The effect of the implementation of the international code of marketing of breast-milk substitutes on child mortality in Ghana and Tanzania.

OBJECTIVE: The International Code of Marketing of Breast-Milk Substitutes is an important instrument to protect and promote appropriate infant and young child feeding and the safe use of commercial milk formulas. Ghana and Tanzania implemented the Code into national legislation in 2000 and 1994, respectively. We aimed to estimate the effects of the Code implementation on child mortality (CM) in both countries. SETTING: The countries analysed were Ghana and Tanzania. PARTICIPANTS: For CM and HIV rates, data from the Institute for Health Metrics and Evaluation from up to 2019 were used. Data for income and skilled birth rates were retrieved from the World Bank, for fertility from the World Population Prospects, for vaccination from the Global Health Observatory and for employment from the International Labour Organization. DESIGN: We used the synthetic control group method and performed placebo tests to assess statistical inference. The primary outcomes were CM by lower respiratory infections, mainly pneumonia, and diarrhoea and the secondary outcome was overall CM. RESULTS: One-sided inference tests showed statistically significant treatment effects for child deaths by lower respiratory infections in Ghana (P = 0·0476) and Tanzania (P = 0·0476) and for diarrhoea in Tanzania (P = 0·0476). More restrictive two-sided inference tests showed a statistically significant treatment effect for child deaths by lower respiratory infections in Ghana (P = 0·0476). No statistically significant results were found for overall CM. CONCLUSION: The results suggest that the implementation of the Code in both countries had a potentially beneficial effect on CM due to infectious diseases; however, further research is needed to corroborate these findings.

Mechanism Linking Cigarette Pack Factors, Point-of-Sale Marketing and Individual Factors With Smoking Intention Among School-Going Adolescents.

CONTEXT: Tobacco usage accounts for one of the most preventable causes of death. OBJECTIVE: This study aimed to explore mechanisms linking cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study conducted among 6 urban secondary schools. A pretested and validated self-administered questionnaire was used. Data analysis for structural equation modeling was done using SMART-PLS v3.2.8. MAIN OUTCOME MEASURE: The main outcome measure was to determine the direct and indirect effects of cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents in a theory-based model. RESULTS: A total of 386 adolescents fulfilling the inclusion criteria participated. Pictorial warning message reactance (ß = .153, P  ≤ .001), pack receptivity of conventional pack (ß = .297, P  = .004), and psychological reactant trait (ß = .174, P  ≤ .001) were positively related to smoking intention. Pictorial warning negative affect (ß = -.153, P  = .001) was negatively related to smoking intention. The psychological reactant trait was positively related to message reactance (ß = .340, P  ≤ .001). However, recall exposure to point-of-sale marketing and pack appraisal of conventional pack was not positively related to smoking intention (ß = .038, P  = .22 and ß = -.026, P  = .39, respectively). Pictorial warning message reactance also positively mediates the relationship between psychological reactant trait and smoking intention (ß = 0.05, p = .001). The model has strong predictive power. CONCLUSION: In conclusion, cigarette pack factors and psychological reactant traits are essential in predicting smoking intention. Hence, policymakers should consider these factors in developing smoking policies.

Ecological Momentary Assessment of Alcohol Marketing Exposure, Alcohol Use, and Purchases Among University Students: Prospective Cohort Study.

