations, such as FCVs; alternatively, specific regulations prohibiting FCVs may be required.

Assurances of Voluntary Compliance: A Regulatory Mechanism to Reduce Youth Access to E-Cigarettes and Limit Retail Tobacco Marketing.

Objectives. To evaluate assurances of voluntary compliance (AVCs) between state attorneys general and retail chains by assessing e-cigarette sales to underage decoys and tobacco marketing violations in corporate-owned stores (that sign AVCs) and franchise stores (that do not sign AVCs).Methods. Decoys 18 to 19 years of age attempted to purchase e-cigarettes without presenting ID in California convenience stores (n = 540). Auditors characterized the presence and content of age-of-sale signage and advertising for tobacco products. Data were collected and analyzed in 2018.Results. Corporate-owned stores were less likely than were franchise stores to violate ID requests (adjusted odds ratio [AOR] = 0.29; 95% confidence interval [CI] = 0.12, 0.71) and to sell e-cigarettes illegally (AOR = 0.37; 95% CI = 0.15, 0.88). Regardless of AVC category, advertising violations were common in stores (vaping products, 26.3%; other tobacco products, 74.3%).Conclusions. The differences in violation rates found in corporate and franchise stores imply that AVCs could reduce youth access to e-cigarettes. However, merchant education and routine enforcement are needed to better leverage restrictions on retail tobacco marketing in AVCs.Public Health Implications. Strengthening compliance with existing AVCs and establishing new agreements with retailers shown to be in violation through federal or state inspections could reduce youth access to e-cigarettes and exposure to tobacco marketing.

Assessment of structure and performance of cattle markets in western Kenya.

Cattle markets play a major role in economic empowerment among cattle-keeping communities in developing countries. The objective of this study was to assess the structure and performance of selected cattle markets in western Kenya. Data was collected using a semi-structured questionnaire administered to livestock traders who visited markets and by conducting focus group interviews. Data was collected on availability of market information, price setting behavior, marketing costs, practices of traders on livestock movements, sources of working capital, and characteristic of respondents. A total of 252 questionnaires and six focus group discussions were conducted for the study. Cattle market concentration indices were analyzed by calculation of Gini coefficient and plotting of Lorenz curves. Additionally, gross marketing margins were calculated to evaluate market performance. The results from this study showed a positive marketing margin in study markets for all cattle categories, the relatively high Gini coefficient of 0.65, and Lorenz curves revealing that in some markets 20% of traders control about 48% of the market share which is an indication of high market concentration. The high Gini coefficient and positive marketing margin obtained imply that study markets were highly concentrated but profitable which is an indication of inequality in the markets. The main barriers to entry in these livestock markets included lack of adequate market information, high operational capital requirements, and high costs of transporting animals. In conclusion, cattle marketing within western Kenya is profitable. However, the high concentration index in markets and presence of entry barriers including lack of flow of information on sources of livestock for trade, mechanism of price setting within markets' high capital outlay, may encourage poor trade practices which may compromise biosecurity standards within markets, and hence necessitating increased risk for spread of livestock diseases and even zoonoses to connected farms and systems.

End-user perspectives to inform policy and program decisions: a qualitative and quantitative content analysis of lifestyle treatment recommendations by adolescents with obesity.

BACKGROUND: Lifestyle modifications represent the first line of treatment in obesity management; however, many adolescents with obesity do not meet lifestyle recommendations. Given that adolescents are rarely consulted during health policy development and in the design of lifestyle interventions, their first-hand experiences, preferences, and priorities may not be represented. Accordingly, our purpose was to explore adolescents' lifestyle treatment recommendations to inform policy and program decisions. METHODS: Conducted from July 2017 to January 2018, this study adhered to a qualitative, crosslanguage, patient-oriented design. We recruited 19 13-17-year-old adolescents (body mass index [BMI] ≥85th percentile) seeking multidisciplinary treatment for obesity in geographically and culturally diverse regions of Canada. Adolescents participated in one-on-one, in-person, semi-structured interviews in English or French. Interviews were audio-recorded, transcribed verbatim, managed using NVivo 11, and analyzed using quantitative and qualitative content analysis by two independent researchers. RESULTS: Adolescents' recommendations were organized into five categories, each of which denotes health as a collective responsibility: (i) establish parental support within limits, (ii) improve accessibility and availability of 'healthy foods', (iii) limit deceptive practices in food marketing, (iv) improve accessibility and availability of varied physical activity opportunities, and (v) delay school start times. Respect for individual autonomy and decision-making capacity were identified as particularly important, however these were confronted with adolescents' partial knowledge on nutrition and food literacy. CONCLUSIONS: Adolescents' recommendations highlighted multi-level, multi-component factors that influenced their ability to lead healthy lifestyles. Uptake of these recommendations by policy-makers and program developers may be of added value for lifestyle treatment targeting adolescents with obesity.

Countering commercial interests: building advocacy campaigns to protect children from food marketing.

OBJECTIVES: To describe the strategies used by Cancer Council NSW (CCNSW) and Obesity Policy Coalition (OPC) to influence government policy on food marketing to children. Type of programs: Comprehensive advocacy campaigns. METHODS: We present the components of an advocacy campaign run by OPC and another campaign run by CCNSW to protect children from unhealthy food marketing. We look at the successes and challenges of the campaigns and discuss future directions. RESULTS: CCNSW has focused on a community-organising and mobilisation model, while OPC has invested in building relationships with key stakeholders such as decision makers. Both organisations have ensured that protecting children from unhealthy food marketing is highlighted through media advocacy and stakeholder engagement. The issue has remained a public health priority despite limited policy windows. LESSONS LEARNT: Creating a climate for change and facilitating policy action to protect children from unhealthy food marketing can be achieved with: 1) presentation of a clear, united public-health solution; 2) using earned (or unpaid) media to gain public attention; and 3) sustained community and political engagement.

Proliferation of 'healthy' alcohol products in Australia: implications for policy.

OBJECTIVES: The Australian alcohol industry has observed that increased health consciousness among consumers is a threat to industry revenue, but also an opportunity for innovation and growth within the sector. METHODS: This paper examines how the alcohol industry has responded to a perceived increase in health consciousness among consumers, considers policy implications and provides recommendations to address supposedly healthier alcohol products. We collected examples of new product developments and monitored alcohol industry publications for information on key trends and comments from alcohol company executives to inform the paper. RESULTS: We found that existing regulations do not appear to be sufficient to adequately restrict health-related claims made by alcohol marketers and producers, as alcohol products continue to be advertised in association with health. Research shows that this can have significant implications for the way consumers view these products. LESSONS LEARNT: Restrictions on health-related claims should form part of broader reforms to alcohol marketing that should include strong, independent, legislated controls.