image: Freepik.

com
December 2020

Controls on the marketing of

food and non-alcoholic
beverages to children in Thailand:
legislative options and regulatory design
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
legislative options and regulatory design
3

Acknowledgements

This publication was prepared through the support of the UNICEF Thailand Country Office. Valuable
input was received from colleagues at the Bureau of Nutrition, Department of Health, Thailand, the
International Health Policy Programme and WHO Thailand Office.

Lead Authors:

Kathryn Backholer, Deakin University and Fiona Sing, University of Auckland.

Technical advisory group:

Payao Phonsuk, International Health Policy Programme

Thanapan Suksa-ard, WHO Thailand Office
Fiona Watson, UNICEF East Asia and Pacific Regional Office.

Acronyms

HFSS High in fat, sugar and salt

NCD Non-communicable disease

UNCRC United Nations Convention on the Rights of the Child

UNICEF United Nations Children’s Fund

WHO World Health Organisation

 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
4 legislative options and regulatory design

Table of Contents

Executive summary 6

Part 1: Rationale for strengthening legislation on food

and non-alcoholic beverage marketing in Thailand 10
1.1 Government of Thailand commitments for supporting controls
on marketing of food and non-alcoholic beverages 10

1.2 Non-communicable diseases and childhood overweight in Thailand 12

1.3 Dietary factors and the increase of childhood overweight in Thailand 13

1.4 Influence of food and non-alcoholic beverage marketing

on children’s health 15

1.5 Evidence for HFSS food marketing in Thailand 16

1.6 Existing food and marketing regulation and legislation in Thailand 17

Part 2: Required scope of legislation to protect children from the harmful

impacts of HFSS food marketing 18
2.1 Regulatory approach 18

2.2 Governance 20
Managing external stakeholders 24

2.3 Objectives 24

2.4 Key provisions 25

Definition of children 25
Definition of marketing to children 25
Definition of child-directed marketing 26
Settings, times and media covered by marketing regualtion 27
Settings-based regulation 28
Time-based regulations 31
Medium-based regulations 33
Classification of ‘permitted’ foods 36
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Part 3: Monitoring, evaluation and enforcement of legislation 38

3.1 Monitoring overview 38
3.2 Monitoring for compliance with regulation 40
Standards and indicators 40
Responsible agencies 40
Penalties for non-compliance 42
Communication of monitoring and compliance 42
3.3 Monitoring intended impact of regulation on policy objectives 43
Identification of institution for evaluation of legislation 43
Data collection types and timelines 44
Communication of the evaluation 45

Appendix 1: Thai commitments for supporting action on HFSS food marketing 46

Appendix 2: Existing food and advertising restrictions in Thailand 48

Appendix 3: Thailand’s multi-sectoral working groups for tobacco

and breast milk substitute control 50

References 51
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
6 legislative options and regulatory design

Executive summary

The purpose of this report is to provide background evidence to the Government of Thailand as it
considers the introduction of stronger controls on the marketing of food and non-alcoholic beverages
to children. The report sets out i) the rationale for strengthening legislation ii) the required scope of
legislation and iii) the mechanisms for legislation monitoring, evaluation and enforcement.

Rationale for strengthening legislation

The Government of Thailand has committed to a ban on inappropriate marketing of foods and non-
alcoholic beverages1 high in saturated fats, trans-fatty acids, free sugar and salt (HFSS) (1). This is in
response to rapidly rising rates of overweight and obesity2, particularly among Thai children. Excess
weight is linked to reduced educational achievements, increased risk of non-communicable diseases
(NCDs) and negative impacts on quality of life (2-4). The alarming increase in overweight violates
Thailand’s commitment to the United Nations Convention on the Rights of the Child (UNCRC), ratified
by Thailand in 1992, which states that parties should act appropriately to combat disease and malnutrition,
of which overweight is one form.

The rise in childhood overweight is associated with changes in diet (5). Thailand now ranks highest
among 54 low and middle income countries for adolescent fast food intake (6) and Thai sales of ultra-
processed foods are rapidly increasing (7). Strong evidence shows that children who are exposed to
HFSS food marketing are more likely to desire, request and eat those foods and thereby increase their
total daily energy intake (8-10), leading to excess weight gain and overweight over time. Children are
exposed to high volumes of HFSS food marketing every day as they go about their daily lives, through
various settings, including schools, sports, supermarkets, television and the internet. The amount of

1 Food and non-alcoholic beverage food marketing will be referred to as ‘HFSS food marketing’ from herein.
2 Overweight defined as a Body Mass Index (BMI) between 23.0 and 24.9kg/m2 and obesity of BMI ≥25.0 kg/m2 will be collectively
referred to as overweight.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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television advertisements for HFSS foods across 22 countries was found to be highest for Thailand
(11). In the online environment, marketing by the most popular Thai food and beverage brands (across
confectionery, soft drinks, and chain-restaurant foods) have been found to contravene Government
regulations and industry’s self-regulatory codes of practice (12).

Thailand is a leader in global health (13) with progressive legislation restricting the marketing of tobacco
and breast milk substitutes and a tiered tax on sugar-sweetened beverages. Progress has been made
to restrict food marketing in schools and improve the marketing on food labels. However, to adequately
protect all children from HFSS food marketing and to uphold commitments to the UN Interagency
Taskforce for NCDs in Thailand, controls on HFSS food marketing must be strengthened.

Recommendations for strengthening legislation

The report makes the following recommendations for strengthening legislation to control the marketing
of HFSS foods and non-alcoholic beverages:

1. Adopt mandatory government legislation

Mandatory government legislation is more effective than government-led voluntary regulation or
industry-led codes as shown by strong and consistent independent evaluations assessing the
effectiveness of marketing restrictions globally (14-25).

2. Assign the Ministry of Public Health as the lead government agency

The Ministry of Public Health has a strong mandate from the United Nations Interagency Taskforce
on NCDs to lead a steering group of other relevant government agencies on the design,
implementation and monitoring of the legislation. This aligns with international examples where
the Ministry of Health has been the main implementing government body, along with other
associated health regulatory bodies (26).

3. Set reduction in children’s exposure to HFSS food marketing as the overarching

objective
Setting clear and specific objectives that can be realistically achieved and monitored will help
protect the legislation from legal challenge. It will also help the government to evaluate the
effectiveness of the law against the objectives. Reducing children’s exposure to HFSS food
marketing should be the overarching objective with other outcomes such as reducing purchases
of HFSS food and reducing childhood overweight as secondary outcomes. Once the objectives
are defined, the reach, goal and scope of the legislation can be drafted.

4. Protect all children up to 18 years of age

Children up to 18 years old must be protected from HFSS food marketing in line with the UNCRC.
Younger and older children are exposed to large volumes of HFSS food marketing, which has
shown to increase preference and consumption of targeted products among all children up to 18
years of age (8, 9). Younger children do not have the cognitive ability to interpret the persuasive
intent of marketing (27) and older children are particularly vulnerable to marketing that promotes
products that provide immediate gratification (28, 29).
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
8 legislative options and regulatory design

5. Include all marketing of HFSS foods regardless of target audience

Legislation should cover all marketing that children are exposed to, regardless of the intended
audience or whether it is ‘directed to’ children or not. Children and adults share many of the same
physical spaces, communication platforms and exposure times (11, 30-32). Legislation that is
narrowly focused on marketing that is ‘directed to children’ will not adequately protect children
from all HFSS marketing to which they are exposed (33).

6. Implement comprehensive legislation covering all settings, times and media

channels when children are exposed to marketing of HFSS food and beverages
All marketing strategies including advertising, sponsorship, direct marketing (e.g. mail, text),
product placement and branding, and product packaging should be covered by the legislation.
This can be achieved by applying a settings-based, time-based or media-based approach to
legislation. Evidence from tobacco and breast milk substitute marketing controls shows that when
limited settings or channels are subject to legislation, companies shift their marketing practices
from regulated to unregulated media, which undermines the legislation’s impact (34).

7. Restrict HFSS food marketing in all settings where children are present
These settings-based restrictions should include:

a) Child-centred settings
Child-centred settings include, but are not limited to, schools, early childhood settings, playgrounds,
family and child services, children’s sports sponsorship and cultural activities. Thailand’s Ministry
of Education recently (11 June 2020) announced a Notification to ban marketing of all types for
foods and beverages in educational institutions. It will be important that this is implemented in
full and that regulations are extended to cover the environment around schools and in other
settings where children gather.

b) Public spaces, public transport and public events

Marketing in public spaces, on public transport or at public events (e.g. sponsorship or advertising
at sporting and cultural events) is highly visible to children as they go about their daily lives and,
in most instances, cannot be avoided. Urban areas of Thailand have large volumes of traffic,
supporting a strong outdoor advertising sector. Banning the marketing of HFSS foods in these
spaces will require action on publicly-owned and privately-owned advertising space.

c) Retail environments
Retail marketing strategies influence children’s consumption through ‘pester power’ which
describes children’s relentless requests to parents for marketed food items, and by attracting the
attention of older children and adults thereby increasing unplanned or impulse purchases (35-37).
Key marketing strategies include product displays in prominent locations (e.g. end-of-aisle, check-
out or free-standing displays) and messaging on product packages (36), in addition to price
promotions and free tastings.
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8. Restrict HFSS food marketing across all broadcast media between the hours of
6am and 12am (midnight)
A time-based restriction on the marketing of HFSS foods during the hours that children are viewing
broadcast media, including television, cinema and radio, is important to capture the full exposure
of children to such marketing.

9. Ban HFSS food marketing across non-digital and digital platforms

A whole-of-medium based restriction to HFSS food marketing should be applied to all non-digital
and non-broadcast mediums and all digital media when there are mixed-use audiences. Marketing
through digital media channels needs to include on-line marketing, which involves a large network
of stakeholders (30, 38) and rapid spread of information. Existing mechanisms to protect children
(e.g. on-line age verification) are inherently weak and largely ineffective (39). This is particularly
important as internet usage is increasing year-on-year among Thai children and youth (40).

10. Categorise food and drink as ‘permitted’ or ‘not permitted’ for marketing based
on a robust classification system
The legislation should be underpinned by an objective and easy-to-use system that classifies foods
and beverages as ‘permitted’ (healthy) or ‘not-permitted’ (unhealthy) to be marketed. The Thai
nutrient profile model (41) can be used as a starting point as it has been developed based on
recommendations from the WHO and tested against other international systems. Marketing using
master brand logos, without food items or alongside healthier foods, for brands primarily associated
with HFSS foods (e.g. fast food restaurants) should also be banned as evidence shows this type
of marketing increases HFSS food consumption (42, 43).

