Testing the effectiveness of alcohol health warning label formats: An online experimental study with Australian adult drinkers

Emily Brennan; Kimberley Dunstone; Amanda Vittiglia; Sam Mancuso; Sarah Durkin; Michael D Slater; Janet Hoek; Simone Pettigrew; Melanie Wakefield

doi:10.1371/journal.pone.0276189

Testing the effectiveness of alcohol health warning label formats: An online experimental study with Australian adult drinkers

PLoS One. 2022 Dec 7;17(12):e0276189. doi: 10.1371/journal.pone.0276189. eCollection 2022.

Authors

Emily Brennan¹, Kimberley Dunstone¹, Amanda Vittiglia¹, Sam Mancuso¹, Sarah Durkin¹, Michael D Slater², Janet Hoek³, Simone Pettigrew⁴, Melanie Wakefield¹

Affiliations

¹ Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.
² School of Communication, The Ohio State University, Columbus, Ohio, United States of America.
³ Department of Public Health, University of Otago, Wellington, New Zealand.
⁴ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.

Abstract

Health warning labels (HWLs) on alcohol containers may help reduce population-level alcohol consumption. However, few studies have examined the most effective formats for alcohol HWLs. This study tested the effects of three different types of alcohol HWLs. In an online experiment, N = 1,755 Australian adult drinkers were randomly assigned to one of five conditions: (a) No HWL control; (b) DrinkWise control (industry-developed labels currently on some containers); (c) Text-Only HWLs; (d) Text + Pictogram HWLs; or (e) Text + Photograph HWLs. In the three intervention conditions, participants were exposed to eight HWLs, each depicting a different long-term harm. Exposure occurred during an initial session, and repeatedly over the subsequent eight days. Differences between conditions were assessed immediately following initial exposure and at nine-day follow-up. Compared to participants in the No HWL control, participants exposed to Text + Pictogram HWLs were more likely to have intentions to avoid drinking alcohol completely in the next month (post-exposure) and intentions to drink less alcohol in the next week (follow-up), and participants in all three intervention conditions reported stronger negative emotional arousal (follow-up) and weaker positive emotional arousal (follow-up). Compared to participants in the DrinkWise control, those exposed to Text + Pictogram HWLs had stronger intentions to drink less alcohol in the next week and intentions to avoid drinking alcohol completely in the next month (follow-up), participants in the Text + Photograph condition reported significantly weaker positive emotional arousal, and all three intervention conditions resulted in stronger negative emotional arousal. There would likely be benefits to public health if any of the three types of intervention HWLs were implemented. However, there is some evidence that Text + Pictogram HWLs should be recommended over Text-Only or Text + Photograph HWLs, given they were the only HWLs to increase intentions to drink less.

Copyright: © 2022 Brennan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alcohol Drinking*
Alcoholic Beverages*
Australia
Food Labeling*
Humans

Grants and funding

The study was funded by an Australian National Health and Medical Research Council (https://www.nhmrc.gov.au/) Project Grant [#1129002] awarded to MW, EB, SD, SP, JH, and MDS. The funders had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript.