What restrictions do local authorities place on harmful commodity advertising and what factors impede or facilitate the development, implementation and impacts of these restrictions? A mixed methods study

Background There is strong evidence that advertising commodities which are harmful to human and planetary health increases the consumption of these commodities and exacerbates health inequalities. Yet there has been little evaluation of local government policies to restrict this advertising. We therefore aimed to characterise the components of local authority policies for restricting harmful commodities advertising and explore facilitators and barriers to their development, implementation and impacts.

Methods We systematically searched for advertising policy documents pertaining to local authorities in England and extracted key information including restrictions placed on advertising harmful commodities. We conducted semi-structured interviews with local authority workers involved in developing and/or implementing a diverse subset of these policies, purposively sampled for diversity in their advertising restrictions and the geographical, political and sociodemographic characteristics of their local authority. We explored how these policies were developed and implemented and their actual or anticipated impacts. Data were analysed using a data-driven framework analysis.

Results Most of the identified policies (N=107 local authorities) included advertising restrictions for tobacco (92.5%), gambling (81.3%), alcohol (76.6%) and payday loans (63.6%). A minority placed restrictions on advertising foods with high fat, sugar or salt content (32.7%), e-cigarettes (22.4%), environmentally-harmful commodities (10.3%), formula milk (5.6%), weight loss products (3.7%) and tanning salons (0.9%). Interviewed stakeholders (N=15) identified barriers to the adoption, enforcement and impacts of these restrictions, including dissuasion by commercial stakeholders, political concerns about nanny statism, revenue and local economy impacts, a lack of resources for enforcement, and the limited reach of council-owned advertising. Facilitators included political buy-in for whole-systems approaches to obesity and the commercial determinants of health, evidence of cost-effectiveness, and cross-council collaboration. Stakeholders highlighted a need for national legislation in this area, and complementary strategies to improve the availability of healthful commodities.

Conclusion Across England, local authority powers for restricting harmful commodity advertising are underutilised. Future research should evaluate the cost-effectiveness of these restrictions, to enable local authority teams seeking to implement them to address potential commercial and political pushback. National government should introduce further legislation in this area, to avoid wastage of local authority resources through duplicated effort.