ASA Adjudication on The British Diabetic Association

Ad

A press and poster campaign for Diabetes UK featured diabetes as the "Silent Assassin".

a. One poster showed a man lying collapsed on the pavement with a shadowy figure looming over him, looking as if it was about to kick him. Large text stated "Diabetes. Beware the silent assassin". Smaller text underneath stated "The death certificate will say heart attack. It was really diabetes." Text at the bottom of the ad stated "Learn how to beat it ..." and included the website of the charity.

b. A second poster, which also appeared as a press ad in the Observer, featured a woman in a supermarket; a shadowy figure behind her seemed to be leaping towards her to grab or push her. Large text stated "Diabetes. Beware the silent assassin". Smaller text stated "Diabetes causes more deaths than breast and prostate cancer combined". Text at the bottom of the ad stated "Learn how to beat it ..." and included the website of the charity.

c. A press ad, which appeared in the Daily Telegraph, showed a man walking down an escalator. A shadowy figure was coming from behind him with arms outstretched as if to push him down. Large text stated "Diabetes. Beware the silent assassin". Smaller text underneath stated "Diabetes causes heart disease, stroke, amputations, kidney failure and blindness." The ad included the same website address as the posters.

d. A second press ad, inserted in a TV listings page, consisted of a small black box with text that stated "Diabetes. Beware the silent assassin. Learn how to beat it ..." and included the website of the charity.

Issue

1. Fifteen of the complainants, including the Meadows Association of Diabetics, thought ads (a), (b) and (c) were distressing, particularly to children who had diabetes or who knew their parents had it.  They found the ads' appeal to fear and focus on the negative impact of diabetes offensive.  They were also concerned that ads (a) and (b) were untargeted.

2. Four complainants were concerned that ads (a), (b) and (c) were misleading, because they did not distinguish between Type 1 and Type 2 diabetes and did not clarify that some people had diabetes through no fault of their own, not because of lifestyle choices such as smoking and/or drinking.

3. Three complainants said it was rare for people who controlled their diabetes to die from related illnesses but ads (a), (b) and (c) misleadingly implied it was very common, if not inevitable.

4. One complainant was concerned that ad (d) was misleading, because it did not distinguish between Type 1 and Type 2 diabetes and did not clarify that some people had diabetes through no fault of their own, not because of lifestyle choices such as smoking and/or drinking.

5. One complainant was concerned that ad (d) may frighten people who were trying to control their diabetes, because it implied they were going to die from it regardless.

CAP Code (Edition 11)

Response

1. Diabetes UK said the 'Silent Assassin' campaign was aimed not only at people with diabetes and those at risk of developing the condition but also the public at large, and aimed to highlight that diabetes was a serious condition and to improve awareness of its devastating complications.  They pointed out that not treating either Type 1 or Type 2 diabetes could have severe, if not fatal, consequences.  They argued that many people, including those with diabetes, did not realise that the condition could lead to heart disease, stroke, amputation, kidney failure or blindness, and many also did not realise that their weight, lifestyle and failure to manage their diabetes could put them at greater risk.

They argued that early diagnosis of diabetes and good management of it were crucial and believed the ads made clear that the 'Silent Assassin' could be avoided to some extent, because they stated "Learn how to beat it" and urged people to contact Diabetes UK for information and support.

In anticipation of potential anxieties about the campaign, Diabetes UK consulted with the general public, people with Type 1 or Type 2 diabetes and parents of children with diabetes before the ads appeared.  Although some of the parents did raise objections, many others, including those with relatives who had died as a result of diabetic complications, supported the campaign.

2. & 4. They felt the ads did not need to distinguish between Type 1 and Type 2 diabetes, because the potential complications mentioned in the ads were the same for both groups.  They also said diabetes reduced life expectancy for those with either Type 1 or Type 2.

3. They believed research had shown that, although an improved control of diabetes could reduce the risk of developing complications, it could not entirely remove the dangers.

