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Airborne Settles Case On False Advertising

The story of Airborne – a popular supplement marketed as an “herbal health formula that boosts your immune system to help your body combat germs” – is representative of what is wrong with the supplement industry and how it is regulated in the US. Recently the company that sells Airborne – Airborne Health, Inc – agreed to pay $23.3 million to refund consumers who purchased the product (if they have proof of purchase). This was to settle a class-action law suit brought by the Center for Science in the Public Interest (CSPI) and others claiming false advertising. In the settlement the company did not admit any wrongdoing. While this can be viewed as a minor victory for science-based medicine, it actually highlights the many deficiencies in the system.

For background, Airborne was launched in 1999 as a supplement designed to ward off the common cold. It has been extremely successful, due largely to its slick packaging, a clever slogan that it was developed by a school teacher, and promotion by Oprah Winfrey. The Airborne brand of products has expanded, including pixie powder for children, Airborne seasonal, Airborne Jr., Airborne on-the-go, and others. Advertising urged users to take Airborne at the first sign of a cold or as a preventive treatment if about to enter a germ-filled area, like an airplane. They also cited a “scientific” study that demonstrated Airborne is effective.

What is in Airborne is nothing more than common vitamins and herbs. There is no reason to believe that this particular concoction has any health benefit (beyond the basic nutritional value of the vitamins) or specifically that it enhances immune function or helps fight off infections. David Schardt from CSPI is quoted as saying:

There’s no credible evidence that what’s in Airborne can prevent colds or protect you from a germy environment. Airborne is basically an overpriced, run-of-the-mill vitamin pill that’s been cleverly, but deceptively, marketed.

It should also be noted that Airborne is not without risk because it is a supplement. Airborne contains too much vitamin A. Two pills contains 10,000 IU, which is the maximum safe limit, but the instructions say to take three pills per day. So taken as directed Airborne contains more than the safe limit of vitamin A. This would also have to be added to vitamin A consumed in food, and of course many consumers may also be taking a multivitamin without realizing that Airborne is essentially just another vitamin pill itself.

Airborne is marketed as a supplement – in the US this means it falls under the Dietary Supplement Health and Education Act of 1994 (DSHEA). Under DSHEA a health product can be marketed as a supplement and make “structure/function” claims for the product without any FDA oversight, as long as they place a disclaimer on their label and advertising stating that the claims have not been reviewed by the FDA and that they do not make “disease” claims for the product.

What this means is that any company can put together an essentially random combination of vitamins and herbs and make any structure/function claim they choose (boosts the immune system, gives energy, improves sleep, aids mental focus -whatever) as long as they don’t mention a specific disease by name. There is no FDA oversight to make sure their claims have been validated scientifically.

Companies are still responsible for the claims that they make, but accountability is entirely post-marketing. The Federal Trade Commission (FTC) can take action for false advertising – just as it can with toasters, vacuum cleaners, or any product. And, of course, the civil courts can always be used to seek compensation for any deception or wrong-doing by the company. But there is no pre-marketing oversight – no hurdle to get over before getting to market with specific claims.

In the case of Airborne there was no FTC action – a grass roots watchdog group, CSPI, brought a class action suit for false claims. Specifically they were able to document that there is no scientific evidence to support the claims made for Airborne. In addition, Airborne Health cited a “clinical study” to back its claim that Airborne is effective at preventing colds. But an ABC news investigation reported:

Airborne said that a double-blind, placebo-controlled study was conducted with “care and professionalism” by a company specializing in clinical trial management, GNG Pharmaceutical Services.

GNG is actually a two-man operation started up just to do the Airborne study. There was no clinic, no scientists and no doctors. The man who ran things said he had lots of clinical trial experience. He added that he had a degree from Indiana University, but the school says he never graduated.

In response to these critical news reports (and likely fear of legal ramifications) references to the clinical trial have now been removed from Airborne packaging. Elise Donahue, Airborne CEO, explained: “”We found that it confused consumers. Consumers are really not scientifically minded enough to be able to understand a clinical study.” The packaging has also been changed to remove the claim that Victoria Knight-McDowell (the school teacher) developed Airborne because she was “sick of catching colds,” and replace it with the claim that she created Airborne because she “needed help supporting her immune system.”

