Fear in Health-Related Marketing

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Marketing is one of the most substantial factors that define the development of the free market and the culture of consumerism. It is particularly relevant in the United States, and several experts have noted that capitalism is frequently described as a patriotic type of economy in the country (Finley & Esposito, 2019). From these considerations, the various marketing strategies have been developed and perfected for over a century. One of such tactics is the implementation of fear to shift the preferences of the customers toward or away from a certain production. This strategy is highly prominent in health-related marketing, where the customers are frequently exposed to the harmful consequences of extensive alcohol, tobacco, and drug usage (Yoo & Jin, 2020). However, the experts argue concerning the effectiveness of fear appeals and, how much fear should be implemented in advertisements. The current paper examines the concept of fear in health-related marketing, analyzes the factors defining the impact of the method, and attempts to establish the most effective quantity of emotion stimulus in fear appeals.

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Fear Appeal Dynamics

The effectiveness of fear appeals varies significantly, depending on the area of research, the type of experiment, the control groups, and other research factors. The studies have demonstrated direct positive correlations, boomerang, and curvilinear results without substantial evidence to explain these findings (Yoo & Jin, 2020). Evidently, fear is a highly subjective concept, and it is near impossible to evaluate all factors that determine the effectiveness of a marketing strategy. Furthermore, fear is frequently described as an emotional spectrum, ranging from low anxiety levels to high degrees of panic (Daniel-Wanatabe & Fletcher, 2021). As a result, various stimuli lead to diverse outcomes, which make it complicated to predict the effectiveness of fear appeals. Nevertheless, it is possible to analyze some of the most prominent factors, which are commonly recognized to determine the outcomes of the marketing strategies.

Cultural Affiliation and Uncertainty

There is a large variety of constituents that define the individual response to fear in health-related marketing; however, cultural affiliation might significantly affect the outcomes of the advertisement. The recent research on fear appeals in Canada, China, and France has demonstrated that the ads have diverse effects on the public (Bartikowski et al., 2019). According to the researchers, this phenomenon occurs due to different levels of uncertainty avoidance among the citizens (Bartikowski et al., 2019). In other words, if the viewer of the advertisement is confident that the message is trustworthy, the overall effect on the individual would be more impactful. In the study by Bartikowski et al. (2019), the findings demonstrate that French citizens demonstrate considerably lower levels of trust in the advertisements compared to people in Canada and China. From these considerations, the effects of fear appeals are also less meaningful since the customers do not find them trustworthy. These findings show that the ultimate response to fear appeals depends significantly on the cultural background and the overall trust in advertisements.

Cessation and Adoption

The objectives of health-related advertisements also determine the quantity of fear. Concerning smoking, for instance, the cessation ads generally demonstrate disturbing imagery of health consequences, while adoptive methods promote the usage of counseling and nicotine patches (Lucchesi, 2019). Some experts argue that risk perception is likely not the most impactful determinant of the customers’ behavior (Peters et al., 2018). From these considerations, the effectiveness of cessation advertisements, which demonstrate the negative health consequences, is also debatable. However, Lucchesi (2019) proposes the differentiation between cessation and adoptive behavior on the basis of active and passive measures. According to this theory, adoptive methods would require active interference from the customer, which might not be a preferable strategy (Lucchesi, 2019). In this sense, the fear appeals of cessation advertisements should be more effective since they passively remind people that smoking is detrimental to health. Ultimately, there are various theories concerning the outcomes of cessation and adoption strategies; however, it is advisable to take this factor into consideration to establish the most impactful quantity of fear.

Visual Information

Consequently, the level of fear inflicted by the advertisement might depend on the representation of the risk. Imagery and texts are the two most prominent visual methods to convey emotion (Boshoff & Toerien, 2017). The former produces a much more robust neural response; for instance, a picture of a gangrene-affected foot has had a more impactful effect on the respondents compared to text representation (Boshoff & Toerien, 2017). As a result, disturbing imagery is an effective way to create an emotional response; however, the implications of such an approach are not fully studied.

