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Nudges for a healthy lifestyle – Part II

In the article Nudges for a healthy lifestyle – Part I”, we talked about the nudges created by governments around the world related to improving people´s lifestyles.

If you wonder why governments care about lifestyles of their citizens, the reason is mainly money. Unhealthy diet, frequent consumption of addictive substances (mainly alcohol or tobacco), and lack of physical movement are all widespread and may lead to “non-communicable diseases”, such as diabetes or cardiovascular diseases. The governments have two possibilities – either encourage the change in lifestyles and decrease the occurrence of such diseases or pay for the cure. Obviously, prevention is a cheaper choice and in case of lifestyle issues, also feasible.

Moreover, if governments understand human behaviour, their attempts to change it will probably be more successful. That is why Behavioural Economics can be helpful in this domain.

Part I of this article was dedicated to the nudges related to food consumption. Part II will discuss nudges concerning tobacco and alcohol consumption and physical movement.

 

As for physical movement, there has been a very simple nudge trial conducted in the City of Melbourne in Australia. To encourage people to take the stairs instead of elevators in a train station building, the City of Melbourne had the stairs painted in a colourful and catchy way (see Picture 1). It may not seem like  a very strong nudge; why would anyone struggle on the painted stairs if they can see them also from the elevators? But it seems that the citizens of Melbourne did not think like this – according to a report by the Behavioural Insights Team (that collaborated on this trial), the usage of the stairs increased by 25% during off-peak times and by 140% in  peak times!

Stairway-art-Zest-Events-Southern-Cross-Station-Melbourne

Picture 1

Source: Zest Events

 

Moving to tobacco consumption, the nudges used around the world are quite uniform. There are two major manipulations that have been implemented.

1) The first one is plain packaging, whereby the tobacco producers cannot use the package as a marketing space and have to comply with rules for uniform font, size and colour of the text, as well as uniform package colour. The space previously used by companies is now dedicated to health warnings, both in words and in pictures (see Picture 2). The rationale behind such a policy is that it decreases the appeal of tobacco products and at the same time, gives more importance to the health warnings, which should deter people from smoking. It seems like a good idea at first glance, but when one thinks about it more, the following doubts arise. Firstly, there is a large amount of brand loyalty among smokers, so it is not probable that they will stop smoking only because of a change in design. Secondly, there is the optimism bias that goes against the effectiveness of health warnings. People usually overestimate the probability of positive things happening to them and underestimate the probability of the negative ones. Hence, when they see a health warning, they may simply think “it happens, but to the others, not me”.

Copy_right_Action_on_Smoking_and_Health_story

Picture 2

Source: WHO

2) The second widespread anti-smoking nudge-based policy is the tobacco display ban. In the countries where it has been introduced, tobacco products have to be displayed so as not to be visible to the customers in the shops (with the exception of specialised tobacco shops, of course). Again, such policy goes against marketing possibilities of tobacco producers and the hope is that it will decrease the amount of impulse purchases, which are frequent mostly among the young.

There are several papers trying to evaluate the impact of these two anti-smoking policies, but there is no clear conclusion to be drawn. It seems that smoking is a very complex issue and is cannot be easily solved by using only nudges. Another issue is that in many countries, these policies have been implemented only recently, so it is too early to know their impact. Anyway, even if the nudges are not the solution in this case, maybe they could still complement some other policies to make a real change.

The last lifestyle issue is alcohol consumption and there is a very nice example of the use of nudges in this domain. At the Northern Illinois University, a simple marketing campaign based on social norms (i.e. informing the students about how many drinks other students have when they party) was enough to decrease students´ binge drinking.

(If you want to know more about this particular policy, see the article A Social Norms Approach to Preventing Binge Drinking at Colleges and Universities.)

To conclude both articles about the nudges related to healthy lifestyles, I would like to say one thing. Clearly, nudges do not automatically solve all problems. But as long as they are low-cost and do not harm anyone (such as removing the salt shakers from restaurant tables or painting the stairs in a train station), I think they are worth trying, because even a small positive difference is a step forward towards a healthier life.

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Article Review

A Social Norms Approach to Preventing Binge Drinking at Colleges and Universities

Review of the paper by Michael P. Haines (1996)

It is well-known that increased alcohol consumption of young people is a persistent problem and college and university students are no exception.

The Northern Illinois University (NIU) came up with a solution that has since spread to other US universities and even high schools. It all started by conducting a survey about students´ drinking behaviour, which revealed the presence of a large knowledge gap. Most of the students thought that binge drinking was more widespread than it really was.

The Health Enhancement Services Office at NIU decided to take action – develop a campaign to correct the perceptions of the students. What is the logic behind this? It is the belief that people are sensitive to social norms and tend to behave in line with them. For example, we all know that when we ask for something, we should say “please” and “thank you”. We do it because it is a norm accepted in our society and everyone does so. There are several papers proving that perceptions about the drinking behaviour of other students are a strong predictor of the actual drinking behaviour, so norms are at work also in this case (for the reference, see Graham et al., 1991 or Prentice and Miller, 1993).

The organisers of the NIU campaign were very careful with the design, since they wanted to spread the message as much as possible. They chose the campus newspaper, widely read by the students, as their medium to publish the following very simple message: “Most NIU students (55 percent) drink five or fewer drinks when they party”. This message was repeated on flyers, posters and on any occasion the students were likely to hear it.

The NIU team also came up with incentives for students to pay attention to the message. Two students were hired to work as “Money Brothers” (inspired by the movie The Blues Brothers). They would ask students how many drinks most NIU students consume and give $1 to anyone who answered correctly.  They also created some posters and would give $5 to those students living in university dorms who were found to have it on the wall of their rooms during random checks.

It is clear that the NIU team really worked hard to make students notice the message. The result? After the first year, there was an 18 % reduction in perceived binge drinking and a 16 % reduction in real binge drinking. Obviously after such success, the campaign has been repeated in the following years and binge drinking decreased further.Graph

Source: Haines, M. P. (1996): A Social Norms Approach to Preventing Binge Drinking at Colleges and Universities

The take home message of this initiative is that social norms are powerful and capable of changing our behaviour. However, the message needs to be simple, truthful and most importantly, noticed by the target audience.

Since then, other universities and high schools applied the same technique to fight binge drinking of their students. Here are some of the campaign materials:

Sources: Social Norms Consultation & Nudge blog

How about you? Do you know how many drinks people from your university/company normally have?