{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:25:47Z","timestamp":1789035947013,"version":"build-2803163510"},"reference-count":39,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000268","name":"BBSRC","doi-asserted-by":"crossref","award":["BB\/V004832\/1"],"award-info":[{"award-number":["BB\/V004832\/1"]}],"id":[{"id":"10.13039\/501100000268","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute for Health and Care Research [Public Health Research Programme","award":["152114"],"award-info":[{"award-number":["152114"]}]},{"name":"National Institute for Health and Care Research Applied Research Collaboration West","award":["Not applicable: NIHR ARC West"],"award-info":[{"award-number":["Not applicable: NIHR ARC West"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,4,1]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In 2021, Bristol (UK) became the first city outside London to introduce a policy restricting advertisements of high fat, salt and sugar (HFSS) products and other unhealthy commodities (alcohol, gambling and payday loans) on council-owned advertisement sites, predominantly bus stops. This research evaluates the impact of this policy on household purchasing of HFSS products specifically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Take-home purchasing data for food and drink items recorded from October 2020 to May 2023 (74 weeks before and 59 weeks after policy implementation) by 1012 households from Kantar\u2019s Worldpanel division were included in the analysis: 217 households from Bristol (intervention) and 795 from Cardiff, Sheffield, Gloucestershire and South Gloucestershire (controls). Controlled interrupted time-series analyses adjusted for confounders were used to estimate the change in average weekly household purchases of energy and nutrients from HFSS products in the post-intervention period (from 1 April 2022) compared with the counterfactual (data from controls and pre-intervention in Bristol).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no indication of changes in purchasing of HFSS products in Bristol following the policy; mean change in weekly household purchases of energy and nutrients from take-home HFSS products was 897.6 kcal (95%\u2009CI \u221257.7 to 1.853) or 6.1% (95% CI \u22120.7 to 12.9) for energy, 4.6% (95% CI \u22122.6 to 11.9) for fat, 6.1% (95% CI \u22122.9 to 15.0) for sugar and \u22121.9% (95% CI \u221217.4 to 13.6) for salt, respectively, compared with the counterfactual. Stratified analyses by household socio-demographics also showed no evidence of changes in energy purchased from HFSS products in Bristol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study did not observe evidence of changes in purchasing of HFSS products following Bristol\u2019s advertising restriction policy. Bristol City Council owns a relatively small part (~30%) of the city\u2019s outdoor advertisement estate, so changes in exposure may have been too small to lead to measurable effects. Extending similar policies to cover more outdoor spaces and advertising platforms is probably required to impact purchasing behaviour.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004137","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:20:31Z","timestamp":1777562431000},"page":"e004137","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating the changes in household purchases of foods and drinks high in fat, salt and sugar following Bristol\u2019s outdoor advertisement restrictions policy: a quasi-experimental study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-6598","authenticated-orcid":false,"given":"Genevieve","family":"Buckland","sequence":"first","affiliation":[{"name":"Centre for Public Health, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Sillero-Rejon","sequence":"additional","affiliation":[{"name":"NIHR Applied Research Collaboration West, Bristol, UK"},{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoi","family":"Toumpakari","sequence":"additional","affiliation":[{"name":"Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russ","family":"Jago","sequence":"additional","affiliation":[{"name":"Centre for Public Health, University of Bristol, Bristol, UK"},{"name":"NIHR ARC West, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Yau","sequence":"additional","affiliation":[{"name":"Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Cummins","sequence":"additional","affiliation":[{"name":"Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Nobles","sequence":"additional","affiliation":[{"name":"Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9385-6307","authenticated-orcid":false,"given":"Sarah Kate","family":"Harding","sequence":"additional","affiliation":[{"name":"NIHR Applied Research Collaboration West, Bristol, UK"},{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7092-4960","authenticated-orcid":false,"given":"Jeremy","family":"Horwood","sequence":"additional","affiliation":[{"name":"NIHR Applied Research Collaboration West, Bristol, UK"},{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Nairn","sequence":"additional","affiliation":[{"name":"Bristol Hub for Gambling Harms Research, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hollingworth","sequence":"additional","affiliation":[{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Blake","sequence":"additional","affiliation":[{"name":"Centre for Research in Health and Social Care, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"de Vocht","sequence":"additional","affiliation":[{"name":"Centre for Public Health, University of Bristol, Bristol, UK"},{"name":"NIHR Applied Research Collaboration West, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"2026043008200896000_4.2.e004137.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2011.00456.x"},{"key":"2026043008200896000_4.2.e004137.2","unstructured":"Nesta . 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