Do the size of servings, glasses and bottles influence how much people drink?

People consume more food and non-alcoholic drinks when presented with larger portions or packages, and when using larger items of tableware, such as plates or glasses. But what about when presented with larger servings and containers of alcohol? We conducted a review to summarise the evidence for the influence of the size of servings glasses and bottles on how much people drink, to investigate whether making sizes smaller could reduce alcohol consumption across populations, thereby improving health.

We found 10 relevant published reports of 15 studies and one review. Twelve studies and the review focused on wine drinking, one study on beer and two on both. All were conducted in England, by just two research groups. Read more

Impact of wine bottle and glass sizes on wine consumption at home: a within and between households randomised controlled trial

People drink less in restaurants when wine is served with smaller glasses and less at home from smaller bottles of wine. Would they also drink less wine at home when drinking from smaller glasses? And how much wine would people drink when using smaller glasses and smaller bottles? The results of the first study to address these questions –– suggests that consuming wine at home from smaller glasses could reduce consumption by about 6.5%. The effect of drinking wine in smaller bottles is less certain. Read more here

What is the impact of health warning labels on motivation towards energy-dense snack foods?

Excess consumption of energy is a key driver of increasing rates of obesity, which in itself contributes to a range of non-communicable and communicable diseases.

One way to tackle excess consumption of energy is to use health warning labels (HWLs) that include aversive images illustrating the negative consequences of consuming high-calorie foods. Previous studies have found that image-and-text HWLs increase dietary self-control in relation to snacks and reduce hypothetical selection of high-calorie snacks.

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What is the impact of e-cigarette retail displays on attitudes to smoking and e-cigarette use in children?

Tobacco retail displays are banned in many countries, including in the UK. This ban is to address the link between these displays and increased smoking among adults, and greater susceptibility to smoking among children, leading to poorer health. Tobacco products are stored instead within covered units; however, these units often remain visible and positioned below tobacco signage.

There is no equivalent ban on displays of electronic cigarettes (e-cigarettes) in the UK, which are often positioned alongside covered tobacco storage units. There is currently an absence of evidence on whether e-cigarette retail displays are linked to increased smoking or e-cigarette use.

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Changing the assortments of foods and drinks on offer to consumers could make diets leaner and greener

Altering the mix of foods and drinks available in shops, restaurants and bars could help improve diets, reduce inequalities and protect the environment, according to a new analysis by Professor Theresa Marteau and colleagues at the Universities of Cambridge, UCL, Oxford and Aston.

Such measures, called availability interventions, might see a proportion of confectionery items on offer in supermarkets replaced with fruit or nuts, for example; or some meat based meals replaced with plant-based ones on a restaurant menu.

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Does communicating evidence of multiple compared to single benefits increase public support for policies

Reducing the amount of high calorie foods, meat and alcohol people consume would improve population and planetary health. Interventions shown to work, however, tend to lack public support, which reduces their chances of being implemented into government policies. Telling people that policies are effective can increase public support but there is uncertainty about how best to communicate this information.

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Do different sizes and shapes of tableware impact self-serving of food and alcohol?

Excessive consumption of alcohol and high calorie foods are two significant preventable causes of many diseases. Changing the size of tableware or packaging is one possible method for reducing consumption.

In a laboratory setting, we randomised 140 adults to the order they completed two studies. In each study participants were asked to complete six conditions in random order, during which they were instructed to self-serve their typical amount of food or wine.

In Study 1 participants served a rice meal on three different plate sizes (small; medium; large) of two different plate shapes (square; round). We found that the smaller the plate, the less rice was served, with less served on small and medium plates compared to large plates. There was no evidence plate shape influenced amounts self-served.

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Impact of decreasing the proportion of higher energy foods and reducing portion sizes on food purchased in worksite cafeterias: A stepped-wedge randomised controlled trial

Unhealthy food environments contribute to high and increasing rates of obesity. There is growing evidence that interventions that target the food environment may be effective at reducing energy intake. The current study aimed to investigate whether two such interventions could result in people buying food and drinks that are lower in calories.

The first intervention is termed an Availability intervention. This involved replacing some higher energy products with lower energy products. The second intervention is termed a Size intervention. This involved reducing the portion size of some higher calorie products by about 14% in volume. We tested these interventions in 19 worksite cafeterias across Great Britain over a 25-week-long period. The first period served as a baseline in which no intervention was present. After this, the Availability intervention was introduced and maintained. The Size intervention was then added to the existing Availability intervention.

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How visible are e-cigarette and smoking paraphernalia retail displays in England? And is visibility higher in more deprived areas?

