Regulations and legislation to limit advertising that may negatively influence the health behaviours of children and adolescents - current practice and evidence of effectiveness

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• Regulations and legislation to limit advertising
  that may negatively influence the health
  behaviours of children and adolescents - current
  practice and evidence of effectiveness
• WHO Technical Meeting, Vancouver June 2007
• Ross Gordon, Gerard Hastings Laura McDermott
• Institute for Social Marketing
• University of Stirling The Open University

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structure

• The Problem Effect of food, tobacco alcohol
  advertising on behaviour
• Current regulations and effects
• Potential Solutions
• 4 . Conclusions

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The Problem - Food advertising Effect on
Behaviour

• ISM Conducted a systematic review of the evidence
  of the extent, nature effects of food promotion
  to children (Hastings et al 2003, 2006, McDermott
  et al 2004)
• Comprehensive, rigorous, transparent and
  replicable procedures
• Reports prepared for Safefood (Ireland), Food
  Standards Agency (UK) the WHO.
• Review identified 63 studies on the extent
  nature of food promotion to children 70 on its
  effects

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The Problem - Food advertising Effect on
Behaviour

• Does food promotion influence childrens
• nutritional knowledge? Yes
• food preferences? Yes
• purchasing and purchase-related behaviour (eg.
  pester power) Yes
• consumption? Yes
• diet and health-status? Yes
• If food promotion has an effect, what is the
  extent of this influence relative to other
  factors? ?
• Does food promotion affect total category sales,
  brand switching, or both? BOTH

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The Problem - Food advertising Effect on
Behaviour

• Similar research in Australia also concluded that
  food advertising has an effect on childrens
  behaviour
• Therefore evidence base is well established.

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The Problem - Tobacco advertising Effect on
Behaviour

• Clear evidence base of effect of tobacco
  advertising on childrens behaviour.
• Cross sectional survey in the BMJ found that
  teenagers were aware of and participated in
  tobacco marketing, both awareness and
  participation were associated with smoking status
  (McFadyen et al 2001).

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The Problem - Tobacco advertising Effect on
Behaviour

• Cochrane Systematic Review on the impact of
  tobacco advertising promotion found that
• tobacco advertising and promotion increases the
  likelihood that adolescents will start to smoke
• (Lovato et al 2003)

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The Problem - Alcohol advertising Effect on
Behaviour

• Longitudinal studies in U.S have established a
  causal link between alcohol marketing and youth
  drinking.
• Ellickson et al (2004)
• Stacy et al (2004)
• Snyder et al (2006)

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The Problem - Alcohol advertising Effect on
Behaviour

• However there are gaps in the evidence base
• No longitudinal studies carried out in the UK
• Few studies have looked at the impact of new
  media and viral marketing
• No attempt has been made to examine the
  cumulative impact of alcohol marketing
• No one has checked for any differential effect on
  gender and inequality

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The Problem

• Evidence is there to show that the marketing of
  food, tobacco and alcohol has an effect on
  childrens behaviour
• Marketing not advertising products, price and
  place as well as promotion
• Our task then is to make marketing healthier

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Current regulations of food advertising

• Hawkes (2005) questioned the effectiveness of
  Self Regulatory Systems in their current form
• Called for time period restrictions, no branded
  promotional activity at schools, no targeting of
  certain products at children, restrictions on
  certain marketing practices used to target
  children (e.g viral marketing, product
  placement), restrictions on use of celebrities
  cartoons

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Current regulations of food advertising

• Self regulation with teeth required.
• Multi-stakeholder regulation with independent
  body concerned with public health guiding the
  process
• Otherwise statutory regulation will be required
• (Hawkes 2005)

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Current regulations of food advertising

• Food advertising in the UK was self regulated
  under the Advertising Standards Authority (ASA).
• Ofcom the communications regulator in the UK
  recently announced a ban on TV junk food
  advertising to children under 16.
• Therefore in food advertising voluntary
  regulation alone has not worked. Move towards
  statutory regulations and ad bans.

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Current regulations of food advertising

• Will take time good quality research to assess
  the effectiveness of the ban.
• In Sweden food advertising to children under 12
  is banned as part of a wider ban on advertising
  to children.
• However there has been no reduction in obesity
  rates in Sweden. Yet ban on advertising is only
  part of the solution for obesity

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Current regulation of Tobacco Advertising

• Reg campaign in the UK
• Paper in BMJ (Hastings et al 1994) found campaign
  was getting through to children more effectively
  than adults held most appeal for young smokers
  aged 14-15.
• Advertising Standards Agency withdrew the
  campaign. However damage was already done.
  Indicated the co-regulatory system was not
  working.

