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Television Food Advertising to Children in Malta

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Television Food Advertising to Children in Malta Health Promotion International, 2017;32:419–429 doi: 10.1093/heapro/dav105 Advance Access Publication Date: 24 October 2015 Article Television food advertising to children in Malta Daniel Cauchi1,*, Sascha Reiff2, Cecile Knai1, Charmaine Gauci2, and 3 Joanna Spiteri Downloaded from https://academic.oup.com/heapro/article/32/3/419/2950982 by guest on 01 October 2020 1Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK, 2Health Promotion and Disease Prevention Directorate, Msida, Malta, and 3Broadcasting Authority, Hamrun, Malta *Corresponding author. E-mail: [email protected]; [email protected] Summary To undertake a cross-sectional survey of the extent and nature of food and beverage advertising to chil- dren on Maltese national television stations. Seven national free-to-air channels were recorded for seven consecutive days in March 2014 between 07:00 and 22:00 h. Advertisements were coded accord- ing to predefined categories, with a focus on advertisements aired during ‘peak’ children’s viewing times, defined as periods during which more than 25% of children were likely to be watching television on any channel. Food and beverage advertisements were classified as core (healthy), non-core (unhealthy) or miscellaneous foods. Malta. Whole population, with a focus on children. Food and drinks were the most heavily advertised product category (26.9% of all advertisements) across all channels. The proportion of non-core food/drink advertisements was significantly greater during peak compared with non-peak children’s viewing times (52 vs 44.6%; p ≤ 0.001). A majority of advertisements aimed at children are for non-core foods, and are typically shown during family-oriented programmes in the late evening rather than being restricted to children’s programmes. ‘Taste’, ‘enjoyment’ and ‘peer status’ were the primary persuasive appeals used in adolescent and child-focused advertisements. This first content analysis of television advertising in Malta suggests that there is scope for the implementation of statutory regulation regarding advertising of foods high in fat, sugar and salt (HFSS) during times when children are likely to watch television, rather than during children’sprogrammesonly. Ongoing, systematic monitoring is essential for evaluation of the effectiveness of regulations designed to reduce children’s exposure to HFSS food advertising on television. Key words: television, Malta, obesity prevention, regulation INTRODUCTION association between time spent watching television and Excess weight in children is of significant public health body weight (Lobstein and Dibb, 2005; Cairns et al., concern globally and in Malta, a small Mediterranean is- 2013). Television watching is a sedentary behaviour, land republic (Lobstein et al.,2004; Grech et al.,2006; and there might be a concomitant tendency to consume Farrugia Sant-Angelo and Grech, 2011). Overweight energy-dense snack foods during viewing (Hastings and obese children are known to have a high risk of et al., 2003). Marketing of unhealthy foods and beverages suffering from a range of adverse non-communicable dis- to children may adversely affect children’s dietary choices eases (Lobstein et al., 2004). There is a well-established and energy intake by influencing their food preferences, © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected] 420 D. Cauchi et al. knowledge, attitudes, purchasing behaviour and purchas- in 2014; this was true across gender and age groups. ing requests to parents (Hastings et al., 2003; Cairns et al., Almost three-fourths of respondents listed one of the 2013; O’Dougherty et al., 2014). seven free-to-air national television channels as their pre- Reducing children’s exposure to the promotion of un- ferred station, suggesting that a substantial proportion of healthy foods and beverages high in saturated fats, trans- the Maltese population still watch local television regularly fat, free sugars or salt (HFSS) has been recognized as a key (Axiak, 2014). target for childhood obesity prevention policy (United The aim of this study was to conduct a cross-sectional Nations, 2011). In many countries, HFSS foods such as survey to assess the extent of exposure and nature of food sugar-sweetened breakfast cereals, soft drinks, confection- and beverage advertising across national free-to-air televi- ery and high-fat snacks are frequently advertised to chil- sion stations in Malta, in order to establish whether the Downloaded from https://academic.oup.com/heapro/article/32/3/419/2950982 by guest on 01 October 2020 dren on television (Cairns et al.,2009). Children under problem of unhealthy food promotion