摘要：Objectives. We investigated whether a price increase on regular (sugary) soft drinks and an educational intervention would reduce their sales. Methods. We implemented a 5-phase intervention at the Brigham and Women's Hospital cafeteria in Boston, Massachusetts. After posting existing prices of regular and diet soft drinks and water during baseline, we imposed several interventions in series: a price increase of 35% on regular soft drinks, a reversion to baseline prices (washout), an educational campaign, and a combination price and educational period. We collected data from a comparison site, Beth Israel Deaconess Hospital, also in Boston, for the final 3 phases. Results. Sales of regular soft drinks declined by 26% during the price increase phase. This reduction in sales persisted throughout the study period, with an additional decline of 18% during the combination phase compared with the washout period. Education had no independent effect on sales. Analysis of the comparison site showed no change in regular soft drink sales during the study period. Conclusions. A price increase may be an effective policy mechanism to decrease sales of regular soda. Further multisite studies in varied populations are warranted to confirm these results. Consumption of regular (sugary) soft drinks has risen substantially over the past 25 years. Of all individual food types, soft drinks are the single largest contributor to caloric intake in the United States; they account for 7% of all calories consumed daily from 1999 through 2001 compared with 2.8% from 1977 through 1978. 1 , 2 The increased intake of regular soft drinks and other sugary beverages has significant health implications, including weight gain and an increased risk of developing diabetes. 3 , 4 Individual-level interventions, those targeting 1 individual or a small group of individuals at a time, can lead to a reduction in sugary beverage consumption. One trial reduced the consumption of sugary beverages and achieved modest weight loss goals among adolescents who were randomized to receive home deliveries of noncaloric beverages and counseling on healthy beverage consumption. 5 A school-based nutrition education program for children aged 7 through 11 years achieved a modest reduction in carbonated beverage consumption and decreased the incidence of obesity and overweight. 6 Population-level point-of-purchase strategies have the potential for larger effects at lower cost. Point-of-purchase interventions have successfully increased sales of fruits and vegetables in a cafeteria 7 and low-fat snack foods in vending machines 8 through the posting of educational messages and a reduction in the price of those items. Additionally, levying taxes has been associated with reduced cigarette smoking rates in several areas, including New York City 9 and the state of California. 10 Public health leaders have called for the taxation of sugary beverages to discourage consumption and to raise public health funding for obesity prevention programs. 11 , 12 Alternatively, salient information about the health effects of regular soft drinks may affect consumption. To determine whether point-of-purchase strategies can reduce the consumption of regular soft drinks, we employed price and educational interventions in a hospital cafeteria.