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Current regulation of Tobacco Advertising

• Evidence based convinced the UK government to
  take action.
• A ban on tobacco promotion was introduced in the
  UK from February 2003
• Prohibited tobacco marketing through print
  broadcast media, billboards, the internet, direct
  mail, product placement, promotions, free gifts,
  coupons sponsorship

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Current regulation of Tobacco Advertising

• Evidence has emerged that suggests the UK ban has
  significantly reduced awareness of and exposure
  to pro-tobacco influences (Harris et al 2006)
• Reviews on the effectiveness of tobacco
  advertising bans have suggested they reduce
  tobacco consumption (World bank 1999, Saffer
  2000)
• In Norway the introduction of a ban appeared to
  reduce the prevalence of young smokers,
  particularly females (Rimpela 1993)

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Current regulation of Alcohol Advertising

• Largely self regulated in the UK
• Industry body the Portman Group employs a
  voluntary code of regulations
• Advertising on TV and in the Print media overseen
  by the Advertising Standards Agency
• Does it work? ISM has carried out research

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Current regulation of Alcohol Advertising

• Interviews with practitioners regulators
• I think the major change recently that will
  continue is much more experiential marketing
• What often happens in advertising is advertisers
  try to push the rules as much as they can because
  obviously that is how you getracier ads and you
  get a bit of controversy now and then and that
  has never hurt any brand
• they're using more 'under-the-radar' tactics to
  target young people

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Current regulation of Alcohol Advertising

• Interviews with practitioners regulators
• Brand marketers are accepting that we have got
  to move towards a day when it will just have to
  be a different way of getting your messages
  across
• I think it is well accepted that this is how
  advertising has to be these days
• it is a realistic scenario to say that in five
  years time alcohol advertising will be
  bannedeveryone has got to behave as an industry
  pretty impeccably to stop that process speeding
  up

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Current regulation of Alcohol Advertising

• So practitioners raise some doubts
• What about children?
• Yeah I drink quite a bit. You want to get a wee
  buzz out of it. It feels good. (Males, 13,
  C2DE, Drinkers)
• For the tonic wine its 5.15 for a full bottle
  and for a half bottle, its 2.89 in my local
  shop. (Female, 14, ABC1, Drinkers)

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Current regulation of Alcohol Advertising

• On the internet I get pop ups for alcohol, and
  if you go to the Rangers website, or Celtic then
  a Carling sign comes up. (Females, 14, ABC1,
  Drinkers)
• I prefer WKD to Bacardi Breezer. It's just
  because most people would probably rather drink
  that one and be seen with it, its got a better
  image. Ive seen them advertised, the WKD
  (Females, 14, ABC1, Drinkers)
• Smirnoff vodka is cool. (Female, 13, C2DE,
  Drinkers)

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Potential Solutions Self Regulation

• - This is part of the solution
• - Can control inappropriate content
• - Involvement of industry and advertising
• trade bodies is therefore to be welcomed.
• - However the limitations of self regulation
  
• have to be recognised.

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Potential Solutions Self Regulation

• Can often lack teeth
• Does not limit the amount of ads
• Doesnt deal with the other three Ps
• It is arguably not advertising that is the
  problem but what is advertised

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Potential Solutions Statutory Regulation

• Makes the regulatory environment clearer to
  everyone industry, practitioners, regulator,
  public
• Can control the amount of ads
• However can be costly to implement
• Needs to be well constructed to be effective.
• Can produce complexity and loss of flexibility

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Potential Solutions Ad bans

• Have been shown to have an effect on behaviour
  (Saffer 2000, 2002)
• One thing we no works, certainly in tobacco
• However viewed as draconian a last resort
• Tobacco is different to food and alcohol
• Doesnt do anything to promote responsible
  marketing or recognise the potential positives of
  marketing

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Potential Solutions - Social Marketing

• Marketing can be used to encourage healthy
  behaviours Social Marketing
• There is evidence that it works (McDermott et al
  2005, Stead et al 2007)
• Social marketing also includes critical research
  on the effects of commercial marketing.
• Helps build the evidence base and inform
  regulation

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Potential Solutions - Social Marketing

• In alcohol ISM is carrying out research to
  address Gaps in the evidence base
• Using a cohort design to investigate the impact
  of whole marketing mix used by UK alcohol
  industry
• 2 wave survey. Random sample of 13-15 year olds
  (period when most young people start
  experimenting with alcohol)
• Will assess for differences by levels of
  affluence and disadvantage, and by gender

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Potential Solutions - Social Marketing

• Similar research has recently commenced in New
  Zealand.
• Findings from the research will inform practice
  in two ways
• 1. Will help social marketing efforts, develop
  interventions
• 2. Will inform the debate surrounding the
  regulation of alcohol marketing

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Conclusions

• There is a problem - Marketing has an effect on
  childrens behaviour with negative health
  effects.
• Regulation can work but only part of the
  solution. Need the right mix of voluntary,
  statutory regulation, outright ad bans. Consider
  the whole marketing mix including price and
  place, deploy social marketing.
• Multiple stakeholder involvement is needed and we
  need to realise that this is a long term, global
  problem it will need a long term global solution