within television 8 years of age are particularly vulnerable to such promo- exists. To our knowledge, this is the first such study con- tion, as they have limited cognitive ability to discriminate ducted in Malta. The overall proportion of food advertise- entertainment content from commercial content (Carter ments and the balance of ‘healthy’ versus ‘unhealthy’ et al., 2011). Older children also tend to accept com- foods, as well as variations in advertising patterns by sta- mercial claims uncritically (American Psychological tion; viewing times and day of the week were analysed. Association, 2004; Kunkel and Castonguay, 2012). In The use of persuasive techniques in food and beverage ad- 2010 the World Health Organization (WHO) released a vertisements was explored. set of recommendations to guide Member States’ efforts in development of policies on food marketing communica- tions in order to reduce the impact of HFSS foods and bev- MATERIAL AND METHODS erage promotion to children, including a recommendation Recording for the establishment of monitoring and evaluation sys- Television transmission was recorded from 07:00 to tems to ensure that policy objectives are reached (World 22:00 h daily for all seven national free-to-air television Health Organization, 2010). Regulatory changes have stations broadcasting during the week between 10th and been implemented in a number of countries as regulation 16th March, 2014, in accordance with the guidelines out- of food marketing is increasingly recognized as a promis- lined by the International Network for Food and Obesity/ ing avenue for intervention (Hawkes and Lobstein, 2011). non-communicable diseases, Research, Monitoring and Action Support (INFORMAS) group (Kelly et al., 2013). Contextual factors and the policy environment These were TVM and TVM 2 (Public Service channels); To date, there has been limited discourse on regulation of ONE TV and NET TV (political-commercial channels) HFSS food and beverage advertising in Malta. A recently and fLiving, SMASH TV and XEJK TV (commercial updated Food and Nutrition Policy and Action Plan channels). The second week of March was selected as (Health Promotion and Disease Prevention Directorate, being a period representative of usual advertising patterns 2015) recommends that media service providers develop that did not contain any special events or holiday periods. codes of conduct regarding inappropriate promotion of HFSS foods to children, in line with Article 9(2) of the Audiovisual Media Services Directive (AVMSD) of the Coding European Union (Council of the European Union and Television station broadcasts were recorded and scanned European Parliament, 2010). The Broadcasting Act by the BA, and all advertising content was subsequently encompasses a Legal Notice that makes reference to mis- forwarded to the authors. Thirty hours of content selected leading and deceptive advertising to minors, including at random were coded independently by two of the HFSS food promotion (Government of Malta, 2010). authors, D.C. and S.R., according to predefined criteria Television is still regarded as the media platform preferred (Gantz et al.,2007; Kelly et al., 2008, 2010). Inter-rater by food marketers, although its dominance is gradually reliability for classification of advertisements as either decreasing (Cairns et al., 2013). In 2010 in Malta, around ‘food’ or ‘non-food’ was very high (100% agreement), 60% of Maltese children aged 11–15 years reported whereas 92% agreement for classification of food adver- watching television for more than 2 h daily on weekdays tisement category and target audience was achieved. (Health Promotion and Disease Prevention Directorate, Inter-rater reliability for coding of primary persuasive 2010). A Broadcasting Authority (BA) of Malta audience technique was 81%. Disagreements were resolved by dis- assessment survey suggests that around 62% of the cussion. Subsequently, coding of remaining hours was car- Maltese population regularly followed a television station ried out by D.C. and S.R. according to standard procedure Television food advertising to children in Malta 421 in order to achieve consistency. Where more than one food day and whether the advert was aired during children’s product was shown, the most dominant product was peak or non-peak viewing times. coded, whereas the first product shown was coded when multiple products were given equal importance. Other Food and beverage advertisements coding categories included channel, programme category Advertisements showing food and beverages were categor- (e.g. drama, news, discussion/current affairs, based on ized into 29 sub-categories (Table 1). In general, nutrient- an in-house classification issued by the BA) around dense items low in excess energy that
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