Is evoking fear effective? Exploratory findings from a randomised experiment on the impacts of health warning labels on sugar-sweetened beverages

Abstract

Objective: Health warning labels (HWLs) have been suggested to be effective in reducing consumption of sugar-sweetened beverages (SSBs). Yet, the efficacy and acceptability of SSB HWLs of different formats (textual/pictorial) and severity remain unclear. This exploratory study aims to examine the extent and mechanism through which HWLs of different formats and severity may affect responses towards the HWLs and SSB consumption. Design: Randomized online experiment. Participants were exposed to images of a hypothetical SSB bearing a HWL of one of three conditions: text-only HWL, moderately severe pictorial HWL, highly severe pictorial HWL. They then responded to theory-based affective, cognitive, and behavioral measures. Setting: Singapore Participants: 127 young adult consumers from a public university Results: Direct effects were found for fear, avoidance, reactance, and acceptability of the HWLs, but not attitude, intention, or motivation to consume less SSBs. Pictorial (moderately severe and highly severe) HWLs were associated with greater fear, avoidance, and reactance, and lower acceptability than text-only HWLs. There was weak evidence that highly severe pictorial HWLs resulted in greater reactance than moderately severe pictorial HWLs. Fear mediated the effect of HWLs of different severity levels on avoidance, reactance, intention, and motivation, but not for attitude or acceptability. Conclusions: Exploratory findings indicate that although pictorial HWLs were less acceptable, they may still be effective in influencing intention and motivation to reduce SSB consumption through the psychological mechanism of fear. Hence, graphic HWLs should not be dismissed too quickly when considering strategies for reducing SSB consumption.