Adopting and implementing local government policy restrictions on harmful commodities advertising in England: A qualitative exploration of challenges, facilitators and impacts

Background : Restricting the advertisement of commodities which are harmful to human and planetary health is an evidence-based policy priority for improving population health and reducing inequalities. Yet only a minority of local authorities in England have adopted advertising restriction policies, and these vary widely in the commodities they cover. As little is known about why this variation exists, we aimed to explore the diverse experiences of local authorities in England who have developed, adopted, and implemented these policies, and identify facilitators, barriers, and perceived impacts. Methods : We conducted semi-structured interviews (N=15) with local authority professionals involved in developing and/or implementing advertising restriction policies, purposively sampled for diversity in policy components and the geographical, political and sociodemographic characteristics of their local authorities. We explored how these policies were developed and implemented, and their actual or perceived impacts. Data were analysed using a data-driven framework analysis. Results : Participants identified barriers to the adoption and impacts of these policies, including industry warnings of revenue loss, political concerns about individual choice, revenue and local economy impacts, a lack of resources for enforcement, and the predominance of privately-owned advertising. Facilitators included multi-party political support for whole-systems approaches to public health issues, evidence of cost-effectiveness and public support, exemptions for local businesses, and collaboration between local authorities. Policies were broadly supported by the public, with limited industry resistance post-implementation. Participants reported visible reductions in harmful commodity advertising in their localities and minimal advertising revenue losses, with more ‘positive’ and pro-social advertisements replacing restricted ones. To further these impacts, many authorities were working to persuade businesses and public organisations to adopt similar policies. Participants highlighted a need for clearer, universally-accepted advertising eligibility guidelines, more stringent policy enforcement, national legislation to ensure consistent, nationwide policy coverage and avoid duplication of effort, and complementary strategies to improve the availability of healthy alternatives. Conclusions : Future research should evaluate the cost-effectiveness and wider impacts of harmful commodity advertising restrictions to enable local authority teams to address commercial and political pushback. More comprehensive national legislation is needed to address the fragmentary coverage of localised restrictions and conserve local authority capacity.