Evaluating the impact of Chile's marketing regulation of unhealthy foods and beverages: pre-school and adolescent children's changes in exposure to food advertising on television.

OBJECTIVE: To evaluate the effects of Chile's 2016 regulation restricting child-directed marketing of products high in energy, saturated fats, sodium and sugars on reducing children's exposure to 'high-in' television food advertising. DESIGN: Television use by pre-schoolers and adolescents was assessed via surveys in the months prior to implementation and a year after implementation. Hours and channels of television use were linked with the amount of high-in food advertising observed in corresponding content analyses of food advertisements (ads) from popular broadcast and cable channels to estimate changes in exposure to food ads from these channels. SETTING: Middle-lower and lower-income neighbourhoods in Santiago, Chile. PARTICIPANTS: Pre-schoolers (n 879; mothers reporting) and adolescents (n 753; self-reporting). RESULTS: Pre-schoolers' and adolescents' exposure to high-in food advertising in total decreased significantly by an average of 44 and 58 %, respectively. Exposure to high-in food advertising with child-directed appeals, such as cartoon characters, decreased by 35 and 52 % for pre-schoolers and adolescents, respectively. Decreases were more pronounced for children who viewed more television. Products high in sugars were the most prevalent among the high-in ads seen by children after implementation. CONCLUSIONS: Following Chile's 2016 child-directed marketing regulation, children's exposure to high-in food advertising on popular broadcast and cable television decreased significantly but was not eliminated from their viewing. Later stages of the regulation are expected to eliminate the majority of children's exposure to high-in food advertising from television.

Food Advertising and Prevention of Childhood Obesity in Spain: Analysis of the Nutritional Value of the Products and Discursive Strategies Used in the Ads Most Viewed by Children from 2016 to 2018.

In Spain, 40% of children are overweight or obese. Television advertising is a widely acknowledged factor contributing to high-calorie food intake. This study longitudinally correlates some variables involved in childhood obesity prevention strategies in Spain. A mixed-methods approach was used. A quantitative analysis of audience data was conducted to determine the advertising campaigns most viewed by Spanish children from 2016 to 2018. The Nutri-score system was applied to determine the nutritional quality of the food advertised. A content analysis and a study of the discursive strategies used as an advertising ploy was undertaken. The results were examined in relation to the regulatory framework of the Spanish PAOS Code for the co-regulation of food advertising aimed at children. The study shows that Spanish advertising aimed at children mostly advertises very low nutritional value products. Moreover, these campaigns violate the PAOS Code in terms of the use of language in relation to the product, its benefits, and the appearance of popular characters. Our findings suggest a direct association between low nutritional value food ads and discursive strategies based on the intangible and extrinsic characteristics of these products. There remains the need for stricter legislation that takes into consideration the nutritional value of advertised foods and the language used in their hedonistic advertising.

What arguments and from whom are most influential in shaping public health policy: thematic content analysis of responses to a public consultation on the regulation of television food advertising to children in the UK.

OBJECTIVES: We explore one aspect of the decision making process-public consultation on policy proposals by a national regulatory body-aiming to understand how public health policy development is influenced by different stakeholders. DESIGN: We used thematic content analysis to explore responses to a national consultation on the regulation of television advertising of foods high in fat, salt and sugar aimed at children. SETTING: UK. RESULTS: 139 responses from key stakeholder groups were analysed to determine how they influenced the regulator's initial proposals for advertising restrictions. The regulator's priorities were questioned throughout the consultation process by public health stakeholders. The eventual restrictions implemented were less strict in many ways than those originally proposed. These changes appeared to be influenced most by commercial, rather than public health, stakeholders. CONCLUSIONS: Public health policy making appears to be considered as a balance between commercial and public health interests. Tactics such as the questioning and reframing of scientific evidence may be used. In this example, exploring the development of policy regulating television food advertising to children, commercial considerations appear to have led to a watering down of initial regulatory proposals, with proposed packages not including the measures public health advocates considered to be the most effective. This seems likely to have compromised the ultimate public health effectiveness of the regulations eventually implemented.

Prevalence, duration, and content of television advertisements for breast milk substitutes and commercially produced complementary foods in Phnom Penh, Cambodia and Dakar, Senegal.

