The ASA have adjudicated on a complaint againts a CTC helmet leaflet.
Complaint:
Objections to a leaflet entitled "7 REASONS TO OPPOSE A CHILD HELMET
LAW". Text on the front page stated "1. The principal threats to
children''s lives are obesity, heart disease and other illnesses
resulting in large part from inactivity. Cycling has a key role to play
in preventing these illnesses. Less cycling through a helmet law would
aggravate the situation ... 2. Cycling is a healthy activity, and the
likelihood of serious head injury is widely exaggerated ... 3. Cycling
becomes safer the more people do it. Encouraging cycling is by far the
most effective way of reducing risk of injury ... 5. The benefits of
helmets are greatly over-stated ... 7. A helmet law would make it a
crime for children to take part in a health giving activity ...". Text
inside the leaflet continued " ... Cycling gives a level of fitness
equivalent to being 10 years younger [*1] and a life expectancy 2 years
above the average [*2]. The health benefits of cycling far outweigh any
risks involved [*3], by a factor of around 20:1 according to one
estimate [*4] ... It takes over 3,000 years of on-road cycling to suffer
a serious head injury ... In Australia, the courts rapidly became
overloaded with the prosecution of those who had not paid their fines.
The Victorian Children''s Court pleaded to the police to reduce the
number of helmet fines being issued [*5]. On other occasions children
faced detention for up to 3 months, tearing families apart [*6] ...
MISLEADING CLAIMS Claim: "Cycle helmets prevent 85% of head injuries and
88% of brain injuries" Fact: This claim originates from only one source
[*7], and has never been approached by real-world evidence anywhere. In
places where helmet use has become significant, there has been no
detectable reduction in head injuries relative to cycle use. The
research on which the prediction was made has been widely criticised
(e.g. [*8]) for comparing two quite different groups of cyclists. The
substitution of more robust data, collected at the same time as the
original research, leads to the conclusion that helmets make no
significant difference ... Claim: "Over 70% of child cyclist deaths
involve head injury" Fact: Over 70% of all impact deaths involve head
injury. In fact, 82% of cyclists and 86% of pedestrians and motor
vehicle occupants who die in crashes suffer lethal head injuries. 71% of
cyclists die primarily from head injuries, more than the other groups.
However, this is not because cycling fatalities are more likely to
involve head injury (they are not), but because they are less likely to
involve lethal injuries to the thorax and abdomen [*9] ... "; the
footnotes were sourced in a reference section and the last page of the
leaflet stated "FOR MORE INFORMATION www.cyclehelmets.org, an
international site supported by doctors, cycling safety experts,
statisticians and people with professional involvement in helmet design
and performance ... ". The complainants, who included a woman whose son
died from the head injuries he received whilst cycling without a helmet,
a paediatric nurse and two academics whose research was criticised in
the leaflet:
1. objected that the approach used in the leaflet was irresponsible and
could discourage children from wearing helmets;
2. challenged the claim "The principal threats to children''s lives are
obesity, heart disease and other illnesses resulting in large part from
inactivity ...", because they believed accidents, the subject of the
leaflet, were the greatest threat to children''s lives;
3. challenged the claim "... the likelihood of serious head injury is
widely exaggerated";
4. challenged the claim "Cycling becomes safer the more people do it.
Encouraging cycling is by far the most effective way of reducing risk of
injury";
5. challenged the claim "A helmet law would make it a crime for children
to take part in a health giving activity";
6. challenged the claim "Cycling gives a fitness equivalent to being 10
years younger and a life expectancy 2 years above the average. The
health benefits of cycling far outweigh any risks involved, by a factor
of around 20:1 ... ";
7. challenged the claim "It takes over 3,000 years of on-road cycling to
suffer a serious head injury ...";
8. objected that the claim "On other occasions children faced detention
for up to 3 months, tearing families apart" was alarmist, distressing
and exaggerated;
9. challenged whether the claim "The benefits of helmets are greatly
over-stated" was justified;
10. challenged whether the leaflet''s criticism of the claims "Cycle
helmets prevent 85% of head injuries and 88% of brain injuries" and
"Over 70% of child cyclist deaths involve head injury" and the claims
"In places where helmet use has become significant, there has been no
detectable reduction in head injuries relative to cycle use ... The
research on which the prediction was made has been widely criticised for
comparing two quite different groups of cyclists" were misleading,
especially because the latter two claims implied objective peer-view
criticism, not opinion;
11. challenged the claim "www.cyclehelmets.org, an international site
supported by doctors, cycling safety experts, statisticians and people
with professional involvement in helmet design and performance".
