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Innovative Marketing, Volume 5, Issue 4, 2009

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Melby Karina Zuniga Huertas (Brazil), Marcos Cortez Campomar (Brazil)Rational and emotional appeals in advertising of prescriptionmedicines: study of a slimming drug in BrazilAbstractThe Direct-to-Consumer (DTC) advertising of medicines encourages people to ask physicians about medicines andtreatments that require medical prescription. Advertising models recommend matching the appeals (rational and/oremotional) to the consumer's attitude toward the product (cognitive and/or affective). Such recommendation generatescontroversies in the DTC advertising context. Emotional appeals might always appear to be inadequate in this type ofadvertising. Adequate or not, medicine advertising exists and within the scope of this article our discussion will focuson the forms of persuasion of drug advertisements and consumer attitudes towards them. Because there is no empiricevidence about Brazilian consumer's perspective, a descriptive research was undertaken with a sample of women. Theobjective was to evaluate: i) components of attitude towards medicines; ii) attitude and behavioral intentions towardsDTC ads (rational and emotional). The study measured five constructs: i) cognitive component of attitude towardsslimming drugs; ii) affective component of attitude towards slimming drugs; iii) general attitude towards slimmingdrugs; iv) consumer attitude towards slimming drug ads (one with predominantly rational appeal and another withpredominantly emotional appeal); and v) behavioral intention as a consequence of exposure to ads. A prescriptionweight-loss medicine was chosen. Results revealed an attitude predominantly cognitive toward the product and anattitude and a behavioral intention more favorable toward the rational ad. Negative cognition about the product wasidentified, restricting the persuasive power of emotional appeals.

Keywords: advertising, appeals, attitude, consumer.

Introduction7Pharmaceutical companies have been increasinglyusing Direct-to-Consumer (DTC) advertising toencourage consumers to ask doctors about certainprescription drugs in countries such as the UnitedStates and New Zealand where there are norestrictions on medication advertising and

treatments in countries such as Brazil where DTCadvertising is not allowed to include the productsname. In the United States, the use of emotionalappeals in DTC advertising is intense (Main et al.,2004) and is a cause for concern (Menon et al.,2004). In Brazil, DTC advertising is also loadedwith emotional appeals (Huertas & Urdan, 2004).

In order to increase persuasiveness, someadvertising models recommend matching appeals(rational and/or emotional) with consumersattitudes toward the product (cognitive and/oraffective). This recommendation is of disputableappropriateness in the case of potentially harmfulproducts such as medicines. Messages intended toappeal to the consumers feelings and emotions areindisputably valid for several product classes. Butwhen it comes to medicinal drugs, some critics ofDTC advertising understand that the use ofemotional appeals is inappropriate, as they differfrom other products and, therefore, should not bepromoted in the same way (Findlay, 2001). Ratherthan make a well informed choice among thetreatment options with the doctor, patients seem to

be demanding and often getting brands of medicines

Melby Karina Zuniga Huertas, Marcos Cortez Campomar, 2009.

which use emotional appeals (happiness, fun) inadvertising (Mintzes, 2002). It seems more likelyconsumers may be influenced by emotions ratherthan rational appeals (information) (Main et al.,2004). For example, in the United States, thepharmaceutical company Pfizer emphasizes theemotional benefit (happiness) to launch its drugViagra (Clow & Baack, 2002). Then, the excessiveconsumption of the drug without a doctorprescription led Pfizer to adopt a more informativeapproach. But without forgetting the emotionalappeal. According to a more radical view aboutmedicines advertising, some understand that anyform of drug promotion is completely inappropriate(Nascimento, 2005). For example, in Brazil, beyondrestrictions to prescription medicines advertising,promotion of erectile dysfunction drugs, like Viagra,is forbidden (Propaganda, 2003). Adequate or not,medicine advertising exists and within whether the

scope of this article, our discussion will focus on theforms of persuasion of drug advertisements andconsumer attitudes towards them.

1. Theoretical frameworkIn order to be persuasive, the advertiser must knowif an advertisements appeals (whether rational oremotional) should or should not coincide with theconsumers (whether cognitive or affective)attitudes towards the advertised product (Dub etal., 2003). Rationally-appealing adverts motivateconsumers by means of logical information and

arguments (Woochang & Franke, 1999). Emotionalappeals attempt to evoke effective responses (Mainet al., 2004). On the other hand, attitude towardsproducts consists in assessments that may derive

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from qualitatively different types of information(Blackwell et al., 2005), forming the cognitive andaffective components (Bagozzi et al., 2002). Thecognitive element concerns knowledge and thinking,while the affective aspects concern emotions andfeelings, in both cases toward the object of theattitude (Shimp, 2002).

