Promoting corporate image or preventing underage use? Analysis of the advertising strategy and expenditures of the JUUL parent education for youth vaping prevention campaign.

OBJECTIVE: In April 2018, JUUL Labs announced a $30 million investment in efforts to combat underage use of its products through 'independent research, youth and parent education and community engagement'. Prior evidence demonstrates that tobacco industry-funded prevention programmes are ineffective and may work against tobacco control efforts; they do not discourage novices and youth from tobacco use but often improve the tobacco industry's public image. We describe the nature, timing of and expenditures related to the JUUL underage use prevention advertisements across media channels. METHODS: Expenditures for newspaper, magazine, television, and radio marketing and promotional efforts were collected through Kantar Media's 'Stradegy' dashboard, an online platform which provides counts of advertisement occurrences and expenditures on various media channels. JUUL public relations and corporate social responsibility ads were identified in the Kantar Database. All ad expenditures were extracted and aggregated by date. Analysis of the expenditure data was triangulated with newspaper and industry advertisement archives. RESULTS: Advertisements aired nationally and in over half of all US-designated market areas (n=130) across media platforms including newspapers, magazines, radio, and online in mobile web and internet displays. In 2018, JUUL Labs spent $30 million, predominantly for print advertising. The 'What Parents Need to Know about JUUL' ads primarily advertised JUUL's smoking reduction 'mission' and promoted the product. By 2019, advertising increased to $36.2 million. JUUL's message strategy transitioned to 'Cracking Down on Underage Sales in Retail Stores' and featured adult smoker testimonies, linking JUUL to smoking cessation. DISCUSSION: Marketing expenditures promoting JUUL's corporate social responsibility mission exceeded their $30 million investment in the underage use prevention efforts. The expenditures were focused on the media market areas where health organisation and legislative officials were launching investigations into JUUL social media and other promotional strategies.

Can social media monitoring help identify the next EVALI? An examination of Reddit posts about vitamin E acetate and Dank Vapes.

BACKGROUND: Scientists identified vitamin E acetate (VEA) and "Dank Vapes" (a fake brand of tetrahydrocannabinol [THC] vaping products) as contributors to the 2019-2020 outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). On social media, people who post about vaping or THC discussed the causes of EVALI. We examined whether Reddit conversations may have served as early signals of the outbreak. METHODS: We collected Reddit posts from March 2018 to February 2020 on vaping- and THC-related subreddits that mentioned VEA or Dank Vapes. We identified peaks in post volume, examined post content, and used natural language processing to identify terms most characteristic of posts. RESULTS: There were almost no posts about VEA before EVALI. Subsequently, there were two peaks, both referencing media coverage of scientific findings that linked VEA to EVALI. Discussion regularly referenced concerns about the legitimacy of Dank Vapes before EVALI; peaks in posts were largely unrelated to scientific findings or media coverage of those findings. The terms most characteristic of VEA posts were EVALI-related; those most characteristic of Dank Vapes posts were about quality or legitimacy. CONCLUSIONS: Although posts about VEA and Dank Vapes did not predict the outbreak, the public health community could use social media to encourage people who vape or use THC to report future health concerns (e.g., through FDA's Safety Reporting Portal). Researchers and regulators could also use social media to see if potentially problematic products, such as Dank Vapes, have a history of concern among individuals who use those products.

Characterising JUUL-related posts on Instagram.

