My book, Soda Politics, came out not quite a year ago but so much has happened since then that it’s been hard to keep up with everything that’s happening in campaigns to discourage consumption of sugar-sweetened beverages.
Fortunately, Healthy Food America’s Casey Hinds puts out a daily roundup of sugar and soda news (you can sign up for it and HFA’s other materials here).
More effective ways already are being used to change people’s diets. The best use of government authority is to empower people with the information they need to make healthier choices.
The editorial comes with a poll, still up. You can vote on it here. At this moment only 183 votes have come in, 51% strongly in favor of the editorial opinion.
The time has come to tax sugary drinks like we tax tobacco. The analogy is powerful: As with tobacco, rock-solid evidence shows habitual use harms health. Sugary drinks are a prime culprit in rampant health problems — diabetes, obesity, and heart, dental and liver disease – that cut lives short and drive up health care costs. Tobacco taxes have reduced smoking, while raising money to make lives better. Taxing sugary drinks would do the same
This too has a poll on which you can still vote. Only 92 votes have come in, and only 38% strongly agree.
Americans don’t like taxes. Even so, either this issue doesn’t generate much interest or it’s just August and too hot to think about such things.
The beverage industry spent $10.6 million to oppose Philadelphia’s soda tax initiative
The soft drink industry does not like taxes and seems willing to put fortunes into opposing them.
The Philadelphia City Council passed the tax anyway. I keep thinking of all the good things nearly $11 million could do for public health.
The hospital did an experiment to see if they could shift the mix of drinks purchased from sugary to less sugary. They did this by increasing the price of sugary drinks and hiding them under counters. Sales of sugar-sweetened beverages sales fell by 36,500 drinks in a year.
I don’t get it. Why not just stop selling them altogether?
That’s it for this August Monday. Stay cool. More to come.
Addition, August 23
A reader from New Zealand writes to say that “all of its hospitals no longer sell sugary sodas and some are also beginning to remove juice and artificially sweetened beverages due to their acidic nature and detrimental impact on oral health.”
Even in ‘healthy’ foods, calories can tick up fast
Nutrition professor that I am, if I could teach just one thing to the American public, it is this: Larger portions have more calories.
Please don’t laugh.
If we all understood this, the United States would not have an obesity problem. And the recent revelation that places like Chipotle and Panera serve meals with more calories than McDonald’s would surprise nobody. We would realize the former’s “health” aura blinds people. But this basic rule applies to those places, too.
We would also, strangely, thank McDonald’s for at least one thing: It limits portion sizes. It’s easy to pile on calories by asking for a little more of this, then a refill of that—without realizing that the calories surpass those in McDonald’s meals.
It’s not easy to understand calories. They are not intuitive because they’re abstract. They cannot be seen, tasted or smelled, and are extraordinarily difficult to count accurately, even for scientists. My colleague Lisa Young, author of The Portion Teller, once asked an entry-level nutrition class to guess the calories in 8-ounce and 64-ounce soft drinks. We didn’t expect students to know that an 8-ounce Coke has 100 calories—but we certainly expected them to multiply whatever they guessed by eight for the 64-ounce drink. But the average multiplier was three.
The unintuitive relationship between amounts eaten and calorie intake is one of the reasons behind public health campaigns like the new soda tax in Philadelphia, which in part aims to get people to think twice before drinking sugary beverages. No nutritionist worries about an occasional 90-calorie mini-can of soda. But many people drink sugary beverages in 12-ounce, 20-ounce or liter sizes. Bigger sizes mean more calories, and more calories means more weight unless you compensate with physical activity.
But exercising off calories takes a lot of work. That was the message of aNew York City health department campaign demonstrating the need to walk the three miles from Union Square to Brooklyn to compensate for the nearly 300 calories in a 20-ounce soft drink.
And let’s not forget that all of the calories in soft drinks come from sugars, which provide nothing but calories—no vitamins, no minerals, no fiber. They may be delicious, but they have no redeeming nutritional value. That’s why their calories get called “empty.”
Does where calories come from make any difference? Yes, but in complicated ways. Weight balance depends on calories. But managing weight—and overall health—very much depends on where those calories come from. It’s not so easy to overeat vegetables, fruits and whole grains, or relatively unprocessed foods of any kind, because these tend to be bulky and fill you up before you eat too much. You can still gain weight on these healthy foods, but it’s harder. Chipotle may have healthier calories than McDonald’s, but its calories still count.
