This article criticizes the predominant use of fear appeals in social marketing. Laboratory studies, which have been the basis for most of the research on fear appeals and which generally suggest that high fear works, have limitations that include forced exposure, short-term measurement, and an overdependence on student samples. Although, unfortunately, field research evaluations of fear appeals are few, they usually reveal that fear has both weaker effects and unintended deleterious effects in real-world social marketing campaigns. Ethical concerns about fear appeals include maladaptive responses such as chronic heightened anxiety among those most at risk and, paradoxically, complacency among those not directly targeted, and increased social inequity between those who respond to fear campaigns, who tend to be better off, and those who do not, who tend to be the less educated and poorer members of society. Alternatives to fear appeals are the use of positive reinforcement appeals aimed at the good behavior, the use of humor, and, for younger audiences, the use of postmodern irony

Methodology/Approach: Review of systematic reviews and primary studies using prespecified search and inclusion criteria. Social marketing interventions were defined as those which adopted specified social marketing principles in their development and implementation.Findings: A total of 54 interventions met the inclusion criteria. There was evidence that interventions adopting social marketing principles could be effective across a range of behaviours, with a range of target groups, in different settings, and can influence policy and professional practice as well as individuals.Research limitations/implications: As this was a systematic review, the quality of included studies was reasonable and many were RCTs. However, many of the multi-component studies reported overall results only and research designs did not allow for the efficacy of different components to be compared. When reviewing social marketing effectiveness it is 3 important not to rely solely on the 'label' as social marketing is often misrepresented; there is a need for social marketers to clearly define their approach.Practical implications: The review shows that social marketing can form an effective framework for behaviour change interventions and can provide a useful 'toolkit' for organisations that are trying to change health behaviours.Originality/Value: The research described in this paper represents one of the few systematic examinations of social marketing effectiveness and is based on a clear definition of 'social marketing'. It highlights both social marketing's potential to achieve change in different behavioural contexts and its ability to work at individual, environmental and wider policy levels.

Methodology/Approach: Review of systematic reviews and primary studies using prespecified search and inclusion criteria. Social marketing interventions were defined as those which adopted specified social marketing principles in their development and implementation.Findings: A total of 54 interventions met the inclusion criteria. There was evidence that interventions adopting social marketing principles could be effective across a range of behaviours, with a range of target groups, in different settings, and can influence policy and professional practice as well as individuals.Research limitations/implications: As this was a systematic review, the quality of included studies was reasonable and many were RCTs. However, many of the multi-component studies reported overall results only and research designs did not allow for the efficacy of different components to be compared. When reviewing social marketing effectiveness it is 3 important not to rely solely on the 'label' as social marketing is often misrepresented; there is a need for social marketers to clearly define their approach.Practical implications: The review shows that social marketing can form an effective framework for behaviour change interventions and can provide a useful 'toolkit' for organisations that are trying to change health behaviours.Originality/Value: The research described in this paper represents one of the few systematic examinations of social marketing effectiveness and is based on a clear definition of 'social marketing'. It highlights both social marketing's potential to achieve change in different behavioural contexts and its ability to work at individual, environmental and wider policy levels.