"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Friday, March 15, 2013

‘Fatsmack’–A Health Marketing Campaign That Will Fail

I worked in the field of Social Marketing for over 40 years, and in fact was one of the originators of the discipline.  The USAID-CARE Nutrition Communications Campaign carried out in India in 1970 was based on the assumption that modern advertising and marketing techniques could be applied to social programs. “If you can sell soap, you can sell nutrition”, we said, and set out to conduct extensive market research on consumer behavior, preferences, fears, and expectations; use an international, India-based advertising company to design and create the campaign; produce a range of media from the most modern, especially Bollywood film, to the most traditional and community-based.

Our project helped launch the discipline of Social Marketing which continues to this day, and for that result alone it was successful; but it was singularly unsuccessful in changing nutritional behavior.  Why?

1. Selling consumer products – the bread and butter of the commercial marketing industry – is very different from altering deeply rooted behavioral practices.  A consumer in the United States runs very little risk changing from Coke to Pepsi, since the cost relative to income is insignificant.  Asking a poor, rural farmer living on the margins to change the fundamental practice of his life – eating – is very, very different indeed.

2. Advertising campaigns are considered a success if they influence market share by a fraction of a percent; and they invest hundreds of millions of dollars to do so.  Social marketing campaigns aim at changing basic, life-altering behavior budgets that would be laughable on Madison Avenue.

3. USAID wanted results now, and the project cycle for our campaign as most State Department development projects today, was three years.  Any social researcher, social psychologist, or serious marketer knows that behavior change, other than from changing soft drinks, takes years.  Change must move from new adopters, outliers who will try anything, to the more conservative and wealthier middle, and finally to the masses.  The more deeply-held the belief, the harder it is to change and the longer it takes.

4. Media alone can never change deeply-held beliefs or traditional practices.  A behavior change campaign must consider positive and negative reinforcement through taxes (e.g. tobacco purchase is price sensitive and the higher the tax, the lower the consumption), monetary incentives, or legislation.

I have followed the course of Social Marketing over the years and have found few if any projects which have succeeded largely because of failure to consider the factors listed above. 

Jason Hayes, writing in The Atlantic (Fatsmack – What It Takes To Make Health Campaigns Stick, 3.15.13) limns the praises of social marketing to effect dietary change, especially the use of non-health strategies to convince consumers to eat better.  This idea has been around a long time, and was the organizing principle around which we built and executed our early India campaign.  Advertising is based on the notion that image is everything, and that if you can sell cars and cigarettes based on sex and allure, why not social behavior?  The problem is to find what particular image will be successful.  This is not so easy, for the choices are almost limitless. Anti-smoking campaigns tried for years to get kids to kick the habit by talking about stained teeth, bad breath, and stinky clothes.  Nothing worked, for these negatives were far outweighed by the positive appeal of cool and sexy.

The one idea that did work (in the Florida ‘Truth’ Campaigned cited by Hayes) focused on teenagers’ rebellious anti-capitalism.  Don’t bother to talk about health or breath, advertisers argued, but convince adolescents that every dollar spent on cigarettes would go in the pockets of fat cat corporate devils.  It worked; but it worked only because some smart marketer looked at the reams of data about adolescents and happened to connect random thoughts about capitalism and link them to smoking.  The data were not self-evident.  There were no obvious clues that this was the link that would work. It was the insight of one person on the creative team. This type of insight cannot be codified, reproduced, or bottled.  Even in the coming days of Big Data someone will have to ask the right questions, know what to look for, and come up with a reasonable hypothesis in order to organize, synthesize, and interpret the information generated.

Obesity is a far more complex behavioral issue than smoking because there are so many variables which affect it.  For one thing, obesity is highly correlated with low income.  People with little disposable income can only afford cornmeal and fatback, the occasional McDonald’s, and quart of ice cream.  They cannot afford health clubs, are too tired after a long day at a boring job to jog or bicycle.  Their low levels of functional literacy (the US average is now approaching a startling twenty percent) and education close them off from rational examination of nutrition labels, risk, and rewards. 

Food has a fundamental psychological dimension.  People eat not just to survive but to derive pleasure, reduce boredom, and to add some small measure of diversity and excitement to otherwise humdrum lives.

