Comparison of ten policy options to equitably reduce children’s exposure to unhealthy food marketing

Abstract Objective: Reducing children’s exposure to unhealthy food marketing is crucial to combat childhood obesity. We aimed to estimate the reduction of children’s exposure to food marketing under different policy scenarios and assess exposure differences by socioeconomic status. Design: Data on children’s exposure to unhealthy food marketing was compiled from a previous cross-sectional study in which children (n=168) wore wearable cameras and GPS units for four consecutive days. For each exposure, we identified the setting, the marketing medium and food/beverage product category. We analyzed the percentage reduction in food marketing exposure for ten policy scenarios and by socioeconomic deprivation: 1) no product packaging, 2) no merchandise marketing, 3) no sugary drink marketing, 4) no confectionary marketing in schools, 5) no sugary drink marketing in schools, 6) no marketing in public spaces, 7) no marketing within 400m of schools, 8) no marketing within 400m of recreation venues, 9) no marketing within 400m of bus stops, and 10) no marketing within 400m of major roads. Setting: Wellington region of New Zealand. Participants: 168 children aged 11-14 years. Results: Exposure to food marketing varied by setting, marketing medium and product category. Among the 10 policy scenarios, the largest reductions were for plain packaging (60.3%), no sugary drink marketing (28.8%) and no marketing in public spaces (22.2%). There were no differences by socioeconomic deprivation. Conclusions: The results suggest that plain packaging would result in the greatest decrease in children’s exposure to food marketing. However, given that children are regularly exposed to unhealthy food marketing in multiple settings through a range of marketing mediums, comprehensive bans are needed to protect children’s health.