11. Monitor and evaluate the legislation using an independent government agency
and robust enforcement mechanisms
Once legislation is implemented, it should be regularly monitored to ensure compliance and to
evaluate its effectiveness against the stated objectives. Monitoring, evaluation and enforcement,
should be coordinated by an independent government agency with other agencies that are free
of conflicts of interest given powers to carry out monitoring and enforcement on that agency’s
behalf. Agencies may include government departments, regional departments for local monitoring
or civil society groups. Strong enforcement mechanisms, such as fines and prohibitions should
be used to ensure compliance.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
10 legislative options and regulatory design

Part 1:
Rationale for strengthening legislation on food
and non-alcoholic beverage marketing in
Thailand

Overview
Part 1 of this report outlines the rationale for protecting children from the harmful
impacts of HFSS food marketing in Thailand. Part 1 is divided into six sections:

1.1 Existing commitments

1.2 NCDs and overweight

1.3 Dietary factors and overweight

1.4 Influence of HFSS marketing

1.5 Evidence for HFSS food marketing

1.6 Existing food and marketing regulation and legislation in Thailand

1.1 Government of Thailand commitments for supporting

controls on marketing of food and non-alcoholic beverages
Thailand’s commitment to banning the inappropriate marketing of HFSS foods is evidenced in the
Government of Thailand’s Framework for Co-operation developed to implement the recommendations
arising from the United Nations Interagency Taskforce on NCDs visit in 2018 (1). Recommendation 4.4
states:
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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‘Ban inappropriate marketing of unhealthy food and beverages to children and

implement the Act on Control of Marketing of Infant and Young Child Food’

To implement recommendation 4.4, the framework states:

‘Draft regulation to ban inappropriate marketing of unhealthy food

and beverages to children be developed.’

This is in addition to many other international resolutions and frameworks that Thailand has signed up
to, which call for marketing restrictions (Appendix 1). These commitments reflect the alarming increases
in overweight and non-communicable diseases (NCDs) in Thailand over the past 10-20 years (44) and
the recognition that HFSS food marketing influences children’s diets in a negative way, leading to
excess weight gain and life-long ill-health (2-4).

Definitions of marketing, HFSS foods, and marketing exposure

and power
Marketing:The WHO defines marketing as ‘any form of commercial communication
of messages that are designed to, or have the effect of, increasing the recognition,
appeal and/or consumption of particular products and services - it comprises
anything that acts to advertise or otherwise promote a product or service’ (45).
This broad definition of marketing is intended to cover the wide breadth of
marketing strategies, including, but not limited to, advertising, sponsorship, direct
marketing (e.g. mail, text), product placement and branding and product packaging.
Although it is not explicitly stated in the WHO Set of Recommendations on the
Marketing of Foods and Non-alcoholic Beverages to Children (46), marketing also
encompasses the promotion of brands (usually the only marketing element for
sponsorship), as brand loyalty awareness is one of the mechanisms through which
marketing increases HFSS food consumption.

HFSS foods and non-alcoholic beverages: Foods and non-alcoholic beverages

considered to be harmful to health due to the high content of saturated fat, trans-
fatty acids, free sugars or salt (often referred to as ‘unhealthy’ foods and beverages).
These are the target foods and beverages for food marketing policies and,
throughout this document, are collectively referred to as HFSS foods.

Marketing exposure and power: The impact of marketing is a function of exposure

and power (45). Exposure refers to the reach (how many people are exposed to
given marketing message or campaign over a specified period) and frequency
(how many times people are exposed). Power refers to the content, design and
execution of the marketing message (e.g. using techniques of cartoon characters
or celebrities, use of competitions or games).
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1.2 Non-communicable diseases and childhood overweight in

Thailand
Overweight and NCDs are rising at alarming rates in Thailand. This is leading to increased early deaths,
illness and is having a profound impact on the economy. NCDs account for 74% of all deaths in Thailand,
with most deaths caused by cardiovascular diseases, cancers, chronic respiratory disease and diabetes
(44). Overweight, a key risk factor driving Thailand’s rapidly rising burden of NCDs, increased sharply
for school-aged children (6-14 years) from 4.9% in 2009 to 13.9% in 2014. Similar increases were
observed for pre-school aged children (1-5 years) rising from 5.6% in 2009 to 11.4% in 2014 (Figure 1)(7).

1-5 years 6-14 years 13.9

11.4

5.7 5.5 5.6

4.9
3.3
2.3

1995 2001 2009 2014

Figure 1: Prevalence of overweight and obesity among Thai children between 1995 and
2014. Source: Wichai Aekplakorn et al. The 5th National Health & Examination Survey 2014:
Child Health. Health System Research Institute, Nonthaburi 2018.

Childhood overweight is associated with reduced educational achievements and negative impacts on
quality of life (2-4). In 2016, conservative estimates of the costs of obesity (BMI≥25m2) in Thailand
were US$0.8-2 billion (0.20-0.37% of Thailand’s Gross Domestic Product) (46). Children who are
overweight are more likely to become overweight adults (47), with lifelong health and economic
consequences. This alarming increase in overweight violates Thailand’s commitment to the UNCRC
(ratified by Thailand in 1992), which states that parties should act appropriately to combat disease and
malnutrition, of which overweight is one form.
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NCDs and obesity as risk factors for COVID-19

Increasing evidence demonstrates that obesity is associated with a higher risk of
COVID-19 complications and hospital admission (48) , intensive care surveillance
(48) and a need for invasive mechanical ventilation (49). Building resilient populations
to the ongoing threat of COVID-19 and other future pandemics will require
prioritisation and implementation of strong comprehensive policies to reduce
population levels of obesity and NCDs.

1.3 Dietary factors and the increase of childhood overweight

in Thailand
Strong evidence indicates that poor diets are the major cause of overweight among children (50).
Excess consumption of HFSS foods combined with inadequate consumption of fruit, vegetables and
whole grains, contribute to one in five deaths globally (51). Dietary risk factors drive excess weight
gain, leading to overweight and obesity and increased risk of NCDs (52). For example, a strong
relationship exists between consumption of a poor diet and premature death (53, 54), diabetes (53-
56), cardiovascular disease (53-56), cancer (53, 54, 56-58), in addition to excess weight gain (53, 56,
59, 60).

Data from Thailand demonstrates a positive relationship between HFSS food consumption and children’s
body weight. A cross-sectional study of 263 children aged 10–12 years from Bangkok Metropolitan
Region found that overweight or obese children were more likely to consume greater quantities of
flavoured milk, sugary drinks, street-side snacks (e.g. light meals, local mixed dishes, or local/Western
fast food sold by street-side vendors and road-side shop) and confectionary compared to normal weight
Thai children (5).

Thailand has undergone a significant nutritional transition over the past 30 years, which has seen a
shift from the consumption of traditional diets with high fibre and low fat content towards Western
diets characterised by HFSS content and convenience (61). Sales of highly processed HFSS foods and
beverages have increased with per capita sales volume of soft (sweet) drinks, savoury and sweet
snacks and breakfast cereals increasing steadily between 2013 and 2019 and are projected to continue
to rise in the near future (7). In 2019, the Thai population purchased an average of 166 litres of soft
drinks (approximately 3 litres, per person, per week including bottled water which is classified as a
soft drink by Euromonitor International) (7). Thailand now ranks among the highest Asian countries
with regard to consumption of processed convenience foods and reliance on ‘ready meals’ (7). Similarly,
a 2020 study ranked Thailand highest among 54 low and middle income countries for adolescent fast
food intake, with an estimated 43% of Thai adolescents consuming fast food 4-7 days per week with
a mean frequency of 4 times per week (6) (Figure 2).

Rapidly changing diets and the steep increase in childhood overweight in Thailand warrants urgent
action. Whilst many factors have contributed to changes in the diet of the Thai population, the high
levels of marketing of HFSS food are a key concern (19).
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
14 legislative options and regulatory design

Figure 2: Frequency of fast-food consumption among adolescents 12-15 years. Source: Li

et al, 2020 (6).
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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1.4 Influence of food and non-alcoholic beverage marketing

on children’s health
Marketing of HFSS foods increases children’s consumption of these products and total energy intake.
HFSS food marketing is ubiquitous around the world (62, 63). Children are constantly exposed to HFSS
food marketing as they go about their daily lives, through various settings, including schools, sports,
supermarkets, television, the internet and many other settings. Sophisticated marketing techniques,
the many and varied communication channels through which marketing is disseminated and the rise
of personalised and targeted marketing through digital platforms means the marketing of HFSS foods
has never been so prominent and influential.

Research evidence consistently demonstrates that exposure to, and the power of, HFSS food marketing
increases consumption of HFSS foods and beverages (8). This occurs by influencing children’s awareness
and preferences for products (9, 10), increasing brand loyalty (28, 30), reinforcing the normalisation of
HFSS food consumption (9, 64, 65) and by undermining food literacy (66). This in turn increases
purchasing of HFSS foods among youth who have independent purchasing power and encourages
younger children to relentlessly request the marketed foods (pester power), which undermines parent’s
desires and intentions to provide their children with healthy nutritious food (67). Evidence also shows
that the increase in HFSS foods that occur shortly after exposure to HFSS marketing (8) is not
compensated for later in the day, which means total daily energy intake is also increased (28). This is
important as excess energy intake ultimately leads to excess weight gain and overweight (58). As
demand for HFSS food increases, market competition increases, and thus the marketing ecosystem
is intensified (Figure 3).

Figure 3: Pathway of effects between HFSS food marketing and weight gain and diet-related
disease. Blue boxes are supported by direct evidence, green boxes by indirect evidence.
All stages of the pathway contradict the UNCRC (ratified by Thailand in 1992) that all children
have the right to enjoy the highest attainable standard of health and that parties should act
appropriately to combat disease and malnutrition.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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1.5 Evidence for HFSS food marketing in Thailand

Evidence from Thailand demonstrates high volumes of HFSS food marketing on television and through
online social media platforms.

A 2014 nationwide audit of food advertising on Free TV including channels 3, 5, 7, MCOT, and Digital
TV including 3 Family, LOCA and MCOT Family), in Thailand found that the majority of food items
advertised were classified as non-core, meaning HFSS foods (11). On average, Free TV aired 2.9 non-
core food advertisements per hour, per channel, with sugary drinks the most commonly advertised
food product (11). For Digital TV, non-core food advertisements were aired on average once per hour,
per channel. The rate of non-core food advertising was higher during weekends compared to weekdays
(11). A later international benchmarking study found that, across 22 countries, there was on average
four times more TV advertisements for HFSS foods or beverages per hour (‘not permitted’ according
to the WHO nutrient profiling system) compared to healthier (‘permitted’) items, and that this rate was
highest for Thailand with 58 advertisements for HFSS foods and beverages for each single advertisement
for a healthier item (63). The most frequently advertised foods in Thailand were beverages (carbonated
soft drinks, mineral water, and flavoured waters), ready-made foods and dishes, chocolate and
confectionary and yoghurts or sour milks.