BACKGROUND: The relationships between alcohol marketing exposure, alcohol use, and purchase have been widely studied. However, prospective studies examining the causal relationships in real-world settings using mobile health tools are limited. OBJECTIVE: We used ecological momentary assessment (EMA) to examine both the within-person- and between-person-level effects of alcohol marketing exposure on any alcohol use, amount of alcohol use, any alcohol purchase, and frequency of alcohol purchase among university students. METHODS: From January to June 2020, we conducted a prospective cohort study via EMA among university students in Hong Kong who reported current drinking. Over 14 consecutive days, each participant completed 5 fixed-interval, signal-contingent EMAs daily via a smartphone app. Each EMA asked about the number and types of alcohol marketing exposures, the amount and types of alcohol used, and whether any alcohol was purchased, all within the past 3 hours. We used 2-part models, including multilevel logistic regressions and multilevel gamma regressions, to examine if the number of alcohol marketing exposure was associated with subsequent alcohol use and alcohol purchase. RESULTS: A total of 49 students participated, with 33% (16/49) being male. The mean age was 22.6 (SD 2.6) years. They completed 2360 EMAs (completion rate: 2360/3430, 68.8%). Participants reported exposure to alcohol marketing in 5.9% (140/2360), alcohol use in 6.1% (145/2360), and alcohol purchase in 2.4% (56/2360) of all the EMAs. At the between-person level, exposure to more alcohol marketing predicted a higher likelihood of alcohol use (adjusted odd ratio [AOR]=3.51, 95% CI 1.29-9.54) and a higher likelihood of alcohol purchase (AOR=4.59, 95% CI 1.46-14.49) the following day. Exposure to more alcohol marketing did not increase the amount of alcohol use or frequency of alcohol purchases the following day in participants who used or purchased alcohol. At the within-person level, exposure to more alcohol marketing was not associated with a higher likelihood of alcohol use, amount of alcohol use, higher likelihood of alcohol purchase, or frequency of alcohol purchases the following day (all Ps>.05). Each additional exposure to alcohol marketing within 1 week predicted an increase of 0.85 alcoholic drinks consumed in the following week (adjusted B=0.85, 95% CI 0.09-1.61). On days of reporting alcohol use, the 3 measures for alcohol marketing receptivity were not associated with more alcohol use or purchase (all Ps>.05). CONCLUSIONS: By using EMA, we provided the first evidence for the effect of alcohol marketing exposure on initiating alcohol use and purchase in current-drinking university students. Our findings provide evidence of the regulation of alcohol marketing for the reduction of alcohol use and purchase among young adults.

Supplemental Nutrition Assistance Program issuance timing is associated with sugar-sweetened beverage marketing in the USA.

OBJECTIVE: Prior research has shown that there are more supermarket displays of sugar-sweetened beverages (SSB) during times when Supplemental Nutrition Assistance Program (SNAP) benefits are distributed ('issuance periods'). This may contribute to inequitable purchasing and consumption. This study examines whether SSB marketing in weekly supermarket circulars, which retailers use to advertise products, is more prevalent during issuance periods compared to non-issuance periods. DESIGN: We conducted longitudinal, difference-in-differences analyses of data extracted from weekly supermarket circulars of randomly selected SNAP-authorised retailers in six states. Analyses tested whether SSB advertisements ('ads') were more prevalent during SNAP issuance periods compared to non-issuance periods within states with distinct issuance periods (3, 5, 10 or 15 d), compared to one state with continuous benefit issuance (28 d; the 'control' state). SETTING: Weekly online supermarket circulars collected from August to September 2019 were analysed in 2021. PARTICIPANTS: The study sample included 5152 circulars from 563 SNAP-authorised retailers in the states California, Connecticut, Nebraska, New Jersey and Texas (distinct issuance period states) as well as Florida ('control' state). RESULTS: The estimated mean percentage of beverage ads classified as SSB ads during issuance days was 51·5 % compared to 48·4 % during non-issuance days (P < 0·001). In difference-in-differences analyses comparing to the 'control' state with continuous issuance, SSB ad counts were 2·9 % higher (95 % CI 1·9 %, 3·9 %) during SNAP issuance relative to non-issuance. CONCLUSIONS: SSB ads are slightly more prevalent in weekly supermarket circulars during SNAP issuance periods. Future research should explore the linkages between circular ads and SSB purchasing and consumption.

Offense and defense between streamers and customers in live commerce marketing: Protection motivation and information overload.