Codes Section: 2.2, 3.1, 3.2, 7.1, 8.1, 9.1, 10.1, 47.2 (Ed 11)
Adjudication:
The advertisers said CTC, the Cycle Campaign Network (CNN) and the
London Cycling Campaign (LCC) co-operated to produce the leaflet; CTC
responded on behalf of the other two organisations. The advertisers said
the leaflet was a policy briefing that targeted Members of Parliament
(MPs) primarily and was intended to encourage them to oppose the
Protective Headgear for Young Cyclists Bill, which was a Private
Members'' Bill being considered in Parliament at the time the leaflet
was distributed. They said the remaining leaflets were distributed to
cycle campaigners who were engaged in lobbying MPs to oppose the Bill.
The advertisers believed the leaflet was public relations material and
did not fall within the remit of the Code. They said they did not oppose
the wearing of helmets, but opposed a law that would make it illegal for
children to cycle without a helmet.
The Authority noted the advertisers'' assertions that the leaflet fell
outside the remit of the Code but considered that, because it sought to
persuade recipients to the advertisers'' point of view, the leaflet
constituted advertising material.
1. Complaints not upheld
The advertisers said the leaflet targeted MPs, policy makers and
lobbying groups, not children; they believed its tone and language was
unlikely to appeal to, or be understood by, children. The advertisers
argued that the leaflet was not designed to discourage children from
wearing helmets, but to point out that the evidence supporting the
benefits of wearing helmets was not widely agreed, and to dissuade MPs
from supporting a law that required children to wear helmets when
cycling. The advertisers sent various studies and some peer-reviewed
articles that they believed showed the evidence often cited in support
of the legislation was greatly contested.
The Authority noted the leaflet targeted MPs, policy makers and lobbying
groups. Although it noted one of the complainants had received the
leaflet by post, the Authority considered that the leaflet''s target
audience was likely to understand that its purpose was to encourage
people to oppose a child helmet law, not to discourage children from
wearing helmets. The Authority did not object on that point.
2. Complaints upheld
The advertisers argued that accidents were not the subject of the
leaflet; they said the leaflet was about the proposed child helmet law
and the health, safety and environmental consequences of such
legislation. The advertisers argued that many threats to the lives and
well-being of children, such as obesity and its potential to lead to
diabetes, cardiovascular and heart disease in later life, resulted from
inactivity and lack of exercise; they sent articles from the New England
Journal of Medicine (NEJM), the Journal of Endocrinology and Metabolism,
the Journal of Clinical Nutrition, International Journal of Obesity, a
report from the National Audit Office, and a briefing paper for the
Regional Cycling Development Team that they believed showed how those
additional threats could affect and shorten children''s lives and how
exercise was important for their health. The advertisers also sent a
graph taken from a report entitled "Road Casualties Great Britain 2003"
that showed the number of deaths under the headings "child cyclists",
"all cyclists", "all road users", "obesity" and "heart disease due to
inactivity"; the graph showed the number of deaths for the latter group
was 46,000, compared to 22 for child cyclists and 130 for all cyclists
during that year. The advertisers believed the claim would not mislead,
but offered to amend it to make clear that they were referring to the
threats to children''s future life expectancy.
The Authority noted the advertisers'' evidence showed how inactivity
could lead to health problems, particularly later in life, with the
potential to reduce life expectancy. It noted the figures from Road
Casualties Great Britain 2003 showed the number of overall deaths due to
inactivity was far greater than the number of deaths due to injury from
cycling, but was concerned that those figures did not differentiate by
age. The Authority considered that most readers would interpret the
claim "The principal threats to children''s lives ..." to imply that
illnesses caused by inactivity were the primary contributing factor to
deaths among children, not deaths that occurred later in adulthood as a
result of early lifestyle choices. Because the advertisers had not
proved that was true, the Authority concluded that the claim was
misleading. It welcomed the advertisers offer to amend the claim to
avoid ambiguity and advised them to seek help with the amendment from
the CAP Copy Advice team.
3. Complaints not upheld
The advertisers believed the claims made in support of the campaign for
a helmet law for cyclists under the age of 16 years were exaggerated;
they said their leaflet was intended merely to highlight that and
provide balancing evidence. The advertisers cited as examples some
quotations from the literature in support of the legislation, including
a press release from the Bicycle Helmet Initiative Trust, a
Parliamentary Early Day Motion and a letter to the Reading Press, which
emphasised the high number of deaths and hospitalisations of cyclists
due to head injuries. The advertisers sent evidence from Hansard and the
Department of Health, some of which had been referenced in the leaflet,
that they believed refuted those figures and suggested that the risk of
head injury from cycling was not as great as claimed.
