Understanding how unhealthy food companies influence advertising restrictions
Authors: Stanton A. Glantz
Journal: PLoS Medicine (2021)

Because of the growing global importance of noncommunicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory disease, and diabetes, the United Nations adopted the 2011 Political Declaration of the High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases [1].The declaration recognized that NCDs are "linked to common risk factors, namely, tobacco use, alcohol abuse, an unhealthy diet, physical inactivity, and environmental carcinogens."In contrast to infectious disease, exposure to these risk factors is increased by corporations actively and consciously working to increase the consumption of unhealthy products to maximize profits [2].As a result, in contrast to controlling nonsentient infectious diseases, public health interventions to reduce NCDs have to anticipate and counter conscious opposition from these corporate interests.Advertising is a key vector used to promote unhealthy products, and there is a long history of efforts to ban or restrict advertising as a key element of tobacco control [3].Ulucanlar and colleagues [4] used the substantial literature on how the tobacco industry opposes advertising restrictions (and tax increases) to develop the policy dystopia model (PDM) as a theoretical framework to understand this opposition.They found that the tobacco industry used "discursive" (argument based) and "instrumental" (action based) strategies to work through third parties and front groups to argue that proposed public health policies will not only fail but also lead to widely dispersed adverse social and economic consequences.The real motivation for industry opposition-maintaining markets and profits-is rarely, if ever, mentioned.While based on experience in just 2 policy areas (tobacco advertising restrictions and taxation) in high-income countries, the PDM has been successfully applied to other tobacco control issues and in low-and middle-income countries [5][6][7][8].In this issue of PLOS Medicine, Lauber and colleagues [9] apply the PDM to analyze food industry opposition to London's 2018 proposed ban of advertising of foods high in fat, sugar, and/or salt (HFSS) across Transport for London (TfL), a major advertising channel.They used the Freedom of Information Act to obtain industry responses to the London Food Strategy Consultation, correspondence between officials and key industry actors, and information on meetings.Except for some smaller businesses, most food and advertising industry respondents opposed the proposed advertising restrictions.Consistent with the PDM, many of these comments contested the evidence supporting the ban, promoted ineffective voluntary approaches, exaggerated costs of implementation and to society, and underplayed benefits of the advertising ban.Some industry comments also hinted at potential legal action, although none was filed during the period reported in the paper (through April 2021).Significantly, the adverse effects on food industry profits were not among the arguments that the industry raised against the proposed advertising ban.