(P26-005-20) Effectiveness of Sugary Drink Warnings: A Meta-Analysis of Experimental Studies

Objectives: Policymakers in five U.S. states have proposed sugary drink warnings. A growing number of experimental studies have examined sugary drink warnings’ impacts, but no research has synthesized this literature. To inform ongoing policy debates, this study aimed to identify, across the body of experimental studies, the effects of sugary drink warnings compared with control conditions.

Methods: In 2019, we systematically searched four databases using comprehensive search terms. We also searched reference lists of relevant articles. Two investigators independently screened titles, abstracts, and full-texts to identify peer-reviewed experiments that examined the effects of sugary drink warnings compared to a control condition. Two investigators independently extracted study characteristics and effect sizes from all relevant articles. We meta-analyzed any outcome assessed in at least two studies, combining effect sizes using random effects meta-analytic procedures.

Results: Twenty-three experiments with data on 16,241 individuals were included in the meta-analysis. Relative to control conditions, sugary drink warnings were more likely to be noticed (d with Hedges’s correction= .83, 95% CI: .54, 1.12), caused stronger emotional reactions (d= .69, 95% CI: .25, 1.13) and elicited more thinking about health (d= .65, 95% CI: .29, 1.01).  Sugary drink warnings also led to lower healthfulness perceptions (d = -.22, 95% CI: -.27, -.17) and stronger disease likelihood perceptions (d= .15, 95% CI: .06, .24). Moreover, sugary drink warnings reduced both hypothetical (d= -.32, 95% CI: -.44, -.21) and actual consumption and purchasing behavior (d= -.17, 95% CI: -.30, -.04). Significant effects were not observed for perceptions of added sugar (d= .25, 95% CI: -.05, .55) or positive sugary drink attitudes (d= -.54, 95% CI: -1.43, .35). Moderation analyses revealed that health warnings (e.g., “Beverages with added sugar contribute to obesity”) led to greater reductions in hypothetical SSB selection than did nutrient warnings (e.g., “High in sugar”, moderation p= .04).

Conclusions: Evidence from the experimental literature supports sugary drink warnings as a population-level strategy for changing behavior, as well as cognitions, emotions, perceptions, and intentions.

Funding Sources: Healthy Eating Research Program of the Robert Wood Johnson Foundation