Food and drink high in fat, sugar and salt - out of home advertising restrictions: rapid evidence review

Summary and conclusions

This report aimed to provide information about policies that restrict OOH advertising of HFSS products in the UK. This research was carried out using several sources of information including policy documents, published and grey literature, engagement with industry and advocacy groups and conversations with local authority representatives with an implemented or forthcoming policy.

The findings provide information about policy implementation, including the scope of product and advertising site restrictions, facilitators and challenges to policy implementation, and the effectiveness and economic impact of HFSS advertising restrictions. In addition, the findings offer valuable insights about the process of policy implementation from local authority representatives in several areas of England. The findings also include the perspectives of representatives from industry and advocacy groups to whom the ongoing changes to advertising restrictions are impactful.

By evaluating and synthesising the identified information, this research comes to the following conclusions:

• Independent evaluations of the TfL policy, which restricts OOH advertising of HFSS products, have shown that advertising restrictions can reduce purchasing of HFSS products and calories consumed, thus reducing obesity and associated health care costs in the longer term.
• Similar policies have been implemented across England in several additional local authorities. Many more local authorities are in the planning stages in England. As far as we are aware, no policies have been implemented in Scotland.
• Evaluating the effectiveness of the policy is an area of challenge across local authorities, leading to a lack of evidence on evaluating the impact or success of the policy.
• Despite an atmosphere of support, policy implementation is not without challenge. In most cases, the policy can only be upheld on council-owned property, which is generally only a very small proportion of the advertising estate. Other challenges come from those who oppose the restrictions, mainly industry, and companies who fear revenue losses. Although there is no evidence that the TfL network experienced revenue losses due to the restrictions, there may be hidden costs such as if advertisers must change their advertising campaign.
• Importantly, it should be acknowledged that restricting unhealthy advertising is just one of many approaches required to support the reduction in obesity in Scotland.

Recommendations for future research

Based on the findings, some directions for future research can also be suggested:

• More research is required evaluating the effectiveness of policy implementation in local authorities beyond the TfL network and in Bristol.
• Independent, academic evaluations of policy implementation are recommended; therefore, grants may be required to fund the research. If applying for funding, it is important to highlight the novelty of the proposed research. For example, the focus may be on reducing inequalities in health outcomes through limiting OOH advertising exposure to HFSS products. Another example may be comparing policy implementation or evaluation in two different areas of Scotland.
• If planning to measure advertising exposure through self-reporting methods using a survey, it is advisable to consider including other measures that may be useful, for example, dietary intake.
• Further efforts are required to understand the scope of advertising sites in Scotland, as the study funded by Obesity Action Scotland included just four local authorities in the East of Scotland^[74]. It is important to note that advertising estates are fluid and are always changing.