Changes

While in the US, mass-produced cards have become the norm, other countries have either been influenced by this or have developed their own traditions. In the UK, there are perhaps among the highest number of publishers focused on greeting cards, where the tradition of sending greeting cards is not only well established but is also among the most profitable. Over 1.5 billion cards are sent by UK publishers alone, making it the highest number on a per-capita basis. While many traditional publishers have suffered, they have also adapted by making more creative ways to send personalized messages and cards as well as using digital media.  In Japan, greeting cards that have combined other popular culture themes, such as Hello Kitty, have become popular for people to send on different occasions. In Germany, birthdays such as 18th birthday and 25th birthday have led to developed specialized cards for these occasions.