1
|
Walker FC, de Visser RO. Messages focused on the effect of alcohol on the immune system boosted intention to adhere to alcohol intake guidelines during Covid-19 lockdown. Psychol Health 2024; 39:1321-1336. [PMID: 36412106 DOI: 10.1080/08870446.2022.2145606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 10/30/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022]
Abstract
Objective: Research shows that personal relevance may affect the impact of alcohol-related health information. This study explored alcohol consumption during the UK Covid-19 lockdown, and whether a message emphasising the effect of alcohol on the immune system was more effective in altering intentions to follow low-risk drinking guidelines than other messages about the effects of alcohol on health. Methods & Measures: From April to June 2020, 953 drinkers completed an online questionnaire, and were randomly allocated to exposure to a control condition or one of three messages emphasising the impact of alcohol on: the immune system; mental health; or physical health. Outcome variables were: concern about alcohol intake, and intention to adhere to low-risk drinking guidelines. Results: Pre-post ANCOVAs revealed that participants in the immunity message group had significantly stronger intention to adhere to low-risk guidelines than the control group (after controlling for initial intention). Concern for the effect of alcohol on health was not significantly affected. Conclusion: During Covid-19 lockdown, a message emphasising the impact of alcohol on the immune-system had a greater effect on intention to observe low-risk drinking guidelines than other messages. Contextually relevant messages could be used for alcohol health campaigns and for improving alcohol labelling.
Collapse
Affiliation(s)
| | - Richard O de Visser
- School of Psychology, University of Sussex
- Department of Primary Care & Public Health, Brighton & Sussex Medical School
| |
Collapse
|
2
|
Davies E, Lewin J, Field M. Am I a responsible drinker? The impact of message frame and drinker prototypes on perceptions of alcohol product information labels. Psychol Health 2024; 39:1005-1022. [PMID: 36190181 DOI: 10.1080/08870446.2022.2129055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/01/2022] [Accepted: 09/21/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Current alcohol product labelling tends to include ambiguous messages such as 'drink responsibly'. Consumers who identify as responsible drinkers may not pay heed to health warning messages, believing that they are not the intended target. AIMS We aimed to determine how responses to responsible drinking labels would differ from responses to positively and negatively framed health messages. We also explored if prototype perceptions would moderate the message impact. METHODS A between groups, three arm (ambiguous, positive or negative messages) experiment recruited 465 participants. Outcomes were drinking intentions and label acceptability (novelty, believability, personal relevance, and potential to change behaviour). Measures of heavy and responsible drinker prototype perceptions were included for exploratory moderation analyses. RESULTS Positive and negative messages were rated significantly more likely to change behaviour than ambiguous messages. There was also a moderation effect: participants with stronger favourability and similarity to the responsible drinker prototype intended to drink more alcohol in the future after exposure to negatively framed labels, but not after exposure to ambiguous or positively framed labels. DISCUSSION Drink responsibly' messages are unlikely to lead to behaviour change. Incorporating theoretical moderators may have value in developing our understanding of the impact of alcohol product labelling.
