Advertising is a form of marketing and communication, whose intent is persuasion, generally about values or beliefs, and usually with the intent of influencing behavior, such as buying a commercial product, but also about supporting a political or religious community. It's about creating or changing beliefs, values, and behaviors. In the last lecture, we saw how successful such influences have been around tobacco use in low and middle-income countries. Young people are vulnerable to selling and marketing techniques, which have become more aggressive, including around potentially harmful subjects, not just tobacco, but also alcohol. There's evidence that young people are less adept at reading advertising for what it is. But advertising works, which is why large sums are invested in it. Around alcohol, for example, while parents and peers have a large impact on young people's decisions to drink, research clearly indicates that alcohol advertising and marketing is highly effective in influencing young people's expectations, and helping to create social environments that promote drinking of alcohol. There is evidence that increasing exposure to advertisements influences alcohol expectations, drinking intentions, and current and future drinking patterns. It is also apparent that the impact of alcohol advertising on young people goes beyond these direct associations between exposure and drinking behaviors, to how advertising can influence normative behavior, such as gender roles, with alcohol being seen as condoning violence in males. The alcohol industry disputes that it targets adolescents, of whom many, by definition, are under age in terms of drinking alcohol. There is, however, little debate that even young adolescents are exposed to and recall alcohol advertising. An area in which the alcohol industry has faced particular criticism is about their development of what is known as Alcopops, sweet tasting, brightly colored drinks with names and tastes that appeal to younger, especially female, audiences. And there is growing blurring of the lines between social media and advertising. Embedding tailored advertisements to your use of social media, or geographically linking text messages as you enter the vicinity of a product that is known to be of interest to you through your past use of social media, are examples of this. Advertising is becoming much more sophisticated, and arguably more effective. In 2008, Barack Obama led the first political campaign in history that harnessed the power of social media, dubbed the first Facebook president. It is said that Team Obama used up to 15 different social networking tools in a grassroots campaign. By the end of the campaign, Obama had attracted over 2.5 million Facebook supporters, 115,000 Twitter followers, and more than 50 million views on his YouTube channel. Young people are increasingly realizing the significance of social media as a potent communications tool, as are governments. The second photograph on the right is of George presenting at the International Association of Adolescent Health, the scientific conference that was held in Istanbul, Turkey in 2013. This conference coincided with the protests in Taxim Square, which, fueled by the Turkish government's violent response to a peaceful protest about the redevelopment of a park, then expanded to protests in support of freedom of the press, freedom of expression, and freedom of assembly. It is said that at that time, there were over 5,000 demonstrations across Turkey, with estimations that 3.5 million of Turkey´s 80 million population participated in the uprisings, in which 11 people were killed, and over 8,000 were injured. The well-documented failure of major Turkish media outlets to cover the protests led to what has also been described as a Twitter explosion, with the most popular hashtag tweeted 1.8 million times in three days. As with the Arab Spring uprisings before it, and the Occupy movement, social media now constitutes a potent aspect of communication. The annual Super Bowl football final in the United States is a highly watched sporting event, with an audience globally of over 100 million. I confess to never having watched it, but I'm intrigued that the average cost of a single 30 second television spot during this game recently reached $4 million US. But here, too, it is interesting to see the blurring of lines between advertising, marketing, and social media, for products, but also wider ideas. At this year's Super Bowl, the three minute Like a Girl YouTube video went viral, with over 25 million hits. The fact that Always, the company that funded it, makes various products like tampons, period pads, and panty liners for women has been somewhat lost in the appreciation of the very powerful message. The award winning director, Loren Greenfield, uses the brief clip to demonstrate the dramatic change in confidence and self-perception that comes during adolescence for girls. This is a must-watch clip for those who haven't seen it, and I'd be interested in your thoughts about the relevance of this message in different countries and different cultures. Self-inflicted harm is a leading cause of death in young people, and at any age, suicide has a devastating effect on those who are close to the person who has died. Appropriate reporting in the media can play an important role in working towards basic community understanding, community responses, and, indeed, suicide prevention. Since 1774 and the publication of Gurta's book, The Sorrows of Young Verta, which generated a spate of suicides after the depiction of suicide by the protagonist, it has been appreciated that suicide can be influenced by publicity about it. We now have very good evidence that some ways of reporting and portraying suicide in the media may increase rates of suicide behavior, a phenomenon know as copycat suicide, or the Werther effect. There is also evidence of the reverse, that quality reporting about how suicidal ideations were able to be overcome, have similarly led to reductions in the suicide rate. The harmful effects of media portrayal of suicide are especially when the media reports include details of the method of death, when the act of suicide is sensationalized, and when a celebrity is involved. In response, media guidelines, standards, and codes of conduct have been developed that articulate how to ensure that newsworthy events that involve suicide are reported accurately, but also that they are reported responsibly and ethically. In particular, such guidelines recognize the role of a media in educating the public about complex health and social issues, in raising awareness, about the link between depression and suicide, and providing information about sources of help for vulnerable individuals. In order for this to happen, coalitions of professionals from the media, mental health, and public health are required, as was the case for the development of revised media guidelines and standards on suicide reporting by the Australian Press Council in 2011. But there is a sting in the tail. Such standards are only binding for publications, for example, in this case in Australia, for those that are affiliated with the council. While this includes all major newspapers and magazines around Australia, as well as their associated websites, it obviously does not relate to the global media, and certainly does not relate to individual blogging or twittering. This raises some interesting challenges about responding to the globalization of media, including social media and markets, which is equally appreciated by those working to limit the intake of alcohol by the young, as can be seen in this declaration by the World Health Organization on the dangers of young people and alcohol. Trade agreements, common markets, and increased globalization have increased the difficulty of individual nations maintaining effective policies, whether for alcohol or for other legal products. In this context, there is even more onus on national governments to invest in public health interventions that they can support. Outlined here are the breadth of some of the interventions, that as with tobacco control policies, need to be comprehensive, consistent and sustained. The power of advertising to influence behaviors absolutely affirms that governments need to be investing in commensurately large public health interventions in order to balance this influence. One of the major challenges is that most products sold by companies big or small are legal, and for most products, the extent of health concerns are not nearly as clear as they are for tobacco or, indeed, even for alcohol. In this regard, and we can see this played out by the food industry's squealing response to any potential curtailment of their sales by regulation, it is time to consider a less combative approach to industry by those within the public health field. The Oxford Martin Commission for Future Generations, called Now for the Long Term, is a fascinating report that I commend to you. Chaired by Pascal Lamy, a former Director General of the World Trade Organization, their commission consisted of a who's who of globalization and development. It's available online, and I urge you to check out the report. One of the key actions from the report relates to the need to form different types of partnerships to address the more complex challenges that are affecting the world, for which there are no easy solutions. They argue that creative coalitions of different groups of multi-stakeholder partners will be required to generate deeper change, learning, and practical action. Some of the areas they recommend attending to are outlined here, such as coalitions around climate change, protection of data, and prevention of non-communicable diseases. A well-known health example of some more creative coalitions has been the Global Alliance for Vaccines and Immunizations, known as GAVI, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. These are examples of public-private partnerships that align different constituencies working on a common problem, that have the ability to channel resources based on locally determined needs. Adolescents have gained greatly from such coalitions, including, for example, with GAVI, recent funding that supports implementation of the HPV vaccine in many countries. A challenge for these coalitions is, how can we also ensure that young people gain at the seat of the table, to ensure that their insights are heard about what is most critical for them, and what is necessary to improve their lives?