Sugars post particular problems because they induce insulin production, but also because they make foods taste good. We eat something sweet and want more of it. We start loving sweet tastes in infancy. Breast milk is sweet; it contains a tablespoon of lactose per cup and that’s there for a reason—to make babies do the work of nursing.
But sodas are very sweet. A 12-ounce soda contains more than threetablespoons of sugars—and the calories that go with them.
It’s also very hard to separate the effects of sugars from their calories. If scientists want to know whether the calories from sugars are worse than those from any other foods, they need to feed people precisely the same number of calories from diets widely varying in their content of sugar, other carbohydrates, protein, and fat for a long enough period of time to get meaningful results. The only way to do something like this would be to keep the study subjects under lock and key for as long as it takes—inconvenient, to say the least, and very expensive.
Until the science is resolved, we can all agree that eating less sugar is a good idea for just about everyone. Sugars are nutritionally empty, are hidden in foods, and encourage overeating.
Notice that I said less, not none. Personally, I love desserts and would never want to give up sugars entirely or ask anyone else to do so. I just follow my own dietary advice: eat lots of vegetables and other relatively unprocessed “real” foods, and for everything else, pay attention to portion size. This way, an occasional sugary treat is a pleasure and nothing to worry about.
One of the newsletters I subscribe to, BeverageDaily.com, has a special edition—a collection of its articles—on what the industry is doing to address its biggest problem: reducing sugar.
Health and wellness is at the forefront of consumers’ minds, and sugar gets plenty of bad press. Obesity is as big a concern as ever, and soft drinks are in the firing line.
What is the beverage industry doing to reduce calories? How are market leaders reformulating and revamping their portfolios; and what healthier brands are appearing?
From alternative sweeteners to packaging sizes, we look at what the industry is doing to cut calories – and how well these initiatives are working.
From reformulation to nutritional labeling, the non-alcoholic beverage industry has adopted a variety of strategies to reduce the calorie content of drinks. We look at how different strategies from around the world are being implemented. .. Read
UK sugar tax: comment and analysis: The UK government has announced a sugar tax on sugar-sweetened beverages, which will come into effect in April 2018. From public health officials to think tanks, we take a look at some of the comments and analysis following the announcement. .. Read
Stevia’s star keeps rising: MintelThe use of stevia in non-alcoholic beverage launches increased 487% between 2011 and 2015, according to figures from Mintel, with carbonates and RTD iced tea in particular turning to the natural sweetener. .. Read
Scientists find way to make sweetest sweetener taste sweeter: Japanese researchers have devised a method to make one of the sweetest natural sweeteners even sweeter in a development that will be seen as a breakthrough at a time when consumers are moving away from sugar… Read
You can see why the industry has a problem. Sugar tastes good. These other things not so much.
Simon N. Williams, Marion Nestle(Editors). Big Food: Critical perspectives on the global growth of the food and beverage industry. Routledge, 2016.
Here’s what the publisher says about it:
Obesity is a global public health problem of crucial importance. Obesity rates remain high in high-income countries and are rapidly increasing in low- and middle- income countries. Concurrently, the global consumption of unhealthy products, such as soft drinks and processed foods, continues to rise. The ongoing expansion of multinational food and beverage companies, or ‘Big Food’, is a key factor behind these trends.
This collection provides critical insight into the global expansion of ‘Big Food’, including its incursion into low-and-middle income countries. It examines the changing dynamics of the global food supply, and discusses how low-income countries can alter the ‘Big Food’-diet from the bottom-up. It examines a number of issues related to ‘Big Food’ marketing strategies, including the way in which they advertise to youths and the rural poor. These issues are discussed in terms of their public health implications, and their relation to public health activities, for example ‘soda taxes’, and the promotion of nutritionally-healthier products. This book was originally published as a special issue of Critical Public Health.
When these papers came out in Critical Public Health, I did a post on them. The new hardback book is expensive. To save money, try the journal.
Last summer, Brian Wansink, a friend and Cornell colleague and the editor of the new Journal of the Association for Consumer Research, asked me to write a commentary on a paper to be published in its inaugural issue.
The paper turned out to be by a group of authors, among them John Peters and Jim Hill, both members of the ill-fated Global Energy Balance Network, the subject of an investigation by the New York Times last August.
