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

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

Emily Brennan  1 , Kimberley Dunstone  1 , Amanda Vittiglia  1 , Sam Mancuso  1 , Sarah Durkin  1 , Michael D Slater  2 , Janet Hoek  3 , Simone Pettigrew  4 , Melanie Wakefield  1
Affiliations

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

Emily Brennan et al. PLoS One. .

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.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: EB, KD, SD and MW are employed by a non-profit organisation that conducts research, public health interventions and advocacy aimed at reducing alcohol-related health harms in the community, especially those pertaining to cancer. EB, SP and MW have received other NHMRC grants on alcohol harm communication. MDS has current grant support for alcohol-related research from the NIH National Institute on Drug Abuse and has previously received grants from the National Institute on Alcohol Abuse and Alcoholism, National Cancer Institute, and the Robert Woods Johnson Foundation. EB and SP are members of the Expert Reference Group for the Alcohol. Think Again campaign. JH has provided advice to Alcohol Healthwatch, a New Zealand non-profit organisation that conducts advocacy to reduce alcohol-related health harms in the community. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Condition allocation and flow of participants through study.
Fig 2
Fig 2. Appearance of warning labels on one example of an alcohol container (beer).
Fig 3
Fig 3. Adjusted means for negative emotional arousal by condition type and dose of repeated exposure (N = 1,087).
See this image and copyright information in PMC

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