Some advertising models, such as the ElaborationLikelihood (Petty & Cacioppo, 1986), Foote, Cone& Belding (Vaughn, 1986), Rossiter-Percy (Rossiter,1987; Rossiter et al., 1991), and Affect-Reason-Involvement (Buck et al., 2004) suggest matchingappeals with attitude toward the product. That is,using advertising with rational appeals for productswhere the consumers attitude is predominantlycognitive, and emotional appeals for productstowards which attitude is predominantly affective.

From this perspective, knowing the consumers

attitude toward medicinal drugs is crucial toassessing the persuasiveness of rational andemotional appeals in DTC advertising. This leads tothe first part of the empirical research objective:assessing the cognitive and affective components ofconsumers attitudes towards medicinal drugs.

One of the arguments used by the critics of DTCadvertising is that prescription drugs should only beprescribed when a doctor believes them to be thebest way to reduce a patients suffering (Findlay,2001). Now, instead of making an informed choice

among treatment options in consultation with theirdoctors, consumers appear to be demanding, andoften receiving, prescription drug brands whoseadvertising is based on emotional appeals (Mintzes,2002; Wolfe, 2002). Consumers may not understandthe nature of DTC advertising, and are more likelyto be misled or influenced by non-rationalarguments (Main et al., 2004).

In Brazil, DTC drug advertising also tends tointensify (Sonego, 2005 Fev 21). It has been blamedfor the potentially harmful consequences of self-

prescription (won-volition consumption ofprescription drugs) (Morais, 2003 Fev). For Morais,Brazils fifth place in the world rank of medicinaldrugs consumption, reflects serious problems thatare a matter of debate in developed countries: theprescription drug abusive use as a public healththreat and the billion-dollar interests ofpharmaceutical industry.

The Brazilian governments concern can beperceived in steps such as the 2003 ban on erectiledysfunction drugs advertising and the constant

oversight of legal compliance in promotional pieceson the part of the National Sanitary InspectionAgency (Agncia Nacional de VigilnciaSanitria ANVISA) (Jimenez, 2004 Abr 21).

Another initiative that reflects a concern withexcessive medical drugs consumption in Brazil isthe presence of the Brazilian Medicinal DrugInformation System (Sistema Brasileiro deInformao sobre Medicamentos SISMED),coordinated by the Brazilian Center for MedicinalDrug Information (Centro Brasileiro de

Informao sobre Medicamentos CEBRIM) ofthe Federal Pharmacy Council (Conselho Federalde Farmcia). SISMED is made up of MedicinalDrug Information Centers where the general publicand health professionals have access to informationon the rational use of medicinal drugs.

Generally speaking, medicinal drug advertising iscontroversial, as illustrated by works such as Barros(Barros, 1995) and Pizzol (Pizzol et al., 1998), andarticles published in the bulletins of the BrazilianMedicinal Drug Advertising Society (Sociedade

Brasileira de Propaganda de Medicamentos SOBRAVIME). On the specific topic of DTC drugadvertising in Brazil, the works of Heineck(Heineck et al., 1998), Nascimento (Nascimento,2005) and Huertas & Urdan (Huertas & Urdan,2004) are particularly noteworthy. The latterprovides evidence of increased use of emotionalappeal in this kind of advertising.

Worldwide, the growing use of emotional appeal inDTC advertising is subject to constant criticism,which suggests its replacement with rational appeal(Main et al., 2004). Equipping consumers withinformation enables them to choose the best solutionavailable for a health problem (Meek, 2001 Nov).Furthermore, increased consumer awareness maylead doctors to have richer discussions with patients,helping them to explain whether or not a certaintreatment is considered necessary (Menon et al.,2004). In this sense, there are those in Brazil whounderstand that the fundamental issue is not whetheror not consumers should be given information onalternative treatments, but whether the promotion ofmedicinal drugs whose main purpose is to

maintain and expand sales is the appropriatemeans to convey the information consumers need(Barros, 2004). Some argue for a total ban onmedicinal drug advertising as an instrument toprotect society against asymmetric economic power(Nascimento, 2005). Whether it is appropriate ornot, DTC medicinal drug advertising exists and theway in which consumers are influenced by itsappeal is yet unclear.

