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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 October 13; 335(7623): 778.
PMCID: PMC2018824
Review of the Week

Selling health the Tesco way—every little helps?

Reviewed by Petra M Boynton, lecturer in international health care research

Can health promotion messages be pushed withlearn from the same techniques that Tesco and McDonald's use? Petra Boynton examines a new book on the subject

Before you left the house this morning or on your journey to work you'll probably have experienced social marketing in the form of advertisements for everything from fast food to fast cars. Some of these messages may even affect your future behaviour from where you shop to what you buy.

The influence of advertising has long been a source of debate and concern, with plenty of research indicating negative causal effects of advertising messages on health. Rather than follow this path, Hastings' book promotes the use of techniques similar to those used by advertising and public relation agencies to influence social and health behaviours. The text will teach you how you can use the same approaches as big corporations and advertising agencies to influence how your patients understand and act on health information.

Initially I was skeptical sceptical about this claim. It reminded me of the old saying “you can't take down the master's home with the master's tools.” I wondered whether we should be fighting against the influence of consumerism rather than what might be seen as colluding with it.

Fortunately that's not what Hastings is advocating. His text takes you through the theory behind social marketing (in particular, stages of change and social, cognitive, and exchange theories). This is refreshing in an area where ideas are often not underpinned by evidence.

Hastings outlines the basic principles behind social marketing, and throughout the text there are exercises to help you consider questions that arise. For example, you are asked to consider why established corporations like McDonald's are so successful or to consider how pharmaceutical companies promote their products to doctors—and what research questions you might ask to delve into how and why these approaches work. Through each chapter you are guided with strategies for completing social marketing, so by the end of the text you have a clearer understanding of how you might apply the ideas for yourself.

Many aspects of social marketing are controversial: the chapter dedicated to the ethics of working in this area includes how and when you deliver key messages—and what to do when your messages are in conflict with those of other stakeholder groups.

Case examples at the end of the text show social marketing at work in campaigns to combat everything from cutting speeding to promoting healthy eating. The case studies show that social marketing has been particularly effective in smoking cessation programmes. The book includes global case studies to indicate that social marketing isn't confined to Western audiences or client groups.

Though the book shows us how we can combine research with marketing approaches, it does not go far enough in challenging how commercial organisations are also blurring research and advertising. Today, public relations campaigns fill our daily media with junk mathematical formulas, suspect surveys, and other promotional activities that lead to consumers being misled about science and being taught to mistrust health messages.

Although the social marketing pundits have cleverly learnt to turn advertising to their advantage, the public relations industry is already a step ahead. The book does little to advise on how we might challenge the PR industry's advantage—or how to ensure that research using social marketing techniques doesn't get lost in the sea of publicity stories that wash up on journalists' desks every day.

Hastings opens with the concept “if it's good enough for Tesco,” but as we know there are major problems with the ethics, activity, and environmental and consumer impact of such industries. So for some readers, copying techniques without challenging core problems may sit uneasily with their political outlook and may make it difficult for them to apply the theories in the text. That would be a shame, as the book is undoubtedly useful if you work in health promotion and education and are interested in finding new strategies for health interventions and evaluations. It gives a clear overview of a technique that you and your patients may find invaluable.

If you are struggling to find ways to help your patients give up smoking, use contraception, eat more healthily, exercise regularly, or manage their health more effectively, Social Marketing could give you some useful ideas on how you might reach people with key messages. At least, you'll have a greater understanding about how other more dominant messages in advertising are affecting your patients' health and wellbeing. In ad speak: it's a win-win situation.

You can use the same approaches as big corporations and advertising agencies to influence how your patients understand and act on health information


Social Marketing: Why should the Devil have all the Best Tunes?

Gerard Hastings

Elsevier, £24.99, pp 392

ISBN 978 0 7506 8350 0

Rating: ***

Articles from The BMJ are provided here courtesy of BMJ Publishing Group