While live commerce provides consumers with a new shopping experience, it also leads them to experience shopping failures and to develop a self-protection mechanism to prevent wrong purchases. To address this issue, merchants have attempted to explore new marketing methods for live commerce, giving rise to an offense and defense game between streamers and consumers. In this study, we sought to confirm the effectiveness of consumer protection mechanisms and the impact of streamers' information overload marketing strategy in live commerce. Accordingly, we constructed a hypothetical model based on protection motive theory and information overload theory. In addition, we analyzed the data from the simulated live streaming marketing on seven hundred people through partial least squares structural equation modeling. The results indicate that product utilitarian value uncertainty, consumers' experiential efficacy, and response costs, which are the main factors in the formation of consumer protection mechanisms, influence consumers' intention to stop their purchases. Streamers can circumvent consumer self-protection mechanisms through information overload marketing by reducing utilitarian value uncertainty and consumers' experiential efficacy and increasing consumers' response costs. However, consumers would be able to rebuild their self-protection mechanism through consumer resilience, which moderates the effects of information overload. This study's results provide important theoretical perspectives and new ideas for formulating marketing strategies for live commerce.

Perceptions of Food Marketing and Media Use among Canadian Teenagers: A Cross-Sectional Survey.

Despite the prevalence of digital food marketing to teenagers and its potential impact on food preferences and consumption, little is known about the specific food advertisements teenagers see in Canada and how they perceive them. Further, few studies consult teenagers directly about their perceptions of teen-specific food marketing content. To shed light on such issues, this study examines perceptions of food marketing and self-reported media use of Canadian teenagers via an online survey. Four hundred and sixty-four teenagers (ages 13-17) participated. Overall, teenagers identified Instagram and TikTok as the most popular social media platforms. The top food or beverage brands that teens felt specifically targeted them were McDonald's, Starbucks, Coca-Cola and Tim Hortons, while Instagram was deemed the most important media platform when it comes to teen-targeted food marketing. Teens deemed "celebrity" and "visual style" as the most important (food and beverage) advertising techniques when it comes to persuading teenagers to buy. Overall, the study provides insights into teen media use and brand preference, including the brands teens feel target them most directly and what they consider to be salient in terms of the food advertising they see. It also provides valuable details for researchers seeking to further identify and measure elements of teen-targeted food marketing.

Investigating the relationship between stereotyping and creativity during marketing campaigns in marketeers and audiences.

Stereotyping others in a creative process may negatively affect creative output, yet there is currently scant empirical evidence of a link between stereotyping and creativity; here, we explore this link in marketing communications. In a quasi-experiment, we introduced a novel intervention to disrupt marketeers' dependency on stereotypes and boost their creativity. The intervention decreased marketeers' use of stereotypes when selecting consumer labels-descriptive labels of a typical consumer based on consumer information-while enhancing the creativity of ideas. In another set of online experiments, we asked British residents to rate the creativity of advertisements and purchase intentions toward advertising products with different levels of stereotypical depictions of people. We found a linear relationship between the stereotypical depictions of people in advertisements and perceived creativity. We also observed a potential U-shaped relationship between stereotypical representations of people in advertisements and purchase intention, such that advertisements with low and high stereotypical representations induced greater purchase intention than did those with medium stereotypical representations. Finally, we discuss the psychological mechanisms that potentially link stereotyping and creativity and the implications for marketing communications.

Nigerian adolescents' exposure to fast food marketing via Instagram.