The healthy defaults reduced calories (21.4%), fat (43.9%) and sodium (43.4%) for kid’s meal sides and beverages sold in the park. These results suggest that healthy defaults can effectively shift food and beverage selection patterns toward healthier options.
The authors explain:
This work was supported by the Walt Disney Company and by the National Institutes of Health…The Walt Disney Company and the National Institutes of Health had no role in the design, analysis, or writing of this article. Full disclosure: JH is a consultant for the Walt Disney Company and for McDonalds; KA is a consultant for the Walt Disney Company.”
I thought Disney’s sponsorship of this research and its withholding of critical baseline and sales data on kids’ meals that the company considered proprietary did indeed deserve comment, and wrote my piece accordingly. Brian Wansink soon accepted it for publication but to my surprise, gave it to Peters et al. for rebuttal. They filed a lengthy response. I was then given the opportunity to respond, and did so, briefly.
The paper by Peters, et al. did was published in the journal’s first issue. This issue also includes several commentaries on other papers (none of which are accompanied by rebuttals).
My commentary—and the back-and-forth—however, were omitted.
After some discussion, the journal published my commentary online. You have to scroll down to find it. The site provides no links to it in the table of contents or in the article by Peters et al.
Is it possible that Disney or the authors’ contractual relationships with Disney could have had anything to do with the omission of my accepted-for-publication commentary? Brian Wansink says no, they just ran out of room (despite room for others).
Whatever.
Here’s what I wrote:
Dietary nudges for obesity prevention: They work, but additional policies are also needed
In 2006, the Walt Disney Company announced a new initiative to improve the nutritional quality of meals served to children at its theme parks. The company would be changing the default kids’ meals—the components that come without having to be ordered separately–to include low-fat milk, juice, or water rather than soft drinks, and sides such as apple sauce or carrots rather than French fries. Parents who wanted sodas or fries for their children would have to ask for them, something many might not bother to do. Health groups had long advocated for this policy change (Wootan 2012).
As I commented to a reporter at the time, “going to Disney World is an excuse for eating junk food…Disney or its advisers must be feeling they have some responsibility” (Horovitz and Petrecca 2006). Indeed, the healthier defaults were part of a larger effort by Disney to deal with its contribution to obesity in America. After ticket prices, food is the second greatest source of revenue at Disney World. Although reducing the amount of food consumed at the parks might help create a less “obesogenic” food environment, revenues might fall. But the default change might be revenue neutral. By 2008, Disney could report that two-thirds of U.S. customers ordering kids’ meals had accepted the default, with no loss in sales. In Hong Kong Disney parks, nearly all customers accepted the default. The report, however, did not include data on the numbers or proportions of customers ordering kids’ meals (Walt Disney Company 2008).
Disney’s more recent summary of its child health initiatives states that it is funding investigators at the University of Colorado to conduct a more formal evaluation of use of the default options (Walt Disney Company 2015). The paper by Peters et al. (2016) in this issue of the Journal presents the results of that research. Their work confirms the ongoing effectiveness of the strategy. Nearly half the customers ordering kids’ meals accepted the healthy default side dishes and two-thirds accepted the healthier beverages. These choices resulted in significant reductions in the calories, fat, and sodium in purchased kids’ meals, but not sugar (Peters et al 2016).
The authors argue that gentle nudges changes like these are preferable to more coercive policies that smack of nanny statism. Such reductions help, but are they enough to make a real difference? To answer this question, it would help to know what else the children were eating along with the drink and side dishes. Although the authors were given raw sales data, Disney did not permit them to use this information as part of the overall analysis. The company also refused to provide information about the number of children who visited the park or the number of kids’ meals sold.
These missing pieces raise red flags because this is a Disney-funded study that produced results that Disney can use to advertise itself as a company that cares about kids’ health, and to deflect attention from Disney World’s’ reputation as a junk-food paradise. Corporate funding of research introduces conflicts of interest and reduces the credibility of the results, not least because the biases inherent in such research are largely unconscious, unintentional, and unrecognized (Moore et al 2005) The results of this study merit especially careful scrutiny. Taking them at face value, the default strategy worked well for the drink, but the sides are still a problem, and so are the sugars. They do not reveal much about what kids eat in a day at Walt Disney World
Nudges like this default are an important part of strategies to counter childhood obesity. But are they enough to deal with the public health problem? To make a real difference, they need to be accompanied and supported by a range of policy approaches. Current thinking about such approaches recommends combining insights from behavioral research, economics, and public health to establish a food environment far more conducive to making the healthy choice not only easy choice, but also the preferred choice. Doing so is likely to require multiple actions—for example, regulation of nutrient content and marketing; incentives such as subsidies of healthier foods; disincentives such as taxes, warning labels, and nutritional rating systems for unhealthier foods; and education of adults and children (Hawkes et al 2015). Disney’s voluntary default is a small step in the direction of such policies, but many more are needed if we are to make real progress in reducing the prevalence of childhood obesity.
