February 26, 2024

Products with pink ribbons on their labels are a common sight in stores, especially during Breast Cancer Awareness Month every October.

Brands and companies frequently incorporate pink into their marketing, leveraging the strong awareness the pink ribbon carries in American culture to create an impression of social responsibility and increase sales. Because there are no restrictions or trademarks on the pink ribbon, companies are free to use it for any purpose, regardless of whether they contribute profits from the imagery to support breast cancer research or treatment.

This is so commonplace that Breast Cancer Action, a patient-centered advocacy group, coined the term “pinkwashing” to describe pink ribbon marketing done by companies whose products have a direct link to breast cancer, such as alcohol.

Such a practice may seem counterintuitive, but it’s a common problem with big implications that public health researchers like Marissa Hall, PhD, assistant professor of health behavior at the UNC Gillings School of Global Public Health, and colleagues are trying to tackle.

Dr. Marissa Hall

Dr. Marissa Hall

“Somewhere between 5-16% of breast cancers in the United States are attributable to alcohol. So, it’s surprising that alcohol is sometimes marketed in conjunction with breast cancer charities,” said Hall, who is also a member of the UNC Lineberger Comprehensive Cancer Center and a faculty fellow at the Carolina Population Center. “Understanding how consumers are reacting to this kind of marketing felt like an important research gap for us to fill, especially given rising rates of alcohol use among women in the U.S.”

Phoebe Ruggles

Phoebe Ruggles

Dr. Melissa Cox

Dr. Melissa Cox

Hall and researchers at UNC-Chapel Hill – including doctoral student Phoebe Ruggles, MS, and Assistant Professor Melissa Cox, PhD, at the Gillings School – worked with colleagues at Stanford University School of Medicine and Boston School of Public Health on a recent study that found that viewing pinkwashed alcohol ads made no difference in a person’s intent to purchase beer, wine or liquor or view them as harmful to health. But for certain beer products, pinkwashed ads led viewers to believe products had a greater health benefit and increased their perception of the brand as favorable and socially responsible.

The study, published in Addictive Behaviors, invited 602 adults in the U.S. to take part in a survey where they were shown pinkwashed Instagram ads from one of three common beer, wine and liquor brands. They were also shown one of three ads from the same companies that were not pinkwashed as a control. The survey measured participants’ perceptions of the products and brands shown in the ads, including how healthy they thought the products were, how socially responsible the brand was, and how much they liked the brand overall. The survey also asked participants how likely they would be to purchase the products.

The questions also assessed participants’ perceptions of how much drinking alcohol affects the risk of certain health conditions, including breast cancer. When participants were informed about the strong link between alcohol and breast cancer, they were also asked how misleading they thought the ads were.

On average, the perceptions of health risk and intentions to purchase were not different between the control ads versus the pinkwashed ads. However, after being informed about the link between alcohol and breast cancer, participants were more likely to view the pinkwashed ad as misleading and were more likely to support a policy that required breast cancer warnings on alcohol products.

The researchers wondered if participants would be skeptical of the practice of pinkwashing, but the results did not suggest any skepticism of pinkwashed ads. In fact, pinkwashed beer ads made participants view the beer as healthier, view the brand as more socially responsible, and like the brand more overall.

The researchers said there could be multiple reasons why the pinkwashed ads had no impact on people’s perception of breast cancer risk from alcohol, but the finding highlights a need to further explore reasons for the lack of awareness, such as advertising that misrepresents alcohol’s harms or a lack of public health messaging. When participants were informed about the risk, those in the pinkwashed arm were more in favor of stronger alcohol regulations, suggesting that exposing deceptive marketing practices like pinkwashing (often called “countermarketing”) could increase support for stronger alcohol policies.

“Overall, our findings suggest that exposing the industry practice of pinkwashing could help consumers recognize and disregard this type of advertising,” said the study’s senior author, Anna Grummon, PhD, a Gillings School graduate and Stanford faculty member. “Policies like health warning labels could also ensure consumers are not misled about the link between alcohol and breast cancer risk.”

As a next step in this line of research, Hall and Grummon are co-leading a five-year project from the National Institute on Alcohol Abuse and Alcoholism to design and evaluate the impact of evidence-based health warnings on alcohol consumption.

Read the full study online.

Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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