Advertising

I. Economic AspectsLester G. Telser

BIBLIOGRAPHY

II. Advertising ResearchCharles K. Ramond

BIBLIOGRAPHY

I ECONOMIC ASPECTS

As more resources are spent on advertising, there is increasing controversy about its consequences. Only the economic aspects of advertising, however, are within the scope of this article. First, we will give some facts about the use and importance of advertising as a means of promotion; the data relate mainly to the United States, but we will also cite some figures for the United Kingdom and Canada. Second, we will show why firms use advertising. We will then discuss how advertising affects price competition and the size of firms and why advertising is used in the Soviet Union. Finally, we will consider those communications media that depend on advertising as their major source of revenue and discuss the relation between advertising and consumer sovereignty.

Scope of advertising

In 1960 total advertising outlays in the United States were estimated to be about $12,000 million, which was 2.3 per cent of gross national product (GNP). Since in 1947 advertising was 1.8 per cent of GNP, there is a slight upward trend in the post-World War II period. However, too much should not be made of this evidence. It covers a short period of time, advertising figures prior to 1935 are unreliable, and the figures just preceding World War II show that the relation between advertising and GNP was about the same as in the late 1950s (Blank 1963).

In 1954 Canadian advertising outlays were 1.6 per cent of GNP, and comparable figures for the United Kingdom are of the same order. In both of these countries advertising outlays constitute a smaller percentage of either GNP or national income than they do in the United States. So far as can be judged from the limited data available, advertising is a less important means of promotion in most other countries than it is in the United States.

There are four major channels of advertising. The printed media, such as magazines and newspapers, contain both advertising and editorial material and are sold directly to the public. The audio–visual media, such as television and radio, are supported primarily by advertising receipts. These media do not, in many countries, collect fees directly from the public. Instead, they aim to attract an audience for advertisers by providing the public with free entertainment. Direct-mail and outdoor advertising attempt to attract the public’s attention and make direct sales appeals. In the United States in 1959, advertising in the printed media accounted for between 45 and 50 per cent of total estimated advertising expenditures. Television and radio received about 14 per cent and 6 per cent, respectively, of advertising expenditures. Direct mail accounted for 14 per cent of the advertising bill, and outdoor advertising was about 2 per cent. The remaining expenditures were on sale display, advertising departments, and the like.

Modern advertising began during the early part of the nineteenth century, after the cheap daily newspaper and the national magazine were introduced. Radio in the 1920s and television in the 1950s caused major changes in the composition of advertising outlays. As a result of these innovations, the cost per advertising message has sharply decreased and the number of advertising messages has risen more than would be implied by the increased dollar expenditures.

The ratio of advertising to sales differs considerably among products. Industrial products, which are purchased primarily by a relatively small number of firms, have a much lower ratio of advertising to dollar sales than do consumer products. Promotion of industrial products depends primarily on salesmen. The products advertised most heavily in relation to dollar sales in the United States in 1957 were toilet preparations (14.7 per cent of sales), drugs and medicines (10.3 per cent), and soaps (7.9 per cent).

Canadian figures that give advertising as a percentage of sales by product category are roughly the same as the U.S. figures. Moreover, a study of advertising relative to sales in 1940 and 1941 by the U.S. Federal Trade Commission (1944) shows that the ratios by product category in the United States are quite close to comparable figures for the year 1935 in the United Kingdom as shown by the Kaldor and Silverman study (1948). That the pattern of advertising outlay with respect to commodity is similar in all three countries is an important finding and deserves a fuller explanation than has so far appeared. Equally important would be an explanation for the differences among the advertising intensities of various products.

Why firms advertise

A correct but umlluminating explanation of advertising is that firms find it profitable. Advertising, however, is only one, and not even the most important, method of sales promotion. Although some products are promoted mainly by advertising, personal selling still accounts for the largest share of promotional outlays. Advertising is a much less labor-intensive method of promotion than are many alternatives for accomplishing the same end. Therefore, it is a technique well suited to sell those products that are, or can be, widely used and for which potential customers are not readily distinguished from the rest of the population. A firm deliberates over the same kinds of factors in allocating its funds to different advertising media as in allocating funds to other methods of sales promotion.

For an understanding of why firms advertise, it is helpful to see how advertising affects sales. Advertising affects sales in two stages. In the first stage a firm buys space in the press or time on television in order to convey advertising messages that create awareness in potential customers. In the second stage these advertising messages induce sales with varying degrees of effectiveness. In order to determine its advertising budget a firm must both decide how many advertising messages of each type it should buy and estimate their effectiveness.

The audience of an advertising medium approximates the number of advertising messages that can be received via that medium. For printed media, such as magazines or newspapers, the paid circulation gives a first approximation of the audience. However, the readership of a newspaper or magazine may exceed the circulation, and, conversely, the number of readers who take note of the advertising may fall short of the circulation. Thus, paid circulation is at best only an approximation to the number of advertising messages received via a printed medium. The audience of a television or radio program is harder to estimate, and special research techniques have been devised for this purpose. Audience size (along with composition) is one of the key determinants of advertising rates. Given this information about an advertising medium, a company can calculate the cost and estimate the effectiveness of advertising messages conveyed by that medium.

The number of advertising messages is the relevant physical measure of the quantity of advertising. This is why advertising per dollar of sales is not always a reliable measure of the quantity of advertising. The absolute advertising outlay and the number of messages transmitted may be very large although the ratio between advertising expenditure and sales is very low. For example, advertising as a percentage of sales is very low for automobiles. However, in 1957 U.S. consumers received nearly $400 million of automobile advertising messages, half from auto manufacturers and half from auto dealers.

Advertising messages can be effective indirectly. Thus, potential customers can learn about products, even though not directly exposed to advertising messages, by hearing about these products from others. By a chain reaction, advertising messages can stimulate transmission of a sizable volume of information (Katz & Lazarsfeld 1955; Ozga 1960).

The preceding analysis explains some dynamic aspects of advertising. There is typically a delayed response to advertising for several reasons. First, many of the advertised products are not of great importance to consumers; thus, a certain amount of repetition or redundancy is necessary to create awareness of the product. Advertising in smaller amounts is not likely to pass the threshold of awareness and, therefore, is likely to be ineffectual. Second, in addition to the problem of making consumers aware of the product, there is the further problem of overcoming their inertia. Although inertia increases the delay between advertising messages and sales, it also makes the effects of advertising persist beyond the time the messages are disseminated. Thus, advertising expenditure can be thought of as an investment to create an asset—sometimes called good will. This asset yields a return for some period of time, it depreciates like a capital good, and it requires maintenance. The marginal rate of return on advertising, as well as the rate of depreciation, can be calculated. Nerlove and Arrow (1962) provide theoretical analysis and Telser (1962) shows empirical results along these lines.

This approach to advertising has several implications. First, we can expect new products to be more heavily advertised than established products. Second, continuous advertising of established products is necessary because new consumers enter the market and others either leave it or forget about the product. Third, in an expanding economy there will be relatively more advertising than in one that is stable or declining.

Advertising versus price competition

One of the criticisms of advertising is that it is wasteful. If firms compete by offering to sell at low prices, then buyers benefit. Such competition among sellers results in products of given quality being sold at the lowest price. However, it is argued, if sellers compete for customers by advertising, then buyers do not benefit by obtaining a lower price; on the contrary, they pay a higher price to reimburse the sellers’ advertising expenses. In its crude form this argument has little merit; if some buyers do not wish to purchase advertised goods, there will generally be sellers who find it profitable to cater to their demand. Then some buyers will seek out the lowpriced sellers who do not advertise, whereas other buyers will choose to pay higher prices for well-known goods.

A more sophisticated version of the argument that advertising may increase prices assumes that by advertising, a company can reduce the elasticity of demand for its product [seeElasticity]. Advertising can change the character of the demand so that customers become less sensitive to price and the advertiser obtains a loyal clientele. This makes possible higher prices and larger profits. Whether advertising can as a matter of fact create brand loyalty is not known with certainty although it is a possibility. There is some evidence worth bringing to bear on this question. We noted above that toilet preparations are the most intensively advertised consumer articles. If advertising tends to create brand loyalty, market shares of cosmetics and similar products should be more stable than market shares of less advertised items, such as branded food products. However, a study of the four leading brands of each of a number of articles in these two product classes over a 13-year period showed that market shares of toilet preparations were markedly less stable than were shares of branded foods. There was, in addition, a substantial turnover of brands in the toilet-preparation class. Because new brands are advertised much more intensively than are established brands, the high ratio, among toilet preparations, of advertising to sales may reflect the short life and high turnover of brands rather than brand loyalty. If this is true, the high intensity of cosmetics advertising results from the lack of brand loyalty to such products as compared with branded food items.

It is by no means obvious that advertising necessarily reduces the price elasticity of demand. Increased advertising may bring a firm new customers whose preferences for the product are weaker than those of the old customers. The new customers are consequently more sensitive to price, and the increased advertising thus increases the price elasticity. Although advertising by a given firm may reduce the price elasticity for its goods by strengthening preferences, competitive advertising has the opposite effect. On balance, increased advertising may increase price elasticity.

Advertising can intensify competition among retailers, thereby reducing retail prices. Since shoppers can compare the various retail prices of a well-known brand at different stores more easily than they can those of a nonstandard item, competition is keener among retailers selling the well-known item. This forces the retail prices of advertised articles closer to invoice costs. Retailers’ advice influences consumer choice of nonstandard items more than the choice of advertised articles. Hence, advertised goods need less promotion at the point of purchase. As a result, the character of both retailing and wholesaling has changed markedly. Sales personnel can be less skilled, and discount houses and self-service stores have become feasible.

Advertising and the size of firms

Defenders of advertising often claim that advertising, by creating mass markets, makes it possible to produce goods at lower unit costs. It is doubtful that this claim is supported by the evidence available. First, many companies that rely heavily on advertising operate plants of different sizes; this is inconsistent with production economies of scale. Second, there are many industries in which a few firms are quite large but which use little advertising; examples of these are to be found primarily among producers of industrial goods. Third, as was noted above, there are some heavily advertised commodities manufactured primarily by small firms; the leading examples are toilet preparations.

There are, however, certain important producers of consumer goods who are heavily dependent on advertising and account for sizable fractions of their industry sales. Examples are producers of breakfast cereals, soaps, automobiles, cigarettes, razors and razor blades, soft drinks, canned soups, baby foods, and distilled liquor. To sum up, there is considerable evidence against the general proposition that advertising, by expanding the market, makes it possible to lower unit costs, and some evidence to support the idea that in some industries, high concentration of output is associated with considerable advertising.

An understanding of the association between advertising and concentration in the industries just cited begins with an examination of the advertising rate schedule. Advertising rates rise as audience increases, but less rapidly. This can give the national advertiser of a given product an advantage over the local advertiser, because the former has a lower promotional cost. The cost advantage to the large firm makes the growth of the small firm more difficult. In addition, sales may rise more rapidly in response to advertising expenditures over some range. If this is true, it reinforces the tendency brought into play by the structure of the advertising rates. For these reasons some firms will make and advertise a large number of consumer goods in order to obtain the savings of largescale advertising. Certain large firms in the food and drug industries owe their size in part to these economies.

Advertising in the Soviet Union

Many of the effects of advertising stand out more clearly in the light of the Soviet Union’s experience with forgoing the use of both trademarks and advertising. Because of adverse experience with this policy, the Soviet Union has come to encourage advertising and the use of brand names. Its reasons for abandoning the old policy and adopting the new are very instructive. First, anonymous producers had less incentive to maintain quality because shoddy goods were not so easily identified by consumers. The government can now shift some of the burden of quality control to factories that are forced to trademark their products and can lose customers if their goods prove unsatisfactory. Second, when advertising is encouraged, information about new goods is disseminated more rapidly, and innovations are stimulated. Because in the past it was not possible to use advertising to generate demand for new products, the incentive to contrive new products was discouraged. Third, a more efficient marketing system, which conserves scarce resources of the state as well as saving the consumer’s time and trouble, is made possible by the use of advertising. Thus, the Soviet Union can now use self-service stores and distribute a given volume of goods with a smaller amount of labor. Goldman (1960) contains a careful account of Soviet advertising experience.

Advertising and the communications industry

In the United States, the broadcasting industry receives virtually all of its revenue from advertisers. Newspapers and periodicals obtain some two-thirds of their revenue from advertising and the balance from sales and subscriptions. Clearly, a substantial part of the entertainment and news provided the public in the United States is paid for directly by advertisers and only indirectly by the public. This creates concern about the quality of the entertainment and the degree to which it reflects the public’s taste. There is, in addition, the question of whether advertising affects freedom of the press. Finally, because most television advertising in the United States is purchased by relatively few companies and only three national networks exist, there are some special problems of economic policy with regard to regulation of the industry.

