Background
Summary of Council decision:
Five issues were investigated, all of which were Upheld.
Ad description
Three regional press ads for BodyToxing, a day spa:
a. Text in the first ad titled "iCleanse (BODY SMOKING)", stated "Using 100% Pure Omani Frankincense ... Smooths [sic] & Tightens The Whole Body". Text further down the ad stated "Benefits: Helps correct digestive disorder while soothing the nervous system. Relieves stress. Boosts fertility. Eases menstrual cramps. Balances hormones. Fights infections. Gives the skin a glow. Nourishes and hydrates the skin. Helps reduce dull complexion. Soothes and Tightens after child birth it is popularly practiced among different cultures worldwide".
b. Text in the second ad titled "Al-Hijama/Wet Cupping", stated "Cupping therapy dates back to ancient Egyptian, Chinese, and Middle Eastern cultures. One of the oldest medical texts books in the world describes how the ancient Egyptians were using cupping therapy in 1,550 BC for medicinal purposes". Text further down the ad stated "Benefits of Wet Cupping: Reducing pain and inflammation throughout the body. Can promote mental and physical relaxation and well-being. Removes toxins from the body. Detoxifying. Removes harmful substances from the body. Stimulating and strengthening effects. Healing effects. Stress relief. Stimulating blood circulation. Boosting the immune system. Prevents illness. Good pain relief. Migraine and headache relief".
c. Text in the third ad titled "Salt Therapy" stated, "... Salt Therapy aka Halotherapy is a powerful, natural treatment in a controlled air medium that simulates the natural salt cave microclimate to treat respiratory and skin conditions. This is no health fad - from the ancient Greeks to modern-day doctors, medical experts have championed its amazing effects. In fact, the NHS officially endorses Salt Therapy to treat COPD [Chronic Obstructive Pulmonary Disease]." Text in the ad further stated "Salt therapy can significantly help to: Reduce the need for inhalers and antibiotics. Make your breathing easier after just a few sessions. Improve lung function. Reduce the number of hospital admissions. Alleviate sneezing, coughing, and shortness of breath. Clear mucus and sticky phlegm from the lungs. Increase the resistance to respiratory tract diseases. Strengthen your immune system. Prolong remission times. Improve general health and quality of life. The treatment's efficacy is estimated at 75-98% depending on conditions. Enhance sport performance for professionals". Below the text was an NHS logo with text stating "Endorsed by the NHS for COPD first session FREE".
Issue
The complainant challenged whether:
1. the efficacy claims listed in ad (a) for 'iCleanse (BODY SMOKING)' were misleading and could be substantiated;
2. the efficacy claims listed in ad (b) for 'Al-Hijama/Wet Cupping' were misleading and could be substantiated;
3. the efficacy claims listed in ad (c) for 'Salt Therapy' were misleading and could be substantiated;
4. the ads discouraged essential treatment for conditions for which medical supervision should be sought; and
5. ad (c) misleadingly implied that salt therapy treatments were endorsed by the NHS, whereas they understood that this was not the case.
Response
BodyToxing stated that they did not believe the information stated in their ads was false or misleading to potential customers. They said that all of the statements featured in the ads were based on research from reputable sources. BodyToxing said that they had studied each therapy offered and that the benefits of the treatment were known to them in their training. They also stated that all of their staff were qualified to carry out the treatments.
1. BodyToxing stated that they underwent training for this treatment in Sudan and that only trained members of staff could assist in this treatment. They explained that body smoking consisted of the use of a chair and did not involve active administration of the treatment by members of staff. They stated that the benefits of the treatment were delivered by the steam, frankincense, myrrh and sandalwood and that many women in Oman and Sudan used this treatment daily with noticeable effects.
They had provided weblinks to a number of online articles discussing the cultural practice of body smoking and the purported anti-inflammatory and fertility boosting properties of frankincense that was used in body smoking. They also provided article extracts discussing the various effects of body smoking, such as 'detoxing', skin firming, easing symptoms of arthritis.
2. BodyToxing stated that they studied wet cupping at the Hijama Clinic in Luton and that only their Wet Cupping Therapist who had qualified from the Hijama Clinic could carry out the treatment. They provided weblinks to articles in relation to the cultural and religious practice of wet cupping and articles authored by a naturopathic practitioner, a chiropractor and from the website WebMD.com, in respect of the benefits of the therapy in treating a number of medical conditions, such as blood disorders and skin problems. They also provided an article detailing the testimonial of a certified athletic trainer and her experience of using wet cupping to treat muscular pain and injuries.