Studies have shown that thin people living in a fat people environment will tend towards the norm – i.e., they gain weight.  America is a nation of fatties, and with them as an example, it is very difficult for a normally-sized teenager to refuse another helping of fries.

The Fatsmack campaign does not seem promising.  The author recounts being on the subway and checking out a poster along with his fellow riders:

I would wager most of us recognized the "Fatsmack" poster, which featured a startled black teenager from the chest up, getting the equivalent of an open hand slap in the face by a viscous, orange glob of fat. The model in the ad was carelessly dapper and drank a generic beverage labeled "sports drink." The poster, part of a citywide Boston Public Health Commission (BPHC) social marketing campaign, is meant to decrease sugary beverage consumption. But ever since the Fatsmack campaign began in September 2011, all I could do was question whether the ads would work -- can chortles create change?

Who came up with this idea and why? What is there in the literature that suggests that this particular humorous idea – getting hit by a glob of fat while you are sucking down a sugary drink – will get anything more than silly laughs.  At first glance the poster defies traditional and successful advertising logic – it must say everything in the image and be understood at first glance.  This poster makes no sense at all unless you read the text, and even then the message is not immediately crystal clear.

This is not surprising.  The market research was done by amateurs unfamiliar with and with no access to the big data tools and limitless financing of commercial advertisers:

In order to create a teen-appropriate message, BPHC logically hired the help of teenagers: the Youth Media Counsel was paid by the hour to provide guidance on the campaign. BPHC wanted something that would stand out to teens. "It had to be eye-catching and we had to make something that had the ability to go viral," said Yanik Ruiz-Ramon, Fatsmack's Multimedia Producer.

Where Fatsmack struggled was their budget. A corporate marketing campaign pays for focus groups, pilot projects, and market segmentation to develop an ad specifically for the target audience. This process can be expensive and, as the Fatsmack website points out, companies like Coca-Cola will spend billions for ads annually. Ruiz-Ramon and the Fatsmack crew, on the other hand, had only $100,000 for development, production, and distribution.

The chances of success are slim.  Taking on one of the most complex issues of human behavior – food and eating – is not a job for beginners. 

Perhaps most importantly, addressing obesity may not be a job for advertising at all.  The US currently indirectly contributes to obesity by subsidizing corn and potatoes.  If such government support were to stop and subsidies transferred to fresh fruits and vegetables, maybe we would see a difference.  If high enough taxes were levied on junk foods, demand would certainly decline.  If graduation from high school was contingent on a demonstrated understanding of food, nutrition, health risk and their attendant variables, perhaps teenagers might think twice about eating glop. If schools were forbidden from selling soft drinks and snacks, the education might bite.

If cities abandoned their resistance to big box stores like Walmart and thought more about consumers than small shop-keepers, then low-income shoppers would have a wide variety of healthy foods at moderate prices.   These are but a few of the ideas bandied about in our desperate search for solutions.  Some are reasonable but not politically acceptable.  Every change in food legislation, any promotion of consumer protection, is challenged by the Food Industry.  I have written about these and other difficulties in my recent blog post Obesity – We’re In It For The Long Haul http://www.uncleguidosfacts.com/2012/05/obesitywere-in-it-for-long-haul.html and I am not very hopeful of any progress any time soon.

Health food practices do trickle down from the wealthy to the middle-class.  Marketers have capitalized on the low-fat trend started by educated professionals and such products are available to all; but true to form these marketers have skirted every rule and legislation to make products seem low fat and low calorie without actually being so. Statistics show that although people have made adjustments to their diet, responding to food fads and pseudo-nutrition, the number of calories consumes still continues to rise.

Reducing obesity rates means confronting and dealing with many complex underlying causes – poverty and poor education; government subsidies; powerful food lobbyists; psycho-social demand for gratifying food; and many more. Recently Dr. Richard Kessler, former head of the FDA, wrote a book about physiological dependence on salt, sugar, and fat – a dependency deeply-rooted in our caveman past.  The Dorito corn chip, according to Kessler, is the perfect marketers’ food.  Even the most disciplined among us cannot resist the salty, tangy, slightly sweet, filling crunchiness of this beautiful chip.  If we are hardwired into Doritos, then woe is us.

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