Intended for healthcare professionals

Mixed Messages

Whatalotwegot—the messages in drug advertisements

BMJ 1994; 309 doi: (Published 24 December 1994) Cite this as: BMJ 1994;309:1734
  1. R E Ferner, consultant physician Anglia and Oxford Regional Health Authority, Oxford OX3 7LFa,
  2. D K Scott, principal pharmacista
  1. aCity Hospital NHS Trust, Birmingham B18 7QH
  1. Correspondence to: Dr Ferner.

    Advertisers are increasingly using symbols to circumvent logical argument when trying to persuade people (the “targets” of the advertisement) to make choices that are not strictly rational. Symbols can convey covert meanings and awaken or exploit subconscious feelings, such as a desire for power or a fear of doing harm. Some of the ways in which pharmaceutical advertisements use these techniques are examined: advertising by contagion; adding to our worries; polarity of choices; teasers; idealisation. Rational prescribing should be based on logic, but advertisements do not depend on logical arguments for their most powerful effects: the advertisers may subvert us by appealing to our unconscious desires.

    Readers of medical journals are “targets” for drug advertising, an important part of drug marketing. The pharmaceutical industry spends around £300m on marketing each year in the United Kingdom, and studies suggest that the money is well spent, since marketing undoubtedly influences the way that doctors prescribe.1 2

    Science requires the unambiguous description and logical analysis of facts. This is not the purpose of advertising, which shares with art the use of oblique visual and verbal images to convey the message it wants us to receive.3 The advertiser tries to influence our feelings and alter our perceptions and so persuade us to change our actions. We may believe that our actions are dictated by logic, but a large body of advertising theory holds that we are more strongly motivated by subconscious needs and wants, which advertising should exploit. These subconscious motives include a longing for control over the chaos of daily life; a wish to allay anxieties about our professional, social, and intellectual standing; and a need for reward. Dichter, an early advocate of motivational research in advertising, called this “the strategy desire.”4 Prescribing driven by advertisements predicated on this strategy …

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