BACKGROUND: JUUL, a high-tech, popular vaping device, was the first major electronic cigarette (e-cigarette) brand to incorporate social media into its marketing strategy. There is growing concern around the increasing use of JUUL and other electronic nicotine delivery devices among youth, and their potential to addict a new generation to nicotine. The current study analysed the amount and characteristics of JUUL-related posts on Instagram, a social media platform used frequently among youth and young adults. METHODS: Hashtag-based keyword queries (n=50) were used to collect JUUL-related posts from the Instagram application programming interface, March 2018-May 2018. Using a combination of machine learning methods, keyword algorithms and human coding, posts were characterised as featuring content related to product promotion, nicotine and addiction, youth culture and lifestyle. RESULTS: Keyword queries captured 14 838 JUUL-relevant posts by 5201 unique users. Over one-third of posts were promotional (eg, linked to commercial website) and 11% contained nicotine and addiction-related information. Approximately half of posts featured content related to youth (55%) or lifestyle (57%). Youth-related content or lifestyle appeals were also notably present within promotional posts and nicotine and addiction-related posts, respectively. Nicotine and addiction-related posts featured memes, hashtags (eg, #nichead, #juulbuzz) and tag lines (eg, 'more flavor, more buzz'). CONCLUSIONS: Findings reveal a proliferation of JUUL-related content on Instagram, which focused on product promotion and nicotine and addiction that included youth culture and lifestyle appeals. Regulatory actions should focus on restricting promotional efforts for e-cigarette products, particularly on social media platforms where young people are a primary audience.

Exposure and reach of the US court-mandated corrective statements advertising campaign on broadcast and social media.

OBJECTIVE: As a remedy to committing fraud and violating civil racketeering laws, in November 2017, four major tobacco companies were court-ordered to develop and disseminate corrective statements regarding smoking health risks using mass media channels. We aimed to describe the nature, timing, reach of and exposure to the court-mandated tobacco industry corrective advertising campaign on social, broadcast and print media. METHODS: Data from social, print and broadcast media were used to measure potential exposure to corrective messages. Keyword rules were used to collect campaign-related posts from the Twitter Firehose between November 2017 and January 2018. Data were analysed using a combination of machine learning, keyword algorithms and human coding. Posts were categorised by source (commercial/institutional, organic) and content type (eg, sentiment). Analysis of social media data was triangulated with ratings data for television advertising and print advertising expenditure data. RESULTS: Keyword filters retrieved 13 846 tweets posted by 9232 unique users. The majority of tweets were posted by institutional/commercial sources including news organisations, bots and tobacco control-related accounts and contained links to news and public health-related websites. Approximately 60% of campaign-related tweets were posted during the first week of campaign launch. Household exposure to the televised corrective advertisements averaged 0.56 ads per month. DISCUSSION: The corrective campaign failed to generate social media engagement. The size and timing of the advertising buys were not consistent with strategies effective in generating high sustained impact and audience reach, particularly among youth.

Vaping versus JUULing: how the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market.

BACKGROUND: While national surveys showed declines in e-cigarette use in the USA between 2015 and 2016, recent reports indicate that JUUL, a sleekly designed e-cigarette that looks like a USB drive, is increasingly being used by youth and young adults. However, the extent of JUUL's growth and its marketing strategy have not been systematically examined. METHODS: A variety of data sources were used to examine JUUL retail sales in the USA and its marketing and promotion. Retail store scanner data were used to capture the retail sales of JUUL and other major e-cigarette brands for the period 2011-2017. A list of JUUL-related keywords was used to identify JUUL-related tweets on Twitter; to identify JUUL-related posts, hashtags and accounts on Instagram and to identify JUUL-related videos on YouTube. RESULTS: In the short 3-year period 2015-2017, JUUL has transformed from a little-known brand with minimum sales into the largest retail e-cigarette brand in the USA, lifting sales of the entire e-cigarette category. Its US$150 million retail sales in the last quarter of 2017 accounted for about 40% of e-cigarette retail market share. While marketing expenditures for JUUL were moderate, the sales growth of JUUL was accompanied by a variety of innovative, engaging and wide-reaching campaigns on Twitter, Instagram and YouTube, conducted by JUUL and its affiliated marketers. CONCLUSIONS: The discrepancies between e-cigarette sales data and the prevalence of e-cigarette use from surveys highlight the challenges in tracking and understanding the use of new and emerging tobacco products. In a rapidly changing media environment, where successful and influential marketing campaigns can be conducted on social media at little cost, marketing expenditures alone may not fully capture the influence, reach and engagement of tobacco marketing.

Twitter analysis of California's failed campaign to raise the state's tobacco tax by popular vote in 2012.

