Effect of Social Media Advertisements on Adolescents' Sugar-Sweetened Beverage Choices: A Randomized Field Experiment.

Abstract

This study aimed to quantify the impact of adolescents' exposure to unhealthy food marketing in real-world digital environments. We conducted a single-blinded randomized field experiment including 121 Australian adolescents aged 16-17. A latent class analysis was used to identify personas, and participants were randomized (1:1) to an intervention or control group. Using retargeting pixels, the intervention group was exposed to advertisements for a fictitious sugar-sweetened beverage "Clu" embedded in their feed for 2 weeks. The control group was not exposed to Clu advertisements. An exit survey collected data on purchase intention for Clu. Exposure effect on purchase intention was estimated using logistic regression, reported as a risk ratio. An intention to purchase Clu was reported by 26.2% of participants (n = 16) in the control and 71.6% in the intervention group (n = 43). Participants in the intervention group were 2.73 times more likely to report intention to purchase Clu than those in the control (RR = 2.73; 95% CI: 1.74-4.28). Social media advertisements for sugar-sweetened beverages significantly influence adolescents' purchase intentions of the beverages, highlighting digital advertising as a modifiable commercial determinant of dietary risks. These findings underscore the need for policy interventions that address unhealthy food digital marketing to reduce obesity-related behaviors among adolescents.