Margo G. Wootan. Children’s meals in restaurants: families need more help to make healthy choices. Childhood Obesity 2012;8(1):31-33.
Bruce Horovitz and Laura Petrecca. Disney to make food healthier for kids. USA Today, October 17, 2006.
Walt Disney Company. Walt Disney Company—2008 Corporate Responsibility Report. 2008.
Walt Disney Company. Magic of Healthy Living brochure. 2015. https://thewaltdisneycompany.com/sites/default/files/MOHL_Brochure.pdf.
John C. Peters, Jimikaye Beck, Jan Lande, Zhaoxing Pan, Michelle Cardel, Keith Ayoob, and James Hill. Using healthy defaults in Walt Disney World restaurants to improve nutritional choices. J Assoc Consumer Res., 2016;1:1.
Don A. Moore, Daylian M. Cain, George Loewenstein, and Max H. Bazerman, editors. Conflicts of Interest: Challenges and Solutions in Business, Law, Medicine, and Public Policy. Cambridge University Press, 2005.
Corinna Hawkes, Trenton G Smith, Jo Jewell, Jane Wardle, Ross A Hammond, Sharon Friel, Anne Marie Thow, Juliana Kain. Smart food policies for obesity prevention. The Lancet 2015;385:2410–2421.
And here’s my response to the rebuttal by Peters et al.
The response from Peters and Hill still fails to acknowledge the severity of the problems posed by Disney’s sponsorship of their research—the company’s failure to produce data essential for proper interpretation of study results, and the level to which sponsorship by food companies biases such interpretations. At one point, Disney boasted of the results of this research, confirming its benefit to marketing goals. The threat of industry sponsorship to research credibility has received considerable press attention in recent months, as must surely be known to these authors.1,2
Yesterday, members of Mexico’s Nutritional Health Alliance held a press conference to complain that a Coca-Cola Christmas television ad violated the human rights of the indigenous people of the Mixe community of Totontepec.
The ad, released by Coca-Cola in late November on social media as part of its “OpenYourHeart” Christmas advertising campaign shows young people who are outsiders to the Mixe indigenous community arriving to build a Christmas tree of wood and Coca-Cola bottle caps, distributing Coca-Cola to young people from the community and transmitting the message “Stay United” in the Mixe language.
Coca-Cola removed the ad from its social media channels, but you can watch a version produced by the Alliance in which Mixe youth comment on the ad. The Alliance also has produced a translation.
On November 6, the New York Times reported that the University of Colorado was returning a million dollar grant that had paid for the Global Energy Balance Network (GEBN), the group funded by Coca-Cola that said you didn’t need to worry about what you ate as long as you were active.
On November 24, AP reporter Candice Choi published e-mails between the U. Colorado scientist behind the GEBN. These revealed that “Coke helped pick the group’s leaders, edited its mission statement and suggested articles and videos for its website.”
On November 29, Helena Bottemiller Evich wrote in Politico how health advocates are running endless campaigns for so taxes, and that these will soon be coming to a polling place near you.
On December 1, the GEBN closed shop as a result of loss of funding.
This week’s issue of The Lancet Diabetes and Endocrinology contains an opinion piece by U North Carolina professor Barry Popkin and Corinna Hawkes of City University London arguing that the world is eating too much sugar and that changes in policy are needed to encourage reduced consumption of sugary drinks. According to Politico Morning Agriculture, the American Beverage Association (ABA) is most unhappy about the piece. It claims that the prevalence of obesity and diabetes are rising but soft drink sales are falling in the U.S., saying “This proves that beverages are not driving these epidemics.” [Comment: as I discuss in Soda Politics, only half the population drinks sugary beverages meaning that those who do drink them drink a lot. Also, diabetes rates are falling in the U.S.]