Tobacco (smoking) retail displays are banned in many countries, including in England. Following a ban, tobacco products are often stored within covered units, although typically the units are visible and positioned below tobacco signage. These bans are put in place because tobacco retail displays are linked to increased smoking among adults, and greater susceptibility to smoking among young people, leading to poorer health.

There is no equivalent ban on displays of electronic cigarettes (e-cigarettes) or smoking paraphernalia (products such as cigarette lighters) in England, which are often positioned alongside covered tobacco storage units.

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Beyond Choice Architecture: advancing the science of changing behaviour at scale

Our new publication is out which addresses the global threats to population and planetary health requires changing many behaviours at scale. This demands consideration not only of the effect size of an intervention but also its reach – the proportion of the population exposed to the intervention.

We propose that a relatively under-researched and generally poorly specified set of interventions involving changes to physical micro-environments – often referred to as Choice Architecture – has the potential to make a significant contribution to meeting this urgent challenge.

Read more here

Cigarette pack sizes and smoking

Smoking remains one of the largest risk factors for preventable disease and is also one of the major contributors to the gap in life expectancy and years lived in good health between the most and least affluent groups.

The size of a pack is one of the last few ways that tobacco companies can directly encourage smoking. Read more about the need for evidence to show whether capping cigarette pack sizes would help people to cut down their smoking here.

Energy labelling for healthier selection and consumption of food or alcohol

Our new systematic review protocol is now published in the Cochrane Library. This protocol is an update to a previous review published in 2018, which found that adding calorie labels to menus and next to food in restaurants, coffee shops and cafeterias, could reduce the calories that people consume, although the quality of evidence was low. Read more

Health warning labels and alcohol selection in a naturalistic shopping laboratory

Health warning labels (HWLs) on tobacco products reduce smoking. Initial findings suggest HWLs can reduce alcohol selection in online hypothetical studies, but there is an absence of evidence on their impact on selection or purchasing in naturalistic settings.

Using a naturalistic shopping laboratory (Blue Yonder Ltd), we aimed to estimate the impact on of HWLs on selection of alcoholic drinks. HWLs described adverse health consequences of excessive alcohol consumption. Read more

Do you drink beer and cider more slowly from a straight-sided glass compared to a curved glass?

Drinking excessive amounts of alcohol increases the risk of a range of diseases, including liver disease, heart disease, and many cancers.

Previous work in a laboratory setting suggested that beer might be drunk more slowly from a straight-sided glass compared to a curved glass. This in turn suggests that using straight-sided glasses could potentially lower overall alcohol consumption, improving health. However, no previous studies have looked at this in a real-life bar or pub setting. Read more

Do social norms contribute to the impact of changing food availability on food selection?

Increasing the availability of lower-energy foods increases their selection. Social norms might contribute to this effect:  The relative availability of foods could imply how popular these options are, leading to changes in social norms, adding to their increased chances of being selected. Read more

Does increasing the availability of healthier vs. less-healthy food alter food selection?

Environmental cues shape behaviour, but few studies compare the impact of targeting healthier vs. less-healthy cues. We looked at whether 417 participants choose a healthier or less-healthy snack when offered one of the following selections: equal number of healthier and less-healthy options (2 of each); increased healthier options (6 healthier and 2 less-healthy); or increased less-healthy options (2 healthier and 6 less-healthy). Read more

Glass shape influences drinking behaviours in three laboratory experiments

Reducing consumption of drinks which contain high levels of sugar or alcohol could improve population health. There is increasing interest in changing behaviour by changing cues in environments – sometimes called nudging. The shape of a glass is one such cue that can influence how much we drink. Published in Scientific Reports on 7th August 2020, this paper presents three laboratory experiments investigating the impact of glass shape (straight-sided vs outward-sloped) on drinking soft drinks. Read more

Do face coverings create a false sense of security?

Face coverings, if worn correctly, can reduce the spread of SARS-CoV-2, the virus that causes COVID-19. Concerns have been raised, however, that wearing face coverings might lead people to forgo other protective behaviours, such as frequent handwashing and maintaining physical distance from others, sometimes called risk compensation. In our new BMJ paper, we examine the evidence for this concern. Read more

The Lancet–Chatham House Commission on Improving Population Health post COVID-19

The Lancet-Chatham House Commission on Improving Population Health post COVID-19 will launch this autumn to map the shared roots of the biggest risks to population and planetary health, and to build a framework for action. It will be led by Professor Dame Theresa Marteau (University of Cambridge) and Professor Harry Rutter (University of Bath). We are recruiting for a Research Associate to work on the Commission: deadline 28th July 2020 Read more

Impact of health warning labels on selection and consumption of food and alcohol products

