The marketing campaigns of multinational corporations are harming our physical, mental, and collective wellbeing. Gerard Hastings urges the public health movement to take action

Background: Despite the clear policy intent to contain it, the marketing of formula milk remains widespread, powerful and successful. This paper examines how it works. Methods: The study comprised a mix of secondary analysis of business databases and qualitative interviews with marketing practitioners, some of whom had previously worked in formula marketing. Results: The World Health Assembly Code aims to shield parents from unfair commercial pressures by stopping the inappropriate promotion of infant formula. In reality marketing remains widespread because some countries (e.g. the USA) have not adopted the Code, and elsewhere industry has developed follow-on and specialist milks with which they promote formula by proxy. The World Health Assembly has tried to close these loopholes by extending its Code to these products; but the marketing continues. The campaigns use emotional appeals to reach out to and build relationships with parents and especially mothers. Evocative brands give these approaches a human face. The advent of social media has made it easier to pose as the friend and supporter of parents; it is also providing companies with a rich stream of personal data with which they hone and target their campaigns. The formula industry is dominated by a small number of extremely powerful multinational corporations with the resources to buy the best global marketing expertise. Like all corporations they are governed by the fiduciary imperative which puts the pursuit of profits ahead of all other concerns. This mix of fiscal power, sophisticated marketing, and single-mindedness is causing great harm to public health. Conclusions: Formula marketing is widespread and using powerful emotional techniques to sell parents a product that is vastly inferior to breast milk. There is an urgent need to update and strengthen regulation.

Although the content of alcohol advertisements is restricted, Gerard Hastings and colleagues find that advertisers are still managing to appeal to young people and promote drinking

Background:In February 2003, a comprehensive ban on tobacco promotion came into effect in the United Kingdom, which prohibited tobacco marketing through print and broadcast media, billboards, the internet, direct mail, product placement, promotions, free gifts, coupons and sponsorships.Objective:To investigate the impact of the UK’s comprehensive ban on tobacco promotion on adult smokers’ awareness of tobacco marketing in the UK relative to Canada, the United States and Australia.Design:A total of 6762 adult smokers participated in two waves of a random digit dialled telephone survey across the four countries. Wave 1 was conducted before the UK ban (October–December 2002) and Wave 2 was conducted after the UK ban (May–September 2003).Key measures:Awareness of a range of forms of tobacco marketing.Results:Levels of tobacco promotion awareness declined significantly among smokers in the UK after implementation of the advertising ban. Declines in awareness were greater in those channels regulated by the new law and change in awareness of tobacco promotions was much greater in the UK than the other three countries not affected by the ban. At least in the short term, there was no evidence that the law resulted in greater exposure to tobacco promotions in the few media channels not covered by the law. Notwithstanding the apparent success of the UK advertising ban and the controls in other countries, 9–22% of smokers in the four countries still reported noticing things that promoted smoking “often or very often” at Wave 2.Conclusions:The UK policy to ban tobacco advertising and promotion has significantly reduced exposure to pro-tobacco marketing influences. These findings support the effectiveness of comprehensive bans on advertising and promotion, as included in the Framework Convention on Tobacco Control.

An old enemy and a new friend Marketing has long been a force to be reckoned with in public health. In the hands of the tobacco, alcohol, and food industries it has had a well documented effect on our behaviour.3–6 In the case of tobacco companies this has culminated in extensive controls being placed on their marketing activities. Social marketing argues that we can borrow marketing ideas to promote healthy behaviour. If marketing can encourage us to buy a Ferrari, it can persuade us to drive it safely. Marketing is based on a simple and unobtrusive idea: putting the consumer and the stakeholder at the heart of the business process. Whereas Henry Ford focused on selling what he could produce—any colour you want as long as it's black—modern marketers invert this rubric and produce what they can sell. This deceptively simple change has revolutionised commerce over the past 50 years, making Nike and Coca-Cola the behemoths they are. It has succeeded because, paradoxically, listening to consumers and taking care to understand their point of view makes it easier to influence their behaviour. Social marketers argue that attempts to influence health behaviour should also start from an understanding of the people we want to do the changing. The task is to work out why they do what they do at present—their values and motivations—and use these to encourage healthy options. Often the picture is much more complex than ignorance of the public health facts. Most people know, for instance, that smoking is dangerous or how their diet could be improved. They continue with unhealthy behaviour because they see some other benefit in doing so—relaxation, perhaps, or a treat. The secret for the social marketer is to devise a way of enabling them to get the same benefit more healthily. In this sense social marketing has a great deal in common with good, patient centred health care. The extensive health expertise of doctors and other health professionals is much more effectively deployed when combined with empathy for the patient. Ultimately, better health has to be a joint endeavour.