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The image is chilling: a series of menacing bear traps laid out like footsteps. "Is a bear trap snapping shut on a human foot, your foot, too scary a thought?" goes the copy. "Good ... "

A promotion for the latest Hollywood horror blockbuster? How about an ad for the Diabetic Foot Care Centers of Paramus, N.J. Now running in area newspapers and on radio, the campaign, from McQueeny Davis Kohm & Partners, Oradell, N.J., is one example of the growing use of scare tactics by drug and healthcare marketers.

"It's shock jock advertising, a bit of desperation on the part of marketers who are faced with new challenges," said Burt Flickinger III, manager of consultancy A.T. Kearney, New York.

There are no hard numbers to illustrate the trend, but observers say fear marketing is definitely on the rise. The issue came to a head in California in recent weeks. There, as in other markets, Abbott Labs' Ross Products division is using heavy print and radio to push its Advera nutritional drink for HIV-positive or AIDS patients.

The print ad shows a handsome, seemingly healthy young man with a pair of running shoes and a glass of Advera nearby. AIDS groups say the ad uses an implicit scare tactic, since anyone as healthy looking as the ad's model wouldn't need the product.

The medical director of San Francisco General Hospital's AIDS clinic, Dr. John Stansell, called the ads "disgusting."

At about $3,600 a year, Advera has a premium price tag not covered by third-party payers while comparable, less expensive products frequently are.

Ross Products is so sensitive about the flak they refused to name the agency that created the ads or comment beyond a written statement. "Ross and Abbott have a responsibility to communicate the availability of products that may improve the quality of life for people with special nutritional needs-including those with HIV," said the company.

Some argue scare marketing is actually necessary at times.

"Sometimes you have to scare people to save their lives," said Jerry Della Femina, chairman of Jerry & Ketchum, New York. "But I'm very much against it if you're trying to sell a product."

Mr. Della Femina created an outdoor campaign for the Asthma Zero Mortality Coalition now running in inner city subways and buses nationwide. The ads that urge asthmatics to seek professional help begin, "When those painful, strained breaths start coming, keep in mind that any one of them could easily be your last."

"Is it a scare tactic? You bet," said Mr. Della Femina, himself an asthma sufferer. "But is it without a hidden agenda? You bet."

Mr. Flickinger said many of today's fear tactics are driven by marketers frustrated by a plateau in sales growth born of greater competition and worries about healthcare reform.

Health Midwest, an alliance of 11 Kansas City hospitals, created frightening images of the future-a seemingly homeless family carrying a sign that read, "Will work for healthcare"-for a campaign it ran a year ago.

"Our purpose was to get people's attention, and we did. Within six months awareness was up 20% to 30%," said Paul Barthelemey, assistant account exec at McDonald Davis & Associates, Milwaukee, which created the spot. "But that kind of approach can backfire. You don't want to terrify. You need to stay as close to the public mindset as you can."

Alice Z. Cuneo contributed to this story.

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