Although TV has traditionally been the primary means by which children are exposed to food marketing,
increasingly marketing is being complemented by digital mediums. A recent study assessed the
marketing of the most popular food brands with young people in Thailand (covering confectionery, soft
drinks, and chain-restaurant foods) on Facebook. The study found that none of the food and beverage
Facebook brand pages complied with Government of Thailand’s regulations or industry’s self-regulatory
codes of practice (12).
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1.6 Existing food and marketing regulation and legislation in

Thailand
While progress has been made in some areas of HFSS food regulation in Thailand and there is legislation
to control the marketing of other harmful commodities, such as tobacco and breast milk substitutes,
existing policies do not adequately protect all children from HFSS food marketing.

The current legislative environment in Thailand protects younger children and parents from the marketing
of breast milk substitutes, including regulating specific marketing techniques, such as using children
under three in an advertisement. Food marketing in the school setting has also been addressed in the
latest Notification from the Ministry of Education announced in June 2020. Broadcasting is regulated
in some areas, including controls on the frequency and timing of television advertisements, but there
is no specific focus on HFSS food marketing. Product packaging regulations require a Guideline Daily
Amount label to be displayed and warning messages must be present on certain food labels and
television advertisements to inform consumers (e.g. certain foods must display the message “consume
little and exercise for good health”). Foods that contain false claims on their labels or advertisements
are also regulated. Appendix 2 outlines the current regulations in place in Thailand that relate to
advertising laws, restrictions on marketing in school settings, food labels and marketing of breast milk
substitutes and tobacco.

New comprehensive legislation is required to regulate all types of HFSS foods in the same way,
covering all of the relevant marketing media, settings and times - not just schools, labels or television
advertisements featuring children - and to protect children up to 18 years old (see section 2.4 for
further discussion).

The Government of Thailand now has an opportunity to make further investments in the future of their
children’s health and well-being and to uphold their commitments to protect children from the harmful
impacts of HFSS food marketing. The following two sections of this report outlines what a comprehensive
legislative response would look like and how to implement one to remedy the gaps in the current
regulatory environment. All recommendations are supported by good practice legislative examples
from the East Asian and Pacific region, which are supplemented with broader international examples,
where regional examples are lacking.
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Part 2:
Required scope of legislation to protect children
from the harmful impacts of HFSS food marketing

Overview
Part 2 of this report sets out the key points and recommendations for effective
legislation to protect children from the harmful impact of HFSS food marketing
in Thailand. The evidence underpinning each recommendation are presented
together with global examples. Part 2 is divided into four sections:

2.1 Regulatory approach

2.2 Governance

2.3 Objectives

2.4 Key provisions

2.1 Regulatory approach

Recommendation 1: Adopt mandatory government legislation

A mandatory approach, using a government-led legislative response, is required. This will be much
more effective than self-regulatory and government-led voluntary approaches, which have been shown
to be largely ineffective at reducing the exposure of HFSS food marketing to children (48-59).
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Definitions of regulatory mechanisms

To date, governments internationally have used a variety of regulatory mechanisms
to restrict HFSS food marketing to children. They fall into three categories:

Self-regulatory approach: A collection of food and beverage companies commit

themselves to restrict marketing of unhealthy products to children by setting their
own guidelines or targets, independent of government.

Government-approved voluntary approach: Government provides guidelines on

how companies can regulate their marketing practices and companies decide
whether to comply with guidelines or not.

Mandatory approach: Legislation is passed by government to establish the general

legal framework of principles to which the relevant stakeholders are required to
adhere to, including regulations. A robust legal framework would also include
enforcement mechanisms to ensure compliance.

Effectiveness of different regulatory mechanisms

Strong and consistent independent evaluations assessing the effectiveness of HFSS marketing
restrictions globally have shown that mandatory approaches are more effective than government-led
voluntary or industry-led regulation (14-25). For example, research in Australia found that the frequency
of food advertising and children’s exposure to HFSS food marketing remained unchanged despite the
implementation of industry self-regulatory pledges (20, 68). Similar results were found in Canada (22),
Germany (18), Spain (14), and the US (19). This contrasts with countries that have implemented
mandatory restrictions, such as South Korea and Chile. Research from South Korea found that the
volume of HFSS food advertising reduced after the introduction of the Special Act on Safety Management
of Children’s Dietary Life (69). Research from Chile shows that a comprehensive mandatory marketing
restriction can reduce the exposure of HFSS food marketing to children, with significant decreases
found in exposure to HFSS food advertising on TV and a reduction in child-directed marketing strategies
on breakfast cereal packages post implementation of the statutory marketing regulation (33, 70).

A mandatory approach, using a government-led legislative response, is also required for a number of
reasons. The Government of Thailand is accountable for upholding international and human rights law
(such as the UN Convention on the Rights of the Child) and is required to implement national laws to
uphold these international legal obligations. Therefore, it is the Government, not the private sector,
that must design and implement marketing restrictions, as industry stakeholders are not accountable
under international and human rights law (30, 71, 72).

Mandatory marketing restrictions can be accompanied with enforcement provisions such as fines.
Voluntary regulation or self-regulation do not have the same level of enforcement and are therefore
much less of a deterrent. Where there is little or no risk of (financial) sanction, a business may decide
it is in its interests not to follow the self-regulation (72).
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Mandatory regulation creates a level playing field for businesses, where compliance is not left to the
voluntary commitment of industry. This removes any possibility of a company attempting to gain market
advantage through non-compliance (an option under voluntary or self-regulation) (30, 72).

Internationally, self-regulatory measures and industry pledges are not aligned with the WHO Set of
Recommendations (they do not cover the breadth of marketing practices or adequately limit the
exposure and power of HFSS advertising). Government-led mandatory mechanisms are more likely,
if designed comprehensively, to ensure that the WHO Set of Recommendations are implemented
(72).

2.2 Governance
Recommendation 2:
Assign the Ministry of Public Health as the lead government agency

In Thailand, there is a strong mandate for the Ministry of Public Health to carry out the recommendations
of the United Nations Interagency Taskforce on NCDs and fulfil the commitments made in the Framework
for Co-operation. From the wording of Recommendation 4.4 in the Framework for Co-operation, a ban
on inappropriate marketing of HFSS food and beverages to children must be introduced. This is a strong
starting point to consider what legislative framing is needed and what legislative objectives will fulfil
this recommendation.

In other countries, the Ministry responsible for health has primarily been the main implementing
government body, along with other associated health regulatory bodies, because the policy objectives
have been health related. When other government departments have led policy development and
implementation, these regulations have narrowed in scope. For example, broadcast legislation is often
led by broadcast authorities, but this does not cover the full range of marketing of HFSS foods. A wider
legislative framing is needed, which requires an implementing body that can cover the full breadth of
marketing restrictions. This needs to cover retail settings, online media, brand advertising, outdoor
advertising and sponsorship as part of the law, not just the traditional broadcast channels.

Table 1 outlines country examples of the legislative framing used, the lead government agencies, and
legislative objectives.
Table 1: Country examples of legislation titles, lead government agencies and legislative objectives

Lead government agencies Legislative objectives

Chile Law of Nutritional Composition of Food and Ministry of Health 1. Child protection
its Advertising (Ley 20.606) (Food Labelling 2. Promoting informed selection of food
and Advertising Law) (69) 3. Decreasing food consumption with excessive amounts of critical nutrients
Ireland The Children’s Commercial Communications Broadcasting Authority of Ireland 1. To offer protection for children from inappropriate and/or harmful
Code commercial communications
Department of Health 2. To acknowledge the special susceptibilities of children and ensure that
Non-Broadcast Media Advertising and commercial communications do not exploit these susceptibilities
Marketing of Food and Non-Alcoholic 3. To ensure that commercial communications are fair and present the
Beverages, including Sponsorship and Retail product or service promoted in a way that is easily interpreted by children
Product Placement: Voluntary Codes of and does not raise unrealistic expectations of the capabilities or
Practice characteristics of the product or service being promoted
4. To provide unambiguous guidelines to broadcasters, advertisers, parents,
guardians and children on the standards they can expect from commercial
communications on Irish broadcasting services
UK Advertising restrictions on TV and online Department of Health and Social 1. Reducing children’s exposure to HFSS advertising, to reduce children’s
for products high in fat, sugar and salt (HFSS) Care and Department for Digital, overconsumption of these products
(proposed legislation) Culture, Media and Sports 2. Drive reformulation of products by brands
3. Restrictions would be proportionate and targeted to the products of
Restricting promotions of food and drink Department of Health and Social most concern to childhood obesity, and limit the advertising children
that is high in fat, sugar and salt (proposed Care see
legislation) 4. Easily understood by parents, so that they can be supported in making
healthy choices for their families
South Korea The Special Act on the Safety Management Minister of Food and Drug Safety, To promote children’s health by prescribing matters necessary for supplying
of Children’s Dietary Life Republic of Korea safe and nutritionally balanced foods to equip children with healthy eating
habits
Taiwan Regulations Governing Advertisement and Ministry of Health and Welfare Aims to protect children from unhealthy food and carry out balanced diets
Promotion of Food Products Not Suitable for them
for Long-term Consumption by Children Taiwan Food and Drug Administration
legislative options and regulatory design
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
22 legislative options and regulatory design

The Thailand Framework of Co-operation addressing the United Nations Interagency Taskforce
recommendations identified the Ministry of Public Health supported by the Ministry of the Interior,
the Office of the National Broadcasting and Telecommunications Commission and the Ministry of
Digital Economy and Society as the responsible Government agencies for drafting the marketing
regulations related to HFSS foods and non-alcoholic beverages.

Table 2: Government agencies and areas of responsibility in Thailand

Government agency Area of responsibility

Food and Drug Administration • Food labelling and packaging

• Food marketing (age limit of presenter)
• Retail advertising
Department of Health, Ministry of Public health • Nutrient or food classification
Office of The National Broadcasting and Telecommunications • Broadcast media (time and content)
Commission
Ministry of Education • Marketing in schools
Ministry of Social Development and Human Security • Child Rights
Office of the Consumer Protection Board • Consumer affairs/Consumer protection
Ministry of Interior • Local Government
• Town and City Planning
• Settings where children gather (public parks, playgrounds, etc.)
• Control of food marketing of contests or sweepstakes
Ministry of Transport • Transport (including public transport)
Ministry of Finance • Taxation (SSB, Salt)
Ministry of Commerce • Trade
• Price
Ministry of Digital Economy and Society • Digital marketing (including brand advertising)
Ministry of Tourism and Sports • Sport sponsorship
National NCD Steering Committees • Establish policy and implementation framework for the
5 -year national NCD prevention and control 2017-2021

Note: Areas of responsibility in italic letters means that this area of regulation does not yet exist in Thailand but should be under the
responsibility of the selected government agency.

