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Journal of Marketing Management

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De‐marketing: Putting Kotler and levy's ideas into

practice
a a b
Steven Lawther , Gerard B. Hastings & R. Lowry
a
Centre for Social Marketing , University of Strathclyde , 173 Cathedral Street, Glasgow, G4
0RQ
b
NHS Executive — Northern and Yorkshire Region , Benfield Road, Newcastle upon Tyne, NE6
4PY, UK
Published online: 06 May 2010.

To cite this article: Steven Lawther , Gerard B. Hastings & R. Lowry (1997) De‐marketing: Putting Kotler and levy's ideas into
practice, Journal of Marketing Management, 13:4, 315-325, DOI: 10.1080/0267257X.1997.9964475

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 Journal of Marketing Management, 1997, 13, 315-325

Steven Lawther1, De-marketing: Putting

Gerard B. Hastings1,
and R. Lowry2
1
Centre for Social
Marketing, University of
Strathclyde, 173 Cathedral
Street, Glasgow, G4 0RQ
and 2NHS Executive —
Northern and Yorkshire
Region, Benfield Road,
Newcastle upon Tyne,
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Kotler and Levy's Ideas into
Practice
The concept of de-marketing was initially proposed by Kotler and
Levy in 1971. Since then only limited consideration has been given
to this theory or how to apply it in practice. This paper examines
existing definitions of de-marketing and considers a recent attempt to
use a de-marketing strategy on a service (general anaesthesia in
general dental practice).
The study sought to use both primary and secondary research to
identify the nature of the problem and to develop a de-marketing

strategy, whilst ensuring that none of the parties involved would be

NE6 4PY, UK inconvenienced or disadvantaged. It presents the experience with
dentists in the case of de-marketing general anaesthesia and, in the
light of this experience, seeks to better understand the nature of
selective de-marketing. The findings suggest that de-marketing can
provide original insights and allow a different approach when
attempting to change service provision. In particular the adoption of
a consumer orientation and the use of marketing tools (such as the
marketing mix, segmentation, targeting and positioning) can add a
new level of sophistication to service planning.

Introduction

In 1971 Philip Kotler and Sidney Levy first put forward the idea of de-marketing —
the notion that marketing could be used to dampen and control demand as well as
generate and satisfy it. Since then there have been few published attempts to further
understand this notion or assess whether their ideas work in practice. This paper
redresses this balance using the case of a dental health service that was a suitable
candidate for de-marketing to develop a greater understanding of the nature of
selective de-marketing.

Kotler and Levy' Ideas

Marketing is typically perceived as a mechanism for furthering or increasing, and

then satisfying, demand. However, at any point in time demand levels may be
below, equal to or in excess of those desired by an organisation. In the latter case a
tool for reducing or controlling demand is required. This process is known as de-
marketing and was defined by Kotler and Levy (1971) as:
"that aspect of marketing that deals with discouraging
customers in general or a certain class of customer in
particular on either a temporary or permanent basis."
0267-257X/97/040315 + 11 $12.00/0 ©1997 The Dryden Press
 316 Steven Lawther et al.

Traditional marketing tools are used, but in reverse: for example, the marketing
mix variables are adjusted to "cool" demand. Advertising and sales promotion
activity is suspended, price may be increased or distribution channels can be
changed to make the product less accessible. This will result in demand being
curbed and the product being effectively de-marketed.
Kotler and Levy identified differing types of de-marketing, dependent on the
nature of the demand that it is necessary to reduce. These are:
(1) General de-marketing;
(2) Selective de-marketing; and
(3) Ostensible de-marketing.
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General de-marketing

This occurs when demand for a product or service is deemed to be too high. De-
marketing is undertaken effectively to shrink total demand to an acceptable level.
Demand may exceed the potential supply for a variety of reasons:
(1) There may be a temporary shortage of products, with the company unable to
meet the resultant demand. This presents the problem of adjusting supply to
meet the unsatisfied demand by, for example, increasing production capabil-
ities through plant expansion. However, long term solutions like this will not
resolve temporary shortages, therefore companies must seek to contain
demand to reduce the risk of further aggravating product shortage.
(2) Chronic over-popularity may exist for a product or service. This is of particular
relevance for manufacturers of exclusive products where scarcity contributes
to their quality image and widespread popularity will undermine this.
Alternatively, producers may simply not wish to cope with high levels of
demand for practical reasons.
(3) The decision may have been taken to eliminate a product for which a level of
demand still exists. The challenge for the company is to eliminate the demand,
or encourage customers to accept substitutes, without losing their goodwill.