Collapse
Affiliation(s)
- Emma Davies
- The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Joel Lewin
- The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, UK
| |
Collapse
|
3
|
Kemper J, Rolleston A, Matthews K, Garner K, Lang B, Jiang Y, Ni Mhurchu C, Walker N. Perception is reality: qualitative insights into how consumers perceive alcohol warning labels. Alcohol Alcohol 2024; 59:agae053. [PMID: 39155516 PMCID: PMC11330865 DOI: 10.1093/alcalc/agae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/10/2024] [Accepted: 07/31/2024] [Indexed: 08/20/2024] Open
Abstract
AIMS This study explores perspectives of on-pack alcohol warning labels, and how they might influence alcohol purchase and/or consumption behavior to inform culturally appropriate label design for effective behavior change. METHODS New Zealand participants ≥18 years, who reported having purchased and consumed alcoholic beverages in the last month were recruited via a market research panel and grouped into 10 focus groups (n = 53) by ethnicity (general population, Māori, and Pacific peoples), age group, and level of alcohol consumption. Participants were shown six potential alcohol health warning labels, with design informed by relevant literature, label framework, and stakeholder feedback. Interviews were transcribed and analyzed via qualitative (directed) content analysis. RESULTS Effective alcohol labels should be prominent, featuring large red and/or black text with a red border, combining text with visuals, and words like "WARNING" in capitals. Labels should contrast with bottle color, be easily understood, and avoid excessive text and confusing imagery. Participants preferred specific health outcomes, such as heart disease and cancer, increasing message urgency and relevance. Anticipated behavior change included reduced drinking and increased awareness of harms, but some may attempt to mitigate warnings by covering or removing labels. Contextual factors, including consistent design and targeted labels for different beverages and populations, are crucial. There was a strong emphasis on collective health impacts, particularly among Māori and Pacific participants. CONCLUSIONS Our findings indicate that implementing alcohol warning labels, combined with comprehensive strategies like retail and social marketing campaigns, could effectively inform and influence the behavior of New Zealand's varied drinkers.
Collapse
Affiliation(s)
- Joya Kemper
- University of Canterbury Business School, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Anna Rolleston
- The Centre for Health, 103 Third Avenue, Tauranga 3110, New Zealand
| | - Kristen Matthews
- The Centre for Health, 103 Third Avenue, Tauranga 3110, New Zealand
| | - Katie Garner
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Bodo Lang
- School of Communication, Journalism and Marketing, Massey University, Private Bag 102-904, North Shore, Auckland 0745, New Zealand
| | - Yannan Jiang
- Department of Statistics, Faculty of Science, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Cliona Ni Mhurchu
- Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- The George Institute for Global Health, 300 Barangaroo Ave, Barangaroo, NSW 2000, Australia
| | - Natalie Walker
- Social and Community Health, School of Population Health, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| |
Collapse
|
4
|
Joyce KM, Davidson M, Manly E, Stewart SH, Al-Hamdani M. A systematic review on the impact of alcohol warning labels. J Addict Dis 2024; 42:170-193. [PMID: 37212771 DOI: 10.1080/10550887.2023.2210020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Findings on the effects of alcohol warning labels (AWLs) as a harm reduction tool have been mixed. This systematic review synthesized extant literature on the impact of AWLs on proxies of alcohol use. PsycINFO, Web of Science, PubMED, and MEDLINE databases and reference lists of eligible articles. Following PRISMA guidelines, 1,589 articles published prior to July 2020 were retrieved via database and 45 were via reference lists (961 following duplicate removal). Article titles and abstracts were screened, leaving the full text of 96 for review. The full-text review identified 77 articles meeting inclusion/exclusion criteria which are included here. Risk of bias among included studies was examined using the Evidence Project risk of bias tool. Findings fell into five categories of alcohol use proxies including knowledge/awareness, perceptions, attention, recall/recognition, attitudes/beliefs, and intentions/behavior. Real-world studies highlighted an increase in AWL awareness, alcohol-related risk perceptions (limited findings), and AWL recall/recognition post-AWL implementation; these findings have decreased over time. Conversely, findings from experimental studies were mixed. AWL content/formatting and participant sociodemographic factors also appear to influence the effectiveness of AWLs. Findings suggest conclusions differ based on the study methodology used, favoring real-world versus experimental studies. Future research should consider AWL content/formatting and participant sociodemographic factors as moderators. AWLs appear to be a promising approach for supporting more informed alcohol consumption and should be considered as one component in a comprehensive alcohol control strategy.