3. BodyToxing stated that they were a franchisee of the company the Salt Cave (TSC). They said that they were provided with sufficient training in the use of the salt cube and that their advertising for this treatment had been based on promotional material with which they were supplied. They referred us to an abstract of a PubMed article examining the effect of dry salt inhaler in adult sufferers of COPD.
4. BodyToxing asserted that if the complainant had used the treatments that they offered at length, they would have experienced the benefits as stated in the ads. They also stated that consumers would have been recommended to seek medical advice before using the treatments for the benefits that they referred to in the ads. They objected that the complaint was not justified, because their staff were qualified to administer the treatments and their certificates were on display in their premises. The issue, therefore, of whether their treatments were conducted under the supervision of suitably qualified health professionals should not have been raised by the complainant.
5. BodyToxing provided extracts from the TSC website which stated that TSC participated in an NHS pilot project, as part of the Personal Health Budget programme (PHB), to provide therapy for COPD sufferers. The extract further stated that the TSC had been recruited to provide therapy for COPD at Havering Personal Care Trust, one of the 71 pilot sites that had been selected to conduct an in-depth study looking at how COPD sufferers could benefit from the PHB programme.
The extract also stated that those eligible for NHS Continuing Healthcare funding would have the right to apply for PHB from 1 April 2014 and if successful, they would be able to attend salt therapy sessions funded by NHS PHB from 1 October 2014.
Assessment
1. Upheld
The ASA noted that the information submitted by BodyToxing referenced research conducted in Germany in 2011 examining the anti-inflammatory substances contained in the resin from the trunk of Boswellia trees, which we understood to be commonly known as frankincense. We noted the abstract of one of the articles provided briefly set out the findings of a study that examined the effects of frankincense in capsule form on arthritis patients. We also noted that a number of articles supplied by BodyToxing stated that body smoking, also known as Dukhan, was traditionally used by Sudanese women as a form of cleansing before a wedding.
We acknowledged that body smoking was a form of ritual traditionally practised amongst a number of Asian and Middle Eastern cultures. However, we did not consider that we had seen robust evidence, such as studies on human subjects, that demonstrated that body smoking, when the treatment was administered in the form offered by the advertiser, could have the effects referred to in ad (a). On this basis, we considered that the efficacy claims in ad (a) had not been substantiated and concluded that the ad was misleading.
On this point, the ad breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
(Misleading Advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
(Medicines, Medical Devices, Health-related Products and Beauty Products).
2. Upheld
We acknowledged the comments that BodyToxing made about the historical, cultural and religious origins of the practice of wet cupping. We noted that the article extracts, including a web article on WebMD.com, provided by the advertiser explained the rationale, and the intended effects, of wet cupping.
We did not consider that we had seen robust evidence, such as studies on human subjects, that demonstrated the efficacy of wet cupping in "remov[ing] toxins from the body", "detoxifying" or "remov[ing] harmful substances from the body", that the treatments had "healing effects" or that the treatments had the ability to "prevent illness", or other evidence that adequately supported the specific claims made.
On this basis, we considered that the efficacy claims in ad (b) had not been substantiated and concluded that the ad was misleading.
On this point, the ad breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
(Misleading Advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
(Medicines, Medical Devices, Health-related Products and Beauty Products).
3. Upheld
We noted that ad (c) contained a number of claims implying the effectiveness of salt therapy in treating COPD, in support of which BodyToxing had supplied a PubMed article abstract that referenced a study evaluating the effects of a dry salt inhaler on adult COPD sufferers. We noted that the study referred to in the abstract related to the use of dry salt inhalers, which did not equate to the form of therapy offered by BodyToxing. We also noted the extracts from TSC's websites in regards to their participation in the NHS PSB project.
We did not consider that we had seen robust evidence, such as studies on human subjects that demonstrated the efficacy of salt cave therapy in treating the symptoms of respiratory conditions referred to in the ad. We did not consider the excerpt of the testimonial from a certified athletics trainer to be adequate evidence to demonstrate the efficacy of the treatment in enhancing sporting performance. We also had not seen robust evidence from BodyToxing to substantiate the claims "the treatment's efficacy is estimated at 75-98% depending on conditions" and that the therapy "improve[s] general health and quality of life". On this basis, we considered that the efficacy claims in ad (c) had not been substantiated and concluded that the ad was misleading.
