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Ban on all HFSS promotions in food retail businesses (volume and price)

Ban all price promotions of discretionary foods in the retail sector excluding small and micro businesses

  • Very high impact on obesity

    Impact refers to the effect on obesity associated with a particular policy intervention.

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    • Adults: 0.00% estimated impact on population-level obesity
    • Children: 0.00% estimated impact on population-level obesity
  • Moderate evidence quality

    Evidence refers to the effect on obesity associated with a particular policy intervention.

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    • Adults: 3.00% estimated impact on population-level obesity
    • Children: 4.00% estimated impact on population-level obesity
  • Very low cost to governments

    Cost refers to the effect on obesity associated with a particular policy intervention.

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    • Adults: 0.10% estimated impact on population-level obesity
    • Children: 2.00% estimated impact on population-level obesity

What is the policy?

This policy relates to a ban on all price promotions for food and drinks that are classified as high in fat, salt, or salt (HFSS) and labelled as discretionary. 

Price promotions include both volume offers (such as multi-buys (e.g. buy one, get one free), combinations (e.g. a discount if you buy a fizzy drink with a pizza), bulk discounts, etc.), and temporary price reductions (such as reference pricing cuts like Was/Now prices, and comparisons to other retailer prices). 

Discretionary items are a subset of HFSS products that contribute to high intake of calories, fats, and sugars and displace nutrient-rich foods. Based on an analysis from Food Standards Scotland, they include confectionery, sweet biscuits, savoury snacks, cakes, pastries, puddings and sugar-containing soft drinks. 

Recent context

In the UK Government’s initial consultation on HFSS promotion restrictions in 2019, a decision was made to focus on volume promotions alone (rather than volume and temporary promotions). This decision was made to limit potential cost-of-living price increases; volume promotions were also deemed to have a greater impact on health than temporary price reductions. As such, only volume promotions were included in The Food (Promotion and Placement) Regulations 2021

In Wales, the Welsh Government announced that they are planning to restrict all types of HFSS price promotions (volume and temporary cuts) in legislation that is set to be introduced in 2024 and rolled-out across Wales by 2025. The Scottish Government’s recent consultation states that their preferred position is to consider restricting all types of HFSS promotions on discretionary foods. They propose that price and location restrictions (both instore and online) will apply to qualifying businesses including retail: supermarkets, convenience stores, discounters and bargain stores (including online sales).

Case studies

Ban on multi-buy alcohol promotions, Scotland

The Scottish government enacted a ban on multi-buy promotions in ‘off-trade stores’ (retailers licenced to sell alcohol) in 2011, becoming the first in the UK to attempt to influence alcohol purchasing through promotion restrictions. By prohibiting popular price promotions like “4 for the price of 3”, the aim was to curb bulk purchasing and in turn encourage responsible drinking. 

A comparative study found the multi-buy ban had no significant effect on the volume of alcohol purchased in Scotland, at population level or by socio-economic group. The study found that retailers replaced multi-buy discounts with temporary price reductions, making it possible for consumers to buy alcohol at the same discount, but for a smaller financial outlay. Ultimately, households that regularly utilised multi-buys offers prior to the ban purchased fewer products per shopping trip post-ban, but took more trips, leaving the overall amount purchased unchanged.Scotland has since introduced Minimum Unit Pricing (MUP) in 2011, which has been effective in reducing alcohol-related harm.

Considerations for implementing policy

  • Refining this policy for implementation would require considering the scope of discretionary products covered by the restrictions, and the types of price promotions to be included in the regulations
  • Welsh and Scottish governments are considering restricting temporary price reductions in future legislation. Temporary price reductions are a natural replacement of multi-buy promotions, offering a similar discount for a smaller outlay. 
  • Ensuring alignment of regulation scope across the nations will ensure consumer confidence and reduce potential confusion for retailers. Most large retailers operate a national pricing policy, and seek to maintain price per product across the nations. Variance in regulated promotion types across the nations may create challenges for retailers

Estimating the population impact

There are no systematic reviews or meta-analyses on these policy interventions, but a Scottish Government Impact Assessment estimates that this policy would reduce daily calorie intake by 87.6 kcals for adults

Cost and benefits

TBC

Effects on inequalities

Socio-economic status

The UK Government’s Impact Assessment concluded that there is little variance in use of HFSS volume promotions between socioeconomic groups, meaning restrictions are not expected to exacerbate inequalities.

What works well in combination with this policy?

Access to family-based weight management services

References [1] Ejlerskov, Katrine T., Stephen J. Sharp, Martine Stead, Ashley J. Adamson, Martin White, and Jean Adams. “Supermarket Policies on Less-Healthy Food at Checkouts: Natural Experimental Evaluation Using Interrupted Time Series Analyses of Purchases.” Edited by Barry M. Popkin. PLOS Medicine 15, no. 12 (December 18, 2018): e1002712. <https://doi.org/10.1371/journal.pmed.1002712.>[2] Hollands, Gareth J, Patrice Carter, […]

Impact on obesity
Very low
Evidence quality
Mod.
Cost to governments
High

Advertising watershed

Estimating the population reach Estimating the per-person impact We identified two meta-analyses that evaluated the impact of unhealthy food advertising on children and adults respectively.  A meta-analysis published in 2016 by Boyland et al. reviewed experimental studies investigating the impact of unhealthy food screen advertising exposure and subsequent food intake in adults. Their study found […]