While the Department of Health, Ministry of Public Health, can lead the legislative process, a steering
group of relevant government agencies should be set up to guide the design, implementation and
monitoring of the regulation, where relevant.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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Other potential government agencies may include:

• Office of Consumer Protection Board
• Food and Drug Administration
• Ministry of Social Development and Human Security
• Ministry of Education
• Department of Children and Youth
• Department of Health Services Support
• Department of Local Administration
• National Health Commission of Thailand

To aid the decision of which government agencies need to be involved in the working group it would
be useful to consider what government agency is responsible for the following areas that are relevant
to the comprehensive legislative response outlined in this report (73):

Ensuring the relevant government departments are engaged with the legislative design will ensure
the most effective legislative approach is developed and will also increase political buy in and increase
the chances of successful implementation. See Appendix 3 for an example of the types of multi-
sectoral steering groups that have been set up by the Government of Thailand in relation to the control
of tobacco and breast milk substitutes.

Other countries have created agreements between Ministries or agencies who need to partner on
implementation and enforcement – such as broadcast agencies and the Ministries of Education. See
Table 3 for a case example from Chile outlining which Government departments and agencies were
involved throughout the legislative process for the Chilean Food Labelling and Advertising Law.

Table 3: Chile Case Study: who was in charge of different aspects of the legislative process

Steps Chile

Scientific evidence gathering Nutrition Department of the Ministry of Health with an

academic institution and experts
Draft legislation Nutrition Department of the Ministry of Health
Consultation with stakeholders Nutrition Department of the Ministry of Health
Implementation Nutrition Department of the Ministry of Health and Regional
Ministry of Health Offices
Monitor Ministry of Health regional departments and inter-sectoral
network formed of representative from government, academia,
NGOs, consumer associations, food marketing institutions
and consumers’ rights organisations.
School settings: Ministry of Health entered into an agreement
with Ministry of Education by asking inspectors of the
Superintendents of Education to monitor food offered within
schools when carrying out their usual tasks
Broadcast: Ministry of Health entered into an agreement
with Television National Council to monitor broadcast
Enforcement Ministry of Health and Regional Ministry of Health Offices
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
24 legislative options and regulatory design

Managing external stakeholders

When designing legislation, the government needs to consider the principles of inclusiveness and
participation (two core principles of good governance) by consulting with the public and impacted third
party stakeholders. It is also important to include mechanisms to shield this process from commercial
interests that conflict with the legislation’s purpose – for example, the food and beverage industry
who will be financially negatively impacted by such regulations. In other countries, those industries
with conflicts of interest have challenged proposed marketing restrictions to prevent their businesses
from being regulated by arguing the law is not necessary, or that self-regulation is effective, or that
there is not enough evidence to support the legislation, amongst other things (71). Such conflicts of
interest may cause delay or undermine the legislation’s impact, especially its scope and potential
effectiveness.

Existing tools to help protect policymaking from commercial interference or conflicts of interest are
available from the WHO (74). This includes a recommendation for an initial mapping of stakeholders
and interests in the policy area, followed by a clear and transparent guidance on who can participate
in the policy development process, mechanisms for disclosing interactions with an actual, perceived,
or potential conflict of interest, and methods for managing these conflicts of interest. For example,
during the development of its marketing restrictions, Canada adopted an openness and transparency
policy, which meant that a copy of all communications received or meeting minutes held with external
parties about the policy were published online (75).

2.3 Objectives
Recommendation 3: Set reduction in children’s exposure to HFSS
food marketing as the overarching objective

Effective implementation starts with setting clear objectives about what the marketing restrictions
will achieve and how the restriction will operate. The WHO advises that an effective marketing regulation
should have a stated objective of reducing children’s exposure to, and the persuasive power of,
marketing of HFSS food to provide an important standard to measure the performance of the system
(76-78). Regulatory systems are weaker if underpinned by vague objectives that are not aligned with
reducing exposure and power of marketing practices (76).

Other objectives should be chosen from the short-term and intermediate outcomes on the pathway
of effects between HFSS food marketing and human health (Figure 3). For example, another strong
objective would be to reduce the purchase or consumption of HFSS foods. Because a strong international
evidence base underpins this pathway of effect, the Government of Thailand can rely on this evidence
base to demonstrate the need for the legislation. This will help protect the legislation against industry
challenge, who typically argue that marketing restrictions are more restrictive than necessary or that
there is not enough evidence to support the introduction of regulation and self-regulation is effective
enough (71).

Longer term objectives can be identified by the Government of Thailand (for example, ‘to prevent
NCDs’), but only if short- and/or medium-term outcomes have been defined. This is because it is
difficult, and takes longer, to show how the legislation will meet long-term objectives without addressing
the short and intermediate effects the policy will have. Once the objectives are defined, the reach,
goal and scope of the legislation can be drawn up based on existing recommendations and evidence.
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2.4 Key provisions

Recommendation 4 of the WHO’s Set of Recommendations states that clear definitions for key terms
and conditions are essential for successful and uniform policy implementation (45). This section sets
out these terms and conditions, with evidence to support each recommendation. In summary, a robust
regulatory system that effectively restricts exposure and power of marketing to children would address
the following key components:
• Use a definition of children that protects children up to 18 years.
• Accurately capture the full extent of marketing that children are exposed to, regardless of the
intended audience, in the scope of the regulation by using time- setting- and medium-based
restrictions on HFSS food marketing (without defining a prescriptive list that could be interpreted
as exhaustive).
• Use a robust, objective and easy-to-use system to define which food and beverages are permitted
and not permitted under the regulatory framework (ensuring that brand marketing is also
considered).

Definition of children

Recommendation 4: Protect all children up to 18 years of age.

The definition of children should align with the UNCRC where a child is defined as every human being
below the age of 18 years unless, under the law applicable to the child, majority is attained earlier (79).
In Ireland, South Korea and the UK the definition of children under marketing regulations are up to 18
years. This definition aligns with scientific evidence. HFSS food marketing increases preference and
consumption of targeted products and brands among younger and older children (up to 18 years) (9).
Young children (<13 years of age) do not have the cognitive ability to interpret the persuasive intent
of marketing (27). Adolescents (aged 13-18 years) are reward driven, impulsive, strongly influenced
by their peers and are particularly vulnerable to marketing that promotes products that provide immediate
gratification (28, 29). Adolescents of this age have their own purchasing power and purchase and
consume high volumes of HFSS foods and drinks (80, 81).

Definition of marketing to children

Recommendation 5:
Include all marketing of HFSS foods regardless of target audience

Regulatory scope should cover all marketing that children are exposed to, regardless of the intended
audience and/or whether it is ‘directed to’ children or not.

Children and adults share many of the same physical spaces, communication platforms and exposure
times (11, 30-32). As the age of children increases up to 18 years, audiences become increasingly
mixed with adults and marketing that is ‘directed to children’ becomes increasingly difficult to define.

Legislation that is narrowly focused on marketing that is ‘directed to children’ can be difficult to enforce
and is therefore less effective due to the complexities with different interpretations of the intended
audience. For example, in 2016 Chile implemented the Food Labelling and Advertising Law, which
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26 legislative options and regulatory design

included a ban on advertising for foods and beverages high in sugars, fats and sodium on television
programs considered to be i) ‘child-targeted’, ii) where >20% of the audience consists of children aged
<14 years and iii) where advertising appeals to children by including characters, toys or other strategies
considered to be ‘directed to children’ (82). Analysis of the impact of this law on television advertising
revealed that, whilst the legislation resulted in a significant reduction in children’s exposure to television
advertising for foods and beverages high in sugars, fats and sodium, it did not eliminate it (33). The
legislation was updated in June 2018 to a time-based restriction, where all HFSS food advertising is
banned on television programs between the hours of 6am and 10pm. Similar deviations of industry
interpretation of ‘child-directed’ marketing with intended regulatory definitions has been noted across
marketing mediums and countries (83, 84).

Legislation that focuses on children’s exposure to HFSS food marketing, rather than marketing that is
‘directed to children’, circumvents potential legal challenges by the food industry contesting what is
and what is not ‘directed to children’.

Children’s exposure to HFSS food marketing consists of the communication mediums, settings and
times whereby a large number of children are exposed.

Country examples of regulation that cover children’s exposure

to unhealthy food marketing
Chile (2018 update): Time-based restriction on television programming aired
between 6am and 10pm. Outside of these hours child-directed marketing of HFSS
food is prohibited.

United Kingdom (Proposed): Television and internet 9pm watershed.

Definition of child-directed marketing

When the requirement arises, marketing that is directed to children, should include any marketing
technique that has appeal to children, including through the use of images, sounds or language designed
to appeal to children such as characters or celebrities (licensed or unlicensed), children actors or voices,
references to school or play, toys or book give-aways, competitions or promotional giveaways or other
child-directed appeals. This definition should be upheld even if the intended audience is adults and/or
if the content also appeals to adults. Marketing that occurs in settings where children gather (e.g.
schools, sports etc) and that is given or sent directly to a child (e.g. through email, sms, app notification)
is also considered to be directed to children. ‘Child-directed’ marketing prohibitions should be used
outside of time-based, settings-based and medium-based restrictions and for food and beverage
package marketing, where the content of the marketing is specifically directed to children.
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Settings, times and media covered by marketing regulation

Recommendation 6: Implement comprehensive legislation covering

all settings, times and media channels where children are exposed to
marketing of HFSS food and beverages

The WHO Set of Recommendations state that a comprehensive approach to regulation is required to
adequately reduce the power and exposure of HFSS food marketing to children. International evidence
shows that HFSS food marketing is highly prevalent and found across a wide range of settings and
communications channels (85), which influences food choice and consumption across the life-course
(9). In addition, evidence from tobacco and breast milk substitute marketing controls shows that when
limited settings or channels are considered in HFSS food marketing restrictions, industry shifts their
marketing spend from regulated to unregulated mediums (34).

Whilst Thailand has some marketing regulations in place, these do not adequately cover the full range
of settings and communication channels required to protect children from the harmful impacts of HFSS
food marketing (see section 1.5). It is recommended that the Government of Thailand develop overarching
governing legislation that sets the policy objectives and covers the full range of settings and communication
channels such as in the Chile Food Labelling and Advertising Law.

To adequately and effectively capture the full range of communication channels and settings, different
types of design approaches are required within the regulation. These design approaches can be
categorised into settings-based, time-based or medium-based restrictions. The box below defines each
design approach and gives examples of the different types of marketing communication channels that
fall under each. The report then goes on to detail these design approaches for all these settings and
communication channels listed. A secondary, broad-based ban on all ‘child-directed’ HFSS food marketing
across all marketing platforms should also be included to cover all marketing communication channels
that do not easily fall into one of these three design approaches.

