“If I saw that, a drink with 16 teaspoons of sugar, I’d put it down”: qualitative insights into Australian adolescents’ reactions to front-of-pack label options for sugar-sweetened beverages - BMC Nutrition

Background Mandatory front-of-pack warning labels on food and beverages assist consumers in making informed consumption and purchase choices. There has been limited research into adolescents’ responses to warning label options for sugar-sweetened beverages (SSBs), despite being the highest consumers of these products globally. Methods Twelve focus groups of 6–8 adolescents were undertaken (ntotal = 89), stratified by gender, location (metropolitan/regional), and school type (public/private). After initial discussions of beverage consumption and preferences, the main label discussion was based on 15 potential SSB warning labels across 4 label categories: sugar content, nutrient content (calories, % daily energy intake), exercise equivalent information and health effects. Graphic warning labels were also shown separately at the end of group discussions to explore preliminary reactions to a novel contrasting approach. Results It was apparent from Theme 1, Drivers of consumption, that participants’ consumption was driven by a range of individual (e.g., taste, functional benefit) and situational (school, work and home environments, social settings) factors. Within Theme 2, Perceptions of label effectiveness, labels needed to command attention and be perceived as serious, and the word ‘warning’ and shape of the label contributed to participants’ perceptions of the label as serious. Theme 2 also related to providing information that was clear and informative, relevant, resistant to self-exemption, and perceived as prompting reconsideration of consumption and purchase of SSBs. Labels depicting teaspoons of sugar content (text and pictogram) were perceived most strongly across these criteria, with responses indicating potential for behaviour change. In Theme 3, Consideration of potential unintended consequences, responses to some labels ranged from perceptions relating to potential switching to artificially sweetened beverages, to more serious issues such as the potential for stigma and encouraging negative eating behaviours among some adolescents. Conclusions This study adds valuable in-depth insights into the potential effects of warning labels on SSBs among adolescents, a group with high consumption levels with the teaspoons of sugar label a standout in potential effectiveness. These findings highlight the importance of testing messaging among specific consumer groups, to assist in determining approaches perceived as effective while limiting stigma and other unintended consequences.