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Health warning labels and alcohol selection

OAI: oai:www.repository.cam.ac.uk:1810/322983 • DOI: 10.17863/CAM.70437
Published by: Addiction

Abstract

Abstract: Background and aims: Health warning labels (HWLs) on tobacco products reduce smoking. There is an absence of evidence concerning the impact of alcohol HWLs on selection or purchasing in naturalistic settings. Using a commercial‐standard naturalistic shopping laboratory, this study aimed to estimate the impact on selection of alcoholic drinks of HWLs describing adverse health consequences of excessive alcohol consumption. Design: A between‐subjects randomised experiment with three groups was conducted: group 1: image‐and‐text HWL; group 2: text‐only HWL; group 3: no HWL. Setting: A commercial‐standard naturalistic shopping laboratory in the United Kingdom. Participants: Adults (n = 399, 55% female) over the age of 18 years, who purchased beer or wine weekly to drink at home. Interventions: Participants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: (i) image‐and‐text HWL (n = 135); (ii) text‐only HWL (n = 129); (iii) no HWL (n = 135). Participants completed a shopping task, selecting items from a range of alcoholic and non‐alcoholic drinks, and snacks. Measurement: The primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability. Findings: There was no clear evidence of a difference in the HWL groups for the percentage of drinks selected that were alcoholic compared to no HWL (44%): image‐and‐text HWL: 46% (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 0.82, 1.42); text‐only HWL: 41% (OR = 0.87, 95% CI = 0.67, 1.14). Concordant with there being no difference between groups, there was extreme evidence in favour of the null hypothesis (Bayes factor [BF] < 0.01). Negative emotional arousal was higher (P < 0.001) and acceptability lower (P < 0.001) in the image‐and‐text HWL group, compared to the text‐only HWL group. Conclusions: In a naturalistic shopping laboratory, there was no evidence that health warning labels describing the adverse health consequences of excessive alcohol consumption changed selection behaviour.