OBJECTIVES: To explore the promotion of fast food to lower-income adolescents on Instagram with the specific aims of (i) identifying the marketing strategies used by fast food brands on Instagram to promote fast food to Nigerian adolescents and (ii) examining the influence of these strategies on user engagement. DESIGN: A content analysis of posts from a 90-day period of the Instagram accounts of five fast-food brands in Nigeria was conducted. Overall, 576 posts were analysed, using a codebook developed based on the relevant literature, to identify adolescent-targeted strategies. User engagement was measured by number of likes each post received. RESULTS: The observed brands frequently utilised adolescent-targeted marketing strategies, with the most popular strategies being emotional appeal, 'teen language' and product appeal. The results of Mann-Whitney U tests revealed significant associations between the use of these promotional strategies and user engagement. Adolescent-aimed strategies like product appeal and competitions resulted in higher user engagement with fast food promotional content. CONCLUSION: Fast food companies heavily target lower income adolescents through the use of Instagram. This raises health concerns related to the consumption of unhealthy food that arises from regular advertising in that demographic. Further, this exposure increases ad interactions that could cause adolescents to view fast foods more positively. Overall, findings indicate the need for actions aiming to limit and reduce the effect of adolescents' exposure to fast food marketing on social media, to target the features of social media platforms which affords users the ability to interact with fast food advertisements.

Understanding mediated sports consumption by Irish children: a qualitative study exploring their exposure and understanding of gambling marketing, risks and harms.

BACKGROUND: Gambling marketing communications create a public health risk by increasing the normalisation of gambling in sports. In a context where broad level studies report significant underage gambling, currently no evidence exists on how these communications are received by children in the Republic of Ireland (hereafter Ireland) and Northern Ireland. To build this evidence base and provide granular detail below broad level data, this study explored the sport consumption habits and views of Irish children (aged 14-17 years) on their exposure, awareness and perceptions of the relationship between sport and gambling. METHODS: Drawing on a constructivist approach to data collection, 6 face-to-face focus groups were staged with a total of 51 youth sport consumers from both sides of the border region on the island of Ireland. RESULTS: Four main themes were established. First, mediated sport consumption was predominantly via mobile social media. Second, we found that their exposure to gambling marketing was high and while frequently seen through social media channels it was also prevalent in peer-to-peer conversations and on the main street. Third, we found mixed responses on their perceptions about gambling and sport. While many felt that sport and gambling were a good fit, they were aware of the financial risks involved. Few children understood the wider social risks with gambling harm. Fourth, children were sceptical of claims made in gambling communications. These findings highlight concerns about how exposure to gambling marketing is impacting children's views on sport and on gambling. These views need to be taken into consideration when broadcasters and sport organizations are entering into commercial associations. CONCLUSIONS: Gambling marketing is noticed by children watching mass and social media, and in the towns in the border regions of the island of Ireland. Our study provides children's viewpoints on this topic which complements the larger quantitative studies in Ireland and Northern Ireland that highlight the growing prevalence of children and gambling. This study not only extends the literature on the exposure, awareness and perceptions of children on the island of Ireland but provides crucial evidence to public health advocates in this region demonstrating the pervasiveness of gambling communications in and around children's spaces.

IQOS point-of-sale marketing: a comparison between Arab and Jewish neighborhoods in Israel.

BACKGROUND: Philip Morris International's IQOS, with its heatsticks (HEETS), is the heated tobacco product with the largest global market share. IQOS and/or electronic cigarettes use rate is higher among Arabs vs. Jews in Israel. This paper aims to compare IQOS point-of-sale marketing strategies, and regulatory compliance in Arab vs. Jewish neighborhoods in Israel. METHODS: We integrated data from two separate studies including a cross-sectional survey with IQOS retailers (December 2020-April 2021) and audits of points-of-sale that sold IQOS/HEETS (April 2021-July 2021) in 5 large cities in Israel, after marketing restrictions including a points-of-sale display ban and plain packaging became effective in Israel (January 2020). The survey included 69 points-of-sale (21 Arab, 48 Jewish neighborhoods) and the audits included 129 points-of-sale (48 Arab, 81 Jewish neighborhoods). Comparisons of IQOS marketing strategies between points-of-sale in Arab and Jewish neighborhoods were conducted using Chi-Square test, Fisher's exact test or Mann-Whitney test, as appropriate. Thematic analysis was used to analyze open-ended questions. RESULTS: The survey showed that most marketing strategies, such as promotions to customers, were uniform across points-of-sale in Arab and Jewish neighborhoods. The most noteworthy differences were that a higher proportion of retailers from Arab neighborhoods were invited to IQOS parties (47.6% vs. 21.7%, p < 0.05) and reported personal communication with a Philip Morris International's representative (80.0% vs. 51.2%, p < 0.05). Additionally, Philip Morris International's representatives assisted points-of-sale in both Arab and Jewish neighborhoods in implementing the display ban by providing free compliant cabinets and product placement instructions, and directly interacted with customers. The audits showed that points-of-sale in Arab neighborhoods were more compliant with the display ban (25.5% vs. 8.8%, p < 0.05), but less compliant with plain packaging (62.5% vs. 79.3%, p < 0.05). CONCLUSIONS: There were not many notable differences in IQOS marketing across points-of-sale in Arab vs. Jewish neighborhoods, but Philip Morris International utilized marketing elements of cultural significance, especially for points-of-sale in Arab neighborhoods, such as more personal communication and invitation to social events. Continuous surveillance of tobacco points-of-sale marketing and legislation compliance is needed, with a special focus on demographic/location-based differences.