Selective De-marketing

Selective de-marketing is concerned with a company seeking to reduce demand

within certain segments of the market amongst specific types of consumer. For
example, a motorway service area may seek to discourage football fans or a pub may
want to de-market itself to underage drinkers. As Kotler emphasized, the
classification of customers into "desirable" and "undesirable" may raise ethical
questions and can be interpreted, in some instances, as discrimination.

Ostensible De-marketing

Ostensible marketing involves the manufacturer appearing to discourage demand,

with the actual intention of increasing it. This relies on the principle that customers
 De-marketing: Kotler and Levy's Ideas in Practice 317

will be attracted as the product becomes harder to obtain. For example, a concert
promoter will promote a concert as "nearly sold out — limited number of tickets
left", with the hidden intention of encouraging potential attenders to rush out and
purchase tickets.
De-marketing, Kotler and Levy argue, presents unique problems. There is a
danger of over-reducing demand or harming long-term customer relations,
particularly with selective de-marketing. Bad customer relations as a result of de-
marketing one product will counteract the effect of marketing other products —
there is a difficult balance to be struck between marketing and de-marketing
products or services.
Kotler and Levy also acknowledge that their paper is purely theoretical and that
there is a need for careful research to substantiate and clarify their ideas. This
injunction apparently fell on deaf ears. An extensive literature search revealed only
one significant article about de-marketing (Mark 1994) and none that have
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attempted to put the theory into practice. This paper will start to fill this gap by
examining an attempt to actually use selective de-marketing on a real service. The
experience of de-marketing in action and the contribution made by de-marketing to
the strategic planning process will be examined to clarify Kotler and Levy's original
ideas.

The Problem Service

The service in question was general anaesthesia in general dental practice — what
is commonly referred to as "going to the dentist to get gas".
Concern has been expressed about the use of general anaesthesia in general dental
practice for many years. (The Spence Report 1981; Editorial 1987). Though serious
incidents are rare, it is acknowledged to be more dangerous than the alternatives,
and fatalities occasionally do occur. This led a working party on general anaesthesia,
sedation and resuscitation in dentistry, headed by Poswillo (1990), to call for
reductions in its use except where there is clinical justification. This has contributed
to an increasing reluctance among younger anaesthetists to administer anaesthetics
in general dental practice.
Nonetheless, general anaesthesia continues to be used on a discretionary basis; the
rates of use vary between districts in a way that cannot be explained by
epidemiological differences (Dental Data Update 1990). It has also been reported that
non-clinical factors account for one third to one half of general anaesthetic
administrations (Woolgrove and Cumberbatch 1984). There is a need, therefore, to
reduce — but not eliminate — the use for general anaesthesia. In particular, certain
categories of people who are currently using the service need to be discouraged from
doing so.
Changing service provision is complex. In the UK, general dental practitioners are
independent contractors, and run their practices as small businesses. They are not
employees of the health service and cannot be told what to do, although some
limited control is possible through their NHS contracts. Any programme of change,
therefore, has to be largely voluntary and mutually acceptable. Consequently, when
the Northern and Yorkshire Region of the NHS Executive decided to tackle the
problem of general anaesthesia, marketing (and, by extension, de-marketing), with
 318 Steven Lawther et al.

its emphasis on mutually beneficial exchange, seemed to offer an obvious way

forward. Furthermore, given the need to reduce the use of the service by certain
types of consumer, this seemed an ideal opportunity to apply Kotler and Levy's idea
of selective de-marketing.
However, because there was so little experience of de-marketing to draw on, the
Health Authority approached it cautiously, anxious to determine its value.
Specifically, they wanted to find out if it could offer original insights, new solutions
and a workable way forward. It was therefore decided to produce a detailed de-
marketing plan and see if this could meet these criteria.
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Problem Definition Research

The first step in developing a de-marketing plan was to conduct research that would
clarify the problem. Specifically there was a need to map the occurrence of general
anaesthesia in the Region, to determine how the decision to use general anaesthesia
is made, and by whom, and to find out how to influence key decision-makers. In
addition, it was important to ensure that none of the parties involved (patients,
dentists and other professionals) would be distressed, inconvenienced or dis-
advantaged by any de-marketing strategy. The research adopted a customer
orientation, examining the decision to use general anaesthesia from the point of view
of both professionals and patients, assessing their respective needs and the extent to
which these are currently being met and how they could be met in the future.
The research with patients focused on parents, because, as Poswillo (1990)
highlighted, around 70% of general anaesthetics are administered to children.

