Reduction of free sugar intake to <5 % of total energy intake has been recommended by Public Health England(Reference Tedstone, Targett and Allen1), the Scientific Advisory Committee on Nutrition(2) and the WHO(3). Sugar-sweetened beverages (SSB) account for a large proportion of sugar intake in the UK, particularly in children and adolescents(2), and consumption has been associated with obesity and dental cavities(Reference Tedstone, Targett and Allen1). As SSB consumption continues to increase globally(Reference Popkin and Hawkes4), SSB taxes have been proposed and supported by public health advocates to improve the food and beverage environment. SSB taxes have been implemented in a number of countries globally with evidence to support their effectiveness to reduce the purchase and consumption of SSB(Reference Backholer, Vandevijvere and Blake5) and their potential to reduce population weight(Reference Backholer, Sarink and Beauchamp6). The UK became one of the latest countries to introduce an SSB tax when the UK Government implemented the Soft Drinks Industry Levy (SDIL) in April 2018(7,8) .
However, the food and drink industry has strongly opposed taxation(Reference Ainger and Klein9). Taxation can reduce profits for the industry since SSB consumption is reduced(Reference Niblett, Coyle and Little10,Reference Colchero, Rivera-Dommarco and Popkin11) and taxes can spark substitution to other market actors such as those making water or milk drinks(Reference Teng, Jones and Mizdrak12). Opposing industry arguments emphasise individual responsibility and using tactics similar to those employed by the tobacco industry(Reference Brownell and Warner13,Reference Mejia, Dorfman and Cheyne14) . Self-regulatory programmes (such as the UK responsibility deal)(Reference Panjwani and Caraher15,16) have been supported by the food and drink industry but have done little to reduce the obesogenic environment whilst legitimising industry involvement in regulation(Reference Panjwani and Caraher15). Previous research suggests that individual responsibility and paternalistic rhetorics are used to shift responsibility from industry onto individuals, thus influencing how government regulate products such as SSB(Reference Brownell and Warner13,Reference Buckton, Fergie and Leifeld17) . The potential for the food and drink industry to oppose taxation is possible because although the association between SSB consumption and poor health is extensive, the association, like the diseases themselves, is complex, with some opposing findings(Reference Gibson18,Reference Malik, Schulze and Hu19) .
The media has the power to shape what is on the public agenda by focusing attention on certain topics(Reference McCombs20). Solutions to obesity are debated both politically and socially but how such solutions are framed in news coverage can influence public perceptions. A frame is a ‘package’ which delivers a particular description of an issue and identifies causes and solutions, either implicitly or explicitly(Reference Jenkin, Signal and Thomson21). Framing involves the selection or omission of certain information or making certain aspects of an issue more salient(Reference Entman22). Regarding policy, framing can determine how the public understand the information they receive(Reference Törrönen23) and how accepting they are of proposed solutions. Frames can also shape perceptions amongst policymakers which can influence how political decisions are made(Reference Camaj and Weaver24,Reference McCombs and Shaw25) and what policies are implemented. The impact of frames has been demonstrated across a range of public policy debates including those related to alcohol, tobacco and mandatory car seat belt wearing(Reference Nathanson26).
As the media is an important factor in how readers, including policymakers, understand and act upon societal issues(Reference Scheufele27), multiple stakeholders engage in power struggles to shape public perceptions of an issue. In relation to policy issues, the Advocacy Coalition Framework suggests that these stakeholders are the coalitions of actors that argue for or against a certain policy(Reference Sabatier28). The coalitions, as they relate to health policies such as SSB and sugar taxes, are public health and private industry. These coalitions are typically in opposition, engaging in battles to frame debates in relation to individual freedom and collective responsibility(Reference Dorfman, Wallack and Woodruff29). In doing so, the groups push frames of market justice and social justice(Reference Nixon, Mejia and Cheyne30). Advocates of social justice argue for shared responsibility (and thus support fiscal policies such as taxation), whilst those advocating market framing push individual freedom (and oppose government regulations)(Reference Dorfman, Wallack and Woodruff29). According to the Advocacy Coalition Framework, the ‘Secondary Aspects’ of personal beliefs, such as those that relate to the implementation of policy can be changed through framing, as people learn about the issue in question and the policy effects(Reference Hu31).