What we see here is the evolution of the packaging and marketing of Airborne to conform to DSHEA, which effectively shields them from legal repercussions. Scientific evidence is not needed – so why bother going through the motions of doing a “clinical study.” You are not allowed to claim that you can treat a cold, but you can “support the immune system.” Yet, the public still understands what the product is supposed to do. Airborne has created a market using deceptive claims and now they are allowed to benefit from that market.

The class action suit resulted in a settlement of $23.3 million, but the company has estimated revenue of over $150 million in 2006 alone. Such settlements are little more than the cost of doing business. The FTC is looking into also investigating the company as well, so fines may be forthcoming. While the FTC has taken up some of the slack since DSHEA, and appears sincere about wanting to crack down on fraudulent supplement claims, they are also overwhelmed and understaffed. In addition their fines are often little more than slaps on the wrist – again the cost of doing business.

This situation is not the same as otherwise legitimate companies that behave badly and need to be punished or to compensate wronged consumers. The entire existence and marketing of Airborne is based upon a deception of the consumer. Allowing such companies to continue to do business, with some tweaks to their claims and fines that are a minor inconvenience, has not been an effective protection for the consumer.

Given that Airborne is nothing more than an overpriced (and potentially unsafe) vitamin pill, and that there is no reason (either theoretically or based upon clinical evidence) to conclude that this product is of any use in fighting off germs, as is claimed, Airborne seems to be of no practical use to the consumer. It is a waste of health resources, and may serve as a source of false confidence and therefore distract consumers from effective means of avoiding infectious disease – like simple hand washing. Our current regulations have not prevented such products from getting to the marketplace, nor removed them from the market once the facts come to light.

Posted in: Herbs & Supplements, Science and Medicine

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16 thoughts on “Airborne Settles Case On False Advertising

  1. DavidCT says:

    Airborne is just one more example of the misinformation about health care being promoted just about everywhere. I have been recently treated to an early morning infomercial telling me about all the pounds of waste accumulating in my colon and the wonder drug available to clean it away. Not only was there a useless cure, but a total misrepresentation of the physiology of the colon.

    There are two problems at work.

    First there is no meaningful protection of the public from false health claims.

    Second we have a large portion of the public educationally too poorly prepared to evaluate advertising claims of any kind.

  2. I’ve been noticing “Airborne” at my local Wallgreens for a couple of years. Jeez: $150 million in 2006. It certainly verifies P.T. Barnum’s observation. As I write this, to my right are the following “Ads by Google”:

    Is science right?
    Evolution is the origin of all life Expelled: No Intelligence Allowed
    http://www.Expelledthemovie.com

    Natural Immune Booster
    Prevent colds, flu, toxins and other illnesses. Herbal supplement
    BellLifestypeProducts.com/Immune-B

    Airborne Official Store
    Effervesent Health Formula Get Your AirborneDirect!
    theConsumerLink.com/Airborne

    *NOW* Brand Supplements
    Enter Coupon Code: SAVINGS Receive 10% Discount On All Orders
    http://www.healthfitlabs.com

    Recovery Pack
    Supplements for cyclists to recover Faster and train harder
    http://www.recoverydoc.net

    Wow. No wonder their side is winning: nonsense sells. What we could do with the profits from one year of “Airborne” alone to push back the tidal wave of pseudomedicine in medical schools.

    A few other things come to mind. Do pharmacists have a code of ethics? My Wallgreens sells not only Airborne, but its own version of the same thing (“Compare to the ingredients in Airborne”) and numerous other bogus “supplements” and homeopathic bushwah. Here in Massachusetts, as I imagine is true in other states, pharmacists are seeking greater autonomy in advising customers about what meds to take. How can they do that with a straight face while they hawk snake oil at the same time?

    “Boost the immune system” and variations of that phrase are among the group of “CAM” product slogans—”detoxify” and its variations, “energy boost” and its variations, etc.—that virtually guarantee that the author is trying to sell you the Brooklyn Bridge. How ironic that the same salesmen are usually opposed to the most important methods that real scientists have devised to “boost the immune system”: immunizations.

    I’m glad that the CSPI got involved in this, but where have they been for the rest of the massive consumer fraud that is “CAM?” They seem to worry a lot about how much fat is in the food at Chinese restaurants, which is obvious and hence a matter of informed consumer choice. In general they seem to worry a lot less about a hoax that has insinuated itself into not only consumer goods but medical schools, regulatory boards, the federal and state governments, and the NIH—and is considerably less obvious to the untrained eye, thus in need of exposure by such an organization.