The ABA won a battle in San Francisco, but is surely losing the public relations war. It sued the city over a Board of Supervisors ban on ads for sugary drinks on city property and requiring warning labels on all billboards and other surfaces within the city. The ABA argued that both laws violate the First Amendment. You might think this argument would get thrown out of court immediately, but you would be wrong, as the Supreme Court is becoming more hostile to such laws. If you want to hear how the Board of Supervisors reacted to this, click here for the meeting transcript. (thanks to Politico Morning Agriculture for this item too and to Michele Simon for clarifying the legal issues).
I keep getting asked “why pick on sodas?” The answer: they are an easy target, low-hanging fruit in public health terms. They contain sugars but nothing else of redeeming nutritional value, are strongly associated with diets that raise the risk of obesity and its consequences, and are heavily marketed as what you need to be happy. The industry is fighting hard and on many fronts to maintain sales. Advocates are keeping its lawyers and lobbyists busy.
All this was just in the last month. Expect more to come.
Use and enjoy the list of media resources—links to videos, audios, songs, movies, infographics, commercials—keyed to illustrate the text.
This book:
Answers the question, how did what is essentially flavored sugar-water come to mean so much and to have such devastating health and food policy consequences?
Is the first to focus on the history, politics, nutrition, and health of soda, integrating public health science with historical and cultural research
Helps readers understand how we created this food system, what its problems are, and what we can do to fix these problems
Is illustrated with 70 figures and 50 tables
Comes with a Foreword by Mark Bittman, food journalist and columnist for The New York Times
Comes with an Afterword by Dr. Neal Baer, pediatrician and television writer and producer
Here are the book’s blurbs:
“The soda industry is a powerful economic operator. Economic power readily translates into political power. Soda Politics is exactly the kind of carefully-researched investigative reporting needed to open the eyes of the public and parliamentarians to the health hazards of what is, as the author rightly notes, essentially liquid candy in a bottle.” –Dr. Margaret Chan, Director-General, World Health Organization
“No book in history has so completely laid bare the soda scourge that touches every corner of the world. Marion Nestle shows how this happened, its impact on human health and well-being, who the players are, and, most importantly, what might be done. This is the right book at the right time.” –Dr. Kelly Brownell, Dean, Sanford School of Public Policy, Duke University
“Marion Nestle is one of the greatest muckrakers of our time, and what she does is vitally important-for our health, our environment, and for future generations. Here, she wages war against the soda titans with such piercing clarity and so many irrefutable truths that all other arguments crumble.” –Alice Waters, Founder and Proprietor of Chez Panisse
“Comprehensive and well-written, this book will help frame a thoughtful public policy debate about nutrition and the societal impacts and costs of obesity.” –Ann M. Veneman, Former US Secretary of Agriculture and Former Executive Director of UNICEF
“What happens when the food industry’s most insightful critic turns her sights on soda? This razor-sharp, fun to read, plan-of-battle for one of the greatest public health fights of our time. Big soda may have all the money, but those who would enter this fray, as we all should, now have their champion.” –Michael Moss, Author of Salt Sugar Fat: How the Food Giants Hooked Us
“For decades, soda companies have amassed fortunes off drinks that are making us sick. It took someone like Marion Nestle to cut through the spin and uncover the high cost of cheap sodas.” –Robert Kenner, Director/Producer, Food Inc. and Merchants of Doubt
“Long recognized as an important and informed voice in our national and international discussions on nutrition and health, Marion Nestle has written another book that will keep us talking. With an impressive combination of scholarship and advocacy, Dr Nestle takes an unflinching look at the soda industry, its products and the impact on health. Soda Politics deserves the attention of the public and policy makers, and should make us all think more carefully about choices we can make to improve health and well-being.”–Margaret Hamburg, M.D., Former Commissioner, U.S. Food and Drug Administration
REVIEWS
Here’s the first review from the August 2015 Library Journal:
Nestle (nutrition, New York Univ.) once again exposes the dark side of the food business. As in her 2007 Food Politics: How the Food Industry Influences Nutrition and Health, the author examines the soft drink industry, demonstrating how products that are basically flavored water with added sugar contribute to obesity, type-2 diabetes, and metabolic syndrome. She discusses the composition and production of soda, the adverse effects of excess sugar consumption, and product marketing. The companies’ targeting of children, low-income, and minority communities; lobbying of Congress to prevent legislation that would impact profits; funding of research to produce results that obscure the facts about soda; and donations to health organizations and charities in order to be portrayed as socially responsible corporations make it difficult for citizens to act. Nestle reveals what can be done and how to do it, providing relevant data, analyzing that information, and illustrating its difficulties. She then advocates for smaller portions, taxing sugary drinks, and excluding soda from the Supplemental Nutrition Assistance Program (SNAP) and provides examples of successful campaigns, a list of groups advocating for healthy beverage choices, and extensive notes. VERDICT An outstanding manual for health educators, activists, and anyone seeking information about the soda industry and its impact on health.— Barbara Bibel, formerly Oakland P.L.
