BMJ 2012;345:e4682 doi: 10.1136/bmj.e4682 (Published 18 July 2012) OBSERVATIONS
Miracle pills and fireproof trainers: user endorsement
in social media
Adam Smith and Greg Jones investigate the marketing of sports products in social media in the
UK and the US
Adam Smith freelance journalist, London, Greg Jones freelance journalist, London “Boosted metabolism” and “increased stamina” are but two of This is only a single example, but if any company were to the many benefits promised to wearers of ion emitting manipulate its UGC in this way, would the ASA step in? A wristbands. These claims were made on Facebook by the spokesperson said, “The ASA has never dealt with a case where wristband manufacturer Ionic Balance—until the UK the manipulation of UGC in the way you describe has been Advertising Standards Authority (ASA) took a look. In October judged to be a breach, or not, of the advertising codes.4 Without 2011 the authority ruled that the evidence provided by Ionic any precedent to use, and considering that social media are a Balance was “not sufficiently robust to substantiate the claims.”1 new and evolving arena, we can’t really indicate one way or Ordered to stop making claims of effectiveness unless they another whether or not those types of manipulation would be could be supported by science, Ionic Balance removed an entire problematic. However, it would only take one complaint about list of assertions from its Facebook page. But the company an action such as that for us to assess and form an opinion of continued to allow consumers to post their own messages about Given that regulators have no precedents on which to rely when In fact, Ionic Balance relies on consumer conversation as part monitoring health claims made in social media environments, of its marketing. “Beware of companies with no online reviews,” are online platforms becoming the international waters of the the company states on its website.2 “Do they have a Facebook web, where jurisdictional boundaries are confused and page for user feedback? Are any of the reviews praising lawlessness prevails? And are regulators partly to blame for this customer service as well as product performance? Are the problematic situation? Even the ASA is not yet clear about how reviews recent? Do the reviews even have a date on them?!” companies should behave. It requires every advertisement to Although Ionic Balance may appear to be concerned about the abide by the advertising codes in whatever form it takes, but it information that consumers receive, the company’s behaviour has also said, “We’re continuing to investigate precedent setting remains a cause for concern at the ASA. The regulator told us: cases which mark out the rules and boundaries for the ad “Ionic Balance is currently on our list of non-compliant advertisers3 for continuing to feature problematic claims on its Ionic Balance is but one company still testing these waters.
website and Facebook page, in contravention of the ASA Facebook and Twitter are certainly facilitating dialogue between companies and their customers, some of which is marketing One of the key problems faced by regulators used to adjudicating and some not. Our analysis shows that the line between in traditional, not social, media is “user generated content” conversation, advertising, and health claims is being blurred.
(UGC), such as that left by Ionic Balance’s customers. The ASA As social media expand, regulators in the UK and the United says that it does not adjudicate on private individuals’ opinions.
States are still catching up. It was only in March last year that However, a company that removes negative feedback from its the ASA extended its remit to regulate advertisements on social media presence could be seen as manipulating user company websites and other sites over which they have control, generated content for marketing purposes. We left a comment on Ionic Balance’s Facebook page, highlighting the ASA’s Regulators in the US are just as stretched. “There’s been an decision regarding the veracity of the company’s claims. Within explosion with regard to claims,” said Mary Engle, director of 24 hours the comment had been deleted. We asked the chief the advertising practices division at the Federal Trade executive of Ionic Balance to explain the rationale for this, but Commission. The advent of social media, she added, has meant that “there’s a lot to keep track of.” This is especially the case Correspondence to: A Smith adam@adamesmith.co.uk For personal use only: See rights and repr BMJ 2012;345:e4682 doi: 10.1136/bmj.e4682 (Published 18 July 2012) in the sports and health product industry, which includes not seem to be happening. We searched through thousands of tweets just wristbands but also compression socks, hydration drinks, and Facebook postings and found barely a handful of instances fitness trainers, and dietary supplements, such as PacificHealth in which customers asked for the science to back up claims Laboratories’ Endurox Excel training pills.
In the US dietary supplements are regulated by the Food and On the Facebook page for the Maxitone weight loss product, Drug Administration (FDA) as “food” and as such do not require one customer asked whether she could take fluoxetine at the preapproval from the FDA for safety or efficacy as same time as its product. The company replied that while “there pharmaceutical products do. “With respect to dietary are no expected side effects,” the customer might want to consult supplements, anything can go on the market,” said Engle, whose a doctor.9 There was no link to the studies conducted on team enforces the statutes that require advertising claims to be truthful, substantiated, and not misleading.