Collapse
Affiliation(s)
- Kayla M Joyce
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Myles Davidson
- Department of Psychology at Saint Mary's University, Halifax, Nova Scotia, Canada
| | - Eden Manly
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | | |
Collapse
|
5
|
Hobin E, Thielman J, Forbes SM, Poon T, Bélanger-Gravel A, Demers-Potvin É, Haynes A, Li Y, Niquette M, Paradis C, Provencher V, Smith BT, Wells S, Atkinson A, Vanderlee L. Can a health warning label diminish the persuasive effects of health-oriented nutrition advertising on ready-to-drink alcohol product packaging? A randomized experiment. Addiction 2024; 119:1238-1252. [PMID: 38528612 DOI: 10.1111/add.16475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/11/2024] [Indexed: 03/27/2024]
Abstract
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.
Collapse
Affiliation(s)
- Erin Hobin
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | | | | | - Ariane Bélanger-Gravel
- Department of Information and Communication, Université Laval, Québec, Canada
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- Research Center of the Quebec Heart and Lung Institute, Québec, Canada
| | - Élisabeth Demers-Potvin
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- École de nutrition, Université Laval, Québec, Canada
| | - Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ye Li
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Manon Niquette
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- Département d'information et de communication, Université Laval, Québec, Canada
| | | | - Véronique Provencher
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- École de nutrition, Université Laval, Québec, Canada
| | - Brendan T Smith
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Samantha Wells
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- School of Psychology, Deakin University, Geelong, Australia
| | - Amanda Atkinson
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Lana Vanderlee
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- École de nutrition, Université Laval, Québec, Canada
| |
Collapse
|
6
|
Lewin J, Field M, Davies E. Investigating the impact of 'dark nudges' on drinking intentions: A between groups, randomized and online experimental study. Br J Health Psychol 2024; 29:272-292. [PMID: 37839822 DOI: 10.1111/bjhp.12698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/25/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES This study explored how 'dark nudges' (tactics used in alcohol industry-funded responsible drinking campaigns) affect drinking intentions, perceived source credibility and whether individual differences in perceptions of prototypical drinkers moderated these effects. DESIGN Two 2 × 2 between-groups online experimental studies. METHODS Study 1 (N = 164) presented three alcohol health messages per condition, comprising social norm (healthy/unhealthy ("dark nudge")) by frame (loss/gain). Study 2 (N = 229) presented one message per condition, comprising cancer causality (single cause/multiple causes (dark nudge)) by funding disclosure (disclosure/non-disclosure (dark nudge)). Outcomes were drinking intentions and perceived source credibility. Exploratory analyses considered prototype perceptions as a between-subjects moderator. RESULTS No significant effects of message frame, social norm, fundi or multiple cancer causality arguments on drinking intentions were found. In Study 2, in the dark nudge multiple cancer causality conditions, perceived source credibility was high when funding was undisclosed, but significantly lower when it was disclosed. Exploratory analyses suggested effects were moderated by prototype similarity. In Study 1, higher perceived similarity to a heavy drinker and lower perceived similarity to a responsible drinker were associated with higher drinking intentions in the unhealthy norm/gain frame condition, but lower drinking intentions in the other conditions. CONCLUSIONS Framing, social norm, funding disclosure and multiple causality manipulations as tested in this study did not exert a dark nudge effect on drinking intentions. However, the exploratory analyses suggest it could be hypothesised that the types of messages used in alcohol industry-funded responsible drinking campaigns may result in greater drinking intentions among those who identify more as heavy drinkers and less as responsible drinkers. Perceived prototype similarity may be an important moderator of the impact of alcohol health messages that warrants further research. Study 2 suggests disclosure of industry funding guides judgements of the credibility of sources of misleading messages about alcohol and cancer.