  3. SimonRX says:

    “Do pharmacists have a code of ethics? My Wallgreens sells not only Airborne, but its own version of the same thing (”Compare to the ingredients in Airborne”) and numerous other bogus “supplements” and homeopathic bushwah. Here in Massachusetts, as I imagine is true in other states, pharmacists are seeking greater autonomy in advising customers about what meds to take. How can they do that with a straight face while they hawk snake oil at the same time?”

    It may not be known to the general public that the things that get sold in the Walgreens store has no input from the pharmacists who work in the pharmacy. Its not unlike the ads that get placed on the skeptical blog sites promoting pseudoscience. In the pharmacy I had a rotation in many people asked about Airborne, Head-On, what-ever-super-vitamin-cures and I succeeded talking a few out of it, but despite my efforts people still buy them. It is on TV, on the internet, and of course it does not help when they sell it in the store.

    It is the same old issue of what ever sells and keeps the businesses going. In pharmacy school we learn the same pharmacology, physiology, pathology that is taught in med schools and most pharmacists know that all that woo does not work.

    http://www.theangrypharmacist.com/archives/2008/03/airborne_wasting_your_money_si.html#comments

    Of course there will always be those who do buy into the magic and woo…

  4. Zetetic says:

    Yes – The ingredients in Airborne, excluding the worthless herbals, can be purchased as Costco vitamins for pennies!

  5. apteryx says:

    It is not easy to find out what is in Airborne. Their website does not give the ingredients in any conspicuous place. Usually, manufacturers who are proud of their product’s quality are eager to tell you what is in it. Regarding the vitamin issue, the FAQs say:

    “8. Should I be concerned about any of the levels of vitamins in Airborne?
    Airborne is meant to be taken in short duration. If used properly, there is no concern of the higher dose vitamins.”

    Later they say: “Do not take a multi vitamin on the same days that you take Airborne.” [I wonder if the packaging gave the same warning?]

    Oh yes, and: “The law requires that we have competent and reliable scientific evidence to support the claims for our product. The science demonstrates that our product helps to boost your immune system, and have confirmed this fact through independent scientific experts.”

    Snerk. Anyway, the proprietary herbal mixture includes Lonicera (honeysuckle), forsythia, schizonepeta, ginger, Chinese vitex, isatis root, and echinacea. There is no indication of relative proportions. All of these are used in traditional medicine to treat colds. However, the total quantity of herbal extracts included is 350 mg, which if it were echinacea alone would be about 10% of the effective dose. Chinese recommendations are to take 3-10 g of decocted ginger per day; larger quantities are used of honeysuckle and forsythia. Unless this product uses highly concentrated extracts – which is not likely given that no chemical standardization is done – this is what’s called “fairy dusting,” where you take a pinch of the herb and throw it into the vat and put it on the label. There probably isn’t enough there to have any effect. I am a strong supporter of correctly made traditional medicines, but this isn’t one of them. This is garbage.

  6. It may not be known to the general public that the things that get sold in the Walgreens store has no input from the pharmacists who work in the pharmacy.

    I must admit that I did know that, but wrote what I did to tweak any pharmacist out there to respond. It worked; thank you, and I like the site that you linked. It would be nice, however, if pharmacists would get together, put their collective foot down and refuse to be tarnished by the fraudulent products that surround them in most drug stores. Most customers tacitly (and reasonably) assume that pharmacists endorse those products, so the stores’ managers and owners are, in essence, slandering the pharmacists who work for them. Yet those stores couldn’t operate without pharmacists. You’ve got the pow-ah if you want to use it.

