Health halo or genuine product development: Are better-for-you alcohol products actually healthier?

Can a health warning label diminish the persuasive effects of health-oriented nutrition advertising on ready-to-drink alcohol product packaging? A randomized experiment

BACKGROUND AND AIMS

A health warning label (HWL) cautioning about the link between alcohol and cancer may be able to communicate alcohol risks to consumers and potentially counter health-oriented nutrition advertising on ready-to-drink alcoholic beverages. This study aimed to examine the independent and combined effects of nutrient content claims (e.g. 0 g sugar) and a HWL on perceived product characteristics and intentions to consume, and whether these effects differed by gender and age.

DESIGN

A between-subjects randomized experiment. Participants were randomized to view one of six experimental label conditions: nutrient content claims plus nutrition declaration (NCC + ND), ND only, NCC + ND + HWL, ND + HWL, HWL only and no NCC, ND or HWL, all on a ready-to-drink (RTD) vodka-based soda container.

SETTING AND PARTICIPANTS

Alcohol consumers (n = 5063; 52% women) in Canada aged 18-64 recruited through a national online panel.

MEASUREMENTS

Participants completed ratings of perceived product characteristics, perceived product health risks, and intentions to try, buy, binge and drink the product.

FINDINGS

Compared with the reference condition NCC + ND (current policy scenario in Canada), the other five experimental label conditions were associated with lower ratings for perceiving the product as healthy. All experimental conditions with a HWL were associated with lower product appeal, higher risk perceptions and reduced intentions to try, buy and binge. The experimental condition with a HWL only was associated with intentions to consume fewer cans in the next 7 days (β = -0.72, 95% confidence interval [CI] = -1.37,-0.08) versus the reference. Few interactions were observed, suggesting that label effects on outcomes were similar by gender and age.

CONCLUSIONS

Health warning labels on alcohol packaging appear to be associated with lower product appeal, higher perceived health risks and reduced consumption intentions, even in the presence of nutrient content claims.

"They start on the zero-alcohol and they wanna try the real thing": Parents' views on zero-alcohol beverages and their use by adolescents

OBJECTIVE

Zero-alcohol beverages containing 0.0-0.5% alcohol by volume may offer public health benefits if individuals use them to substitute for alcohol-containing products, thereby reducing alcohol use. There are, however, concerns that zero-alcohol beverages may encourage adolescents' earlier interest in alcohol and increase exposure to alcohol company branding. As this poses a challenge for parents, we studied parents' views on zero-alcohol beverages and their provision to adolescents.

METHODS

We interviewed n=38 parents of 12-17-year-olds and used reflexive thematic analysis to interpret interview data.

RESULTS

Parents considered zero-alcohol beverages to be 'adult beverages' that potentially supported reduced adult drinking but were unnecessary for adolescents. Parents were concerned that adolescent zero-alcohol beverage use could normalise alcohol consumption and be a precursor to alcohol initiation. There was a potential conflict between moderate provision in 'appropriate' contexts, and potential benefits, which were each supported by some parents. Uncertainty on health qualities was also reported.

CONCLUSIONS

Parents reported conflicting and cautious views on zero-alcohol beverage provision to adolescents.

IMPLICATIONS FOR PUBLIC HEALTH

As evidence on the impacts of zero-alcohol beverage availability develops, parent-targeted messages highlighting the potential risk of normalisation of alcohol use for young people could be developed, in conjunction with broader policy responses.

Falling through the cracks: How do policies for alcohol marketing apply to zero alcohol products in Australia?

ISSUES

There is a decline in youth drinking, but also a causal link between alcohol marketing and drinking among young people. Therefore, novel alcohol marketing strategies should be scrutinised, particularly where children are exposed. This includes marketing for zero-alcohol products (ZAP) (containing 0.00% to 1.15% alcohol by volume), which has expanded considerably in recent times. This review examines how the current industry-managed regulatory approach to alcohol marketing applies to ZAPs in Western Australia.

APPROACH

The marketing mix (four Ps of marketing: product, promotion, place, price) was used as a framework to examine federal and state government policies and industry managed codes. Policies were included if they applied to marketing of alcohol products, for example, product labelling, promotion and advertising across various media, the place of purchase and pricing measures (taxation).

KEY FINDINGS

ZAPs were inconsistently defined, meaning that products between 0.05% and 1.15% alcohol by volume were covered under some but not all alcohol policy measures, and application to products under 0.5% alcohol by volume was limited.

IMPLICATIONS

Government policy should more clearly define alcohol marketing and whether ZAPs and other alcohol brand extensions should be treated in the same way as alcoholic products.

CONCLUSION

In Western Australia, the ways in which alcohol policy measures apply to ZAPs are limited and close attention must be paid to how ZAPs may provide additional marketing opportunities for the alcohol industry.

