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Science

Healthy Skepticism

Artwork by Julia Thouas

 

Health advertising, like any other advertising, is meant to be compelling. Health ads may promise to fix anything and everything, to entice you to hand over exorbitant amounts of money. Adverts for health products and services, however, come with an extra proviso: they not only have a financial influence over consumers but dangerously sway community perceptions around healthcare.

Like me, you may remember this unfortunate billboard (pictured) or its more explicit companions from when you were just old enough to vaguely understand what it meant. Due to this insensitive advertising, provocatively preying on the fears of men, the Advanced Medical Institute pocketed several millions selling their shonky products and services. AMI was receiving 7,000 calls a week allowing for thousands of clients to be locked into deceptive contracts for products that were not only ridiculously marked-up, but scientifically ineffective compared to mainstream medications. Whilst the Advertising Standards Bureau banned the billboards in 2008 (acting on an influx of complaints), only recently was the entire AMI charade legally unmasked. In 2015, AMI was charged with unconscionable conduct in the Federal Court against the ACCC (Australian Competition and Consumer Commission) and ordered to halt advertising and providing services.

You would think that the problem was solved. Sadly, it wasn’t. Despite this official ruling, a simple trip to the AMI website reveals the serious limitations in the regulatory framework.

Misleading advertising

As educated university students, why should we give a second thought to this little anecdote about an obvious scam? Well, firstly because the conduct of AMI is merely symbolic of the ridiculous behaviour which pervades the world of health advertising. Many health-related businesses have little regard for consumer protection when promoting their products, which results in a widespread culture of routinely deceiving consumers for financial gain.

You may recall Reckitt Benckiser was recently fined $6 million for their blatantly deceptive marketing of Nurofen (which provides non-specific pain relief) as “targeted pain relief” for period pain or back pain. Many consumers opted for these “targeted” products, unaware they had simply paid an outrageous premium for the same active ingredient in a normal Nurofen tablet. It was an evil but easy way for an already enormously wealthy company to make a profit anew.

The same goes for companies like Swisse, whose products are “based on scientific research” but their trials are generally self-funded and non-transparent. This is because it is more economical to pay for Nicole Kidman’s star power in your ad campaigns and sign million dollar partnerships with La Trobe, ABC and CSIRO, than scientifically prove your products.

The list continues with modern health hacks and fads, such as giving your gut a charcoal cleanse (yummo) or the IV vitamin clinics that have been in and out of the news, being promoted as the cure for a hangover.

Plot twist: sticking liquid vitamins into your bloodstream is a dangerous placebo with little or no scientific basis. And sure, charcoal cleansing “works”- because they use charcoal in hospitals for drug overdoses to “get rid of the toxins,” it will certainly work for your “toxins” too. Unfortunately, it seems the human body is not quite that simple. This, however, doesn’t prevent people from making their fair share of cash out of pseudoscience.

A failing system

The second parallel to the AMI saga is that the Australian regulatory framework, screening processes and penalties for misleading and deceptive health advertising are not stringent enough to eradicate this kind of conduct. The many costs of this reality end up falling upon consumers.

For example, the Therapeutic Goods Administration, which among other things currently regulates the registration and advertising of complementary medicines (mostly vitamin and herbal supplements), does not assess these products for efficacy.

So, if I wanted to sell a sugar pill and market it for bone health, I would first have to register the product in the Australian Register of Therapeutic Goods. I must also state my claim that the sugar pill “supports bone health” in the Australian Register. In terms of “evidence” to support my claim, all I need do is declare that I “hold” the scientific evidence supporting those claims. Then I can advertise my sugar pill for bone health on any garish yellow billboard I choose. I might get into trouble because someone will complain that my claim breaches the Therapeutic Goods Advertising Code and is deceptive and misleading advertising, but the complaint will likely take several months to be resolved. By this I mean that with some luck on the complainant’s behalf, I might merely have to remove my advertising, but I will still walk away with a lovely net profit.

