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Social Marketing: Improving the Quality of Life.

Philip Kotler,
Ned Roberto and Nancy Lee. Sage Publications. Pp. 438.
Social marketing is dened as the use of marketing principles
and techniques to inuence a target audience to voluntarily
accept, reject, modify, or abandon a behaviour for the benet of
individuals, groups or society as a whole. It is recognized that
its use is widespread in the elds of public health, community
and environmental advocacy. This book is an attractive, highly
illustrated primer that explores the application of social market-
ing principles in great depth in an accessible way to a range of
(not necessarily professional) audiences. However, translating
not only the US context and language, but also the overall plac-
ing of the concept into UK public health system and values is
difcult. We accept that there are also other ways to inuence
public behaviour, including technology, economics, legislation,
policy-making and education. And yet these last are given only
three pages of consideration in the book. It is in this imbalance
of attention to the multiplicity of approaches available to
address public health issues in widespread use in the United
Kingdom, and the lack of positioning of social marketing as
only one of a number of methods in the public health toolbox,
that makes the value of the book to the UK audience question-
able.
In traditional health promotion texts, social marketing has
been given a degree of attention but it has never been the single
method of choice. Rather we have integrated some of the mar-
keting principles of: selecting target audiences, setting objectives
and goals, being aware of the four Ps of product, price, place
and promotion, and evaluating impact, into more complex pub-
lic health interventions. This book details each of these steps
clearly, and, abstracting them from their social marketing con-
text, this is a useful guide to systematic and planned project
management. However, social marketing as a central organiz-
ing concept falls down in a number of ways. First, the method is
predicated on the awed belief that information provision and
exhortation to change behaviour will work. Granted there is
recognition that providing supports will help, such as doorstep
provision of reduced-ow showerheads for water conservation,
which increased installation, and other methods to sustain
changed behaviour are briey addressed towards the end of the
book. Second, the stages of change model underpins the target-
ing and market stratication principles, so that those ready to
take action are the primary target of any campaign as they are
the most likely to be inuenced by information and persuasion.
The fundamental processes of a marketing approach are implic-
itly based on diffusion of innovation theory, where early
adopters take up the message, which is then diffused through
the rest of the population. We have also been using this theory
for a long time; however, we are now all too acutely aware of the
effect that this has had on widening health inequalities. Those
who are better educated and better off have been able to use
information or take advantage of health-promoting opportun-
ities, whereas those more disadvantaged have not. Nowhere
in this book are health inequalities addressed, or the potential
consequences of partial take-up of health messages on overall
population health considered.
Another shortcoming in the proposed methodology is the
absence of consideration of evidence of effectiveness of the
interventions. Although practitioners are advised to consider
other successful examples, and the book is full of them, the
notion of reviewing the evidence base for public health before
planning an intervention does not feature. The methods used in
some of the campaigns are also not evidence based; for example,
messages based on fear (described as vivid, personal and con-
crete), such as a poster with a circle of words This is the size of
the hole theyll cut in your throat if you continue to smoke, are
not questioned. However, the sections on how to evaluate local
programmes of activity for impact and achievement of objec-
tives are sound.
What does this book do well? Apart from giving an insight
into the similar but actually very different ways in which we
perceive health and its determinants in the USA and United
Kingdom, it does bring together a wealth of examples of activi-
ties to address both health and environmental issues to focus on
quality of life in an integrated and illuminating way. Examples
of how personal behaviour affects environment abound, even
if programmes to increase salmon-friendly gardening might
not translate well to the average suburban garden. The book is
practical and accessible and could be of value to students on a
public health or health promotion course, not only for its clear
exposition of project planning, but also to provide a critique of
the pros and cons of social marketing and to illustrate the over-
lapping methods and principles that have been integrated into
effective public health practice in the United Kingdom. The
amount of interpretation and sheer translation required would,
however, not make it of value to the busy practitioner.
Viv Speller
Director of Public Health Development
Health Development Agency
Holborn Gate
330 High Holborn
London WC1V 7BA
Book review
Journal of Public Health Medicine Vol. 25, No. 2, p. 186
DOI: 10.1093/pubmed/fdg040 Printed in Great Britain
Journal of Public Health Medicine 25(2) Faculty of Public Health Medicine 2003; all rights reserved.