Association of a Community Campaign for Better Beverage Choices With Beverage Purchases From Supermarkets

Abstract

IMPORTANCE Data are needed to evaluate community interventions to reduce consumption of sugary drinks. Supermarket sales data can be used for this purpose.OBJECTIVE To compare beverage sales in Howard County, Maryland (HC), with sales in comparison stores in a contiguous state before and during a 3-year campaign to reduce consumption of sugary beverages. DESIGN, SETTING, AND PARTIPICANTSThis observational experiment with a control group included 15 HC supermarkets and 17 comparison supermarkets. Weekly beverage sales data at baseline (January 1 to December 31, 2012) and from campaign years 1 to 3 (January 1, 2013, through December 31, 2015) were analyzed. A difference-in-differences (DID) regression compared the volume sales per product per week in the HC and comparison stores, controlling for mean product price, competitor's product price, product size, weekly local temperature, and manufacturer.EXPOSURES The campaign message was to reduce consumption of all sugary drinks. Television advertising, digital marketing, direct mail, outdoor advertising, social media, and earned media during the 3-year period created 17 million impressions. Community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care, and government settings.MAIN OUTCOMES AND MEASURES Sales were tracked of sugary drinks highlighted in the campaign, including regular soda, sports drinks, and fruit drinks. Sales of diet soda and 100% juice were also tracked. Sales data are expressed as mean fluid ounces sold per product, per store, per week.RESULTS Regular soda sales in the 15 HC supermarkets decreased (−19.7%) from 2012 through 2015, whereas sales remained stable (0.8%) in the 17 comparison supermarkets (DID adjusted mean, −369 fl oz; 95% CI, −469 to −269 fl oz; P < .01). Fruit drink sales decreased (−15.3%) in HC stores and remained stable (−0.6%) in comparison stores (DID adjusted mean, −342 fl oz; 95% CI, −466 to −220 fl oz; P < .001). Sales of 100% juice decreased more in HC (−15.0%) than comparison (−2.1%) stores (DID mean, −576 fl oz; 95% CI, −776 to −375 fl oz; P < .001). Sales of sports drinks (−86.3 fl oz; 95% CI, −343.6 to 170.9 fl oz) and diet soda (−17.8 in HC stores vs −11.3 in comparison stores; DID adjusted mean, −78.9 fl oz; 95% CI, −182.1 to 24.4 fl oz) decreased in both communities, but the decreases were not significantly different between groups. CONCLUSIONS AND RELEVANCEA locally designed, multicomponent campaign to reduce consumption of sugary drinks was associated with an accelerated decrease in sales of regular soda, fruit drinks, and 100% juice. This policy-focused campaign provides a road map for other communities to reduce consumption of sugary drinks.

Association of the LiveLighter mass media campaign with consumption of sugar‐sweetened beverages: Cohort study

“…These positive behaviour change findings extend the literature which to date has shown public health campaigns in the United States targeting SSB consumption not accompanied by complementary policy or regulatory change have demonstrated population‐level impacts on message awareness and intentions to reduce consumption, but less so on more distal behaviour changes . On the other hand, those that have run concurrently with healthy beverage policy implementation or financial disincentives have demonstrated the greatest impacts on SSB consumption . For the latter interventions, it is not possible to determine the unique contribution of the media component to effecting behaviour change.…”

“…The World Health Organization identified mass media as an effective tool for obesity prevention, and public health advertisements about the health consequences of excess body weight accompanied by graphic imagery are most persuasive . Campaigns promoting reduced SSB consumption have been implemented in several states of the United States . Those consisting primarily of mass media advertising have promoted increased knowledge and intentions, while the more comprehensive campaigns where mass media advertising was accompanied by significant policy or regulatory change demonstrated impact on SSB consumption …”

“…10 Campaigns promoting reduced SSB consumption have been implemented in several states of the United States. [11][12][13][14][15][16] Those consisting primarily of mass media advertising have promoted increased knowledge and intentions, while the more comprehensive campaigns where mass media advertising was accompanied by significant policy or regulatory change demonstrated impact on SSB consumption. 13,16,17 In Australia, the first application of mass media designed to reduce SSB consumption was the Western Australian governmentfunded LiveLighter "Sugary Drinks" campaign, which targeted adults and was based on behavioural theory and considerable formative research.…”

Tackling Obesity and Disease: The Culprit Is Sugar; the Response Is Legal Regulation

“…Tobacco control offers a powerful model, suggesting that success requires a suite of interventions working in concert: labeling, warnings, taxation, portion sizes, product formulation, marketing restrictions, and bans in high‐risk settings such as schools and hospitals. For example, public education combined with multiple interventions reduced SSB consumption in one Maryland county by 20 percent . Each intervention deserves detailed analysis, but I'm kick‐starting scholarly and policy conversation by systematically laying out the major legal tools.…”

“…For example, public education combined with multiple interventions reduced SSB consumption in one Maryland county by 20 percent. 5 Each intervention deserves detailed analysis, but I'm kick-starting scholarly and policy conversation by systematically laying out the major legal tools.…”