Nudge Italia

Mexico has been largely studied for having one of the largest obesity prevalences in the world. Its obesity epidemic affects both adults and children, but not in the same way. Children are more vulnerable to the advertisement, for example. Considering that the industry of sugary drinks spends billions of dollars per year in advertising its products, and Mexico is one of its main markets, this is something to be worried about.

It is estimated that Mexican children ingest up to 30% of their daily calorie intake, through sugary drinks, either carbonated like sodas, or not carbonated, such as juices with added sugar. One single can of soda, for example, can contain more sugar than what the WHO recommends for a child to consume daily. Sugary drinks are, of course, closely related to obesity development.

The Mexican government has reacted to this problem and since 2014, a tax on sugary drinks was imposed, aiming to reduce consumption of this kind of beverages. In addition, there is a current prohibition of advertising junk food on TV on those times in which children are commonly the main audience. However, the drinks industry has reacted to these new conditions. On the one hand, the industry has partially absorbed the tax for the drink’s segment with the most elasticity, i.e. Non-carbonated drinks, whereas it has transferred the tax to the consumer in the segment with the least elasticity, i.e. carbonated drinks. On the other hand, the drinks industry has reallocated its advertisement budget, investing in media outlets that are not regulated. An example of this would be, product placement, “below-the-line” strategies, the Internet, and so on.

It is yet early to know whether the tax and prohibition will overcome the obesity problem, despite the enthusiasm shown by some stakeholders. But it is clear now, that the industry has tremendous adaptation skills (and resources) that are hard to catch-up by the governments and that its reactions may cause a backfire of the public-health strategies.

A counter-marketing of healthy products may be a great alternative to prohibitions. This kind of strategies has proven to be valuable in other public-health problems, such as tobacco consumption. There was a regulation in the USA forcing the tobacco industry to fund a counter- marketing advertisement for every tobacco publicity shown on TV on a 1:1 ratio. That means, for every 1-minute long tobacco advertisement, there should be a 1-minute long anti-tobacco advertisement, too. This was so effective that the tobacco industry was one of the main promoters of banning the tobacco publicity from TV. The ban was considered to be a success but only until it was found that the tobacco industry reported a temporary decrease in sales, recovering its profits baseline quickly. How? By shifting its marketing from traditional channels to non-regulated and practically new channels, such as digital media. Nevertheless, the bottom line of this story is that counter-marketing is effective. So we, a team of researchers from the Heidelberg University, in Germany, wanted to try a counter-marketing intervention in Mexico.

Our intervention focused on children, aiming to reduce the sugary drinks consumption among them. However, this was not a simple counter-marketing strategy. We use behavioral economics insights to design nudges within the scholar context, and promote a water flavored with fruits and herbs, that is easy to prepare so the children could do it themselves. We tried to have the same quality in our promotional products as the beverage industry, and we design an “above-the-line” promotional campaign. We partner with schools, and an NGO in Mexico and, with funding from the University, we were able to start the intervention in February 2016.

We developed a workshop where the children could learn to prepare the water, we had promotional posters and flyers, we involved parents and teachers, and we gave the children gifts and promotional objects. In order to compare the effectivity of our intervention, we decided to measure the BMI of the children and see if there was a change. And of course, we had to compare it to the traditional approach to finding out whether we were more effective or not. So we had two more schools. One of the schools was given a regular talk about the benefits of drinking water, we called it the “classic” group; and the other was our control group, that means, we did nothing with this school except measuring the children.

After our intervention, with the help of our partner NGO, we continued measuring the children for 5 more months. A manuscript with this intervention and its results has been submitted to a Journal, and it is currently under revision, impeding me to give too many details. However, what I can say right now is that the results were outstanding in an unexpected way and that “nudging” can indeed make a big difference in a public-health design. The behavioral economics insights, as most things in life, work better when they are combined with other disciplines. In our case, it was the combination of marketing, public health, sociology, etc. what helped us to have a better understanding of the problem, and to propose a sound alternative solution.

Salvador Camacho
Doctoral researcher in public health; MBA; MScIH Heidelberg University

Note: This work is part of the doctoral research of the author. The scientific paper from this intervention has been submitted to the Journal “Obesity Science and Practice” and it is currently under consideration for publication.