Collapse
Affiliation(s)
- Joel Lewin
- The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
- Oxford Institute of Clinical Psychology Training and Research, The University of Oxford, Oxford, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Emma Davies
- The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| |
Collapse
|
7
|
Doyle A, O'Dwyer C, Mongan D, Millar SR, Galvin B. Factors associated with public awareness of the relationship between alcohol use and breast cancer risk. BMC Public Health 2023; 23:577. [PMID: 36978036 PMCID: PMC10044731 DOI: 10.1186/s12889-023-15455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Public awareness of the carcinogenic effects of alcohol is low, particularly the association between alcohol use and the risk of developing breast cancer. Breast cancer is the third most common cancer in Ireland and alcohol use remains high. This study examined factors related to awareness of the association between alcohol use and breast cancer risk. METHODS Using data from Wave 2 of the national Healthy Ireland Survey, a representative sample of 7,498 Irish adults aged 15 + years, descriptive and logistic regression analyses were conducted to investigate relationships between demographic characteristics, type of drinker and awareness of breast cancer risk. RESULTS A low level of awareness of the risk of alcohol use (drinking more than the recommended low-risk limit) associated with breast cancer was found, with just 21% of respondents correctly identifying the relationship. Multivariable regression analyses found that factors most strongly associated with awareness were sex (female), middle age (45-54 years) and higher educational levels. CONCLUSION As breast cancer is a prevalent disease among women in Ireland, it is essential that the public, in particular women who drink, are made aware of this association. Public health messages that highlight the health risks associated with alcohol use, and which target individuals with lower educational levels, are warranted.
Collapse
Affiliation(s)
- Anne Doyle
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland.
| | - Claire O'Dwyer
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
| | - Deirdre Mongan
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
| | - Seán R Millar
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Cork, Ireland
| | - Brian Galvin
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
| |
Collapse
|
8
|
Ranney LM, Clark SA, Jarman KL, Lazard AJ, Kowitt SD, Cornacchione Ross J, Baler G, Thrasher JF, Goldstein AO. How do current tobacco warnings compare to the WHO FCTC guidelines: a content analysis of combustible tobacco warnings worldwide. BMJ Open 2023; 13:e062033. [PMID: 36940946 PMCID: PMC10030571 DOI: 10.1136/bmjopen-2022-062033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
OBJECTIVE Many countries have adopted warning labels for combustible tobacco products, yet little research exists describing tobacco warning characteristics globally and to what extent they meet the WHO Framework Convention for Tobacco Control (FCTC) Guidelines. This study evaluates characteristics of combustible tobacco warnings. DESIGN We conducted a content analysis to describe the overall landscape of warnings using descriptive statistics and compared to the WHO FCTC Guidelines. SETTING We searched existing warning databases for combustible tobacco warnings from English-speaking countries. We compiled warnings meeting inclusion criteria and coded for message and image characteristics using a pre-defined codebook. PRIMARY AND SECONDARY OUTCOMES MEASURES Characteristics of combustible tobacco warning text statements and warning images were the primary study outcomes. There were no secondary study outcomes. RESULTS We identified a total of 316 warnings from 26 countries or jurisdictions worldwide. Of these warnings, 94% included warning text and an image. Warning text statements most often described health effects to the respiratory (26%), circulatory (19%) and reproductive systems (19%). Cancer was the most frequently mentioned health topic (28%). Fewer than half of warnings included a Quitline resource (41%). Few warnings included messages about secondhand smoke (11%), addiction (6%) or cost (1%). Of warnings with images, most were in colour and showed people (88%), mostly adults (40%). More than 1 in 5 warnings with images included a smoking cue (ie, cigarette). CONCLUSIONS While most tobacco warnings followed WHO FCTC guidance on effective tobacco warnings, such as communicating health risks and inclusion of images, many did not include local Quitline or cessation resources. A sizeable minority include smoking cues that could inhibit effectiveness. Full alignment with WHO FCTC guidelines will improve warnings and better achieve the WHO FCTC objectives.
