Public transport and the promotion of unhealthy food and drink
Authors: Stuart W Flint, Jim McKenna
Journal: The Lancet Public Health (2018)

Unhealthy diets are associated with chronic illness such as diabetes, and remain a focus for government and local authority action. Efforts to intervene have been the subject of policy development,1WHOSet of recommendations on the marketing of foods and non-alcoholic beverages to children.http://www.who.int/dietphysicalactivity/publications/recsmarketing/en/Date: 2010Date accessed: May 21, 2018Google Scholar which has identified and directed actions aimed at reducing unhealthy food and drink marketing—for instance, to minimise child exposure to the marketing of foods that are high in saturated fats, trans-fatty acids, free sugars, or salt. Although the role of public transport in supporting public health through reducing carbon emissions, decreasing city-centre congestion, and increasing physical activity,2WHOTransport and health. Activities.http://www.euro.who.int/en/health-topics/environment-and-health/Transport-and-health/activitiesDate: 2017Date accessed: May 21, 2018Google Scholar is widely recognised, counterproductive actions—through advertisement of unhealthy food and drink—remain. Although WHO identifies the potential of public transport to reduce the risk of non-communicable disease,2WHOTransport and health. Activities.http://www.euro.who.int/en/health-topics/environment-and-health/Transport-and-health/activitiesDate: 2017Date accessed: May 21, 2018Google Scholar continued advertising of unhealthy consumption actively undermines and derails its positive effects on public health. Within the London Food Strategy,3Mayor of LondonThe Draft London Food Strategy: healthy and sustainable food for London, drafts for consultation.https://www.london.gov.uk/sites/default/files/london_food_strategy_2018_15.pdfDate: 2018Date accessed: May 21, 2018Google Scholar the Mayor of London proposed a ban on unhealthy food and drink adverts in the London underground, overground, buses, and bus shelters. For years, public transport companies have used their many locations to advertise unhealthy food and drink to the public. Advertisements and offers often appear on the back of bus tickets, and more recently on other forms of transport such as airplanes. Research highlights high exposure to chain brands via public transport in areas of low socioeconomic status,4Settle PJ Cameron AJ Thornton LE Socioeconomic differences in outdoor food advertising at public transit stops across Melbourne suburbs.Aust NZ J Public Health. 2014; 38: 414-448Crossref PubMed Scopus (25) Google Scholar and the risk of child exposure to food marketing on public transport is also higher in these areas,5Signal LN Stanley J Smith M et al.Children's everyday exposure to food marketing: an objective analysis using wearable cameras.Int J Behav Nutr Phys Act. 2017; 14: 137Crossref PubMed Scopus (73) Google Scholar with food marketing being primarily dominated by products high in saturated fat, calories, salt, and sugar. Public transport companies have a valuable role by serving population needs, and represent an important part of any society's infrastructure. Even these companies can be expected to actively promote public health. Without burdening them with sole responsibility, because many factors influence population health, these pillars of society need to be aligned around collective action and responsibility. Given the challenges of securing even small changes in positive-health behaviour at the population level, to require that all public transport companies pursue what we feel are their corporate social responsibilities is justifiable. Instead of being associated with what can harm us, to see all such providers of community-wide services doing more to actively enhance public health would be exciting. We declare no competing interests.