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"It will sort of drive us to rethink our approach to high fat salt sugar products"- a qualitative analysis of businesses' reactions to the landmark Food (Promotion and Placement) Regulations in England

"It will sort of drive us to rethink our approach to high fat salt sugar products"- a qualitative analysis of businesses' reactions to the landmark Food (Promotion and Placement) Regulations in England
"It will sort of drive us to rethink our approach to high fat salt sugar products"- a qualitative analysis of businesses' reactions to the landmark Food (Promotion and Placement) Regulations in England

Background: retail food environments have largely become settings which promote less healthy foods to their customers. In an effort to prompt healthier choices, the UK Government introduced regulations in October 2022 restricting most retailers in England from promoting products high in fat, sugar, or salt (HFSS) at store entrances, aisle-ends, and checkouts, and their online equivalents. Evidence is needed on how businesses approach compliance and adapt to these regulations. This study used in-depth interviews to examine business responses and generate insights to support effective implementation.

Methods: this cross-sectional qualitative study involved semi-structured interviews with 22 business representatives responsible for interpreting and implementing the regulations. The interviews were conducted via MS Teams/Zoom between August 2021-April 2022, prior to the implementation of regulations. Preparations to implement changes and predicted impact on businesses' promotional practices were examined. Six researchers collected and analysed the data using an inductive thematic approach.

Results: participants' reactions to regulatory compliance varied according to perceived commercial impact and resource availability. While some businesses explored opportunities for healthful promotions and invested in layout changes, a significant proportion planned to comply only to the letter of the law and were testing alternative strategies for unhealthy promotions. Trade bodies played a crucial role in preparations, supporting member businesses to interpret the regulations and fostering a unified approach to compliance. Anticipated barriers to compliance included challenges such as accurately assessing product scores, reformulating products to meet standards, and ensuring consistent store-level adherence within large businesses. To enhance the regulations' impact, participants called for (i) smaller in-scope businesses to receive additional technical support from the government, (ii) manufacturers be required to share detailed nutrient information with retailers or a centralised product nutrient profile repository be established, and (iii) out-of-home businesses be required to comply.

Conclusions: these mandated regulations hold potential to shift food retailers' priorities from solely profit maximisation, to also supporting public health. However further government action is needed to ensure effective compliance for all business types and sizes. A consistent, long-term policy approach aligned with other food policies and informed by industry expertise to optimise implementation could better support obesity reduction.

Commerce/legislation & jurisprudence, Cross-Sectional Studies, Dietary Sugars, England, Health Promotion/legislation & jurisprudence, Humans, Qualitative Research, Qualitative research, Food policy, Less healthy foods and drinks, Retail food environment, Business perspectives, HFSS regulations
1741-7015
Dhuria, Preeti
470c09bf-2b4d-4db6-9100-a6878b4d4d32
Muir, Sarah
019137d3-2f8c-406c-ac6e-2c57ddd6ce32
Shaw, Sarah
9629b12a-8ee2-4483-a9ca-6efb4eef74c8
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8
Roe, Emma
f7579e4e-3721-4046-a2d4-d6395f61c675
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
Vogel, Christina
708e7fda-a6d3-4362-b5f8-69fe2b3e9d7b
Dhuria, Preeti
470c09bf-2b4d-4db6-9100-a6878b4d4d32
Muir, Sarah
019137d3-2f8c-406c-ac6e-2c57ddd6ce32
Shaw, Sarah
9629b12a-8ee2-4483-a9ca-6efb4eef74c8
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8
Roe, Emma
f7579e4e-3721-4046-a2d4-d6395f61c675
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
Vogel, Christina
708e7fda-a6d3-4362-b5f8-69fe2b3e9d7b

Dhuria, Preeti, Muir, Sarah, Shaw, Sarah, Lawrence, Wendy, Roe, Emma, Baird, Janis and Vogel, Christina (2025) "It will sort of drive us to rethink our approach to high fat salt sugar products"- a qualitative analysis of businesses' reactions to the landmark Food (Promotion and Placement) Regulations in England. BMC Medicine, 23 (1), [576]. (doi:10.1186/s12916-025-04384-5).

Record type: Article

Abstract

Background: retail food environments have largely become settings which promote less healthy foods to their customers. In an effort to prompt healthier choices, the UK Government introduced regulations in October 2022 restricting most retailers in England from promoting products high in fat, sugar, or salt (HFSS) at store entrances, aisle-ends, and checkouts, and their online equivalents. Evidence is needed on how businesses approach compliance and adapt to these regulations. This study used in-depth interviews to examine business responses and generate insights to support effective implementation.

Methods: this cross-sectional qualitative study involved semi-structured interviews with 22 business representatives responsible for interpreting and implementing the regulations. The interviews were conducted via MS Teams/Zoom between August 2021-April 2022, prior to the implementation of regulations. Preparations to implement changes and predicted impact on businesses' promotional practices were examined. Six researchers collected and analysed the data using an inductive thematic approach.

Results: participants' reactions to regulatory compliance varied according to perceived commercial impact and resource availability. While some businesses explored opportunities for healthful promotions and invested in layout changes, a significant proportion planned to comply only to the letter of the law and were testing alternative strategies for unhealthy promotions. Trade bodies played a crucial role in preparations, supporting member businesses to interpret the regulations and fostering a unified approach to compliance. Anticipated barriers to compliance included challenges such as accurately assessing product scores, reformulating products to meet standards, and ensuring consistent store-level adherence within large businesses. To enhance the regulations' impact, participants called for (i) smaller in-scope businesses to receive additional technical support from the government, (ii) manufacturers be required to share detailed nutrient information with retailers or a centralised product nutrient profile repository be established, and (iii) out-of-home businesses be required to comply.

Conclusions: these mandated regulations hold potential to shift food retailers' priorities from solely profit maximisation, to also supporting public health. However further government action is needed to ensure effective compliance for all business types and sizes. A consistent, long-term policy approach aligned with other food policies and informed by industry expertise to optimise implementation could better support obesity reduction.

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Accepted/In Press date: 8 September 2025
Published date: 21 October 2025
Keywords: Commerce/legislation & jurisprudence, Cross-Sectional Studies, Dietary Sugars, England, Health Promotion/legislation & jurisprudence, Humans, Qualitative Research, Qualitative research, Food policy, Less healthy foods and drinks, Retail food environment, Business perspectives, HFSS regulations

Identifiers

Local EPrints ID: 507055
URI: http://eprints.soton.ac.uk/id/eprint/507055
ISSN: 1741-7015
PURE UUID: 1790771b-f6b5-4f13-9263-334ca664f295
ORCID for Preeti Dhuria: ORCID iD orcid.org/0000-0003-2803-4424
ORCID for Sarah Muir: ORCID iD orcid.org/0000-0001-7444-7321
ORCID for Sarah Shaw: ORCID iD orcid.org/0000-0002-2206-6858
ORCID for Wendy Lawrence: ORCID iD orcid.org/0000-0003-1264-0438
ORCID for Emma Roe: ORCID iD orcid.org/0000-0003-4674-2133
ORCID for Janis Baird: ORCID iD orcid.org/0000-0002-4039-4361

Catalogue record

Date deposited: 26 Nov 2025 17:33
Last modified: 27 Nov 2025 02:56

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Contributors

Author: Preeti Dhuria ORCID iD
Author: Sarah Muir ORCID iD
Author: Sarah Shaw ORCID iD
Author: Wendy Lawrence ORCID iD
Author: Emma Roe ORCID iD
Author: Janis Baird ORCID iD
Author: Christina Vogel

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