Restricting promotions of food and drink high in fat, sugar or salt: business and regulatory impact assessment - partial

2. Purpose and Intended Effect

2.1 Background

As we set out in our 2018 Diet and Healthy Weight Delivery Plan, we want to create a Scotland where everyone eats well and has a healthy weight.

To protect public health, we need change that supports healthier eating and healthy weight. In our Delivery Plan, we outlined five key outcomes to help realise our vision:

1. Children have the best start in life – they eat well and have a healthy weight; this includes aiming to halve childhood obesity by 2030;

2. The food environment supports healthier choices;

3. People have access to effective weight management services;

4. Leaders across all sectors promote healthy diet and weight; and

5. Diet-related health inequalities are reduced.

As part of a wide range of action to improve diet and create a food environment that encourages healthier choices, restricting promotions of less healthy food and drink at the point of purchase seeks to reduce the purchase (and consumption) of food and drink that is high in fat, sugar or salt, given the public health harm associated with their overconsumption. We anticipate such action will help deliver outcomes 1, 2 and 5 of our Delivery Plan.

The policy to restrict food and drink promotions was initially cited in the 2017/18 Programme for Government (PfG). The subsequent 2019/20 PfG and 2021/22 PfG built on this proposal with a commitment in the 2022/23 PfG to legislate to make it easier for people to spend less and make healthier food choices. The 2023/24 PfG reaffirmed our commitment to improve the health of the nation.

In May 2023 in a statement to the Scottish Parliament, the Minister for Public Health and Women’s Health confirmed plans to consult on the detail of proposed regulations to restrict the promotion of less healthy food and drink where those are sold to the public, with a view to laying regulations before the Scottish Parliament subject to the outcome of the consultation.

2.2 Objective

The primary aim of this policy is to reduce the public health harms associated with the excess consumption of calories, fat, sugar and salt, including the risks of developing type 2 diabetes, various types of cancer and other conditions such as cardiovascular disease as part of wide-ranging suite of actions to support healthier diets and healthy weight. In this context the objective of this policy is to create a food environment that supports healthier choices. This will be delivered through regulations to restrict the promotions of HFSS foods^[1] where they are sold to the public. This policy will contribute towards the reduction of diet-related health inequalities, including in relation to socioeconomic disadvantage, and our aim to halve childhood obesity by 2030.

This is a devolved policy area. However, due to the inter-connected food environment in the UK, detailed consideration is being given to the potential for alignment with the rest of the UK where that is in Scotland’s best interests to do so.

Policy landscape across the UK

UK Government

The UK Government put in place regulations to restrict the promotion of targeted HFSS foods by location and volume price in England in The Food (Promotion and Placement) (England) Regulations 2021 (SI 2021/1368). Restrictions include:

• volume price restrictions – such as a multi-buy promotion (including “3 for the price of 2”, “3 for £10”, or “buy 6 and save 25%” and a promotion that indicates that an item, or any part of an item, is free including “50% extra free”, or “buy one get one free”).
• locations restrictions - store entrances, aisle ends and checkouts when retail stores are over 185.8 square metres (m2) (or 2,000 square feet (sq ft)) and the equivalent key locations online
• business exemptions from location and volume restrictions for micro or small businesses (businesses with under 50 employees).
• Business exemptions from location restrictions for premises smaller than 2000 square feet.

On 14 May 2022, the UK Government announced a year’s delay in restricting volume price promotions on foods and drinks high in fat, salt or sugar in England. This has since been delayed by a further two years until October 2025. Location restrictions came into force in England on 1 October 2022.

Welsh Government

The Welsh Government published its Healthy Food Environment consultation on 9 June 2022. The consultation closed on 1 September 2022 with an update on healthy food environment legislation announced on 27 June 2022. The statement confirmed:

• the intention to consider consistency with definitions set out within England’s location and volume-based restrictions in retailers with over 50 staff members.
• that they are minded to include temporary price promotions and meal deals within scope of the policy.
• legislation to be brought forward in 2025 with implementation for both volume and price restriction by 2025.

2.3 Rationale for Government intervention

As set out in the Policy Prospectus^[2], our vision is for a fairer Scotland with equality, opportunity and community at its heart. Focusing on transforming the food environment is more likely to help improve diet and weight and be more effective in reducing health inequality than only encouraging individual behaviour change^[3].

The objectives of this policy support wider Scottish Government priorities, align with our vision for a Wellbeing Economy and are underpinned by our refreshed National Outcomes which describe the kind of Scotland we want to see. This includes:

“We are healthy and active”

One of the health indicators by which progress towards these outcomes is measured is healthy weight.

As a nation we have consistently not met our dietary goals since they were set in 1996^[4]. These goals describe, in nutritional terms, the diet that will improve and support the health of the Scottish population. Our diet remains too high in calories, fat, sugar and salt which can have serious consequences for our health^[5].

