BOB GARFIELD:
This is On the Media. I'm Bob Garfield.
BROOKE GLADSTONE:
And I'm Brooke Gladstone, with another reason why reading may be good for your health. We've all seen the lists of side effects listed in magazine ads for prescription drugs, but the ads for products that help people quit smoking should probably disclose one more side effect - just reading the ad may actually increase your chances of quitting.

A new study from Cornell University has found that just seeing the ads for antismoking products increases your chances of quitting, even if you never use the product. Alan Mathios, who coauthored the study with Rosemary Avery, Don Kenkel and Dean Lillard, says public health would improve if the patch-pushers pitched more.
ALAN MATHIOS:
The number that we come up with in our projection is that if the pharmaceutical companies increase their expenditures by 10 percent, we would generate about 80,000 extra quits each year.
BROOKE GLADSTONE:
Given the public service that these advertisements are providing, maybe the government should be subsidizing the ads, especially if they work against, in some cases, the actual profitability of the company.
ALAN MATHIOS:
That's actually a reasonable conclusion to make. [BROOKE LAUGHS] If many people are actually quitting without the use of these products, the ads are generating benefits to society that's not being incorporated into their profit. And so in some sense, these ads are doing exactly what the public health authorities try to do in their advertising, in their big campaigns to get people to quit.

So then one question is who's likely to be better at marketing these quit messages - pharmaceutical firms who are experts in marketing because they market a lot of products, or public health agencies that are sending messages? That's an interesting question as to who's going to be more effective.
BROOKE GLADSTONE:
All right. You've raised the question. I'm going to ask you to speculate on the answer. Are marketers for products more effective than marketers for good personal behavior?
ALAN MATHIOS:
When you see an advertisement for a smoking cessation product like Nicorette, there's sort of several messages embedded in there. First is the message that you should try to quit. The second message implicit there is that if you're having trouble quitting, there's technologies available to help you quit.

And so public health authorities are not likely to point out specific products. They're going to generate messages that say, just stop smoking. That extra information contained in the advertisements by pharmaceutical companies might be the difference as to why they're effective.

Now, we didn't do a direct comparison. What we've established is the smoking cessation ads by pharmaceutical companies are effective.
BROOKE GLADSTONE:
Can you give me an example about products addressing, say, another health problem?
ALAN MATHIOS:
Sure. For many years, the health claims for food products weren't permitted by the Food and Drug Administration. Health authorities and the Surgeon General were sending messages that consumers should increase the fiber in their diet.

And for years and years, those messages were incredibly unsuccessful. [BROOKE LAUGHS] Fiber content in the diet was not going up. And then the regulations changed so that firms could provide disease prevention claims and started a lot of advertising related to the fact that high fiber consumption is related to reduced risks of cancer.

When the market was saturated with those ads, it was then that we saw big behavioral changes and more people eating high-fiber cereals. And so it was instead of just saying fiber's good for you, actually saying fiber's good for you, here's why it's good for you and here are the products that contain a lot of fiber - that information together through advertising seemed to engender the behavioral change that the simple message, just increase your fiber consumption, was not able to achieve.
BROOKE GLADSTONE:
So when it comes to regulation, it sounds as if it would be better if there were less rather than more on these ads.
ALAN MATHIOS:
What's truly ironic in the market for smoking cessation products is print ads for cigarettes with a full-page ad, and in the corner is one of four rotating Surgeon General warnings about the dangers of cigarettes. But it's a pretty small warning.

If you see an ad for a smoking cessation product that's still a prescription-only drug, not only do you see the ad, but turn the page in the magazine and you'll see an entire full page of fine-print disclosure talking about the risks of using the smoking cessation product.

So we've created a regulatory asymmetry here where it's actually much more expensive to advertise a smoking cessation product if it's prescription-only compared with selling a cigarette.
BROOKE GLADSTONE:
Do you think that the results from your study could be applied to other health issues?
ALAN MATHIOS:
Yeah. Well, one of the big ones right now is statin drug advertising. Statin drugs are the pharmaceutical products that reduce cholesterol in the blood and are shown to be very effective in doing that.

One role of advertising is to get consumers to think that they may have high blood cholesterol and get them to the physician. One of the instructions to physicians, however, is that before you prescribe these drugs, they should also recommend therapeutic lifestyle changes, such as more exercise, and diet.

And because of the recommendations to do diet and exercise before prescribing, one of the impacts of advertising, if they get people to see their physician, might be the spillover effects to more positive behavioral changes independent of using the drugs.
BROOKE GLADSTONE:
That's the bright side. The dark side of these prescription drug ads is that it creates anxiety within people to go get themselves treated for things that don't need to be treated - you know, like toenail fungus, which apparently is not a big problem but it's a nice expensive drug you get to take every day for six months in order to cure it.
ALAN MATHIOS:
Direct-to-consumer advertising, actually quite controversial, and I recognize that. In fact, New Zealand and the United States are essentially the only two countries that allow direct-to-consumer advertising of pharmaceutical prescription drugs.

This is really a question of how well is the physician a gatekeeper to the process. The pharmaceutical companies send representatives to physicians' offices talking about their drugs, giving free samples of their drugs, those types of things. That effort dwarfs the DTC advertising expenditures.

And so, in the end, the physicians monitoring the system is essentially what we have to depend on, whether we allow direct-to-consumer advertising or not.
BROOKE GLADSTONE:
Well, thank you very much.
ALAN MATHIOS:
Thank you, Brooke.
BROOKE GLADSTONE:
Alan Mathios is interim dean for the College of Human Ecology at Cornell University.
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