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Public Acceptability in the UK and USA of Nudging to Reduce Obesity: The Example of Reducing Sugar-Sweetened Beverages Consumption

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  • Dragos C Petrescu
  • Gareth J Hollands
  • Dominique-Laurent Couturier
  • Yin-Lam Ng
  • Theresa M Marteau

Abstract

Background: “Nudging”—modifying environments to change people’s behavior, often without their conscious awareness—can improve health, but public acceptability of nudging is largely unknown. Methods: We compared acceptability, in the United Kingdom (UK) and the United States of America (USA), of government interventions to reduce consumption of sugar-sweetened beverages. Three nudge interventions were assessed: i. reducing portion Size, ii. changing the Shape of the drink containers, iii. changing their shelf Location; alongside two traditional interventions: iv. Taxation and v. Education. We also tested the hypothesis that describing interventions as working through non-conscious processes decreases their acceptability. Predictors of acceptability, including perceived intervention effectiveness, were also assessed. Participants (n = 1093 UK and n = 1082 USA) received a description of each of the five interventions which varied, by randomisation, in how the interventions were said to affect behaviour: (a) via conscious processes; (b) via non-conscious processes; or (c) no process stated. Acceptability was derived from responses to three items. Results: Levels of acceptability for four of the five interventions did not differ significantly between the UK and US samples; reducing portion size was less accepted by the US sample. Within each country, Education was rated as most acceptable and Taxation the least, with the three nudge-type interventions rated between these. There was no evidence to support the study hypothesis: i.e. stating that interventions worked via non-conscious processes did not decrease their acceptability in either the UK or US samples. Perceived effectiveness was the strongest predictor of acceptability for all interventions across the two samples. Conclusion: In conclusion, nudge interventions to reduce consumption of sugar-sweetened beverages seem similarly acceptable in the UK and USA, being more acceptable than taxation, but less acceptable than education. Contrary to prediction, we found no evidence that highlighting the non-conscious processes by which nudge interventions may work decreases their acceptability. However, highlighting the effectiveness of all interventions has the potential to increase their acceptability.

Suggested Citation

  • Dragos C Petrescu & Gareth J Hollands & Dominique-Laurent Couturier & Yin-Lam Ng & Theresa M Marteau, 2016. "Public Acceptability in the UK and USA of Nudging to Reduce Obesity: The Example of Reducing Sugar-Sweetened Beverages Consumption," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-18, June.
    • Handle: RePEc:plo:pone00:0155995
    DOI: 10.1371/journal.pone.0155995
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    1. James P. Reynolds & Milica Vasiljevic & Mark Pilling & Marissa G. Hall & Kurt M. Ribisl & Theresa M. Marteau, 2020. "Communicating Evidence about the Causes of Obesity and Support for Obesity Policies: Two Population-Based Survey Experiments," IJERPH, MDPI, vol. 17(18), pages 1-19, September.
    2. Rafaï, Ismaël & Ribaillier, Arthur & Jullien, Dorian, 2025. "The impact on nudge acceptability judgements of framing and consultation of the targeted population," Behavioural Public Policy, Cambridge University Press, vol. 9(1), pages 176-191, January.
    3. Lan Nguyen & Hans De Steur, 2021. "Public Acceptability of Policy Interventions to Reduce Sugary Drink Consumption in Urban Vietnam," Sustainability, MDPI, vol. 13(23), pages 1-18, December.
    4. Mariusz Duplaga, 2020. "The Acceptance of Key Public Health Interventions by the Polish Population Is Related to Health Literacy, But Not eHealth Literacy," IJERPH, MDPI, vol. 17(15), pages 1-19, July.
    5. Arthur Ribaillier & Ismaël Rafaï & Dorian Jullien, 2021. "The Impact on Acceptability Judgments about Nudges of Framing and Consultation with the Targeted Population," GREDEG Working Papers 2021-12, Groupe de REcherche en Droit, Economie, Gestion (GREDEG CNRS), Université Côte d'Azur, France.
    6. Reynolds, J.P. & Archer, S. & Pilling, M. & Kenny, M. & Hollands, G.J. & Marteau, T.M., 2019. "Public acceptability of nudging and taxing to reduce consumption of alcohol, tobacco, and food: A population-based survey experiment," Social Science & Medicine, Elsevier, vol. 236(C), pages 1-1.
    7. Agnieszka Piekara, 2022. "Sugar Tax or What? The Perspective and Preferences of Consumers," IJERPH, MDPI, vol. 19(19), pages 1-12, October.
    8. Ori Katz & Eyal Zamir, 2021. "Do People Like Mandatory Rules? The Choice Between Disclosures, Defaults, and Mandatory Rules in Supplier‐Customer Relationships," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 18(2), pages 421-460, June.
    9. Le Bodo, Yann & Etilé, Fabrice & Julia, Chantal & Friant-Perrot, Marine & Breton, Eric & Lecocq, Sébastien & Boizot-Szantai, Christine & Bergeran, Céline & Jabot, Françoise, 2022. "Public health lessons from the French 2012 soda tax and insights on the modifications enacted in 2018," Health Policy, Elsevier, vol. 126(7), pages 585-591.
    10. Reynolds, J.P. & Pilling, M. & Marteau, T.M., 2018. "Communicating quantitative evidence of policy effectiveness and support for the policy: Three experimental studies," Social Science & Medicine, Elsevier, vol. 218(C), pages 1-12.
    11. Marteau, Theresa M. & Mantzari, Eleni & Hollands, Gareth J., 2025. "Do nudges need a regulatory push? Comparing the effectiveness and implementation of exemplar nudge (size-based) and non-nudge (price-based) dietary interventions," Social Science & Medicine, Elsevier, vol. 373(C).
    12. Reisch, Lucia A. & Sunstein, Cass R. & Gwozdz, Wencke, 2017. "Viewpoint: Beyond carrots and sticks: Europeans support health nudges," Food Policy, Elsevier, vol. 69(C), pages 1-10.
    13. Mantzari, Eleni & Reynolds, James P. & Jebb, Susan A. & Hollands, Gareth J. & Pilling, Mark A. & Marteau, Theresa M., 2022. "Public support for policies to improve population and planetary health: A population-based online experiment assessing impact of communicating evidence of multiple versus single benefits," Social Science & Medicine, Elsevier, vol. 296(C).
    14. Sandro Casal & Francesco Guala & Luigi Mittone, 2019. "On the Transparency of Nudges: An Experiment," CEEL Working Papers 1902, Cognitive and Experimental Economics Laboratory, Department of Economics, University of Trento, Italia.
    15. Hagmann, Désirée & Siegrist, Michael & Hartmann, Christina, 2018. "Taxes, labels, or nudges? Public acceptance of various interventions designed to reduce sugar intake," Food Policy, Elsevier, vol. 79(C), pages 156-165.
    16. Vivica Kraak & Tessa Englund & Sarah Misyak & Elena Serrano, 2017. "Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environme," IJERPH, MDPI, vol. 14(7), pages 1-31, July.
    17. Bialowolski, Piotr & Weziak-Bialowolska, Dorota & McNeely, Eileen, 2021. "A socially responsible financial institution – The bumpy road to improving consumer well-being," Evaluation and Program Planning, Elsevier, vol. 86(C).

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