The Daily Telegraph said they had received no complaints from readers about ad (c).  They believed the ad clearly highlighted the dangers of undiagnosed and/or untreated diabetes and did not seem to be aimed at those already undergoing a treatment regime.  They argued that their readers would understand the ad was urging them to seek further, potentially life saving information.

The Observer said the strong images and wording in ad (b) were in line with the serious nature of the issue.

5. Diabetes UK did not comment specifically on this point.

Assessment

1. Not upheld

Although the ASA noted Diabetes UK intended the ads to be aimed at the general public as well as people with diabetes or those at risk of developing it, we considered that consumers were likely to infer that the ads were primarily targeted at people who might be at risk of developing illnesses or conditions because they had diabetes without knowing it, or at those who knew they had diabetes but were unaware of how serious the potential dangers could be.  The ads were therefore unlikely to cause fear or distress to people with diabetes who led healthy lifestyles, were aware of the risks of their condition and were managing their diabetes properly.  Although we considered there was an appeal to fear in people with diabetes who were unaware of the potential dangers of their condition or who led unhealthy lifestyles, and in people at risk of developing the condition, that was justified because it encouraged prudent behaviour: diagnosis and proper management of diabetes.  We considered the fear likely to be aroused was not disproportionate to the risk of having undiagnosed and untreated diabetes.  If children with diabetes or who had parents with diabetes were initially concerned by the ads, we considered their parents ought to be able to explain the reasons behind the campaign and could reassure them that they could "learn how to beat it", as the posters instructed, which introduced a positive element to the ads and counteracted the references to the negative impact of diabetes.  We considered the presentation of negative consequences and the appeal to fear were likely to be seen as outweighed by the importance of raising awareness of the condition and its risks, thereby reducing the risk of offence.  We concluded that the posters were not irresponsible for being untargeted.  We also concluded that the posters and press ad were unlikely to cause serious or widespread offence or to cause undue fear or distress.

On this point, we investigated ads (a) and (b) under CAP Code clause 2.2 (Responsible advertising) but did not find them in breach.  We also investigated ads (a), (b) and (c) under CAP Code clauses 5.1 (Decency), 9.1 and 9.2 (Fear and distress) but did not find them in breach.

2. & 4. Not upheld

We considered that, because it was possible that people with either Type 1 or Type 2 diabetes might be at risk of developing complications, and because the ads did not, in our view, imply that only people with unhealthy lifestyles developed diabetes, it was not necessary for the ads to distinguish between Type 1 and Type 2 diabetes or to clarify that some people had diabetes through no fault of their own.  We concluded that the ads were unlikely to mislead.

On points 2 and 4, we investigated ads (a), (b), (c) and (d) under CAP Code clause 7.1 (Truthfulness) but did not find them in breach.

3. Not upheld

We considered the ads did not imply it was very common, if not inevitable, for people who controlled their diabetes to die from related illnesses, because the ads were likely to be seen as targeting people whose information about diabetes was lacking more than those who were managing their diabetes properly.  We considered it was implicit in the words "Learn how to beat it" that people who had proper information about their diabetes and how to deal with it were less likely to die from related illnesses.  We concluded that the ads were unlikely to mislead.

On this point, we investigated ads (a), (b) and (c) under CAP Code clause 7.1 (Truthfulness) but did not find them in breach.

5. Not upheld

We considered that ad (d), which merely stated "Diabetes.  Beware the silent assassin.  Learn how to beat it at www ..." and did not give any details of the ways in which diabetes might cause death, was unlikely to frighten people who were trying to control their diabetes by implying they were going to die from it regardless.  Instead it suggested that the potentially fatal dangers of diabetes could be avoided and the first step was to seek further information.  We concluded that the ad was unlikely to cause fear or distress.

On this point, we investigated ad (d) under CAP Code clauses 9.1 and 9.2 (Fear and distress) but did not find it in breach.

Action

No further action necessary.

Adjudication of the ASA Council (Non-broadcast)