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Using Google online advertising as a public health tool for cancer prevention

The JAMA Network Journals

Online advertising may be a feasible way to deliver targeted prevention messages related to indoor tanning and skin cancer, according to an article published online by JAMA Dermatology.

Skin cancer is more common than all other cancers combined and indoor tanning is a preventable risk factor that accounts for more than 450,000 new malignant neoplasms (cancers) each year. Awareness of the dangers of tanning beds is one factor that can lead to behavior change.

Eleni Linos, M.D., Dr.P.H., of the University of California, San Francisco, and coauthors used Google's advertising service to disseminate skin cancer prevention messages to Internet users conducting searches related to tanning beds.

Google AdWords is a pay-per-click advertising service that places three-line, 105-character advertisements next to Google search results. Google Nonprofits provided free advertising. The advertisements were divided into three thematic groups: appearance (i.e., tanning causes wrinkles, prevent skin aging and tanning makes you ugly); health (i.e., protect your skin, tanning causes cancer and prevent skin cancer); and education (i.e., the truth of tanning beds, the truth behind UV light, and know what tanning beds do).

The authors report that each month Google processes an average of more than 75,000 searches with the terms tanning, tanning bed and tanning salon. The authors' advertisements were shown 235,913 times and clicked more than 2,000 times. A clock-through ratio of 1 percent is considered adequate for commercial advertisements.

"However, the effect of these advertisements on health behavior remains unknown. Further studies of this approach are needed to explore the characteristics of messages that generate views and clicks, and ultimately to determine whether this type of intervention successfully changes behavior," the authors conclude.


(JAMA Dermatology. Published online October 7, 2015. doi:10.1001/jamadermatol.2015.3998. Available pre-embargo to the media at

Editor's Note: This study was supported in part by Google for Nonprofits, which provided an AdWords grant to fund advertisements. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding author Eleni Linos, M.D., Dr.P.H., call Elizabeth Fernandez at 415-514-1592 or email

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