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Environmental advantage: marketing the messages. (Spheres of Influence).

Does seeing a milk mustache on a child make you think of the slogan Got Milk? Do fried eggs remind you of the 1987 This Is Your Brain on Drugs ad? In addition to leaving lasting memories, such ads have convinced some who see them to modify their behavior, studies show. And that is the hope of the increasing numbers of organizations that are now starting to use marketing as a means of disseminating their messages about environmental health.

The Ad Council, a private group in New York that is one of the biggest promoters of public service ads, which basically is advertising in the public interest, including both paid and free ads. The Ad Council has studied the impact of its own work; before-and-after surveys show that public service ads do change behavior. For example, the council found that one year of public service advertising about colon cancer increased the percentage of men who spoke to their doctors about their risk for the disease by 43%.

Environmental and public health groups first discovered the value of such ads back in 1970. That's when the Washington, D.C., advocacy group Environmental Defense (ED)--then called the Environmental Defense Fund--ran an ad in The New York Times (NYT) warning about the dangers of DDT in breast milk. The ad showed a mother breastfeeding her child. The caption stated that if her milk were sold in interstate commerce, the Food and Drug Administration (FDA) would ban it because of its high concentration of DDT.

"A lot of people saw the ad, and it hit a nerve, and they donated or became a member of [the Environmental Defense Fund]," says Robert Harris, associate director of the group's toxic chemicals program from 1973 to 1979 and cofounder of the environmental consulting firm Environ International Corporation in Princeton, New Jersey. The ad brought in enough money to enable the group to launch a national fight against DDT.

The use of eye-catching, prominent, and expensive ads by environmentalists seems to be growing, says Lois Gibbs, executive director of the Center for Health, Environment & Justice, a public interest group in Falls Church, Virginia. As Michael Replogle, transportation director at ED, says, "Strategic communications and message development is something that the environmental community is getting better at."

"There's definitely been an increase in paid public service ads," says Ellyn Fisher, manager of corporate communications at the Ad Council. "There was a time when we had no competition," she says. "Now more organizations are seeing the importance of public communications and the impact of ads, and so they are putting more resources into it." The increase in ads is in part due to a sense of frustration in the environmental community that the mainstream media has not paid enough attention to their issues, says one advertising expert who asked to remain anonymous.

It's not just environmentalist groups that are seizing the medium to get their messages out. Other stakeholders that have entered the advertising world include the government and academic groups. For example, the NIEHS runs public service announcements on U.S. network and cable television stations. The latest ones, begun this summer, target young families and discuss environmental pollutants at home.

Controversial CCHE Ads

One of the most extensive advertising campaigns ever done to promote environmental health ran this summer in the NYT. Between June 6 and August 15, a total of seven ads appeared in the newspaper, giving readers full-page lessons in the dangers to children of toxic chemicals in the environment. The ads warned of the link between exposure to toxicants and learning disabilities, cancer, and reproductive system abnormalities. The government needs to assess the health effects of chemicals, including mixtures of chemicals, the ads stated. They also urged parents to keep their children away from dangerous chemicals in their homes and to buy organic produce when possible.

The ads also appear in the October 2002 issue of the Columbia Journalism Review, which is a cost-effective outlet for reaching journalists, says Philip Landrigan, director of the Mount Sinai School of Medicine Center for Children's Health and the Environment (CCHE). He developed the ads, along with colleagues Herbert Needleman of the University of Pittsburgh, Lynn Goldman of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and Michael McCally of the Oregon Health & Science University in Portland. McCally was co-director of CCHE, the titular sponsor for the ads, when they were developed.

The ads focus on the most important health effects--including learning disabilities, endocrine disruption, and cancer--known to have chemical causes, says Landrigan. He says the group decided to run the ads because "there's been sufficient progress made in the pediatric community on children's environmental health that it was time to bring to the attention of the press and policy makers what we now know. There needed to be an effort to present the most recent health-related science and to draw conclusions from it for journalists, policy makers, and the public."

The scientists hired Fenton Communications, a public relations firm, to create the ad series. The Rockefeller Family Fund (RFF) provided $400,000 for the campaign, including $315,000 to run the ads. RFF funds programs that promote a variety of issues, including economic justice for women and environmental concerns. It had supported Landrigan's work in the past and was happy to do it again, says Lee Wasserman, executive director of RFF. "We think the issues in the ads have not been given the attention they deserve," he says. He further asserts that public policy debates on these issues have been highly influenced by people who have direct financial interest in the use of chemicals.

The ads refer readers to the CCHE website (, where they can find articles written for a lay audience about the research papers, including articles from EHP, that support the ads' claims. The site also includes the names of 36 researchers who endorse the ads. According to Landrigan, hits on the CCHE website increased more than 10-fold after the first ad ran, from less than 100 hits per day to more than 1,000. He also says that he and his colleagues met with journalists and members of editorial boards during the ad campaign to explain the research findings that support the ads, to underscore the importance of the central messages of the campaign, and to suggest that editors need to pay more attention than they have to children's environmental health.

