Abstract
BackgroundHealth warning labels (HWLs) using images and text to depict the negative health consequences of tobacco consumption are effective and acceptable for changing smoking-related outcomes. There is currently limited evidence concerning their potential use for reducing consumption of alcoholic drinks and energy-dense foods. The aim of this research was to describe the potential effectiveness and acceptability of image-and-text (also known as pictorial or graphic) HWLs applied to: i. alcoholic drinks and ii. energy-dense snack foods.MethodsTwo online studies were conducted using between-subjects designs with general population samples. Participants rated one of 21 image-and-text HWLs on alcoholic drinks (n = 5528), or one of 18 image-and-text HWLs on energy-dense snacks (n = 4618). HWLs comprised a graphic image with explanatory text, depicting, respectively, seven diseases linked to excess alcohol consumption, and six diseases linked to excess energy intake. Diseases included heart disease and various cancers. Outcomes were negative emotional arousal, desire to consume the labelled product, and acceptability of the label. Free-text comments relating to HWLs were content analysed.ResultsFor both alcoholic drinks and energy-dense snacks, HWLs depicting bowel cancer generated the highest levels of negative emotional arousal and lowest desire to consume the product, but were the least acceptable. Acceptability was generally low for HWLs applied to alcohol, with 3 of 21 rated as acceptable, and was generally high for snacks, with 13 of 18 rated as acceptable. The majority of free-text comments expressed negative reactions to HWLs on alcohol or energy-dense snacks.ConclusionsImage-and-text health warning labels depicting bowel cancer showed greatest potential for reducing selection and consumption of alcoholic drinks and energy-dense snacks, although they were the least acceptable. Laboratory and field studies are needed to assess their impact on selection and consumption.
Highlights
Alongside tobacco, excess consumption of alcohol and of energy-dense foods are two of the most significant preventable causes of a range of non-communicable diseases globally, including heart disease and many cancers [1,2,3]
Each Health warning labels (HWLs) was rated by a minimum of 259 participants
Image-and-text HWLs portraying bowel cancer elicited the highest levels of negative emotional arousal and lowest desire to consume both alcoholic drinks and energy-dense snacks
Summary
Excess consumption of alcohol and of energy-dense foods are two of the most significant preventable causes of a range of non-communicable diseases globally, including heart disease and many cancers [1,2,3]. Both products significantly contribute to energy intake, with alcohol being energy-dense and on average accounting for an estimated 8.8% of total energy intake in drinkers [4]. There is currently limited evidence concerning their potential use for reducing consumption of alcoholic drinks and energy-dense foods. The aim of this research was to describe the potential effectiveness and acceptability of image-and-text ( known as pictorial or graphic) HWLs applied to: i. alcoholic drinks and ii. energy-dense snack foods
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