BACKGROUND: The rapid diffusion of social media in the past decade has allowed community members to sway the discourse on elections. We use analyses of social media to provide insight into why the strong public support 1 year prior to the election did not result in an increased tobacco tax from the 2012 California Proposition 29 vote. METHODS: Using the Twitter historical Firehose, we chose all tweets on Proposition 29 posted between 1 January and 5 June 2012 differentiating between early and late campaign periods. Tweets were coded for valence, theme and source. We analysed metadata to characterise accounts. Television ratings data in 9 major California media markets were used to show the strength of the 2 campaigns. RESULTS: 'No on 29' launched television advertising earlier and with much higher household gross rating points (GRPs) than the 'Yes on 29' campaign. Among 17 099 relevant tweets from 8769 unique accounts, 53% supported Proposition 29, 27% opposed and 20% were neutral. Just under half (43%) were from accounts affiliated with the campaigns. Two-thirds of campaign messages originated outside California. The 'Yes' campaign focused on simple health messages, which were equally represented in both campaign periods. However, anti-tax tweets increased at relative to pro-tax tweets in the second period. CONCLUSIONS: Although the Prop 29 campaigns did not effectively engage the Californian twitter communities, analysis of tweets provided an earlier indication than public polls of the loss of public supporting this election. Prospective Twitter analysis should be added to campaign evaluation strategies.

LMFAO! Humor as a Response to Fear: Decomposing Fear Control within the Extended Parallel Process Model.

This study seeks to analyze fear control responses to the 2012 Tips from Former Smokers campaign using the Extended Parallel Process Model (EPPM). The goal is to examine the occurrence of ancillary fear control responses, like humor. In order to explore individuals' responses in an organic setting, we use Twitter data-tweets-collected via the Firehose. Content analysis of relevant fear control tweets (N = 14,281) validated the existence of boomerang responses within the EPPM: denial, defensive avoidance, and reactance. More importantly, results showed that humor tweets were not only a significant occurrence but constituted the majority of fear control responses.

Earned media and public engagement with CDC's "Tips from Former Smokers" campaign: an analysis of online news and blog coverage.

BACKGROUND: In March 2012, the US Centers for Disease Control and Prevention (CDC) launched the first-ever paid national tobacco education campaign. At a cost of US $54 million, "Tips from Former Smokers" (Tips) ran for 3 months across multiple media, depicting the suffering experienced by smokers and their families in graphic detail. The potential impact and reach of the Tips campaign was not limited to that achieved through paid media placements. It was also potentially extended through "earned media", including news and blog coverage of the campaign. Such coverage can shape public understanding of and facilitate public engagement with key health issues. OBJECTIVE: To better understand the contribution of earned media to the public's engagement with health issues in the current news media environment, we examined the online "earned media" and public engagement generated by one national public health campaign. METHODS: We constructed a purposive sample of online media coverage of the CDC's 2012 Tips from Former Smokers television campaign, focusing on 14 influential and politically diverse US news outlets and policy-focused blogs. We identified relevant content by combining campaign and website-specific keywords for 4 months around the campaign release. Each story was coded for content, inclusion of multimedia, and measures of audience engagement. RESULTS: The search yielded 36 stories mentioning Tips, of which 27 were focused on the campaign. Story content between pieces was strikingly similar, with most stories highlighting the same points about the campaign's content, cost, and potential impact. We saw notable evidence of audience engagement; stories focused on Tips generated 9547 comments, 8891 Facebook "likes", 1027 tweets, and 505 story URL shares on Facebook. Audience engagement varied by story and site, as did the valence and relevance of associated audience comments. Comments were most oppositional on CNN and most supportive on Yahoo. Comment coding revealed approximately equal levels of opposition and support overall. We identified four common arguments among oppositional comments: government intrusion on personal behaviors, problematic allocation of governmental spending, questionable science, and challenges regarding campaign efficacy. Supportive comments tended to convey personal stories and emotions. CONCLUSIONS: The Tips campaign received limited coverage on either online news or blog sources, but the limited number of stories generated engagement among online audiences. In addition to the content and volume of blog and news coverage, audience comments and websites' mechanisms for sharing stories via social media are likely to determine the influence of online earned media. In order to facilitate meaningful evaluation of public health campaigns within the rapidly advancing media environment, there is a need for the public health community to build consensus regarding collection and assessment of engagement data.

