The Message Effect

The big healthy eating news in July was McDonald’s announcement of the Happy Meal health makeover. Okay, perhaps makeover is too strong a word. More like putting on a nice new lipstick. Good ‘ole Ronald is cutting the size of the fries in half and adding in fresh fruit. There has been a lot of speculation about why they are doing this. In my experience, corporations are motivated by 3 factors:
1. Consumer demand (current or anticipated),
2. Profit margins, and
3. Regulatory/legal pressure.

How have these three played a role in the other issue campaigns I mentioned last time: smoking cessation, seatbelts and skin cancer prevention?

Let’s start with smoking. There is no such thing as a healthier cigarette (though the tobacco industry made a lot of dough via the insinuation with “light” cigarettes). So, the only healthy alternative to smoking cigarettes is not smoking cigarettes–clearly bad for the bottom line. And, given the addictive properties of nicotine, consumer demand was unlikely to be dramatically impacted by anti-smoking communications campaigns alone.

Enter government action. First, taxes. There is a clear link between smoking rates and the cost of cigarettes, particularly among underage smokers. When states started taxing the bojangles out of a pack of smokes, consumer demand declined. The feds also increased regulation on marketing: warning labels on packages, no broadcast ads, and less smoking in movies. When proof of the damage caused by second-hand smoke emerged, governments started limiting smoking in the workplace and public spaces. Finally, the states sued the pants off the tobacco companies for lying about the health-risks and addictive properties of cigarettes. Of note, the requirement in the settlement that the industry make payments to the states for state agencies to spend on smoking cessation and prevention programs proved genius for big tobacco. Though most states spent that money as intended in the early years on effective communication and education programs, budget demands soon sucked that money into other unrelated line items. Nonetheless, we have a lower smoking rate in the US today than we did before this combination of public policy and persuasion shamed Joe Camel.

Seatbelts is a more nuanced issue. Technically, it is possible to drive a car without your seatbelt on and cause no harm to anyone. Having lived in Massachusetts–even today, a surprisingly anti-seatbelt state–I know people who have done it. The challenge is that those low-likelihood, high-hazard car wrecks are a killer (often, literally) if you are harness free. The National Highway Transportation Safety Administration (NHTSA) has done a lot of research on this topic, and they found that the secret sauce for increasing seatbelt use is primary seatbelt laws (you can get pulled over and ticketed for not wearing your seatbelt) + broadcast advertising reminding people that they will be pulled over for not wearing their seatbelt. In the states with primary seatbelt laws, usage rates average about 10% higher.

Finally, skin cancer prevention. Growing up in Florida in the 1980s has earned me many a biopsy in the interest of melanoma prevention. Those will scare anyone into buying stock in SPF 70. Plus, who doesn’t know about the risks of sun damage these days? So, it was surprising for me to learn that in the US, skin cancer rates are on the rise. Similar to the obesity epidemic, skin cancer prevention is complicated by the fact that people actually need some sun exposure to be healthy. Ironically, the Vitamin D produced by sun-to-skin contact can help prevent some cancers. Of course, the real challenge to lowering skin cancer rates is that most people believe they look better with a tan. Long-term, sunscreen fanatics age better, but see previous comments about instant v. delayed gratification.

What’s to be done about the sun? The good news is that there is an entire industry behind sun protection, and anyone who has been to a drug store knows it is a crowded field. Where there is an industry, there are big marketing dollars. Perhaps they could collude to copy some of the old tobacco tricks like using product placements in movies. Maybe Neutrogena could outbid Smartwater for a Jennifer Anniston endorsement of Helioplex SPF 100 to see if she can start a trend by abandoning her perma-tan. In the meantime, the FDA has stepped in to regulate the labeling and claims made by sunscreens, so those who do use them are clear about what they are or aren’t protected from.

Which lessons learned from these three problems can be applied to our obesity epidemic? The third and final installment is coming soon…