Promotion of breast milk substitutes (BMS) and inappropriate marketing of commercially produced complementary foods (CPCF), including through television, can negatively influence infant and young child feeding. The World Health Organization International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly (WHA) resolutions prohibit such advertising and require manufacturers and distributors to comply with its provisions; however, such regulations at national level may vary. Advertisements require Ministry of Health approval in Cambodia but are not regulated in Senegal. Television stations were monitored for 13 months in Phnom Penh and for 3 months in Dakar to assess advertisements for BMS and CPCF. Ten television channels (out of 16) in Phnom Penh and four (out of 20) in Dakar aired advertisements for BMS. Three and five channels, respectively, aired advertisements for CPCF. All BMS advertised in Phnom Penh were for children over 1 year of age. BMS products for children 6+ months of age and 1+ years of age were advertised in Dakar. Average air time for BMS advertisements was 189.5 min per month in Phnom Penh and 29.7 min in Dakar. Air time for CPCF advertisements averaged 3.2 min per month and 13.6 min, respectively. Fewer than half of BMS advertisements and three quarters of CPCF advertisements explicitly stated an age of use for products. Nutrition and health claims were common across BMS advertisements. This study illustrates the need to adopt, regulate, monitor, and enforce legislation prohibiting BMS promotion, as well as to implement regulations to prevent inappropriate promotion of CPCF.

Applying Corporate Political Activity (CPA) analysis to Australian gambling industry submissions against regulation of television sports betting advertising.

AIMS: This research aimed to assess the application to the gambling industry, of Corporate Political Activity (CPA) analysis previously developed from public health research on tobacco industry interactions with political institutions and previously applied to the alcohol industry, but not the gambling industry. BACKGROUND: A growing body of literature has confirmed how public interest outcomes are frequently opposed by vested interests. This research focused on gambling industry submissions to a 2013 Australian Parliamentary inquiry into sports betting advertising. Gambling advertising became highly controversial following deregulation of sports betting advertising in Australia subsequent to the 2008 Australian High Court Betfair challenge. The dramatic increase in gambling advertising during sporting event broadcasts at children's viewing times and on new interactive technology, sparked public concerns. A series of national regulatory reviews followed and the gambling industry was actively involved in opposing further regulation. METHOD: The research used a corporate political activity (CPA) framework of analysis developed by UK tobacco public health researchers, which identified strategies and tactics used internationally by the tobacco industry, to broker pro-tobacco public policy outcomes. Testing the application of this CPA framework to gambling pro-industry strategies/tactics, this research focused on gambling industry submissions to the 2013 Australian Parliamentary Committee Inquiry. RESULTS: Like the tobacco industry, the research found the gambling industry used identified strategies and tactics, some new tactics and a new strategy of 'Corporate Social Responsibility', promoting 'responsible' industry practices and pre-emptive establishment of internal 'responsibility' units/practices. Despite public concerns regarding sports betting advertising, the gambling industry reinforced individual choice/blame for harms and claimed it acted responsibly. It did this using strategies identified in the tobacco industry CPA framework: information strategy (and shaping the evidence base); financial incentive strategy; constituency building strategy; policy substitution strategy; legal strategy; and constituency fragmentation and destabilization strategy. CONCLUSION: Similar to the CPA analysis applied to tobacco and alcohol industries, the research demonstrated the usefulness of the CPA taxonomy for analyzing and documenting pre-emptive industry policy strategies and tactics, exposing gambling industry efforts to maintain industry self-regulation via voluntary codes and avoid more government regulation. Cross-sectoral application of the framework signals great potential for use of CPA by policymakers and public health advocates as a tool in the analysis of corporate industry arguments/discourses.

The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children.

Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M⁻AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m²). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372⁻25,155); total cost-savings AUD126.3M (95% UI AUD58.7M⁻196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812⁻15,679); total cost-savings AUD90.9M (95% UI AUD44.3M⁻136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP.

Tobacco advertising, promotion and sponsorship in entertainment media: a phenomenon requiring stronger controls in the Eastern Mediterranean Region.

Tobacco use and placement of tobacco products in television (TV) productions and movies is a way to promote tobacco use while avoiding tobacco advertising bans that exist in most countries. The fact that such productions are broadcast widely and viewed by millions, including children and young people, is of concern. This paper reviews the evidence on the use of tobacco advertising, promotion and sponsorship (TAPS) in TV and films in the Eastern Mediterranean Region and the ways to combat it. Evidence from Egypt shows considerable and increasing use of tobacco products by actors on screen, including female actors, in programmes aired during Ramadan in 2015-2017. A study of Iranian movies in 2015 showed that tobacco scenes in Iranian movies were increasing. In 2014, the WHO Regional Office for the Eastern Mediterranean held a consultative meeting on TAPS in drama. The consultation recommended regulating the tobacco presence in movies and TV through complete implementation of Article 13 of the WHO FCTC, and raising the issue to the WHO FCTC Conference of the Parties. In 2016, the Conference of the Parties called on parties to consider scaling up the implementation of WHO FCTC Article 13 and monitoring the use of TAPS in entertainment media in accordance with national legislation. A comprehensive approach is essential to end the tobacco industry's use of TV productions and movies to promote their products.

