The Effects of Alcohol Warning Labels on Population Alcohol Consumption: An Interrupted Time Series Analysis of Alcohol Sales in Yukon, Canada

Zhao, Jinhui; Stockwell, Tim; Vallance, Kate; Hobin, Erin

doi:10.15288/jsad.2020.81.225

Cited by 77 publications

(84 citation statements)

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“…Previous experimental and laboratory based studies have indicated that not only did AWLs displaying standard drink information and LRDG limits improve consumers’ ability to estimate recommended consumption limits ( Hobin et al, 2017 ; Osiowy et al, 2015 ), but adding labels with cancer warnings also decreased consumers’ motivation to drink ( Blackwell et al, 2018 ). Recent real-world evidence using data from subsequent waves of the current study further showed that exposure to such labels increased knowledge of alcohol–cancer risk and daily and weekly LRDG limits, and reduced overall alcohol consumption over time ( Hobin et al, 2020 ; Schoueri-Mychasiw et al, 2020 ; Weerasinghe et al, 2020 ; Zhao et al, 2020 ). Importantly, as knowledge of alcohol-related harms increases, so too does support for AWLs and other effective alcohol control measures shown to reduce alcohol harm, such as increasing minimum pricing and restricting alcohol availability and marketing; women, those who are older, and those who consume less alcohol are more likely to support such policies ( Bates et al, 2018 ; Buykx et al, 2016 ; Li et al, 2017 ; Macdonald et al, 2011 ; Moskalewicz et al, 2013 ; Pechey et al, 2014 ; Weerasinghe et al, 2020 ).…”

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confidence: 55%

Baseline Assessment of Alcohol-Related Knowledge of and Support for Alcohol Warning Labels Among Alcohol Consumers in Northern Canada and Associations With Key Sociodemographic Characteristics

Vallance

Stockwell

Zhao

et al. 2020

J. Stud. Alcohol Drugs

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Objective: Evidence-informed alcohol warning labels (AWLs) are a promising, well-targeted strategy to increase consumer awareness of health risks. We assessed consumers’ baseline knowledge of alcohol-related cancer risk, standard drinks, and low-risk drinking guidelines as well as levels of support for AWLs. We further assessed associations with sociodemographic factors. Method: Forming part of a larger study testing new evidence-informed AWLs in a northern Canadian territory compared with a neighboring territory, baseline surveys were completed among liquor store patrons systematically selected in both sites. Chi-square and multivariable logistic regression analyses were performed to assess outcomes. Results: In total, 836 liquor store patrons (47.8% female) completed baseline surveys across both sites. Overall, there was low knowledge of alcohol-related cancer risk (24.5%), limited ability to calculate a standard drink (29.5%), and low knowledge of daily (49.5%) and weekly (48.2%) low-risk drinking guideline limits. There was moderate support for AWLs with a health warning (55.9%) and standard drink information (51.4%), and lower support for low-risk drinking guideline labels (38.7%). No sociodemographic characteristics were associated with cancer knowledge. Identifying as female and having adequate health literacy were associated with support for all three AWLs; high alcohol use was associated with not supporting standard drink (adjusted odds ratio = 0.60, 95% CI [0.40, 0.88]) and low-risk drinking guideline (adjusted odds ratio = 0.57, 95% CI [0.38, 0.87]) labels. Conclusions: Few consumers in this study had key alcohol-related health knowledge; however, there was moderate support for AWLs as a tool to raise awareness. Implementation of information-based interventions such as evidence-informed AWLs with health messages including alcohol-related cancer risk, standard drink information, and national drinking guidelines is warranted.

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confidence: 55%

Baseline Assessment of Alcohol-Related Knowledge of and Support for Alcohol Warning Labels Among Alcohol Consumers in Northern Canada and Associations With Key Sociodemographic Characteristics

Vallance

Stockwell

Zhao

et al. 2020

J. Stud. Alcohol Drugs

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“…The evidence from alcohol labelling schemes without strong design and placement requirements shows that these labels have little effect on consumption behaviour [11]. The new research evidence confirms that well‐designed labels can impact consumption [14,15]. It is vital that regulatory space is left wide open for governments to implement forms of alcohol health information labelling which will benefit the public's health.…”