For me, the single most stunning and appalling revelation comes in the section about environmental impact and industry responses to it. It is that between 340 and 620 litres of water are used for every litre of soft drink produced, about 20% of that related to packaging. Despite such disturbing revelations,Soda Politics is not discouraging…Throughout the book, Nestle provides tactics for practical, local advocacy, such as working with school wellness committees and engaging local policymakers. And since 2002, the proportion of US citizens who say that they avoid soft drinks has risen by 20%, reaching nearly two-thirds of the population…For public health to prevail over soda politics as usual, we have miles to go. This book is the richly drawn map of how to get there, from here.
The standard operating practices of companies like Coca-Cola and PepsiCo demand the same level of scrutiny as cigarette companies, and for many of the same reasons, argues Marion Nestle in the introduction of her new book, Soda Politics. What follows is a thorough and unflinching look at the soft-drink industry’s role in promoting the consumption of sugary drinks despite growing evidence that they are detrimental to our health. The book begins with a basic primer of the range of health problems that have been linked to soda consumption, from tooth decay to obesity and diabetes, hitting its stride with an eviscerating assessment of the industry’s marketing and advocacy practices.
For those readers who share Nestle’s critical perspective on the food industry, it is obvious that this book would be informative. But here is the greater surprise: this solid book is by far the best source on this topic for any reader, with any perspective on economics or politics. If I worked for a trade association, or an industry front group, or an esteemed professional association that relies on soda industry funding, or the House Agriculture Committee, or a sugar manufacturer, or a high-powered corporate law firm, I might store this book in my desk drawer rather than my book shelf … yet I would read it word for word.
In Soda Politics (OUP, £19.90), Dr Marion Nestle does us all a great service by spelling out clearly and authoritatively the dreadful price we are paying for guzzling gallons of sugared water – Coke and Pepsi by any other name. Big Soda, as Dr Nestle calls the billion-dollar corporate giants behind this poison, know exactly how bad their products are for us but are so powerful no one takes them on. Rise up and rebel, Nestlé urges.
Nestle writes like an investigator hunting every possible scrap of damning material for a prosecutorial brief, which will no doubt make her book an excellent resource for activists and reformers seeking remedies in Washington, in the courts, and, perhaps, in the aisles of the local supermarket.
Fortunately, so does Marion Nestle. The nutrition professor, advocate and investigator best known for “Food Politics” profiles the soft drink industry in her expansive, superbly researched new book, “Soda Politics: Taking On Big Soda (and Winning).” It isn’t so much a narrative as a well-organized barrage of facts, some eye-popping (the world’s soda companies produce nearly two trillion 12-ounce servings annually), others banally incriminating. They come off the page like jabs in a sustained pummeling lasting more than 400 pages. Even if Nestle is only half right, it’s still a total knockout.
Nestle is foremost an educator and an activist, and Soda Politics is worth its price alone for the chapters on advocacy, from recruiting public health leaders and working from within to protecting public water resources…In other words, we can change things, one Big Gulp at a time.
Sabnavis M. Bitter fizz. Financial Express (India), March 20, 2016: A book that exposes that there’s more ill in a cola bottle than mere sugar—environment costs, high water use and pure politics.
Here is the online version of my commentary in New Scientist, March 14, 2015:24-25.
I submitted an illustration with it, which the editors did not use. It’s from the Ontario Medical Association.
Cigarettes get plain packets – will junk food be next?
The tobacco industry is fighting moves to sell cigarettes in plain packs by claiming food manufacturers will be hit next. Will they?
