Month: July 2017

We are being marketed to death

Dr. Trevor Hancock

17 July 2017

699 words

My two latest columns discussed the marketing of alcohol and unhealthy foods, especially high sugar foods, just a few of the many products that produce ill health, injury and premature death. Clearly the industries that market these products are less concerned with the wellbeing of the population than their own profits. The question is, why do we allow this, and how can we stop it?

Tobacco marketing is the poster child for how to market a harmful product to the public and fight like hell to be able to continue to do so in the face of all the evidence. One reason that some of the products being marketed are called ‘the new tobacco’ in the public health literature is because they clearly look to tobacco marketing as a model, and employ many of the same techniques that industry used to try to fight off controls over its sales and marketing.

These techniques include denying and casting doubt on the evidence, hiding evidence of harm, attacking the scientists who produce the evidence, raising issues of free speech and their right to market a legal product, making political donations and lobbying hard at all levels, supporting art and sport organisations that make them allies, opposing regulation and taxation, initiating lengthy court cases, and funding (but not publicly) supposed citizen organisations that support the right to buy and use the product.

Let’s look at some of the products that have been called ‘the new tobacco’, and more generally at the business of marketing, which I believe is generally bad for our health. The most obvious ‘new tobaccos’ currently are sugar and the related issues of unhealthy fast foods and childhood obesity (my topic last week); two others are the fossil fuel and auto industries.

Perhaps the closest cousin to tobacco marketing these days is the fossil fuel industry. Some companies in particular have been fostering climate change denial and attacking both the science and the scientists, while cultivating powerful political allies, especially in the USA. In a report on this issue, the Centre for International Environmental Law states that based on its research into the documents in the Tobacco Industry Archives, there have long been close ties between the two industries and that “The oil industry used the tobacco playbook in its fight against climate science”.

A related example of unhealthy marketing is the auto industry. A 2011 article in the Journal of Public Health asked whether cars are the new tobacco. The authors concluded that “Private cars cause significant health harm”, including through air pollution and climate change due to fossil fuel combustion, but that “the car lobby resists measures that would restrict car use, using tactics similar to the tobacco industry”.

Another troubling aspect of auto marketing is the marketing of high speed and dangerous driving. A 2010 article in the journal Canadian Public Policy examined auto ads aired or published in 2006/07. The authors found that 27 percent of TV ads (and 10 percent of print ads) featured unsafe or aggressive driving; my impression is that TV ads have become even worse since then. This is socially irresponsible.

But let’s face it, the purpose of marketing is to persuade us to buy more of their products – why else would a business spend all that money? And therein lies perhaps the greatest danger. Because marketing feeds into and supports the dominant narrative of growth, it stimulates us to want and need more products, more ‘stuff’.

But endless growth within a finite system is impossible, as is becoming apparent as we move into the Anthropocene. Three percent economic growth coupled with one percent population growth translates into a 22-fold increase in demand by the end of this century. We can’t afford to increase our material demands and yet that is what most marketing is about.

That is why I believe that the marketing industry as a whole is in itself a threat to the health of the population. So instead of celebrating the ingenuity of the advertising industry, and all the clever ways in which it tries to trick us into buying more stuff, we need to re-think the role and responsibility of the marketing industry in the 21^st century.

© Trevor Hancock, 2017

 

 

Protect our kids from unhealthy advertising

Dr. Trevor Hancock

10 July 2017

700 words

As a public health physician I am dedicated to improving the health of the population and protecting them from harm. Thus it is troubling to me that so often we identify a threat to health – such as tobacco, alcohol or asbestos – provide clear evidence and solid proposals to protect the health of the public – and then little or nothing is done. Too often, governments seem to err on the side of protecting industry, rather than protecting the health of the population.

Which brings me to the marketing of unhealthy food and beverages to our kids, especially sugar-rich products they do not need and that are contributing to the epidemic of obesity, heart disease, diabetes and other health problems. Here is another situation where government is not doing enough to protect us from harm.

This is not just my opinion, but the opinion of the Heart and Stroke Foundation of Canada. Their 2017 report on the health of Canadians, ominously entitled ‘The kids are not alright’, notes predictions that “today’s children may be the first generation to have poorer health and shorter lifespans than their parents”. And they lay much of the blame on the fact that “today’s kids are bombarded with food and beverage marketing morning, noon and night, every day of the week”.

How much are kids exposed?: A lot more than you might think. These days, kids are not just exposed through TV and billboards. They spend almost 8 hours a day in front of screens, at home and in school. On average, they spend 2 hours watching TV, where they see “4 – 5 food and beverage ads per hour”. The other 6 hours are spent on their other screens – laptops, smartphones and tablets – where they see many, many ads.

So Heart and Stroke asked Dr. Monique Potvin Kent, an expert on food and beverage marketing and children’s nutrition, to review food and beverage advertising on children’s and youth’s top ten preferred websites. She found that “over 90% are for unhealthy foods — mostly processed foods and beverages which are high in fat, sodium, or sugar”. And she found “the most frequently advertised product categories on children’s favourite websites are restaurants, cakes, cookies, ice cream and cereal”; the same is true for teens, with the addition of sugary drinks.

