Local authority restrictions on harmful commodity advertising: Variation, barriers and facilitators

Background
Advertising commodities which are harmful to human and planetary health increases their consumption and exacerbates health inequalities. Yet there has been little evaluation of local government policies to restrict this advertising. We thus aimed to characterise the components of these policies and explore facilitators and barriers to their development, implementation and impacts.

Methods
We systematically searched for advertising policies pertaining to local authorities in England and assessed whether they placed restrictions on advertising harmful commodities. We interviewed local authority workers involved in a diverse subset of these policies to explore how they were developed and implemented, and their anticipated impacts. Data were analysed using the framework method.

Results
Most of the identified policies (N = 107 local authorities) included advertising restrictions for tobacco (92.5%), gambling (81.3%) and alcohol (76.6%). A minority placed restrictions on advertising unhealthy foods (32.7%), e-cigarettes (22.4%), environmentally-harmful commodities (10.3%), formula milk (5.6%) and tanning salons (0.9%). Interviewees (N = 15) identified barriers to the adoption and impacts of these restrictions, including industry pushback, political concerns about individual choice, revenue and local economy impacts, and a lack of resources for enforcement. Facilitators included political support for whole-systems approaches to public health issues, evidence of cost-effectiveness and collaboration between authorities. A need for national legislation in this area was highlighted.

Conclusions
Across England, local authority powers for restricting harmful commodity advertising are underused. Future research should evaluate the cost-effectiveness of these restrictions to enable local authority teams to address commercial and political pushback. National governments should introduce further legislation in this area to address the fragmentary coverage of these restrictions.

Key messages
• Greater national legislation to restrict harmful commodity advertising is needed to address the fragmentary coverage of localised restrictions on this advertising and conserve local authority capacity.

• Further evidence on the cost-effectiveness of harmful commodity advertising restrictions is needed to enable local authority teams to address industry pushback and concerns about economic impacts.