238096 A new take on sugary beverage taxation and calorie labeling: Does offering price discounts or presenting energy equivalent information change behavior?

Monday, October 31, 2011

J. Jane S. Jue, MD, MSc , Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania and Department of Veterans Affairs, Philadelphia, PA
Matthew Press, MD, MSc , Department of Public Health, Weill Cornell Medical College, New York, NY
Daniel McDonald, MA , Department of Statistics, Carnegie Mellon University, Pittsburgh
Kevin Volpp, MD, PhD , Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
David Asch, MD, MBA , Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
Nandita Mitra, PhD , Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
George Loewenstein, PhD , Departments of Economics and Psychology, Carnegie Mellon University, Pittsburgh, PA
Background: With mixed early evidence on the effectiveness of policies such as sugary beverage taxation and calorie-labeling, the objective of our study was to determine if (1) an alternative financial incentive—a price discount, and (2) an alternative presentation of calories – exercise equivalent messaging, would increase the sales of zero-calorie beverages and decrease the sale of sugary beverages. Methods: This was a national prospective trial with three hospital sites. Each site received five interventions: (1) a 10% price discount on zero-calorie beverages; (2)10% discount plus messaging promoting the discount; (3) messaging comparing calorie information of sugar-sweetened beverages with zero-calorie beverages; (4) messaging comparing exercise equivalent information (time necessary on a treadmill to expend calories); and (5) messaging comparing both calorie and exercise equivalent information. Poisson regression models were used to assess the association between sales of beverages and interventions. Results: Overall there were no significant effects on beverage purchases for any of the five interventions. Subgroup analyses revealed only one site with significant effects, which occurred during only two interventions: the discount and discount plus messaging interventions (purchases of sugary beverages decreased 10.5% (.004) and 10.3% (.008), respectively). However, these results were consistent with random chance under the null model. Discussion: The impact of price discounts and calorie and exercise equivalent messaging on purchasing of beverages was negligible in most settings. Our results suggest consumer behavior around beverage choice is not fully understood. Policies targeting these types of interventions warrant further evaluation before widespread implementation.

Learning Areas:
Public health or related research

Learning Objectives:
Discuss current evidence around price discounts and calorie labeling. Discuss the use of behavioral economics concepts to influence food choice. Evaluate effectiveness of an alternative energy equivalent labeling trial.

Keywords: Obesity, Food and Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have a masters in health policy research and am an internist.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.