Televised obesity-prevention advertising across US media markets: exposure and content, 2010-2011.

OBJECTIVE: To examine levels of exposure and content characteristics for recent televised obesity-prevention campaigns sponsored by state and community health departments, federal agencies, non-profit organizations and television stations in the USA. DESIGN: Nielsen television ratings for obesity-prevention advertising were collected for the top seventy-five US media markets and were used to calculate household exposure levels for 2010 and 2011. Governmental advertisements were coded for content. SETTING: United States. RESULTS: Average household exposure to obesity-prevention campaigns was 2·6 advertisements per month. Exposure increased by 31 % between 2010 and 2011, largely driven by increases in federal advertisements. In 2011, the federal government accounted for 62 % of obesity-prevention exposure, non-profit organizations for 9 %, community departments for 8 %, state departments for 3 %, and television station-sponsored public-service announcements for 17 %. The greatest percentage increase between 2010 and 2011 was in community advertising, reflecting efforts funded by the Communities Putting Prevention to Work (CPPW) programme. Among thirty-four state and community campaigns, the majority advocated both healthy eating and physical activity (53 %). Campaigns typically had positive or neutral emotional valence (94 %). Obesity or overweight was mentioned in 47 % of campaigns, but only 9 % specifically advocated weight loss. CONCLUSIONS: Exposure to televised obesity-prevention advertising increased from 2010 to 2011 and was higher than previously found in 1999-2003, apart from in 2003 during the federal VERB campaign. Nevertheless, exposure remains low relative to advertising for unhealthy foods. New federal campaigns have increased exposure to obesity-prevention advertising nationally, while CPPW grants have increased exposure for targeted areas.

Are you Scared Yet?: Evaluating Fear Appeal Messages in Tweets about the Tips Campaign.

In March 2012, the CDC launched "Tips from Former Smokers," a $54 million national campaign featuring individuals experiencing long-term health consequences of smoking. The campaign approach was based on strong evidence that anti-tobacco ads portraying fear, graphic images, and personal testimonials are associated with attitudinal and behavior change. Yet it was also controversial; critics cited the danger that viewers might reject such intensely graphic messages. Tasked with informing this debate, our study analyzes the corpus of Tips campaign-related tweets obtained via the Twitter Firehose. We provide a novel and rigorous method for media campaign evaluation within the framework of the Extended Parallel Process Model. Among the relevant Tweets, 87% showed evidence of message acceptance, while 7% exhibited message rejection.

Wanna know about vaping? Patterns of message exposure, seeking and sharing information about e-cigarettes across media platforms.

BACKGROUND: Awareness and use of electronic cigarettes has rapidly grown in the USA recently, in step with increased product marketing. Using responses to a population survey of US adults, we analysed demographic patterns of exposure to, searching for and sharing of e-cigarette-related information across media platforms. METHODS: An online survey of 17,522 US adults was conducted in 2013. The nationally representative sample was drawn from GfK Group's KnowledgePanel plus off-panel recruitment. Fixed effects logit models were applied to analyse relationships between exposure to, searching for and sharing of e-cigarette-related information and demographic characteristics, e-cigarette and tobacco use, and media behaviours. RESULTS: High levels of awareness about e-cigarettes were indicated (86% aware; 47% heard through media channels). Exposure to e-cigarette-related information was associated with tobacco use, age, gender, more education, social media use and time spent online. Although relatively small proportions of the sample had searched for (∼5%) or shared (∼2%) e-cigarette information, our analyses indicated demographic patterns to those behaviours. Gender, high income and using social media were associated with searching for e-cigarette information; lesbian, gay and bisexual and less education were associated with sharing. Current tobacco use, age, being Hispanic and time spent online were associated with both searching and sharing. CONCLUSIONS: US adults are widely exposed to e-cigarette marketing through the media; such marketing may differentially target specific demographic groups. Further research should longitudinally examine how exposure to, searching for and sharing of e-cigarette information relate to subsequent use of e-cigarettes and/or combustible tobacco.

A cross-sectional examination of marketing of electronic cigarettes on Twitter.