On this point, the ad breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
(Misleading Advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
(Medicines, Medical Devices, Health-related Products and Beauty Products).
4. Upheld
We noted that ads (a), (b) and (c) listed a number of conditions for which the ads implied that the treatments available would be beneficial. In particular, ad (a) stated "iClenase (BODY SMOKING) ... Benefits: Helps correct digestive disorders while soothing the nervous system ... Boosts fertility, Eases menstrual cramps, Balances hormones, Fights infections". Ad (b) stated "Benefits of Wet Cupping: Reduce pain and inflammation throughout the body ... Stimulating blood circulation, Boosting the immune system ... Migraine and headache relief". Ad (c) stated "In fact, the NHS, officially endorses Salt Therapy to treat COPD. Salt therapy can significantly help to: Improve lung function ... Alleviate sneezing, coughing and shortness of breath, Clear mucus and sticky phlegm from the lungs, Increase the resistance to respiratory tract diseases, Strengthen your immune system".
We considered that the conditions referred to above were conditions for which medical supervision should be sought. The CAP Code required that marketers must not discourage essential treatment for conditions for which medical supervision should be sought; they must not offer advice, diagnosis or treatment for such conditions unless conducted under the supervision of a suitably qualified health professional. Although we noted BodyToxing's comments that they recommended consumers to seek medical advice before using these treatments, we had not seen evidence to demonstrate that BodyToxing administered the treatments advertised in ads (a), (b) and (c) under the supervision of a suitably qualified health professional.
We also noted that ad (c) included the following statements under the section titled “Salt therapy can significantly help to”: "reduce the need for inhalers and antibiotics"; "reduce the number of hospital admissions"; "prolong remission times"; and "Endorsed by the NHS for COPD". We considered that these statements created the impression that salt therapy could be used as a primary treatment for COPD and other respiratory conditions, in place of conventional medical treatments for such conditions. We considered such statements discouraged essential treatment for respiratory diseases for which medical supervision should be sought.
For the above reasons, we concluded that the ads breached the Code.
On this point, the ad breached CAP Code (Edition 12) rules
12.2
12.2
Marketers must not discourage essential treatment for conditions for which medical supervision should be sought. For example, they must not offer specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment is conducted under the supervision of a suitably qualified health professional. Accurate and responsible general information about such conditions may, however, be offered (see rule
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
).
Health professionals will be deemed suitably qualified only if they can provide suitable credentials, for example, evidence of: relevant professional expertise or qualifications; systems for regular review of members' skills and competencies and suitable professional indemnity insurance covering all services provided; accreditation by a professional or regulatory body that has systems for dealing with complaints and taking disciplinary action and has registration based on minimum standards for training and qualifications.
(Medicines, medical devices, health-related products and beauty products).
5. Upheld
We noted that BodyToxing's comments that they were a franchisee of TSC. We also noted that the information stated on the website for The Salt Cave stated that they were invited by the NHS to participate in a pilot project in 2011 as part of the Personal Health Budget program, to provide therapy for COPD sufferers.
We noted that ad (c) stated "In fact, the NHS officially endorses Salt Therapy to treat COPD" and "Endorsed by the NHS for COPD" and featured the official NHS logo. We considered that consumers, upon viewing these claims and the logo within the context of the ad, were likely to interpret the ad to mean that salt therapy was officially endorsed by the NHS as a form of primary treatment for sufferers of COPD. On the basis that we had not seen robust evidence to demonstrate that this was the case, we considered that the claims had not been substantiated and concluded that the ad was misleading.
On this point, the ad breached CAP Code (Edition 12) rules 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading Advertising), 3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation) and 3.50 3.50 Marketing communications must not display a trust mark, quality mark or equivalent without the necessary authorisation. Marketing communications must not claim that the marketer (or any other entity referred to), the marketing communication or the advertised product has been approved, endorsed or authorised by any public or other body if it has not or without complying with the terms of the approval, endorsement or authorisation. (Testimonials and Endorsement).
Action
The ads must not appear again in their current forms. We told BodyToxing to ensure that they did not make the efficacy claims referenced in the ads and claims that implied salt therapy was officially endorsed by the NHS in future advertising unless they held robust evidence to substantiate the claims. We also told BodyToxing to ensure that their ads did not discourage essential treatment for medical conditions for which medical supervision should be sought.
