Reducing health harms of foods high in fat, sugar, or salt: consultation analysis

3. Whether to introduce mandatory measures to restrict promotion and marketing (Q 1)

3.1. The first section of the consultation paper aimed to gauge baseline opinion on whether mandatory measures should be introduced to restrict the promotion and marketing of HFSS foods.

3.2. The consultation paper proposed that such mandatory restriction measures would reduce the volume and frequency of their purchase and, by association, reduce the public health harm of their consumption. Respondents were asked the degree to which they agree or disagree with the introduction of mandatory measures.

Question 1: To what degree do you agree or disagree that mandatory measures should be introduced to restrict the promotion and marketing of foods high in fat, sugar or salt to reduce health harms associated with their excessive consumption?

Overview

3.3. Close to three fifths of organisation respondents (58%) and nearly as many individual respondents (56%) were in favour of the introduction of mandatory restrictions.  A fifth of organisation respondents (21%) and over a third of individual respondents (37%) were against. A further 15% of organisation respondents did not provide a tick box answer. Notably the proposals typically evoked ‘strong’ feelings in the sense that a greater proportion ‘strongly agreed’ than ‘agreed’ and similarly a greater proportion ‘strongly disagreed’ than ‘disagreed’. The full breakdown of responses is displayed in Table 3.1.

Table 3.1 Responses to question 1

Answer	Organisations		Individuals
	n	%	n	%
Strongly agree	43	46%	245	39%
Agree	11	12%	106	17%
Neither agree or disagree	6	6%	46	7%
Disagree	6	6%	68	11%
Strongly disagree	14	15%	163	26%
Not answered	14	15%	3	1%
Conflicting answer[27]	0	0%	1	0%
Total	94	100%	632	100%

In this and all subsequent tables within the report ‘n’ is the number of respondents and % is of all respondents to the consultation.

Organisation respondents overview

3.4. Breaking down the findings further from the responses in the table above, it was possible to see different views in the responses from different types of organisation. Most non-industry organisation respondents (86%) agreed with the introduction of mandatory measures. Nearly half (48%) of the industry organisation respondents disagreed and a further quarter (26%) did not provide a tick box answer. A full breakdown of these responses is provided in Annex 2, Table A2.1.

Views in favour of mandatory restrictions 

3.5. Agreement with the proposed mandatory restrictions typically acknowledged the problem of obesity in Scotland and that, given the link between promotions and sales, the proposed approach would reduce the likelihood of individuals buying and consuming excessive amounts of unhealthy foods.

3.6. Many of the public and third sector organisations that agreed with mandatory restrictions noted that this action was needed to protect people from harm. Reasons for agreement with the mandatory restrictions (each expressed by few) included:

• Voluntary codes and guidance have had limited success and have not been adopted consistently across the sector;
• Relying on education and targeting individual behaviour change was ineffective and risked widening health inequality;
• Change was needed for groups disproportionately affected by an unhealthy food environment – for example, those on a low income, young people or vulnerable groups;
• A universal approach (rather than interventions aimed at increasing knowledge or skills) was required and had the potential to reduce health inequalities; and
• HFSS products should be viewed as carrying the same level of risk as tobacco and alcohol.

3.7. In addition, some public and third sector respondents talked about the need for the regulations to sit within a broader context of health promotion changes. For example, media campaigns about healthy choices and making healthier food options more accessible.

3.8. Few of the individual respondents that agreed with the introduction of mandatory measures noted issues to be considered in relation to the introduction of restrictions such as:

• The potential impact on the choice of individuals;
• As promotions are not the only reason for unhealthy purchases, mandatory measures should be undertaken alongside other measures to form part of a wider solution;
• Some HFSS foods are healthy and a certain amount of fat and salt are needed within a healthy diet;
• The approach could lead to an increase in the level of substitutes/chemicals being used in products;
• An approach should not disadvantage certain individuals and businesses;
• The impact of the approach should not amount to foods being ‘banned’; and
• Unhealthy foods would remain cheaper than healthy foods and therefore impact may be limited.