BACKGROUND: Rapid increases in marketing of e-cigarettes coincide with growth in e-cigarette use in recent years; however, little is known about how e-cigarettes are marketed on social media platforms. METHODS: Keywords were used to collect tweets related to e-cigarettes from the Twitter Firehose between 1 May 2012 and 30 June 2012. Tweets were coded for smoking cessation mentions, as well as health and safety mentions, and were classified as commercial or non-commercial ('organic') tweets using a combination of Naïve Bayes machine learning methods, keyword algorithms and human coding. Metadata associated with each tweet were used to examine the characteristics of accounts tweeting about e-cigarettes. RESULTS: 73,672 tweets related to e-cigarettes were captured in the study period, 90% of which were classified as commercial tweets. Accounts tweeting commercial e-cigarette content were associated with lower Klout scores, a measure of influence. Commercial tweeting was largely driven by a small group of highly active accounts, and 94% of commercial tweets included links to websites, many of which sell or promote e-cigarettes. Approximately 10% of commercial and organic tweets mentioned smoking cessation, and 34% of commercial tweets included mentions of prices or discounts for e-cigarettes. CONCLUSIONS: Twitter appears to be an important marketing platform for e-cigarettes. Tweets related to e-cigarettes were overwhelmingly commercial, and a substantial proportion mentioned smoking cessation. E-cigarette marketing on Twitter may have public health implications. Continued surveillance of e-cigarette marketing on social media platforms is needed.

Effects of tobacco-related media campaigns on smoking among 20-30-year-old adults: longitudinal data from the USA.

OBJECTIVE: Young adults in the USA have one of the highest smoking prevalence rates of any age group, and young adulthood is a critical time period of targeting by the tobacco industry. The authors examined relationships between potential exposure to tobacco-related media campaigns from a variety of sponsors and 2-year smoking change measures among a longitudinal sample of US adults aged 20-30 years from 2001 to 2008. METHODS: Self-report data were collected from a longitudinal sample of 12,931 US young adults from age 20 to 30. These data were merged with tobacco-related advertising exposure data from Nielsen Media Research. Two-year measures of change in smoking were regressed on advertising exposures. RESULTS: Two-year smoking uptake was unrelated to advertising exposure. The odds of quitting among all smokers and reduction among daily smokers in the 2 years between the prior and current survey were positively related to anti-tobacco advertising, especially potential exposure levels of 104-155 ads over the past 24 months. Tobacco company advertising (including corporate image and anti-smoking) and pharmaceutical industry advertising were unrelated to quitting or reduction. CONCLUSION: Continued support for sustained, public health-based well-funded anti-tobacco media campaigns may help reduce tobacco use among young adults.

The effects of smoking-related television advertising on smoking and intentions to quit among adults in the United States: 1999-2007.

OBJECTIVES: We investigated whether state-sponsored antitobacco advertisements are associated with reduced adult smoking, and interactions between smoking-related advertising types. METHODS: We measured mean exposure to smoking-related advertisements with television ratings for the top-75 US media markets from 1999 to 2007. We combined these data with individual-level Current Population Surveys Tobacco Use Supplement data and state tobacco control policy data. RESULTS: Higher exposure to state-sponsored, Legacy, and pharmaceutical advertisements was associated with less smoking; higher exposure to tobacco industry advertisements was associated with more smoking. Higher exposure to state- and Legacy-sponsored advertisements was positively associated with intentions to quit and having made a past-year quit attempt; higher exposure to ads for pharmaceutical cessation aids was negatively associated with having made a quit attempt. There was a significant negative interaction between state- and Legacy-sponsored advertisements. CONCLUSIONS: Exposure to state-sponsored advertisements was far below Centers for Disease Control and Prevention-recommended best practices. The significant negative relationships between antismoking advertising and adult smoking provide strong evidence that tobacco-control media campaigns help reduce adult smoking. The significant negative interaction between state- and Legacy-sponsored advertising suggests that the campaigns reinforce one another.

Trends in the nutritional content of television food advertisements seen by children in the United States: analyses by age, food categories, and companies.

