title: Effects of plain packaging, warning labels, and taxes on young people's predicted sugar-sweetened beverage preferences: an experimental study.
abstract: Consumption of sugar-sweetened beverages (SSBs) is associated with increased risk of obesity, diabetes, heart disease and dental caries. Our aim was to assess the effects of plain packaging, warning labels, and a 20 % tax on predicted SSB preferences, beliefs and purchase probabilities amongst young people.
  
  
  
  A 2 × 3 × 2 between-group experimental study was conducted over a one-week period in August 2014. Intervention scenarios were delivered, and outcome data collected, via an anonymous online survey. Participants were 604 New Zealand young people aged 13-24 years who consumed soft drinks regularly. Participants were randomly allocated using a computer-generated algorithm to view one of 12 experimental conditions, specifically images of branded versus plain packaged SSBs, with either no warning, a text warning, or a graphic warning, and with or without a 20 % tax. Participant perceptions of the allocated SSB product and of those who might consume the product were measured using seven-point Likert scales. Purchase probabilities were measured using 11-point Juster scales.
  
  
  
  Six hundred and four young people completed the survey (51 % female, mean age 18 (SD 3.4) years). All three intervention scenarios had a significant negative effect on preferences for SSBs (plain packaging: F (6, 587) = 54.4, p <0.001; warning label: F (6, 588) = 19.8, p <0.001; 20 % tax: F (6, 587) = 11.3, p <0.001). Plain packaging and warning labels also had a significant negative impact on reported likelihood of purchasing SSB's (p = <0.001). A 20 % tax reduced participants' purchase probability but the difference was not statistically significant (p = 0.2).
  
  
  
  Plain packaging and warning labels significantly reduce young people's predicted preferences for, and reported probability of purchasing, SSBs.
authors: Auckland District Health Board, Auckland City Hospital Nutrition, Auckland, New Zealand.
authors: Tessa
authors: T
authors: Bollard
authors: Department of Marketing, University of Otago, Dunedin, New Zealand.
authors: Ninya
authors: N
authors: Maubach
authors: National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland, New Zealand.
authors: Natalie
authors: N
authors: Walker
authors: National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland, New Zealand. c.nimhurchu@auckland.ac.nz.
authors: Cliona
authors: 0000-0002-1144-9167
authors: C
authors: Ni Mhurchu
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001628:Beverages / Q000191:economics; D002253:Carbonated Beverages / Q000191:economics; D003731:Dental Caries / Q000209:etiology; D004032:Diet / Q000191:economics; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D005260:Female; D005515:Food Labeling; D018857:Food Packaging; D005518:Food Preferences; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D009520:New Zealand; D009765:Obesity / Q000209:etiology / Q000517:prevention & control; D010465:Perception; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D013660:Taxes; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose; D013549:Sweetening Agents
keywords: Experiment; Nutrition labels; Plain packaging; Sugar sweetened beverage; Tax