'Soft drinks are normal': understanding the lived experiences of Dutch teenagers with respect to sugar-sweetened beverages: a qualitative context-mapping study

BACKGROUND: Despite continuing efforts to reduce teenagers' consumption of sugar-sweetened beverages (SSBs), intake remains high across the globe. Currently, we lack a holistic understanding that also includes the lived experiences of teenagers in today's online and offline environments regarding the role of SSB's. The aim of the present paper is therefore twofold: (1) to gain a holistic understanding of teenagers' perspectives, beliefs, barriers, contextual triggers and latent needs (that is, their lived experiences) in relation to SSB consumption; and (2) to explore their views about which intervention strategies would be most likely to reduce their SSB consumption.

METHODS: A qualitative context-mapping approach, including prior sensitising assignments, was used to gain in-depth insights into the lived experiences with regard to SSB consumption of teenagers attending prevocational-level secondary school (VMBO) and living in low socioeconomic position neighbourhoods in Amsterdam, the Netherlands. From March to April 2021, 48 teenagers, aged 12 to 16, took part in the study. Due to COVID-19 restrictions, data were collected partly online and partly in person. All data were coded and analysed using thematic analysis.

RESULTS: Four main themes were identified that appeared to influence the teenage SSB consumption: (1) social norms - drinking SSBs is normal; (2) attitudes and beliefs with regard to health versus enjoyment; (3) the easy availability and affordability of SSBs; and (4) intense industry marketing efforts. We additionally explored teenage views about changes most likely to reduce their SSB consumption and found that they would be receptive to population-level interventions such as taxation.

CONCLUSIONS: The study provides comprehensive insights into teenagers' lived experiences in relation to SSBs. It highlights the prominent roles of strong social norms, conflicting beliefs, and the pervasive marketing, easy availability and low prices of SSBs. This underlines the need for a systems approach, applying combinations of effective, integrated strategies that can be specifically tailored to the perspectives of today's teenagers.