Definitions for settings-based, time-based and medium-based restrictions

Settings-based restrictions: total ban Time-based restrictions: total ban on Medium-based restrictions: total ban
on HFSS marketing in specific venues HFSS marketing between pre-specified on HFSS marketing disseminated through
and locations times specified mediums
• Child-centred settings (schools, child • All broadcast media including • Non-digital, non-broadcast media
services, playgrounds, children’s television, cinemas and radio with mixed-use audiences
sports, etc) • Digital media including online
• Public spaces, public transport and environments
public events
• Retail environments
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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Regulation should be comprehensive in that it should cover a wide range of marketing types and
mediums, but it should have some flexibility in the legislation drafting to allow for additional marketing
techniques to be covered (86). For example, regulatory frameworks should account for marketing drift
– the changing and evolving nature of marketing practices over time – to ensure the capture of new
technologies, techniques and communication channels through which children are exposed to HFSS
food marketing.

If a stepped-approach is required (i.e. the broad range of marketing types and mediums cannot be
legislated all at once), it is recommended that the initial focus be on settings where children gather,
such as in schools and during sports, and broadcast channels (building on existing legislation and
notifications) (77). Plans should be put in place to broaden the legislative scope soon after. However,
it should be recognised that a stepwise approach will create gaps in the regulation and, in countries
where this approach has been used, industry has been found to refocus their marketing spend on
non-regulated areas, with an overall increase in marketing activity (73, 86). The broad scope of legislation
in Chile has been cited as a key enabler to regulatory progress (87).

Country examples of comprehensive coverage of marketing

regulation
Chile (2016): HFSS food marketing restrictions cover the use of child-directed
marketing techniques across any communication channel and the advertisement
of these products on children’s television programs and websites which includes
time-based broadcast restrictions.

Quebec, Canada (1980, updated 2012): Under the Consumer Protection Act, it is
prohibited to market any commercial product, not only foods, that is intended to
appeal directly to children, to attract children’s attention and/or where the placement
or timing are such that >15% of the audience is made up of children.

Settings-based regulation

Recommendation 7: Restrict all HFSS food marketing in all settings

where children are present (child-centred settings, public spaces and
retail environments)

A settings-based regulatory approach should be used in all child-centred settings, public places and
retail environments

a) Child-centred settings
Recommendation 5 of the WHO’s Set of Recommendations states that settings where children gather
should be free from all forms of HFSS food marketing (45). Further, in the 2016 WHO Report of the
Commission on Ending Childhood Obesity, it was stated that “settings where children and adolescents
gather and the screen-based offerings they watch, should be free of marketing of unhealthy foods and
sugar-sweetened beverages” (78).
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Children’s settings include, but are not limited to, schools, early childhood settings, playgrounds, family
and child services, children’s sports including through sponsorship and through cultural activities.
Thailand’s Ministry of Education recently (11 June 2020) announced a Notification to ban promotion
activities for all foods and beverages in educational institutions. It will be important that this is
implemented in full and that regulations are extended to cover the environment around schools and
in other settings where children gather.

Country example of regulations in settings where children gather

India (2020): Foods and beverages high in saturated fat or trans-fat or added sugar
or sodium cannot be marketed on a school campus or to school children in an
area within 50 meters from the school gate in any direction.

Ireland (2018): Generally, for the voluntary code of practice, locations primarily
used by children should be free from all forms of marketing communication for
foods high in fat, salt and sugar. Examples of such settings include registered
crèches, pre-schools, nurseries, family and child clinics, paediatric services, schools,
dedicated school transport, playgrounds and youth centres.

Hungary (2008): All advertising (not just food related) directed at children (<18
years) is prohibited in child welfare and child protection institutions, kindergartens,
elementary schools and their dormitories.

b) Public spaces, public transport and public events

Urban areas of Thailand have large volumes of traffic, supporting a strong outdoor advertising sector.
This includes billboards reaching up to 100m in length in static or digital formats. Across Thailand,
adverting is also considered a key revenue generator for public transport operators and mass transit
system stations are often flooded with advertisements. Marketing in public spaces, at public events
(e.g. sporting sponsorship or sponsorship and advertising at cultural events) and on public transport
is highly visible to children as they go about their daily lives and, in most instances, cannot be avoided.

Whilst much of the HFSS advertising in Thailand is on privately owned property, HFSS food advertising
on publicly owned land or assets is under the control of the Government of Thailand and its presence
undermines the public and preventive health priorities of the Government. London and Brazil are two
jurisdictions that have implemented a ban specifically on publicly owned assets. Outdoor HFSS food
advertising restrictions are also inherently captured in other broad-based laws, including the Chilean
Labelling and Advertising Law and as part of the consumer protection legislation that several countries
have in place, but these are limited to restrictions on food advertising that is considered to be child-
directed, and do not cover the full extent of HFSS food marketing that children are exposed to in these
settings.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
30 legislative options and regulatory design

Country examples of regulation in outdoor spaces or on public

assets
London (2019): Advertising that promotes (directly or indirectly) food or non-
alcoholic drink which is high in fat, salt and/or sugar (‘HFSS’ products) is banned
on all publicly owned advertising estate, including on the underground, rail, buses,
overground, light railway and roads. Brands can only be included if the advertisement
promotes healthy products as the basis of the advertisement.

Brazil (2016): Advertisements and sales promotions of ultra-processed food products

are banned on the premises of the Ministry of Health and its entities.

c) Retail environments
Food retail outlets, formal and informal, are the settings where food is obtained for consumption
immediately or for storage and later consumption. Children are exposed to these settings whilst
shopping with a carer or when purchasing food for themselves.

The key retail marketing strategies that have been found to influence children include product displays
in prominent locations (e.g. end-of-aisle, check-out or free-standing displays) and messaging on product
packages (36), in addition to price promotions and free tastings. Numerous studies indicate that these
retail marketing strategies can influence children’s consumption through ‘pester power’ which is
defined as children’s relentless requests to parents or carers for marketed food items, and by attracting
the attention of older children or adults, and increasing unplanned or impulse purchases (35-37). It is
therefore recommended that in retail settings, a ban should be placed on the placement or authorisation
of placement of HFSS food products below a height of 1 metre from the floor (e.g. young children’s
eye level), within 2 metres from the point of sale (e.g. at check-outs) or in any other manner that is
likely to appeal to children. The advertising of HFSS food products and brands should also be prohibited
in these areas.

Product packaging for HFSS food products should also be free from any form of marketing that is
directed to children (see above for definition of ‘directed to children’). Product packaging can be defined
as the wrapping or box that foods and beverages are contained within for retail sale. Because purchasing
decisions at point-of-sale are made fast and without a great deal of cognitive processing, the appeal
of product packaging has been shown to influence purchases, particularly when the product is purchased
for children (88, 89). For example, the presence of a character on food packaging has been shown to
significantly increase requests for that item and results in more favourable taste and snack preferences
(90, 91).
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Country examples of regulating food packaging

Chile (2016): Tony theTiger, a significant Kellogg’s
brand identity, was removed by Chilean marketing
restrictions that ban techniques and incentives
that could attract the attention of children, such
as cartoons, animations and toys.

UK (proposed): The UK government has committed

to legislative ban on unhealthy food price
promotions. Specifically, this includes a restriction
on multi-buys (buy-one-get-one-free), sale of
unhealthy foods at check-outs and at shop
entrances and on the sale of unlimited refills of
unhealthy foods and beverages in places where
they are sold to the public.

Time-based regulations
As large numbers of Thai children are watching television at times outside of hours when ‘children’s
programs’ are aired (92), a ban on all HFSS food advertising between the hours of 6am and 12am
midnight is recommended to adequately protect Thai children from exposure to HFSS food marketing
on television. This time-based recommendation should be extended to all broadcast media (cinema
and radio) for consistency. This watershed approach has been implemented in Chile and is currently
proposed in the UK (see country example).

According to the 2008 Thai Mass Media Survey (92), approximately 3.4 million (41%) Thai children
aged 6-14 years watched television on weekdays between 8pm-12am midnight and almost 1.7 million
(20%) Thai children watched television on weekend evenings between 8pm-12am midnight (Figure 4).
These data should be updated to better understand children’s TV consumption between the hours of
8pm and 12am midnight to better inform the upper time limit of the regulation. Children are exposed
to television from a young age. Results from the Prospective Cohort Study of Thai Children (260 children
and parents recruited between 2000 and 2002), revealed that almost all Thai children watched television
at the age of 6 months (98.0%), 12 months (95.3%) and 2 years (96.7%) (93).
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
32 legislative options and regulatory design

Figure 4: Proportion of Thai Children (6-14 years) reporting television viewing. Source: 2008
reported television viewing time data from the National Statistical Office, Ministry of
Information and Communication technology and single year population counts from 2010
Census data.

Free-to-air and digital television are key platforms through which HFSS food marketing is disseminated.
A 2014 nationwide audit of HFSS food advertising on Free TV (channels 3, 5, 7, MCOT between 6-10am
and 3-8pm on weekends and 3-8pm on weekdays) and Digital TV (3 Family, LOCA and MCOT Family)
in Thailand found that the majority of food items advertised were non-core HFSS items (11). On average,
Free TV aired 2.9 non-core food advertisements per hour, per channel, with sugary drinks the most
commonly advertised food product (11). For Digital TV, non-core food advertisements were aired on
average once per hour, per channel. The rate of non-core food advertising was higher during weekends
compared to weekdays (11).
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Country examples for regulation restricting HFSS food marketing

on broadcast mediums
UK (proposed): Statutory ban on all foods and beverages considered to be high
in fat, salt or sugar between the hours of 5.30am and 9pm.

Chile (2018 update): Statutory ban on all HFSS food advertising on television
between 6am and 10pm. Outside of these hours, HFSS food advertising is not
permitted on devoted children’s channels, during programs targeting children, or
when children make up >20% of the audience.

Taiwan: Statutory ban on television advertising of foods high in sodium (per

serving) and high in calories from fats, saturated fats or free sugar (%) on children’s
channels from 5pm and 9pm.

South Korea: Statutory ban on advertising foods high in calories, total sugar,
saturated fat and sodium of children’s preferred foods (thresholds defined by
Korean Food and Drug Administration) before, during and after programs aired
5pm-7pm and during children’s programming.

Medium-based regulations
Recommendation 9:
Ban HFSS food marketing across non-digital and digital platforms

A medium-based restriction for HFSS food marketing should be applied to any non-digital, non-broad-
cast mediums, including print publications, direct mail and unsolicited documents, if it is a mixed-use
medium, and to all digital media channels. For non-mixed-use media (i.e. a medium used almost
exclusively by adults) then all HFSS marketing that is directed to children or designed to appeal to
children should be banned.

