Policy on acceptance of advertisements

1. Acceptance of advertisements

The acceptance of all advertisements in BMJG publications is subject to editorial approval.

The BMJG reserves the right to decline any advertisement or discontinue the publication of any advertisement previously approved.

The BMJG’s policy is to accept advertising for products that will be useful for its readers in their professional as well as personal lives, subject to editorial approval and provided that advertisements conform to the guidelines laid out in the British Code of Advertising and Sales Promotion. 

In addition, the BMJG has specific policies on the following types of advertising:

2. Policies for specific advertisement types

(a) Non-medical products that are harmful or potentially harmful to health

(i) Tobacco

Tobacco products

In line with the British Code of Advertising and Sales Promotion, which has banned the advertising of tobacco products, the BMJG will not allow advertising that promotes the use of tobacco products.

Tobacco company recruitment

The BMJG recognises that the tobacco industry continues to exist, and those who work in the industry have a right to an occupational health service. BMJ Careers is the place in Britain to advertise for doctors, and for us to deny the workers in the industry the chance of finding the best possible doctor would be too extreme a step. The BMJ therefore continues to accept recruitment notices from the tobacco industry.

All recruitment notices from tobacco companies should be referred to the BMJ editor for approval. Factors to be considered will include the nature of the job (occupational health or research) and the claims made for the company by the advertiser.

(ii) Alcohol

BMJG policy is to accept advertisements for alcohol, provided that they conform to the guidelines of the British Code of Advertising and Sales Promotion. Recruitment notices from the alcohol industry are generally acceptable.

All copy is to be submitted to the BMJ editor for approval before publication.

(iii) Cars

Advertisements for cars and motoring accessories are acceptable, provided that they conform to the guidelines of the British Code of Advertising and Sales Promotion as regards responsibility to society.

All copy is to be submitted to the BMJ editor for approval before publication.

(iv) Baby milks

All advertisements are to be submitted for editorial approval and have to comply with FMF Code of Practice for the Marketing of Infant Formulae in the UK, which states that "Information provided by manufacturers and distributors to health workers regarding infant formulae should be restricted to scientific and factual matters and such information should not imply or create a belief that bottle-feeding is equivalent or superior to breast feeding." Such information "should accurately reflect current knowledge and responsible opinion." All claims must be referenced to full length research papers published in peer reviewed scientific journals. (Abstracts won't do.)

(v) Sunbeds

According to expert opinion, tanning with sunbeds that emit ultraviolet A radiation should be discouraged. All advertisements should therefore be passed to the BMJ editor for approval.

(b) Medical products licensed for use under medical supervision

No product may be promoted until a product licence has been granted by the Medicines and Healthcare products Regulatory Agency (MHRA). Marketing of the product may start only after data sheets have been released to members of the medical profession and must conform to the marketing authorisation contained in the product licence.

Promotion of a medicine in the UK must conform to both the Medicines Act 1968 and the ABPI Code of Practice. The ABPI code duplicates the legal requirements of the act and extends them considerably. It is binding to all members of the ABPI. Most non-members of ABPI have also agreed to comply with the code. It governs all methods of product promotion and all details of each method.

Throughout the pharmaceutical industry, personnel are trained to ensure that promotional material conforms to the requirements of the Medicines Act and the ABPI code. No material may be released until a final proof has been certified as meeting all code requirements by a nominated physician and a nominated pharmacist (or similarly qualified).

The BMJG holds the view that the stringency of these requirements makes research by the editorial teams of the BMJG into the safety and efficacy of medicines unnecessary.

Advertisements for prescription-only medicines will be accepted subject to editorial approval, provided that they conform to the ABPI code and meet the BMJG’s normal standards.

(c) Medical equipment and instruments

Since April 2005 all medical devices have been regulated by the MHRA. All advertisements for medical devices must conform to the MHRA guidelines. The medical devices being advertised must also carry CE Marking (www.ce-marking.org/). Marketing of a product without this marking will constitute a criminal offence. The advertiser should confirm the presence of CE Marking before the advertisement is submitted for approval.

(d) Books and other publications

The BMJG will accept advertisements for books and other publications, subject to editorial approval.

The BMJ editor reserves the right to request a copy of the publication if he or she believes that the contents should be scrutinised before approval can be given.

Advertisements may be rejected if they are for books that are apparently tasteless, obscene, or make unwarranted claims.

(e) Competitor advertising

The BMJG believes in competition and is against protectionism, and it will accept advertisements from competitors even if they refuse ours.

There may be circumstances where the BMJG refuses an advertisement from a competitor on the grounds that it may have a serious impact on our products and business.