Method

Primary and secondary research were conducted. The secondary research involved
an analysis of recent service usage data ("sales data") for general anaesthesia and the
related epidemiological statistics.
The primary research comprised a combination of focus group discussions and in-
depth interviews. These methods are commonly used in market research, and
increasingly in medical and dental research (Blinkhorn et al. 1983; Leather and
Roberts 1995) and are eminently suitable for identifying and explaining complex
attitudes and emotions. They overcome some of the disadvantages of quantitative
methods, especially non-sampling error such as the superficiality of response and,
given the concern of the research with the complexities of the general anaesthetic
choice process, these methods were felt to be most appropriate here.
Eight focus groups were conducted with (parents of) patients (Table 1), and five
with dentists (Table 2). Twenty depth interviews were conducted with dentists and
twenty-six with other dental health professionals, including hospital consultants,
anaesthetists, health authority advisors and academics.
 De-marketing: Kotler and Levy's Ideas in Practice 319

Table 1. The composition of the parent focus groups

Age of children Use of general Social economic
Group (years) anaesthetics group
1 3-9 High ABC1
2 3-9 High C2DE
3 10-15 High ABC1
4 10-15 High C2DE
5 3-9 Moderate C2DE
6 10-15 Moderate ABC1
7 3-9 Low ABC1
8 10-15 Low C2DE

Findings

The secondary research confirmed that there was indeed a problem with the
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distribution of general anaesthesia. As in the rest of the country, the level of

provision varied significantly within the Region without sufficient clinical explana-
tion. In particular, "hot spots" of over-provision emerged.
The most important findings to emerge from the primary research concern how
the decision to use general anaesthesia is made; the (very limited) influence of
patients on this decision; the structure of provision and the prospects for change.

The Decision

In spite of the fact that patient demand has been cited as a reason for dentists
continuing to supply a high level of general anaesthesia (Poswillo 1990), it is very
apparent that the dentist predominates in the decision whether or not to use it, with
the patient being relatively disempowered. Dentists acknowledge this influence and
use their professional judgement to prescribe the treatment they believe to be
appropriate.
This judgement about general anaesthesia varies between dentists, with three
different types of general anaesthesia user emerging:
— Committed Users. These dentists have extensive experience of using general
anaesthesia, have grown used to it and developed positive attitudes towards it.
Specifically they are inclined to feel that the benefits outweigh the drawbacks.
They actively choose general anaesthesia as an alternative to other
procedures.
Furthermore, committed users are typically older dentists who are senior
within their practice. As a result their influence is great.

Table 2. Composition of dentist focus groups

Age of dentist Incidence of general Providing general
Group (years) anaesthetics anaesthetics
1 20-39 High Mixed
2 40-60 Moderate Mixed
3 40-60 High Mixed
4 20-39 Low Mixed
5 20-60 High •
 320 Steven Lawther et al.

—Non-committed Users. These dentists are also current providers of a general

anaesthetic service, however they are not actively in favour of its use. The
service is provided either to compete more effectively with other dental
practices in the area or because they are junior associates of dentists who are
committed users.
—Non-users. Non-users tend to hold negative attitudes to general anaesthesia,
having ceased to provide an anaesthetic service post-Poswillo or having
recently qualified and, therefore, received training discouraging the use of
general anaesthesia in general practice. Most non-users are located in areas
with low and moderate levels of provision. Despite holding negative attitudes,
they are defensive of clinical freedom for other dentists to operate as they see
fit.
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The Influence of the Patient

The patient's influence on provision is very much secondary, simply serving to

reinforce the status quo. For example, although those parents who use the service
often find the experience of taking their child to a general anaesthesia session fairly
traumatic, they are generally unaware of alternative procedures, or that general
anaesthesia has potentially very serious risks attached to it. Furthermore, they
typically defer to their dentist's judgement.
In this way a cyclical pattern develops. Dentists provide general anaesthesia,
patients experience it and view it as the norm, patients come to expect it and dentists
continue to provide the service. This "self-perpetuating general anaesthesia culture"
results in high levels of general anaesthesia being sustained.

