Association of a Community Campaign for Better Beverage Choices With Beverage Purchases From Supermarkets

Abstract

Importance: Data are needed to evaluate community interventions to reduce consumption of sugary drinks. Supermarket sales data can be used for this purpose.

Objective: To compare beverage sales in Howard County, Maryland (HC), with sales in comparison stores in a contiguous state before and during a 3-year campaign to reduce consumption of sugary beverages.

Design, setting, and partipicants: This observational experiment with a control group included 15 HC supermarkets and 17 comparison supermarkets. Weekly beverage sales data at baseline (January 1 to December 31, 2012) and from campaign years 1 to 3 (January 1, 2013, through December 31, 2015) were analyzed. A difference-in-differences (DID) regression compared the volume sales per product per week in the HC and comparison stores, controlling for mean product price, competitor's product price, product size, weekly local temperature, and manufacturer.

Exposures: The campaign message was to reduce consumption of all sugary drinks. Television advertising, digital marketing, direct mail, outdoor advertising, social media, and earned media during the 3-year period created 17 million impressions. Community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care, and government settings.

Main outcomes and measures: Sales were tracked of sugary drinks highlighted in the campaign, including regular soda, sports drinks, and fruit drinks. Sales of diet soda and 100% juice were also tracked. Sales data are expressed as mean fluid ounces sold per product, per store, per week.

Results: Regular soda sales in the 15 HC supermarkets decreased (-19.7%) from 2012 through 2015, whereas sales remained stable (0.8%) in the 17 comparison supermarkets (DID adjusted mean, -369 fl oz; 95% CI, -469 to -269 fl oz; P < .01). Fruit drink sales decreased (-15.3%) in HC stores and remained stable (-0.6%) in comparison stores (DID adjusted mean, -342 fl oz; 95% CI, -466 to -220 fl oz; P < .001). Sales of 100% juice decreased more in HC (-15.0%) than comparison (-2.1%) stores (DID mean, -576 fl oz; 95% CI, -776 to -375 fl oz; P < .001). Sales of sports drinks (-86.3 fl oz; 95% CI, -343.6 to 170.9 fl oz) and diet soda (-17.8 in HC stores vs -11.3 in comparison stores; DID adjusted mean, -78.9 fl oz; 95% CI, -182.1 to 24.4 fl oz) decreased in both communities, but the decreases were not significantly different between groups.

Conclusions and relevance: A locally designed, multicomponent campaign to reduce consumption of sugary drinks was associated with an accelerated decrease in sales of regular soda, fruit drinks, and 100% juice. This policy-focused campaign provides a road map for other communities to reduce consumption of sugary drinks.

Figure 1.. Comparison of Store Groups in Sales of Regular Soda

This graph was produced by IRI MarketAdvantage to demonstrate the close match between Howard County, Maryland (HC) and comparison stores in sales of regular soda. The total sales of regular soda per 1 million all-commodity volume (ACV) of total supermarket sales in the HC stores (test) and comparison stores (control) for the 52 weeks ending on May 20, 2012, are given.

Figure 2.. Moving Mean of Adjusted Weekly Volume Sales

The moving mean sales of regular soda for stores in Howard County, Maryland (HC) and comparison stores (CS) and the estimated volume sales for HC are shown. The estimated sales represent the expected HC sales without exposure to the campaign. The HC estimated sales were calculated by adjusting the intercept of the volume sales in comparison stores. To convert fluid ounces to milliliters, multiply by 30.