The public registers its taste for drama and motion pictures directly, by the purchase of tickets to those it likes. Producers have a direct financial incentive to cater to public taste. Although viewers and listeners do not pay directly for radio and television programs, it cannot be doubted that similar considerations guide the producers of these programs. Since advertisers desire large audiences and are willing to pay more for them, producers of radio and television shows have strong incentives to provide what they expect will be popular. The reason the cost of radio and television entertainment is not collected directly from the audience is the economic fact that it is cheaper to collect this cost from advertisers. If certain experiments with closed-circuit television prove successful, direct collection from viewers will make subscription television a profitable enterprise. Yet it is by no means obvious that advertising would be absent from subscription television. People buy magazines and newspapers directly, and both these media contain advertising. Newspapers that did not include advertising have either changed their policy or failed. Aside from the absence of advertising revenue, this suggests that people demand certain kinds of advertising.

There is still more direct evidence that people want certain kinds of advertising. Newspaper advertising rates have always been lower for local advertisers than for national advertisers. Since the cost to a newspaper of local advertising is, if anything, higher than the cost of national advertising, and since national advertisers have several alternatives not available to local advertisers, this phenomenon has mystified students of advertising for a long time. Ferguson (1962) provides an explanation. Most of the local advertising gives newspaper readers information about goods available from local retailers and about the terms of sale. Newspaper readers are as eager to learn about these matters as about news. Hence the more advertising of this kind a newspaper contains, the larger its circulation. Therefore, local advertising rates are lower than those for national advertising, which generally does not have the same stimulus on circulation. Perhaps the communications media would freely carry items as news about consumer goods and services if there were no advertising, just as they now review books and motion pictures.

Partly for these reasons, the more sophisticated critics of advertising take the position that advertisers and television producers cater unduly to popular taste and do not experiment boldly enough with higher art forms. Because there are only three major television networks in the United States and few television channels per city, these critics maintain that the desire to reach a maximum audience leads television producers to undue similarity and slavish imitation of what has proved to be popular. Minority audiences are ignored, and the television fare is reduced to a low, vulgar common denominator. It is one thing to argue that intellectuals cannot find suitable fare on television because it never pays an advertiser to try to attract this audience, an extreme position without empirical support; it is another to argue that serious intellectual programs should be provided during the evening hours and on the days when the potential audience is largest. It would be profitable for advertisers to cater more to minority tastes than they now do if there were more commercial television stations per city and if subscription television became a profitable enterprise. Nevertheless, even if both of these developments occurred and increased variety became possible, it would be naive to expect too much. Since there are fashions in novels and in movies, we should not expect less conformity of television programs.

Both radio and television depend on a relatively small number of firms for a substantial part of their advertising revenue. The 20 largest network television advertisers account for more than 22 per cent of network advertising receipts, and the 20 largest spot television advertisers account for nearly 14 per cent. By way of comparison, the 20 largest newspaper advertisers contribute less than 6 per cent of newspaper advertising revenue. Since there are only three national networks, it is safe to conclude that advertising rates for the largest firms are not arrived at by a purely competitive process. The Federal Communications Commission licenses all television and radio stations and limits the number of stations any one company, or network, may own. The public would benefit more from a larger number of television stations per city than it would from regulation of advertising rates. The development of ultrahigh-frequency (UHF) television, for example, would, by increasing competition, lead to a greater variety of television fare, just as the advent of frequency modulation (FM) radio and the consequent opening up of more radio stations gave listeners a wider range of choice.

Defenders of advertising have claimed as one of its benefits that it makes possible a free press. There can be little doubt that if there could not be advertising in newspapers, the price of newspapers would rise considerably and the circulation would fall—not only for this reason, but also because an important kind of news, advertising, could not be published. Without advertising, broadcasting companies could not survive unless subscription radio and television became profitable. When there is a free press the public can hear a greater variety of views than when the press is controlled by the government. Truth is less easily concealed when conflicting views can be presented to the public. A government that supports and controls the news media, no matter how benevolent it is, cannot be trusted to give as much free expression as would unfettered competition among companies in the news industry, which depend on the public and advertisers for revenue.

Advertising and consumer sovereignty

A convenient assumption in textbooks is that consumers have given, and possibly sacrosanct, tastes and that firms cater to these. As a practical matter this is a myth. People are molded by the opinions and pressures of others from the moment of birth. Our role as consumers begins with what we learn from our parents and continues throughout our lives. Of course, advertisers serve their own interests when they try to get us to buy their wares. However, most people attempting to persuade others are often serving their own interests, and we must learn to be discriminating. A free society requires freedom of persuasion, including attempts to influence how people spend their money. Critics who claim that advertisers lie or induce people to buy things they do not need or to discard goods that are still serviceable overlook the fact that sales clerks can do all this just as effectively; these critics certainly exaggerate the power of advertising. Moreover, they ignore certain mundane but nevertheless important facts about advertising. For every advertiser who tries to persuade consumers to do a particular thing or to buy a particular item, there are others trying to persuade consumers to buy a rival product. In modern industrial society consumers can choose from an ever-increasing and ever-changing array of goods. Wise consumption is difficult under these conditions and demands a degree of skill not required of shoppers in a simpler economy. Efficient distribution in a society of rising real wages requires greater reliance on such labor-saving devices as the self-service store. Advertising is one of the promotional techniques that meets the requirements of efficient distribution. We can expect it to play an ever-increasing role in the developing economies of the world.

Lester G. Telser

[Other relevant material may be found inCommunication, mass; Market R>esearch.]

BIBLIOGRAPHY

Advertising Age: The National Newspaper of Marketing. → Published weekly since 1930.

Blank, David M. 1963 A Note on the Golden Age of Advertising. Journal of Business 36:33–38.

Borden, Neil H. 1942 The Economic Effects of Advertising,. Chicago: Irwin.

Canada, Dominion Bureau of Statistics 1956 Advertising Expenditures in Canada, 1954. Reference Paper No. 67. Prepared by the Merchandising and Services Section, Industry and Merchandising Division, Department of Trade and Commerce. Ottawa: Department of Public Printing and Stationery.

Ferguson, James M. 1962 The Advertising Rate Structure in the Daily Newspaper Industry. Ph.D. dissertation, Univ. of Chicago.

Goldman, Marshall I. 1960 Product Differentiation and Advertising: Some Lessons From Soviet Experience. Journal of Political Economy 68:346–357.

Harris, Ralph; and seldon, Arthur 1962 Advertising and the Public. London: Institute of Economic Affairs.

Kaldor, Nicholas 1950 The Economic Aspects of Advertising. Review of Economic Studies 18:1–27.

Kaldor, Nicholas; and SILVERMAN, RODNEY 1948 A Statistical Analysis of Advertising Expenditure and of the Revenue of the Press. Cambridge Univ. Press.

Katz, Elihu; and Lazarsfeld, Paul F. 1955 Personal Influence: The Part Played by People in the Flow of Mass Communications. Glencoe, III.: Free Press.

Nerlove, Marc; and Arrow, Kenneth J. 1962 Optimal Advertising Policy Under Dynamic Conditions. Economica New Series 29:129–142.

Ozga, S. A. 1960 Imperfect Markets Through Lack of Knowledge. Quarterly Journal of Economics 74:29–52.

Printers’ Ink: The Weekly Magazine of Advertising, Selling, and Marketing. → First published in 1888. Since 1954 one issue each year is a guide to marketing.

Stigler, George J. 1961 The Economics of Information. Journal of Political Economy 69:213–225.

Telser, Lester G. 1962 Advertising and Cigarettes. Journal of Political Economy 70:471–499.

U.S. Federal Trade Commission 1944 Advertising as a Factor in Distribution. Part 5 of Report on Distribution Methods and Costs. Washington: Government Printing Office.

II ADVERTISING RESEARCH

Advertising research is here defined as the study of that part of human behavior attributable to overtly paid-for communications. It is thus distinguished not only from the broader discipline of marketing research but also from kindred studies of aggregate purchasing behavior, economic concomitants of advertising, and communications not always or not overtly paid for. [For discussion of these fields, seeCommunication, mass; Consumers, article onconsumer behavior; Market research; Propaganda.]

As subject matter for the social sciences, advertising remains curiously neglected. Advertising has long been of importance and today accounts for at least one per cent of the national income of most highly industrialized countries (International Advertiser 1965), but it had no important place in economic theory until the 1930s. Advertising accounts for a major share of the promotional expenses of most firms but has not been extensively treated in any but the most recent microeconomic theories of the firm (Ramond 1964c, pp. 662–675). Advertising accounts for an undeniably larger and larger visible and audible part of world culture but as a sociological phenomenon has been described mainly by journalists. Advertising is a much-discussed influence on individual behavior but has interested psychologists only insofar as it can be studied in the experimental laboratory or used to illustrate the clinician’s theories of unconscious motivation. It is hardly surprising that there is no accepted theory of advertising.

The little known about how advertising works comes largely from research done since World War II by advertisers and advertising agencies in the United States, western Europe, and Japan. Most early studies remained unpublished. Until the establishment in 1960 of the Journal of Advertising Research (JAR), there was no means for exchange of ideas among all gatherers or users of this work. Since then some fifty or sixty reports of advertising research are published each year, mainly in the JAR.

Not all this research is beyond criticism. Much of it is done by practitioners whose training in the social sciences and ancillary disciplines has been acquired on the job. In the face of time and cost limitations, methodological standards relax, When this happens, advertising research often merits the charge (Forrester 1958) that it is itself nothing more than advertising.

The primary basis for these political considerations is the organizational structure of the advertising industry. Nowhere in business, perhaps, has accurate evaluation been so inhibited by the organizational structure of the process to be evaluated. Advertising is bought for a manufacturer by an agent, and this agency has usually been responsible for the evaluation of advertising effectiveness. Someone has remarked that this is like having the fuel salesman evaluate the furnace. The fact remains that it has not always been in the best interest of the advertising agency to institute adequate research designed to evaluate advertising effectiveness. The agency has little to gain and much to lose. Instead of such evaluative research, it typically performs only those studies which are necessary to aid its own current decision making and that of the client. Such research is done only when needed and can rarely be accumulated for future guidance. Thus, the ultimate promise of any type of research —its self-liquidation through accumulation of permanent knowledge—is almost by definition denied in the advertising realm.

As most advertising research is designed to aid some decision, it is possible to classify the types of research according to the decision each is designed to help make. For example, decisions about what to say come under the heading of motivation research; decisions about how to say it, under copy research; where, when, and how often to say it, media research; and how much to spend, sales research.

Motivation research

The postwar transition from a war production economy to a consumer economy heightened advertisers’ interest in the motives of their target audiences. By the early 1950s the business community had learned from clinical psychologists that consumers were governed in part by unconscious motives, or at least by motives they had trouble expressing to ordinary interviewers. Depth interviews, projective tests, and the other paraphernalia of the clinical psychologist became popular tools in advertising research. By 1955 the public became interested in whether it was in fact being sold by advertising against its will. Popular books exploited this fear on the part of the book-buying public and ultimately received a quiet rejoinder from more realistic students of human behavior. John Dollard, at the second annual conference of the Advertising Research Foundation, in a frequently anthologized paper entitled “Fear of Advertising,” said: Nor do I fear research into unconscious motives, sometimes called motivation research, as an important factor in mass subversion by advertising. My reasons are as follows: many unconscious motives are stark and ugly and cannot be used in advertising appeals. Furthermore, unconscious motives are tricky; they are likely to come in conflicting pairs of desire and disgust, and one cannot evoke the desirable member of the pair without also evoking its linked opposite. It should be noted also that people are not immediately prone to carry out the unconscious motives which they do have. There are strong forces built into the personality which operate against most unconscious motives. Looking at the matter from a quite different standpoint, it has yet to be proved that unconscious motives can be steadily identified or that, if this were done, they are of superior effect in devising advertising themes. At the moment, the notion of using hidden factors in motivation to influence behavior on a mass scale is still in the status of a bright idea or a horrible fantasy, however you prefer to look at it; but it is not a reliable and valid instrument available to advertisers. (Dollard 1956, p. 7)

As public and professional expectations grew more realistic, motivation research gradually ceased to be regarded as the search for exploitable unconscious motives. Instead it became redefined more modestly as the study of those psychological variables which might be related to the consumer’s purchase of products or services. Put another way, motivation research became the study of relationships between the psychological attributes of a brand or product (its “image”) and the psychological attributes of the consumer (his “personality”). If markets can be segmented, so the argument runs, according to psychological as well as demographic variables, then it should be possible to fashion advertising appeals which are unusually effective in causing sales among the appropriate population segments.

Perhaps the largest body of data on which these hypotheses have ever been tested became available at the J. Walter Thompson advertising agency in 1959, when the Edwards Personal Preference Test was administered to a sample of over three thousand households (Koponen 1960). The Edwards test provided scores on 15 personality traits for the male and female head of each household, while a purchase diary indicated amounts and brands of various products purchased. A prior experiment had shown that a subgroup selected for its scores on certain traits bought more of a mail-order product than did an unselected control group, in response to a direct-mail advertisement using appeals designed specifically to satisfy that particular subgroup’s psychological needs. Neither group bought very much, however, and the results were deemed statistically significant but practically unimportant.