Who is being targeted by alcohol social media marketing? A study of Chinese young adults in Hong Kong.

INTRODUCTION: Due to the widespread use of social media by young adults, the alcohol industry has been increasingly using social media marketing (SMM) to target potential customers. This study examines the prevalence and factors associated with past-month exposure to alcohol SMM among young Chinese adults, a group with rapidly increasing uptake of alcohol consumption. METHODS: An anonymous, random telephone survey was conducted between June and August 2021 on Hong Kong Chinese residents between 18 and 34 years old (n = 675). RESULTS: Of respondents, 52.3% reported past-month exposure to alcohol SMM (68.6% of past-month drinkers and 48.0% of non-past-month drinkers, p < 0.05) while 71.6% reported exposure to non-SMM alcohol marketing. Direct alcohol SMM exposure was reported by 40.9% (e.g., business-to-consumer postings, alcohol banner ads) while 27.4% of respondents reported exposure to indirect alcohol SMM marketing (e.g., shared/'liked' alcohol brand posts). Of those exposed to alcohol SMM, 13.7-15.5% reported that the various forms indirect alcohol SMM influenced them to drink more (vs. 6.2-8.9% for direct alcohol SMM). Being male, lower-income, university educated and spirits/cocktail drinker were independently associated with exposure to direct alcohol SMM (ORmv 1.71-3.14). Past-month exposure to indirect alcohol SMM was independently associated with lower income, not working full-time and drinking any type of alcohol (ORmv 1.59-4.44). DISCUSSION AND CONCLUSION: The comparative effectiveness of indirect SMM on influencing young adults drinking intentions may be a form of peer endorsement of drinking. The pervasiveness of alcohol SMM and lack of alcohol SMM policies may indicate the need for greater alcohol marketing regulation in this region.

No- and low-alcohol beer and the sponsorship of sport in Australia: An audit of sponsorship partnerships and analysis of marketing tactics.

INTRODUCTION: Alcohol sponsorship of sport is associated with increased alcohol consumption. Little research to date has examined the sponsorship of sport by no- and low-alcohol (NoLo) beverage brands, despite concern that the marketing of these products might be harmful to young people. This study had dual aims: to identify sporting partnerships between NoLo beers and Australian sport, and examine marketing tactics used in social media advertising to promote these partnerships. METHODS: Our sample included NoLo beers sold online from three large Australian alcohol retailers. First, we performed a qualitative content analysis of partnerships between NoLo beers and sport using publicly available online information. We then analysed the 118 social media posts of NoLo brands linked to these partnerships using a coding framework adapted from the alcohol literature. RESULTS: Of 34 brands, 13 had sporting sponsorship partnerships across a range of spectator and participatory sports. Key marketing tactics identified on social media were activations, time-and event-specific drinking, influencer marketing, competitions, and corporate social responsibility. In particular, NoLo brands aim to disrupt the sports drink market by advertising their products as healthy recovery drinks, or 'sports beers', through activation events. Brands are also using influencer marketing and competitions, two tactics shown to be particularly persuasive for young people. DISCUSSION AND CONCLUSIONS: NoLo beer brands strategically align with Australian sports to promote NoLo consumption. As they are classified as soft drinks in Australia, NoLo beverages are not regulated like alcohol. Future discussions around sports sponsorship and advertising regulation must consider NoLo products.