OBJECTIVE: To examine trends in children's exposure to food-related advertising on television by age, product category, and company. DESIGN: Nutritional content analysis using television ratings data for 2003, 2005, 2007, and 2009 for children. SETTING: Annual age-specific television ratings data captured children's exposure to broadcast network, cable network, syndicated, and spot television food advertising from all (except Spanish-language) programming. PARTICIPANTS: Children aged 2 to 5 and 6 to 11 years. Main Exposure  Television ratings. MAIN OUTCOME MEASURES: Children's exposure to food-related advertising on television with nutritional assessments for food and beverage products for grams of saturated fat, sugar, and fiber and milligrams of sodium. RESULTS: Children aged 2 to 5 and 6 to 11 years saw, respectively, on average, 10.9 and 12.7 food-related television advertisements daily in 2009, down 17.8% and 6.9% from 2003. Exposure to food and beverage products high in saturated fat, sugar, or sodium fell 37.9% and 27.7% but fast-food advertising exposure increased by 21.1% and 30.8% among 2- to 5- and 6- to 11-year-olds, respectively, between 2003 and 2009. In 2009, 86% of ads seen by children were for products high in saturated fat, sugar, or sodium, down from 94% in 2003. CONCLUSIONS: Exposure to unhealthy food and beverage product advertisements has fallen, whereas exposure to fast-food ads increased from 2003 to 2009. By 2009, there was not a substantial improvement in the nutritional content of food and beverage advertisements that continued to be advertised and viewed on television by US children.

Potential exposure to anti-drug advertising and drug-related attitudes, beliefs, and behaviors among United States youth, 1995-2006.

Using nationally representative data from the Monitoring the Future Study on United States middle and high school students, we related exposure to anti-drug television advertising as measured by Nielsen Media Research ratings points to student self-reported drug-related outcomes from 1995 to 2006. Multivariate analyses controlling for key socio-demographics and accounting for the complex survey design included 337,918 cases. Results indicated that attitudes, beliefs, and behaviors regarding substance use were significantly related to such advertising exposure over the six months prior to the date the youth were surveyed. However, the observed relationships varied by grade level, over time and by advertising tagline and marijuana focus. Findings differed markedly between middle and high school students across the study interval. One factor that may partially explain observed differences may be variation in the degree to which the ads focused on marijuana. Putting a concerted effort into increasing anti-drug advertising will likely increase the exposure to and recall of such ads among youth. However, the likelihood that such advertising will result in youth being less likely to use drugs seems to depend heavily on the type of advertising utilized and how it relates to different ages and characteristics of targeted youth.

Trends in exposure to television food advertisements among children and adolescents in the United States.

OBJECTIVE: To examine the trends in food advertising seen by American children and adolescents. DESIGN: Trend analysis of children's and adolescents' exposure to food advertising in 2003, 2005, and 2007, including separate analyses by race. PARTICIPANTS: Children aged 2 to 5 years and 6 to 11 years and adolescents aged 12 to 17 years. MAIN EXPOSURE: Television ratings. MAIN OUTCOME MEASURES: Exposure to total food advertising and advertising by food category. RESULTS: Between 2003 and 2007 daily average exposure to food ads fell by 13.7% and 3.7% among young children aged 2 to 5 and 6 to 11 years, respectively, but increased by 3.7% among adolescents aged 12 to 17 years. Exposure to sweets ads fell 41%, 29.3%, and 12.1%, respectively, for 2- to 5-, 6- to 11-, and 12- to 17-year-olds and beverage ads were down by about 27% to 30% across these age groups, with substantial decreases in exposure to ads for the most heavily advertised sugar-sweetened beverages-fruit drinks and regular soft drinks. Exposure to fast food ads increased by 4.7%, 12.2%, and 20.4% among children aged 2 to 5, 6 to 11, and 12 to 17 years, respectively, between 2003 and 2007. The racial gap in exposure to food advertising grew between 2003 and 2007, particularly for fast food ads. CONCLUSIONS: A number of positive changes have occurred in children's exposure to food advertising. Continued monitoring of food advertising exposure along with nutritional analyses is needed to further assess self-regulatory pledges.

