Further Advertising Restrictions on TV and online for HFSS products June 2019

Statement submitted from Prof Bob Steele and Prof Annie S. Anderson, Co-directors of the SCPN

The Scottish Cancer Prevention Network (SCPN) is focused on moving evidence on cancer risk reduction into everyday life, practice and policy (https://www.cancerpreventionscotland.org.uk/). We are based in Scotland but work throughout the UK.

Whilst it is recognised that governments do much to support changing behaviours we also recognise that there is a need to increase capacity around cancer prevention and screening, and there is much more that agencies and government work streams can do to help to accelerate change. As an advocacy group we raise the profile of cancer prevention and screening research and action through a range of communication channels (newsletter, conference, workshops, social media and web based activities) and support ongoing work in reducing the prevalence of cancer risk factors. The SCPN is funded by the Scottish Cancer Foundation charity (SCO28300).

The evidence base for diet, alcohol and obesity and cancer are provided by World Cancer Research Fund (https://www.wcrf.org/sites/default/files/Height-and-birthweight_0.pdf). Children who are heavier for their height (mainly due to fat) tend to grow faster and become taller (and fatter). These children also reach developmental milestones earlier. These processes are directly or indirectly the result of nutrition during development, and altered hormone levels which influence both the visible structures such as height and the growth and behaviour of cells within the body. Eight cancers are related to adult height (colorectal, breast, ovary, pancreas, endometrium, prostate, kidney, skin). Recent data also show that higher body fatness at a young age increases the risks of developing various types of cancer later in life including lymphomas, stomach, oesophageal, liver, pancreas, kidney and thyroid (https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12705). In terms of the relationship between early nutrition and later health we welcome action that will help achieve equitable, optimal growth trajectories throughout childhood including obesity prevention.

Media in Scope

The Government proposes that any further advertising restrictions apply to broadcast TV and online. Do you think that any further advertising restrictions should be applied to other types of media in addition to broadcast TV and online?

Yes

If answered yes, what other media should be subjected to further HFSS advertising restrictions?

Cinema, Radio, Print, Outdoor, Direct marketing, other.

Please explain why you think that we should extend additional advertising restrictions to these types of media.

Will reduce children’s exposure to HFSS advertising and in turn reduce their calorie intake

Easy for parents and guardians to understand.

HFSS Definition

The Government proposes that any additional advertising restrictions apply to food and drink products in Public Health England’s sugar and calorie reduction programmes, and the Soft Drink Industry Levy, using the NPM 2004/5 to define what products are HFSS. Do you agree or disagree with this proposal?

Disagree regarding the NPM 2004/5

If you do not agree with the proposal what alternative approach would you propose and why? Please provide evidence to support your answer.

The updated Nutrient Profile Model should be used in order to better reflect current knowledge on product compositions and the recent public consultation on this.

Broadcast Consultation Options

Please select your preferred option for potential further broadcast restrictions

Option 1 – Introduce a 9pm – 5:30am watershed on broadcast TV.

Please select the reason/s for your choice, providing supporting evidence for your answer.

Will reduce children’s exposure to HFSS advertising and in turn reduce their calorie intake.

Although television viewing has diminished in recent years the estimated advertising spend (£215m in 2017) indicates this is a worthy investment to the industry in terms of sustaining and growing product sales. These figures come at a time when we must ensure that purchase of foods (and drinks) that are high in fat, sugar and salt (HFSS) are not sustained and must be decreased in order to redress the problem of caloric overconsumption in children (and adults).

We welcome to statutory action to reduce the volume, exposure and negative impacts of advertisning foods high in FSS which has been demosnstarted to be more effective that self-regulatory actions¹

In the recent enquiry by the Health and Social Care Committee on Childhood Obesity Inquiry² a range of outcomes related to food marketing for HFSS products were identified including increased preference for these products, greater demands on parents and lower intake of overall healthy foods.

Option 1 provides a clear and consistent message that is easily understood by manufacturers, programmers and provides the greatest safeguards for children especially in lower socioeconomic groups. This approach is taken with respects to other undesirable exposures in children e.g. television violence. The key issue about advertising is that it has a clear relationship with food preferences, purchase requests and consumption patterns³ which in turn are related to overall caloric intake.

Option 2 (a ladder of advertising restrictions to incentivise reformulation) highlights opportunities for reformulation but for some of these products improvement in nutritional content may not remove factors associated with diets high in ultra- processed foods and obesity associated harms. Three recent report have reported association of ultra-processed foods with poorer health outcomes (obesity in childhood, adult’s cancer and cardiovascular risks) and we need to be mindful of this growing evidence base ^{4, 5,6,.}

(We think that the updated UK nutrient profile model provides excellent guidance for directing non-broadcast advertising; to use any other definition would lead to mixed messages and this would undermine current nutrient profile modelling).

If you selected option 1, the government proposes an exemption for when there are low child audiences. Should this exemption apply to channels or programmes? Please explain your answer.

I do not know

If you selected option 1, do you agree that 1% of the total child audience (around 90,000 children) is the appropriate level at which programmes or channels should be exempted? Please explain your answer.

It is unclear why programmes that may have as many as 89,000 child viewers (e.g. 1% of audience) should be exempt and indeed why there should be any exemption on any channels and programmes.

If you selected option 1 and you do not agree that 1% of the total child audience is the correct threshold to grant an exemption please propose an alternative threshold.

No exemption

Online Consultation Options

Please select your preferred option for potential further online HFSS advertising restrictions

Option 1 – Introduce a 9pm – 5:30am watershed online

Please select the reason/s for your choice, providing supporting evidence for your answer.

Will reduce children’s exposure to HFSS advertising and in turn reduce their calorie intake.

Easy for parents and guardians to understand.

If you selected option 1, should exemptions be applied to advertisers that can demonstrate exceptionally high standards of evidence that children will not be exposed to HFSS advertising?

If you selected option 1, what evidence should be required to meet the definition of “exceptionally high standards” for the purposes of securing an exemption?

No exemptions should be made. This allows a consistent approach for the benefit of children across all platforms.

Implementation and Next Steps

The government proposes to introduce any advertising restrictions arising from this consultation at the same time on TV and online. Do you think restrictions should be applied at the same time for TV and online?

Yes

Public Sector Equality Duty

Do you think that introducing further HFSS advertising restrictions on TV and online is likely to have an impact on people on the basis of their age, sex, race, religion, sexual orientation, pregnancy and maternity, disability, gender reassignment and marriage/civil partnership?

Do you think that the proposed policy to introduce further HFSS advertising restrictions on TV and online would be likely to have a differential impact on people from lower socio-economic backgrounds?

Yes

Obesity in childhood is social patterned and both television viewing and computer use (video game use) are mediators of socioeconomic differences in adiposity⁷. The mediating role of physical activity has been found to have an indeterminate effect highlighting the potential gain from changes in food advertising exposure through screen use. These findings suggest that interventions aimed at decreasing obesity will not lead to increased health inequalities and are likely to be consistent with the findings of Hillier et al who reported that public health interventions (including screen exposure) could be effective in reducing inequalities in obesity⁸

https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12547
https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-834