Adolescents’ perspectives on soft drinks after the introduction of the UK Soft Drinks Industry Levy: A focus group study using reflexive thematic analysis

Catrin P. Jones; Roxanne Armstrong-Moore; Tarra L. Penney; Steven Cummins; Sofie Armitage; Jean Adams; Martin White

doi:10.1016/j.appet.2022.106305

Adolescents’ perspectives on soft drinks after the introduction of the UK Soft Drinks Industry Levy: A focus group study using reflexive thematic analysis

Catrin P. Jones^*, Roxanne Armstrong-Moore, Tarra L. Penney, Steven Cummins, Sofie Armitage, Jean Adams, Martin White

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, is a fiscal policy to incentivise reformulation of eligible soft drinks. We aimed to explore perceptions of sugar, sugary drinks and the SDIL among adolescents in the UK post-implementation. Methods: 23 adolescents aged 11–14 years participated in four focus groups in 2018–2019. A semi-structured topic guide elicited relevant perspectives and included a group task to rank a selection of UK soft drinks based on their sugar content. Braun and Clarke's reflexive thematic analysis was used to undertake inductive analysis. Results: Four main themes were present: 1) Sweetened drinks are bad for you, but some are worse than others; 2) Awareness of the SDIL and ambivalence towards it 3) The influence of drinks marketing: value, pricing, and branding; 4) Openness to population-level interventions. Young people had knowledge of the health implications of excess sugar consumption, which did not always translate to their own consumption. Ambivalence and a mixed awareness surrounding the SDIL was also present. Marketing and parental and school restriction influenced their consumption patterns, as did taste, enjoyment and consuming drinks for functional purposes (e.g., to give them energy). Openness to future population-level interventions to limit consumption was also present. Conclusions: Our findings suggest that adolescents are accepting of interventions that require little effort from young people in order to reduce their sugar consumption. Further education-based interventions are likely to be unhelpful, in contexts where adolescents understand the negative consequences of excess sugar and SSB consumption.

Original language	English
Article number	106305
Journal	Appetite
Volume	179
DOIs	https://doi.org/10.1016/j.appet.2022.106305
Publication status	Published - 1 Dec 2022
Externally published	Yes

Bibliographical note

Funding Information:
This study is part of the evaluation of the health impacts of the UK Treasury Soft Drinks Industry Levy (SDIL), funded by the National Institute for Health Research ( White, 2017 ); a mixed methods project with Critical Realist positioning. Although this study uses an interpretive design, which typically rejects exploration of causal interpretation, the findings of this study will be contextualised ( Sayer, 2000 ) within a synthesis work package in the wider research programmme.

Funding Information:
This project was funded by the NIHR Public Health Research programme (Grant Nos. 16/49/01 and 16/130/01 ). At the time this study was conducted CPJ, MW, RA, TLP, SA & JA were also supported in part by: Programme grants to the MRC Epidemiology Unit from the Medical Research Council (grant No. MC_UU_12015/6 and MC_UU_00006/7 ); and the Centre for Diet and Activity Research (CEDAR) , a UKCRC Public Health Research Centre of Excellence – funding from the British Heart Foundation , Cancer Research UK , the Economic and Social Research Council , the Medical Research Council , the National Institute for Health Research , and the Wellcome Trust , under the auspices of the UK Clinical Research Collaboration is gratefully acknowledged. The views expressed are those of the authors and not necessarily those of the any of the above named funders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 The Authors

Keywords

Adolescents
Children
Obesity
Soft drinks
Soft drinks industry levy
Sugar

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.appet.2022.106305

Cite this

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title = "Adolescents{\textquoteright} perspectives on soft drinks after the introduction of the UK Soft Drinks Industry Levy: A focus group study using reflexive thematic analysis",

abstract = "Background: The UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, is a fiscal policy to incentivise reformulation of eligible soft drinks. We aimed to explore perceptions of sugar, sugary drinks and the SDIL among adolescents in the UK post-implementation. Methods: 23 adolescents aged 11–14 years participated in four focus groups in 2018–2019. A semi-structured topic guide elicited relevant perspectives and included a group task to rank a selection of UK soft drinks based on their sugar content. Braun and Clarke's reflexive thematic analysis was used to undertake inductive analysis. Results: Four main themes were present: 1) Sweetened drinks are bad for you, but some are worse than others; 2) Awareness of the SDIL and ambivalence towards it 3) The influence of drinks marketing: value, pricing, and branding; 4) Openness to population-level interventions. Young people had knowledge of the health implications of excess sugar consumption, which did not always translate to their own consumption. Ambivalence and a mixed awareness surrounding the SDIL was also present. Marketing and parental and school restriction influenced their consumption patterns, as did taste, enjoyment and consuming drinks for functional purposes (e.g., to give them energy). Openness to future population-level interventions to limit consumption was also present. Conclusions: Our findings suggest that adolescents are accepting of interventions that require little effort from young people in order to reduce their sugar consumption. Further education-based interventions are likely to be unhelpful, in contexts where adolescents understand the negative consequences of excess sugar and SSB consumption.",

keywords = "Adolescents, Children, Obesity, Soft drinks, Soft drinks industry levy, Sugar",

author = "Jones, {Catrin P.} and Roxanne Armstrong-Moore and Penney, {Tarra L.} and Steven Cummins and Sofie Armitage and Jean Adams and Martin White",