There are inequalities in political and media influence with the messages presented in newspapers from those who are the most powerful(Reference Livingstone and Lunt32). What is published in the media is also shaped by the ideology of the media sources itself, which in turn is often influenced by the preferred messaging of the most powerful, that is, the political and corporate elites, upon which mainstream news media rely for funding and information(Reference Van Dijk and Paletz33). When certain frames become dominant and appear in the news media more frequently than others, it not only suggests a greater influence of the stakeholders sharing that message but also can lead to alterations in perceptions and impact whether or not an issue reaches the political agenda(Reference Nathanson26), highlighting the power of the media. If the market frame (that pushed by industry in opposition to political regulations such as taxes) becomes dominant, policy implementation can be slowed, avoided or repealed(Reference Freudenberg34). Investigating what is published in the media regarding SSB taxes and how solutions to the reduction of sugar consumption are portrayed can improve understanding of what the dominant frames were and how they may have influenced the political agenda(Reference McCombs20) as well as public acceptance of such strategies.
To understand what messages were prominent in the news media in relation to SSB and sugar taxation, we investigated the portrayal of SSB and sugar taxation in UK national newspapers. The UK has a large and resilient newspaper scene including at least fifteen national newspaper titles, most of which are published daily(Reference Yeomans and Tench35). There is an equally large and diverse national readership, with newspapers read by approximately 38 % of UK adults(36). As a result, newspapers are a relevant platform upon which to investigate how societal issues, such as public health policies, are portrayed. Previous research(Reference Elliott-Green, Hyseni and Lloyd-Williams37,Reference Buckton, Patterson and Hyseni38) has investigated how newspapers have framed the SDIL. Findings of these studies suggested that SSB were increasingly discussed in newspapers and that private industry arguments in opposition of government intervention were prevalent in 2014, decreased in 2015 but reappeared in 2016 following the announcement of the SDIL, echoing portrayal in previous policy debates(Reference Shelton, Colgrove and Lee39). The aim of the current study was, for the first time, to investigate how the SDIL was portrayed between 2016 and 2019, covering the announcement, implementation and 1st anniversary of the policy.
Method
Data sources
Qualitative analysis of newspaper articles reporting on sugar, sugar taxes or the SDIL between 1 April 2016 and 1 May 2019 was conducted. The analysis period incorporates the announcement of the SDIL on 16 March 2016, the Government consultation process on the policy (summer 2016), the implementation of the SDIL on 6 April 2018 and the first year anniversary of the policy in April 2019(8). Newspaper articles were freely available on the online database LexisNexis(40). The search string used was ‘sugar’ and ‘tax’. Articles were ordered according to relevance on LexisNexis. The first fifty articles from each newspaper title that met the inclusion criteria were retrieved. Articles were downloaded between 19 September and 21 September 2019.
Article selection and inclusion
Articles included were published between April 2016 and May 2019, in one of the six of the most highly circulated UK national newspapers (The Daily Telegraph, The Times, The Daily Mirror, The Sun, The Express and The Daily Mail). The focus of all articles included was on sugar or SSB taxation, with most focusing specifically on the UK SDIL. Articles published as editorials, features or letters were excluded, as were articles published in Ireland. The newspapers were selected based on their high circulation figures (as of 2019)(Reference Mayhew41) and their representation of the three newspaper groups present in the UK circulation (text-led newspapers (otherwise called broadsheet or quality newspapers) and tabloids, which can be been further split into ‘middle-market dailies’ and ‘red top’ newspapers). The newspaper groups differ based on the style of articles published and their readerships(Reference Johansson42). Text-led newspapers traditionally publish articles that are serious in their content with few images. Tabloids (red top newspapers and middle-market dailies) typically have a more sensationalist news style with a celebrity-orientated news agenda. Text-led newspaper readers are predominantly from the AB, upper professional and managerial, socio-economic groups, whilst tabloid readers are predominantly in the C2-E socio-economic group(Reference Johansson42). Using this three-way typology in the analysis of newspaper articles helps to ensure representation of the different ways that newspapers present a story or issue and has been employed and supported in previous research(Reference Buckton, Patterson and Hyseni38).
Data analysis
Thematic analysis
Article titles were first read to ensure relevance, and then each article was read in full by the lead researcher. The actors who were mentioned or quoted were recorded. Initial codes were developed to highlight topics in the articles, and then codes were collated into potential themes. The themes were reviewed by a member of the research team and were then defined and named. The themes developed aimed to capture important arguments and notions within the data in relation to sugar and taxation in UK national newspapers. Themes were grouped according to their support for or opposition to taxation. Extract examples were selected to represent each theme. The thematic approach employed here has been described in detail by Braun and Clarke(Reference Braun and Clarke43). Microsoft Excel and QSR International’s NVivo 12 software(44) were used to organise and code the data.
