Public opinion on policy interventions for regulating four unhealthy commodity industries: A cross-sectional online survey of a representative sample of British adults 2023

Background
Tobacco, alcohol, unhealthy food and drink, and gambling are all unhealthy commodity industries which have profound public health consequences. The tactics of these industries intending to undermine policies and scientific evidence are often similar. To counter this, greater coherence in regulatory response is needed within, and across, policy spheres. Understanding public opinion is key in this context.

Objectives
This study assessed public support for policies targeting unhealthy commodities and factors associated with support, including sociodemographic features, current smoking, excess alcohol consumption, obesity and daily gambling.

Design
Across-sectional design, where anonymous data was drawn from the annually commissioned Action on Smoking and Health Smokefree British survey conducted online between 22nd February and 15th March 2023.

Participants
12,271 British adults, invited to participate from the online YouGov panel. Weighted by sociodemographic characteristics to be representative of British adults.

Outcome measures
Percentage support for policies to reduce harm from unhealthy commodities; and associations between the level of support, sociodemographic features, and exposure to unhealthy commodities.

Analysis
Missing data were imputed using multiple imputations and data were weighted to match the British population. The degree of public support for policies were descriptively assessed and associations between this support, sociodemographic characteristics and the harmful consumption of unhealthy commodities, were measured using logistic regression.

Main findings
Respondents strongly supported measures targeting industry interactions with government, and the majority believed that public health policy should be protected from industry influence (69.8% for alcohol, 75.6% for gambling, 75.0% for tobacco and 68.2% for unhealthy food and drinks manufacturers). There was also majority support for industry levies (77.1% for tobacco, 74.2% for gambling, 61.9% for alcohol, 59.5% for unhealthy food and drink), however, taxation and advertising bans received more mixed responses. Some sociodemographic factors (age and social grade) and exposure to some unhealthy commodities (current smoking, alcohol intake >14 units per week, daily gambling) were associated with differential levels of support for public health policies. However, sex and obesity did not have meaningful associations.

Conclusion
The public are generally supportive of public health policies to reduce harm from tobacco, alcohol, gambling and unhealthy food and drink.