The Structure of Provision

The structure of general anaesthesia provision varied across the Region. In some
areas provision has been centralized in one location (for example, a community
dental clinic or hospital) and has completely ceased in general dental practice. In
others the bulk of provision has centralized, but continues to be supported by a
number of practices who specialize to some degree in general anaesthesia. In a third
set of areas, no centralization has taken place. General anaesthesia continues to be
widely available in general dental practice, and is supported by a peripatetic
anaesthetist.
The first two structures have had similar effects, greatly reducing the use of
general anaesthesia. This happens because the structures require those dentists who
wish to continue using general anaesthesia to refer patients away from their own
practice, and just like any other small business owner, they are reluctant to turn
away customers in this fashion, and, effectively, to send them to their business rivals.
A natural disincentive to refer to other dentists for treatment exists, with dentists
more likely to attempt to treat a patient under local anaesthetic in their own practice.
The final structure of provision creates no disincentive to refer amongst dentists and
sustains general anaesthesia use at high levels. There is also a more direct financial
incentive for these dentists to continue providing general anaesthesia — they will
 De-marketing: Kotler and Levy's Ideas in Practice 321

all have made a considerable capital investment in the high-tech equipment now
required to provide this service.
Crucially, the adoption of these different structures has depended first and
foremost on the preference of dentists in that area.

The Potential for Change

Dentists who are currently providing general anaesthesia resist the suggestion that
there is any need for a reduction in this provision. This view is supported by their
positive attitudes towards general anaesthesia, a belief that they are providing the
right level of service and a strong resentment of interference in their clinical
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judgement or professional independence. There is also a wider reluctance amongst

the dental profession to accept the need for any reduction in levels of general
anaesthesia, with dentists defensive of clinical freedom and, accepting of different
treatment philosophies, and strongly resistant to interference from outside bodies.
Despite this, other organizations such as the Health Authorities, the local
Postgraduate Dental Institute, Community Dental Clinics and anaesthetists do have
an impact, albeit a limited one, on dentists and their decision-making. Organizations
which are well perceived by dentists can act as "pressure groups" on the dentistry
profession. An example of this was the Poswillo report itself, which resulted from
pressure from anaesthetists relating to general anaesthesia practice.

Developing the De-marketing Plan

The research has been used to develop a de-marketing plan. The key elements of this
are positioning, segmentation, targeting and the marketing mix.

Positioning

"Positioning" means developing an appropriate image for the de-marketing project

in the minds of the target segments (Kotler 1988). Dentists are crucial here in that
they have a great deal of power over the decision to use general anaesthesia, and will
resent any attempt by an outsider to reduce this power. The image must therefore be
one of professional co-operation, of local ownership and of mutual interest. This can
be achieved by radically altering the focus of the plan. Instead of emphasizing the
issue of safety, which would raise professional hackles and call into question
individual's clinical judgement, it could address the problem of future provision.
Highlighting the increasing reluctance of anaesthetists to provide general anaes-
thesia in general practice enables the initiative to be presented as a necessary
response to external pressures, rather than as interference in dentists' clinical
freedom.
 322 Steven Lawther et al.

Segmentation

Segmentation allowed the RHA to identify areas of problem incidence and severity
(Andreasen 1995).
The research highlighted that a selective de-marketing strategy needed to be
adopted in areas of high incidence and amongst dentists who are still heavily
involved in general anaesthesia. The segmentation of dentists by their commitment
to general anaesthesia has made it possible to identify those who are potentially
more receptive to the concept of reducing levels, as well as the "hard core" of
dentists who remain resistant to change.
However, it is also clear that the overall tone and message needs to be consistent
for all dentists and other professionals, emphasizing the fact that the plan has broad-
based support amongst their peers.
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Patients will have a more limited role in any change programme. The obvious
strategy of simply warning them of these dangers of general anaesthesia seems
inappropriate, given the lack of control over the service. Such an approach is likely
to cause considerable alarm and risk antagonizing and alienating the dentists. It is
clear that those in high incidence areas who are used to having general anaesthesia
available will need help in adjusting to any reduction. It is also apparent that
dentists will have a key role to play in re-education of the public towards alternative
procedures, again emphasizing the need to retain their co-operation and "owner-
ship" of the plan.

