The Role of Alcohol Packaging as a Health Communications Tool: An Online Cross-Sectional Survey and Experiment With Young Adult Drinkers in the United Kingdom
Alcohol packaging is a potentially valuable means of communicating product and health-related information, with growing academic and political interest in its role as a health communications vehicle.
An online cross-sectional survey and experiment were conducted with a non-probability sample of 18–35-year-old alcohol users in the United Kingdom (n = 1360). The survey assessed exposure to, and engagement with, current messaging on packs, and support for displaying product and health-related information. For the randomised experiment, participants were shown, and asked questions about, a vodka bottle with either no warnings (control), small text warnings, large text warnings or pictorial (image-and-text) warnings; the main binary outcome measures were negative product appeal and social acceptability, and positive cognitive and behavioural impact.
Two-fifths of the sample rarely or never saw on-pack health-related information, with almost three-quarters rarely or never reading or looking closely at this. There was strong support for displaying a range of product and health-related information (e.g. units, ingredients) on packs. Relative to the control, products with warnings were more likely to be perceived as unappealing and socially unacceptable, and to positively impact alcohol-related cognitions and behaviors. For example, pictorial warnings were 10 times as likely to positively influence cognitions and behaviours (AOR = 10.01, 95% CI: 8.09, 17.46).
Discussion and Conclusions
Alcohol packaging could have an important role in delivering health messaging. Large pictorial or text warnings may help counteract the appeal and social acceptability of alcohol products and increase awareness of risks, potentially supporting a reduction in consumption and related harms.
The researchers conducted the study on 1360 young adults between 18 to 35 years who consume alcohol and live in the UK. About 80% of the participants were classified as binge alcohol users.
About two fifths (40.1%) of the participants had rarely or never seen health-related information, messages, or warnings on alcohol packaging. Participants strongly agreed that alcohol packaging should display a range of product and health-related information, and agreed there should be warnings.
In the study the researchers stuck three different types of mock up warnings on bottles of Smirnoff vodka. The three types were large text warnings, small text warnings and text and pictorial warnings. The warning sets included a general message stating ‘Alcohol damages your health’ and two specific warnings, ‘Alcohol causes liver disease’ and ‘Alcohol causes mouth cancer’. Those in the pictorial warnings group were shown images that reflected each warning – a blood pressure test, an image of a person clutching their liver, and an image of a CT scanner in a hospital.
Participants were randomly exposed to either the image of a normal Smirnoff bottle or one of three styles of warning label versions.
The study found that,
- Those exposed to the large text warnings or the picture warnings were about five times as likely to perceive the product as unappealing and socially unacceptable than the control group.
- Those who viewed the small text warning were about three times as likely to perceive the product as unappealing and socially unacceptable, compared to the controls.
- Participants viewed the warning labels were between eight and 11 times more likely to report wanting to consume less alcohol, compared to the control group.
- The largest impact on intention to reduce alcohol use was observed for the large text warning and picture labels.
Alcohol industry self-regulation has failed citizens for years
Currently the alcohol industry self-regulates alcohol product labeling. The only product and health-related information legally required on alcohol packaging in the UK is volume, strength of alcohol by volume, and presence of common allergens.
As Movendi International has previously reported the industry has failed in this self-regulation. UK’s Chief Medical Officers updated their low risk alcohol use guidelines in 2016, the alcohol industry’s self-appointed “social responsibility” front group the Portman Group agreed with Government that it had three years to put these on labels. But the labels are still largely not updated well after the self-appointed deadline.
A previous study conducted by Alcohol Change UK and a team from the Alcohol Health Alliance measured and recorded over 400 labels on alcohol products available in supermarkets and shops.
That study found,
- More than 70% of labels did not include the low risk alcohol use guidelines, over three years after they were updated and way past the deadline the alcohol industry had agreed with the Government.
- The industry-funded Portman Group called themselves a “social responsibility body” but only 2% of their members included the correct low-risk alcohol use guidelines.
- More than half (56%) of labels included no nutritional information. 37% of labels listed only the calorie content on the container, and just 7% displayed a full nutritional information table.
- Nearly a quarter (24%) of labels surveyed contained misleading, out-of-date health information, such as the old UK alcohol use guidelines or alcohol use guidelines from other countries.
- Health information was often illegible. Average height of the text displaying information about alcohol units were 2mm which is below the 3.5mm required to be easily readable.
- There were inconsistencies in labeling even between the same product sold at different locations, with some showing updated alcohol use guidelines and others showing old guidelines.
The chief executive of Alcohol Focus Scotland points out that it is vitally important for alcohol products to contain health information so that people can make informed choices. It is necesary to set this labeling requirements in law since the alcohol industry voluntary labeling has failed citizens for years.
We need the Chief Medical Officers’ low-risk weekly [alcohol use] guidelines as well as health information and warnings on labels, but unless labelling requirements are set out in law, we will continue to be kept in the dark about what is in our [alcohol products],” said Alison Douglas, chief executive of Alcohol Focus Scotland, as per University of Stirling website.Alison Douglas, chief executive of Alcohol Focus Scotland
University of Stirling: “Prominent health warnings on alcohol products make drinking “unappealing”, new study finds“