Public health strategies to reduce sugar intake in the UK: An exploration of public perceptions using digital spaces

Objective: To explore UK public perceptions of children's sugar consumption, Public Health England's Change4Life Sugar Smart app and the Soft Drinks Industry Levy, using solicited and unsolicited digital data. Methods: Data from three digital spaces were used as follows: (1) an online questionnaire advertised on parenting forums; (2) posts to UK online parenting forums; and (3) English language Tweets from Twitter. Quantitative data were analysed using descriptive statistics and qualitative data using content and inductive thematic analysis. Results: Data were (study 1) 184 questionnaire participants; (study 2) 412 forum posts; and (study 3) 618 Tweets. In study 1, 94.0% (n = 173) agreed that children in the UK consumed too much sugar and this had a negative health effect (98.4%, n = 181). Environments (n = 135, 73.4%), media/advertising (n = 112, 60.9%) and parents (n = 107, 58.2%) were all reported as barriers to changing children's sugar intake. In study 2, more posts were negative towards the Soft Drinks Industry Levy (n = 189, 45.9%) than positive (n = 145, 35.2%), and themes about the inability of the Levy to affect sugar consumption in children and childhood obesity emerged. Other themes related to distrust of the government, food industry and retailers. In study 3, the Sugar Smart app was viewed positively (n = 474, 76.7%) with its function associated solely with identification of sugar content. Conclusions: Participants accepted the necessity of sugar reduction in children, but recognised the complexity of behaviour change. Public health activities were not always perceived as effective strategies for health promotion. There was some distrust in government, public health officials and the food industry. A less simplistic approach to sugar reduction and more credible sources of information may, therefore, be welcomed by the public.