Public Acceptability of Nudging and Taxing To Reduce Consumption of Alcohol, Tobacco, and Food: A Population-Based Survey Experiment
Abstract
Introduction
There is growing evidence for the effectiveness of choice architecture or ‘nudge’ interventions to change a range of behaviors including the consumption of alcohol, tobacco and food. Public acceptability is key to implementing these and other interventions. However, few studies have assessed public acceptability of these interventions, including the extent to which acceptability varies with the type of intervention, the target behavior and with evidence of intervention effectiveness.
Method
These previous studies were assessed in an online study using a between-participants full factorial design with three factors: Policy (availability vs size vs labelling vs tax) x Behavior (alcohol consumption vs tobacco use vs high-calorie snack food consumption) x Evidence communication (no message vs assertion of policy effectiveness vs assertion and quantification of policy effectiveness [e.g., a 10% change in behavior]). Participants (N = 7058) were randomly allocated to one of the 36 groups. The primary outcome was acceptability of the policy.
Results
Acceptability differed across policy, behavior and evidence communication (all ps < .001). Labelling was the most acceptable policy (supported by 78%) and Availability the least (47%). Tobacco use was the most acceptable behavior to be targeted by policies (73%) compared with policies targeting Alcohol (55%) and Food (54%). Relative to the control group (60%), asserting evidence of effectiveness increased acceptability (63%); adding a quantification to this assertion did not significantly increase this further (65%).
Conclusion
Public acceptability for nudges and taxes to improve population health varies with the behavior targeted and the type of intervention but is generally favorable. Communicating that these policies are effective can increase support by a small but significant amount, suggesting that highlighting effectiveness could contribute to mobilizing public demand for policies. While uncertainty remains about the strength of public support needed, this may help overcome political inertia and enable action on behaviors that damage population and planetary health.