Targeting

The method of communication could also be determined from the research. The
antagonistic attitudes of dentists towards bureaucracy underpins the whole strategy.
Any intervention that was perceived as bureaucratic or coming from individuals
lacking knowledge at the sharp end of dentistry — so called "wet fingered
dentistry" — will fail. The need is for dentists to have ownership of an initiative for
it to have credibility. The emphasis also needs to be placed on local problems being
solved at a local level.

Marketing Mix

All four elements of the marketing mix were considered in the development of the
plan:
—Product. Two alternative product offerings emerged from the research. The first
is the need to reduce the use of general anaesthesia to improve patient safety.
The second is to reduce it as a managerial response to the inevitable reduction
that will happen as a result of the tendency for younger anaesthetists to refuse
to provide the necessary back-up service. It is now clear that the former will be
rejected by all dentists — users and non-users of general anaesthesia — as an
unacceptable interference in clinical judgement.
The second product offering, however, has much more potential as it can be
 De-marketing: Kotler and Levy's Ideas in Practice 323

presented as a joint response by dentists and regional officials to an external

threat to patient welfare.
- Promotion. Communication will be a key element of the mix. The message must
fit with the product, and crucially be seen to originate from respected peers.
Therefore, a communication strategy with three stages was developed. First, a
debate about the issues of general anaesthesia among dental professionals
would be stimulated by publishing papers in the appropriate journals (e.g.
Hastings et al. 1994). Second, working parties would be established in areas of
high provision to raise issues at a local level. These would comprise well
respected individuals, including anaesthetists and working dentists. Consumer
needs and the current research will be fed into these working parties. Third, in
the longer term, local dentists will be encouraged and helped to educate their
patients about the changes.
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- Price. The plan will have to tackle two financial implications of change. First,
any action will need to be co-ordinated across any given area, to ensure that
individual dentists did not lose competitive advantage by acting alone. Second,
compensation will need to be provided for previous capital investment in
general anaesthetic equipment.
In addition, the "psychological" price of change will need to be acknowledged.
Notwithstanding de-marketing dentists will need to compromise, and accept
some changes to the services they provide, by extension limiting their clinical
freedom. The resulting sensitivities will need to be handled with care.
-Place. Key areas of high provision have been identified by the research.
However, care will be needed to ensure that they do not feel unfairly singled
out for attention, or that their professional judgement is being selectively
criticized. There will also be issues of place for any replacement centralized
service. In particular, there will need to be located — and seen to be located —
conveniently for patients.

Conclusion

This paper has examined Kotler and Levy's idea of selective de-marketing and how
it works in practice. Specifically it has looked at its potential for contributing to the
strategic planning process and the extent to which it could provide original insights,
new solutions and a workable way forward.
Our experiences with general anaesthesia suggest a selective de-marketing
approach does hold considerable benefits for organizations wishing to reduce
demand for a product or service. In particular, a consumer orientation is a powerful
initial stance to adopt. Marketing tools, such as the marketing mix, segmentation,
targeting and positioning, all help to convert this stance into a workable plan. They
have allowed the Health Authority to understand the consumer, reducing demand
with reference to their needs and wants and to target efforts and resources in
proportion to problem incidence and likely pay-off. Furthermore, in the case of
general anaesthesia, this plan has provided original insights into the problem and
significantly changed the Health Authorities approach to it.
Previously, the Health Authority would have adopted one of two approaches to
 324 Steven Lawther et al.

the general anaesthesia problem. First, they could have appealed to practitioners'
logic by providing them with information about the dangers of this procedure. This
is a fairly uncertain route to take, as it assumes a purely rational and clinical decision
making process, which is not apparent with general anaesthesia.
Alternatively, they could have used force, by applying contractual controls or
financial penalties. This would probably cause resentment, and may even result in
dentists leaving the NHS altogether.
By contrast, de-marketing added a new level of sophistication to service planning,
enabling the Health Authority to present it as a shared challenge, that, with the
correct approach, could be turned into a mutually beneficial opportunity.
Although the characteristics of dentists may not constitute a sample or case that
can be generalized to all selective de-marketing situations, the experience in the
general anaesthesia case does allow us to better understand the practical process of
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selective de-marketing. It is not satisfactory to view de-marketing as simply the

opposite of conventional marketing. Marketing tools need to be used sensitively to
address the particular requirements of reducing demand and to avoid dentrimental
effects on consumers in the long term. In conclusion, this paper suggests that
selective de-marketing does have the potential to provide new solutions for
organizations wishing to reduce demand and is a workable way forward.

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