Results
An initial search of LexisNexis retrieved 1998 articles from the six newspapers selected: The Times (n 640), The Daily Telegraph (n 336), The Mirror (n 229), The Express (n 126), The Sun (n 447) and The Daily Mail (n 220). Of those articles, only the most relevant articles (assessed according to the LexisNexis search function which ordered articles according to the presence of the search string words (‘sugar’ and ‘tax’) and on brief reading of the article by the lead researcher to assess the topic of discussion) were downloaded, with an aim for fifty articles per newspaper. Fifty articles were considered as an appropriate number for this analysis since thematic saturation was reached. Two hundred and eighty-six articles were included in the analysis (n 50 from The Times, The Daily Telegraph, The Sun and The Daily Mail, n 47 from The Daily Mirror and n 39 from the Daily Express).
The length of the articles varied from <100 words to over 1000. Articles discussing sugar or SSB taxes were published across the sample period, with some indication that articles peaked at key SDIL events (such as the implementation of the SDIL in 2016). The highest publication number per newspaper occurred in 2016 and 2018 (n 10). Whilst in 2017 and 2019 (a period of inactivity in terms of SSB policy change in the UK), an average of five articles were published across the sample period. (As the number of months of publication included in the analysis varied (i.e. 9 months for 2016, 12 months for 2017 and 2018 and 5 months for 2019) the average number of articles published per month across newspapers was assessed).
Three broad categories of stakeholder group were identified in the articles: (1) civil society and public health interest groups (quotes/mentions supported the negative health impacts of sugar and the need to implement sugar/SSB taxes); (2) the soft drink industry, food and drink retailers and civil society interest groups (quotes/mentions opposed the benefits of taxation on health and described the potential negative impact on businesses) and academics (quotes/mentions both supportive of sugar/SSB taxes and in opposition, depending on research being presented).
Results of the thematic analysis
Themes are described, and examples to evidence their presence in newspapers are provided in the text below. Figure 1 shows the themes identified during the analysis and the codes that make them up.
Arguments for sugar taxes
Sugar consumption and impacts on health
Excessive sugar consumption, which in the UK was reported to be ‘the world’s seventh highest…with the average person consuming 93·2 grams a day’ by the Times(45), was linked with a number of health conditions. The three conditions described most frequently were obesity, diabetes and dental decay. Obesity was the most frequently discussed effect on health with most articles describing at least the prevalence of obesity in the UK. For example, ‘More than a quarter of British adults are classified as obese’(46). As obesity is increasing in prevalence, many articles described the condition as a ‘growing crisis’(47), an ‘epidemic’(48) or even as ‘the greatest public health threat’(49) for the UK, highlighting the necessity for action. Some articles went on to state that Britain is on its way to becoming a chronic “nation of fatties’’(50), and likely to ‘become the “fat man of Europe” within a decade’(51).
The association between sugar intake and diabetes was also mentioned frequently. Like obesity, the prevalence of diabetes was often stated. For example, ‘More than four million Britons are blighted by diabetes’(52). Excess sugar consumption was touted as being a ‘leading cause of diabetes’(53), with high SSB consumption reported to be ‘one of the central causes of high sugar intake’(54). The links between high sugar intake and health conditions including obesity and diabetes were widely supported by research, increasing their legitimacy. For example, key findings from sugar intake reports were shared: ‘children aged five are gorging on sugar by eating four times the recommended limit’(55). The third condition associated with excess sugar and SSB consumption was poor oral health. The impacts of this that were reported largely were related to children. For example, stating that ‘children are suffering an “oral health crisis” as more than 100 a day go to hospital to have several rotten teeth removed’(56).
Many articles went on to describe the consequences of conditions associated with excess sugar consumption. Some focused on the individual impacts. For example, the link between obesity and ‘major health problems, including heart disease, cancer and diabetes, in later life and low self-esteem’(57) were described. The increased risk of cancer was particularly prevalent in articles, with many describing obesity (caused by excess sugar consumption) as ‘the biggest cause of cancer after smoking’(58). Poor oral health was touted to cost ‘children around 60 000 d off school a year’(59), likely affecting educational attainment. Whilst, having teeth removed due to decay was described as ‘very traumatising’(60). Societal impacts of excess sugar consumption were also prevalent across articles, with most stating concerns for the National Health Service (NHS). For example, stating that diabetes is a ‘threat to the sustainability of the NHS’(61). Others described poor oral health in children as ‘an epidemic…costing the NHS £50million a year’(62). Some articles extended these financial concerns to the whole economy, describing increasing rates of non-communicable diseases as ‘an economic catastrophe’(63).