In Scotland, high levels of overweight and obesity, as well as poor diet, cause and contribute to a number of health problems, including the risks of developing type 2 diabetes, various types of cancer and other conditions such as cardiovascular disease.

Obesity is defined by the World Health Organisation as a disease characterised by excess adiposity. It is a “chronic, relapsing disease resulting from complex interactions between a range of factors, including those that occur at a biological, commercial, social and political level”^[6]. Obesity is classified as having a Body Mass Index (BMI) of 30 kg/m² or more.

Research has shown that more than 1 in 20 adult cancer cases are linked to excess weight in the UK making obesity possibly the second largest preventable cause of cancer^[7]. Obesity, independently of diet, has also been linked to a range of health outcomes including type 2 diabetes, cardiovascular disease (CVD) and hypertension, in addition to cancer^[8].

The impacts of living with overweight or obesity can be profound, affecting people’s health and ability to lead happy and fulfilling lives. Cardiovascular and respiratory diseases, diabetes and kidney diseases have been highlighted by a Global Burden of Disease 2019^[9] study as key causes of death attributable to high body mass index. This study also showed that a high BMI is among the leading risk factors associated with disease or injury, accounting for 6.3% of disability-adjusted life years (DALYs) in 2019.

Children at risk of obesity can experience an increased risk of fractures, hypertension, type 2 diabetes, asthma, as well as negative psychological effects including lower wellbeing and self-esteem during the childhood years^[10].

The Scottish Health Survey^[11] reported that 67% adults in Scotland were living with overweight (including obesity) in 2022. This is the same level as in 2021. This is similar to or marginally higher than rates in each year since 2008 (ranging from 64% to 67%). The proportions of adults in the healthy weight category decreased as area deprivation increased, from 39% in the least deprived areas to 28% in the most deprived areas. Furthermore, it reported that one third of children were at risk of overweight (including obesity). This was five percentage points higher than in 2021, and the highest level since 2011.

Regular overconsumption of HFSS foods is one of the key factors leading to weight gain and obesity^[12]. Presently the food environment heavily incentivises and promotes low-cost foods^[13] which contribute disproportionately to intakes of calories fat, saturated fat, sugar and salt^[14].

Evidence highlights that sales promotions are intended to encourage the impulsive purchases of products, or encourage purchases more often or in greater volumes than would take place without the presence of the promotion, and that sales promotions aim to increase the appeal and recall of a product to consumers^[15]. According to Kantar data reported by Food Standards Scotland, in 2021 around 23.3% of take home volume of food and drink bought from shops (including supermarkets) was on price promotion. Also, “discretionary foods” (take home confectionery, biscuits, take home savouries, cakes, pastries and higher fats and sugar morning goods, total puddings and desserts, take home drinks and edible ices and ice cream) were more frequently purchased using “Y for £X” promotions than some healthier categories such as fruit, vegetables or bread.

Economic modelling based on purchasing data in Scotland from 2013 to 2018 has estimated that removal of price promotions such as temporary price reductions, multi-buy and “Y for £X”, on discretionary foods, has the potential to reduce calorie intake by 613 calories per person per week. The Scottish Government’s 2022 consultation^[16] sought views on targeting a wider set of categories than discretionary foods, with it being anticipated that the reduction of calories would be greater should more categories be included.

At both national and local level, the Scottish Government is taking many actions to improve diet and support people to be a healthy weight. Some actions promote education, knowledge and skills; however, many are different in approach in recognition that interventions that aim to increase individual knowledge or skills only, such as healthy eating campaigns, can increase inequalities^[17].

Actions include but are not limited to;

• Nutritional standards to support healthier food provision in schools,
• Core funding the four Community Food Networks in Scotland, free school meals,
• Information, advice and support for families through Parent Club and Best Start Foods,
• Supporting small and medium sized businesses in Scotland to reformulate to make their products healthier,
• The provision of information on healthier eating through FSS’s Eat Well Your Way resource,
• Improving availability of healthier food in local communities through the Scottish Grocers’ Federation Healthy Living Programme,
• Funding Football Fans in Training, a programme that provides an opportunity for people to become “fitter, healthier, and happier”.

There continues to be a significant level of engagement and work with industry to encourage voluntary action to support healthy eating. While this has resulted in some action, such as voluntary reformulation of some products, it has not been sufficient to deliver the scale and pace of change needed.

Food Standards Scotland states that “evidence on voluntary approaches overall is not good”, specifically citing the “poor response from industry” to the Scottish Government’s Supporting Healthy Choices framework.^[18]

It is therefore considered that mandatory action to restrict the promotion of HFSS food and drink is proportionate and necessary given Scotland’s continuing poor diet and, high levels of overweight and obesity.