Stronger and stronger adverts appear on our TV screens in an effort to prompt us to make healthier decisions but do they work? asks Ciarán Brennan
Fatty tissue being squeezed from the aorta of a 30-year-old smoker; a motorcyclist being fed through a straw by his wife following an accident; a man severely paralysed from a fall from scaffolding watching his family play around him.
Health advertisements over the past 10 years, whether they promote road or workplace safety or highlight the effects of smoking or an unhealthy lifestyle, have become more gritty and realistic and more shocking.
"The most effective health and safety advertising is the stuff that is pretty gut wrenching or heart stopping. It does work," says Stuart Fogarty, managing director of AFA O'Meara. "In some ways, to get your message noticed the oldest trick in the book is to shock. It creates talkability. In that sense it works, it drives the message home."
Feedback indicates that the advertisements are getting through to their intended audience, according to those behind them.
"Our reading is that our adverts have been extremely effective," says Angus Laverty, spokesman for the Health & Safety Authority (HSA) which has a campaign focusing on farm and construction health and safety. "The ads are mentioned by our inspectors as ads that stick in people's minds. They carry a very direct and stark message and they seem to work."
In an increasingly cluttered media, where health promotion bodies have to compete for the public's attention to get their message heard, the softly softly approach has been abandoned, according to Laverty.
"There's a fog you have to puncture to get through to people. The only way to get through that fog is to talk directly to people and to do it starkly and simply."
But Maureen Mulvihill, health promotion manager with the Irish Heart foundation says the effects of shock advertisements can be limited.
"Our policy in all our materials would be to take a positive, supportive approach. It can be difficult to catch people's attention. We have not done television advertising but I think we would not use shock tactics because I think people can be desensitised or go into denial. If anxiety or fear are raised too much people will just switch off."
Health advertisements on their own are not going to prompt people to change unhealthy behaviour, she argues.
"You need a whole range of other approaches to support the advertising campaign. It has to be multi-faceted, with public education and support. If you look at the tobacco advertisement, that campaign was doing a number of things. It was obviously trying to reach the smoker and, through a bit of fear and revulsion, trigger a reaction but that was also coupled with a strong advertising campaign for the national quitline. There were also very good support materials and support through the HSE in terms of clinics."
Brian Farrell, spokesperson for the National Safety Council which is responsible for a number of "tell it like it is" advertisements, agrees that advertising should not work in isolation to wider campaigns.
"Our advertisements are designed to work on a number of levels," says Farrell. "They are not there simply to change behaviour. In the first instance, if the ads were not there we would effectively have a moral vacuum in this country in relation to what is happening on our roads. The ads are designed to win the moral argument and build the climate of opinion that what is happening on our roads is unacceptable."
The advertising is part of an integrated approach to road safety which includes better road building and strict enforcement. Nevertheless, he says that the NSC's uncompromising road safety advertisements which have featured some gruesome imagery of death and injury have been successful in reaching their audience.
"Our advertising is research-led, it is data-led and it also psychology-led and it is benchmarked to find out is it having an impact on public awareness, on attitudes and behaviour and it is," he says, adding that NSC advertising has figured consistently in the top 10 most recalled advertisements, according to the Irish marketing journal magazine.
Its "damage" ad, which shows how a back-seat passenger who does not wear a seatbelt is thrown around the inside of a car, has changed attitudes.
"We have tracked the seatbelt wearing and in 1999 it was about 55 per cent for drivers and front seat passengers in a car. In 2003 that seatbelt wearing rate had increased to 72 per cent and the only significant intervention that happened between those two periods was the introduction of the seatbelt wearing ad 'Damage'. We believe that ad was responsible for a dramatic increase in the seatbelt wearing rate and it probably was responsible for preventing many serious injuries if not fatalities."
And it is highly likely that we will see more of these types of advertisements as part of campaigns to shock people out of their complacency on a range of health issues. The campaigns will also become more hard-hitting as people become more desensitised to a lot of what they see on television.