Turning great ideas into healthier communities


Sugar Alert: Evaluation of San Francisco's Sugar Sweetened Beverage Advertising Warning Label Law

Project Director(s)

Lynn Silver

Sugar Alert is a 4-year study supported by the National Institutes of Health [award pending] and the Robert Wood Johnson Foundation to assess the impact of the first-ever sugar-sweetened beverage (SSB) warning labeling policy on knowledge and attitudes towards, and consumption of sugary drinks. SSB consumption is a major contributor to the twin epidemics of obesity and diabetes in America.

Starting in late 2016, San Francisco will require prominent warning labels on most SSB advertisements: "WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. This is a message from the City and County of San Francisco.” Because San Francisco is the first jurisdiction to apply a warning label to SSBs, the proposed study offers an unprecedented opportunity to document if and how this approach could provide a viable tool for obesity prevention.

Warning labels are a mainstay in evidence-based tobacco and alcohol policymaking. They have proven effective in changing attitudes, knowledge and the consumption of tobacco and to a lesser extent, alcohol, and therefore hold great promise for obesity prevention. San Francisco’s will be the first real-world experiment in applying them to sugar sweetened beverages (SSBs.) Study aims are geared toward providing answers to key questions that policymakers, deliberating over such approaches, are asking: Are warning labels feasible to implement? Are they effective for raising awareness of health risks, changing public attitudes about SSBs, or lowering their consumption?

The study will interview a random sample of residents by telephone, starting in July 2016, to examine how consumers understand and react to warning labels on advertisements. Data from individuals will be kept in strict accordance with protection of confidentiality. The study will compare changes over a three year period from before the law to 2 years after in San Francisco, where the law will be in effect, to San Jose, a control city. A complementary study that documents relevant advertising in both San Francisco and San Jose locations will assess compliance and advertiser responses to the warning label.

Project Principal Investigator is Lynn Silver, MD, MPH, PHI Senior Advisor for Chronic Disease and Obesity Prevention (lsilver@phi.org), accompanied by Senior Investigator Dr. Tom Greenfield, PhD, Scientific Director, PHI's Alcohol Research Group (tgreenfield@arg.org).