Our observation that little science is being discussed by On Facebook PacificHealth posted this message about Endurox customers is backed up by Scott Baptie, who receives free Excel: “No substitute for hard work, but if there was a ‘miracle Maximuscle supplements in exchange for providing advice pill,’ this is it.”5 The post linked to the company’s web page for about the product on Facebook. “I’ve never seen anybody ask the product, claiming that the pill “contains the remarkable about the science behind Maximuscle on the Facebook page,” ‘adaptogenic herb’ ciwujia proven to improve your immune system, increase your fat metabolism by 24% and boost your But science is important to consumers, apparently. “Some people will just want to look at the lay science; others will want to drill As in the UK, regulations in the US require such claims to be down into the studies,” said Baptie. “A lot of people will base substantiated. (PacificHealth’s page cites three studies on their decisions on what influential people and companies say.
ciwujia, also known as Siberian ginseng, but no studies on They’re almost placing trust in companies that they will be Endurox Excel itself.) But customers remain free, of course, to say anything: one apparent Endurox Excel user claims on the Of course, Baptie is one individual in whom consumers place product page, “It really does work!”6 their trust. With a big online following, Baptie knows that his User generated content extends beyond words and into images reputation is crucial. “Any time I give any advice I’ll always too. Our trawl of social media also turned up the page of a runner try and get the research behind it,” he said. “I’ll go to PubMed with a photograph of himself jumping over fire in his Merrell and look at the studies. If you promote a product that has no Barefoot trainers. He posted the image on Merrell’s Facebook scientific research, you lose your credibility.” While Baptie is open about his arrangement with a company, Although the runner made no specific product claims, US others are not. Indeed, one of the insidious aspects of social regulators told us that there could at least be a health and safety media marketing is the way some people are paid by brands to issue. For example, other customers could harm themselves act as stealthy advocates without disclosing their affiliations.
performing the same stunt after seeing the photo on the official This is “a big issue,” said Engle. She explained: “Companies Merrell Facebook page. “The company has the ability to take have hired people to write glowing reviews of their product and down what’s posted on their page,” Engle noted.
haven’t identified that these were made up or being paid by the User generated content like this is not regulated unless a company incorporates it into its marketing claims. But there Engle admitted to not having any empirical evidence on the seems to be uncertainty as to whether a user’s claim made on extent of the problem. “We have just more anecdotal [evidence] the company’s page becomes a part of the company’s marketing.
or just even some news reports. It seems to be somewhat And the lack of clarity means that some companies push the envelope, especially in the new world of social media. “Plenty But Engle and her colleagues at the Federal Trade Commission of companies adopt a policy that they’ll be very aggressive until had an idea to combat the problem as far as Twitter was the regulator dials it back,” noted Brian Waldman, an attorney concerned. They recommended that customer advocates use the who co-manages the regulatory department at Arent Fox, a law hashtag #ad when promoting a product for some form of firm in Washington, DC. “That’s a business model for some payment. The ASA also backs the use of a hashtag to label endorsements. In June the watchdog banned a Nike campaign But the limited resources of the regulators, combined with the for using the Twitter accounts of Wayne Rooney and Jack explosion of social media, means that regulators focus on big Wilshere without disclosing that it sponsors the footballers.10 offenders, such as Skechers, recently fined $40m (£26m; €33m) But our research indicates that very few tweets about sports for unfounded claims that its Shape-ups trainers could help products carry a disclosure tag. Baptie, who has tweeted about Maximuscle products, thinks that the limitations of Twitter Waldman said that regulators are more inclined to pursue a mean that disclosure in a tweet would be cumbersome. “You small number of high value cases to set an example. With regard have 140 characters, and you have to get across the clearest to the Skechers case, which focused on ads in traditional media, message possible.” In any case, he explained, endorsements are he said, “The general view of the legislators is that this is enough commonplace in the fitness world. Consumers expect to see of a shot across the bow.” But the obvious question then is them from the people they trust to provide recommendations.
whether smaller companies such as Ionic Balance, especially In social media, then, personal brand is just as powerful as those that focus their marketing in low cost social media, are corporate brand. The rugby union player Andy Saull is another more likely to get away with bogus claims.
tweeter who does not use #ad but tweets endorsements all the Even if that were the case, the proliferation of online information is often seen as enabling consumers to make more informed The league Saull plays in is sponsored by the “hydration partner” choices and scrutinise marketing claims. But when it comes to Gatorade, the brand associated with the popular Twitter meme the sports products we looked at in this research, this does not the #watersucks hashtag. The hashtag arises from Gatorade’s For personal use only: See rights and repr BMJ 2012;345:e4682 doi: 10.1136/bmj.e4682 (Published 18 July 2012) product placement in the 1998 film The Waterboy (“Water Advertising Standards Authority. ASA adjudication on Ionic Balance. 26 Oct 2011. sucks; Gatorade is better”).12 But the hashtag is now owned by any Twitter user who cares to tweet it—a bonus for Gatorade ASA. Non-compliant online advertisers: Ionic Balance. but a threat too, as the tag could be hijacked by unhappy User generated content is part of a widening ecosystem of PacificHealth Laboratories. Endurox Excel: natural training supplement. content that includes obvious advertisements and opaque, paid-for endorsements. While the regulatory divisions between these types of message remain unclear, social media continue PR Newswire. Skechers will pay $40 million to settle FTC charges that it deceived to grow and to provide new opportunities. An enterprising brand consumers with ads for “toning shoes.” 16 May 2012. could even conduct huge scientific product tests by engaging consumers (“test subjects”) through the likes of Twitter and 10 Sweney M. Nike becomes first UK company to have Twitter campaign banned. 20 Jun With more than 10 million Twitter users in the UK alone, and 11 Saul A. 13 Mar 2012. https://twitter.com/andysaull/statuses/179603722278666242.
12 YouTube. The Waterboy: water sucks, gatorade is better. the total number of people on Facebook set to hit a billion this year, power is shifting to the consumers, but they remain as Cite this as: BMJ 2012;345:e4682 BMJ Publishing Group Ltd 2012 For personal use only: See rights and repr

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