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Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages
  1. Caroline L Miller1,2,
  2. Joanne Dono2,3,
  3. Melanie A Wakefield4,5,
  4. Simone Pettigrew6,
  5. John Coveney7,
  6. David Roder8,
  7. Sarah J Durkin4,5,
  8. Gary Wittert9,10,
  9. Jane Martin11,
  10. Kerry A Ettridge2,3
  1. 1 School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
  2. 2 Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  3. 3 School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
  4. 4 Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
  5. 5 School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  6. 6 School of Psychology, Curtin University, Perth, Western Australia, Australia
  7. 7 College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  8. 8 Cancer Epidemiology and Population Health, University of South Australia, Adelaide, South Australia, Australia
  9. 9 Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
  10. 10 Centre for Nutrition and GI Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  11. 11 Obesity Policy Coalition and Alcohol and Obesity Policy, Cancer Council Victoria, Melbourne, Victoria, Australia
  1. Correspondence to Dr Caroline L Miller; caroline.miller{at}


Objective To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption.

Design A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2).

Participants Study 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430).

Primary outcome measures: levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses.

Results In 2017, all 10 potential policy initiatives received majority support (60%–88% either ‘somewhat’ or ‘strongly’ in favour). Initiatives with educative elements or focused on children received high support (>70%), with highest support observed for text warning labels on drink containers (88%) and government campaigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%–18% absolute difference) and/or in children (8%–26% absolute difference) and lower among SSB high consumers (7+ drinks per week; 9%–29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55%; χ2=15.7, p<0.001) and graphic health warnings (52%vs68%; χ2=23.4. p<0.001).

Conclusions There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.

  • sugar-sweetened beverages
  • policy
  • sugar tax
  • warning labels

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  • Contributors CLM conceptualised and led the design of the study with substantial contributions from KE, JD, MAW, SP, SJD, JC, DR, GW and JM. JD and KE coordinated the questions and conducted the analyses. CLM, KE and JD drafted the manuscript, and all authors contributed to the interpretation of data and critically revised the publication for important intellectual content. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.

  • Funding This research was supported by a National Health and Medical Research Centre (NHMRC) Project Grant GNT 1120618 and Cancer Council’s Beat Cancer Project on behalf of its donors and the State Government through the Department of Health. CM is supported by an NHMRC Career Development Fellowship and a Heart Foundation future leader fellowship, and MW is supported by a NHMRC Principal Research Fellowship.

  • Competing interests CLM, KE, JD, MAW, JC, DR, SJD and GW declared no competing interests. SP declares expert membership of Australian Government Health Star Ratings Committees, and JC declares membership of the Social Sciences and Economy Advisory Group of Food Standards Australia New Zealand.

  • Ethics approval The study was approved by the University of Adelaide’s Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Not required.

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