Malt Beverage Brand Popularity Among Youth and Youth-Appealing Advertising Content.

BACKGROUND: This study examined whether alcohol brands more popular among youth are more likely to have aired television advertisements that violated the alcohol industry's voluntary code by including youth-appealing content. METHODS: We obtained a complete list of 288 brand-specific beer advertisements broadcast during the National Collegiate Athletic Association (NCAA) men's and women's basketball tournaments from 1999 to 2008. All ads were rated by a panel of health professionals using a modified Delphi method to assess the presence of youth-appealing content in violation of the alcohol industry's voluntary code. The ads represented 23 alcohol brands. The popularity of these brands was operationalized as the brand-specific popularity of youth alcohol consumption in the past 30 days, as determined by a 2011 to 2012 national survey of underage drinkers. Brand-level popularity was used as the exposure variable to predict the odds of having advertisements with youth-appealing content violations. RESULTS: Accounting for other covariates and the clustering of advertisements within brands, increased brand popularity among underage youth was associated with significantly increased odds of having youth-appeal content violations in ads televised during the NCAA basketball tournament games (adjusted odds ratio = 1.70, 95% CI: 1.38, 2.09). CONCLUSIONS: Alcohol brands popular among underage drinkers are more likely to air television advertising that violates the industry's voluntary code which proscribes youth-appealing content.

Analysis of Alcohol Industry Submissions against Marketing Regulation.

A growing body of literature points to the role of vested interests as a barrier to the implementation of effective public health policies. Corporate political activity by the alcohol industry is commonly used to influence policy and regulation. It is important for policy makers to be able to critique alcohol industry claims opposed to improved alcohol marketing regulation. The Australian National Preventive Health Agency reviewed alcohol marketing regulations in 2012 and stakeholders were invited to comment on them. In this study we used thematic analysis to examine submissions from the Australian alcohol industry, based on a system previously developed in relation to tobacco industry corporate political activity. The results show that submissions were a direct lobbying tactic, making claims to government that were contrary to the evidence-base. Five main frames were identified, in which the alcohol industry claimed that increased regulation: (1) is unnecessary; (2) is not backed up by sufficient evidence; (3) will lead to unintended negative consequences; and (4) faces legal barriers to implementation; underpinned by the view (5) that the industry consists of socially responsible companies working toward reducing harmful drinking. In contrast with tobacco industry submissions on public policy, which often focused on legal and economic barriers, the Australian alcohol industry placed a heavier emphasis on notions of regulatory redundancy and insufficient evidence. This may reflect differences in where these industries sit on the 'regulatory pyramid', alcohol being less regulated than tobacco.

Analysis of food advertisements on cable television directed to children based on the food guide for the Brazilian population and current legislation / Análise das propagandas de alimentos veiculadas em canais de televisão fechada direcionada ao público infantil segundo o guia alimentar para a população brasileira e legislação vigente

ABSTRACT Objective: This study examined food product advertisements directed to children and aired on closed television channels in Brazil, according to the types of foods and beverages advertised and the advertising content. Methods: A descriptive study was conducted on the adequacy of food commercials directed to children and aired by six pay-television broadcasters according to two parameters: "The Food Guide for the Brazilian Population, 2014", and the National Council on Children's and Adolescents' Rights Resolution nº 163 of 2014 about food advertising. The advertisements were recorded in July 2015, at different times and days of the week. Results: One hundred and sixty-two hours were recorded, registering 3,468 commercials: 1,850 were related to internal programming and 1,618 advertised toys (22.15%), food and beverages (5.61%), applications for electronic devices (5.58%), and entertainment/events (5.56%). The Fisher exact test showed fewer number of food commercials compared to other types of commercials (p<0.001). The main food items advertised by all television stations were ultraprocessed foods and no advertisements of fresh food were observed (p<0.001). Most of the food commercials (64.30%) used children's language and characters; 43.00% used songs in children's voices, and 21.40% linked gift distribution to food. Conclusion: The number of food commercials observed was lower than in previous national studies. However, the advertisements did not follow current legislation, indicating the abuse of marketing communication to children. More effective public policies and the respect and enforcement of legislation on child advertising could protect children from high consumption of ultraprocessed foods.

