As members of the U.S. Congress consider options on how to fund Obama administration plans to extend health care coverage to those currently uninsured, the drug and advertising are digging in to defend tax breaks on direct-to-consumer advertising. Representative Charles Rangel (D-N.Y.), the chairman of the House Ways and Means Committee, said that "one thing that's not off the table is that you can pick up $37 billion knocking out the deduction for [drug] advertising." The possibility that the tax deduction on drug promotion could be removed has angered the Association of National Advertisers (ANA). "What, anytime somebody doesn't like a particular product category, they're going to take away their tax deduction?" asked Dan Jaffe, ANA's Executive Vice-President. In a media statement, the ANA objected to any change that would make "advertising more expensive" as, it claimed, "advertising is critical to the economic recovery of our nation." The Pharmaceutical Research and Manufacturers of America did not respond to Advertising Age's request for a comment.

The newly-passed FDA tobacco bill, and the restrictions it places on cigarette advertising, are already drawing opposition from the Association of National Advertisers (ANA), a group of 340 companies that spend more than $100 billion a year on marketing and advertising. The new rules will ban outdoor advertising for tobacco within 1,000 feet of schools and playgrounds, and restrict many forms of print advertising to black-and-white text only. The ANA predicts that federal courts will throw out the new marketing restrictions. Tobacco companies have also started complaining about the bill's restrictions. Even Altria Group, the parent company of Phillip Morris, which helped draft the bill and supported the legislation, said in a statement last week that it believed some of the marketing restrictions were illegal. Legal experts have said a court challenge of the bill on First Amendment grounds is virtually certain.

"The advertising firm behind the heavily-aired 'America's Power' campaign, R&R Partners - Advertising, has come out with its own brag-sheet detailing the ad work it did for the coal industry's main front group," the American Coalition for Clean Coal Electricity (ACCCE), reports Kevin Grandia. According to R&R's public relations account supervisor, Rob Van Raaphorst, the firm "educate[d] our audiences on the importance of coal in their daily lives," using "grassroots" outreach, "earned media, paid media and advocacy tactics that created a 'surround-sound' effect." The "grassroots" outreach included "street teams, walking billboards, mobile billboards and recruitment and mobilization of an ACCCE Army ... at presidential primaries, debates, conventions and other key campaign events." R&R also worked on a $400,000 website, CleanCoalUSA.org, "to establish Coal-Based Generation Stakeholders as a recognized advocacy group and source for information about clean-coal technologies."

The new American Legacy Foundation "truth" Campaign ads use a candid-camera approach to educating the public about the health hazards of smoking. To create the ads, the Campaign ran real online announcements seeking employees for executive-level positions at a tobacco company. The "stage" was a mock job recruiting office in New York City. Actors posed as interviewers while multiple hidden cameras recorded conversations with 40 "applicants" who responded to the ads. Interviewers first tried to impress candidates by describing executive job openings and generous benefits packages in an industry that spends $13 billion a year on marketing in the U.S. alone. They then mentioned that the industry's products kill 1,200 people every day in the U.S., asked interviewees whether they thought changing the name of the company was a reasonable way to avoid bad publicity, and whether they thought they could "plead the Fifth" (pointing out that one tobacco industry executive pled the Fifth Amendment 97 times while giving a deposition in 1997). The cameras captured the candidates' reactions, which were used in the ads. Each ad ends with the question, "Do you have what it takes to be a tobacco executive?" The Campaign had a real job recruiter on hand after the fake interviews to help applicants with real job placement. The ads will run in cinemas in 38 regional markets prior to teen-focused films, and the audience will be able to SMS messages to interact with the ad. The spots will also run on youth-centric channels like MTV, VH1 and Fuse. (The American Legacy Foundation is the funder of CMD's TobaccoWiki project.)

Conservatives for Patients' Rights, a group bankrolled by Richard Scott and promoted by CRC Public Relations, is going beyond its "ominous ads warning that President Barack Obama will institute government-run healthcare." It's produced "a 30-minute documentary-style video featuring patients from the United Kingdom and Canada recounting horror stories at the hands of their country's government health care systems." The video is running on cable networks and will air "immediately after NBC's Sunday talk show 'Meet the Press' May 31," just as Congress returns from break. "The spot is part of a planned $20 million ad campaign," reports the Wall Street Journal. Another group, Americans for Prosperity Foundation, is spending $1.7 million on a similar ad campaign. In the Americans for Prosperity spots, a Canadian woman says, "As my brain tumor got worse, my government health-care system told me I had to wait six months to see a specialist." The group plans to run its ads in eight states "seen as influential in the health-care debate" -- Montana, Virginia, Arkansas, Louisiana, South Dakota, Indiana, Alaska and Nebraska -- and hold rallies "in Virginia and elsewhere."

"Prescription drug ads have drawn fire for portraying healthy-looking, active and smiling patients while explaining benefits and then rushing through or providing distractions when required risk information is presented," reports Reuters. For example, an ad for a Schering-Plough allergy drug featured "a bee that flew around during a description of side effects but simply hovered while benefits were explained." These and other marketing tricks may "misleadingly minimize the risks" of drugs and medical devices, acknowledges the U.S. Food and Drug Administration (FDA). The FDA issued new marketing guidelines that say it will consider "the messages conveyed by the promotional piece as a whole" when evaluating whether ads "present risk information adequately." Representatives from two industry groups, the Pharmaceutical Research and Manufacturers of America and the Advanced Medical Technology Association, pointed to their voluntary ad guidelines as proof that their marketing is "responsible."

A Philadelphia judge has ruled that R.J. Reynolds (RJR) violated a provision of the 1998 Master Settlement Agreement that prohibits tobacco companies from using cartoons to sell cigarettes to minors. In November 2007, RJR ran cartoon-like ads in Rolling Stone magazine promoting Camel cigarettes. The ads -- titled "The Farm: Free Range Rock" -- bore the iconic, silhouetted Camel logo and used whimsical pictures of farm animals to promote the company's support of independent rock bands. Judge William J. Manfredi gave RJR the choice of paying a fine of $302,000 or running a full-page anti-smoking ad in a Rolling Stone edition that circulates in Pennsylvania. In making his ruling, Manfredi declared that RJR had violated its pledge not to pitch cigarettes to kids because the ad juxtaposed cartoon illustrations next to an ad for Camel cigarettes.

Pfizer has produced a great example of stealth advertising with its commercial promoting a Web site called MyTimeToQuit.com. The ad has the look and feel of a public service announcement, and mentions neither Pfizer, nor the popular smoking cessation drug it promotes -- Chantix (varenicline). The ad represents a growing trend in drug advertising called "help-seeking ads," which don't mention a drug by name, but instead address the condition the drug is meant to treat, and then drive viewers to a toll-free 800 number or a Web site that offers an option to learn more about a prescription drug meant to treat the condition. It is a sneaky, but legal way to advertise drugs that have particularly bad side effects, since avoiding mentioning the drug by name lets the company off the hook for listing its bad side effects in the ad, too, according to the U.S. Food and Drug Administration (FDA) rules. Chantix has some serious side effects, according to an alert the agency issued on Chantix, including "serious neuropsychiatric symptoms," like changes in behavior, depressed mood, suicidal ideation and completed suicide.