Acceptance of all advertisements from competitors is subject to editorial approval

(f) Medical product purporting to have therapeutic effect but not listed in the BNF

(i) Foodstuffs, food supplements, vitamins, and minerals

Advertisement for foodstuffs, food supplements, vitamins, and minerals should conform to the guidelines of the British Code of Advertising and Sales Promotion and should be submitted with full substantiation of all claims. All claims must be referenced to full length research papers published in peer reviewed scientific journals. (Abstracts won't do.)The BMJ editor must approve all advertisements before publication.

(ii) Slimming aids

Advertisements for products that purport to aid slimming must conform to the guidelines of the British Code of Advertising and Sales Promotion. The BMJ editor must approve all advertisements before publication.

(iii) Non-conventional therapies

Where the advertisement relates to non-conventional therapies, the advertiser must submit full supporting evidence of efficacy with the copy. The BMJ editor must approve all advertisements before publication.

(iv) Health and beauty products

All advertisements should conform to the general guidelines of the British Code of Advertising and Sales Promotion and should in addition meet the following standards:

Hair and scalp

Advertisements should confirm to guidelines of the British Code of Advertising and Sales Promotion.

Cosmetics

Claims made about the action that a cosmetic has on or in the skin should be backed by evidence in the form of human trials. Such evidence should be available for inspection by consumers. If not, the advertisement should carry a clear indication such as “Not backed by evidence” or “Evidence not available to scrutiny.” Advertisements should make it clear if the effects of a cosmetic are due to the composition of the product or the way in which it is applied, such as massage. This distinction should also be based on scientific evidence.

Skin lighteners

Creams that are intended to lighten the skin colour should state clearly that this is their intended purpose and include possible side effects of such preparations. Misleading phrases such as “brighten the skin” should not be used.

Anti-ageing creams

Advertisements for cosmetics which claim to prevent, delay, or mask premature ageing of the skin temporarily should be backed by evidence in the form of trials conducted on people, which are available for scrutiny by consumers.

All advertisements should be submitted for editorial approval.

(g) Services claiming therapeutic effect

(i) Slimming clinics

Whether the advertisement promotes the services of the clinic or seeks to recruit staff, three assurances must be sought from the clinic’s director before the BMJ editor will consider the advertisement for publication:

·         The clinic must be a registered company.

·         It must be run and staffed by medically qualified people who are able to make independent medical decisions.

·         Its staff must be familiar with and operate within the General Medical Council’s criteria for good practice and the Guidelines for Doctors Employed by Private Organisations providing Clinical Diagnostic or Medical Advisory Services and the guidance given on appetite suppressants in the current issue of the BNF.

When an advertisement is received from a slimming clinic, its director must submit a letterhead showing company registration and sign a declaration guaranteeing conformity with above. Only then will the advertisement (with the declaration) be passed on for editorial approval. In addition to the above, if an advertisement promotes services offered by the slimming clinic, it must conform to guidelines of the British Code of Advertising and Sales Promotion.

(ii) Cosmetic clinics

Whether the advertisement promotes the services of the clinic or seeks to recruit staff, the clinic’s director must give two assurances before the BMJ editor will consider the advertisement for publication:

• The clinic must be a registered company.
• Its practices must conform to the advice offered by the BMA Guidelines for Doctors Employed by Private Organisations providing Clinical Diagnostic or Medical Advisory services.

When an advertisement is received from a cosmetic clinic, its director must submit a letter showing company registration and must sign a declaration guaranteeing conformity with above. Only then will the advertisement be submitted (with the declaration) for editorial approval.

In addition to the above, if an advertisement promotes services offered by the clinic, it must conform to guidelines of the British Code of Advertising and Sales Promotion.

(iii) Pregnancy advisory, sterilisation, vasectomy, and pregnancy testing services

All advertisements must be submitted for editorial approval.

(h) Non-medical services

(i) Financial services

The BMA negotiates special rates with numerous preferred suppliers on behalf of its members. The BMJG is contractually unable to accept advertisements from competitive service suppliers without the prior permission of the BMA.

(ii) Travel agents

All advertisements for travel services to appear in BMJ Careers should be submitted to the BMJ Careers director for approval.

Advertisements for travel services to appear in the BMJ or BMJ Journals should be submitted for editorial approval.

Advertisements will be accepted, provided that the company is registered and is ATA/ABTA bonded.

(iii) Mail order

No advertisements will be accepted if they request cash with the order.

(iv) Locum agencies

Until 1994, advertisements from locum agencies were accepted, provided that the agency was registered with the Department of Employment and held an employment licence number.

After deregulation in October 1994, a locum agency needs only to provide evidence that it is a registered company and signs a statement confirming that all claims can be substantiated should a challenge arise. If challenged and unable to provide substantiation, the advertisement will be withdrawn and all future copy claims will have to be substantiated before publication

This procedure is forced by the extraordinary sensitivity of the locum market. Independent of this procedure, the NHS Purchasing and Supply Agency checks the published ads of national contract holders to ensure conformity with NHS guidelines.

