National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
BMC Public Health. 2023 Jun 5;23(1):1078. doi: 10.1186/s12889-023-15995-z.
Bristol City Council introduced a new advertisement policy in 2021/2022 which included prohibiting the advertising of unhealthy food and drink (HFSS), alcohol, gambling and payday loans across council-owned advertising spaces. This mixed methods study is part of the BEAR study, and aimed to explore the rationale and the barriers and facilitators to implementing the policy, and describe the perceived advertising environment prior to implementation.
Semi-structured interviews were carried out with seven stakeholders involved in the design and implementation of the advertising policy. A stakeholder topic guide was developed before interviews took place to help standardise the lines of inquiry between interviewees. A resident survey was developed to collect socio-demographic data and, for the purpose of this study, information regarding observations of advertising for HFSS products, alcohol and gambling.
Fifty-eight percent of respondents residing in Bristol and South Gloucestershire reported seeing advertisements for unhealthy commodities in the week prior to completing the survey. This was highest for HFSS products (40%). 16% of residents reported seeing HFSS product advertisements specifically appealing to children. For HFSS products in particular, younger people were more likely to report seeing adverts than older people, as were those who were from more deprived areas. An advertisement policy that restricts the advertisement of such unhealthy commodities, and in particular for HFSS products, has the potential to reduce health inequalities. This rationale directly influenced the development of the advertisement policy in Bristol. Implementation of the policy benefitted from an existing supportive environment following the 'health in all policies' initiative and a focus on reducing health inequalities across the city.
Unhealthy product advertisements, particularly for unhealthy food and drinks, were observed more by younger people and those living in more deprived areas. Policies that specifically restrict such advertisements, therefore, have the potential to reduce health inequalities, as was the hope when this policy was developed. Future evaluation of the policy will provide evidence of any public health impact.
布里斯托市议会在 2021/2022 年引入了一项新的广告政策，其中包括禁止在议会所有的广告空间上为不健康食品和饮料（HFSS）、酒精、赌博和发薪日贷款做广告。这项混合方法研究是 BEAR 研究的一部分，旨在探索实施该政策的理由以及障碍和促进因素，并描述在实施之前感知到的广告环境。
对参与广告政策设计和实施的 7 名利益相关者进行了半结构化访谈。访谈前制定了一份利益相关者主题指南，以帮助在受访者之间标准化调查内容。还开展了一项居民调查，以收集社会人口统计学数据，并且就 HFSS 产品、酒精和赌博广告的观察情况收集目的数据。
58%居住在布里斯托和南格洛斯特郡的受访者报告称，在完成调查前一周看到了不健康商品的广告。HFSS 产品的广告（40%）最多。16%的居民报告称看到了专门针对儿童的 HFSS 产品广告。就 HFSS 产品而言，年轻人比老年人更有可能看到广告，来自贫困地区的人比其他人更有可能看到广告。限制此类不健康商品广告的广告政策，特别是 HFSS 产品的广告政策，有可能减少健康不平等。这一理由直接影响了布里斯托广告政策的制定。该政策的实施得益于“健康全纳入政策”倡议下现有的支持性环境，以及减少全市范围内健康不平等的重点。
年轻人和生活在贫困地区的人观察到的不健康产品广告，特别是不健康食品和饮料的广告更多。因此，专门限制此类广告的政策有可能减少健康不平等，这也是制定该政策时的希望。未来对该政策的评估将提供任何公共卫生影响的证据。