Qualitative analysis of UK women's attitudes to calorie-based alcohol marketing and alcohol calorie labelling

Mandatory standardized nutritional information on alcoholic drinks such as energy, or calorie labelling, is a population-level public health measure aimed at addressing obesity and alcohol consumption. In the UK, such measures are not a statutory requirement, but some alcohol brands do include references to calories on their products and in their marketing materials, as a marketing strategy to encourage sales and consumption. This article presents findings of semi-structured individual (N = 43) and group (N = 9) interviews with 78 women living in the UK that aimed to gain insight into their attitudes towards calorie-based alcohol brand marketing, and alcohol calorie labelling (ACL) as a health policy. Three themes are presented that outline how women rejected calorie marketing and labelling; the potential positive and unintended impact on alcohol consumption and dietary/eating practices; and how views on calorie labelling were intertwined with women's attitudes towards marketing that draws on calorie messaging. A feminist anti-diet discourse, as well as a discourse of pleasure through alcohol consumption, was at play in women's accounts, which may limit the intended aims of ACLs. It is concluded that ACLs should be considered within the wider commercial context of alcohol marketing that draws on calories to promote sales and consumption, consideration of the gendered factors that may lead some to reject ACLs as a health policy, and the potential for unintended consequences.

Type and prevalence of nutrition-related claims on alcoholic ready-to-drink beverages

OBJECTIVE

To examine the extent of nutrition-related claims on ready-to-drink (RTD) alcohol products to provide insights into the types and prevalence of claims across the category.

METHODS

Product type, alcohol content, and presence/type of nutrition-related claims (n=491) information was collected, March-May 2022. Chi-square analyses with pairwise z-tests were used to identify differences in claim prevalence by product type. Spearman's correlation was used to assess the relationship between alcohol content and number of claims.

RESULTS

Approximately half (52%) of RTDs displayed at least one claim, with the most common claims referring to naturalness (32%), sugar- (31%), and energy-content (32%). Hard seltzers displayed the most claims (96%, M=3.4 claims/product, SD=1.6). There was a moderate negative correlation between alcohol content and number of claims (r =-.43, p<.001).

CONCLUSION

Results show the extensive use of nutrition-related claims on RTDs in Australia, particularly for hard seltzers.

IMPLICATIONS FOR PUBLIC HEALTH

Nutrition-related claims have the potential to mislead consumers about the healthiness of alcohol products and more stringent regulation of nutrition-related claims is needed.

The symbolic consumption processes associated with 'low-calorie' and 'low-sugar' alcohol products and Australian women

The influence of commercial actors, practices and processes on the health and wellbeing of women is still not well understood. The alcohol industry has developed a range of products to appeal to new 'health conscious' markets, such as 'low-calorie' and 'low-sugar' products. While these products may have specific appeal for women, there has been little in-depth research that has sought to understand how women conceptualize these products and the range of symbolic meanings that women associate with these products. An online qualitatively led survey was conducted with n = 497 Australian women who had consumed alcohol in the last year. Questions related to the reasons for and influences on alcohol use, the purchasing of 'low-calorie' or 'low-sugar' products and the influence that these products might have on women's alcohol use. Data were interpreted using reflexive thematic analysis. Women consumed alcohol to relax, cope with everyday stressors and because of the alignment with social practices and social connection. Women perceived that these products provided a healthier alternative to traditional alcohol products and that they aligned with women's values relating to weight and the thin ideal. Some women were concerned that these products could increase alcohol consumption by reducing the perceptions of risk associated with alcohol. Policy consideration is needed to address how product claims and attributes may influence population groups' interpretations of the risks and benefits of these alcohol products, including the illusion that these products have protective potential and are better for overall health and wellbeing.

Nutrition-Related Information on Alcoholic Beverages in Victoria, Australia, 2021

Alcoholic beverages sold in Australia are largely exempt from requirements to display nutrition information on packages, unlike other food and beverages. However, alcoholic beverage manufacturers can provide nutrition-related information voluntarily. This study aimed to investigate the prevalence of nutrition-related information on packaged alcoholic beverages in Australia. An in-store audit of the largest alcohol retailer in Melbourne, Australia was conducted in July 2021. A systematic sampling method was used to assess the presence and format of nutrition information on 850 alcoholic beverages across 5 alcohol categories (wine (n = 200), beer (n = 200), spirits (n = 200), ready-to-drink beverages (n = 140) and ciders (n = 110)). Most products (n = 682, 80.2%) did not present nutrition-related information. Where information was presented (n = 168), it was most frequently on ready-to-drink beverages (n = 81, 57.9%) and least frequently on spirits (n = 9, 4.5%) and wines (n = 9, 4.5%). Nutrition information was most frequently in the format of a nutrition information panel (n = 150, 89.3%) and approximately half of labelled beverages (n = 86, 51.2%) included a nutrition content claim (e.g., ‘low in carbs’). Given limited voluntary implementation of nutrition labelling on alcoholic beverages in Australia and the substantial contribution of alcoholic beverages to energy intake, consideration of mandatory nutrition labelling, in a standardised format designed to maximise public health benefit, on alcoholic beverages is warranted.