This randomized trial investigates how consumers assess risks of sugar and substitutes, highlighting implications for health decisions.
Excessive sugar consumption is widely recognized as a serious health risk, linked to obesity, diabetes, and cardiovascular disease. Sugar substitutes are often promoted as a healthier alternative, yet they carry their own set of potential risks, creating a complex decision-making context for consumers. This study applies secondary risk theory to examine how individuals evaluate both the primary risks of sugar consumption and the secondary risks of sugar substitutes when deciding to opt (or not) for sugar substitutes. Using a between-subjects experimental design, we manipulated severity and susceptibility information of sugar-related risks and tested their influence on response efficacy and intention to use sugar substitutes. Results showed that severity and susceptibility interacted to shape post-exposure response efficacy, underscoring the role of response efficacy in secondary risk appraisal. While severity manipulation had a direct positive effect on intention, susceptibility manipulations did not, suggesting that participants downplayed one risk dimension when the other was more salient. Pre-exposure response efficacy was negatively associated with secondary risk susceptibility, which in turn reduced post-exposure behavioral intention, revealing a mediation pathway. Additionally, information relevance mediated the relationship between secondary risk appraisal and behavioral intention. These findings extend SRT by demonstrating how response efficacy and information relevance impact everyday health risk trade-offs.
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Shah et al. (2026) studied this question.
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