A rapid literature review of the effect of alcohol marketing on people with, or at increased risk of, an alcohol problem.

AIMS: To explore the effect or potential effect of alcohol marketing in people with an alcohol use disorder, in recovery from an alcohol use disorder, and hazardous and harmful drinkers. METHODS: Relevant literature was identified by searching Medline (OVID), EMBASE (OVID), and PsycINFO (OVID) and relevant websites. Both quantitative and qualitative studies were eligible for inclusion. A narrative approach was used to synthesize the findings. RESULTS: The review included 10 studies. Two quantitative and three qualitative studies focused on participants recovering from an alcohol use disorder and five quantitative studies on those with hazardous or harmful consumption levels of alcohol. The effect of alcohol advertising on alcohol use was only assessed in one study, a small experimental study of young adult heavy drinkers, which found no significant association. Studies looking at other outcomes found that people with or at risk of alcohol problems were likely to notice alcohol advertisements and find them appealing, and that advertisements may have an effect on positive alcohol-related emotions and cognitions. Among people in recovery from an alcohol use disorder, findings suggested that there could be an effect on craving, and that alcohol marketing may be perceived to trigger a desire to drink. CONCLUSIONS: Alcohol marketing is likely to have an effect on alcohol consumption in people with, or at increased risk of, an alcohol problem. Studies have also found that alcohol marketing is perceived to act as a trigger by people in recovery from alcohol problems. SUMMARY: A rapid review explored the effect of alcohol marketing in people with an alcohol use disorder, in recovery from an alcohol use disorder, and hazardous and harmful drinkers. The findings of the 10 included studies suggest that an effect of alcohol marketing in these populations is likely.

Child and adolescent exposure to unhealthy food marketing across digital platforms in Canada.

BACKGROUND: Children and adolescents are exposed to a high volume of unhealthy food marketing across digital media. No previous Canadian data has estimated child exposure to food marketing across digital media platforms. This study aimed to compare the frequency, healthfulness and power of food marketing viewed by children and adolescents across all digital platforms in Canada. METHODS: For this cross-sectional study, a quota sample of 100 youth aged 6-17 years old (50 children, 50 adolescents distributed equally by sex) were recruited online and in-person in Canada in 2022. Each participant completed the WHO screen capture protocol where they were recorded using their smartphone or tablet for 30-min in an online Zoom session. Research assistants identified all instances of food marketing in the captured video footage. A content analysis of each marketing instance was then completed to examine the use of marketing techniques. Nutritional data were collected on each product viewed and healthfulness was determined using Health Canada's 2018 Nutrient Profile Model. Estimated daily and yearly exposure to food marketing was calculated using self-reported device usage data. RESULTS: 51% of youth were exposed to food marketing. On average, we estimated that children are exposed to 1.96 marketing instances/child/30-min (4067 marketing instances/child/year) and adolescents are exposed to 2.56 marketing instances/adolescent/30-min (8301 marketing instances/adolescent/year). Both children and adolescents were most exposed on social media platforms (83%), followed by mobile games (13%). Both age groups were most exposed to fast food (22% of marketing instances) compared to other food categories. Nearly 90% of all marketing instances were considered less healthy according to Health Canada's proposed 2018 Nutrient Profile Model, and youth-appealing marketing techniques such as graphic effects and music were used frequently. CONCLUSIONS: Using the WHO screen capture protocol, we were able to determine that child and adolescent exposure to the marketing of unhealthy foods across digital media platforms is likely high. Government regulation to protect these vulnerable populations from the negative effects of this marketing is warranted.

