Impact of NYC Sugar Sweetened Beverage Policy on Calories Purchased and Consumed

在过去的30年里，美国儿童肥胖率增加了两倍，成人肥胖率增加了一倍，导致许多人将肥胖对公共健康的影响与吸烟进行比较。然而，虽然香烟税和室内禁烟令在降低吸烟率方面非常有效，但美国尚未实施类似有效的人口水平政策来降低肥胖率。然而，纽约市（NYC）将很快实施一项创新的新政策，旨在解决人口层面的肥胖问题。该市将禁止在餐馆和其他餐饮服务机构销售份量超过16盎司的加糖饮料。与其他食物或饮料相比，SSBs与肥胖密切相关。虽然一些政策现在限制SSB在学校和政府拥有的建筑物中的销售，但纽约SSB法将是美国第一个针对SSB消费的大规模人口级政策。目前还不清楚消费者和供应商将如何应对。消费者可以遵守政策，购买16盎司的单一饮料。或者，消费者可以购买多种饮料d16盎司，将购买转移到不受政策限制的机构，如杂货店，或增加其他不健康产品的消费。同样，餐馆和汽水行业可能会改变SSB或其他饮料的定价，促销或放置，所有这些都可能影响政策的影响。该政策对公共卫生具有巨大的潜在重要性，但一直是相当大的争议和行业反应的主题。这一规定的引入提供了一个难得的机会来回答有关公共政策在试图改变消费者行为方面的好处和效力的重要问题。我们建议研究这项政策对纽约市成年人在快餐店购买和消费卡路里的影响，大多数受该政策约束的SSB都在快餐店销售。数据收集将包括购买点 从快餐店消费者收集收据和调查（目标1，结果是总饮料卡路里），沿着这些相同消费者的后续24小时饮食回忆（目标2，结果是消耗的总卡路里）。为了控制长期趋势，我们将从与纽约市统计匹配的新泽西两个地区收集数据，作为未处理的比较社区。此外，我们亦会研究这项政策对办学团体环境（目的3）的影响，包括快餐店内饮品的供应、大小、价格、摆放位置及披索等。我们还将在角落和杂货店测量相同的环境特征，在那里销售的SSB没有大小限制。消费者调查和环境评估数据将在政策实施前收集，并在政策实施后的三年半内每年收集两次。政策实施后的第一年数据收集将衡量SSB政策的短期影响，而第二年和第三年将解决对饮料卡路里的长期影响。

DESCRIPTION (provided by applicant): In the last 30 years, U.S. obesity rates have tripled in children and doubled in adults, leading many to compare the public health impact of obesity to that of smoking. Yet while cigarette taxes and indoor smoking bans have been highly effective in decreasing smoking rates, the U.S. has yet to implement similarly effective population-level policies intended to reduce obesity rates. However, New York City (NYC) will soon implement an innovative new policy aimed at addressing obesity at the population level. The city will ban the sale of sugar sweetened beverages (SSBs) in serving sizes >16 ounces at restaurants and other food-service establishments. SSBs, more than other food or beverage group, are strongly associated with obesity. While some policies now limit SSB sales in schools and government-owned buildings, the NYC SSB law will be the first large-scale, population-level policy to target SSB consumption in the US. It is unknown how consumers and suppliers will respond. Consumers may comply with the policy and purchase single beverages d16 ounces. Alternatively, consumers may purchase multiple beverages d16 ounces, shift purchases to establishments that are exempt from the policy, such as grocery stores, or increase consumption of other unhealthy products. Similarly, the restaurant and soda industries may alter the pricing, promotion or placement of SSBs or other beverages, all of which could influence the impact of the policy. The policy has great potential importance to public health, but has been the subject of considerable controversy and industry response. The introduction of this provision provides a rare opportunity to answer important questions about the benefits and efficacy of public policy in attempting to alter consumer behavior. We propose to examine the influence of this policy on NYC adults' calorie purchasing and consumption at fast food restaurants, where the majority of SSBs subject to the policy are sold. Data collection will include point of purchase receipt collection and surveys from fast food restaurant consumers (Aim 1, outcome is total beverage calories), along with follow-up 24 hour dietary recalls of these same consumers (Aim 2, outcome is total calories consumed). To control for secular trends we will collect data from two areas of New Jersey statistically matched to NYC as non-treated comparison communities. In addition, we will examine the impact of the policy on the SSB environment (Aim 3), including beverage availability, size, price, placement and promotion in fast food restaurants. We will also measure the same environmental characteristics in corner and grocery stores, where SSBs are sold without size limitations. Both the consumer survey and environmental assessment data will be collected prior to policy implementation and twice a year for three and a half years after implementation. The 1st year of data collection post-policy implementation will measure the short-term impact of the SSB policy, while the 2nd and 3rd years will address the longer-term impact on beverage calories.