RESUMO Objetivo: O presente estudo analisou propagandas de produtos alimentícios voltados ao público infantil veiculadas em emissoras de televisão fechada do Brasil, de acordo com os tipos de alimentos e conteúdo publicitário. Métodos: Estudo descritivo sobre a adequação de propagandas de alimentos veiculadas em seis emissoras de televisão por assinatura e direcionadas a crianças segundo dois parâmetros: "Guia Alimentar para a População Brasileira, 2014" e Resolução nº 163 de 2014 do Conselho Nacional dos Direitos da Criança e do Adolescente, sobre publicidade de alimentos. A gravação das propagandas foi realizada em julho de 2015, em diferentes horários e dias da semana. Resultados: Foram registrados 3.468 comerciais em 162 horas de gravação, sendo 1.850 referentes à programação interna e 1.618 a brinquedos (22,15%), alimentos e bebidas (5,61%), aplicativos para aparelhos eletrônicos (5,58%) e entretenimento/eventos (5,56%). O teste exato de Fisher mostrou menor número de comerciais de alimentos em comparação aos demais tipos de propaganda (p<0,001). Os itens alimentares mais veiculados em todas as emissoras foram os alimentos ultraprocessados, com nenhuma inserção de comerciais de alimentos in natura (p<0,001). Dos comerciais de alimentos, 64,30% apresentaram linguagem infantil/personagens, 43,00% tinham músicas com vozes infantis e 21,40% vincularam a distribuição de brindes ao alimento. Conclusão: O número de propagandas de alimentos observado foi menor do que o encontrado em estudos nacionais anteriores. Entretanto, os comerciais não estavam em conformidade com a legislação vigente, indicando abusividade de comunicação mercadológica à criança. Políticas públicas mais eficazes, bem como o respeito e cumprimento da legislação sobre publicidade infantil, poderiam proteger as crianças do elevado consumo de alimentos ultraprocessados.

The Potential Impact of a "No-Buy" List on Youth Exposure to Alcohol Advertising on Cable Television.

OBJECTIVE: The purpose of this study was to outline a method to improve alcohol industry compliance with its self-regulatory advertising placement guidelines on television with the goal of reducing youth exposure to noncompliant advertisements. METHOD: Data were sourced from Nielsen (The Nielsen Company, New York, NY) for all alcohol advertisements on television in the United States for 2005-2012. A "no-buy" list, that is a list of cable television programs and networks to be avoided when purchasing alcohol advertising, was devised using three criteria: avoid placements on programs that were noncompliant in the past (serially noncompliant), avoid placements on networks at times of day when youth make up a high proportion of the audience (high-risk network dayparts), and use a "guardbanded" (or more restrictive) composition guideline when placing ads on low-rated programs (low rated). RESULTS: Youth were exposed to 15.1 billion noncompliant advertising impressions from 2005 to 2012, mostly on cable television. Together, the three no-buy list criteria accounted for 99% of 12.9 billion noncompliant advertising exposures on cable television for youth ages 2-20 years. When we evaluated the no-buy list criteria sequentially and mutually exclusively, serially noncompliant ads accounted for 67% of noncompliant exposure, high-risk network-daypart ads accounted for 26%, and low-rated ads accounted for 7%. CONCLUSIONS: These findings suggest that the prospective use of the no-buy list criteria when purchasing alcohol advertising could eliminate most noncompliant advertising exposures and could be incorporated into standard post-audit procedures that are widely used by the alcohol industry in assessing exposure to television advertising.

Local Climate Experts: The Influence of Local TV Weather Information on Climate Change Perceptions.

Individuals who identify changes in their local climate are also more likely to report that they have personally experienced global climate change. One way that people may come to recognize that their local climate is changing is through information provided by local TV weather forecasters. Using random digit dialing, 2,000 adult local TV news viewers in Virginia were surveyed to determine whether routine exposure to local TV weather forecasts influences their perceptions of extreme weather in Virginia, and their perceptions about climate change more generally. Results indicate that paying attention to TV weather forecasts is associated with beliefs that extreme weather is becoming more frequent in Virginia, which in turn is associated with stronger beliefs and concerns about climate change. These associations were strongest for individuals who trust their local TV weathercaster as a source of information about climate change, and for those who identify as politically conservative or moderate. The findings add support to the literature suggesting that TV weathercasters can play an important role in educating the public about climate change.