Section: Discussionmentioning

confidence: 99%

“…Although the evidence of effects of alcohol warnings on actual consumption has been weak, based as it has been on the USA alcohol warning labels [11], recent studies of sample labels have started to show effects of labels on intermediary variables, such as intentions to reduce consumption [12,13]. Furthermore, a recent experimental study from the Yukon Territories in Canada (which briefly introduced warnings about the increased risk of cancer from alcohol consumption) found that that the warnings were associated with a significant increase in awareness of alcohol's cancer risk and intentions to reduce consumption, and a decline in alcohol sales [14,15]. However, the rationales for introducing alcohol health warnings may extend beyond immediate behaviour change.…”

Section: Introductionmentioning

confidence: 99%

Alcohol labelling rules in free trade agreements: Advancing the industry's interests at the expense of the public's health

Gleeson

O’Brien

2020

Drug and Alcohol Review

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Introduction and AimsThe Trans‐Pacific Partnership Agreement (TPP) included novel rules for wine and spirits requiring parties to allow wine and spirits importers to display information required by the importing country on a supplementary label rather than on the standard label. Since the TPP negotiations concluded, alcohol‐specific supplementary labelling rules have begun to appear in other trade agreements. The aim of this paper was to map the new instruments containing these rules and examine developments in the rules with implications for health information on alcohol containers.Design and MethodsTrade agreements signed after the TPP negotiations concluded were retrieved and searched for alcohol‐specific labelling provisions. A legal analysis of these provisions and related exceptions was undertaken.ResultsSupplementary labelling rules similar or identical to those in the TPP have been included in five subsequent trade agreements. The United States–Mexico–Canada Agreement also includes several additional provisions about alcohol labelling. Exceptions in the agreements provide some space for governments to defend labelling measure that might otherwise breach the rules, in the event of a dispute.Discussion and ConclusionsBy securing these rules, the alcohol industry is better positioned to claim the space on the standard label as industry ‘real estate’ and to oppose mandatory health information incorporated into the standard labelling. These risks can be mitigated by stemming the adoption of supplementary labelling rules in further trade agreements; clarifying the text of agreements and ensuring that regulators understand that the rules do not prevent the use of ‘best‐practice’ warning labels.

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“…The labels were large and colourful, and included a health message linking alcohol to cancer, Canada's low risk drinking guidelines and standard drink information. The study found reduction of per capita alcohol sales in sites where alcohol warning labels were introduced, suggesting reduced population alcohol consumption (Zhao et al, 2020). However, the label included product information and health messaging so it is not possible to determine what specific aspects of the label had an impact on alcohol consumption.…”

Section: Other Informationmentioning

confidence: 98%

Rapid literature review on the impact of health messaging and product information on alcohol labelling

Dimova

Mitchell

2021

Drugs: Education, Prevention and Policy

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Background and aim: Alcohol labelling enables people to make informed decisions about the products they purchase and consume. This rapid review explores the impact of health messaging and product information on consumer attention, comprehension, recall, judgment and behavioural compliance in relation to alcohol use. Methods: The rapid review adopted a multi-faceted search strategy to identify primary studies on health messaging and/or product information on alcohol packaging, and the impact of these on consumer-related outcomes. Results: The review provides support for large, colourful labels on the front of alcohol products and the use of plain packaging to increase the visibility of health messaging. It also supports the use of explicit, negatively-framed statements that link alcohol to specific diseases. Colour-coded schemes and pictorial warnings may further optimize the effectiveness of alcohol labels. We did not find sufficient evidence to support the effectiveness of product information alone in influencing consumerattention, comprehension, recall, judgment and behavioural compliance. Conclusion: Well-designed alcohol labels can positively influence consumers' attention, comprehension, recall, judgment and behavioural compliance. The findings have implications for alcohol labelling research and policy.

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The Effects of Alcohol Warning Labels on Population Alcohol Consumption: An Interrupted Time Series Analysis of Alcohol Sales in Yukon, Canada

Cited by 77 publications

References 0 publications

Baseline Assessment of Alcohol-Related Knowledge of and Support for Alcohol Warning Labels Among Alcohol Consumers in Northern Canada and Associations With Key Sociodemographic Characteristics

Baseline Assessment of Alcohol-Related Knowledge of and Support for Alcohol Warning Labels Among Alcohol Consumers in Northern Canada and Associations With Key Sociodemographic Characteristics

Alcohol labelling rules in free trade agreements: Advancing the industry's interests at the expense of the public's health

Rapid literature review on the impact of health messaging and product information on alcohol labelling

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