So, in fact, were the relationships found between personality variables and purchase behavior using the J. Walter Thompson data on beer, coffee, tea, and toilet tissue. Although brand loyalty, store loyalty, and amount purchased do correlate significantly with certain demographic and personality traits of the 8,900 subjects in the sample, these correlations are too small to give practical guidance. It seems safe to conclude that until more discriminating personality scales are developed, perhaps for the specific purpose of predicting purchase behavior, psychological market segments will not be significantly more useful to the advertiser than demographic market segments.

Copy research

Having learned the needs of his prospects and chosen general appeals or themes by which to reach them, the advertiser must then determine how best to execute those themes. Which copy, headlines, illustrations, music, etc., will best communicate his message? Studies answering questions of this sort have traditionally made up the bulk of advertising research and are still called —even in the age of television—copy research.

Reviews and collections of recent copy research appear elsewhere (Lucas & Britt 1963; National Industrial Conference Board 1963; Twedt 1965). The common implication of many of these studies is that the respondent’s verbal testimony about exposure to advertising cannot be taken at face value. Commercial services report the proportion of a sample who on being shown an advertisement claim to have noted it (the recognition method) or who, on being shown a brand advertised in a magazine they have read, can “play back” enough of the advertisement to indicate convincingly that they have in fact seen it (the aided recall method). The simultaneous popularity and questionability of these techniques led to the largest purely methodological investigation ever conducted in copy research, the five-volume Printed Advertising Rating Methods Study, or PARM (Advertising Research Foundation 1956–1957). The PARM study found, among other things, that recognition scores did not decrease as the time since reading increased, as one would expect if memory loss were occurring. This suggests not that the respondent was “recognizing” the advertisement he had actually seen but the likelihood that this was the kind of advertisement he would have noted, given the opportunity. Other studies find that respondents claim to recognize control advertisements that they could not have seen. The extent of misclaiming was directly related to the respondent’s reports of past reading behavior, his interest in the product advertised, and other personal characteristics. It may be concluded that while these claims perhaps have some value as projective data describing the respondent, they are substantially useless as reports of prior exposure.

They may also be useless as predictors of future behavior. Haskins (1964), in a review of 28 studies, has shown that factual recall of advertising can change without corresponding changes in behavior or other attitudes. He concludes that what is retained by respondents may have nothing to do with their subsequent purchases. Ramond (1965) has shown that such failure of attitude change to predict or coincide with behavioral change may be an artifact of the methods commonly used to measure these changes.

As verbal behavior became increasingly suspect, nonverbal behavior became increasingly popular as a measure of copy effectiveness. Laboratory methods, themselves suspect for their artificiality, found increasing favor as they began to measure relatively involuntary responses to advertising. These included visual recognition, skin moisture, pupillary dilation, and even the rate at which someone would press a pedal to maintain a television picture and sound. No measure has been found completely free from conscious cognitive influences, but the trend of current copy research seems to indicate that such is the goal.

Media research

Having decided what to say and how to say it, the advertiser must then decide where, when, and how often to say it. Surveys and analyses that guide these decisions are known as media research and have as their aim the selection of the audiences for advertising placed in media. They should not be confused with studies that are intended to determine the audiences of only the media themselves.

A comprehensive bibliography of U.S. media research may be found elsewhere (Ramond 1964a), along with a comparison of U.S. and European approaches. For example, there is much variety and controversy in U.S. media research. In the United States no single method has been hammered out for use in an industry-wide study, whereas this has been done in France, Britain, and Sweden (Ramond 1964b). All of these studies have been influenced by the work of the Advertising Research Foundation’s (ARF) Audience Concepts Committee as expressed in its booklet, Toward Better Media Comparisons (Advertising Research Foundation . . . 1961). The committee maintains that to understand the transmission of advertising through media one must count or measure at six stages: vehicle distribution, vehicle exposure, advertising exposure, advertising perception, advertising communication, and consumer response— usually sales.

Vehicle distribution is a count of things, namely, the number of physical units through which advertising is distributed. In broadcast media these are receiving sets in use; in print media, number of copies sold.

Vehicle exposure is a count of people, those whose open eyes or ears were confronted by the vehicle: for broadcast media, by the ongoing program; for print media, by the open page.

Advertising exposure is a count, not of things or people, but of events. These events are also confrontations of open eyes or ears by a turned-on set or an open page, but only where the set or page is carrying a commercial or advertisement.

The fourth, fifth, and sixth stages of the model are perception, communication, and response. There is both a conceptual and an operational difference between these stages and the previous three.

Distribution and exposure measures can in principle be—and have in practice been—objectively defined to the satisfaction of many if not all. In dealing with perception and communication of advertising, however, we face the problem of separating the effect of the medium from the effect of the advertising message itself. So far no research supplier has come forward with any measure of these stages which is as objective, repeatable, and intuitively compelling as those of distribution and exposure.

Actually, perception and communication may be defined by an infinite number of responses. Though a perception may be defined as that which is seen, heard, or in some way received by a sense organ, our knowledge of whether it has been received must be derived from the response of the receiving person. He must somehow translate his private observation into a public gesture. Reports of recognition, recall, or attitudes are possible classes of responses which might define perception or communication of advertising. But note that whatever definition is used, it will require not only that the consumer see or hear the advertising but also that he remember something about it until he is asked to report it. Thus the number of possible definitions is further multiplied by the number of cues or aids to memory which could be used.

While the ARF Audience Concepts Committee made no recommendations concerning operational definitions of perception and communication, it did suggest a conceptual distinction. Perception is defined as an all-or-none phenomenon: it either occurs or does not occur. There are no degrees of perception.

But communication involves more than merely seeing an advertisement. For example, an advertisement can add to the consumer’s knowledge, change his attitude, or make him resolve to purchase the product advertised. It may change his beliefs, make some more prominent than others, or even evoke moods in which his judgments operate differently. Thus one must recognize degrees of communication. One may merely count perceptions, but one must measure communication in a more complex way. The goal in counting perceptions is to extract from each the effect of memory, but the goal in measuring communication is to learn the degree of remembering. Thus, although perception and communication differ conceptually, in practice they both require measures that isolate and distinguish the effect of advertisement-plusmedium from memory, and the effect of the advertisement from that of the medium.

We now come to the final stage of response to advertising, and from the advertiser’s point of view by far the most important. Response at this stage is necessary to justify any advertising at all. Other measures are satisfactory only insofar as they are related in some way to sales. However, sales are the outcome of a great many factors other than advertising. Not only are the personal factors, the attitudes, beliefs, perceptions, and so forth of each individual important, but external factors such as price, market conditions, changing tastes, etc., are also operative.

Theoretically, the way to estimate the sales response to an advertising unit is to arrange for tests with all factors that could possibly influence sales—except for advertising—held equal or randomized. In one area the advertising unit would be displayed, in the other it would not, and the difference in sales in the two areas would be measured. Practically, experiments of this kind turn out to be very difficult. In the first place, if we try to choose markets that are identical in all the relevant characteristics, we usually find some discrepancy between the markets on a variable which we feel sure will affect the outcome of the experiment decisively. Again, we may list what we think are the relevant variables in order to account for their effects, but we never know whether we have been able to identify them all. Even with an exhaustive list of market variables, we may find that the nature of our advertising unit is such that it may act differently in the two markets because of the different psychological characteristics of their inhabitants, or the differing media habits in the two markets. Perhaps the ultimate objection to research designed to attribute sales gains to single advertising units is the very small effect which any one advertising unit may have. Sales tests have been applied mainly to the evaluation of campaigns, not of individual messages.

Sales research

No amount of research into motivation, copy, or media will tell the advertiser what, if anything, his advertising has done to influence the sales of his product. For this information he must conduct sales research, wherein he isolates the contribution to sales of his advertising expenditures. Many advertisers have done so, in the United States and elsewhere, despite the difficulties enumerated in the previous section. The most comprehensive recent review and bibliography is Martin Mayer’s booklet for ARF, The Intelligent Man’s Guide to Sales Measures of Advertising (Mayer 1965). Others include Dominick (1960), the National Industrial Conference Board (1962), Palda (1963) and Ramond (1965).

Properly designed marketing experiments are used to avoid many of the above difficulties (Banks 1965). Proper design requires, among other things, that extraneous influences on sales be dealt with: controllable factors should be controlled; uncontrollable but measurable factors should be measured and accounted for statistically in the analysis; and enough experimental units should be used in each treatment to permit accurate estimates of their variability. From experiments published, we may conclude that when the following conditions are met the sales effects of advertising can be estimated with accuracy, speed, and economy:

(1) The product or the brand has no substitute now or in the foreseeable future. The number of competing products or brands is small, and it is unlikely to be made obsolete by technology during the period of experimentation.

(2) The buyers of the product or brand (a) can be unambiguously defined; (b) can be easily reached by advertising and interviewers; (c) are geographically concentrated; (d) are temporally concentrated—the shorter the selling season the better; (e) spend little time “in the market.”

(3) The lot size of the purchase is constant from purchase to purchase by the same buyer and the same from buyer to buyer.

(4) Price is constant over time, markets, amount purchased, etc.

(5) Channels of distribution are many. The more channels of distribution to the consumer the less likely he will be frustrated in an advertisinginduced attempt to buy.

(6) Levels of distribution are few. The more wholesalers, dealers, and distributors there are between producer and consumer, the more individuals who must decide before purchase can occur, and the more individuals who must be influenced by advertising.

(7) The influence of personal selling is constant over time and over markets.

(8) Technical services provided by competitors do not differ.

(9) The copy platform is constant and unambiguous. The fewer the copy points, the easier it is to tell if communication has occurred.

(10) Special promotions are not undertaken. (11) Packaging is distinctive and constant. (12) The producer is the only advertiser of the brand, i.e., there is no cooperative or local advertising.

(13) Competitors are slow to respond to changes in marketing strategy and maintain more or less the same marketing policies.

(14) Competitors’ advertising and marketing policies are relatively constant over markets.

(15) Potential sales can be accurately estimated for small geographical units, e.g., counties or census tracts, and during short time periods such as weeks or months. This follows from several of the previous desiderata.

(16) Government controls over product design, price, competition, and advertising are minimal or at least unchanging.

Clearly not all of these conditions can be met by most advertisers. Meeting them, moreover, does not guarantee a conclusive experiment but only the avoidance of certain common errors. Experimentation is increasingly popular, not because it always works, but because in many cases it is the only way to have a chance of getting unambiguous measures. In marketing as elsewhere in business, chance plays its inevitable role. Part of this role, however, can be made manifest by the experiment itself.

As published experiments accumulate, the conditions under which the sales effects of advertising can be accurately estimated will become clearer. Until then the prudent advertiser will determine for himself whether his own circumstances augur well or ill for this valuable form of marketing control.

Charles K. Ramond

[Directly related are the entriesConsumers; Market research. Other relevant material may be found inAttitudes, article onAttitude change; Communication, mass; Persuasion; Propaganda.]

BIBLIOGRAPHY

Advertising Research Foundation 1956–1957 A Study of Printed Advertising Rating Methods. 5 vols. New York: The Foundation.

Advertising Research Foundation, Audience Concepts Committee 1961 Toward Better Media Comparisons. New York: The Foundation.

Advertising Research Foundation 1965 Are There Consumer Types? New York: The Foundation.

Banks, Seymour 1965 Experimentation in Marketing. New York: McGraw-Hill.

Dollard, John 1956 Fear of Advertising. Pages 1-9 in Advertising Research Foundation, Proceedings of the Second Annual Conference. New York: The Foundation.

Dominick, Bennet A. 1960 Research in Retail Merchandising of Farm Products: Appraisal of Methods and Annotated Bibliography. Washington: U.S. Department of Agriculture, Market Development Research Division, Agricultural Marketing Service.

Forrester, Jay W. 1958 The Relationship of Advertising to Corporate Management. Pages 75–92 in Advertising Research Foundation, Proceedings of the Fourth Annual Conference. New York: The Foundation.

Haskests, Jack B. 1964 Factual Recall as a Measure of Advertising Effectiveness. Journal of Advertising Research 4, no. 1:2–8.

HRB-Singer, Inc., State College, Pennsylvania 1962 The Measurement and Control of the Visual Efficiency of Advertisements. New York: Advertising Research Foundation.

International Advertiser. → See especially 1965, Volume 6, no. 10.

Koponen, Arthur 1960 Personality Characteristics of Purchasers. Journal of Advertising Research 1:6–12.

Lucas, Darrell B.; and Britt, Steuart H. 1963 Measuring Advertising Effectiveness. New York: McGraw-Hill.

Mayer, Martin 1961 The Intelligent Man’s Guide to Broadcast Ratings. New York: Advertising Research Foundation.

Mayer, Martin 1965 The Intelligent Man’s Guide to Sales Measures of Advertising. New York: Advertising Research Foundation.

National Industrial Conference Board 1962 Measuring Advertising Results. By Harry D. Wolfe et al. New York: The Board.

National Industrial Conference Board 1963 Pretesting Advertising. By Harry D. Wolfe et al. New York: The Board.

Palda, Kristian S. 1963 Sales Effects of Advertising: A Review of the Literature. Journal of Advertising Research 4, no. 3:12–16.

Ramond, Charles K. 1964a Operations Research in European Marketing. Journal of Marketing Research 1, no. 1:17–24.