Focused attention is now being given to HFSS food marketing on digital mediums. Restriction of digital
marketing will ensure that all marketing to which children are exposed is captured within the regulation.
This includes exposure on internet sites, social media platforms, apps and other digital communication
channels that children use, regardless of whether they are the intended audience or not (see country
example for a comprehensive digital media ban on alcohol advertising in Finland).
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34 legislative options and regulatory design

Figure 5: Percentage of the Thai population aged 6+ who used the internet in 2014-2018,
by age group. Source: 2018 household survey on the use of information and communication
technology

Online marketing differs from traditional marketing – it is more targeted and personalised, highly
engaging and can be virally spread, exposing large volumes of children to marketing content in a very
short period. The mechanisms by which online marketing is produced and disseminated is extremely
complex, involving a large network of stakeholders (including users) (30, 38). The audience across
online platforms are highly mixed with regard to age, and online age verification by companies and
platforms are inherently weak and largely ineffective (39). Regulations must reflect this unique online
marketing environment. Internet and social media use is prevalent across all age groups in Thailand
(Figure 5 and 6).

Internet usage is high and increasing year-on-year among Thai children. Approximately 80% of Thai
children aged 6-19 years used the internet in 2018 (40). The majority of young people in Thailand used
the internet 5-7 days per week (58.5% of children aged 6-14 years and 87.4% youth aged 15-24 years).
Among the population aged 6 and over, 39.7% use the internet for approximately 2-4 hours per day
with 30.5% using it for 1-2 hours per day (40). In 2018, 18% of children aged 6-9-years and 65% of
10-14-years reported engaging with social media platforms in Thailand (Figure 6), despite an age
verification of 13 years required for most social media platforms. Social media use increases to 92%
for those aged 15-19-years.
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Figure 6: Proportion of Thai population that engaged with social media platforms during
2018, by age group. Source: Data derived from ‘The 2018 household survey on the use of
information and communication technology report (Quarter 1)’.

At the same time, online platforms are increasingly being used to market HFSS foods and beverages
as part of a combined marketing approach. Research findings from Thailand demonstrates extensive
use of social media platforms to market HFSS foods and beverages (12). Because food marketing
through digital platforms is more targeted, personalized and engaging than traditional marketing
channels, the adverse influence on children’s health is amplified (30). European data shows that
combining online marketing with marketing on television and in cinemas can increase returns on
investment by approximately 70% (94). Social media platforms claim that marketing through their
platforms increase target audience reach, ad memorability, brand linkage and likeability (95).

The mechanisms for delivering paid HFSS food advertisements are extremely complex and lack
transparency with neither the brand, media agency, nor publisher fully understand which advertisements
have been served to whom. This, in combination with other practical challenges, makes it currently
impossible to block all paid-for HFSS food advertisements to children and youth on digital platforms
(62). Exposure to user-generated content (content created by members of the general public - paid or
unpaid - or content that is spread through sharing, following and commenting) is also impossible to
regulate once the marketing material is available in the digital ecosystem.

Because of the rapid (real-time) and wide-spread generation and spread of digital marketing, it is
essential that regulatory terms and conditions are unambigous to minimise subjective interpretations
and potential challenges with enforcement. The time taken to deal with such interpretation and
enforcement challenges will by far surpass the time required for the marketing campaign in question
to reach and impact large numbers of children and youth.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
36 legislative options and regulatory design

It is important that all marketing techniques and digital platforms are included in regulatory design,
otherwise online marketing (and marketing innovation) is likely to shift from regulated to unregulated
digital mechanisms (34, 38). There is little precedent for regulating HFSS food marketing in digital
mediums, however, and the need for regulation is globally recognised (62) and technical guidance is
becoming increasingly available.

Country examples of regulation of digital marketing

South Korea (2010): Internet advertising, not limited to, but includes, unhealthy
food, that includes “gratuitous” incentives to purchase (e.g. free toys) is prohibited.

UK (2020 proposed):To harmonise regulation of both broadcast and non-broadcast

media (media neutrality) the UK has proposed to ban online unhealthy food
advertising, including banner and video advertising, between 5.30am and 9pm.
It is proposed that brands and marketers may be responsible for compliance and
complaints for potential breach to be referred to the Advertising Standards Authority.

Finland (2015): Law prohibits use of advertising, indirect advertising or sales

promotion for alcohol using online games and apps, online competitions, requests
of users to share content from brand-controlled sites and social media accounts
and for content intended to be virally shared. Banner and pop-up advertising is
permitted if it is not aimed at children, does not contain high alcohol content and
does not contain irresponsible messages. User-generated content is permitted
but there must be no financial ties with the alcohol industry. Marketers cannot
op-opt users to participate in the marketing process. The National Supervisory
Authority for Welfare and Health is tasked with enforcement of regulations, with
breaches of compliance largely indicated through a third-party complaints system.

Classification of ‘permitted’ foods

Recommendation 10: Categorise food and drink as ‘permitted’ or ‘not

permitted’ for marketing based on a robust classification system

A key aspect of any regulatory framework is that marketing restrictions target foods and non-alcoholic
beverages that have been shown to be harmful to health. The Government of Thailand should adopt
a government-led and evidence based food classification system. Systems that have been developed
by industry have been less strict and shown to be less effective. Food classification systems fall into
two broad types: Nutrient profiling and foods-based classifications.

Nutrient profiling: The WHO South-East Asian region has developed a nutrient profile model (96) to
implement the WHO Set of Recommendations on the marketing of foods and non-alcoholic beverages
to children. This evidence based nutrient profile model provides an objective method of categorizing
foods that are more likely to be constituents of a healthy diet from those that are less likely to be
constituents of a healthy diet. The model was developed through three key steps: 1) pilot testing of
the draft model in five Member States (India, Indonesia, Maldives, Myanmar and Sri Lanka) by comparing
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
legislative options and regulatory design
37

it to a range of foods commonly consumed by children in each country, through stakeholder discussion
on the applicability, feasibility, strengths and weaknesses of the draft model in each country and
alignment of the model with country’s food based dietary guidelines; 2) a technical workshop to review
and finalise the model and 3) consolidation and consideration of WHO South-East Asian Member
States input into the model.

The model includes nutrient thresholds for different food and non-alcoholic beverage categories as
well as several food categories where all marketing, regardless of nutrient thresholds, is ‘not permitted’
(chocolate and sugar confectionery, energy bars, and sweet toppings and desserts; cakes, sweet
biscuits and pastries; other sweet bakery wares, and dry mixes for making such; juices; energy drinks;
edible ices). Similarly, there are categories where all items are ‘permitted’ (fresh and frozen meat,
poultry, fish and similar; fresh and frozen fruit, vegetables and legumes). The WHO nutrient profile
models have been found to be stricter in which foods and beverages are classified as ‘not permitted’
compared to other nutrient profile models so would permit fewer products to be marketed to children
(97), than systems developed by industry (31). It is recommended that this model is used as a guide
and adapted and tested to reflect the Thai country context.

The Thai nutrient profile model (41) has been developed to align with the WHO nutrient profile model
and can be used as a starting point for classification of foods and non-alcoholic beverages under food
marketing legislation. When tested against other international systems, the Thai nutrient profile model
performed well (41), but must be tested with a larger number, and broader range, of foods and non-
alcoholic beverages for alignment with the WHO South-East Asian model. It will also be important to
update the model to reflect the WHO food and beverage categories where nutrient thresholds are not
applicable and blanket bans are applied. The Government of Thailand may also consider extending the
non-nutrient threshold categories to sweetened beverages as evidence suggests that non-nutritive
sweeteners are also likely to increase the risk of adverse health outcomes (98). These updates to the
Thai nutrient profile model will be important to ensure the system adequately protects children from
the marketing of all foods and non-alcoholic beverages considered to be harmful to health.

Food-based classification: The evidence for food-based classification systems (e.g. food-based dietary
guidelines or level of processing) is increasing as an alternative classification system to the nutrient
profile models. In fact, the WHO nutrient profile model is in effect a combination of nutrient profiling
and food-based classification as there are whole category bans for some food categories. Classifying
foods according to the level of processing is associated with poorer diet quality and adverse health
outcomes (99), regardless of the nutrient content of foods and beverages. This is important as emerging
evidence shows that in countries where a nutrient profile model has been used to classify foods and
beverages, there has been an increase in the use of artificial sweeteners and other artificial ingredients
so that products can fall under nutrient thresholds and can then be marketed (100).

Inclusion of brands: Classification of what is ‘not permitted’ under marketing restrictions should also
include Master brands that are primarily associated with HFSS food products (regardless of whether
a food and/or beverage product is marketed alongside the brand). Brand marketing for brands that are
strongly associated with HFSS foods (e.g. for quick service restaurants or confectionary) has been
shown to increase reward pathways in the brain and to increase selection and consumption of HFSS
products (42, 43). Brands can be classified as ‘permitted’ or ‘not permitted’ by assessing the top five
selling items by market share against the food classification system – if the majority of these products
are classified as ‘not permitted’, then the master brand should also be prohibited from marketing.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
38 legislative options and regulatory design

Part 3:
Monitoring, evaluation and enforcement
of legislation

Overview
Part 3 of this report outlines the steps required for a robust monitoring system to
ensure compliance with the regulation and to evaluate the effectiveness of the
regulation over time. Part 3 is divided into three sections:

2.1 Monitoring overview

2.2 Monitoring for compliance with the regulation

2.3 Monitoring intended impact of regulation on objectives

3.1 Monitoring overview

Recommendation 11: Monitor and evaluate the legislation using an
independent government agency and robust enforcement mechanisms.

Monitoring marketing restrictions after policy implementation is important for two reasons. Firstly, to
ensure companies are complying with the legislation and being penalised for breaching the law.
Secondly to ensure the regulation is effective at meeting its objectives, having the intended impact
and to review any loopholes in the legislation.

The Government of Thailand should forecast and allocate an appropriate budget to support ongoing
monitoring, which should be reviewed periodically so that monitoring can be sustained over time.