Proposed actions to reduce sugar consumption
Taxation of SSB was cited as an effective method to reduce overall sugar consumption across newspapers. Support for taxation was largely from public health advocates. Jamie Oliver was the most frequently cited advocate for such a tax, arguing that it ‘would be the “single most important” change that could be made’(64) as ‘soft drinks are the biggest source of sugar among school kids and teenagers.’(65). Exemplifying the influence of the celebrity chef, he was touted as being ‘the most influential person in the UK’s food and drink industry’(66).
The UK sugar tax was implemented in 2016, with the aim of encouraging reformulation of SSB. Despite industry opposition, months before the implementation, extensive reformulation had occurred as ‘The mere threat of imposing sugary drinks levies…sent manufacturers scrambling to reduce their levels to below 5 g per 100 ml’(67). Some industry spokespeople were quoted in relation to reformulation, with many presenting their efforts in a positive light: ‘We’ve been working hard to reduce the sugar in Fanta even further, without compromising on the taste.’(68). As a result of the changes to sugar content: ‘Drinks now contain 45 million fewer kilos of sugar’(69), and also to positive consumer responses to the tax: ‘consumers are switching to healthier options’(70). Newspapers also mentioned the results of international sugar taxes, for example, in Mexico, describing their impacts on sugar consumption and touting taxation as an effective solution.
As a result of the positive effects of the sugar tax on reducing sugar consumption, but given the continued increases in obesity, and the continued industry opposition, some articles presented the argument that the tax is just a first step. Arguments for extension of the sugar tax to other products were widespread with most presented by public health advocates and academics. For example, stating that ‘the sugar tax to be extended to milk drinks(71), or ‘Junk food should be taxed and vegetables subsidised to tackle our obesity crisis’(72). Other articles presented arguments for the implementation of additional policies. For example, arguing that there should be ‘a crackdown on junk food advertising, with a 9 pm watershed’(71), as well as ‘controlling the ‘deep discounting’ by supermarkets of unhealthy foods should be given a high priority’(73).
Arguments against sugar taxes
A number of articles presented arguments in opposition to sugar taxes. These arguments, which were largely presented by actors from the food and drink sector, included the potential regressive effects of food and drink taxes, the impacts of artificial sweeteners, concerns over Brexit, the notion of individual responsibility and the unnecessary over-involvement of the government. Opposing arguments were apparent across the entire sample but were focused at the announcement (2016) and implementation (2018) of the SDIL.
Sugar taxes are unfair
First, opponents stated that taxes are unfair and thus almost ‘certain to be blocked by Euro judges for being “discriminatory”’(74). This argument related to the impact of taxes on business performance (comparative to other drinks makers), with the tax likely to affect the profit-making ability of businesses across the entire soft drinks supply chain. It also related to the regressive nature of taxes since, according to quotes from opponents, they ‘hit the poorest families hardest’(75), and ‘just drive poor people further into poverty’(76) without reducing ‘sugar consumption in a “meaningful way”’ (77). These arguments were concentrated in early 2016, around the time of the SDIL announcement, but continued throughout the sample period.
A related argument against sugar taxes was the unfair dual impact of the new sugar tax and the uncertain nature of Brexit – an argument which first appeared in 2017. The tax was touted as being an additional burden for soft drink businesses in the UK. Opponents stated that ‘The Government would be well advised to pause it [the sugar tax] during Brexit negotiations…’(78). Having to change recipes would be a ‘“monumental distraction” when the UK faced a no-deal Brexit’(79), that would, unnecessarily, make it harder for them to operate and compete with other organisations.
Artificial sweeteners
The third argument against sugar taxes was presented largely by consumers of SSB who were concerned by the increased use of artificial sweeteners. Some opponents stated that the tax had negatively impacted people with diabetes who ‘rely on Lucozade to boost blood glucose [as they] will have to buy twice as much as the amount of sugar in the drink is being halved…’(80). Whilst others stated that sweeteners may be associated with an increased risk of health problems, presenting research to support such claims. For instance: ‘men who had two diet drinks a day were 23 percent more likely to develop heart failure’(81). Yet more opposition related to the altered taste of SSB due to the increased use of sweeteners.