In summary, the current system here doesn’t focus on removing the misleading adverts before they are published but “remedying” the situation (somehow without fining the offenders) after the damage has been done to consumers’ wallets and perceptions. Despite reforms on the horizon for this terrible system, there is still a long road ahead to ensure consumer protection.

Healthy skepticism and evidence-based science: What you can do

From the small vitamin collection in the kitchen pantry, to those irregular physio visits, we are and will continue to be consumers of many health-related goods and services. University students may not be the target demographic of all Swisse commercials, but health advertising can still subtly influence our perceptions of health and what we end up buying on that chance visit to Chemist Warehouse.

It really comes down to consumers being educated and equipped with the skills to protect themselves against the pitfalls of the regulatory system and the greed of the industry. We deserve to enter a Pharmacy and clearly see what is worth buying from the labels, without a science degree or years of professional exposure to evidence-based medicine. But until a consumer utopia arrives, applying a bit of evidence-based knowledge to your encounters with health advertising will leave you better off.

This might involve double checking the advice of a friend or shop assistant who said a certain pill banished all her health problems against the body of validated scientific research easily available online. For example, a simple search in Pubmed (a free online database of medically-related scientific studies) may reveal that Vitamin C supplements are unlikely to shorten the length of your cold.

For those from a non-science background, the studies on this database generally compare a group of people on the same intervention, whether it is a pill or a type of treatment, with another group of people who are given a placebo pill. Theoretically, this allows for the efficacy of the pill in question to be properly examined. Although large trials with heavily controlled variables are difficult to conduct, the results of these studies provide us with a wealth of knowledge that is used to inform the practice of health professionals. If it is used by our Doctors and Pharmacists, then it is probably worth considering.

Admittedly, the average student wanting to get rid of their cold faster is unlikely to spend their energy trawling through Pubmed. A uni-friendly option is to search for the medicine on NPS Medwise (http://www.nps.org.au/), a government-funded Australian website providing evidence-based information about all medications from grandma’s cholesterol-lowering meds to the Vitamin C you are contemplating purchasing. It is the easiest way to get informed by just reading the small summary of the evidence for that medication.

Otherwise it is just worth becoming very sceptical of the following phrases on labels and in ads:

“Clinically/ scientifically tested/ proven:” hmmm how intriguing. The implication here is that the product has been the subject of a clinical trial, however what you probably won’t find on the label is that the trial was:

a) funded by the company themselves leaving them to tamper or selectively alter results to appear positive.

b) included bias that significantly altered the validity of results. For example, if the participants knew whether they were given the intervention or placebo.

c) conducted by another company that literally guaranteed a positive trial result by rigging everything.

d) not tested for the specific health issues it is advertised as being able to treat.

“More effective than the leading treatment:” an ambiguous statement that requires scepticism. What was the leading treatment? Was it a fair trial where both participant groups were given the same dose in equivalent conditions? Hmmm?? Approach with caution.   

“Natural:” Ummmm ok. What do you mean natural? Do you mean plant-based? Or not synthetic? Are you implying because it is “natural” that it is less harsh on the body? Or do you mean it hasn’t been refined and processed? Natural unrefined arsenic can still kill you so the fact that the product is “natural” doesn’t really tell us much. It is useful to remember that there is a definite distinction between “natural” and “harmless,” even when it comes to vitamins.

“Traditionally used:” the only validation needed to make this claim is…. oh wait, no validation needed! Picking an obscure Peruvian root and selling it for back pain with the label “traditionally used” (even though Peruvians have never heard of it) occurs more than you would think. Yes, there are traditionally used herbs that have actually been traditionally used, so just make sure you google the name of it to check before spending on some useless placebo.

So next time you find yourself perusing the aisles at Priceline, avoid taking the ads at face value and apply your healthy scepticism and evidence-based know-how instead: was that clinical trial actually transparent and independently funded? Did 95% of users truly feel they had more energy? And is that obscure Peruvian root really “traditionally used”? With a simple change of thinking, you can avoid falling prey to the world of health advertising.

Sasha Hall

The author Sasha Hall

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