Elsevier

Public Health

Volume 150, September 2017, Pages 121-129
Public Health

Original Research
Evaluation of compliance with the Spanish Code of self-regulation of food and drinks advertising directed at children under the age of 12 years in Spain, 2012

https://doi.org/10.1016/j.puhe.2017.05.013Get rights and content

Highlights

  • Non-compliance with the PAOS Code is higher than for 2008.

  • Techniques used by the industry to target minors have been increased.

  • There is a lack of effectiveness of self-regulation in Spain.

  • A statutory system is needed to ban unhealthy food and drink advertisements.

Abstract

Objective

To evaluate compliance levels with the Spanish Code of self-regulation of food and drinks advertising directed at children under the age of 12 years (Publicidad, Actividad, Obesidad, Salud [PAOS] Code) in 2012; and compare these against the figures for 2008.

Study design

Cross-sectional study.

Methods

Television advertisements of food and drinks (AFD) were recorded over 7 days in 2012 (8am–midnight) of five Spanish channels popular to children. AFD were classified as core (nutrient-rich/low-calorie products), non-core (nutrient-poor/rich-calorie products) or miscellaneous. Compliance with each standard of the PAOS Code was evaluated. AFD were deemed to be fully compliant when it met all the standards.

Results

Two thousand five hundred and eighty-two AFDs came within the purview of the PAOS Code. Some of the standards that registered the highest levels of non-compliance were those regulating the suitability of the information presented (79.4%) and those prohibiting the use of characters popular with children (25%). Overall non-compliance with the Code was greater in 2012 than in 2008 (88.3% vs 49.3%). Non-compliance was highest for advertisements screened on children's/youth channels (92.3% vs. 81.5%; P < 0.001) and for those aired outside the enhanced protection time slot (89.3% vs. 86%; P = 0.015).

Conclusions

Non-compliance with the PAOS Code is higher than for 2008. Given the lack of effectiveness of self-regulation, a statutory system should be adopted to ban AFD directed at minors, or at least restrict it to healthy products.

Introduction

Childhood obesity is one of the major public health problems and concerns of this century. In developed countries, one in every four children suffers from overweight.1 In Spain, this figure rises to one-third of all children, ranking it among the highest in Europe.1, 2, 3 Overweight children have a higher likelihood of suffering from obesity in adult age,4 which in turn increases the risk of developing chronic diseases and can reduce life expectancy by as much as eight years.5, 6 Intervening in the appearance of obesity are genetic, familial, psychological and environmental factors of a complex multifactorial aetiology, which affect diet, physical activity or both.

Overweight and obesity are in great measure preventable. A first step is to guarantee children's right of access to nutritionally appropriate, safe and nourishing foods.7 In this respect, the factors that influence the choice of foods in childhood are crucial, since food preferences are established in the early years of life.8 Food and drink advertising concentrated on products which are high in fat, sugar and/or salt (HFSS) and calories directly affects these preferences and the consumption patterns of children8, 9, 10, 11 and is estimated to be responsible for 16%–40% of all childhood obesity.12, 13, 14 The main medium of exposure to advertising is television;14 in Spain, children aged 4–12 years watch a mean of 22 food and drink advertisements per day, which represented 25%–33% of all advertising on children's programmes in the period 2010–2012.15, 16

Restricting food advertising directed at children is one of the most cost-effective public health interventions.17 Self-regulation of food and drink advertising is the leading intervention strategy in this field, world-wide.8 Spain was one of the first countries to introduce self-regulation in the world, and one of the few (along with the United States, Australia, Canada, Germany and United Kingdom) that has published an independent scientific evaluation of the effectiveness of industry-led self-regulation.8, 18

In 2005, the Ministry of Health, along with the Spanish Federation of Food & Drink Industries and the association of the leading advertising agencies, news and advertising media tasked with managing the Spain's self-regulatory commercial communication system (AUTOCONTROL), approved the code of self-regulation of food advertising directed at children under the age of 12 years, prevention of obesity and health (Publicidad, Actividad, Obesidad, Salud [PAOS] Code for its acronym in Spanish). The PAOS Code, which is voluntary in nature and applies to food advertising messages disseminated via audiovisual and printed media, contains 25 ethical standards that regulate the marketing techniques used, but standards regulating the nutritional composition of the products advertised (nutritional standards) are lacking.19 In 2009, public and private television channels subscribed to the PAOS Code. In 2012, the PAOS Code was renewed to include, among other things, internet advertising directed at children and teenagers under the age of 15 years.20

The main aim of this study is to evaluate the compliance of television food advertising with the PAOS Code in 2012. In addition, it also sought to compare the results against those of a previous evaluation made in 2008, so as to ascertain to what extent the effectiveness of self-regulation might have changed over time.

Section snippets

Study design and sample

We conducted a cross-sectional study on television advertisements of food and drinks (AFD) directed at children in Spain. The sample was obtained by recording 7 days broadcasting (Monday to Sunday) by nation-wide specialist channels targeted at a child-youth population (Boing, Disney Channel and Neox) and two generalist channels with the highest child-audience ratings (Antena 3 and Telecinco).21 The broadcasts were recorded from January to April 2012, excluding vacation periods, during the 8 am

Results

Across the study period, a total of 4212 AFD were identified. Of these, 2582 were directed at children below 12 years of age, and thus came within the purview of the PAOS Code. Table 1 shows the characteristics of the AFD directed at children under 12 years of age in Spain in 2012: 65.6% were broadcast on school days and 32.8% in the enhanced-protection time slot for children; Neox was the channel with the highest AFD broadcasting frequency, with 28.4% of the total; 72.6% of all products

Discussion

Close on nine out of ten advertisements of food and drinks failed to comply with one PAOS Code standard, and one-third were in breach of 3 standards simultaneously. The standards with the highest levels of non-compliance were those relating to the clarity and simplicity of the information presented in AFD, and those which prohibited the use of personalities popular with children, well-known or famous persons. Non-compliance with the PAOS Code was: highest on children's/youth channels, which

Acknowledgements

The authors would like to gratefully acknowledge the research team for their valuable advice and assistance at all stages of the project. KLF wrote the first draft of the manuscript, participated in the analysis of data, elaboration of results and revision of the final manuscript. The manuscript was assisted by ARG and MRF. MAM and LL participated in data collection. MJB and JD collaborate in the analysis of the data. MARB participated in the design and revision of the final manuscript.

Ethical approval

None

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