Individual responsibility
The penultimate argument related to the promotion of individual responsibility. This was demonstrated by the emphasis on behaviour change, the importance of physical activity and the need for self-control. Education was pushed as a preferential focus for efforts to reduce sugar consumption, with articles presenting quotes such as: ‘The only realistic way of tackling obesity is to educate people about nutrition and encourage them to exercise self-control’(82) and ‘Children should simply be advised to move about more and eat less’(83). In a similar vein, the soft drink industry reported that education and voluntary sugar reduction initiatives would be enough to control sugar consumption in the population. Such individual framing attributes blame to the individual, suggesting health issues such as obesity and diabetes are the result of social deviances and propose that public policy is unwarranted. This individualistic framing by newspapers has been reported previously(Reference Flint, Hudson and Lavallee84). The final, but highly related argument presented in opposition to sugar taxes, related to their paternalistic nature. This argument occurred across newspapers and across the sample period and can be demonstrated by quotes such as: ‘this is another example of irresponsible meddling from the high priests of the nanny state’(85).
Discussion
The aim of this study was to assess the portrayal of sugar, SSB taxes and the UK SDIL in UK national newspapers from 2016 to 2019. This period represents the announcement, implementation and anniversary of the SIDL and has not been investigated previously. The SDIL has become a prominent topic in UK national newspapers as evidenced by the number of articles published and assessed in this and previous studies(Reference Elliott-Green, Hyseni and Lloyd-Williams37,Reference Buckton, Patterson and Hyseni38) . The peaks in newspaper coverage between 2016 and 2019 coincided with key policy events: the announcement of the SDIL (March 2016), the public consultation which concluded in October 2016, and the introduction of the SDIL (April 2018). Buckton et al.(Reference Buckton, Patterson and Hyseni38) observed a similar pattern of coverage between 2015 and 2016. The results of the present study highlight the continued political interest in sugar, the society-wide health problems that SSB pose and the governmental solutions to overconsumption.
Supportive messages, presented by public health advocates, academics and celebrity endorsers were largely consistent across the sample period. The negative health impacts of excess sugar intake were frequently discussed and often supported by research linking sugar or SSB consumption with poor health(Reference Grimes, Riddell and Campbell86). Similar messages have been found in earlier analyses(Reference Elliott-Green, Hyseni and Lloyd-Williams37,Reference Buckton, Patterson and Hyseni38) . SSB taxation including the SDIL was also portrayed as a positive action with the potential to reduce SSB intake. Public health groups highlighted the importance of industry taking at least some responsibility for public health, describing them of vectors of disease. This has been found to be effective in shifting blame from individuals to the industry in other contexts, such as tobacco control(Reference Mahood87). As has been found in previous analyses, supporters also portrayed industry corporate social responsibility programmes (such as the sponsorship of events) as disingenuous(Reference Dorfman, Cheyne and Friedman88), whilst highlighting the unnecessary overzealous marketing of SSB and related products to children(Reference Buckton, Fergie and Leifeld17). The consistency of support for the SDIL across newspapers may reflect media advocacy efforts of public health groups which pushed social justice frames(Reference Jones and Wolfe89). It is also possible that the fame of Jamie Oliver, who acted as a policy entrepreneur, could have helped to push supportive messages. It is possible that the supportive frames presented in the media may also have played a part in the alteration the ‘secondary aspects’ of personal beliefs to garner political and public support for the SDIL(Reference Wallack and Dorfman90), as theorised by the Advocacy Coalition Framework(Reference Sabatier28).
Opposing messages for SSB taxation were also prevalent across the articles analysed. However, they were less cohesive than those presented by supportive groups. This lack of cohesion may be due to the unexpected announcement of the UK SDIL, but other possible reasons have been hypothesised previously(Reference Buckton, Fergie and Leifeld17). Opposing messages were apparent throughout the sample, but were most frequent at key policy events, such as at SDIL announcement, implementation and its anniversary. This may suggest efforts to promote the individual responsibility rhetoric and encourage the repeal of the SDIL. Individual companies focused on positive messages, for example, highlighting their efforts to reduce sugar via reformulation and their corporate social responsibility programmes, which they touted as being part of the solution. Similar actions have been described in previous media analyses(Reference Nixon, Mejia and Cheyne30). Neutral industry-wide groups such as the Food and Drink Federation were often quoted in relation to opposition for taxation and the health harms of SSB.