Table 5 summarises the types of data to be collected, the frequency that data should be collected,
the agencies responsible and the actions to be taken after analysis of monitoring data.
Table 5: Summary of monitoring for compliance and evaluation

Frequency of Actions from

Monitoring intent Type of data collected Agencies responsible
data collection monitoring
Compliance with Audit of marketing practices of advertisers across all mediums/ Ongoing Independent complaints Sanctions for breaches of
regulation settings covered by legislation: agency regulations
• Inspections of schools, sports and other settings regulated Informed by
(ensure diverse representation across urban and regional annual monitoring Varying government Identification and
locations and areas of high and low socioeconomic status) of policy departments (education, rectification of loopholes
objectives broadcasting etc) in regulations
• Monitoring of broadcast media
• Monitoring of social media and other digital forms Regional departments for
• Monitoring of retail practices local monitoring

Civil society groups &

NGOs
Intended impact of Audit of marketing practices across all mediums/settings Prior to policy Government Agencies Identification and
regulation on the (regardless of what is covered by legislation to monitor shifts in implementation (Ministry of Public Health, rectification of any
policy objectives marketing to unregulated mediums): (for baseline data) Ministry of Education, regulatory loopholes to
• Inspections of schools, sports and other settings regulated Ministry of Interior, improve intended impact
(including analysis of sub-group differences, e.g by level of Every 12 to 24 Ministry of Social
socioeconomic disadvantage) months (with Development and Human Communicate regulatory
additional Security, Ministry of Digital effectiveness to
• Monitoring of broadcast media evaluation for all Economy and Society, stakeholders and public
• Monitoring of social media and other digital forms policy Office of Consumer
amendments) Protection Board, etc), IHPP
National dietary intake surveys for changes in HFSS food intake
Academic collaborators
Household sales data for changes in HFSS purchasing commissioned by lead
agency
Marketing spend of major food brands and companies (can be
obtained through mandatory reporting as part of legislation) National Statistical Offices

Cross-border marketing practices

legislative options and regulatory design
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
39
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
40 legislative options and regulatory design

3.2 Monitoring for compliance with regulation

In keeping with recommendation 10 of the WHO Set of Recommendations, marketing restrictions
should include a monitoring system to ensure compliance with the legislation, using clearly defined
indicators (45). Recommendation 9 of the WHO Set of Recommendations, notes that the regulation
should specify enforcement mechanisms and establish systems for their implementation (45). This
should include clear definitions of sanctions for violations of the legislation and a system for monitoring
compliance. The administrative body in charge of enforcement should possess a wide range of
enforcement sanctions and the full mandate to carry out the enforcement function. It is important
that monitoring and enforcement is independent, transparent and free from any commercial influence (101).

When monitoring for compliance, the Government of Thailand can take the following steps:

Step 1: Develop standards and indicators for compliance with the legislation and ensure these
are readily available for industry bodies.
Step 2: Identify responsible agencies.
Step 3: Define penalties for non-compliance and mechanisms for enforcement.
Step 4: Develop methods for communicating findings to stakeholders and the public.

Standards and indicators

Standards and indictors should align with definitions derived from the regulatory terms and conditions
so that ‘permitted’ and ‘not permitted’ marketing practices are clearly understood. Doing so will increase
the effectiveness of the monitoring and auditing process. Standardised data collection templates
should be developed to ensure consistency across media, settings and data collectors.

Responsible agencies
Two forms of monitoring should be put in place: government-led monitoring and a public complaint’s
system. Adequate resources should be allocated to establish and maintain the monitoring system and
ensure resources are sufficient to carry out ongoing monitoring. It is important that a complaints
system is not the only mechanism to monitor compliance because the onus should not be placed on
the public to enforce government legislation by carrying out the monitoring function. Moreover, the
process from complaint to judgement to action can take considerable time, at which point the marketing
message has already had its intended effect which is particularly relevant for digital media.

Government led monitoring

A mandatory ban on marketing of HFSS food to children requires the government to carry out its own
compliance monitoring to ensure that industries are complying with the law. This requires ongoing
auditing of marketing practices across all media and settings covered by the legislation. Monitoring
compliance of comprehensive legislation will be extensive, and it is recommended that monitoring
responsibilities are devolved to regional departments and agencies in coordination with civil society
groups, when appropriate (e.g. schools, sports, retail) and integrated into existing systems (e.g. with
food safety audits of schools). For broadcast and digital media, periodic random audits should be
conducted of broadcast media during the regulated hours and an audit of a cross section of digital
media to check for breaches of the regulation. The Government of Thailand could also introduce legal
mechanisms to compel regulated industries to disclose data on their marketing spend on brands or
products that fall under the regulation and their related marketing practices. This would increase
industry accountability and reduce the resources required by the Government to monitor marketing
practices.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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41

Public complaints system

Most countries that have restrictions on marketing of HFSS foods have a complaints system in place
where the public can identify examples of marketing that potentially breach the regulation in place
and file a complaint with a designated complaints-handling body. The complaints-handling bodies
manage the complaints process by taking the decision to a Complaints Board or an advisory panel
who make a decision on whether the complaint will be upheld and the industry body responsible
penalised.

A complaints-handling scheme should be independent and credible so that the public feel confident
using it and so that any amendments can be made to improve the system. Publishing the decisions
on each complaint ensures the system is transparent and that a series of precedents can be developed
to help understand the regulatory schemes’ terms and conditions.

Case examples of monitoring for compliance

Chile: In Chile, regional departments of the Ministry of Health are tasked with
monitoring the implementation of the regulations co-ordinating with an inter-
sectoral network including government agencies, academia, civil society, consumer
associations, food marketing and consumers’ rights organisations. Recent reports
state that 3,000 inspections had been made of food distribution companies,
supermarkets, food processors, schools, cinemas, and different media such as TV,
internet, radio, street advertising, magazines and newspapers. The government
found that 70% of the inspections made complied with the regulations. In relation
to broadcast media monitoring, the Ministry of Health and the Television National
Council have entered into an agreement, where the Television National Council
provide the Ministry of Health with the following information: all content broadcast
between 6am and 12am for all open and paid TV channels targeting at a young
audience; information specifically aimed at identifying audiences under 14 years
old; information about the advertising offered on channels split by block time, day
of the week, type of product and hours of advertising.

Canada: Health Canada is considering putting in place reporting obligations that

would compel industry to provide data on advertising practices on a scheduled
basis.

United Kingdom: The Advertising Standards Authority has primary responsibility

for ensuring compliance with the restrictions on food advertising to children
contained in the 253 codes within the Committee of Advertising Codes and the
UK Code of Broadcast Advertising.The Advertising Standards Authority undertakes
spot checks on advertising in all media and conducts surveys of advertisements
published by sectors where there is unsatisfactory compliance with the codes.

International: An international toolkit (102) has been developed to monitor continued

inappropriate promotion of breast milk substitutes in violation of the International
Code of Marketing of Breast-milk Substitutes. It is used by 10 countries including
Thailand (Brazil, Chile, Dominican Republic, Ecuador, Mexico, Nigeria, Panama,
Sri Lanka, Thailand and Uruguay).
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
42 legislative options and regulatory design

Penalties for non-compliance

A range of enforcement mechanisms including incentives to encourage compliance and strict measures
such as fines should be used to increase compliance (76) . Penalties can take the following formats
and must be expressly stated and defined in the governing legislation (103):
• Name and shame the offending company in media and on public websites.
• Requiring the offending company to modify or withdraw their marketing campaign.
• Make any offending company pass a pre-clearance of further advertisements before using them.
• Prohibit an offending company from using a particular communication channel, like broadcast
television, for a specific time period.
• Prohibit an offending company from marketing or selling a product for a specific time period.
• Suspend or revoke the license of the broadcaster.
• Prosecution – criminal or civil charges for company officers or company directors.
• Impose monetary fines for infringement, with different levels of severity graded for seriousness
of breach or repetition of non-compliance, so that they are effective and dissuasive. The size of
the fine could be proportionate to the global turnover of the entity or corporate group that has
violated the restrictions, or as above could be applied to individuals for corporate offences.
• Criminal liability including imprisonment.

Case examples of penalties for non-compliance

Chile: enforcement provisions for the Food Labelling and Advertising Law include
penalties for violation, reprimands, fines, and prohibition from selling the advertised
product, and, in the UK, persistent violators can be fined or have their broadcasting
license withdrawn for non-compliance with broadcast regulations.

South Korea: advertisers who breach the regulations are liable to fines up to ten
million won (270,000 Baht)

Communication of monitoring and compliance

It will be important that the Government of Thailand fund and implement a system to communicate
the complaints system and its mechanics, including educational materials on how to use the complaints
system, to community groups and organisations. Communication of violations to the law to stakeholders
and the public will be important for ongoing engagement and to encourage continued ownership of
the issue.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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Case example of communicating monitoring and compliance

Philippines:The Department of Health has partnered with World Vision to establish
a system for communicating violations of the Milk Code with stakeholders and
the public using mobile application and text messages.

3.3 Monitoring intended impact of regulation on objectives

Recommendation 11 of the WHO Set of Recommendations states that policy frameworks should
include a system to evaluate the impact and effectiveness of the legislation to meet the overall policy
objectives, using clearly defined indicators (45). This is important to understand if the legislation is
having its intended effects, to identify and amend any regulatory loopholes and to communicate
findings back to stakeholders and the public. The following steps can be taken by the Government of
Thailand and partners to ensure a robust and comprehensive evaluation of the legislation.

Step 1: Identify an independent institution for evaluation that is free from conflict of interest.

Step 2: Evaluation institution to work with the Government of Thailand to identify data sources
and to develop new methods of data collection.

Step 3: Develop a timeline for data collection and undertake data collection.

Step 4: Develop methods for communicating findings to stakeholders and the public.

Identification of institution for evaluation of legislation

The Ministry of Public Health, who has oversight of the legislation, should be responsible for ensuring
that it is evaluated, but the task of evaluation should be commissioned to an independent academic
institution or similar body. The appointed institution for evaluation should be free from any actual,
perceived or potential conflict of interest. The Ministry of Public Health (and other relevant government
departments) should work with the appointed institution to identify data sources and assist with data
procurement, but should not be involved with evaluation design, analysis or interpretation of findings.

Country examples of independent policy evaluation

Mexico: The National Institute of Public Health Mexico, along with other academic
institutions, civil society and the Ministry of Health are currently monitoring and
evaluating the effect of the sugar sweetened beverage taxes on prices, consumption
and the use of fiscal revenues for obesity-related programs.

Chapel Hill: The Global Food Research Programme based at the University of
North Carolina is working in partnership with the Institute of Nutrition and Food
Science at the University of Chile to evaluate the short and long term outcomes
of the Food Labelling and Advertising Law.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
44 legislative options and regulatory design

Data collection types and timelines

The appointed institution should work with government bodies to identify specific, quantitative,
measurable and reliable indicators for the evaluation. Data may be pre-existing (e.g. household purchase
data, national dietary surveys), newly reported (e.g. the legislation may stipulate mandatory reporting
of marketing spend and activities by all food companies on a scheduled basis (62) ) or newly collected
(audit of marketing practices using standardized tools and protocols (104)). The incorporation of
mandatory reporting requirements of marketing spend and practices by the food industry will substantially
reduce the resources required for monitoring and will provide a mechanism for industry accountability.
Regardless of the regulatory scope, monitoring and evaluation should capture a wide breadth of
marketing mediums, settings and times to monitor shifts from regulated to unregulated mediums,
settings and times.

Baseline data, prior to evaluation, should be collected as soon as possible after the legislation is
announced, with repeated data collection at 12, 24 and 36 months, using the same tools and indicators
to enable comparable data. Indicators for the evaluation should be chosen along the policy pathway
of effect (Figure 3) and should capture the stated objective of the legislation. It is not appropriate to
solely evaluate the effectiveness of the legislation based on overweight rates, as this is a long-term
outcome in the pathway of effect. If the evaluation includes analysis of outcomes at the long-term
end of the policy pathway (e.g. prevalence of overweight) it is important to allow sufficient lag time
for impacts to occur (3+ years) and to recognise that the mechanisms causing overweight are highly
complex with many drivers and therefore impact is likely to be small. This has been illustrated by
tobacco control regulation, where a comprehensive approach, covering many different drivers, has
been essential to the decline in smoking rates and improvements in heart and lung disease over time
(105).