Online advertising is cheap, and companies can place ads on sites that appear to be – and indeed are – educational. The report notes one of the top ten sites used by children is an educational math site, “but it is filled with ads”, including “lots of food and beverage ads”. In addition they can create their own websites, where ‘advergames’ – “video games with embedded advertising” can keep kids engaged and encourage them to share the site with their friends.

The report notes that industry self-regulation of marketing to children through their own Children’s Advertising Initiative (CAI) has failed; indeed, Dr. Potvin Kent found that “Three-quarters of the unhealthy ads viewed by children and youth were from companies that participate in the CAI”.

To their great credit, the Heart and Stroke Foundation takes a strong line on all this: “Both young children and adolescents should be protected from food industry tactics”. Specifically, they call for the federal government to “enact legislation to restrict commercial food and beverage marketing to children and youth ages 16 and under”. And they call upon provincial governments to “implement and enforce restrictions on the commercial marketing of foods and beverages to children and youth” and to “restrict exposure to food and beverage marketing in public places, including settings where children gather”.

These approaches have been implemented elsewhere and have been shown to work. One good example is Quebec, where advertising of all goods and services to children under 13 was banned in 1980. A 2011 study concluded that compared to Ontario there was “a 13% reduction in the likelihood to purchase fast food”; the report also noted that “Quebec has the lowest obesity rate in Canada among children ages 6–11 and the highest rate of vegetable and fruit consumption”.

It is time governments acted to protect Canadians from the unhealthy marketing practices of the food and beverage industry – we will all benefit.

© Trevor Hancock, 2017

 

If we want to save lives, control alcohol

Dr. Trevor Hancock

3 July 2017

701 words

This is not going to make me popular with my beer-drinking Morris-dancing friends, or with a lot of other people I imagine, but we need to put higher taxes on alcohol and implement other proven policies that make it less accessible and less glamorous. This is the conclusion one must come to on reading the report on Alcohol Harm in Canada just released by the Canadian Institute for Health Information (CIHI) and a 2015 report by Canada’s Chief Public Health Officer (CPHO).

What caught people’s attention in the CIHI report was the finding that in 2015-16 there were more hospitalisations due to alcohol than for heart attacks. What perhaps was missed is that they were reporting only on conditions that were wholly attributable to alcohol, mainly the mental health aspects of alcoholism as well as alcoholic cirrhosis of the liver. Moreover, only those over age 10 are reported, so presumably children with fetal alcohol spectrum disorder (FASD) were excluded.

But they did not include conditions partially attributable to alcohol such as various forms of cancer, motor vehicle traffic injuries or heart disease. Had they done so, a study from England suggests, the number of hospitalisations attributable in part or in whole to alcohol would have more than tripled.

Overall, CIHI notes, “Alcohol was the third leading risk factor for death and disability globally in 2010, up from sixth in 1990”. In Canada, alcohol is the top risk factor for disease among Canadians aged 15 to 49, according to the 2015 report from the CPHO. The Canadian Centre for Substance Abuse (CCSA) reported that in 2002 (the last time this seems to have been fully studied, which in itself is scandalous) more than 8,000 deaths in Canada were attibutable to alcohol.

The CCSA also reported that the direct health care costs of alcohol in 2002 was about $3.3 billion, and the total cost was more than $14 billion, almost half due to lost productivity. It is likely more by now; the CPHO noted that the full health and social costs of impaired driving alone in 2010 (including alcohol and other drugs) was more than $20 billion.

These are the latest in a long string of reports that make it clear that governments – both provincial and federal – have been neglecting the health of the public and foregoing significant revenues – revenues that could have been put to good social purpose such as daycare or housing – while pandering to the alcohol industry.

Back in 2008, BC’s Provincial Health Officer updated a cautionary 2002 report that he issued when the new Liberal government was planning to make alcohol more available. He found “the total number of liquor stores in the province increasing from 786 in 2002 to 1,294 in 2008”, while “the economic availability of alcohol appears to have increased, with wine and spirits becoming relatively cheaper over time because of the prices for these products not keeping pace with the cost of living”.

Yet both the CIHI and CPHO reports, and a 2013 report from Toronto’s Centre for Addictions and Mental Health (CAMH), make it clear that alcohol-related harm is directly related to price and availability. Increasing price to at least keep pace with inflation, relating price to alcohol content and reducing availability are among the most effective ways of reducing harm.

The CAMH report noted that “Several provinces, including British Columbia, Alberta, Ontario, Quebec and PEI, have not raised the prices of all their products to match inflation since 2006”. When combined with the increase in the number of outlets noted above, it is not surprising that the CCSA noted in a 2014 fact sheet that in BC “hospitalization rates attributable to alcohol increased from an estimated 361 per 100,000 residents in 2002 to 437 per 100,000 residents in 2011”, while CIHI reported that “British Columbia had the highest provincial rate for hospitalizations entirely caused by alcohol and higher-than-average sales” in 2015-16”.

Clearly, and consistent with their approach in other policy areas, BC’s Liberal government was more interested in protecting and promoting the health of the alcohol industry than the health of the population. Let us hope the new BC government has a more enlightened approach to protecting the health of the public.

© Trevor Hancock, 2017