Ramond, Charles K. 1964b Trends in U.S. Media Research. European Society for Opinion Surveys and Market Research, Commentary (Special Supplement): 35–43.

Ramond, Charles K. 1964c Marketing Science: Stepchild of Economics. Pages 662-675 in Stephen Greyser (editor), The Marketing Concept in Action. Chicago: American Marketing Association.

Ramond, Charles K. 1965 Must Advertising Communicate to Sell? Harvard Business Review 43, no. 5:148–158.

Twedt, Dik Warren 1965 Consumer Psychology. Annual Review of Psychology 16:265–294.

Advertising

Over the course of the twentieth century, child consumers have played an increasingly important role in the economies of developed nations. Children's consumer clout is especially pronounced in the United States, where, according to early-twenty-first-century estimates, children spend or influence the spending of up to $500 billion annually. Advertisers in turn spend hefty sums to capture the consumer allegiance and nagging power of children. Thanks to the power of television, advertising to children in the twenty-first century has become a ubiquitous practice across the globe. It is, however, by no means a recent phenomenon.

A market for children's goods–books, toys, clothing, and furniture–had existed since at least the eighteenth century, but market awareness of children as consumers first emerged in the United States during the 1870s and 1880s, when national advertisers began supplying retailers with colorful trade cards and advertising jingle books based on parodies of Mother Goose rhymes. Corporations hoped that child shoppers would digest the advertising messages on the backs of trade cards and bring the advertisements to their mothers' attention, but advertisers' primary goal was to stimulate sales at the point of purchase. If a mother had neglected to specify a brand when she sent her child on a shopping errand, an alluring trade card displayed on a store countertop might decide the issue. Children prized trade cards for their luxurious color images–a novelty made possible by advances in chromolithography printing. Collecting the cards in scrapbooks was a favorite childhood pastime, especially among girls. Advertisers encouraged this hobby by producing a set or series of collectible trade cards, and children reveled in the status that an unusual card or fine collection conferred on its owner.

At the turn of the twentieth century, the advertising trade largely dismissed children as members of the buying public, but readily embraced the notion that children constituted the future buyers of tomorrow. Theorists of advertising psychology such as Walter Dill Scott argued that buying was in-fluenced less by rational arguments than by unconscious decision making, including "suggestions" that advertisers implanted in the consumer's mind. The plasticity of young minds, Scott surmised, made children especially valuable targets of advertising. If repeatedly exposed to trademarks and brand names, children could, imperceptibly and unconsciously, acquire brand preferences that would last a lifetime.

Such psychological insights hardly constituted a revolution in children's advertising, but they did suggest, contrary to what some Victorians supposed, that the concept of a sheltered childhood was not inherently at odds with children's exposure to the world of commerce. The whole notion that children possessed a consumer consciousness long before they possessed purchasing power circulated broadly in turn-of-the-century advertising iconography. In magazine advertisements and trade cards read by adults and children alike, admakers depicted children as product endorsers, discriminating shoppers, and voracious consumers. These images traded on new cultural ideals of childhood that prized children as much for their spunk and savvy as their innocence.

These middle-class cultural ideals of the spunky child paved the way for even bolder departures in advertising during the 1920s. By then, advertisers conceived of middle-class children not just as buyers of tomorrow but as buyers of today and selling agents within the home. They recognized children as a more definable and viable group of consumers partly because modern childhood itself had become more organized around peer activities. Compulsory schooling, agesegregated classrooms, and the rise of youth organizations like the Boy Scouts and the Girl all elevated the salience of peer interactions. The fact that the Boy Scouts, Girl Scouts, and Camp Fire Girls published their own magazines provided advertisers a ready means of reaching boys and girls with common interests. Indeed, advertisers frequently capitalized on these peer affiliations by suggesting that their products could be used to earn scouting merit badges or enhance camping experiences. Transformations within the middle-class family also contributed to advertisers' enthusiasm for cultivating child consumers. Owing partly to their own middle-class backgrounds, admen and adwomen sensed new opportunities in the democratization of the urban middle-class companionate family, which unlike its Victorian predecessor, granted children greater latitude for self-expression and, in many cases, their own allotment of spending money.

Children's magazine publishers such as St. Nicholas, Boy's Life, and American Boy played an important role in promoting advertising to children as a worthy long-term and short-term investment. American Boy placed numerous ads in advertising trade journals, touting the exuberance of boy consumers and their influence over family purchasing, thanks in part to boys' expertise on new consumer technologies such as cars, radios, cameras, and batteries. AmericanBoy 's promotional efforts paid off handsomely. During the mid-1910s, American Boy began to swell with ads for bicycles, erector sets, rifles, and breakfast cereals. By 1920 annual advertising revenues for the magazine had reached half a million dollars. By the middle of that decade, American Girl and Everygirl's, magazines published respectively by the Girl Scouts and the Camp Fire Girls, had also attracted advertisers who sought both to cultivate the loyalty of future housewives and to boost present sales.

In the early twentieth century, advertisers and magazine publishers alike initiated numerous games, contests, and educational ventures to teach children an appreciation of advertising and train them in brand-conscious shopping. Publishers' investment in this project was at least as deep as advertisers' because magazines now depended more on advertising revenues than subscription sales for their survival. To gain credibility as a profitable advertising medium, American Boy and Scholastic, the national weekly for secondary school students, ran a series of columns explaining why their readers should trust in advertisers and the superior economic value of advertised goods over unbranded goods. Juvenile magazine publishers also won advertisers' confidence by sponsoring contests and games that trained children to pay close attention to advertising.

The public schools provided advertisers with another promising venue for raising brand consciousness. Though ostensibly limited by the conventional boundaries of the school curriculum, advertisers spared little effort in getting their messages into the classroom and via the classroom into the home. They offered free booklets, exhibits, charts, and other "enrichment" materials that promised to transform run-of-the-mill lessons into livelier fare. Because restrictive school budgets often curtailed the use of visual aids, teachers and teaching organizations proved remarkably receptive to corporate-sponsored innovations in the curriculum. In the late 1920s, for example, teachers in some 70,000 schools across the country used Cream of Wheat's graded contest devices, prizes, and breakfast charts to encourage regular consumption of hot breakfast cereals. Although editorialists criticized advertisers for diverting "school facilities to its own selfish purposes," schools provided no substantive counterpoint to the claims of modern advertising until the mid-1930s, when the consumer education movement got underway.

Early-twentieth-century juvenile advertisers struggled to strike the right balance in addressing children's desires and parents' concerns. Overt parental appeals that linked children's consumption to nutrition and achievement often appeared in children's advertising. Yet juvenile advertising in the 1920s and 1930s was remarkably bold in its efforts to empower children within a consumer democracy. Advertisements in children's magazines literally instructed children how to lobby their parents for new purchases, supplying them with sales ammunition that appealed to pressing parental concerns. While Canadian broadcast advertising trade guidelines in the 1970s advised advertisers not to "directly urge children to… ask their parents to make inquiries or purchases," early-twentieth-century American advertisers exhibited no such compunctions (quoted in Kline 1993). With boldfaced headlines like "Please–Father–Please," advertisements routinely sanctioned begging and the old childhood standby–buttering up mom and dad.

During the interwar years, advertisers also sought to cultivate children's consumer loyalty and interest by addressing their concerns about popularity and personal appearance. As high school enrollments ballooned and adolescents began spending more time in the company of their peers, adjusting to the norms and expectations of age-based peers became an adolescent preoccupation. Even as they presented purchasable solutions to problems of peer approval and image control, advertisers exacerbated adolescent insecurities by reminding teens of their susceptibility to impersonal judgments. Advertisements for products like Postum cereal and Keds shoes encouraged a greater preoccupation with physical appearance in both boys and girls, but advertisers' messages to girls were especially contradictory. They celebrated the athletic girl as emblematic of the post-Victorian gender freedoms modern girls enjoyed, but they narrowed the scope of feminine aspirations and feminine achievement by making peer acceptance and beauty, rather than athletic performance, the ultimate rewards of bodily discipline. If girls purchased their product, advertisers repeatedly counseled, they were sure to garner more dates–a reassuring promise in the newly emerging public culture of dating, where popularity was measured by the frequency and variety of dates one commanded.

With the advent of children's radio programs in the 1930s, advertisers, no longer limited to the typically urban, middle- and upper-middle-class readers of juvenile magazines, made children's consumer culture a truly national phenomenon. Millions of Depression-era children satisfied yearnings for autonomy and recognition when they joined radio-inspired clubs like Little Orphan Annie's Secret Circle or Post Toasties' Junior Detective Corps and received "free" premiums in exchange for proofs of purchase. Armed with secret passwords, decoding devices, and mysterious languages impervious to adult comprehension, children embraced the privileges of club memberships as a road to empowerment. Membership in such clubs, however, also afforded many children their first lessons in consumer disappointment, when long-awaited premiums failed to live up to advertisers' hype. Children exercised their own limited form of consumer payback in choosing cash contest prizes over dubious premiums and in mocking exaggerated advertising claims. Though some parents complained about broadcasters' advertising excesses, including their practice of inserting ad pitches into story lines, radio paved the way for perhaps even greater advertising intrusions in the television age.

During the postwar years, the spread of affluence and permissive child rearing in the United States gave children greater economic power, while the advent of television gave advertisers new means to reach children en masse. Despite some initial doubts about television's viability as an advertising medium, advertisers enthusiastically took to the airwaves once they became convinced that popular programs like The Howdy Doody Show and The Mickey Mouse Club could deliver a captivated audience. Radio, however, still had the greater impact on the youth market, as baby boomers accounted for eighty percent of rock and roll record sales during the 1950s.

Advertisers' investment in nurturing children's consumer appetites grew along with the expansion of children's own discretionary funds. In 1960, according to a survey by Seventeen magazine, the average teenage girl had a weekly income of $9.53. By 1999, the typical weekly allowance for thirteen-to fifteen-year-olds ranged from $30.50 to $34.25, with girls receiving on average three to four dollars more than boys. Supplementary earnings typically doubled the weekly yield for teenage boys and girls. Though younger children aged ten to twelve received only a modest five to six dollar boost to their weekly income from earnings, allowances on average swelled their weekly take by an additional twenty-one to twenty-two dollars. According to one 1996 estimate, allowances accounted for more than a third of the $89 billion in spending money at children's disposal. Children's collective consumer clout was weighty, indeed.

In the last two decades of the twentieth century, the barriers between children and the market all but disappeared in the United States. Not only did children's media consumption become more difficult to monitor in families with both parents in the workforce–now the American norm–but parental restraints became more difficult to enforce. Parental acquiescence, of course, also contributed to the commercialization of childhood. Advertisers' work was made easier when many American children enjoyed personal televisions and computers with Internet access in their own private bedrooms. Still, the most vigilant parents could at best exercise limited control over children's exposure to commercial messages. Even in public schools, a morning viewing of the Channel One news service exposed children to a daily dose of commercials along with reports on current events. Indeed, what began as a marriage of convenience between under-funded public schools and advertisers in the 1920s grew into a virtually irresistible collaboration, thanks to the anti-tax movement of the last quarter of the twentieth century and voters' reluctance to approve school bond measures. Cash-strapped public schools welcomed the additional revenues– an exclusive contract with soda companies could net millions, while a restricted arrangement with a computer company could yield a new supply of "free" computers. In return for their largesse, corporations were rewarded with an advertising venue that reached masses of children far more cheaply than television.

Children's advertisers have added some new spices to old recipes for marketing success. The tradition of weaving product endorsements into children's entertainment programming, a technique first perfected on radio, was taken to new lengths with the advent of toy-based television programs like The Smurfs, Strawberry Shortcake, and He-Man in the 1980s–a marketing ploy the toy industry cynically defended by asserting that children needed preformulated story lines to help them play. This strategy also harkened back to the Depression-ridden 1930s, when toymakers revitalized sagging sales by creating licensed character toys that revolved around children's celebrity idols such as Mickey Mouse, Shirley Temple, Buck Rogers, and Superman.

Much like their early twentieth-century predecessors, contemporary marketers judge the effectiveness of children's advertising by the so-called "nag factor"–the aim being to maximize the nag until the parental gatekeeper yields. But where earlier advertisers were more cautious about upsetting the balance of power within the family–winning parental goodwill, after all, was the goal of winning juvenile good-will–late twentieth- and early twenty-first century advertisers have pushed the limits of those boundaries. The promises of self-improvement and edification that appeased previous generations of parents have given way to a children's advertising culture in which hedonism, antiauthoritarianism, and kid power reign supreme. Today's kids, as Ellen Seiter puts it, are "sold separately," with appeals designed more to increase the nag factor than to placate the parental gatekeeper.

To acknowledge contemporary marketers' greater investment in creating a distinct children's fantasy culture, however, is not to romanticize the early twentieth century as some utopian moment in children's consumer culture. Far from it. The Pokemon fad of the 1990s, in fact, can be viewed as a direct descendant of the children's radio clubs of the 1930s. Just as the promise of special premiums from Little Orphan Annie and Jack Armstrong got children to pester their parents for more Cocomalt or Wheaties, the Pokemon craze led children to plead for the precious trading cards that would help them capture all 150 Pokemon characters, the mythical "pocket monster" creatures featured in the popular animated kids' television show and video game. While in each case clever market tie-ins with radio idols or popular television shows provided the building blocks for the craze, the appeal of joining a distinct kids' world fueled the fad. Radio club members decoded secret messages to which only their peers were privy, while Pokemon traders became experts in Pokemon lore, memorizing the names, special fighting skills, and point values of each Pokemon.

