Date Published: December 5, 2018
Publisher: Public Library of Science
Author(s): Christina H. Buckton, Chris Patterson, Lirije Hyseni, S. Vittal Katikireddi, Ffion Lloyd-Williams, Alex Elliott-Green, Simon Capewell, Shona Hilton, Russell J de Souza.
Excess sugar consumption, including sugar-sweetened beverages (SSBs), contributes to a variety of negative health outcomes, particularly for young people. The mass media play a powerful role in influencing public and policy-makers’ perceptions of public health issues and their solutions. We analysed how sugar and SSB policy debates were presented in UK newspapers at a time of heightened awareness and following the announcement of the UK Government’s soft drinks industry levy (SDIL), to inform future public health advocacy.
We carried out quantitative content analysis of articles discussing the issues of sugar and SSB consumption published in 11 national newspapers from April 2015 to November 2016. 684 newspaper articles were analysed using a structured coding frame. Coverage peaked in line with evidence publication, campaigner activities and policy events. Articles predominantly supportive of SSB taxation (23.5%) outnumbered those that were predominantly oppositional (14.2%). However, oppositional articles outnumbered supportive ones in the month of the announcement of the SDIL. Sugar and SSB consumption were presented as health risks, particularly affecting young people, with the actions of industry often identified as the cause of the public health problem. Responsibility for addressing sugar overconsumption was primarily assigned to government intervention.
Our results suggest that the policy landscape favouring fiscal solutions to curb sugar and SSB consumption has benefited from media coverage characterising the issue as an industry-driven problem. Media coverage may drive greater public acceptance of the SDIL and any future taxation of products containing sugar. However, future advocacy efforts should note the surge in opposition coinciding with the announcement of the SDIL, which echoes similar patterns of opposition observed in tobacco control debates.
Excess consumption of sugary foods and sugar-sweetened beverages (SSBs), particularly among children and adolescents, is a major public health concern. Sugar contributes to obesity, which in turn increases the risk factors for type-2 diabetes and other non-communicable diseases such as cardiovascular disease and common cancers [1–4]. Excess sugar consumption is also associated with poor dental health [5, 6]. In 2015, approximately 27% of adults in England were obese and an additional 36% were overweight . Furthermore, 28% of children aged 2–15 years old were either overweight or obese . The consequences of the negative health outcomes relating to obesity cost the NHS over £5 billion per year .
We conducted quantitative newsprint content analysis using a method developed by Hilton and colleagues [23, 28–31] at the University of Glasgow’s Social and Public Health Sciences Unit to facilitate systematic recording of media content to understand framing [25, 26]. Typically, this research method involves: retrieving newspaper articles from a database; manually excluding insufficiently relevant results; constructing a coding frame designed to capture features of each article relevant to the research aims; systematically coding each article; and performing statistical analysis of the coded data. The research design of this study closely followed Elliott-Green and colleagues’  prior content analysis of earlier media representations of SSBs to facilitate comparison of findings.
Newspaper coverage of sugar and SSB consumption, and potential fiscal measures targeted at reducing consumption, has become increasingly high profile. Peaks in coverage coincided with three key policy events: PHE’s report on sugar reduction , evidence of effectiveness of the Mexican sugar tax [14, 15], and the UK Government’s SDIL announcement . Articles were predominantly favourable towards taxation as a solution, particularly around the first two peaks, but there was evidence of a surge in opposition coinciding with the SDIL announcement. Most articles presented sugar as a health concern (76.6%), and the risks were often associated with children (39.9%). The problem of ‘excessive sugar’ consumption was characterised as being driven by the food and drink industry (n = 58.2%) (specifically their production (44.7%) and marketing (24.1%) of ‘unhealthy’, sugary products), and primarily characterised as having governmental solutions (69.2%), though industrial voluntary responsibility was also mentioned frequently (46.5%).