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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