(P17-069-23) Warning Labels are Effective in Reducing Intent to Purchase Unhealthy Packaged Foods in Addis Ababa, Ethiopia: A Randomized Field Experiment

Objectives: To compare the effectiveness of front-of-pack labels (FoPL) on intent to purchase packaged foods high in sodium or sugar in Ethiopia, where back-of-package and FoPL nutrition labeling are not currently mandatory.

Methods: Consumers (n=1200) were recruited outside supermarkets and souqs in Addis Ababa, Ethiopia, using a street-intercept survey methodology in 2022-23. Participants were randomized to one of four FoPL arms: a warning label (triangle with “High in [nutrient]”), no label, multiple traffic light (MTL, color-coded, nutrient-specific information), or Nutri-Score (NS, color-coded summary letter grade). Participants viewed a series of chips, a salty snack, cookies, and juice with the assigned FoPL or no label and rated their intent to purchase these products on a 7-point Likert scale (1=would certainly not buy to 7=would definitely buy). Mixed effects linear regression was used to model the effect of FoPL on intent to purchase. ClinicalTrials.gov identifier: NCT05549388.

Results: Participants reported a mean age of 31.6 years, 53.2% were female, and 97.4% had at least a high school education. The average household size was 4.6 people; 72% reported purchase of packaged foods at least every month and 34% reported purchases at least once a week. The mean score among participants randomized to the warning label arm was 3.95 (95% CI 3.72, 4.17), significantly lower (p < 0.001) than no label (4.30, 95% CI 4.08, 4.52), MTL (4.32, 95% CI 4.10, 4.54), or NS (4.32, 95% CI 4.10, 4.54).

Conclusions: Ethiopian consumers report frequent purchase of packaged foods. Warning labels were more effective than no label, multiple traffic light, or Nutri-Score at reducing intent to purchase packaged foods high in sodium or sugar. These results support mandatory front-of-package warning labels to decrease the purchase of packaged foods high in nutrients of concern in Ethiopia.

Funding Sources: This study was supported by Resolve to Save Lives. Resolve to Save Lives is funded by Bloomberg Philanthropies, the Bill and Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Initiative.