In Brazil, the claims of specialists against and infavor of DTC advertising and its rational and

emotional appeals lack empirical evidence from theconsumer perspective. Are people more favorable toprescription drug ads with rational (emotional)appeals and, therefore, more inclined to take action?

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This question leads to the second part of theempirical research objective: to assess attitude andbehavioral intention towards DTC ads, one withpredominantly rational appeal and another withpredominantly emotional appeal.

2. Empirical research methodThe empirical research method consisted of adescriptive survey with individuals in the city of SoPaulo in April 2006. Life-improving medicinaldrugs that fight conditions from depression toobesity have helped the pharmaceutical industrygrow their business. In particular, the abundance ofslimming-drug advertisements led to the choice ofthis product type for the empirical study.

Sample The target population included womenover the age of 18 with residence in the city of SoPaulo. The sampling frame was Ibirapuera Park. The

sampling technique was intentional by judgment andquota. Women who had and had not ever takenslimming drugs were considered (50 percent each).Sample size was 320 individuals, defined based onthe resources available. Two interviewers weretrained to approach potential participants and helprespondents fill out forms.

Measurement The measurement process involvedthree constructs:

Attitude towards slimming drugs Measurementof the attitude towards slimming drugs focused on

its cognitive and affective components (Bagozzi etal., 2002). We used as base the semanticdifferential scale provided by Crites (Crites et al.,1994), which includes three sub-scales: cognitive,affective and general. Items form bipolarcontinuums anchored in pairs of wordsrepresented by numbers from 7 (positive) to 1(negative). Scale items were translated intoPortuguese from English. New indicators wereadded in light of consumers needs inpharmaceutical markets (Smith et al., 2002). Thisled to the final scale: i) Cognitive Component Useful/Useless, Reliable/Doubtful, Beneficial/Harmful, Healthy/Unhealthy, Necessary/Unne-cessary, Excellent/Terrible, Convenient/Inconve-nient, Effective/Ineffective; ii) Affective Compo-nent Excited/Unexcited, Motivated/Unmoti-vated, Con-tented/Discontented, Confident/ Mis-trustful, Hopeful/Hopeless, Acknowledged/Igno-red; iii) General Attitude Desirable/ Undesirable,Favorable/Unfavorable.

Attitude towards ads Measurement of theattitude toward ads focused on a summary

judgment of the object (ads) on a dimensionfrom positive to negative (Petty et al., 1997).The first step was selecting the ads. Among

slimming drugs there is Xenical, an anti-obesity agent whose marketingcommunications are not restricted tophysicians. In September 2004, Rochelaunched a campaign targeted at consumersacross Latin America, with the motto: Whatwould you do with a few pounds less?(Roche, 2004). The Xenical TV advertisementshows five beautiful women who want to loseweight asking themselves what they would dowith a few pounds less. They provide answerssuch as make amends with the mirror anddo a lingerie catwalk. The piece concludeswith the information that there is a way toeliminate 30 percent of the fat of ingestedfoods and recommends that people interestedin losing weight should see a doctor. Thepurpose of the ad is to show how weight-loss

boosts self-esteem, with a predominantlyemotional appeal. To measure the attitudes ofconsumers towards predominantly emotionalads, one of the magazine advertisements ofthe campaign described above, was chosen.Additionally, we prepared the predominantlyrational ad based on information from theXenical Website for Brazil (www.xeni-care.com.br). Following Brazilian legislationabout advertising of prescription medicines,for both ads the product name did not appear.

Measurement of the constructs of the attitudetoward the advertisement was based onHenthorne & LaTours attitude towardadvertisement scale (Henthorne & LaTour,1993), whose indicators are as follows:Good/Bad, Interesting/Uninteresting, Infor-mative/Uninformative, Easily understood/Hard to understand. Indicators identified in apre-test with the advertisements under appraisalwere added to this scale. The followingindicators were included: Useful/Useless,Convincing/Unconvincing, Entertaining/Bo-

ring, Arouses curiosity/Does not arouse cu-riosity, Captivating/Dull, Easily remembered/Hard to remember, Reliable/Unreliable, andDifferent/Ordinary.

Behavioral intention Studies of behavioralintention towards medicine advertisements havebecome frequent in recent years in the UnitedStates, New Zealand and Australia, but theitems used are a poor reflection of Brazilianreality. In Brazil, prescription medicines could bebought without showing the physiciansprescription. Because of this, behavioral intentions

of Brazilian consumers couldnt be evaluatedusing exactly the same indicators employed inprevious studies. Then, some indicators previous-

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ly used were translated and others were added.The items used were: to question a physicianabout the drug, to ask a physician to prescribethe drug, to inquire about the drug in adrugstore, to buy the drug in a drugstore, tobrowse the site indicated in the ad to obtainmore information, and to call a toll free

telephone number indicated in the ad to obtainmore information. Utilizing this scale,respondents indicated the likelihood ofperforming these actions represented bynumbers 7 (definitely yes) to 1 (definitely no),with intermediate degrees between the twoextremes.