Whilst industry stakeholders stated that obesity is a serious problem that needs a solution, they did not agree with the proposed solutions advocated by public health, nor did they agree that industry is to blame for the problem. Although opposing messaging appeared valid, when read in isolation, they were contradictory when considered together. For example, arguments against taxation included the ineffectiveness of SSB taxes to reduce consumption, the benefits of voluntary self-regulation (and the sugar reduction already done by the sector), the unfairness of taxation both for the public and industry themselves, and the potential impact of an SSB tax on the economy especially in light of the uncertainties of Brexit. This confused argument to support a single point (that SSB taxes should not be implemented) has been reported previously(Reference Fooks, Williams and Box91) and has been considered as a form of kettle logic (Reference Derrida92). Similar confused opposing arguments from SSB manufacturers have been reported previously, with some additional reports of the industry inflating the effects of SSB taxation on the economy (including greater job losses and reduced public revenue generation) to reduce acceptance of taxation(Reference Fooks, Williams and Box91). The arguments put forward by industry add detail in the context of specific national nutrition policy, namely the SDIL, and also support the market justice frame identified in prior studies(Reference Jenkin, Signal and Thomson21,Reference Shelton, Colgrove and Lee39) . Framing conditions such as obesity in this way is an oversimplification, suggesting that health is controllable and also ignores the role of the environment, in which research has shown to play an important role in the development of the condition(Reference Papas, Alberg and Ewing93).
The study presents how a recent public health policy debate was portrayed in national newspapers. Findings improve understanding of the stakeholders involved in SSB or sugar tax policy debates and also highlight the opposing messages presented. For public health, the findings may be useful for future policymakers in anticipating private industry frames following policy implementation. Since the UK newspaper readership is large, it is possible that a substantial proportion of the UK population may have been exposed to the frames presented by journalists on a near-daily basis, and thus their acceptance of policy solutions may have been impacted. However, it is also important to consider other factors that may be involved in shaping public and political debates. For example, research has posited that social media may set the media agenda through reverse agenda-setting(Reference Lycarião and Sampaio94). Further research should investigate the frames present on social media and ongoing public debates.
The findings of this study are subject to limitations. First, only a sample of newspapers published across the time period was included in the study which may mean that some key messages were missed. Secondly, the images presented in newspaper articles were not included in the analysis. As images can alter the focus and sentiment of an article, without implicitly stating it within the text, it would be beneficial for future research to analyse images and other media presented with articles on the SDIL to investigate the impact on the portrayal of the policy. Thirdly, although media influence on public health-related perceptions using thematic analysis is well researched, this method alone cannot determine the extent to which audience understandings, perceptions and behaviours relate to media representations(Reference Kosho95). Finally, the public is exposed to various media such as TV, social media and radio which could all add to or alter understandings. Audiences also do not consume news media in a passive, non-critical way and nor do they take in all the information that they read(Reference Abiocca96).
Conclusion
This study contributes to an understanding of how the SDIL was portrayed in UK newspapers between the announcement of the policy and its implementation. The research contributes to the field by highlighting prominent frames and identification of the stakeholders involved in the policy debate in UK newspapers. The findings highlight that the SDIL was discussed widely in UK national newspapers in largely a positive light across the sample period, but suggests that opposing arguments continued and were most apparent in the period immediately following SDIL implementation. The publication of newspaper articles was highest at key policy moments suggesting topic saliency for journalists and readers.
The study contributes to the literature on framing, public health advocacy and corporate political strategies, highlighting how a range of actors seek to influence political decision makers and the general public through shaping what is published in newspapers via providing information and quotes. Such actions by private industry and public health advocates should be investigated to better understand the policy development process. To further understand the importance of framing within the development of the SDIL, the research could ask actors what strategies they used via survey or interview research. Finally, an investigation of frames presented on different media platforms including social media should be conducted to further inform theoretical understandings of policy development.
Acknowledgements
Acknowledgements: The authors have no specific acknowledgements to make. Financial support: This study received no specific funding. G.B. is a sponsored PhD student, funded by OneLife Suffolk. The organisation had no role in the design, analysis or writing of this article. Conflicts of interest: The authors have no conflicts of interest to declare. Authorship: All authors discussed the topic and planned the study. G.B. conducted the data collection and analysis. All authors contributed to writing and revising the manuscript. All authors read and approved the manuscript before submission. Ethics of human subject participation: The study received ethical approval from the Leeds Beckett University ethics review board. No human participants were included in the study.