Ambiguity is persuasion’s best friend.  When you are uncertain, persuasion principles drive your thinking, feeling, and acting.  If you doubt this, consider health and safety, or more properly nowadays, Health and Safety.  I’m going to take one example, use it to kick open a door, then drive a truck through it.

Statins.

Those wonderful little pills that reduce cholesterol, have virtually no side effects, and help everyone to live longer and healthier lives.  Except that’s not true.  Not even close.  The original research demonstrated that among people with existing cardiovascular disease, statins did help, but at a rather small effect.  Now add in fear (of death) and confusion (among patients and doctors), and soon almost anyone was taking a statin.  Instead of acting as a curative agent that reduced disease in sick people, statins became preventative agents that reduced the risk of disease ever starting in healthy people.

But the data never supported that shift from cure to prevention and today even the medical establishment is beginning to say it loudly out loud.  Journal Watch reports a nice summary of recent summary studies on statins.  Let me quote the headlines and the lead paragraph.

Statins and Primary Prevention for Patients at High Risk for Heart Disease.

The benefit, if any, is very small.

Statins – which clearly confer an all-cause mortality benefit in patients with known cardiovascular disease (CVD) – are prescribed extensively for primary prevention in patients at high CVD risk but without CVD.

The article then nicely summarizes results from several recent studies that demonstrates “preventative” statins had not even statistically significant effects on extremely large samples (68,000 cases!) in carefully controlled experiments.  In other words, among people who were not sick with CVD, but at risk (smokers, hypertensives, obese, etc.) the statins had no effect on mortality.  And, doctors prescribe and patients take statins like the pills were breath mints.

And this is not news.  If you doubt me, I’m not going to make the case here because you won’t believe me in a blog post.  Read the research yourself.  And read it.  Look at the numbers.  Think about the numbers.  Find the absolute rates, not those Sophistical Statistics like relative ratios that persuasively inflate outcomes.  And don’t look just at statins.  Look at the persuasion on:  vitamin D, omega-3, hormone replacement therapy, obesity, prostate cancer, screening tests.  For people who are already sick, various interventions do produce helpful, real, if small, effects.  But past that limited application, most of the Health (and Safety) research over the past 20 years operates more like persuasion than science.

Consider again just the instance of statins.

Even many children know that many people die of heart problems so that anything that reduce the chance is a Good Thing.  And, if a little statin pill helps sick people, won’t it help not so sick people?  If you don’t think carefully about it, the answer seems to be yes.  So, when you visit a doctor and she says you might consider this little pill that is covered in your health plan, tastes like nothing, and is easy to swallow with your breakfast juice, why not?

Now, here’s the persuasion analysis.

The pill has no effect.  You don’t know that, but because somebody in a white coat gave it to you, you think you are doing the right thing.  And the right thing here is not thinking for yourself, but doing what someone else suggests.  Thus, you are making external attributions (my doctor) rather than internal attributions (me) for your health.  You don’t have to think.  You can proudly stroll along the Peripheral Route cue-ing along with Credibility (your doc) and Comparison (everyone’s doing it).

Worse still, you are now also cue-ing with Commitment/Consistency meaning the next time your doc recommends something, say a screening test, you are more likely to comply simply because you did it in the past, so you need to stay consistent with that past commitment – taking a statin.  And, maybe that next New New Thing comes in a pill and your kindly doc gives you a free sample which you use without thinking, then thoughtlessly continue with in a Reciprocity cue (your doc gave you something – the free sample – and you need to give something in return – a paid order covered under your health plan).

Small effects, fear, and confusion combine to make health and safety not a science problem, but a persuasion problem.

Sure, this is all science, no persuasion, right?

TAMANA, Japan — Two pedals, inches apart, one for gas and the other for brakes. For years, a Japanese inventor has argued that this most basic of car designs is dangerously flawed.   The side-by-side pedal arrangement, the inventor says, can cause drivers mistakenly to floor the accelerator instead of the brakes, especially under stress. The solution? A single pedal that accelerates the car when pressed with the side of the foot. More to the point, when the pedal is pushed down, it always activates the brakes.

Hey, this must be true science because the story is the most emailed and viewed at the NYT!

Hey, just install this new pedal and no more human error in driving!  It’s just a falling apple and remember:

You Cannot Persuade a Falling Apple.

The New York Times is reporting the tip of the iceberg.

Now a hard-nosed effort by the federal government to forge tougher advertising standards that favor more healthful products has become stalled amid industry opposition and deep divisions among regulators.

The Times even quotes a communication expert, so you know things are getting desperate.

“All of a sudden everything is dead in the water,” said Dale Kunkel, a communications professor at the University of Arizona who is an expert on children’s advertising. “I have heard no arguments to slow this down other than that the industry doesn’t like it.”

Even a former research partner is called for comment.

“With obesity rates the way they are, it’s no longer acceptable for companies to be marketing foods to kids that contribute to obesity and heart disease and other health problems,” said Margo G. Wootan, director of nutrition policy of the Center for Science in the Public Interest, an advocacy group.

How do those Evil Forces do it?  The Good People pass Good Laws then hand them to the Executive Agencies led by President Obama and what do those agencies do?  Nothing.  Clearly the Evil Forces have Evil Powers that Good People cannot yet overcome.

Or.