Having defined the scales, we compiled a three-partquestionnaire. The first question was intended todistinguish between respondents who had and who hadnot taken slimming drugs. Next with slimming drugcategory in mind, respondents moved on to the firstpart of the questionnaire, which contained the batteriesof affective component of attitude, cognitivecomponent of attitude and general attitude sub-scalequestions. In the first battery, concerned with theaffective component sub-scale, respondents wereasked to think of a slimming drug and mark theposition that best described their feelings about thiskind of drug. The chosen statement was: aboutslimming drugs, I feel... In the second battery,containing the cognitive component of attitude sub-scale, respondents were asked to mark the position that

best described the attributes or characteristics of thiskind of drug. The statement was: slimming drugs are...In the third battery, dedicated to the general attitudesub-scale, respondents were asked to mark theirjudgment of sliming drugs in general. The statementwas: generally speaking, slimming drug is...

The second part of the questionnaire contained fourbatteries of questions. Respondents were asked to seeboth (rational and emotional) ads for a few minutesand then answer the questions, beginning with eitherone. The first battery concerned the attitude towards

the first ad and the second battery concernedbehavioral intention. The third and fourth batteries hadthe same content, but in connection with the secondad. Finally, respondents were asked about their relativeweight, with the following alternatives: below idealweight, at ideal weight, very little over ideal weight, alittle over ideal weight, over ideal weight, far overideal weight.

Analysis The variables were measured on Likertscales, which, strictly speaking, are ordinal only. Butsome authors endorse treating such scales as intervalscales (Malhotra, 2006). Prenovost brings up theimportance of this issue, because Likert scales areprevalent in behavioral and social science research(Prenovost, 1999). He regrets that ordinal variables are

so often used for the purposes of parametric analysis.Here, the data in the Likert scales are assumed to be ofa purely ordinal nature. Scales such as these allowhypothesis-testing with non-parametric statistical tests,but these were not run because a non-probabilisticsample such as ours does not permit generalization.

Non-parametric statistics include association metrics inaddition to tests. Association metrics include theSpearmans rank correlation coefficient (rs) ameasure of association between two variables. Theeffectiveness of Spearmans coefficient reaches 91percent compared with the most powerful parametricassociation test, Pearsons coefficient (r) (Siegel &Castellan, 1988). That is to say, using rs to test for thepresence of association in the population for which theassumptions required for Pearsons coefficient havebeen met, the efficiency of rs reaches 91 percent of r inrejecting the null hypothesis.

3. ResultsThe study measured five constructs: i) cognitivecomponent of attitude towards slimming drugs; ii)affective component of attitude towards slimmingdrugs; iii) general attitude towards slimming drugs; iv)consumer attitude toward slimming drug ads (one withpredominantly rational appeal and another withpredominantly emotional appeal); and v) behavioralintention as a consequence of exposure to ads. 320questionnaires were applied, 315 of which were valid.Participants were concentrated in age groups: 21-30

(36%) and 31-40 (26%). Third came respondents inthe 41-50 age group (15%). Age groups up to 20(14%), 51-60 (7%) and over 61 (1%) followed. Interms of scholarly achievement, most respondentswere high school graduates and had some higherlearning (51%), followed by higher education degree(18%). The sample had rather similar shares ofrespondents who had (51%) and had not (48%) takenweight-loss drugs. Only 1 percent of respondentsrefused this question. Among respondents who hadtaken a slimming drug, 70 percent did so withprescription and 29 percent without. As for relative

weight at the time of the survey, the vast majority ofrespondents indicated that they were over-weight(71%). Respondents at or below their ideal weightaccounted for 29 percent of the sample.