"It's changing our lives, not for the better. It's important that we have a say". The role of young people in informing public health and policy decisions about gambling marketing.

BACKGROUND: Marketing has a significant impact on the normalisation of gambling for youth across the globe. This has included shaping positive attitudes towards gambling, as well as increasing the social and cultural acceptance of gambling - particularly aligned with valued activities such as sport. Because of this, public health experts argue that gambling marketing poses a significant risk to the health and wellbeing of youth. While young people are increasingly exposed to, and impacted by marketing for gambling products, they are rarely consulted about policy issues and options. This study aimed to explore young Australians' perceptions of current policy responses to gambling advertising, whether they thought young people should be involved in discussions and decisions about gambling marketing regulations, and their perceptions of the duty of governments to protect young people from gambling industry marketing strategies. METHODS: Qualitative focus groups (n = 22) were held with n = 64, 12-17 year olds in the Australian states of Victoria and New South Wales. Participants were asked to reflect on current gambling policies, particularly relating to marketing, what they thought should be done about gambling marketing, and if and how young people should be included in public health responses to gambling. An interpretivist 'Big Q' approach to reflexive thematic analysis was used. RESULTS: Young people highlighted the need for more effective regulations around the content and frequency of gambling marketing. They also wanted to see more realistic representations of the negative impacts of gambling to counter persistent positive commercial marketing messages. Most thought that young people should be given an opportunity to have a say about responses to gambling due to their unique experiences. Participants identified mechanisms to increase young people's engagement in decision making, such as direct lines of communication to different levels of government, involvement in research, and diversifying ways of engagement. Specific recommendations included more regulatory action such as bans on gambling advertising. CONCLUSIONS: Creating formal structures that facilitate the inclusion of young people's perspectives in decisions made about gambling can result in more innovative and effective strategies to prevent the harms from gambling industry products, promotions, and practices.

Effects of bitten food images in marketing communications.

Marketing communications (e.g., food packages, restaurant menus, coupons, social media posts) often include images of bitten and non-bitten (i.e., complete) foods. Taking an empirics first approach, the current research explores how and why these images influence consumers. A field study shows a higher redemption rate for discount coupons featuring a bitten (vs. non-bitten) food. However, a controlled online study fails to replicate this effect. Two additional preregistered studies shed light on the inconsistent results observed online and in the field by identifying two competing mechanisms catalyzed by bitten food images. Bitten food images lead to vicarious enticement, an automatic process in which a viewer makes sense of a bitten food image by picturing someone approaching and tasting the food, as well as emotional conflict (i.e., the simultaneous activation of positive and negative thoughts and feelings). While vicarious enticement has a positive impact on product responses, emotional conflict has a negative impact. The effect of bitten (vs. non-bitten) food images on product responses appears to depend on the strength of these two mechanisms in a given context. These findings yield insights for researchers examining visual characteristics of food images as well as advertisers designing marketing communications.

Understanding parents' perceptions of children's exposure to unhealthy food marketing in digital and retail environments.

Unhealthy food and non-alcoholic beverage marketing (UFM) adversely impacts children's selection and intake of foods and beverages, undermining parents' efforts to promote healthy eating. Parents' support for restrictions on children's exposure to food marketing can catalyse government action, yet research describing parent concerns is limited for media other than television. We examined parents' perceptions of UFM and their views on potential policies to address UFM in supermarkets and on digital devices - two settings where children are highly exposed to UFM and where little recent research exists. We conducted in-depth interviews with sixteen parents of children aged 7-12 from Victoria, Australia, analysing the data thematically. Parents perceived UFM as ubiquitous and viewed exposure as having an immediate but temporary impact on children's food desires and pestering behaviours. Parents were concerned about UFM in supermarkets as they viewed it as leading their children to pester them to buy marketed products, undermining their efforts to instil healthy eating behaviours. Parents generally accepted UFM as an aspect of contemporary parenting. Concern for digital UFM was lower compared to supermarkets as it was not directly linked to pestering and parents had limited awareness of what their children saw online. Nevertheless, parents felt strongly that companies should not be allowed to target their children with UFM online and supported government intervention to protect their children. While parents supported government policy actions for healthier supermarket environments, their views towards restricting UFM in supermarkets varied as some parents felt it was their responsibility to mitigate supermarket marketing. These findings could be used to advocate for policy action in this area.