Views against mandatory restrictions 

3.9. A number of reasons for disagreement with mandatory restrictions were given. Among individual respondents, the reason expressed most commonly (by some) was the belief that individuals should have unrestricted control/choice of the purchases that they make and that the proposed restrictions would deny this; and similarly, that the approach was specifically unfair to those who do not over-consume HFSS products as it would limit their ability to take advantage of price promotions. 

3.10. Other reasons for disagreement which were each expressed by few individual respondents included:

• That making restrictions of this nature were not within the remit of the Scottish Government;
• That in order to tackle the problem, action should instead be taken to educate and inform the public and promote healthier lifestyles;
• That the approach would not be effective due to reasons such as the relative expense of healthy foods, other reasons for purchasing HFSS foods (such as comfort eating) and other causes of overweight/obesity;
• The potential negative impact on businesses, and specifically Scottish businesses, as a result of restrictions in relation to the ways that they will have to market foods; and
• The potential that mandatory restrictions may increase food costs for those on a low income by removing the opportunity to take advantage of price promotions.

3.11. Close to half of the industry organisation respondents that held concerns about mandatory restrictions felt that there was a lack of evidence of the effectiveness of legislation to restrict food and drink promotions. Other points that challenged the justification for mandatory measures, each made by few, included:

• A belief that, due to the absence of scientific consensus linking health benefits to mandatory restriction policies, there should be a focus on positive incentives to foster healthy eating habits, education to understand a healthy diet and support for consumers to make healthy choices in-store;
• The success and value of voluntary measures and collaborative partnership working, which has resulted in actions such as the removal of confectionery at checkouts and restriction on the sale of energy drinks to under 16 year olds;
• An expression of pride in the efforts made by the sector in recent years, particularly in regards to reformulation efforts to provide healthier alternatives;
• A concern that any response had to be undertaken using a unified approach, this includes unification across geographical borders, in consideration of various different government policies and in collaboration with manufacturers, suppliers, wholesalers and retailers.  It was felt that this kind of approach would avoid unnecessary contradiction and confusion, as well as avoid a high business burden.

3.12. Many industry organisation respondents expressed concerns that the proposed measures would negatively impact manufacturers, retailers, and the Scottish economy. Few noted this might result in job losses. Close to half suggested that small Scottish manufacturers and retailers would be the most impacted by the changes, due to their reliance on low-cost marketing techniques that would be restricted by the legislation, while large companies with big advertising and promotional budgets would be able to adapt and adjust their marketing strategy. Consequently, this could reduce small Scottish firms’ competitiveness and ability to grow and contribute to the Scottish economy.

3.13. There were also concerns, each expressed by few industry organisation respondents, that the proposals would be: ineffective; restrict choice; increase cost for consumers across the whole food sector (and that this would have a disproportionate impact on lower income households); and remove incentives for manufacturers to reformulate products.

3.14. Alternative approaches that were suggested, each by few industry organisation respondents, included: the promotion of healthier options through price or reward points; considering whether to legislate the proportion of promotions which should apply to healthier food; and education and promotion of a healthy, active and balanced lifestyle.

3.15. Other suggestions regarding the proposals, each expressed by few industry organisation respondents, included that:

• Any steps taken should be proportionate and fair – they must consider how restrictive measures could negatively impact on businesses;
• A graded approach should be adopted to continue to incentivise industry to reformulate products;
• There should be exemptions for lower sugar/fat products or ‘best in category’;
• Exemptions could be made for products hitting targets in Public Health England’s calorie cap on sugar per 100g/100ml; and
• Regulation should not apply retrospectively to equipment, materials or existing contracts (e.g. between brand owners and retailers in regards to use of branded equipment).

Views neither for nor against mandatory restrictions

3.16. Individual respondents that did not state an overall preference varied widely in their reasoning. Although they generally expressed similar concerns to those already highlighted above, few raised other points such as: 

• Whether some specific aspects included in the proposals were the correct approach (such as the inclusion of fats); 
• Whether it would be preferable to educate and support people to make healthier choices and lead healthier lifestyles; and 
• Whether restrictions should instead focus on the reduction of levels of fat, sugar and salt in products.