To analyze the components of consumer attitudetoward slimming drugs, we analyzed the associationbetween constructs: i) cognitive component of attitudeand general attitude; ii) affective component of attitudeand general attitude. For each construct, item-by-item,the frequency in each position on the scale wascounted, creating three new variables corresponding tothe constructs. The frequency count for the cognitivecomponent construct can be seen in Table 1; the sameprocedure was used for the affective component andgeneral attitude constructs. Spearmans correlation was

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4. Discussion of resultsConsumer attitudes towards slimming drugs werefound to be predominantly cognitive. But given thatthe drug is related to peoples lifestyles (appearance)and quality of living, we expected the affectivecomponent to have greater influence over attitude.Cognitively, weight-loss drugs were consideredunhealthy, doubtful and harmful, althoughnecessary, convenient and effective. Their emotionalbenefits were given a positive evaluation, causingwomen to feel excited, reliant, motivated, hopefuland acknowledged. Still, the general attitudetowards slimming drugs is predominantly negative.

There was a slight difference between respondentsof different relative weights. For both respondentgroups (at or below ideal weight and over idealweight), the attitude towards slimming drugs waspredominantly cognitive. But, in the former group,

the cognitive and affective components of attitudewere more closely associated with the generalattitude. Among respondents at or below idealweight, the cognitive component evaluations werepredominantly negative. Affective componentevaluations, in turn, were predominantly indifferent.Women at or below ideal weight regard slimmingdrugs as unhealthy, harmful, unnecessary andinconvenient, and show no emotion towards them.

Among respondents over ideal weight, cognitivecomponent evaluations were split: one half of them

were predominantly negative and another half predominantly positive. Affective componentevaluations were predominantly positive. Generalattitude evaluations were almost equally indifferentand negative. Women above ideal weight regardweight-loss drugs as unhealthy and harmful, butnecessary, convenient and effective, and experiencepositive emotions and feelings towards them.

The results reinforce the perception that, as concernsmedicinal drugs, the products functional attributesare more closely associated with attitude (Vaughn,1986). But we expected the affective component tohave a greater influence on respondents over idealweight. The probable cause of a different outcome isthe negative cognition of slimming drugs amongrespondents, causing the products emotionalbenefits to lose relevance in attitude formation. Thisis perhaps why the association between the affectivecomponent and the general attitude of respondentsabove ideal weight was so low. They acknowledgethe drugs emotional benefits, but their generalattitude is not very favorable.

Results indicate some differences between

respondents who have and who have not takenslimming drugs, confirming the importance ofconsumer experience with a product in attitudeformation. Attitude of respondents who had

previously taken slimming drugs was predominantlycognitive. For respondents who had not ever takensuch drugs, on the other hand, while attitude wasalso predominantly cognitive, both componentswere more strongly associated with the generalattitude.

Among respondents who had previously takenslimming drugs, cognitive component evaluationswere markedly negative. Affective componentevaluations were positive in essence. Generalattitude, on the other hand, was predominantlynegative. Therefore, respondents who have takenslimming drugs regard them as necessary,convenient, effective, unhealthy, unreliable andharmful, even though they generate excitement,hope and acknowledgment, making for a generallynegative attitude.

Among respondents who had not ever taken

slimming drugs, cognitive component evaluationswere predominantly negative; affective componentones were generally indifferent; and general attitudeevaluations were markedly negative. Respondentswho had never taken weight-loss drugs considerthem unhealthy, unreliable, harmful, unnecessaryand ineffective, and experience no emotion towardsthem. They also sport a predominantly negativegeneral attitude. This negative cognition ofslimming drugs may be the reason why overweightindividuals in this respondent group never used suchdrugs.

The second step towards achieving the plannedresearch objective was to evaluate consumerattitudes towards predominantly rational andpredominantly emotional ads. The results showmore favorable behavioral attitudes and behavioralintention towards the former. This, together with theattitude component results for slimming drugs(predominantly cognitive), leads to a relevantfinding. As suggested by advertising models(Elaboration Likelihood; Foote, Cone & Belding;Rossiter-Percy; Affect-Reason-Involvement), when

consumer attitudes toward a product arepredominantly cognitive, a rationally appealingadvertisement should be more effective (morefavorable attitude and behavioral intention towardsthe ad). Here, however, the difference in favorableattitude and behavioral intention between therational and the emotional ads was not tooexpressive. A significant share of respondents wasmore favorable to the emotional piece.

The results show no difference between respondentsof different relative weights as regards attitude and

behavioral intention towards advertisements. Theattitudes and intended behaviors of the two groups(at or below ideal weight and above ideal weight)were similar when faced with the rational and

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emotional ads. This indicates that respondentweight, as a consumer characteristic, should notinfluence their attitude towards slimming drugs. Nordid we detect any difference in attitude andbehavioral intention towards advertisementsbetween respondents that have and have notexperience with slimming drugs. As a result, attitudetowards advertisement does not appear to beinfluenced by the consumers experience with theproduct or lack thereof.