ANTI-SMOKING advocates will be delighted. MPs have today voted in favour of introducing uniform packaging for cigarettes in the UK. That plain wrappers will undoubtedly further reduce smoking, especially among young people, is best confirmed by the tobacco industry’s vast opposition to this government measure and positive evidence from Australia, the first country to adopt it.
Along with lobbying and appeals to the World Trade Organization, the tobacco industry, when under attack, inevitably wheels out well-worn arguments about the nanny state, personal freedom, lack of scientific substantiation, and losses in jobs and tax revenues.
So to perk up its tired and thoroughly discredited campaign, the tobacco folks have added a new argument. Requiring plain wrappers on cigarettes, they say, is a slippery slope: next will be alcohol, sugary drinks and fast food. This argument immediately raises questions. Is it serious or just a red herring? Should the public health community lobby for plain wrappers to promote healthier food choices, or just dismiss it as another tobacco industry scare tactic?
Let me state from the outset that foods cannot be subject to the same level of regulatory intervention as cigarettes. The public health objective for tobacco is to end its use. So for cigarettes the rationale for plain wrappers is well established. Company logos, attractive images, descriptive statements, package colours and key words all promote purchases. Plain wrappers discourage buying, especially along with other measures such as bans on advertising, smoke-free policies, taxes and health warnings.
Australia’s pioneering law specified precise details of pack design, warning images and statements. The result: cigarette brands all look much alike. Most reports say plain packaging boosts negative perceptions of cigarettes among smokers and increases their desire to quit. Australia expects plain packaging to further reduce its smoking rate, which, at 12.8 per cent, is already among the world’s lowest. Along with the UK, New Zealand and Ireland are well on the way to adding plain packaging to their anti-smoking arsenal. More nations are considering it.
Which is all bad news for the tobacco industry. So it ramps up the slippery slope argument, hoping the food industry will support its fight against plain wrappers. It cites examples such as the regulation of infant formula in South Africa, where pictures of babies on labels are forbidden; that’s a big problem for the Gerber food brand – Gerber’s company logo is a smiling baby.
But those peddling the slippery slope idea ignore the fact that the health message for tobacco is simple: stop smoking. But beyond tobacco, it is more complex. For alcohol it is a little more nuanced: drink moderately, if at all. For food it is much more nuanced. Food is not optional; we must eat to live. Nutritional quality varies widely. Foods are spread across a spectrum from unhealthy to healthy, from soft drinks (no nutrients) to carrots or fish (many nutrients). Most fall somewhere in between. What’s more, an occasional soft drink is fine; daily guzzling is not. So the advice is to choose the healthy and avoid or eat less junk, both in the context of calorie intake and expenditure.
Is there any evidence that plain packaging for unhealthy foods would reduce demand? Research has focused on marketing’s effect on children’s food preferences, demands and consumption. Brands and packages sell foods and drinks, and even very young children recognise and desire popular brands. When researchers compare the responses of children to the same foods wrapped in plain paper or in wrappers with company logos, bright colours or cartoon characters, kids invariably prefer the more exciting packaging.
But the problem is deciding which foods and beverages might call for plain wrappers. For anything but soft drinks and confectionery, the decisions look too vexing. Rather than having to deal with such difficulties, health advocates prefer to focus on interventions that are easier to justify – scientifically and politically.
We know that some regulations and market interventions –analogous to, if not the same as those aimed at smoking cessation – are essential for reducing the damage from harmful products. If not plain packaging, then what? Studies suggest small benefits from a long list of interventions such as taxes, caps on portion size, front-of-package traffic-light labels, nutrition standards for school meals, advertising restrictions, and elimination of toys from fast food meals and cartoons from packaging. Rather than dealing with the impossible politics of plain wrappers on foods, health advocates increasingly favour warning labels.
These first appeared on cigarette packs in the 1960s and have been considered for food products since the early 1990s. Heart disease researchers suggested that foods high in calories and fat should display labels such as: “The fat content of this food may contribute to heart disease.” More recently, health advocates in California and New York proposed warning labels on sugary drinks. The Ontario Medical Association takes a similar view: “To stop the obesity crisis, governments must apply the lessons learned from successful anti-tobacco campaigns.” It has mocked up examples of warnings on foods.
Although no warning label law has passed so far, such messages are the logical next step in promoting healthy food choices, in the same way that plain wrappers are the next logical step for all cigarette packages. Health advocates should recognise the slippery slope argument for the typical tobacco ploy that it is.