The ads do indeed reflect scientists' frustration with not being able to get out the story on environmental health risks to children, agrees Philip Lee, a consulting professor of human biology at Stanford University and former assistant secretary of health at the U.S. Department of Health and Human Services. He praises the ads, saying they are "well done, not overstated."

The New York Times or Good Housekeeping?

Some environmental health advocates argue that ads must reach a consumer audience to be effective. Landrigan and colleagues chose the NYT as the first carrier for the CCHE ads because it's a national paper read by many journalists and policy makers. Landrigan would have liked to run the ads in more newspapers and magazines to reach a broader audience, but the project didn't have enough money, he explains.

Environmental health advocates also assert that ads should include strong recommendations for what readers can or should do--a call to action. Many activists believe the CCHE ads were not purposeful enough, says Charlotte Brody, executive director of Health Care Without Harm (HCWH), a coalition of 300 groups in 27 countries organized to reform the health care industry. "But in time," she predicts, "the CCHE series will prove to have been worth the resources." She adds, "It's unpopular to say this"--because of the sentiment that the ads should have been more action-oriented--"but I thought they were terrific."

The ads are "extraordinary in the sense that they really catch what's going on and put out information on health risks," says Gibbs. At the same time, "I'm not convinced that how we make change is through people who read the NYT, "she says. She argues that corporate CEOs, professionals, and, to only a small extent, policy makers read the NYT, so it is useful primarily in educating those professionals. "I'd take those same ads and put them in Ladies' Home Journal and Good Housekeeping, or in Trout Unlimited and focus on fish and men's fertility," she says--since some chemicals found in fish impair fertility.

The role of scientists, however, is not necessarily to advocate a cause, says McCally. Instead, he says, their role is to review, evaluate, and interpret science in ways that may be helpful to public decision making. In addition, Lee notes that foundations have legal restrictions on how much advocacy work they can fund, so informational ads may get more financial backing.

Gibbs's group has twice placed ads in national newspapers, and both focused on specific issues. One ran during the 1996 presidential race, when Hillary Clinton was campaigning for her husband in Pensacola, Florida, which was home to a neighborhood contaminated by hazardous waste. CHEJ ran an ad in USA Today calling on President Clinton to evacuate citizens from the area, and the media repeatedly asked Mrs. Clinton about the neighborhood. Two days later it was evacuated.

Not all ads do work, of course. In June 2000 CHEJ ran its second ad, on dioxin, in the Washington Post, timed to appear with the release of a U.S. Environmental Protection Agency (EPA) draft reassessment of the health impact of the chemical. The ad asked, What are you having for breakfast? and featured a picture of eggs and bacon, because 90% of the general public's exposure to dioxin comes through food, particularly meat and dairy products, says Steve Lester, science director at CHEJ.

The ad campaign was unsuccessful, however. "We were hoping it would move policy makers to take action on the federal level, and it didn't do that," Gibbs says. The reasons for its lack of success were varied, she says. For one, the ad didn't really answer the question that consumers and policy makers ask when faced with a problem: what do you do about it?

Second, for activist ads to succeed, they need to be part of a well-organized campaign, and that was not the case here, she says--CHEJ doesn't have the Washington lobbyists needed to make a campaign like that work. Third, she says, the ad upset some allies of the group, including organic farmers, who try to make their products free of chemicals but can't do anything about dioxin. Finally, the Chlorine Chemical Council ran a more extensive series of ads that Gibbs says "basically stole the show." Those ads promoted the benefits of chlorine, but were not a direct rebuttal of the CHEJ ad.

Reaching All Audiences

One problem with general interest, sports, and women's magazines is that their ad space costs more because the publications have a longer shelf life, explains Brody. But sometimes, when you're lucky, an ad in the NYT gets free publicity in those popular publications.

For example, HCWH, the Environmental Working Group, and Coming Clean--all public interest groups--ran an ad in the 11 July 2002 NYT warning consumers about phthalates in beauty products such as perfume, nail polish, and deodorants. The chemical, which softens plastic and is used, for example, to keep nail polish from peeling and flaking, can impair human development and reproduction, according to the National Toxicology Program.

The groups became interested in doing the ad campaign after reading an article by Benjamin C. Blount and colleagues in the October 2000 issue of EHP, which reported that women of reproductive age had the highest concentrations of a particular phthalate metabolite of any of the age/sex groups studied. They hired a national laboratory to test 72 beauty products and found that almost three-fourths of the products, including all of the perfumes, contained phthalates.

In the ad, a pregnant woman is smelling perfume. Sexy for her, the ad states. For baby, it could really be poison. The ad refers readers to a website ( that suggests how to take action on the issue--for example, by writing to legislators. "Our ad was tied directly to taking action," notes Brody.