(v) Escort agencies, introductory services, and private advertisements

Escort agencies, introductory services, and dating agencies exist to meet a demand. There is no reason to believe that the demand does not exist among the medical community. The BMJG therefore accepts advertisements from this group of advertisers as it does from any advertiser promoting a service of use to doctors. Advertisements should be submitted to the BMJ editor for approval and should conform to the general principles of the British Code of Advertising and Sales Promotion.

(vi) Property advertisements

Property advertisements are accepted subject to the usual adherence to the British Code on Advertising and Sales Promotion.

Where property or land is being sold as part of a land banking scheme or where fractional land plots are being sold, the advertiser must be  registered with the FSA.

(i) Recruitment advertisements

Intending applicants are solely responsible for checking terms and conditions of service. Warnings to this effect appear in BMJ Careers. Applicants are also asked to bear in mind that UK law does not apply to advertisements from other countries.

Some job advertisements are subjected to particular scrutiny/monitoring:

• Slimming/cosmetic surgery clinics—see sections 1 (f) (i) and 1 (f) (ii)
• Locum agencies—see section 1 (g) (v)
• Overseas posts, if potentially discriminatory in UK law, but not in the country which the post will be based, must be submitted to the BMJ editor for approval.

 (j) Discrimination

In 1992 the BMJ attempted to introduce an independent anti-discrimination policy whereby all copy that was considered in any way discriminatory was refused for publication. It quickly became clear that extending the available statutes made every decision subjective, confused advertisers who thought that conformity with statute should assure publication, disallowed exemptions that the EOC and CRE accepted, and isolated the BMJ from any higher authority should adjudication be required.

BMJ Careers now publishes all advertisements that conform to the Race Relations Act and the Sex Discrimination Act.

Where exemptions are claimed by the advertiser, she or he will be sent a declaration for signature to cover the publisher liability of the BMJG.

(k) Advertisement features (advertorials)

The BMJG accepts advertisement features (advertorials) subject to editorial approval and provided that the following criteria are met:

The whole advertisement should appear in a box, which should be centred on the page. A minimum of a 10 mm gap should separate the box and the edge of the page.

The words “Advertisement Feature” should be prominently displayed between the top of the box and the top of the page.

Advertisers should have no intention to imitate the editorial style of the BMJ or any of the BMJ Journals.

The typefaces Plantin, Baskerville, and any other typeface closely resembling these must not be used in body count, headlines, and crossheads.

Copy should not be presented on any grid pattern that matches part of the BMJ or the BMJ Journals.

Tints that commonly appear in the BMJ must not be used, thereby avoiding confusion with editorial matter.

All clinical photographs should be accompanied by written permission for their use, provided by the patient, guardian, or next of kin. Bars across the eyes are not acceptable for masking identity and should not be used. (This condition is applied to clinical photographs used elsewhere in journals published by the BMJG.

Where possible, advertisers should provide copies of references used in the text.

BMA approval or acceptance should not be implied in the copy or in any offers.

The BMJ editor retains the right to amend any copy.

Draft copy should be submitted to the BMJ editor at least four weeks before the cover date. This period may be reduced at the BMJ editor’s discretion.

The sponsoring company’s name must appear somewhere in the advertisement feature.

Advertisement features should be restricted to a maximum of two per edition.

(l) Political and politically sensitive advertising

The BMJG avoids identifying itself with particular political parties. At election times efforts are made to achieve balance in coverage of the proposals and policies of the major parties. There might thus be an argument for not carrying advertisements from political parties, but refusing to carry legal and decent advertisements would be against the BMJG’s liberal policy on advertising. The BMJG will therefore carry political advertising if it conforms to the British Code of Advertising and Sales Promotion. The advertisement should, however, be approved by the BMJ editor or his or her deputy.

In the case of advertisements making non-party political points, we will follow our liberal policy, but all advertisements should be approved by the BMJ editor or deputy editor.

There are times when certain advertisements will create political sensitivities—perhaps for example, because they come from bodies that are in dispute with the BMA

If an advertisement is thought to be politically sensitive then it should be approved by the BMJ editor or deputy editor.

(m) Accusations against advertisers

The BMJG takes seriously all accusations against advertisers, but complainants must be advised that they can gain redress only through the usual legal channels.

The advertiser should be invited to respond to accusations. The advertiser may accept the complaint and revise the advertisement, or may argue that that the complaint is unjust.

The advertising manager will consider all complaints against advertisers and their responses, and sometime may decline further advertising. This step can rarely be taken after a single complaint but may be taken after several independent complaints.