Textual information might also produce a substantial emotional stimulus. For instance, the recent COVID-19 outbreak is associated with increased online activity, and people frequently encounter textual information related to fear of the pandemic (Du et al., 2019). Evidently, this data is not always trustworthy, but it changes the behavior of the readers based on the concept of fear. However, several experts have argued that fear appeals concerning COVID-19 might be detrimental (Stolow et al., 2019). For instance, some of the advertisements have demonstrated the burial grounds to indicate the dangers of the virus (Stolow et al., 2019). The authors argue that such an approach does not explain how to combat the pandemic and is detrimental to people’s understanding of COVID-19 (Stolow et al., 2019). Ultimately, visual representation is a highly significant factor that determines the quantity of fear.


The current paper has covered some of the most prominent factors that determine the emotional quantity in fear appeals and the public’s response to them. Evidently, contemporary neuroscientific models, such as functional magnetic resonance imaging (fMRI), might be used to accurately evaluate the reaction of people to fear imagery (Mostafa, 2018). The results of similar experiments are highly beneficial since they demonstrate the neural response, depending on the fear level. For instance, the figure below shows the correlation between the level of fear and acceptance of the message:

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Fear Appeal Effects
Figure 1. Fear Appeal Effects (Mostafa, 2018)

Note. These results demonstrate the average response to fear stimuli; therefore, the individual reaction may vary significantly, depending on the person.

Nevertheless, such methods cannot be used to generalize the findings due to the large variety of cultural backgrounds and personal experiences that define the identity of a person. Therefore, the safest method to establish the ‘goldilocks’ amount of fear level is to take a large variety of factors into consideration. The primary marketing principles, such as the analysis of target audience and feedback evaluation, should be combined with cultural affiliation, level of uncertainty, types of advertisements, and visual representation. Following all these guidelines, it is possible to establish the most effective quantity of fear in the ads, which would affect the largest number of people possible.


Fear appeals have been used in health-related marketing for a long time; however, the effectiveness of this method is still a hot topic in the academic community. Unfortunately, the accurate evaluation of fear quantity in the advertisements can only be conducted via contemporary neuroscientific equipment. Nevertheless, it is also possible to establish an approximate level of fear based on such factors as cultural affiliation, degree of certainty, types of the advertisement, and visual representation. Ultimately, there is a large variety of determinants of emotional response, and the advertising agencies should conduct a thorough analysis to establish the potential effectiveness of fear appeals.


Bartikowski, B., Laroche, M., & Richard, M. O. (2019). A content analysis of fear appeal advertising in Canada, China, and France. Journal of Business Research, 103, 232-239.

Boshoff, C., & Toerien, L. (2017). Subconscious responses to fear-appeal health warnings: An exploratory study of cigarette packaging. South African Journal of Economic and Management Sciences, 20(1).

Daniel-Watanabe, L., & Fletcher, P. C. (2021). Are fear and anxiety truly distinct? Biological Psychiatry Global Open Science.

Du, H., Yang, J., King, R. B., Yang, L., & Chi, P. (2020). COVID‐19 increases online searches for emotional and health‐related terms. Applied Psychology: Health and Well‐Being, 12(4), 1039-1053.

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Finley, L., & Esposito, L. (2019). Campaign of fear and consumption: Problematizing gender-based marketing of weapons. Contemporary Justice Review, 1-14.

Lucchesi, J. N. (2019). To fear or not to fear: An examination of fear appeals in health messaging by message frame and behavior request. University of Delaware.

Mostafa, M. M. (2018). Neural correlates of fear appeal in advertising: An fMRI analysis. Journal of Marketing Communications, 1–25.

Peters, G. J. Y., Ruiter, R. A., Ten Hoor, G. A., Kessels, L. T., & Kok, G. (2018). Towards consensus on fear appeals: A rejoinder to the commentaries on Kok, Peters, Kessels, ten Hoor, and Ruiter (2018). Health Psychology Review, 12(2), 151-156.

Stolow, J. A., Moses, L. M., Lederer, A. M., & Carter, R. (2020). How fear appeal approaches in COVID-19 health communication may be harming the global community. Health Education & Behavior, 47(4), 531-535.

Yoo, J. W., & Jin, Y. J. (2018). Comparative impact of fear appeals and induced hypocrisy advertising in encouraging intent to quit smoking: Applying self-construal theory to consumers’ attitudes. Global Health Promotion, 27(1), 51-58.

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