Impact on obesity
Low
Evidence quality
High
Cost to governments
Low

Ban advertising of HFSS on public transport

Estimating the population impact We estimated this policy would reduce the prevalence of UK obesity rates by x%.  Estimating the per-person impactWe estimated the impact of this policy on using data published in the evaluation of the TfL advertising ban.  Yau et al., (2022) evaluated the impact of HFSS advertising restrictions, implemented across the London […]

Impact on obesity
Low
Evidence quality
Mod.
Cost to governments
Low

Ban discretionary HFSS promotions in out of home businesses

Estimating the population impact There is limited evidence on the impact of price promotions in out of home settings. Some research in retail settings indicates that:  Effect on inequalities Access and affordability While there is limited literature directly addressing the effects of this specific policy on equalities, it is essential to consider potential disparities in […]

Impact on obesity
Very high
Evidence quality
Mod.
Cost to governments
Very low

Ban HFSS volume promotions in food retail businesses

References [1] Ejlerskov, Katrine T., Stephen J. Sharp, Martine Stead, Ashley J. Adamson, Martin White, and Jean Adams. “Supermarket Policies on Less-Healthy Food at Checkouts: Natural Experimental Evaluation Using Interrupted Time Series Analyses of Purchases.” Edited by Barry M. Popkin. PLOS Medicine 15, no. 12 (December 18, 2018): e1002712. <https://doi.org/10.1371/journal.pmed.1002712.>[2] Hollands, Gareth J, Patrice Carter, […]

Impact on obesity
Very low
Evidence quality
Low
Cost to governments
Low

Sources

Number of studiesSample SizeCountry (Number of studies)Age rangeIntervention and comparisonMagnitude of effect in SD
(95% CI)Magnitude of effect
(calorie intake)Quality of Evidence*
High income countries (lab and field settings); Most studies from USAHigh income countries (lab and field settings); Most studies from USAIntervention: larger-sized portions, package, individual unit or item of tableware

Comparison: smaller-sized portions, package, individual unit or item of tableware
Outcome of interest: Consumption;
Effect size: SMD -0.60 (95% CI -0.84 to – 0.36, P < 0.001 )
Mean energy intake on an average snack occasion would be -38 kcal (18.9%) with lower proximity
(CI: -53 kcal to -23 kcal)
High income countries (lab and field settings); Most studies from USAHigh income countries (lab and field settings); Most studies from USAIntervention: larger-sized portions, package, individual unit or item of tableware

Comparison: smaller-sized portions, package, individual unit or item of tableware
Outcome of interest: Consumption;
Effect size: SMD -0.60 (95% CI -0.84 to – 0.36, P < 0.001 )
Mean energy intake on an average snack occasion would be -38 kcal (18.9%) with lower proximity
(CI: -53 kcal to -23 kcal)

References

[1] Ejlerskov, Katrine T., Stephen J. Sharp, Martine Stead, Ashley J. Adamson, Martin White, and Jean Adams. “Supermarket Policies on Less-Healthy Food at Checkouts: Natural Experimental Evaluation Using Interrupted Time Series Analyses of Purchases.” Edited by Barry M. Popkin. PLOS Medicine 15, no. 12 (December 18, 2018): e1002712. <https://doi.org/10.1371/journal.pmed.1002712.>
[2] Hollands, Gareth J, Patrice Carter, Sumayya Anwer, Sarah E King, Susan A Jebb, David Ogilvie, Ian Shemilt, Julian P T Higgins, and Theresa M Marteau. “Altering the Availability or Proximity of Food, Alcohol, and Tobacco Products to Change Their Selection and Consumption.” Edited by Cochrane Public Health Group. Cochrane Database of Systematic Reviews, August 27, 2019. <https://doi.org/10.1002/14651858.CD012573.pub2.>
[3] Liu, Peggy J., Steven K. Dallas, Matthew Harding, and Gavan J. Fitzsimons. “The Sales Impact of Featuring Healthy Foods, Indulgent Foods, or Both: Findings from a Large-Scale Retail Field Study.” Journal of the Association for Consumer Research 3, no. 3 (July 2018): 346–63. <https://doi.org/10.1086/698329.>
[4] Restricting Checkout, End-of-Aisle, and Store Entrance Sales of Food and Drinks High in Fat, Salt, and Sugar (HFSS) Impact Assessment (IA) Summary: Intervention and Options RPC Opinion: Fit for Purpose <https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1008423/impact-assessment-restricting-checkout-end-of-aisle-and-store-entrance-sales-of-HFSS.pdf>
[5] Shaw, Sarah C, Georgia Ntani, Janis Baird, and Christina A Vogel. “A Systematic Review of the Influences of Food Store Product Placement on Dietary-Related Outcomes.” Nutrition Reviews, June 1, 2020, nuaa024. <https://doi.org/10.1093/nutrit/nuaa024.>
[6] Whitehead, R., S. Greci, H Thomson, G. Armour, K. Angus, and L. Martin. “The Impact of Non-Price In-Premise Marketing on Food and Beverage Purchasing and Consumer Behaviour: A Systematic Review.” Preprint. Public and Global Health, September 16, 2021. <https://doi.org/10.1101/2021.09.13.21258115.>

Obesity monitoring for children

Continued universal BMI monitoring for children in reception and year 6