Self magazine, The Wall Street Journal, the Los Angeles Times, the London Daily Mail, Agence France-Presse, and Canada's National Post, along with a whopping 342 television stations did take action, running pieces on the controversy over phthalates, says Stacy Malkan, communications director at HCWH. The ad was even spotted on MTV, she says. By the end of August, the online version of the beauty products ad had received its one-millionth hit, says Arlie Schardt, president of Environmental Media Services, a Washington, D.C.-based environmental and public health news outlet.

The ad was one component of a three-month, $150,000 campaign, which was paid for by an anonymous foundation. The campaign included a report on the dangers of phthalates that cites the group's own study, FDA and EPA studies, and eight EHP research articles. They are now planning outreach efforts to cosmetic companies and to women's health organizations, says Brody.

Taking out an ad in a prestigious newspaper makes an organization look legitimate, says Brody. "The fact that you have the money to run the ads makes the world take you more seriously," she says.

Success with Rejection

Some environmental health campaigns succeed even when their ads fail. As part of its campaign to have the arsenic removed from pressure-treated wood, the Healthy Building Network (HBN) produced a full-page advertisement, also in conjunction with Fenton Communications. HBN, a Washington, D.C.-based coalition of builders and environmental and health advocates, opposes the sale of wood treated with chromated copper arsenate because the arsenic leaches out of the wood and can cause lung, bladder, and skin cancer in humans, explains Paul Bogart, campaign coordinator for the HBN. [See "Caution--Children at Play: How Dangerous Is CCA?" EHP 109:A262-A269 (2001).] Zoos have banned its use, but Home Depot and other large lumber stores still sell the wood.

The ad, which appears on the HBN website (, shows a monkey and a boy, each playing on a jungle gym. The copy reads, If arsenic-treated wood is too toxic for zoo animals, why does Home Depot think it's safe for your kids?

HBN tried to sell the ad last summer to regional newspapers in the suburbs of Washington, D.C., Boston, Denver, and elsewhere. All but a few papers in the Denver and San Francisco areas refused to run the ad, asserting that its claims could not be supported or that the ad was inappropriate, says Bogart. They did not approach the NYT because they had a limited budget of about $20,000, he says.

However, their rejection got them more attention than the ads. Professional Builder, a trade magazine for contractors, ran an article about the ad, and included the picture. "That was an audience we could only dream of reaching," says Bogart. In addition, a wood treater in Wisconsin faxed the ad to about 10,000 people in the industry. The ad never reached the intended consumers, but word got out anyway. The campaign, which included a report on the amount of arsenic that is in wooden playsets and retail lumber, began in April 2001. Eight months later, industry announced it will phase out chromated copper arsenate in wood for residential uses by 31 December 2003.

The Opposition

Some activists argue that money spent on ads should go instead to grassroots organizations. But Gibbs disagrees. "Putting all the money in Pensacola [into] organizing a local campaign wouldn't have made the difference," she says. "It's the ad that worked."

While environmentalists and health activists may debate the merits of different advertising styles and strategies, some public health groups and industry representatives are coming down hard on the content of some recent ad campaigns. "We were disappointed with the alarmist nature of the CCHE ads," says Jeff Stier, associate director of the American Council on Science and Health, a New York advocacy group closely associated with the chemical manufacturing industry.

For example, Gilbert Ross, medical director for the council, says the ads suggest there is an epidemic of brain cancer, when in fact it may just be a case of better detection and changes to the way malignant tumors are classified, according to research published in the 2 September 1998 issue of the Journal of the National Cancer Institute. In reply, Landrigan notes that the rate of brain cancer has continued to increase, even after the new imaging equipment and other changes discussed in the fact sheet had been in use for a long time. "If increased sensitivity to detect disease had been the sole cause of the observed increase," he says, "the incidence should have risen temporarily and then returned to baseline.... In fact, however, in the fifteen years since wide adoption of new imaging techniques, the incidence rate has continued to rise."

Stier adds that studies published in "a legitimate science publication," such as the New England Journal of Medicine (NEJM), don't need paid advertisements to get press coverage. In addition to defending the scientific legitimacy of their claims, Landrigan and others say that many important epidemiology and toxicology findings get published in journals that simply don't have the promotional budget of NEJM. As a result, they don't get covered by the press. In addition, says Landrigan, "The NYT ads were intended for a different audience than NEJM readers."

Despite their differences over many environmental and public health issues, industry and environmentalists once joined forces to run an ad campaign of their own. ED and the American Chemistry Council, which represents 180 chemical manufacturers, placed ads in February 2000 in USA Today, Congressional Quarterly, and other Washington, D.C., publications to encourage companies to join in a voluntary program to review data on chemicals produced in quantities greater than 1 million pounds annually. The proof of that campaign's success lay in whether chemical companies would join in the program, says Tom Gilroy, a senior director at the council, "and that's exactly what happened."

Whether future environmental health advertising campaigns will be successful depends on a number of factors, but it seems clear that environmental and health groups are learning a basic tenet of marketing: before you can get people to change, you have to get their attention.
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Author:Adler, Tina
Publication:Environmental Health Perspectives
Date:Oct 1, 2002
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