Anna K M Blackwell1, Katie De-Loyde2, Gareth J Hollands3, Richard W Morris4, Laura A Brocklebank2, Olivia M Maynard2, Paul C Fletcher5,6, Theresa M Marteau3, Marcus R Munafò2,7,8. 1. School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK. anna.blackwell@bristol.ac.uk. 2. School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK. 3. Behaviour and Health Research Unit, University of Cambridge, Cambridge, CB2 0SR, UK. 4. Bristol Medical School: Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. 5. Department of Psychiatry, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK. 6. The Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories (IMS-MRL), University of Cambridge, Cambridge, CB2 0QQ, UK. 7. MRC Integrative Epidemiology Unit (IEU), University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK. 8. National Institute for Health Research Bristol Biomedical Research Centre (NIHR Bristol BRC), Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
Abstract
BACKGROUND: Increasing the availability of healthier food increases its selection and consumption. However, there is an absence of evidence related to alcohol. This study aimed to estimate the impact of increasing the absolute and relative availability of non-alcoholic compared to alcoholic drinks on selection. We also assessed whether effects were modified by cognitive resource. METHODS:UK adult weekly alcohol consumers (n = 808) were recruited to an online experiment with a hypothetical drink selection task. Participants were randomly assigned to one of eight conditions, in a 4 (availability) × 2 (cognitive resource) factorial design. The four availability conditions were: i. Reference 1 (two non-alcoholic, two alcoholic drinks); ii. Reference 2 (four non-alcoholic, four alcoholic drinks); iii. Increased non-alcoholic drinks (six non-alcoholic, two alcoholic drinks); iv. Increased alcoholic drinks (two non-alcoholic, six alcoholic drinks). The two cognitive resource conditions were: a. Low (high time pressure); b. High (low time pressure). Logistic regression was used to assess selection of a non-alcoholic drink. RESULTS: 49% of participants selected a non-alcoholic drink in the Increased non-alcoholic drinks condition, compared to 36% in Reference 1, 39% in Reference 2, and 26% in the Increased alcoholic drinks condition. Non-alcoholic drink selection was similar between Reference 1 and 2 when the total number of drinks increased (absolute availability) but the proportion of non-alcoholic compared to alcoholic drinks (relative availability) was unchanged (OR = 1.15, 95% CI 0.77, 1.73). In contrast, the odds of selecting a non-alcoholic drink were 71% higher when both absolute and relative availability of non-alcoholic compared to alcoholic drinks was increased from Reference 1 to the Increased non-alcoholic drinks condition (OR: 1.71, 95% CI 1.15, 2.54), and 48% higher when increased from Reference 2 to the Increased non-alcoholic drinks condition (OR: 1.48, 95% CI 0.99, 2.19). There was no evidence of an effect of cognitive resource. CONCLUSIONS: Greater availability of non-alcoholic drinks, compared to alcoholic drinks, increased their online selection, an effect that may be larger when changing their relative availability, i.e., increasing the proportion of non-alcoholic drinks. Naturalistic studies are needed to determine the impact of availability interventions on reducing alcohol purchasing and consumption.
RCT Entities:
BACKGROUND: Increasing the availability of healthier food increases its selection and consumption. However, there is an absence of evidence related to alcohol. This study aimed to estimate the impact of increasing the absolute and relative availability of non-alcoholic compared to alcoholic drinks on selection. We also assessed whether effects were modified by cognitive resource. METHODS: UK adult weekly alcohol consumers (n = 808) were recruited to an online experiment with a hypothetical drink selection task. Participants were randomly assigned to one of eight conditions, in a 4 (availability) × 2 (cognitive resource) factorial design. The four availability conditions were: i. Reference 1 (two non-alcoholic, two alcoholic drinks); ii. Reference 2 (four non-alcoholic, four alcoholic drinks); iii. Increased non-alcoholic drinks (six non-alcoholic, two alcoholic drinks); iv. Increased alcoholic drinks (two non-alcoholic, six alcoholic drinks). The two cognitive resource conditions were: a. Low (high time pressure); b. High (low time pressure). Logistic regression was used to assess selection of a non-alcoholic drink. RESULTS: 49% of participants selected a non-alcoholic drink in the Increased non-alcoholic drinks condition, compared to 36% in Reference 1, 39% in Reference 2, and 26% in the Increased alcoholic drinks condition. Non-alcoholic drink selection was similar between Reference 1 and 2 when the total number of drinks increased (absolute availability) but the proportion of non-alcoholic compared to alcoholic drinks (relative availability) was unchanged (OR = 1.15, 95% CI 0.77, 1.73). In contrast, the odds of selecting a non-alcoholic drink were 71% higher when both absolute and relative availability of non-alcoholic compared to alcoholic drinks was increased from Reference 1 to the Increased non-alcoholic drinks condition (OR: 1.71, 95% CI 1.15, 2.54), and 48% higher when increased from Reference 2 to the Increased non-alcoholic drinks condition (OR: 1.48, 95% CI 0.99, 2.19). There was no evidence of an effect of cognitive resource. CONCLUSIONS: Greater availability of non-alcoholic drinks, compared to alcoholic drinks, increased their online selection, an effect that may be larger when changing their relative availability, i.e., increasing the proportion of non-alcoholic drinks. Naturalistic studies are needed to determine the impact of availability interventions on reducing alcohol purchasing and consumption.
Entities:
Keywords:
Alcohol; Alcohol-free; Availability; Choice architecture; Non-alcoholic; Policy; Public health
Authors: Mirela Anamaria Jimborean; Liana Claudia Salanță; Anna Trusek; Carmen Rodica Pop; Maria Tofană; Elena Mudura; Teodora Emilia Coldea; Anca Farcaș; Maria Ilieș; Sergiu Pașca; Alina Uifălean Journal: Int J Environ Res Public Health Date: 2021-03-23 Impact factor: 3.390