A press advertorial for Manuka Doctor, seen on 28 April 2020, included the heading “TRY HONEY” underneath which text stated “Recommends Public Health England”. Text in the main body stated “IN OUR CURRENT HEALTH CONSCIOUS SOCIETY no-one could be blamed for being concerned about their overall wellbeing. There is, however, a simple form of self-treatment that has government backing. Advice published by NHS watchdog NICE and Public Health England in 2018, confirms what many of us have known for years; honey should be the first line of treatment for patients with a cough. The guidelines, which are aimed at both GPs and patients, say antibiotics make little difference to cough symptoms. Certainly, antibiotics alone will not prevent you getting a cough, while honey can help with the symptoms”.
On the right-hand side of the ad, a box of text included the heading “ATTENTION: DR HILARY JONES SUPPORTS MANUKA HONEY”. Text underneath stated “Dr Hilary Jones, GP and Health Professional, is a big fan of Manuka honey and recommends the award-winning Manuka Doctor brand from New Zealand. ‘The advice from Public Health England is to try honey for a cough before visiting your GP,’ said Dr Jones”. Further down, text stated “Whilst there is no evidence that this is relevant to the current coronavirus outbreak, I recommend this Manuka honey to patients this Winter” and “The greater the MGO number on the pot, the higher the anti-microbial properties in the Manuka honey”.
IssueThe complainant challenged whether the references throughout the ad to honey as a treatment for coughs and to its “anti-microbial” properties, stated or implied that a food prevented, treated or cured human disease.
Manuka Doctor (UK) Ltd said they agreed that honey could not prevent, treat or cure a human disease. However, they said it helped with a cough, which was official government advice, communicated to the public via Public Health England since 2018. They said that it was important to note that a cough was not a disease. A cough was a voluntary or involuntary act of expulsion of air from the lungs that cleared the throat and breathing passage of foreign particles. A cough could be a symptom of some wider health conditions, but not all coughs were linked to diseases and coughs themselves were not diseases.
Manuka Doctor said the ad echoed official government advice which was to use honey for coughs, and that it did not claim that a random food could prevent, treat or cure a disease. To make that fact explicit in the ad, they said they clearly marked that trying honey for a cough was current government advice. The point was reiterated in the headline, the body copy and the references. Manuka Doctor said that they had discussed the ad with Derby City Council Trading Standards prior to its publication, with which they had a Primary Authority relationship.
Trading Standards advised that the ad referenced the alleviation of a symptom (the cough) which could be caused by a number of factors rather than treating a specified disease or ailment such as a cold or flu. Regarding the claim “anti-microbial”, Manuka Doctor said that Manuka honey’s ‘anti-microbial’/’anti-bacterial’ qualities were found in peer reviewed scientific journals and they referenced one such article. They said it featured in scientific journals as a descriptive term used to communicate the inherent properties of methylglyoxal (MGO) not any benefits it may have had. They said it was appropriate to use the terms anti-bacterial/anti-microbial to describe Manuka honey because it was a scientific differentiator to other honeys.
The CAP Code stated that claims which stated or implied a food could prevent, treat or cure human disease were prohibited for foods. The ad contained various references to the treatment of a cough: “honey should be the first line of treatment for patients with a cough”, “Certainly, antibiotics alone will not prevent you getting a cough, while honey can help with the symptoms”, “taking a spoonful of honey or a honey and lemon drink is a good first step a person can take for self-treatment for a cough” and “a 10g spoonful of honey significantly reduced the frequency and severity of coughs within a day”.
We sought a view from the Food Standards and Information Focus Group. Members of the group included enforcement officers from local authorities and membership consisted of representatives from the regional food enforcement groups, Primary Authority supermarkets group and Chartered Trading Standards Institute. In addition the group included invited policy officials as observers from the FSA, DHSC, Defra and Regulatory Delivery as well as representatives from the Association of Public Analysts, the ASA and the Business Expert (Food Standards and Labelling) Group. The Group considered the claims “honey should be the first line of treatment for patients with a cough” and “antibiotics alone will not prevent you getting a cough, while honey can help with the symptoms” were claims that a food could treat human disease.
The ASA considered coughs were a symptom of a range of diseases and adverse health conditions, and therefore claims that honey treated coughs were claims that a food could prevent, treat or cure human disease. In addition, the ad referenced public concerns about the Covid-19 pandemic through the wording, “IN OUR CURRENT HEALTH CONSCIOUS SOCIETY no-one could be blamed for being concerned about their overall wellbeing. There is, however, a simple form of self-treatment that has government backing”, and in that context we considered the references to coughs would be understood as references to a symptom of Covid-19 in particular.
We acknowledged that the public health body Public Health England recommended using honey as a first approach to relieving coughs. The Advertising Code, however, prohibited advertisers from stating or implying that a food prevented, treated or cured human disease in any circumstance. The ad also stated “The greater the MGO number on the pot, the higher the anti-microbial properties in the Manuka honey”.
We considered that claim would be interpreted by consumers to mean that the featured products, or substances in those products, killed harmful microorganisms and therefore could both prevent those who consumed the products from contracting diseases caused by such microorganisms, and treat or cure diseases caused by such microorganisms.
We therefore considered the ad’s claim “anti-microbial” was a claim that a food could prevent or treat human disease. Because it was prohibited to make such claims for foods, we did not assess the evidence submitted to substantiate the claim in the ad. Because we considered claims that honey could treat coughs were claims that a food could treat human disease, and because we considered the claim “anti-microbial” was a claim that a food could prevent or treat human disease, we concluded that the ad breached the Code.
The ad breached CAP Code (Edition 12) rule 15.6.2 15.6.2 Claims that state or imply a food prevents, treats or cures human disease. Reduction-of disease-risk claims are acceptable if authorised by the European Commission (Food, food supplements and associated health or nutrition claims).
The ad must not appear again in its current form. We told Manuka Doctor (UK) Ltd to remove claims to prevent, treat or cure human disease from their advertising.