Passing a regulation is one of the least effective tactics for creating change.  Once Congress passes a law that describes regulation, relevant Federal Executive agencies must then begin to create and enact the regulation.  There is also a long public comment period as all citizens of the country voice their opinions and concerns about the regulation.  Agencies then meet among themselves and with Congressional staffs to discuss how to write the regulations in ways that do not contradict Congressional intent, coordinate with all affected Federal agencies, and will survive judicial review.  Change cannot happen overnight as reporters, academics, and zealots expect.  Government does not operate that way.

[Sidebar:  Every citizen should be required to follow the regulatory process for just one new regulation.  Create a Google alert that sends you a daily email with key terms like "regulation" "advertising" and "children" and read what you get.  You'll be tested over your comprehension and will be fined depending upon your score on the Race To The Top Regulation Education Test.  I mock, but you should spend 40 days and 40 nights in the Wilderness of Regulation.  You think you're tough.]

Eventually, a regulation will get implemented and then you will have the Deepwater Horizon oil rig disaster where a Federal agency led by an Obama appointee repeatedly cleared work standards as meeting relevant regulations.  And, then, you will have the public hue and cry on all sides of the issue, calling for more regulations and the circus will circle around on itself, a serpent eating its own tail.

Regulations tend to function more like informal norms of conduct.  When people internalize them, things change.  When people don’t, enforcement of regulations becomes a diverting game of “Gotcha; No, You Don’t” where everyone is Evil or Good, but nothing changes.

To my zealot friends who truly wish to make the world a better place and save people from themselves:  these Regulations will get written, implemented, and enforced.  Many years from now.  The problem you solved with these Regulations will have changed by then and the old Regulations will have no effect, so you can fight for new ones!  Along the way, you can receive grants, contributions, and contracts to study new solutions.

All Bad Persuasion Is Sincere.

It’s about the Other Guy, Stupid.

All People Resist Significant Change.

Power Corrupts Persuasion.

Great Persuaders Don’t Need Rich Uncles, Kindness from Strangers, or Third Party Vote Splitters.

And on and on.

If you really want to change people, get outside of yourself.  The way the Big Food and Big Tobacco and Big Oil and the Military-Industrial Complex and the true Change Agents do.  Regulation was invented to keep you looking in the mirror.

You may remember that Margaret Thatcher served as conservative Prime Minister for the United Kingdom during the 1980s.  Now, the Iron Lady is getting the Hollywood treatment as Meryl Streep stars in the biopic.  Thatcher’s children are concerned.

. . . the screenplay of The Iron Lady depicts Baroness Thatcher as an elderly dementia-sufferer looking back on her career with sadness. She is shown talking to herself and unaware that her husband, Sir Denis Thatcher, has died.

Cameron McCracken who is a major creative force behind the movie notes

. . . Lady Thatcher’s health will be featured, but insists that it will be “treated with appropriate sensitivity”.  He adds of the film: “Although fictional, it will be fair and accurate.”

This echos, of course, Dan Rather’s infamous line, “Fake, but Accurate” when describing on his CBS News broadcast the fake documents about President George W. Bush’s military service.  Rather got fired for his unpersuasive sincerity.  But, at least Rather meant what he said which is why it was unpersuasive.

But, what about “Fictional, but Accurate?”  It sounds like most artful MovieSpeak.

Green with the environment, green with money, and green with envy – put them together and you get the Eco Index.

The Eco Index, which is basically a software tool any apparel maker can use, poses a series of questions to companies on their environmental and labor practices—some of which require answers from the companies’ suppliers. It then assigns a score representing a percentage of a perfect score.

The folks who make and sell clothes have spent the last three years developing the Eco Index.  They think it addresses Green concerns in a way that will make more Green for them.  See, consumers torn between two different brands of jeans, say Levi and Wrangler, might just look at the Eco Index score to close their decision.

At first glance, I’m impressed with the Eco Index.  It is fabulously inSincere and if implemented, probably will work as advertised.

However, I’m worried.

It’s taken three years to develop a self report scale?

And, they chose a self report scale to measure things like labor practices and environmental impact?

Sounds like those bad observational studies from epidemiology, climate studies, evolutionary psychology, and economics I laugh about on this blog.

Three years to develop a new self report measure?  That’s the time period for a new NIH grant.  Can’t tell you how many planning meetings I’ve attended where someone was proposing to take three years and a quarter of a million taxpayer dollars to invent a self report scale to measure perceived breast cancer risk or estimated calorie expenditure while eating Hostess Cup Cakes or whatever.  The guys behind the Eco Index must have some NIH experience.

And why self report?  Why not just count things like, total amount of fines and penalties paid, worker mortality and morbidity, amount and type of materials used in products?  It’s really better to use an epi conceit like

1.  Estimate the amount of pollution you’ve contributed to local water systems over the past 10 years.  Circle the letter that best describes your estimate.
a. none (we never pollute, we recycle in novel ways)
b. very little (accidental)
c. some (in a hurry)
d. a bit (profits were down that quarter)

If the WSJ was covering some crazy science project on global warming that used self reports like this, they’d beat the writers into the ground like tent pegs.  But, for a Green solution to a Green problem, business is simply Green with envy for epi.

Will the Eco Index work as a persuasion tactic for sales?  Yes.  Of course.

A society advances by the number of operations its people can perform without thinking!!!

“Hey, an Eco Index of 99!  I’ll take three!!!”