In the decades since the 1950s, this privileging of children's culture has contributed to greater age segmentation within the children's market. The often fuzzy distinctions between teenagers and children that typified advertising in the interwar years have evolved into clearly delineated categories ranging from toddlers to kids to 'tweens to teens. Marketers also expend more time and money gathering data about their various child audiences. Information formerly gleaned from contest data, children's advertising testimonials, and a smattering of personal interviews now comes to advertising agencies through the more scientific channels of surveys and focus groups. During the 1990s, advertisers found more deceitful means to acquire information about children's tastes by requiring children to provide critical personal data–including name, sex, age, e-mail address, favorite television show, and favorite musical group–before they could enter certain websites. In response to indignant parents and media watch groups, the Federal Trade Commission made it illegal in 1998 to solicit personal information from preteens online without parental permission. Nevertheless, children's advertisers still hold high hopes that the Internet's virtual mall might become as popular a hangout as the neighborhood shopping mall.

Although politicians and consumer advocacy groups have pressured media companies and advertising firms to exercise more restraint and responsibility in promoting violent products and films to children, these limited external controls have done little to rein in a capitalist culture resistant to infringements on free markets and commercial free speech. Indeed, savvy child consumers themselves have discovered avenues of resistance only within the parameters of consumerism itself. One of these avenues is Zillions, a magazine for kids published by Consumer Reports that teaches children the basics of product testing and comparative shopping. Children have also turned consumerism into a language of protest, marketing their own anticorporate sentiments through self-styled Internet zines (self-published magazines) and fashions. Yet such protests have not prevented advertisers from extending their global message. Thanks to rapid commercialization and China's one-child-only birth control policy, Shanghai's singletons have become sufficiently acculturated to consumer abundance and global tastes that they readily grasped the moral dilemma of Toy Story –a Disney tale, told from the perspective of animated toys, about how easily children lose interest in a favorite old toy when a new one arrives. Consumerism paradoxically allows children more control over fashioning independent identities, but it also increasingly binds them to a global commercial culture.

See also: Consumer Culture; Media, Childhood and the.

bibliography

Cross, Gary. 1997. Kids' Stuff: Toys and the Changing World of American Childhood. Cambridge, MA: Harvard University Press.

Davis, Deborah S., and Julia S. Sensenbrenner. 2000. "Commercializing Childhood: Parental Purchases for Shanghai's Only Child." In The Consumer Revolution in Urban China, ed. Deborah S. Davis, pp. 54-79. Berkeley: University of California Press.

Forman-Brunell, Miriam. 1993. Made to Play House: Dolls and the Commercialization of American Girlhood, 1830-1930. New Haven, CT: Yale University Press.

Garvey, Ellen. 1996. The Adman in the Parlor: Magazines and the Gendering of Consumer Culture, 1880s to 1910s. New York: Oxford University Press.

Jacobson, Lisa. Forthcoming. Raising Consumers: Children, Child-rearing, and the American Mass Market in the Early Twentieth Century. New York: Columbia University Press.

McNeal, James. 1987. Children as Consumers: Insights and Implications. Lexington, MA: Lexington Books.

Palladino, Grace. 1996. Teenagers: An American History. New York: Basic Books.

Seiter, Ellen. 1993. Sold Separately: Parents and Children in Consumer Culture. New Brunswick, NJ: Rutgers University Press.

Lisa Jacobson

Advertising

Advertising, a form of communication between a paying sponsor and an identified audience (Dunn and Barban 1986), has become ubiquitous. Advertising's financial impact is significant: In 2004 within the United States alone, $263.77 billion was spent on advertising (Coen 2006). However, focusing exclusively on advertising's economic impact means that one overlooks the significant cultural power that advertising wields. Corporations, consumers, and other agencies have begun examining the phenomenon with more complexity to measure the degree of social and political influence of advertising. They note the limitations of seeing advertising only as a paid communication designed to sell products or services to an identified audience, acknowledging that many factors—including the advertised messages and their visual elements, contexts, and viewers—shape the meaning of the advertisement. More importantly, they argue that focusing on the economic role of advertising omits the degree to which other messages and values are being, if not sold, at least circulated within society. With growing attentiveness to the values that are associated with advertising (along with consumerism and marketing), many have critiqued the pervasiveness of advertising, its increasingly specific targeting of populations, and the cultural values associated with particular products. Since the 1960s, as advertising became a larger part of consumer culture, a number of questions emerged from a variety of disciplines. How are various identities—such as gender, sexuality, age, and race—portrayed in advertising? How do companies reinforce or challenge social identities? What values and perspectives are being advertised along with specific products?

MARGINALIZATION OF NON-DOMINANT GROUPS

There is a relationship between how people are represented in advertising and the perceived societal role of those groups. Women, people of color, older citizens, and other non-dominant groups (including gay, lesbian, bisexual, and transgendered [GLBT] audiences) have traditionally played a marginal role in the creation of advertising. These groups have historically held little control over their representation, let alone the values and messages that advertising portrays about them. As a result, advertising can convey notions about the perceived values of a group that might not correspond with the actual desires and experiences of the group itself. In addition, although advertisers frequently organize their audiences by various identity factors (e.g., gender, sexuality, age, race, class, and religion), they do not always research those audiences. Consequently, advertisers may not be aware of products and services that might benefit that population. Indeed, they might choose to market products with known health risks (e.g., fast food, tobacco, and alcohol) to particular groups, such as people of color (Dates and Barlow 1990) or women (Deadly Persuasion 2003). Given the ways in which portrayals of non-dominant groups have often been misogynist, racist, and homophobic, such patterns can create social discord (Kellner 1995).

Certainly, other media traffic in these images; however, advertising helps defray the cost of most media to consumers, so all media must consider the dominant images within advertisements. Most media outlets are directly supported by advertisers; in 1990, it was estimated that general audience magazines received 50 percent of their revenues from advertisers, whereas newspapers collected seventy-five percent from advertisers, and broadcasters relied almost exclusively on advertising income (Herman 1990). It is not surprising, perhaps, that the information presented in media outlets can be affected by the interests of their financial supporters (i.e., advertisers). It becomes increasingly difficult for individuals to overlook the influence of advertising when trying to determine their own relationship to society, let alone that of other groups when "neutral" media can be influenced by advertisers. Advertising, then, is a central promoter of values within public discourse, providing "perhaps the most dynamic and sensuous representations of cultural values in the world" (Lears 1994).

REINFORCEMENT OF GENDER NORMS

Advertising can reinforce particular gender norms; advertisements directed at women, for instance, often valorize nurturing and supportive roles. Such depictions, which confine women to the domestic sphere, persist despite the fact that by the 1980s, only ten percent of families included a wife and mother whose sole job was taking care of her children while her husband worked (Levitan, Belous, and Gallo 1988). Other stereotypical feminine or misogynist behaviors are portrayed as representative of all women, including women as naggers, nymphomaniacs, mentally incompetent, animalistic, and as bodies (rather than as humans). In contrast, men are typically featured as dominant, heroic, and/or competent subjects (rather than objects). Male voices are more likely to be featured in voiceovers, reinforcing the notion that authority is masculine. Such representations, then, reinforce norms of men as being linked primarily with the public sphere, whereas women are associated with the private sphere. The few exceptions seem incapable of challenging gendered norms.

In the late 1980s, images began surfacing that featured men as foolish (particularly when juxtaposed with items traditionally thought as feminine, such as those related to food preparation) or as fathers. Yet men are infrequently depicted as caregivers in advertisements. When they do appear as parents, they and the children usually participate in conventionally masculine activities. Such images suggest that men can assume a nurturing role, which has been socially defined as feminine, but they are rarely portrayed in additional feminine modes. For example, in 1999, Kaufman pointed out that men are "never shown caring for girls," suggesting that such choices might be read as excessively effeminate.

OBJECTIFICATION OF WOMEN

When women are represented in advertising—a public domain—they are frequently depicted as objects, rather than as subjects. This objectification of women, and their bodies, can be better understood when one considers the "gaze," which controls and fetishizes the female body (Mulvey 1975). Mulvey's work offers a productive point of origins for many scholars, including John Berger, who highlights the gendered dynamics of this concept: "Men act; women appear. Men look at women. Women watch themselves being looked at. Thus she turns herself into an object—and most particularly an object of vision—a sight" (Berger 1977). Rather than being an active subject with agency, women are presented as passive or decorative objects, who rarely interact with the products being sold (Sheehan 2003): This passivity is part of a larger cultural message being sold along with the product. These objectifying gazes have acquired moralistic dimensions: What is beautiful is considered self-evidently good (Wolszon 1998). Objectification is presented as a desirable goal that can be accomplished if one buys the appropriate products and services. Although advertisers have expanded their portrayal of who can benefit from these products and services—businesswomen, women of color, women of various ages—the demand on consumers to be sexually appealing is still a central theme of many advertisements (Kilbourne 2003).

It has become commonplace that "sex sells" when advertising strategies are discussed. However, the degree to which this maxim might be true has sparked debates and research. In one such study, female subjects on magazine covers had their heads emphasized only four percent of the time (the ratio for men is 900% more); their torsos and bodies (along with their heads) comprise the remaining shots (Lambaise and Reichert 2006). Feminist critique has focused on the high frequency of nearly or completely nude female bodies in advertisements as well as the visual dismemberment of those bodies. Feminists and others have critiqued the disturbing trend of using extremely young girls as sexual objects in ads (Kilbourne 2003, 2000). Such patterns reinforce the objectification of women, presenting it as a normal social phenomenon.

INFLUENCE ON STANDARDS OF BEAUTY

Others have rightly noted that consumers may view the highly artificial portrayal of female beauty (models typically have a lower body weight than the average consumer, are styled by many people, and may have their images digitally touched up in the editing room) as a documentary of female beauty rather than as a highly stylized fiction. Some researchers have found that there is little, if any, proof that an attractive model or spokesperson prompts consumer spending decisions (Cabellero, Lumpkin, and Madden 1989). And yet, these appeals to beauty continue to be pitched at women and girls rather than at men: such appeals appeared in fifty-six percent of television commercials that ran during teenage girls' preferred television shows; in contrast, such appeals appeared in only three percent of television advertisements aimed at men during viewing hours where they were the major audience (Signorelli 1997). Naomi Woolf has maintained that this "beauty myth" is a means of prescribing behavior to women (investing one's time and financial resources to portray youth and naïveté) and not appearance (1992). This distinction focuses on the appeal of beauty as a social control: As images of beauty continually shift, insecure consumers may perpetually justify their purchases of products and services. By endlessly manipulating and redefining beauty, advertising and corporate profits are secured.

OBJECTIFICATION OF MEN

Some researchers see insecurity as the motivating force behind the abundance of overtly muscular or conspicuously athletic men in advertising (Klein 1993). These representa-tions masculinize the values, products, and services that appear in the media. Granted, these masculine images differ from norms of female models—male models are encouraged to exhibit physically strong and intimidating bodies whereas female models are encouraged to be excessively thin—but these images speak to the ways in which men, too, can be objectified in the media. As advertisers began foregrounding the bodies of male models, consumers (women and men) were invited to become voyeurs of male bodies. While sexual objectification of women remains a long-standing phenomenon, consumers have begun to witness an increase in the sexual objectification of men. Mulvey's concept of the "gaze" has been revived with this acknowledgement that men might also be eroticized—and disempowered—as objects of desire (Mulvey 1975, Schroeder and Zwick 1999). When paired, women and men are often positioned to foreground the competition, power, and domination between the two (Goffman 1979). Such domination is often eroticized (hooks 1997).

FUNCTION RANKING AND VIOLENCE

While a model's appearance is scrutinized by advertisers and researchers, other elements of the image matter as well: clothing, activity, facial expression (or lack thereof), setting, other objects, postures, sex of the people portrayed, and other attributes of identity (e.g., race, class, and age). Researchers contend that the action of models within advertising can underscore the power differential between groups. Erving Goffman defines this phenomenon as "function ranking," the relative passivity of female models when male models are present, a pattern that he sees as supporting male dominance; Ellen Seiter finds a similar pattern when analyzing advertising images of black children observing their more active white playmates, which subtly hints at white supremacy (Goffman 1979, Seiter 1995). This passivity becomes even more troubling when advertisers accentuate this power differential so that violence becomes part of the message.

