In March 2021, Berkeley, California, made history by becoming the first city in the world to prohibit the display of sugary drinks and snacks in store checkout lanes. This policy, known as the Healthy Checkout Ordinance (HCO), aimed to reduce impulse buying by removing these items from highly visible areas where shoppers are more likely to make unplanned purchases. A study led by researchers from Boston University School of Public Health and the University of California, Davis, examined the impact of this policy on consumer behavior. Published in The Lancet Public Health, the study found that the HCO was associated with a drop in soda sales and small-package candy sales in supermarkets, though total candy sales remained unchanged. The researchers compared data from Berkeley with three other California cities over a period that included both the implementation and enforcement of the policy. The effects of the HCO varied depending on the type of product and the store. Soda sales dropped significantly after the policy was enforced, and small-package candy sales in supermarkets also declined after enforcement. However, overall candy sales saw only a modest increase after the policy was introduced, and no change occurred after enforcement. Sales of healthier, lower-sugar alternatives such as snack-sized nuts and seeds increased. Supermarkets, which followed the policy most closely, experienced the largest declines in sugary products, while drugstores, which had lower compliance, saw no significant changes in candy or soda sales. Checkout areas are specifically designed to attract attention through bright lighting, eye-level placement, and colorful packaging, often promoting high-sugar snacks and drinks. Co-lead author Dr. Justin White noted that the findings suggest such policies can help reduce impulsive purchases and promote healthier choices, but only if they are actively enforced. The study builds on earlier research by Dr. Jennifer Falbe, who found that checkout areas in Berkeley and nearby cities were heavily stocked with sugary items. After the HCO was implemented, the amount of added sugar in these products dropped by 70% in the first year. The study analyzed sales data from 71 stores in Berkeley and three comparison cities — Davis, Oakland, and Sacramento — between March 2019 and December 2023. Researchers looked at quarterly sales of candy, soda, nuts, seeds, and bottled water. By analyzing sales by package size, they could determine if the HCO reduced the purchase of small, impulse-buy-sized items typically found at checkout. While the policy led to a decline in soda and small-package candy sales in supermarkets, it may not have fully addressed other promotional tactics that stores could use to boost sales, such as moving products to different areas or using seasonal displays. Dr. Falbe emphasized that no single policy can fix the broader issues in the food system. She suggested that expanding healthy checkout policies to other high-traffic areas and combining them with other proven strategies — such as front-of-package labeling, taxes on sugary drinks, and subsidies for healthy foods — could improve overall diet quality. While the U.S. Food and Drug Administration is considering a mandatory front-of-package labeling rule, the final design of such labels has not yet been decided.