Today's NFL and NCAA televised games have eight commercial breaks per half. Two happen at the end of the first and third quarters, and two occur at the two-minute warning. Most of the others happen following natural breaks in play:
Field goal attempts
One or two-point conversion attempts
Possession changes by punt, kickoff, or turnover
Injury stoppage
Instant replay challenges
Team-called timeouts
However, if the game flow does not result in the appropriate number of commercial breaks during a half, the television crew can stop the game to insert a commercial break. So, it used to be that only the first two things were certain, death and taxes, there have been three since 1957 and 1958 when TV timeouts came into being.
Radio did not need established radio timeouts. There was enough dead time during the broadcasts that announcers could insert commercial messages between plays, quickly switching back to game coverage as required. Television did not have that luxury, given the technology of the time. Television could show game coverage or commercials, not both. Quickly switching back and forth was not an option, so the need for dedicated TV timeouts was straightforward.
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