Violence in advertising may include linguistic aggression (using specific language, such as "bitch"), may highlight fear (by featuring models in perilous situations), and may even feature models posed as corpses. Typically, violence is presented as erotic or fashionable with male models as the aggressive party. Given that in the United States one in four women experiences domestic violence and that one in five women and one in thirty-three men have experienced an attempted or completed rape (Tjaden 2000, Rennison 2001), this strategy exploits and glamorizes what is a painful reality for many survivors. Some consumers have negatively responded to these portrayals of sexual objectification and of violence through boycotts, complaints, and media awareness campaigns. Such campaigns include Joan Kilbourne's "Killing Us Softly" video series, the work of the activist organization Guerilla Girls, and the long-running "No Comment" section of Ms. Magazine, which includes objectionable ads and the company's contact information on its penultimate page. These negative responses—particularly those that affect the public image of the company or the financial future of a given product—have affected an industry leery of alienating consumers (Twitchell 1996).

MARKETING TO TARGET GROUPS

This negotiation of sexuality—given its commercial appeal—becomes increasingly coded upon consideration of advertising images that are constructed to be appealing to both heterosexual and homosexual audiences. Brumbaugh and Grier's concept of "encoding" describes the phenomenon in which

marketers draw on knowledge of the selected segment to create advertising that carries a certain intended meaning for that segment. Markets 'encode' the meaning through the use of cues such as culturally similar actors, shared cultural symbols, appropriate media placement, and preferred language or vernacular. The marketer's hope is that the cues will be 'decoded' by viewers in the target segment to yield the intended meaning that encourages favorable evaluates of the product and firm.

                              (Brumbaugh and Grier 1999)

These coded messages allow advertisers to access a larger market of consumers: gay and lesbian audiences are meant to interpret these ads as representing their culture(s) and experiences, subcultural codes that are presumably not legible to heterosexual consumers (Clark 1996). When this strategy works, advertisers can market to the GLBT community without necessarily acknowledging their intent or the existence of the GLBT community.

Additional strategies have emerged to maintain coded ambiguity for GLBT audiences. Ads with "androgynous marketing" deploy "a multifaceted eroticism that includes homoeroticism," including the use of beautiful models of the same sex without presenting their relationship as non-platonic (Soldow 2006). Another strategy that relies on ambiguity is that of "gay window" advertising, which portrays same-sex couples or groups in ads where heterosexual couples might have traditionally appeared (Stabiner 1982). Companies advertise their products in less ambiguous ways when the ads are placed in media that are planned for and used primarily by GLBT people, such as Instinct, Out, The Advocate, and the cable network LOGO. Advertisers might specifically place ads in gay-friendly media despite past policies of discrimination against GLBT employees. For instance, the Adolph Coors Company placed an ad in Instinct in 2000, presenting an attractive image to a community that had previously boycotted Coors for its homophobic company policies in the 1970s. Some images are marketed to both GLBT and heterosexual audiences; however, many have critiqued these strategies.

Some lesbians have contended that objectifying women, as that ad does, fails to become more palatable just because women's desires are acknowledged. They realize that this pattern of portrayal is lucrative, especially in mainstream presses where "lesbian" images cater to male heterosexual viewers. In addition, they note that the financial incentives of presenting homoeroticism in a positive light do not mandate that those representations are personally salient or empowering (Clark 1996). In fact, they can be quite exploitative (Williamson 1986).

Yet companies continue to recognize the financial benefits of broadening their consumer base and have responded accordingly. It has been estimated that corporations within the United States spend about $232 million annually in gay media and in sponsoring gay-specific events (Commercial Closet Association 2007). Advertising in gay media has grown significantly: for example, print ad revenues quadrupled between 1994 and 2007, and there was a 241.9 percent jump in ads with "gay-specific" content between 2003 and 2004 (Commercial Closet Association 2007). Despite the ways in which these groups (and people of color) may be marginalized, advertisers remain aware that these groups have spending power. This research area remains quite undeveloped (O'Guinn, Allen, and Semenik 1998).

DISCRIMINATION IN ADVERTISING

Despite their considerable consumer power, the representations of older adults—and the effects of those representations on consumers—deserve further scrutiny as well. Ageism affects advertising: Consumers' disrespect for or dread about aging are assumed in ads that advertise products designed to restore or resurrect one's youth. For female consumers, physical signs of age that are thought to negatively impact beauty (such as weight gain and facial wrinkles) are presented as terrors that can be avoided. Presenting particular bodies as "too old" reinforces discrimination against older citizens. Certain publications that target these populations, including media presented by the AARP (American Association of Retired Persons), have articulated their criteria for disapproval of such images and insist that advertisers recognize the diversity and dignity of older people (Wood 1989).

Such recognition of human dignity would also alter the representation of people of color. Historically, there has been a pattern of racist and demeaning images, typically in marketing to white audiences, when people of color are included—if they are at all. The rise of the post-civil rights era alerted marketers to the financial gains in addressing African-American audiences. However, racist images persist, such as ads which depict people of color as primitive or as a subservient class. The 1980s marked an increase in advertising companies deliberately seeking out people of color, particularly African-Americans. Researchers have noted that white consumers do not object to having African-Americans in such ads; however, the fact that researchers felt compelled to notice this tacit approval indicates the power differential between these groups (Gren 1999). Some advertisers use different methods to reach people of color than they do for mainstream audiences; in addition, some agencies have begun to specialize in marketing products and services for those populations (Cortese 2004).

CONSUMER BEHAVIOR AS A SOCIAL SCIENCE

Consumers have responded in various ways to advertisers' efforts. Some attempt to distance themselves from the consumerism that these ads foster (Dominquez and Robin 1999). In contrast, some people deliberately seek out advertising as a form of entertainment (including television channels devoted to advertising), often in venues where commercials are seen as more noteworthy than the purported entertainment event: The Super Bowl may be the most notorious example.

Advertisers are understandably interested in what consumers find compelling. Brand images create "a set of associations linked to the brand that consumers hold in memory" (Keller 1993); typically, the strongest ads have held consistent images for two or three decades or longer (Aaker 1991). Other agencies are also interested in the impact of advertising. Public service ads promote programs or values thought to be for the public good. The government is also aware that certain products can cause direct and indirect risks. Sometimes product advertisements are regulated; for instance, tobacco companies must display health warnings in their advertisements. The government is also involved in investigating the process by which goods are marketed; indeed, one of the Federal Trade Commissions tasks is the monitoring of deceptive, and therefore illegal, advertising.

The growth in media corporations and new technologies has furthered the impact and pervasiveness of advertising. Advertising can appear in major mediums: print (e.g., magazines, newspapers), communication networks (including television, Internet, radio), public space (such as billboards), and electronic arenas. In the early 2000s, researchers became increasingly interested in how word of mouth might entice would-be consumers (Rosen 2002). Historically, advances in media have been followed by an increase in advertising. Radio, for instance, debuted without advertising in 1920 and subsequently adopted sponsorship programs and other advertising campaigns in the 1940s and 1950s. The success of such advertising was so impressive that the study of consumer behavior became defined as a social science after World War II (Woods 1995). To learn more about the marketing itself, continued attention to advertising's audience, visual components, copy, and consumer response help the public learn how to decipher the product—and our culture.

see also Media.

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                                          Mary McDonnell

Advertising

From humble beginnings in the 1700s, advertising has become the tobacco industry's primary mechanism for the promotion of tobacco use to each new generation of smokers. Whereas in 1900 tobacco advertising targeted mainly white Western men, by the year 2000 tobacco was promoted to women, men, and even children, in markets across the globe. Although the influence of tobacco advertising is hotly debated, control of advertising is now at the heart of initiatives to reduce tobacco consumption.

Early Tobacco Promotions

Tobacco manufacturers have, at least from the eighteenth century, used strategies to promote their wares. Trade cards, which were used in tobacco distribution in North America from the seventeenth century, and also tobacco wrappers, featured a range of images including those of American Indians, tobacco leaves, snuff boxes, and other tobacco accessories. Promotion efforts were taken a stage further with the introduction of branding, which was one of the earliest forms of advertising.

Branding allowed a manufacturer to sell a range of products but this was dependent on the ability to standardize production: "The Brand acted as a source of information for the nature of the product determined by either advertising, a previous sale, or the connotations provoked by the brand name itself or its image" (Hilton 2000). By the 1850s, tobacco products in the United States and Britain were increasingly given brand names and, through these, specific identities. Cherry Ripe and Wedding Cake were brands of chewing tobacco available in the United States, while in Britain Bishops Blaze and Best Bird's Eye competed for the pipe smoker's attention. Symbols also emerged as branding devices. The image of a bull was used effectively on the wrappings and advertisements for the Bull Durham brand of smoking tobacco manufactured by a North Carolina firm in the 1860s.

Advertising of tobacco products took off toward the end of the nineteenth century in the United States, and afterward in Britain. In the United States, Buck Duke organized his own polo team named after one of his leading cigarette brands, Cross Cut. In Britain, one tobacco company published a magazine, Cope's Tobacco Plant (1870–1879), to promote smoking in general and its products in particular. Sponsorship of events was utilized effectively to promote Bull Durham's smoking mixture in 1877. Advertisements appeared on billboards, and colorful posters that reproduced the images on cigar labels and cigarette advertisements were available from suppliers in the United States and Britain.

Packaging was a particularly important aspect of advertising. For example, from the 1860s to the early 1900s North American cigar boxes were decorated with attractive and technically sophisticated labels that could take up to a month to create. Images of "exotic" women were a common feature of these labels. Cigarette cards , which were used initially to strengthen soft paper cigarette packets, were also well established in the tobacco industry's advertising repertoire by the 1890s. Seductive images of beautiful, and often scantily clad, women were used on cigarette cards on both sides of the Atlantic, although there were also more conservative themes such as the Kings and Queens of England and famous sports personalities. These cards were desirable in themselves and highly collectible.

Twentieth-Century Advertising

The prominence of advertising at the turn of the twentieth century was precipitated by a need for new markets for tobacco products and, in particular, mass-produced cigarettes. Mass demand was required to realize the profit potential of new cigarette manufacturing techniques, in particular the introduction of the Bonsack machine. The "tobacco war" between the American and British tobacco industries in 1901 and 1902 added impetus to cigarette advertising, as did advertising wars inside the United States from 1913. Advertising became a major area of expenditure by tobacco manufacturers in the twentieth century, and the biggest area since 1945.

Image was central to tobacco, and especially cigarette, advertising. Although there are clear taste differences between Turkish, Virginian, and mentholated brands, in other respects cigarettes are "fundamentally homogenous products" (Chapman 1986). To enhance the effectiveness of advertising, the tobacco industry enlisted the help of public relations experts, psychologists, and psychoanalysts. In interwar United States, Washington Hill, the president of American Tobacco, worked with public relations expert Edward Bernays to promote Lucky Strike cigarettes. John B. Watson, one of the founders of behavioral psychology, worked closely with the tobacco industry, and Walter Dill Scott's Psychology of Advertising (1902 and 1921) was one of the guiding texts of the industry.

The media emerged as a principal means of direct and indirect cigarette advertising in the twentieth century and the tobacco industry was quick to exploit new types of media: newspapers, periodicals, film, and television. However, in Australia traditional forms of advertising such as counter displays and shop signs continued to dominate the sale of tobacco for pipes and roll-your-own cigarettes until 1950.

National advertising campaigns became common in the West following the expansion of the popular press. The North American Bull Durham brand was promoted in the 1880s using local newspapers and large dailies. Extensive newspaper advertising appeared during World War I when the U.S. tobacco industry initiated campaigns to provide cigarettes for soldiers. The American Tobacco Company struck a deal with one newspaper for a daily front-page display box along with three or four column articles or displays at the top of an inside page. In Britain, too, newspaper advertising grew in importance from the late nineteenth century, and, by the interwar period, 80 percent of advertising expenditure was spent on the press.

Women's magazines have been an important source of cigarette advertising in the West since the 1930s. Although when television and radio advertising became available in Britain and the United States in the 1950s, magazine advertising slumped; later, when bans were imposed on tobacco advertising in television and radio, cigarette advertisements re-emerged in women's magazines. In the 1970s and 1980s most major U.S. women's magazines took cigarette advertisements and in 1979 cigarettes were the most advertised product in some U.S. magazines. In Britain, a survey of fifty-three magazines aimed at fifteen- to twenty-four-year-old women in 1985 revealed that two-thirds featured cigarette advertising.

The potential of film to promote smoking, especially of cigarettes, was also realized by the tobacco industry. Film stars endorsed De Reszke cigarettes in a string of advertisements in Britain's Vogue magazine in 1919; by the 1930s this was common practice on both sides of the Atlantic. Although smoking appeared in silent films, and was common from the 1930s, there is little explicit evidence of tobacco industry interventions. In the 1980s, however, the tobacco manufacturer Phillip Morris admitted to paying Sylvester Stallone to smoke Kool cigarettes in the action movies Rhinestone (1984) and Rambo: First Blood, Part 2 (1985). Unofficial sources also indicate that films have been used deliberately to advertise cigarettes through product placement. Marlboro vans, for example, appeared in the background of Superman II (1980). An increased occurrence of smoking and of major cigarette brand names has been noted in films released between 1990 and 1996.

