NEJM Perspective Piece Targets “Candy at the Cash Register”

A recent perspective piece published in the New England Journal of Medicine has argued that “steps should be taken” to curb “spur-of-the moment, emotion-related purchases… triggered by seeing the product or a related message.” Deborah Cohen & Susan Babey, et al., “Candy at the Cash Register — A Risk Factor for Obesity and Chronic Disease,” NEJM, October 2012. The article takes issue with impulse marketing focused on “the placement and display of products in retail outlets,” such as candy offered for sale at cash registers.

“Placement of foods in prominent locations increases the rate at which they’re
purchased; purchase leads to consumption; and consumption of foods high
in sugar, fat and salt increases the risks of chronic disease,” state the authors.
“Because of this chain of causation, we would argue that the prominent
placement of foods associated with chronic diseases should be treated as a
risk factor for those diseases.”

In making this claim, the authors point to eye-tracking research and other studies allegedly showing that “the attention drawn by special displays, particularly on the ends of aisles, has more to do with the display characteristics than with the goals and capacities of individual people,” who tend to make impulse purchasing decisions in less than one second. “Although placement is a factor that is right in front of our noses, we should consider treating it as a hidden risk factor, like carcinogens in water, because placement influences our food choices in a way that is largely automatic and out of our conscious control and that subsequently affects our risk of diet-related chronic diseases,” conclude the authors, who ultimately advocate approaches such as “limiting the types of foods that can be displayed in prominent end-of aisle locations and restricting foods associated with chronic diseases to locations that require a deliberate search to find.”