    But of course it won’t happen, for the same reason that it isn’t (yet) happening in medicine, and to which you alluded: a sufficient number of pharmacists are quacks themselves, including some who teach students. Check out the roster of the Board of Advisers for the Integrative Medicine Alliance, with particular attention to the blurb describing June Reidlinger, Pharm. D.: http://www.integrativemedalliance.org/about_boardofadvisers.asp

    Nor are independent pharmacies necessarily any better than chains. Consider this one in my area, which is well-advertised in the local media: http://www.johnsondrug.com/

    Keep up the good work, SimonRX and like-minded anti-woo pharmacists. Now let’s see whether CSPI has been tweaked…

  7. RationalEyes says:

    The DSHEA, pushed into existence by the savior of the dietary supplement industry, Senator Orrin Hatch of Utah, basically allows for the fraudulent peddling of everything and anything to the all too willing and credulous CAM-using community. I am always a bit amused to see the expressions on people’s faces when I inform them that what they see on the labels of these products is not necessarily (and, in fact, not likely to be) what’s inside the container of malarkey they just purchased for themselves or their children. Of course, for most of what’s sold at the health food store, or in the CAM section of the local Walgreen’s, it wouldn’t matter even if it did contain the ingredients printed on the label, since most claims are entirely without merit to begin with. But the fact that the rows and rows of shelves devoted to the myriad products touting immune-boosting, mood-lifting, energy-restoring formulas can’t be stocked fast enough says a great deal about just how much (or how little) most people understand the basic principles of science.

    The fact that we spend $300 million dollars per year on a product like Airborne is a sobering reminder that society is moving away from reason and rational thought when it comes to science and health. This is a very dangerous and slippery slope,and we need to act fast.

  8. Michael X says:

    Oh boy. Just another reason for my Ma to get mad at me. First pointing out that the TV show “psychic challenge” was bunk, and now after years of telling her airborne is wasting her money, I’ll show her how they were sued for, well, wasting peoples money. C’est la vie, no?

  9. slausvonhagen says:

    In response to Dr. Atwood’s comment on pharmacist ethics (although SimonRx already beat me to it):

    Yes, we do have them. No we don’t decide what gets stocked on the shelves. I mean, there’s freakin pork rinds right next to check out. I’m a first year pharmacy student and I do everything I can to talk people out of buying all the crap out there. Most of the pharmacists I work with do too. Sometimes it works and sometimes it doesn’t, but we try. Sadly, people don’t know the science involved and see a “medication” on the shelf and assume that’s what it is. And many times someone’s given them some anecdotal evidence to its efficacy which makes it hell to talk them out of buying it. As to us having the power to do something, we’re trying. I’ve actually been talking to some of our school representatives in APhA (American Pharmacist’s Association) about doing something about the ’94 DSHEA legislation. Don’t know if anything will come of it, but I’m trying.
    As you well know, it’s a difficult battle and just like some of your colleagues, not every pharmacist is a critical thinker. I have, in fact, sent links to this blog to the entire pharmacy school twice now trying to get people to develop more critical, science-based thinking. Anyways, I guess that was a lot of writing to say, “Hey!, we’re on your side.”

  10. slausvonhagen says:

    @Michael X:

    Yeah, I tried last Thanksgiving to tell my mom and family about the uselessness of Airborne. Didn’t go over well. I guess I’ll send them this link and try again.

  11. slausvonhagen (strong handle, by the way),

    I hear you. I wouldn’t worry about the pork rinds, by the way. I wouldn’t even worry about the cigarettes, although I remember noticing a big argument about that a couple of years ago, and although technically cigarettes are “botanicals.” The point is that no rational consumer presumes that the pharmacist endorses the pork rinds or the tobacco any more than the nail clippers or the Tide. Rational consumers probably do presume that the pharmacist endorses the quack remedies that prominently embellish the pharmacy counter, wall, and window. This rational consumer presumes that store owners and/or managers are putting pharmacists in the position of appearing to violate the pharmacists’ code of ethics.

  12. David Gorski says:

    Yeah, I tried last Thanksgiving to tell my mom and family about the uselessness of Airborne. Didn’t go over well. I guess I’ll send them this link and try again.

    That’s nothing. A while back I practically got into a shouting match trying to convince my sister-in-law that Sylvia Browne isn’t really a psychic and that John Edward can’t really communicate with the dead. I was utterly shocked that she could believe such woo.

    I’ve come to realize that my approach was probably, well, not the best.

  13. Fifi says:

    Kimball – It’s now illegal for pharmacies in Quebec, Canada to sell cigarettes. Though they do a thriving trade in various “alternative” remedies and products.

  14. Tommy Gun says:

    “It certainly verifies P.T. Barnum’s observation.”

    If you mean:
    http://en.wikipedia.org/wiki/There's_a_sucker_born_every_minute

    …he didn’t say it.

  15. Tommy Gun says:

    Er, clickable link here: http://tinyurl.com/38vxjl

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