The availability of television after 1950 provided important new channels for advertising a range of tobacco products in the West. In the United States in 1968 the largest tobacco company, R.J. Reynolds, concentrated 80 percent of its advertising budget on television promotions, until a ban in 1971. In Britain, too, bans on television and radio advertising closed off these channels as direct forms of advertising. Direct advertising was not, however, the only form of tobacco promotion on television. Indirect advertising also occurred, particularly when the tobacco industry sponsored major sporting or cultural events. This strategy was commonly used to circumvent restrictions on television and radio advertising. During two state football finals in Australia in 1982, tobacco hoardings were on screen 1,412 times each for an average of 3.7 seconds. This amounted to 26.6 percent of total program time.

In the context of increased restrictions on tobacco advertising since the 1960s, indirect forms of advertising have flourished. One strategy that has allowed the tobacco industry to circumvent advertising bans is the practice of "brand-stretching" whereby tobacco-brand logos appear on nontobacco goods such as Camel boots and Salem holidays.

Whom Do Advertisements Target?

Pipe tobacco and cigars were firmly masculine products in the nineteenth century and remained so throughout the twentieth century. Tobacco advertisers therefore targeted men. The cigarette market was also conceptualized almost exclusively as male prior to World War I, although there were sporadic appeals to Western women smokers before 1918. In Britain, advertisements for mass-produced brands such as De Reske and Players targeted women as smokers from 1919. It was not until 1926 that a U.S. advertisement for a mass-produced brand addressed women as smokers, and not until 1927 that a woman was featured actually smoking. By the 1930s, North American advertising routinely featured women smoking cigarettes and even offering them to their male companions. In Australia, too, women smokers were regular features of cigarette advertising by this time. But although roughly one-quarter of all Australian cigarette advertisements included images of women between 1927 and 1937, only 6 percent focused exclusively on them. Since World War II, cigarette advertising has increasingly targeted women on a global scale.

Promotion of cigarettes outside Europe and North America began around 1900. China was the main foreign market for British American Tobacco and, in the early 1900s, cigarettes were promoted using out-door advertising, handbills, wall hangings, posters, and window displays. The global dimensions of cigarette advertising escalated dramatically after World War II. Latin America was targeted in the 1960s and the newly developed countries of Asia in the 1980s. Eastern Europe, territories previously in the USSR, China, and Africa were targeted aggressively in the 1990s. Tobacco brand advertising budgets were some of the largest of any product in countries such as Malaysia, Hong Kong, Kenya, Indonesia, and South China in the late 1980s. In many cases advertising was, and still is, unregulated.

The tobacco industry claims that its advertising does not target children. However, proportionately more ads were placed in U.S. women's and youth magazines between 1960 and 1985 than in those which targeted other groups of the population. In Britain in the 1980s, a study of magazines aimed at women and young people discovered that 58 percent with a readership predominantly under twenty-five years of age featured cigarette advertising, and that of those magazines whose numerically largest readership group was between fifteen and twenty-four years old, 93 percent carried cigarette advertisements. Young people were also being targeted in the 1980s in the new markets of Asia and Africa; for example, a group of teenagers breakdancing appeared in an advertisement on display in Malaysia. Scholars argue that direct advertising is not the only means by which young people are targeted by the tobacco industry. Representations of adult life can also be very appealing to teenagers: "Any marketer of products and services for adolescents knows that to appeal to youth, one needs to construct a campaign that looks as if it is a product for adults" (Chapman). An investigation into the advertising practices of the producers of Viceroy cigarettes in the 1970s revealed that young people were being deliberately courted by the American tobacco industry. Similar results emerged from an inquiry in 2000 into advertising for the U.K. tobacco industry.

Advertising Themes

National identity was a particular prominent theme in British pipe tobacco advertising around 1900 and included images of Queen Victoria, aristocrats, the military, aspects of British heritage and the British countryside. In Australia during World War I, themes of war, nationalism, and masculine identity were used to sell traditional forms of tobacco to men. In interwar Australia, where pipe and roll-your-own tobacco continued to surpass the sale of tailor-made cigarettes, advertisements emphasized masculine identity with stress on defending male space against female intrusion. Advertisements for cigars and pipe tobacco have continued to have male subjects and masculine themes.

Men and masculinities remained a staple of cigarette advertising. In interwar Australia, themes relating to male camaraderie and masculine anxieties were to the fore in the press. Cigarette advertising on Australian radio was also dominated by a series of masculine sea shanties. In the United States, most cigarette advertisements featured men even when women were targeted as smokers from the late 1920s. In Britain, too, men and masculinities were highly visible; indeed the most famous British icon was the sailor that appeared in advertisements for Player's cigarettes. Initially women were featured in tobacco advertisements to add a seductive element, but after 1920 they were increasingly visible as smokers in their own right.

Emancipation was a key theme in early cigarette advertising to British women. Women's liberation re-emerged in the late 1960s and 1970s as a theme in Western advertisements for "female cigarettes," most notably Virginia Slims: "You've come a long way, baby." Emancipation remained a prominent motif in 1980s and 1990s advertising to women in the former socialist countries of central and eastern Europe, plus Japan, Hong Kong, and Africa. Promising liberation as well as westernization to Hong Kong women in the 1980s, an advertisement for Virginia Slims declared, "You're on your way."

In advertisements, cigarette smoking has been associated with a high quality of life: health, leisure, pleasure, sexual attractiveness, affluence. Health and body issues were common themes in interwar advertisements targeted at Western men and women. Craven "A" cigarettes, for example, were marketed widely as "made especially to prevent sore throats." Smoking was also associated with feminine beauty and, in the United States, it was explicitly linked to slimness. Leisure has also been a prominent theme and from the 1930s companionate leisure often provided the context for smoking in advertisements in Australia, the United States, and Britain. Physical activity and the outdoors featured prominently in the 1930s as men and women smoked after a tennis match or while motoring together in the countryside. After World War II, joint leisure activities were more subdued and intimate; for example, bathing on a beach or relaxing by a roaring fire. A Western definition of the "good life" has remained a feature of much advertising to low and middle income countries; in the 1980s, a Fijian advertisement for Rothmans referred to a "great English tradition" while an Indian advertisement for Chesterfield's promoted "the smooth American experience."

From the 1960s, amid widespread publicity about the health risks of smoking, image became increasingly important to cigarette advertising, "not only because it was meant to confer its qualities on the smoker, but because it was designed to blind consumers to the true nature of what they were buying" (Taylor 1985). However, with the introduction of restrictions on tobacco advertising, advertisers have also been forced to rely less on featuring people and to make more inventive use of symbolism as in the 1980s campaigns for Benson & Hedges and Marlboro cigarettes. When advertising restrictions meant that the cowboy could no longer appear in Marlboro advertisements, Marlboro resorted to using the image of wild horses: "They knew that people would look at a pack of Marlboro and still see the cowboy" (Chapman).

Impact of Advertising

Concerns about children's exposure to tobacco advertising are underpinned by the belief that advertising is influential; this influence extends also to adults. Amid knowledge of the health risks of tobacco consumption, the tobacco industry has come under intense criticism for promoting smoking to new groups of potential smokers, especially children and women, and sustaining levels of consumption in established markets.

The influence of advertising is, however, strongly contested by the tobacco industry. The industry's position is that the sole purpose of advertising is to encourage smokers to change their allegiance to brands, and that advertising does not lead people to smoke or hinder their efforts to stop. The scholar Simon Chapman questions the veracity of this claim on three counts. First, all advertising seeks to maximize sales and even advertising industry workers are not convinced that the tobacco industry is any different. Second, advertising is used even in countries where the government has a monopoly on tobacco sales and where there is, therefore, no competition. Third, if advertising only influenced current smokers then it still follows that a ban on advertising may help reduce smoking.

Establishing a causal relationship between advertising and levels of smoking is not, however, straightforward. Methodological problems bedevil attempts to isolate and assess the influence of different types of advertising: "Unlike the effects of nicotine, advertising cannot be dosed and its effects observed physiologically" (Chapman). The reasons why people smoke are complex: "Tobacco advertising is . . . only one factor among many that appears to influence the decision to smoke. These include social, religious, parental, sibling and peer smoking behaviour and attitudes, price and disposable income, age limit proscriptions, measured intelligence and social class" (Chapman).

Isolating the significance of advertising for the promotion of smoking in the past is also difficult, as evident in the debate about the role of advertising in introducing Western women to cigarette smoking before World War II. The sociologist Michael Schudson argues that women did start to smoke prior to the first advertisements that targeted them and that news coverage of smokers helped in "the first instance to legitimise women's smoking"; advertising merely went on to reinforce and "naturalise" this practice (Schudson 1985). Others acknowledge that smoking had appeal for women prior to their direct targeting, but they argue that advertising "indirectly sought women smokers through images that emphasized the sociability and allure of the cigarette" (Brandt 1996). Cheryl Warsh points out that "cigarette advertising could have shaped women's views of what was masculine and therefore what would be an attractive aspiration for 'new women'" (Warsh 1998). Following the initiation of direct appeal to women in the United States, researchers argue, women's smoking increased at a faster rate than before.

Precise measurement of the effect, past and present, of tobacco advertising is elusive. It is, however, widely established that cigarette advertising contributes to a culture in which smoking is normalized and has a positive image. "Whether advertising initiates consumer trends or only reinforces them . . . it is impossible to ignore their wider role in providing people a general education in goods" (Schudson). Unattractive and negative ways of understanding smoking have often been suppressed by threats from the tobacco industry to deprive the media of advertising revenue. This threat is being eroded by the introduction of national bans on advertising. Studies indicate that a comprehensive set of tobacco advertising bans can reduce tobacco consumption, but that a limited set of advertising bans has little or no effect.

See Also Sponsorship.

▌ PENNY TINKLER

BIBLIOGRAPHY

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Brandt, Allan M. "Recruiting Women Smokers: The Engineering of Consent." Journal of the American Women's Association 51, nos. 1–2 (1996): 63–66.

Chapman, Simon. Great Expectorations: Advertising and the Tobacco Industry. London: Comedia Publishing Group, 1986.

Ernster, Virginia L. "Mixed Messages for Women: A Social History of Cigarette Smoking and Advertising." New York State Journal of Medicine (July 1985): 335–340.

Goodman, Jordan. Tobacco in History. The Cultures of Dependence. London: Routledge, 1994.

Greaves, Lorraine Smoke Screen: Women's Smoking and Social Control. London: Scarlet Press, 1996.

Hastings, Gerald, and Lynn MacFadyen. Keep Smiling, No One's Going to Die: An Analysis of Internal Documents from the Tobacco Industry's Main U.K. Advertising Agencies. Strathclyde: Centre for Tobacco Control Research, University of Strathclyde, 2000.

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Jacobson, Bobbie, and Amanda Amos. When Smoke Gets in Your Eyes. London: British Medical Association Professional Division, Health Education Council, 1985.

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Tinkler, Penny. "'Red Tips for Hot Lips': Advertising Cigarettes for Young Women in Britain, 1920–1970." Women's History Review 10 (2001a): 249–272.

——. "Refinement and Respectable Consumption: the Acceptable Face of Women's Smoking in Britain, 1918–1970." Gender & History 15, no. 2 (2003): 342–360.

Tyrrell, Ian. Deadly Enemies. Tobacco and Its Opponents in Australia. Sydney; University of New South Wales Press, 1999.

Warsh, Cheryl K. "Smoke and Mirrors: Gender Representation in North American Tobacco and Alcohol Advertisements before 1950." Social History XXXI, no. 62 (1998): 183–222.

snuff a form of powdered tobacco, usually flavored, either sniffed into the nose or "dipped," packed between cheek and gum. Snuff was popular in the eighteenth century but had faded to obscurity by the twentieth century.

cigarette cards paper trading cards sometimes featuring sports personalities or movie stars packaged with cigarettes and offered as an incentive for purchase.

ADVERTISING

As the cost of healthcare becomes an increasing focus of attention, advertising becomes an increasing object of concern. At its best, advertising can provide information to help consumers make informed choices. Conversely, it can also inflate expectations, create demand, manipulate desire, transform wants into perceived needs, and increase the use and cost of healthcare services. In the not too distant past, healthcare was understood as medical care. The activities of physicians were regulated by standards of ethics that eschewed commercialism. Though there has always been an economic aspect (usually a fee) associated with the physician–patient encounter, the revolution in the financing of healthcare delivery is transforming the personal doctor–patient relationship into a socially complex interaction in which physicians are cast among a multitude of providers, and patients are transformed into consumers. The focus on the economics of healthcare underscores the commercial aspects of healthcare delivery both by physicians and other providers. Though physicians and not-for-profit institutions should be responsive to a service ethic, they compete in the same economic arena as for-profit organizations and often behave similarly. Furthermore, in some cases the patients are not the direct consumers; services may be purchased by employers, alliances, the state, or other contracting entities, whose interests may not entirely coincide with those of patients.

Advertising may be judged by the standards of business ethics: truthfulness, nondeceitfulness, nonexploitativeness, and profitability. But healthcare is not strictly a commodity to be sold effectively with profit to the public. The care of health is also a fundamental human endeavor binding the caregiver and the care-seeker in mutually reciprocal ways. Otto E. Guttentag, noting the essential human quality of healthcare, defined medicine as "the care of health of human beings by human beings." Lawrence J. Nelson and colleagues argued in a 1989 article that several key features distinguish caring for the sick from other commercial products: (1) Patients are in a distinctive position of vulnerability and dependency on those providing the services; (2) their own self and destiny—even life—are at stake in the encounter with the provider; and (3) the relationship with the provider may become an important aspect of the healing encounter. All of these elements suggest that there are special obligations incumbent on healthcare providers that go beyond the usual obligations of the seller to the buyer of most commodities.