The Authority noted the advertisers'' evidence showed that variations
existed between records of deaths and hospitalisations of cyclists due
to serious head injury and the available data was acknowledged to be
unreliable. In the absence of a generally agreed figure of the number of
deaths or hospitalisations of cyclists due to serious head injury, and
in the context of a leaflet that discussed two opposing points of view,
the Authority concluded that the claim was acceptable.
4. Complaints not upheld
The advertisers believed a positive relationship existed between
increased cycle use and cycle safety. They sent an article from Traffic
Engineering and Control, a paper to the National Cycling Strategy Board
entitled "Safety in Numbers" and an article from the British Medical
Journal (BMJ) that showed collision rates decreased as the number of
people walking or cycling increased. The advertisers argued that, as the
number of cyclists on the road increased, it was reasonable to expect a
driver''s ability to interact safely with cyclists to improve, because
they would become increasingly aware of cyclists.
The Authority noted one complainant''s belief that children who cycled a
lot could become over-confident and therefore less careful on the roads,
but considered that the articles provided by the advertisers supported
the idea that the safety of cyclists could increase as the number of
cyclists increased. The Authority also considered that, in the context
of a leaflet that discussed two opposing points of view, the claim
"Encouraging cycling is by far the most effective way of reducing risk
of injury" was likely to be seen as an expression of the advertisers''
opinion. The Authority did not object to the leaflet on that point.
5. Complaints upheld
The advertisers argued that many health benefits could be gained from
cycling; they maintained that the risks of cycling were overestimated
and argued that more deaths were attributable to heart disease resulting
from inactivity than the number of cyclists killed in road traffic
accidents. The advertisers sent an article from the British Medical
Association (BMA) entitled "Cycling; towards health and safety 1992",
that claimed the benefits gained from regular cycling were likely to
outweigh the loss of life through cycling for the current population and
stressed the need to make exercise for children more fun; they also
submitted an article from the Traffic Engineering Control that they
believed showed increased cycle use would reduce risk per cyclist. The
advertisers believed the passing of the Bill would criminalise a
health-giving activity by making it a crime for children to cycle
without a helmet; they said MPs would understand the intention of the
Bill and would not be misled.
The Authority noted the advertisers'' comments, but noted the leaflet
was distributed to people who were not policy-makers, as well as those
who were, and considered that those readers could interpret the claim "a
helmet law would make it a crime for children to take part in a health
giving activity …" to imply that the proposed legislation would make
it illegal for children to cycle and take part in a health giving
activity, not that such legislation would potentially deter children
without a helmet from cycling. The Authority concluded the claim was
misleading and told the advertisers to amend it to remove the
implication that helmet legislation would criminalise all children for
cycling.
6. Complaints upheld
The advertisers sent copies of studies that they believed supported both
claims; they said they believed the claims were true because they knew
of no evidence that refuted them and argued that the leaflet''s intended
audience was unlikely to interpret them literally.
The Authority noted the advertisers'' evidence. It noted one BMA article
entitled "Life-years lost versus life-years gained" compared the number
of life-years lost through cycling with the number of life-years gained
through improved health and fitness and argued that there were benefits
to those undertaking regular exercise such as cycling through improved
health and fitness and possible longevity. It noted another BMA article
entitled "Road transport and health" referred to the results of studies
that had appeared in other journals and included the figures quoted in
the leaflet.
The Authority acknowledged that the advertisers'' evidence showed
regular cycling could decrease mortality when compared with not cycling.
It nevertheless considered the claim "Cycling gives a fitness equivalent
to being 10 years younger and a life expectancy 2 years above the
average" to be an absolute one. The Authority was concerned that the
case studies referred to in the advertisers'' evidence had been
conducted on a select sample of people only and considered that they
were not enough to substantiate the advertisers'' implication that all
cyclists, and especially child cyclists, would benefit from a decrease
in mortality of the level claimed. The Authority concluded that the
claim was not justified and told the advertisers to amend it.
7. Complaints upheld
The advertisers sent figures to show how the quoted figure of 3000 years
of on-road cycling was derived. The advertisers said, in hindsight, they
should have made clear it was an "on average" figure but argued,
nevertheless, that it would not mislead.
The Authority noted the advertisers had used figures from the Department
of Transport''s "Transport Statistics Great Britain 2001" in the
calculation. The Authority considered, however, that the use of 3000
years to describe the period of time, albeit of on-road cycling, after
which one could or would suffer a serious head injury was, at best,
ambiguous and, at worst, misleading, because it implied a single cyclist
would never suffer from a serious head injury. It told the advertisers
not to repeat the claim.
