Alcohol Warning Labels: A Review and Research Agenda (An Abstract)

Abstract

Warning labels on alcoholic beverages are a policy area with renewed interest, yet a strong evidence base regarding the efficacy of text-based or pictorial warning labels has still to emerge. The current review is important as previous alcohol warning reviews (e.g., Greenfield et al. 1999; Kaskutas and Greenfield 1992; Kaskutas and Greenfield 1997; Stockwell 2006) have been based on studies conducted primarily to evaluate the US warning label introduced in 1989. The results of studies by Greenfield and colleagues who evaluated the US warning label have shown mixed effectiveness but do suggest a large percentage (43 %) of US consumers are aware and can recall the warning. Their research showed that seeing the warning is associated with having conversations about drink driving and drinking during pregnancy but with limited evidence to support that drinkers who see the warning decided to not drive after consuming alcohol (Greenfield et al. 1999). Other research (e.g., Stockley 2006) concluded that the US warning has failed to deliver a significant reduction in alcohol consumption among pregnant women or in the occurrence of drink driving in the USA. Similar conclusions were drawn in a later study by Wilkinson and Room who reported increases in awareness of the US alcohol warning yet no evidence of a reduction in consumption in response to the warning (Wilkinson and Room 2009). Increased interest by policymakers has spurred research into potential alcohol warning label designs and messages. However, research which draws together findings from these recent studies is lacking. The current study seeks to review research (since 2000) that has sought to examine the effectiveness of alcohol warning labels. Searches for English language articles (since 2000) using the terms ‘alcohol’ and ‘warning label*’ were conducted during 2015 in four databases (Web of Science, PubMed, PsycINFO and Cochrane). Articles were included if they empirically assessed the effectiveness and/or design of alcohol warning labels. A narrative analysis approach was used for the 15 articles identified. Findings are reported on four themes: message specificity, types of message and framing, the use of signal words and qualifiers and the use of imagery. On balance, research so far indicates that less-specific messages might work better in encouraging processing of the message, but it is not clear which type of message might work best in achieving responsible consumption. Different target populations may perceive the use of signal words and qualifiers differently. Generally, the limited evidence suggests that quantitative messages are of less utility than qualitative ones. Conflicting results emerged which limit practical implications from being drawn. Overall there was little consistency in approach and measures across the studies, with very limited research having explored the potential of graphic/pictorial warning labels. There exist numerous research gaps; thus, more research is needed. Further, researchers in the area are encouraged to engage with pertinent theories in order to develop and test conceptual models, including mediation designs, which offer a nuanced and sound understanding of how alcohol warning labels can lead to behavioural change. References Available Upon Request