The Effect of Cigarette Content Marketing on Students' Smoking Behavior and Decisions: A PLS-SEM Approach.

OBJECTIVE: This research aims to analyze the influence of cigarette content marketing on student behavior, and on cigarette purchasing decisions, as well as the influence of behavior on cigarette purchasing decisions. METHODS: This research is quantitative, using a sample of 500 smoking students from twelve universities in the city of Medan, Indonesia, who were selected using a simple random sampling technique. Data collection was carried out by distributing questionnaires that had been tested for convergent validity with an Outer Loading value > 0.7 and an AVE value > 0.5, and for discriminant validity with an HTMT value < 0.9. The data was analyzed using a multivariate analysis technique which combines factor analysis and regression analysis. RESULTS: The research results show that the t-statistical value for the behavioral variable (BHV) is 4.128 (> 1.98) and the p-value is 0.000 (< 0.05), which means that the BHV variable has a significant effect on the cigarette purchasing decision variable (PD). The t-statistical value for the content marketing (CM) variable is 27.57 (> 1.98) and the p-value is 0.000 (< 0.05), which means that the CM variable has a significant effect on the BHV variable. The t-statistical value for the CM variable is 18,542 (> 1.98) and the p-value is 0.000 (< 0.05), which means that the CM variable has a significant effect on the PD variable.  93.2% of respondents admitted that they had seen cigarette marketing content on social media, many of them (43%) believed that smoking was detrimental to their health, but the most influential factor was their perception regarding the activity of smoking. CONCLUSION: Cigarette marketing content has been proven to influence students' behavior towards cigarettes, as well as directly influencing their decision to purchase cigarettes. Students' behavior towards cigarettes also influences their decisions in purchasing cigarettes.

Associations of educational and marketing messages with beliefs about nicotine and reduced nicotine cigarettes.

INTRODUCTION: Widespread misperceptions about nicotine may have unintended effects on public health. We examined associations between existing messages about nicotine or tobacco and beliefs about nicotine and reduced nicotine cigarettes (RNC). METHODS: 2962 U.S. 18-45-year-olds were randomized in a May 2022 web-based survey to view one of 26 text-based messages about tobacco or nicotine from three sources: ongoing research (n = 8), messages authorized by FDA for VLN cigarettes (n = 6), and FDA's "From Plant to Product to Puff" campaign (n = 12); six messages from FDA's campaign did not reference nicotine and were treated as the reference source. Analyses examined associations between messages, grouped by source and individually, with beliefs about nicotine and RNC addictiveness and harms. RESULTS: Relative to FDA messages that did not reference nicotine, all message sources were associated with greater odds of a correct belief about nicotine (Odds Ratios [ORs] = 1.40-1.87, p's < 0.01); VLN messages were associated with greater correct beliefs about RNC addictiveness (b = 0.23, p < .05). No campaign produced greater correct beliefs about RNC harms. At the individual level, only five messages were associated with a correct belief about nicotine (ORs = 2.12-2.56, p-values < .01), and one with correct beliefs about RNC harms (b = 1.09, p < .05), vs. the reference message. CONCLUSIONS: Few existing messages improved understanding of the risks of nicotine separately from the risks of combustible products. Communication research is needed to promote greater public understanding of nicotine while minimizing unintended effects on nicotine and tobacco use.