8. Complaints upheld
The advertisers sent an article headed "Boy faces detention for unpaid
bike fines" that appeared in the Sydney Morning Herald on 12 December
1997 to support the claim. They acknowledged that the claim was
exaggerated and offered to amend it to make clear that at least one
child from Australia was reported to have faced detention for up to
three months following the implementation of a helmet law.
The Authority noted the article reported how a 12-year-old boy from
Australia faced a possible three months'' detention for failing to pay
fines for not wearing a bicycle helmet, as required by the Northern
Territory law; the article also told of separate incidences when a
15-year-old boy was strip-searched and spent a night in a detention
centre for not paying a bicycle helmet fine and a 14-year-old boy who
spent the night in a cell because he crossed the road against a red
traffic light. The Authority considered that, although the advertisers
had shown that one boy faced a possible detention for up to three
months, the claim "Children faced detention for up to 3 months ..."
exaggerated the number of children who had faced detention for not
wearing a helmet while cycling and the likelihood of that being a result
of a change in British legislation. The Authority told the advertisers
not to repeat the claim and welcomed their decision to amend it.
9. Complaints not upheld
The advertisers believed the benefits of helmets were greatly overstated
and were at best limited; they sent studies on the effects of similar
legislation in Australia to show that.
The Authority noted the leaflet was intended to communicate that the
evidence for the safety benefits of cycle helmets was not universally
agreed and considered that, in the context of a leaflet that discussed
two opposing points of view, the claim was likely to be seen as an
expression of the advertisers'' opinion on a controversial debate. The
Authority did not object to the leaflet on that point.
10. Complaints upheld
The advertisers said the quote "Cycle helmets prevent 85% of head
injuries and 88% of brain injuries" was from an American study in the
NEJM entitled "A case control study of the effectiveness of bicycle
safety helmets" and that that study had been widely supported in
campaigns to promote a helmet law for children in the UK; they said
several published critiques of the methodology and findings of that
study existed and provided copies of those critiques. The advertisers
argued that a recent report submitted to the Department for Transport
Road Safety Research that reviewed evidence on the effectiveness of
helmets found that the study''s authors had over-estimated the reduction
in risk due to wearing helmets. They maintained that the leaflet made
clear that they did not dispute the claim "Over 70% of child cyclists
deaths involve head injury", but that they were simply highlighting that
similar figures applied to all deaths due to head injuries including
pedestrians and vehicle occupants, not just cyclists; they believed it
was misleading to suggest that cyclists alone were particularly prone to
fatal head injuries.
The Authority noted the critiques of the article whose findings were
disputed in the leaflet. The Authority also noted the studies on the
effects of the legislation on Australia and noted one study from the BMA
pointed out that bicycle helmets were designed primarily to protect the
head during low speed impacts that would occur in a fall to the ground
from a bicycle and were limited in preventing injury to the head and
other parts of the body in the event of a collision with a motor
vehicle. The Authority noted some of the criticisms of the claim
"Cycling prevents 85% of head injuries ..." had come from a
peer-reviewed article in the BMJ and that the advertisers had referenced
their claims in the leaflet.
The Authority noted the leaflet was intended to communicate that the
evidence for the safety benefits of cycle helmets was not universally
agreed. It nevertheless considered that the presentation of the section
of the leaflet in which those claims appeared, with those arguments with
which the advertisers disagreed being presented as "misleading claims"
and the advertisers'' arguments being presented as "FACT", misleadingly
implied that the advertisers'' evidence was generally accepted. Because
it understood that there was a significant division of informed opinion
about the health and safety benefits of cycle helmets, the Authority
concluded that the approach adopted by the advertisers was misleading.
It told the advertisers to amend the presentation of the leaflet and
advised them to consult the CAP Copy Advice team before advertising again.
11. Complaints upheld
The advertisers said the claim was taken from the independent site
www.cyclehelmets.org; they believed the owner of the site was an
epidemiologist, general practitioner and a member of the Faculty of
Public Health, and that other contributors to the site included an
Australian statistician, a UK cycle safety consultant and someone who
had over 50 years experience of testing and designing headgear.
The Authority noted the section of the site headed "Policy Statement"
stated that the site was a website belonging to an international
coalition of people with special interests in cycling and cycle helmets
and that the coalition included doctors, cycling safety experts,
statisticians and people with the professional involvement in helmet
design and performance. The Authority considered that the claim " ... an
international site supported by ..." implied the website was fully
endorsed by doctors, cycling safety experts, statisticians and people
with professional involvement in helmet design and performance. Because
it was not, the Authority concluded that the claim was misleading. It
told the advertisers to amend it and advised them to consult the CAP
Copy Advice team in future.