note = "Funding Information: This study is part of the evaluation of the health impacts of the UK Treasury Soft Drinks Industry Levy (SDIL), funded by the National Institute for Health Research ( White, 2017 ); a mixed methods project with Critical Realist positioning. Although this study uses an interpretive design, which typically rejects exploration of causal interpretation, the findings of this study will be contextualised ( Sayer, 2000 ) within a synthesis work package in the wider research programmme. Funding Information: This project was funded by the NIHR Public Health Research programme (Grant Nos. 16/49/01 and 16/130/01 ). At the time this study was conducted CPJ, MW, RA, TLP, SA & JA were also supported in part by: Programme grants to the MRC Epidemiology Unit from the Medical Research Council (grant No. MC_UU_12015/6 and MC_UU_00006/7 ); and the Centre for Diet and Activity Research (CEDAR) , a UKCRC Public Health Research Centre of Excellence – funding from the British Heart Foundation , Cancer Research UK , the Economic and Social Research Council , the Medical Research Council , the National Institute for Health Research , and the Wellcome Trust , under the auspices of the UK Clinical Research Collaboration is gratefully acknowledged. The views expressed are those of the authors and not necessarily those of the any of the above named funders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2022 The Authors",

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doi = "10.1016/j.appet.2022.106305",

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T2 - A focus group study using reflexive thematic analysis

AU - Jones, Catrin P.

AU - Armstrong-Moore, Roxanne

AU - Penney, Tarra L.

AU - Cummins, Steven

AU - Armitage, Sofie

AU - Adams, Jean

AU - White, Martin

N1 - Funding Information: This study is part of the evaluation of the health impacts of the UK Treasury Soft Drinks Industry Levy (SDIL), funded by the National Institute for Health Research ( White, 2017 ); a mixed methods project with Critical Realist positioning. Although this study uses an interpretive design, which typically rejects exploration of causal interpretation, the findings of this study will be contextualised ( Sayer, 2000 ) within a synthesis work package in the wider research programmme. Funding Information: This project was funded by the NIHR Public Health Research programme (Grant Nos. 16/49/01 and 16/130/01 ). At the time this study was conducted CPJ, MW, RA, TLP, SA & JA were also supported in part by: Programme grants to the MRC Epidemiology Unit from the Medical Research Council (grant No. MC_UU_12015/6 and MC_UU_00006/7 ); and the Centre for Diet and Activity Research (CEDAR) , a UKCRC Public Health Research Centre of Excellence – funding from the British Heart Foundation , Cancer Research UK , the Economic and Social Research Council , the Medical Research Council , the National Institute for Health Research , and the Wellcome Trust , under the auspices of the UK Clinical Research Collaboration is gratefully acknowledged. The views expressed are those of the authors and not necessarily those of the any of the above named funders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2022 The Authors

PY - 2022/12/1

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N2 - Background: The UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, is a fiscal policy to incentivise reformulation of eligible soft drinks. We aimed to explore perceptions of sugar, sugary drinks and the SDIL among adolescents in the UK post-implementation. Methods: 23 adolescents aged 11–14 years participated in four focus groups in 2018–2019. A semi-structured topic guide elicited relevant perspectives and included a group task to rank a selection of UK soft drinks based on their sugar content. Braun and Clarke's reflexive thematic analysis was used to undertake inductive analysis. Results: Four main themes were present: 1) Sweetened drinks are bad for you, but some are worse than others; 2) Awareness of the SDIL and ambivalence towards it 3) The influence of drinks marketing: value, pricing, and branding; 4) Openness to population-level interventions. Young people had knowledge of the health implications of excess sugar consumption, which did not always translate to their own consumption. Ambivalence and a mixed awareness surrounding the SDIL was also present. Marketing and parental and school restriction influenced their consumption patterns, as did taste, enjoyment and consuming drinks for functional purposes (e.g., to give them energy). Openness to future population-level interventions to limit consumption was also present. Conclusions: Our findings suggest that adolescents are accepting of interventions that require little effort from young people in order to reduce their sugar consumption. Further education-based interventions are likely to be unhelpful, in contexts where adolescents understand the negative consequences of excess sugar and SSB consumption.

AB - Background: The UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, is a fiscal policy to incentivise reformulation of eligible soft drinks. We aimed to explore perceptions of sugar, sugary drinks and the SDIL among adolescents in the UK post-implementation. Methods: 23 adolescents aged 11–14 years participated in four focus groups in 2018–2019. A semi-structured topic guide elicited relevant perspectives and included a group task to rank a selection of UK soft drinks based on their sugar content. Braun and Clarke's reflexive thematic analysis was used to undertake inductive analysis. Results: Four main themes were present: 1) Sweetened drinks are bad for you, but some are worse than others; 2) Awareness of the SDIL and ambivalence towards it 3) The influence of drinks marketing: value, pricing, and branding; 4) Openness to population-level interventions. Young people had knowledge of the health implications of excess sugar consumption, which did not always translate to their own consumption. Ambivalence and a mixed awareness surrounding the SDIL was also present. Marketing and parental and school restriction influenced their consumption patterns, as did taste, enjoyment and consuming drinks for functional purposes (e.g., to give them energy). Openness to future population-level interventions to limit consumption was also present. Conclusions: Our findings suggest that adolescents are accepting of interventions that require little effort from young people in order to reduce their sugar consumption. Further education-based interventions are likely to be unhelpful, in contexts where adolescents understand the negative consequences of excess sugar and SSB consumption.

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KW - Children

KW - Obesity

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KW - Soft drinks industry levy

KW - Sugar

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Adolescents’ perspectives on soft drinks after the introduction of the UK Soft Drinks Industry Levy: A focus group study using reflexive thematic analysis

Abstract

Bibliographical note

Keywords

UN SDGs

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