[Regulation of food advertising in Brazil: convergence and conflicts of interest]. / A regulamentação da propaganda de alimentos no Brasil: convergências e conflitos de interesses.

This study conducted a comparative analysis of a bill to regulate advertising for unhealthy food and beverages with low nutritional value, submitted to public hearings in 2006, and the Resolution passed in 2010. The analysis was based on data from official documents pertaining to food advertising, identification of key actors, and their underlying arguments. As approved, the Resolution is less detailed and rigorous from the regulatory perspective. The final documents removed bans and requirements on the format, content, and theme of food advertising, especially targeting children. Stronger discussion is needed on the constitution of the public arena, public interests, and the mechanisms and processes to help guarantee them.

A regulamentação da propaganda de alimentos no Brasil: convergências e conflitos de interesses / Regulation of food advertising in Brazil: convergence and conflicts of interest / La regulación de la publicidad de alimentos en Brasil: convergencias y conflictos de interés

O presente estudo objetivou desenvolver uma análise comparativa entre o documento proposto para regulamentar a publicidade de alimentos não saudáveis e de bebidas de baixo valor nutricional, levado à consulta pública em 2006, e a Resolução aprovada em 2010. A análise se pautou em dados provenientes de documentos legais referentes à regulamentação da propaganda de alimentos, na identificação dos atores-chave e dos argumentos que fundamentaram seus discursos. Verificou-se que a Resolução aprovada se apresenta menos detalhada e rigorosa sob o ponto de vista regulatório. Foram retiradas proibições e exigências sobre o formato, o conteúdo e os temas das propagandas de alimentos, em especial as voltadas ao público infantil. Faz-se necessário fortalecer a discussão sobre o que é a esfera pública, como ela se constrói, o que são interesses públicos e quais mecanismos e processos podem contribuir para garanti-los.

This study conducted a comparative analysis of a bill to regulate advertising for unhealthy food and beverages with low nutritional value, submitted to public hearings in 2006, and the Resolution passed in 2010. The analysis was based on data from official documents pertaining to food advertising, identification of key actors, and their underlying arguments. As approved, the Resolution is less detailed and rigorous from the regulatory perspective. The final documents removed bans and requirements on the format, content, and theme of food advertising, especially targeting children. Stronger discussion is needed on the constitution of the public arena, public interests, and the mechanisms and processes to help guarantee them.

El objetivo del estudio fue desarrollar un análisis comparativo entre el documento propuesto para regular la publicidad de alimentos poco saludables y bebidas de bajo valor nutricional, sobre el que se realizó una consulta pública en 2006, y la resolución adoptada al respecto en 2010. El análisis se basó en datos de documentos legales relacionados con la regulación de la publicidad de alimentos, identificación de los actores y argumentos fundamentales que guiaron sus discursos. Se encontró que la resolución adoptada se presenta menos detallada y exacta desde el punto de vista reglamentario. Se eliminaron las prohibiciones y requisitos sobre el formato, el contenido y los temas sobre publicidad de alimentos, especialmente los dirigidos a los niños. Es necesario fortalecer la discusión de lo que es la esfera pública, ya que se basa en cuáles son los intereses públicos y qué mecanismos y procesos pueden contribuir a garantizarlos.

Evidence of underage targeting of alcohol advertising on television in the United States: lessons from the Lockyer v. Reynolds decisions.

Underage alcohol use is a global public health problem and alcohol advertising has been associated with underage drinking. The alcohol industry regulates itself and is the primary control on alcohol advertising in many countries around the world, advising trade association members to advertise only in adult-oriented media. Despite high levels of compliance with these self-regulatory guidelines, in several countries youth exposure to alcohol advertising on television has grown faster than adult exposure. In the United States, we found that exposure for underage viewers ages 18-20 grew from 2005 through 2011 faster than any adult age group. Applying a method adopted from a court in the US to identify underage targeting of advertising, we found evidence of targeting of alcohol advertising to underage viewers ages 18-20. The court's rule appeared in Lockyer v. Reynolds (The People ex rel. Bill Lockyer v. R.J. Reynolds Tobacco Company, GIC764118, 2002). We demonstrated that alcohol companies were able to modify their advertising practices to maintain current levels of adult advertising exposure while reducing youth exposure.