Evidence from tobacco control shows that placing health warning labels (HWLs) on cigarette packs reduces their selection and consumption, with image-and-text HWLs (often called ‘pictorial’ or ‘graphic’ warning labels) more effective than text-only HWLs. The current study aimed to assess the potential impact of HWLs on food and alcohol products. We conducted a systematic review with meta-analysis to assess the impact of HWLs on selection or consumption of food (including non-alcoholic drinks) or alcoholic drinks. We searched for all randomised controlled experiments and found fourteen eligible studies, with more than 13,000 participants. Most of these studies looked at non-alcoholic drinks, specifically sugary drinks, and the majority of studies measured product selection. Read more

Impact of health warning labels on snack selection: an online experimental study

Excessive consumption of energy-dense foods – such as crisps, biscuits and confectionary – increases the risk of obesity, which in turn increases the risk of heart disease, type 2 diabetes and most non-smoking-related cancers. Evidence from tobacco research suggests that health warning labels (HWLs), especially those that use images showing the health risks of smoking, can change smoking behaviours. The current study aimed to investigate the impact of HWLs – communicating the adverse health consequences associated with excess energy consumption – and calorie information on selection of energy-dense snacks in an online setting. Negative emotional arousal and acceptability to the labels were also measured. Read more

Impact of health warning labels communicating the risk of cancer on alcohol selection: An online experimental study

Excessive consumption of alcohol increases the risk of several diseases, including seven different types of cancers. Evidence from tobacco research suggests that health warning labels (HWLs), especially those that use images showing the health risks of smoking, can change smoking behaviours. The current study aimed to investigate the impact of HWLs – communicating the increased risk of cancers associated with alcohol consumption – on selection of alcoholic drinks in an online setting. Read more

The impact on selection of non-alcoholic vs alcoholic drink availability: an online experiement

Research suggests that increasing the availability of healthier food options increases their selection and consumption, but alcohol-related availability interventions have not been explored to date. Our study provides initial evidence that increasing the availability of non-alcoholic drinks (soft drinks and alcohol-free beer), relative to alcoholic drinks, increases their selection in an online task. Read more

Wine bottle size and consumption in homes

People drink less in restaurants when wine is served with smaller glasses. Would people also drink less from smaller bottles of wine?  The results of the first study to address this suggests that consuming wine at home from 50cl bottles – compared with the usual 75cl bottles –  could reduce consumption by 4.5%. Read More

Tobacco-style health warning labels on alcohol and food: potential effectiveness and acceptability

April 2020

Health warning labels (HWLs) using graphic images that depict the negative health consequences of tobacco consumption can encourage smokers to quit. But could they be used on other products that harm our health? Read more

Wine glass size and sales in bars and restaurants

February 2020

In previous studies (Pechey et. al. 2016, Pechey et. al. 2017, Clarke et. al. 2019) we found larger wine glasses in bars and restaurants increased wine sales but not always, with the overall picture hard-to-interpret. Read more

Policies for tobacco and e-cigarette use: a survey of all higher education institutions and NHS Trusts in England

November 2019

This paper describes the first comprehensive review of smoking and vaping policies in Higher Education Institutions (HEIs) and acute non-specialist NHS Trusts in England. Read more.

Should cigarette pack sizes be capped? – Debate paper

August 2019

Many countries control minimum cigarette pack size to prevent the sale of cheaper, small packs, which particularly appeal to younger people. However, very few countries restrict the range or maximum size allowed, and increasingly large packs are appearing in many countries. Increasing cigarette pack size is a concern as it may lead to increased smoking. Read more.

Do people really eat less food from smaller plates?

August 2019

Despite the uncertainty in the scientific literature regarding the impact of tableware size on food consumption, eating from smaller plates is a commonly suggested strategy for reducing the amount people eat. In this study we investigated the impact of using larger versus smaller plates on the amount people eat of a self-served pasta dish. Read more

Do larger glasses increase sales of wine in bars and restaurants?

July 2019

This replication paper published in BMC Research Notes, adds to previous studies (Pechey et al 2016; Pechey et al 2017- with links) showing an effect of wine glass size on sales in bars and restaurants. This new paper presents four studies, in two bars and one restaurant. In each study, the establishment served wine in small (290ml), medium (350ml) or large glasses (450ml), changed over fortnightly periods for 18 or 26 weeks. Read more

Public acceptability of nudging and taxing to reduce consumption of alcohol, tobacco, and food

July 2019

Smoking, and excessive consumption of alcohol and unhealthy snacks are leading causes of years of life lost globally. Promising interventions include nudging – changes to the physical environment to “nudge” people toward healthier behaviours – and taxation. Implementing such interventions often requires government intervention, which is made more likely by public support. We examined support for these interventions in a survey with an experimental design involving 7058 English adults. Read more