Policy Brief: Countermarketing Unhealthy Food: Lessons from Tobacco
Nicholas Freudenberg, Chris Palmedo, Eleni Murphy and Sarah Garza for the CUNY Urban Food Policy Institute
In the next decade, diseases related to diet are likely to overtake tobacco as the leading cause of premature death and preventable illness in New York City, the United States and globally. Why? One important factor is the relentless marketing by food companies — now estimated to be at least $2 billion a year targeted at children alone. The overwhelming majority of ads are for ultra-processed foods high in fat, sugar, salt and empty calories. A recent meta-analysis concluded that acute exposure to food advertising increases food intake in children. These data make it clear that public health policy action must seek to reduce the high levels of exposure of our children to unhealthy food advertising.
Thirty years of research in tobacco control has shown that countermarketing has been effective in reducing tobacco use, especially among teenagers and young adults. In this policy brief, we describe some of the key elements of effective tobacco countermarketing campaigns, and examine the relevance of these evidence-based countermarketing practices to unhealthy food and beverages, which we define as processed products high in unhealthy fats, sugar, salt and empty calories.
Countermarketing (CM) campaigns use health communications strategies to reduce the demand for unhealthy products by exposing the motives of their producers and portraying their marketing activities as outside the boundaries of civilized corporate behavior. In a review of several recent syntheses of the literature on tobacco counter-marketing,we identified eight common elements of anti-tobacco campaigns.Not every campaign included all eight elements but together these characteristics define CM and distinguish it from other approaches to tobacco communication.
Eight Key Elements of Tobacco Countermarketing Campaigns
Communicate the adverse health consequences of smoking. For more than 40 years, evaluations of tobacco control campaigns have shown that highlighting the health consequences of tobacco use can be effective. While the core message of early programs in California and Florida were to expose tobacco industry deception and manipulation, subsequent CM campaigns in tobacco, notably the nationwide truth campaign, clearly communicated the health consequences of smoking within an anti-industry context.
Publicize industry manipulation of consumers. Messages that highlight deceptive or predatory tobacco industry practices are central to the tobacco CM campaigns that reduced smoking intentions and behaviors. By exposing tobacco industry practices such as denial that tobacco is addictive, distortion or obfuscation of scientific findings on the harms of tobacco, and targeted marketing to youth and other vulnerable populations, countermarketers challenged the veracity and credibility of the industry.
Appeal to negative emotions. Campaigns seeking to spark emotions such as outrage and resistance to manipulation have been successful components of CM tobacco campaigns, especially those focusing on teens. truth magazine ads showing stitched mouths, eyes and ears of youth convey the message that tobacco companies seek to prevent young people from seeing, hearing and telling the truth about industry marketing practices.
Disparage actual popular brands.
Tailor campaigns for specific populations.Substantial empirical evidence indicates that tailoring campaigns by race and ethnicity and peer group can be effective in reaching various segments of the market. The Commune campaign, which reduced smoking among young adult “hipsters” in San Diego, is an example of successful tailoring to reach one segment.
Criticize industry targeting of vulnerable populations. Some tobacco CM campaigns highlight marketing that targets vulnerable populations such as children, Latinos, Blacks or immigrants. For African-American and other groups, the appeal to protect their community against racially targeted ads has often proved successful at mobilizing opposition to tobacco marketing.
Establish a distinct CM campaign brand. Some CM campaigns include design elements such as a logo which differentiates the brand from its competitors. The truth campaign featured a clear and deliberate strategy to market its antismoking anti-industry message as a brand with a logo and specific color schemes. These brand images also symbolized the differences between countermarketers and Big Tobacco companies.
Engage users in all phases of campaign. Another key lesson from tobacco countermarketing is the value of engaging those the campaign hopes to reach in all phases of a campaign. Young people can be credible communicators with their peers and family. Often they are more effective than adults in reaching their own peer group. Three stages of engagement have been widely used: 1) meaningful input on campaign design, 2) peers as spokespeople for the campaign, and 3) interactive peer participation in message delivery. However, the truth and Commune campaigns went beyond merely showcasing youth and young adults in their campaigns; they engaged their audience throughout campaign development and execution. 
To what extent have food countermarketing campaigns incorporated these elements?
To answer that question, we identified nine food CM campaigns that have a presence on the Web and we reviewed their materials and websites. We analyzed some of the ways these organizations are using CM to reduce consumption of unhealthy food. We also explored the extent to which they included the lessons from tobacco CM in their campaigns. The campaigns we identified are listed in the box below.
Some Examples of Food Countermarketing Projects
At least some of the groups used each of the eight common elements from the tobacco CM campaigns.
Communicate the adverse health consequences of unhealthy food
By the time truth launched its CM campaign, most Americans knew about the harmful effects of tobacco. However, some research suggests many Americans, including young people, may be less knowledgeable about the harmful health consequences of unhealthy food. This finding warrants including information on how products like sugary beverages and fast foods harm health, as shown in the images below from food CM videos.
Publicize industry manipulation of consumers
CM gains much of its impact from anger and outrage toward the unethical practices of big corporations. Many of the groups using this approach in food take on the best known brands—Coca Cola, Pepsi, McDonald's, and Kellogg’s, for example. Corporate Accountability International seeks to force McDonald’s to “retire” Ronald, who in their view, embodies an unethical business practice of convincing children to pester their parents to buy them unhealthy food. In Change the Tune, the Center for Science in the Public Interest shows a patient with diabetes, a family member and a doctor singing the Coke song “I’d like to teach the world to sing…”, juxtaposing the happy fantasy of Coke with the reality of a global epidemic of diabetes, exacerbated by Coke’s success in achieving its goal of putting Coca Cola in “arms’ reach” of every person on Earth.