From the consumers viewpoint, the advertisementmodels recommended matching of appeals withconsumer attitude toward the product has beenconfirmed. Consumer attitude towards weight-lossdrugs was predominantly cognitive, and attitude andbehavioral intention were more favorable to therational ad. Generally speaking, the results showthat, when individuals are exposed to

advertisements consistent with the predominantcomponent of their attitudes (cognitive/affective),the advertisement is more effective (more favorableattitude and behavioral intention).

As a consequence, using emotional appeals inweight-loss drug advertisements would have nopositive influence on consumer attitudes, as theirnegative cognition is primordial in attitudeformation, even where interest exists in the product(individuals over ideal weight). The effectivenessof an advertisements appeal, where consumer

attitude towards the product is predominantlycognitive, depends on the degree to which theystrike specific cognitions highly associated withthe product or brand (Drolet & Aaker, 2002). Butusing advertising appeals that fail to strike thecognitions associated with the product might formor reinforce negative attitudes.

One possibility for marketers of slimming drugs isto change the negative cognition of the product byusing predominantly rational advertisements. Onlythen emotional benefits could be exploited withpossible positive effects. At the same time,

authorities might educate the population on the risksand potential negative effects of weight-loss drugs,thereby neutralizing the effects of advertisementsthat attempt to persuade consumers withpredominantly emotional arguments.

These managerial implications offer insights formore effective advertisements. On the other hand,they may help ANVISA in its goal of modernizingand updating medicinal drug-advertisementregulations, as well as in the implementation ofpopulation education and awareness policies

concerned with the hazards of self-medication. Inthe reality of the United States, some critics of drugadvertising prefer rational appeals when it comes to

medicinal drugs. They argue that consumers shouldbe given information, rather than simple attempts atpersuasion with emotional appeals (Menon et al.,2004). The use of emotional appeals in medicinaldrug advertising is deemed acceptable by somecritics of this type of advertisement, and as the bestmeans to control persuasion efforts on the part ofdrug manufacturers (Mehta & Purvis, 2003). Butthis study has determined that consumers are morefavorable to rational appeals and, therefore, thatthese can be more persuasive in the case ofmedicinal drugs. This reinforces the relevance of theconcerns of experts who fully oppose drugadvertising of any kind, such as Nascimento(Nascimento, 2005), as the provision of informationalso poses risks. Consumers may get the impressionthat they have in-depth knowledge of a drug andexert pressure over doctors for prescription. They

may also feel as knowledgeable as doctors and self-medicate. Therefore, the use of rational appeals isno assurance of control over the negative effects ofDTC advertising. Once again, the best path appearsto be educating the population. Consumers shouldbe capable of understanding, interpreting and usinginformation on medicinal drugs. This, however, is adifficult task.

Brazilian authorities seem to be concerned withmedicinal drugs advertising. This can be perceivedin actions like the prohibition advertising for erectile

dysfunction drugs (Propaganda, 2003) and theconstant supervision of ads by the ANVISA(Jimenez, 2004). More recently, all medical drugadvertising was banned in drugstores. Symbols,logos, slogans, names of manufacturers and anyother argument to advertising medicines couldnt beexposed anymore. Consumer can be influenced withexcessive exposure to messages about drugs andANVISA wants to avoid self-medication.

5. Limitations and suggestions for future researchThe first limitation lies in the non-probabilisticsample size, which prevents generalizing results.Future research should address this issue, which willrequire more funds than this survey had. Anotherlimitation consists in the accuracy of field-surveymeasurements. The psychometric properties of thescales used were not examined. Many factors maylead to measurement errors, causing the observedscore to differ from the true scoring of the measuredcharacteristic (Churchill, 1991). Therefore, checkingthe validity, reliability and dimensionality of thescales is crucial in future research; as is testing the

instruments with other types of drugs. Building andvalidating a specific scale for attitude towardsmedicinal drugs would be even better.

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Field-survey respondents may also have been underthe effect of a social desirability bias (Erffmeyer etal., 1999). Such a response bias arises from responsesbased not on what the individuals truly believe andfeel, but on what they perceive as sociallyappropriate. It is possible that such a bias may havehad an effect on respondent attitudes towards weight-

loss drugs and the rational advertisement.

Finally, attitude towards advertising in general isone antecedent of consumer attitude towardsadvertisements (Mackenzie & Lutz, 1989). But noinformation is available on consumer attitudetowards medicinal drug advertising in Brazil.Research on this topic may provide importantmanagerial implications.

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