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“This was radically different from most public health campaigns,” said Beth Scott, an infectious-disease specialist who worked with Dr. Curtis on the Ghana campaign. “There was no mention of sickness. It just mentions the yuck factor. We learned how to do that from the marketing companies.”
The ads had their intended effect. By last year, Ghanaians surveyed by members of Dr. Curtis’s team reported a 13 percent increase in the use of soap after the toilet. Another measure showed even greater impact: reported soap use before eating went up 41 percent.
And while those statistics haven’t silenced critics who say habit-forming advertisements are worrisome, they have convinced people who run other public health initiatives that the Ghana experiment is on the right track.
Today, public health campaigns elsewhere for condom use and to fight drug abuse and obesity are being revamped to employ habit-formation characteristics, according to people involved in those efforts. One of the largest American antismoking campaigns, in fact, is explicitly focused on habits, with commercials and Web sites intended to teach smokers how to identify what cues them to reach for a cigarette.
“For a long time, the public health community was distrustful of industry, because many felt these companies were trying to sell products that made people’s lives less healthy, by encouraging them to smoke, or to eat unhealthy foods, or by selling expensive products people didn’t really need,” Dr. Curtis said. “But those tactics also allow us to save lives. If we want to really help the world, we need every tool we can get.”