Adolescent exposure to food advertising on television.

BACKGROUND: Television viewing is hypothesized to contribute to obesity among children and adolescents through several mechanisms that include the displacement of physical activity, snacking while watching TV, and the influence of food advertising. METHODS: This study drew on television ratings to examine the distribution of food advertising exposure among adolescents aged 12 through 17 based on 170 top-rated shows across network, cable and syndicated TV stations over the 9-month period from September 2003 to May 2004. A total of 238,353 30-second equivalent advertisements on the top-rated shows were assessed. Each advertisement was weighted by its rating to measure actual exposure to advertisements. RESULTS: The results showed that among total nonprogram content time, food-related products accounted for roughly one fifth of advertising exposure. Excluding TV promotions and public service announcements, as a proportion of all product advertising, total food-related advertising made up 26% of advertised products viewed by adolescents. By race, the proportion of advertising exposure to food products was 14% greater for African-American versus white adolescents and total exposure to food advertising would be even larger for African-American teens given that, on average, they watched more TV. Fast food was the most frequently viewed food product category comprising 23% of all food-related advertisements among adolescents. CONCLUSIONS: Food ads made up just over one quarter of TV ads viewed by adolescents with the most commonly viewed products of fast food, sweets, and beverage products well within the reach of their own purchasing power.

Public health obesity-related TV advertising: lessons learned from tobacco.

BACKGROUND: Over the past 25 years, the percent of overweight and obese adults and children in the United States has increased dramatically. The magnitude and scope of the public health threat from obesity have resulted in calls for a national comprehensive obesity prevention strategy, akin to tobacco use prevention strategies undertaken over the past two decades. The purpose of this paper is to describe and compare population exposure to paid media campaigns for tobacco and obesity prevention, draw lessons from tobacco advertising, and compare tobacco and obesity behaviors/influences to identify priorities and pitfalls for further research on obesity adverting. METHODS: This is a descriptive study. Ratings data for the years 1999-2003, for the top 75 designated market areas in the U.S. were used to quantify exposure levels to anti-obesity and anti-smoking advertising in the U.S. RESULTS: Anti-tobacco campaigns preceded anti-obesity campaigns by several years, and in each year exposure levels--both total and average--for anti-tobacco media campaigns far outweighed those of anti-obesity campaigns. CONCLUSIONS: It is important to compare both similarities and differences between smoking- and obesity-related behaviors, which might affect the potential impact of anti-obesity media campaigns. Given the scope of the public health risks attributable to obesity, and the amount of federal, state, and other resources devoted to anti-obesity media campaigns, there is a clear need to evaluate the potential impact of such campaigns efforts. Nonetheless, the challenges are significant in both motivating and monitoring such complex behavior change, and in attributing changes to a given media campaign.

Working to make an image: an analysis of three Philip Morris corporate image media campaigns.

OBJECTIVE: To describe the nature and timing of, and population exposure to, Philip Morris USA's three explicit corporate image television advertising campaigns and explore the motivations behind each campaign. METHODS: Analysis of television ratings from the largest 75 media markets in the United States, which measure the reach and frequency of population exposure to advertising; copies of all televised commercials produced by Philip Morris; and tobacco industry documents, which provide insights into the specific goals of each campaign. FINDINGS: Household exposure to the "Working to Make a Difference: the People of Philip Morris" averaged 5.37 ads/month for 27 months from 1999-2001; the "Tobacco Settlement" campaign averaged 10.05 ads/month for three months in 2000; and "PMUSA" averaged 3.11 ads/month for the last six months in 2003. The percentage of advertising exposure that was purchased in news programming in order to reach opinion leaders increased over the three campaigns from 20%, 39% and 60%, respectively. These public relations campaigns were designed to counter negative images, increase brand recognition, and improve the financial viability of the company. CONCLUSIONS: Only one early media campaign focused on issues other than tobacco, whereas subsequent campaigns have been specifically concerned with tobacco issues, and more targeted to opinion leaders. The size and timing of the advertising buys appeared to be strategically crafted to maximise advertising exposure for these population subgroups during critical threats to Philip Morris's public image.