Expert Commentary

Ads work. Two studies show what this means for public health

Two new studies show how advertising can help promote healthy or unhealthy behaviors.

man looking at ads

People who were exposed to public health ads online were more likely to search for health-related information in the future, a new study in npj Digital Medicine finds.

The study, executed by a researcher at Microsoft, two directors at the advertising firm J. Walter Thompson and a professor of health policy at Columbia University, involved the development and display of ads that promoted exercise and healthy eating.

The research consisted of 2,996 experimental participants and a control group of over 500,000. To be included in the study, people had to be using the Bing search engine while logged into a Microsoft account. They also had to have looked up keywords related to weight during the month-long trial.

Searching these terms triggered the experiment: some participants were randomly subjected to the predesigned wellness ads along with their query results. The control group received the usual ads delivered through the search platform. The researchers then looked at both groups’ prior and subsequent search queries.

They found that 48 percent of people shown the targeted ads searched for weight loss information later, compared with 32 percent of people in the control group. They didn’t find that any particular ad campaign was more effective in eliciting future weight loss-related searches, but exposure to multiple targeted ads increased the chance of a search for weight loss information by 11 percent.

The researchers write that searching for health behaviors is linked with executing these behaviors in everyday life. Online advertisements thus offer the added opportunity “to systematically target users with advertisements to which they are most susceptible, thereby eliciting behavior change.”

“There is a leap here, in the sense that we think that search correlates to behavior in the physical world,” said Elad Yom-Tov, lead author of the study and a principal researcher at Microsoft, in a phone interview with Journalist’s Resource. However, he added, there is evidence to suggest that is indeed true.

The paper concludes, “We show that it is not only technically possible to launch an online campaign that effectively improves health behaviors, but also that corporations that promote an unhealthy diet or a sedentary lifestyle can potentially be outbid or outmaneuvered.”

Another new study shows that corporations are in fact successfully promoting unhealthy behaviors through their own targeted campaigns, both in email and physical mail. A forthcoming study in Tobacco Control looks at the associations between mailed or emailed tobacco coupons and smoking behaviors.

The researchers analyzed survey data collected at two time points over two years from more than 26,000 respondents across the United States. The survey asked respondents about their demographics, smoking history and whether they had received tobacco coupons.

They found that these mailings were targeted to adults with lower educational attainment and of lower socioeconomic status, regardless, for the most part, of whether they were smokers.

Among people who had never smoked, receipt of coupons was associated with increased odds of starting smoking. People who were merely experimenting with smoking who received the coupons were more likely to become established smokers, and non-daily smokers were more likely to become daily smokers. Smokers who received the coupons were also less likely to quit after six months than those who did not.

Moreover, they targeted vulnerable populations: those who were less-educated and less-affluent.

“Our analyses corroborate prior research that demonstrates disproportionate targeting of women and vulnerable populations by the tobacco industry’s use of discount coupons. Female smokers, and individuals of lower SES (defined by education and poverty level in this study), were more likely than those of higher SES to report that they received tobacco direct mail/email coupons,” the authors write.

They conclude, “Our findings, together with previous studies, further support an urgent need for prohibiting tobacco direct mail/email coupons.” They suggest that banning the practice might lessen smoking-associated health disparities.

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