Effects of pictorial warnings on parents' purchases and perceptions of sugar-sweetened beverage categories

Pediatr Obes. 2023 Jul;18(7):e13030. doi: 10.1111/ijpo.13030. Epub 2023 Mar 25.

Abstract

Background: Sugar-sweetened beverage (SSB) consumption remains high among US children. Warning labels on SSBs hold promise for reducing consumption, but their impact may differ by SSB category.

Objectives: This study examined the effects of pictorial warnings on parents' beverage purchases and perceptions across SSB categories.

Methods: Parents of children ages 2-12 (n = 326) visited a convenience store laboratory in North Carolina. Participants were randomly assigned to see SSBs carrying either pictorial warning labels or control labels. Parents purchased a beverage for their child and completed a survey.

Results: Responses from parents in the control arm suggest underlying perceptions of flavoured milk (2.8 on scale ranging from 1 to 5), flavoured water (2.6), and fruit-flavoured drinks (2.5) as the most healthful SSB categories. Compared to the control, pictorial warnings led to the largest reductions in purchases of fruit drinks (-61%), soda (-36%) and flavoured milk (-32%). Warnings also lowered the perceived healthfulness of flavoured water (d = -0.34), flavoured milk (d = -0.28), sports drinks (d = -0.25), and a reduction in intentions to give one's child sports drinks (d = -0.30), flavoured water (d = -0.24) and sweet tea (d = -0.22, all p < 0.05).

Conclusions: Warning labels may have heterogeneous effects across SSB categories. Future research should assess the psychological mechanisms underlying these heterogeneous effects.

Keywords: beverage categories; graphic warnings; health warning labels; pictorial labels; sugar-sweetened beverages; sugary drinks.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Beverages
  • Child
  • Humans
  • Milk
  • Parents
  • Sugar-Sweetened Beverages*
  • Water

Substances

  • Water