Monitoring of the legislation should also consider cross-border marketing (as per WHO recommendation
8) and ensure the effectiveness of the legislation is not compromised by food marketing in bordering
nations (45).

Country examples of amending regulatory loopholes after policy

evaluation
Hungary: Public health experts from the Ministry of Health, National Institute for
Health Development, National Institute for Food and Nutrition Science, the Ministry
of Finance, and WHO worked together to design a sugar sweetened beverage tax
policy and together saw it through several revisions after implementation. The
refinements of the policy ensured the tax was having optimal impacts on product
reformulation after it was identified that superficial modifications were being made
for tax evasion.

Chile: In the initial 2016 Labelling and Advertising Law onlyTV advertising considered
to be ‘child-directed’ was restricted. This was updated in 2018 to time-based
restriction of all HFSS food marketing between 5.30am and 10pm.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
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45

Communication of the evaluation

The Government of Thailand should communicate all evaluation results to stakeholders and the public
to maintain ongoing support for the policy and to provide explanation of any regulatory refinement
that may occur to remedy any inconsistencies or inefficiencies in the legislation.

The results of the evaluation can also be included in the Government of Thailand’s reporting to the
Committee of the Rights of the Child in each UN Convention of the Rights of the Child reporting cycle.
 46
Appendix 1: Thai commitments for supporting action on HFSS food marketing
Name and date of commitment Details of commitment

1992 (ratified by Thailand) The UN Convention on the Rights of the Child is the most ratified human rights treaty in the world (ratified by all
UN Convention on the Rights of the Child (38, 39) but two UN Member States). States that have ratified the Convention have the legal obligation to fulfil the right of
the child to enjoy the highest attainable standard of health and that parties should act appropriately to combat
disease and malnutrition.
legislative options and regulatory design

Article 24 of the Convention states that:

‘all children have the right to enjoy the highest attainable standard of health. States should combat disease and
malnutrition and provide access to adequate and nutritious foods and clean drinking water.’
It also requires that all parents and children:
‘have access to education and are supported in the use of basic knowledge of child health and nutrition…’
and that:
‘state parties shall take all effective and appropriate measures with a view to abolishing traditional practices
prejudicial to the health of children.’
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:

2010 (adopted by Thailand) In May 2010, Member States (including Thailand) of the World Health Assembly unanimously endorsed the World
World Health Organization (WHO) Set of Health Organization (WHO) Set of Recommendations on the Marketing of Food and Beverages to Children ) to
Recommendations on the Marketing of Food and reduce the exposure and the power of marketing of foods high in salt, sugar and fat to children (WHA63.14) (30).
Beverages to Children

2013 (adopted by Thailand) Includes a commitment to halt the rise of obesity by 2025.
WHO Global Action Plan for the Prevention and
Control of NCDs 2013-2020 (40)

2017 In the 2017 ‘Best Buys’ list, implementing the WHO Set of Recommendations on unhealthy food marketing is
WHO published the ‘Best Buys’ outlining the recommended as an overarching/enabling action.
recommended interventions for meeting the
Global Action Plan (41).
 Name and date of commitment Details of commitment

2014 (endorsed by Thailand) In 2014, Member States endorsed the Rome Declaration for the UN Decade of Action on Nutrition which states
Rome Declaration - UN Decade of Action on that improvements in diet and nutrition require relevant legislative frameworks for avoiding inappropriate marketing
Nutrition and Framework for Action to guide the and publicity of foods and non-alcoholic beverages to children. It states governments should protect consumers,
Declaration’s implementation at the Second especially children, from inappropriate marketing and publicity of food.
International Conference on Nutrition ICN2 (42). Recommendation 40 of the Framework for Action states: Regulate the marketing of food and non-alcoholic beverages
to children in accordance with WHO Set of Recommendations.

2015 (adopted by Thailand) The Sustainable Development Goals (SDGs) are an important international measure that governments must work
Sustainable Development Goals (43, 44) towards achieving. The goals include targets on ending malnutrition in all its forms (which includes obesity as well
as undernutrition) in SDG 2.2 and reducing premature death from diet related NCDs in SDG 3.4. Heads of State and
governments, including Thailand, have committed to developing national responses to the overall implementation
of the SDGs, and restricting the marketing of foods is an important policy option to meet the SDGs.

2016 (adopted by Thailand) In September 2016, Member States of the Regional Committee, including Thailand, endorsed a resolution on the
Strategic Action Plan to reduce the double Strategic Action Plan to reduce the double burden of Malnutrition in South-East Asia 2016–2025 (SEA/RC69/ R5).
burden of Malnutrition in South-East Asia Aligned with the timeframe for the WHO Global Action Plan and the UN Decade of Action on Nutrition, the resolution
Region 2016–2025 (SEA/RC69/R5) (45). provides guidance to enact legislation/regulations and implement actions to promote nutritious foods to reduce
undernutrition and overweight and obesity among women and children and to implement the WHO Set of
Recommendations.

2016 In 2016, the WHO released its final report from its Commission on Ending Childhood Obesity (ECHO). Recognising
WHO Commission on Ending Childhood Obesity the complex nature of obesity, the ECHO report outlined a comprehensive, integrated package of recommendations
(ECHO) (46) to address childhood obesity across six areas. On the topic of food marketing to children the report stated:
‘Any attempt to tackle childhood obesity should…include a reduction in exposure of
children to, and the power of, marketing’
The Commission urged Member States to implement the WHO Set of Recommendations.
legislative options and regulatory design
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
47
 48
Appendix 2: Existing Food and advertising restrictions in Thailand
The following table outlines the current regulations in place in Thailand that relate to advertising laws, restrictions on marketing in school
settings, food labels and marketing of breast milk substitutes and tobacco. This is to understand the marketing and food landscape across
different areas of concern in Thailand.

Type Name Description

legislative options and regulatory design

Advertising Food and Drug Administration Notification Restricts the ability to advertise false claims about foods including on food labels. The Notification
regarding Rules on Advertising Foods states that presenters in TV advertisements, particularly for jelly, must not be medical or public
B.E.2551 (2008) health experts or children under three years old (instant jelly and jelly candy) or 12 years old for
(instant jelly and jelly from glucomannan).

Thai Public Broadcasting and Television This Act governs the duration and frequency of television advertising that is allowed per hour, per
Business Act B.E. 2551 (2008) day, on both free and paid television channels. This Act does cover all food products, but there are
no specific rules on the frequency of HFSS food advertisements. It states that in the case of necessity
to protect children and youths, the Commission may prescribe in the Notification the broadcast time
for certain categories of programmes.
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:

Notification on Criteria and Procedures for Regulates the broadcasting times for children’s, youth and family programmes, where children are
Chart List in Broadcasting B.E. 2556 (2013) defined as below 15 years old and youth as below 18 years old. This Notification does not control
food and non-alcoholic beverage advertising during these programmes.

School settings Notification of the Ministry of Education Introduces a ban on marketing promotion activities of all types of foods and beverages in educational
Re: Measures and Approaches to Enhance institutions. Schools are also asked to avoid selling sugary drinks with a high sugar content (more
Knowledge and Skills Related to Oral Health than 5%) as well as sweet and crispy snacks and avoid making them available for consumption in
Care and Selection of Dental Services educational institutions, and promote understanding among retail shops right outside the school
(Announced on 11 June 2020) compound to gain cooperation from sellers.
 Type Name Description

Food labels Ministerial Notification (B.E. 2550) (2007) States that ready-to-eat food and extruded snack advertisements must display text or voice messages
on “Labelling of Certain Pre-cooked Ready- including “Consume little and exercise for good health”. This regulation does not cover sugar-
to-eat Food” sweetened drinks and HFSS food products other than ready-to-eat foods and snacks. Also,
advertisements of these food products on television must have a warning message with clear sound
and text for at least five seconds.

Notification of the Ministry of Public Health Nutrition labelling laws have been implemented in Thailand which require food products to display
(No. 394) B.E.2561 (2018) (food labelling) a Guideline Daily Amount label that provides the consumer with the information on the energy, sugar,
fat and sodium content of the food. The FDA specifies that certain foods must include the text “eat
moderate and exercise for health” to increase consumer awareness.

Breast Milk Control of Marketing Promotion of Infant No person (including manufacturers, producers and distributors) can advertise food for infants. This
Substitute and Young Child Food Act (B.E. 2560) includes (but is not limited to) offering promotions, prizes, sponsorship and discounts.

Tobacco Tobacco Products Control Act B.E. 2560 No person (including manufacturers, producers and distributors) can advertise or conduct marketing
(2017) communications of tobacco products. This ban includes:
(1) television material, movie, radio broadcast, radio television, electronic media, computer
network system or advertisement bill
(2) in theatre, movie theatre or show, game, contest, competition, service provision or any other
activity in the same nature
(3) in any other media or location used for advertisement or marketing communications as
prescribed and announced by the Minister upon recommendation of the Committee.
This includes sponsorship and retail displays.
legislative options and regulatory design
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
49
 50
Appendix 3: Thailand’s multi-sectoral working groups for tobacco and breast milk
substitute control
The following table outlines the different multi-sectoral working groups that are established in the legislation for the Government of Thailand’s
control of tobacco and breast milk substitutes

Breast Milk Substitutes Tobacco

legislative options and regulatory design

• Director-General of the Department of Children and Youth, • Permanent Secretary of the Ministry of Finance,
• Director-General of the Department of Health, • Permanent Secretary of the Ministry of Social Development and Human Security,
• Director-General of the Department of Health Services Support, • Permanent Secretary of the Ministry of Tourism and Sports,
• Director-General of the Department of Local Administration, • Permanent Secretary of the Ministry of Agriculture and Cooperatives,
• Secretary General of the Consumer Protection Board, • Permanent Secretary of the Ministry of Commerce,
• Secretary General of Food and Drug Administration, • Permanent Secretary of the Ministry of Interior,
• Secretary General of the National Broadcasting and Telecommunications • Permanent Secretary of the Ministry of Justice,
Commission, • Permanent Secretary of the Ministry of Labour,
Controls on the marketing of food and non-alcoholic beverages to children in Thailand:

• Secretary General of National Health Commission of Thailand; and • Permanent Secretary of the Ministry of Education,
• Permanent Secretary of the Bangkok Metropolitan Administration. • Commissioner General of the Royal Thai Police,
• Secretary General of the National Health Security Office; and
• Manager of the Thai Health Promotion Foundation.
 Controls on the marketing of food and non-alcoholic beverages to children in Thailand:
legislative options and regulatory design
51

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