The effectiveness of alcohol label information for increasing knowledge and awareness: a rapid evidence review
In this review, researchers investigate the effectiveness of different types of alcohol labelling. They look at three different potential outcomes:
- improving comprehension of health risks,
- improving comprehension of unit and/or standard alcoholic drink information and/or low risk alcohol use guidelines, and
- reducing self-reported intentions to consume alcohol/actual alcohol use.
Current research on the topic of alcohol labelling is limited. There are few real-world examples of this type of intervention to study.
Using a structured literature search, researchers identified 11 studies that met the inclusion criteria. Ten of these studies were experiments. Ten papers were included. Most studies were moderate quality (n = 7).
None of the studies included reporting on actual changes in levels of alcohol use.
The results show that some labelling approaches were effective at increasing participant comprehension, particularly approaches that used pictorial warnings and messages relating to cancer.
However, researchers also remarked:
… these conclusions are based on a small number of moderate/weak studies, with inconsistencies in the strength, and sometimes direction, of findings.”Edmunds, C.E.R., Gold, N., Burton, R. et al. The effectiveness of alcohol label information for increasing knowledge and awareness: a rapid evidence review. BMC Public Health 23, 1458 (2023). https://doi.org/10.1186/s12889-023-16327-x
A single strong study demonstrated motivations to use less alcohol were higher for cancer and negatively framed messages, but the results do not show if these motivations are actually translated into changes in alcohol use.
Pictoral warnings tended to result in greater intentions to reduce alcohol use, but researchers also note that this finding wasn’t consistent across all the studies.
The review highlights the fact that there is a general lack of awareness of how to interpret messages around “standard alcohol units” or what low-risk alcohol use guidelines actually mean. Results indicate that the right type of labeling (if noticeable and clear) could reduce this knowledge deficit.
In conclusion, the researchers note that this review does not show convincing evidence that alcohol labels reduce alcohol use. However, they also point out that “indications that a product is hazardous is a fundamental consumer right, and consumer awareness can increase support for more stringent alcohol policies, such as taxation”.
Researchers also emphasize that this review has supported more recent work, investigating alcohol labels in Yukon, Canada.
Results from the Yukon alcohol labelling study show that strengthening health messages on alcohol containers increased consumer attention to labels as well as increasing consumers’ knowledge of the health implications of alcohol. It also reduced consumers’ self-reported alcohol consumption, intentions to use alcohol, and actual alcohol purchasing.
Consumers have difficulty understanding alcoholic units and low risk alcohol use guidelines. Labelling may improve comprehension. The aims of this rapid evidence review were to establish the effectiveness of on-bottle labelling for (i) improving comprehension of health risks; (ii) improving comprehension of unit and/or standard alcoholic drink information and/or low risk alcohol use guidelines, and (iii) reducing self-reported intentions to use alcohol/actual alcohol use.
Electronic database searches were carried out (January 2008-November 2018 inclusive). Papers were included if they were:
- published in English;
- from an Organization for Economic Co-operation and Development country;
- an experimental/quasi-experimental design.
Papers were assessed for quality using the Effective Public Health Practice Project Quality Assessment tool.
Ten papers were included. Most studies were moderate quality (n = 7).
Five themes emerged:
- comprehension of health risks;
- self-reported alcohol use intentions;
- comprehension of unit/standard alcoholic drink information and/or low risk alcohol use guidelines;
- outcome expectancies; and
- label attention.
Labelling can improve awareness, particularly of health harms, but is unlikely to change behaviour.
Improved comprehension was greatest for labels with unit information and low risk alcohol use guidelines.
Alcohol labelling can be effective in improving people’s comprehension of the health risks involved in consuming alcohol enabling them to make informed consumption decisions, and perhaps thereby provide a route to changing behaviour.
Thus, effective alcohol labelling is an intervention that can be added to the broader suite of policy options.
That being said, the literature reviewed here suggests that the specific format of the label matters, so careful consideration must be given to the design and placement of labels.