Traditional prohibitions against advertising attempted to orient professionals to their service obligations by minimizing the commercialization of the encounter (Relman). According to the traditional view, physicians and other professionals should obtain business by developing a reputation for quality service, getting referrals from satisfied patients/clients or from others who know their work, not through any kind of self-promotion.

The major ethical issue in advertising in a market economy is truthfulness. If given adequate information, the consumer should make appropriate choices: what kind of healthcare, where, when, provided by whom, at what cost. A larger question concerns the justice of a market system of choice based on individual self-interest. Proponents view advertising in healthcare as a way to promote competition and thus reduce cost in a highly regulated industry. Opponents criticize advertising for inflating expectations and thus increasing cost. Others suggest that the quality of care has been lowered by making cost rather than quality the focus of allocation decisions (Rodning and Dacso).

The high cost of healthcare in the United States has prompted a search for ways of reducing both the cost of medical services and the percentage of gross national product devoted to healthcare without appreciably lowering quality of care. Advertising is located at the crossroads between cost and quality, between regulated markets with an emphasis on quality and free markets with an emphasis on cost and choice. Regulations that provide standards for training, licensure, specialty certification, and hospital accreditation have resulted in high-quality, but expensive, healthcare. Market solutions, such as encouraging advertising to promote competition, have been seen as a way of reducing cost.

Historical Background

Physicians participate in markets, but traditionally orient themselves by ethical standards that go beyond economic behavior.

THE ORIGINS OF PROFESSIONALISM. Modern professional organizations, defined by their codes of ethics and regulating themselves by ethical principles, take their origin from the Aesculapian societies of the fourth century b.c.e. and in particular from the oath of the Greek physician Hippocrates, which bound its members to ethical standards that did not apply to society as a whole. The Hippocratic oath emphasized the principle of patient benefit, placing the patient at the center of the physician's attention.

By the nineteenth century, when the British Medical Association (BMA) and the American Medical Association (AMA) were founded, the concept of a profession organized around explicit standards of ethics was well established. Prohibitions against advertising were among the first professional standards because treatments based on scientific knowledge distinguished physicians from their main competitors, itinerant nostrum salesmen promoting often dubious products with even more dubious promotional claims. Advertising was expressly prohibited as unprofessional and undignified in virtually all countries in which physicians had established their professional identity through professional associations such as the BMA and AMA, which were organized around a code of ethics (Havighurst; Dyer, 1985). Although the actual license to practice is granted and regulated by the state, the task of enforcing the ethics codes falls to the professional associations or the specialty societies.

THE ANTITRUST CHALLENGE TO THE PROFESSIONS. The professions have always maintained a delicate balance between altruism and economic self-interest (Jonsen, 1990). As the medical profession became more scientifically effective and better organized, it enjoyed regulations (licensure, specialty certification, and accreditation) that guaranteed a virtual monopoly on healthcare delivery. Healthcare became synonymous with medical care. Although the Sherman Antitrust Act of 1890 banned monopolies, the learned professions were considered exempt from the act, which applied only to businesses. Late in the twentieth century, however, the business aspects of medicine began receiving increased attention, and the learned professions exemption ended in 1975 with the U.S. Supreme Court's Goldfarb v. Virginia State Bar decision, in which Virginia lawyers were found liable to charges of price-fixing the fees charged for title searches. The Goldfarb decision heralded a flurry of antitrust activity in the professional arena, most notably the 1975 suit by the Federal Trade Commission (FTC) against the American Medical Association, holding that the AMA was in restraint of trade because its code of ethics prohibited advertising. The AMA Principles of Medical Ethics then in effect (1957 version) said simply, "[A physician] shall not solicit patients," meaning that a physician should not attempt to obtain patients by deception. The 1980 revision eliminated all reference to advertising. Nonetheless, in the 1982 case Federal Trade Commission v. American Medical Association, the U.S. Supreme Court decided in favor of the FTC, barring the AMA from making any reference to advertising and the solicitation of patients, and further prohibiting the AMA from "formulating, adopting and disseminating" any ethical guidelines without first obtaining "permission from and approval of the guidelines by the Federal Trade Commission."

The FTC suit hinged on the questions of cost, advertising, and the mercantile aspects of medical practice. The position of the FTC was that costs were high because doctors had a monopoly on healthcare delivery and could thus maintain artificially high costs for their own profit. If doctors were not prohibited from advertising, it was argued, prices would come down because patients could shop for the best prices. In other words, medicine could better be controlled if it were regulated as a business rather than as a profession (Pertschuk).

The Ethics and Goals of Advertising

Advertising serves two very distinct and divergent objectives:(1) dissemination of information, and (2) product differentiation, which economists define as public perception of differences between two products, even though such differences may not in fact exist.

Dissemination of information provides the facts on which rational consumers can make informed choices. In healthcare, information about the services provided, location, hours of service, fees charged, and languages spoken are examples of services that might be advertised. Arguments in favor of advertising in healthcare are based on an understanding of advertising as dissemination of information.

Advertising also serves to differentiate products, and the methods for doing so are more ethically problematic. How can the claim be made and justified that one product is better than another? The FTC requires that any claims of product differentiation be empirically measurable. For example, in order to claim that a particular mouthwash "kills germs on contact by millions," it is necessary to be able to count killed germs. Usually advertisers attempt to differentiate products not on the basis of objective criteria about the product but by manipulating unconscious wishes and fantasies (such as youth, power, beauty, sex, and affluence), associating the product with images of attractive people in beautiful surroundings. The consumer is left to feel tremendous anxiety about the possible consequences of making the wrong choice of detergent, antiperspirant, or health plan.

Though many physicians have shown reluctance (or an aversion) to advertising their services, healthcare institutions have readily accepted the imperative to advertise in an attempt to create markets, capture market share, and find niches in the marketplace. Notable in this regard is advertising directed at target populations, for example, women, cancer patients, and those needing psychiatric and substance abuse services.

Truth in advertising was the concern when the field of advertising itself attempted to follow the course of professionalism in the early part of the twentieth century. At issue were the values that distinguished professional advertisers from retail-space merchants. The American Marketing Association established university training programs and codes of ethics that promoted the scientific ideal of detachment and statistical analysis. The scientific vision of community and definition of people as consumers replaced the older, empathic, and value-laden world in which a merchant understood what customers (not consumers) wanted and needed based on living in the same community (Christians, Schultze, and Simms; Schultze).

Professional advertising is illustrative because medicine's traditions of professionalism are derived from an era in which physicians participated in the life of the community in which they practiced. Knowledge of the patient as a person, as well as the patient's life history and social situation, has traditionally been deemed essential to quality care. At issue in 2003 for medicine is whether it will be possible to preserve the values of personal care that characterized the ideals of an earlier era.

The Commodification and Commercialization of Medicine and Medical Technology

Some aspects of healthcare are unquestionably commercial. The pills that only a doctor can prescribe are things, and a price must be attached to their acquisition. Hospital over-head becomes part of healthcare costs. Physicians' services (either for procedures or for time spent with a patient) involve a commercial aspect, though they are not just commercial. The locus of ethical decision-making shifts as the mechanism for financing shifts. Whereas physicians once made decisions on behalf of patients or with patients (according to principles of beneficence or autonomy), decisions are being made by corporations on behalf of populations or in the interest of reducing costs to populations. As this happens marketing of goods and services becomes an investment opportunity, not necessarily in the interest of conserving resources, but in the interest of creating capital for investors.

Medicine and medical technologies are increasingly considered in economic terms as commodities. It is fashionable to think of healthcare as an "industry," and as such the activities of the players—doctors and patients, providers and consumers, hospitals and healthcare organizations, equipment manufacturers and pharmaceutical suppliers—are seen in terms of market value rather than values deriving from a personal healing encounter. Value becomes a matter of money rather than a matter of conscience. It is the job of a market economy to distribute goods and services, bringing together consumers and products. Markets may be trusted to be free (laissez-faire) to the extent they do not violate their own frame of reference. Markets must be valued and controlled on their own terms, such as in the admonition, caveat emptor (let the buyer beware). But when vast public resources are involved, public oversight is also required. Deceptive or coercive marketing practices cannot be tolerated and require regulatory restraints on market freedoms.

DIRECT-TO-CONSUMER MARKETING. The growing trend of direct-to-consumer marketing needs to be evaluated in terms of the integrity of the information provided and the nature of the appeals made. Informed consumers make good partners in the healing relationships. Advertisements whose message is "Ask your doctor if this pill is right for you" provide little or no information about the product being promoted. Hair loss, impotence (erectile dysfunction), unhappiness, and sleeplessness are all subjects to be discussed with physicians and for which pharmacologic remedies may be expected. Once the expectation is created, it may be harder for the physician to assess risks (such as addiction liability) or side effects versus benefits, especially if a drug company has already courted the physician with gifts ranging from pens and notepads (bearing the name of a drug) to dinners (where "information" about products is offered) to vacations in expensive resorts.

The traditional way of mediating such claims is through scientific research, published in peer-reviewed journals. Consumers have access via the Internet to all sorts of information that does not receive such academic scrutiny. In the United States, federal regulatory agencies, such as the Food and Drug Administration (FDA) and the FTC, are charged with evaluating the research on which such claims are made. Yet much of the research is performed or funded by product manufacturers, and results that are unfavorable to the product may be suppressed, resulting in a publication bias in which only positive results are published and leading to a false (unscientific, but commercially advantageous) impression of the efficacy of a particular product (Otto et al.). Expensive high-technology screening tests (such as computed tomography scans for heart disease and cancer) are similarly promoted as educational information directly to consumers even though these tests' lack of specificity (resulting in false positives and negatives) causes physicians to question their value (Lee and Brennan). The ethical standard for judging such advertisements would be the truthfulness of the claims made. But presenting such appeals as informational when they are in fact promotional is a manipulation of demand, especially when the research on which such claims are made is not presented or, even worse, when it is skewed (Wolfe).

Several dramatic examples bring into mind the ethical constraints that might be necessary on advertising designed to create markets. Cosmetic surgery to improve a person's subjective sense of one's own beauty, for example, is medical in a way that is different from reconstructive surgery to repair a face damaged by an accident, although both involve similar skills and may be performed by the same plastic surgeon. Similarly (in an economic sense) assisted reproductive technologies, such as in vitro fertilization, may like other medical treatments relieve the distress of a childless couple, although the availability of such services is based more on the ability to pay than on need. The assisted reproduction industry commodifies the product, a human pregnancy, in ways that are more ambiguous ethically than they are commercially (Macklin and White). Technologies such as assisted reproduction along with the emerging genetic technologies, as well as more established technologies such as safe abortion, intensive care, and organ transplantation, help one to imagine limits on commercialization, advertising, and marketing (Dyer, 1997). As Allen Verhey noted in a 1997 article, "There are some boundaries and limits to the sphere of the marketplace. We do not want a market in which body parts are profitable; we prohibit the sale of organs, even those of the dead. We do not want babies sold at auction. Some things are not to be commodified and commercialized"(p. 135).

Conclusion

It could be debated whether advertising that goes beyond dissemination of information is ever ethical, though it is an accepted feature of market economies. The ethical issue for advertising is whether advertising is truthful and whether there can be objectively measurable standards for judging the truthfulness of advertising claims. A more problematic concern is the way in which advertising plays upon people's unconscious wishes and fantasies: sex, greed, and the quest for power, status, and perfection. The scientific basis for advertising rests on the ability to identify and manipulate such longings and fears. When one speaks of "the market" or "market forces" or "demand," one is generally talking about human wants and wishes.

Key questions facing the ethics of advertising in healthcare include:

• What standards or regulations should be in place concerning the placement of advertisements?
• Is any appeal legitimate so long as it does not mislead, make false claims, or actually harm?
• Is the negative portrayal of women in, for example, the promotion of unhealthful products such as tobacco or alcohol so morally offensive as to persuade the government to extend the scope of regulation of what is permissible in advertising, such as limiting advertising to dissemination of information?
• Is the effectiveness of the psychology of persuasion sufficient to justify advertisements, or can some higher principle be brought to bear?

Perhaps advertising itself should be subjected to the first principle of Hippocratic ethics, primum non nocere (first do no harm). Or to echo the caveat of President Dwight D. Eisenhower about the "military-industrial complex," beware the medical-industrial complex. Advertising that promotes consumer choice by providing information is consistent with the ethical ideal to promote patient autonomy. Advertising that deceptively promotes the interest of the provider at the expense of the consumer could not be ethically condoned, especially when the consumer is a patient.

allen r. dyer (1995)

revised by author

SEE ALSO: Harmful Substances, Legal Control of; Lifestyles and Public Health; Medicine, Profession of; Pharmaceutical Industry; Professional-Patient Relationship; Profit and Commercialism

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