Collapse
Affiliation(s)
- Leah M Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sonia A Clark
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen L Jarman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer Cornacchione Ross
- Department of Health Law, Policy, and Management, Boston University, School of Public Health, Boston, MA, USA
| | - Guido Baler
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Adam O Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
9
|
Davies EL, Cooke R, de Visser RO, Conroy D. Calling time on responsible drinking: A qualitative study of perceptions of information on alcohol product labels. Br J Health Psychol 2022; 28:320-337. [PMID: 36263853 DOI: 10.1111/bjhp.12627] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to explore (a) how people interpret responsible drinking messages on alcohol product labels, and (b) the acceptability of including health information on labels. DESIGN Qualitative interviews. METHODS Face-to-face semi-structured interviews were conducted with 20 people aged 21-63; 18 were classified risky drinkers using AUDIT-C. They were shown three sets of alcohol product labels: one including three responsible drinking messages (drink responsibly), one with three positively worded health messages (drinking less reduces risks) and one with three negatively worded health messages (drinking more increases risks). Health messages included information about cancer, liver and heart disease. RESULTS Thematic analysis identified three themes: ambiguity about alcohol labelling; identifying oneself as responsible; and acceptability of enhanced product labelling. Participants were critical of responsible drinking messages and wary of conflicting health information in the media. They positioned themselves as responsible, knowledgeable drinkers and distanced themselves from problem drinkers. They did not appear to support the inclusion of health information on labels; however, novel information was considered more impactful. CONCLUSIONS Responsible drinking messages were seen by our sample as an alcohol industry ploy. Although health messages about cancer were seen as potentially impactful, the ability of consumers to position themselves as unproblematic drinkers means that they may not see the information on the label as relevant to themselves. Understanding factors that increase the personal relevance of messages is needed, alongside an exploration of a wider range of methods for alcohol health communication.
Collapse
Affiliation(s)
- Emma L Davies
- Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Richard Cooke
- Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
| | - Richard O de Visser
- Department of Primary Care & Population Health, Brighton & Sussex Medical School, Brighton, UK
| | - Dominic Conroy
- School of Social Sciences and Professions, London Metropolitan University, London, UK
| |
Collapse
|
10
|
Giesbrecht N, Reisdorfer E, Rios I. Alcohol Health Warning Labels: A Rapid Review with Action Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11676. [PMID: 36141951 PMCID: PMC9517222 DOI: 10.3390/ijerph191811676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
A rapid review of research on health warning labels located on alcohol containers (AWLs) was conducted. Using five search engines (Embase, Medline, Pubmed, Scopus, Psyinfo), 2975 non-duplicate citations were identified between the inception date of the search engine and April 2021. Of those, 382 articles were examined and retrieved. We selected 122 research papers for analysis and narrative information extraction, focusing on population foci, study design, and main outcomes. Research included public opinion studies, surveys of post-AWL implementation, on-line and in-person experiments and real-world quasi-experiments. Many studies focused on the effects of the 1989 United States Alcoholic Beverage Labeling Act on perceptions, intentions and behavior. Others focused on Australia, Canada, the United Kingdom, England or Scotland, Italy and France. There was substantial variation in the design of the studies, ranging from small-scale focus groups to on-line surveys with large samples. Over time, evidence has been emerging on label design components, such as large size, combination of text and image, and specific health messaging, that is likely to have some desired impact on knowledge, awareness of risk and even the drinking behavior of those who see the AWLs. This body of evidence provides guidance to policy-makers, and national and regional authorities, and recommendations are offered for discussion and consideration.
Collapse
Affiliation(s)
- Norman Giesbrecht
- Centre for Addiction and Mental Health, 33 Ursulla Franklin St., Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
| | | | | |
Collapse
|
11
|
Davies EL, Foxcroft DR, Puljevic C, Ferris JA, Winstock AR. Global comparisons of responses to alcohol health information labels: A cross sectional study of people who drink alcohol from 29 countries. Addict Behav 2022; 131:107330. [PMID: 35504111 DOI: 10.1016/j.addbeh.2022.107330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 02/25/2022] [Accepted: 04/04/2022] [Indexed: 01/21/2023]
Abstract
AIMS The aim of this paper was to explore responses to alcohol health information labels from a cross sectional survey of people who drink alcohol from 29 countries. DESIGN This paper draws on findings from the Global Drug Survey (GDS) - an annual cross sectional online survey. PARTICIPANTS 75,969 (64.3% male) respondents from 29 countries were included in the study. MEASURES Respondents were shown seven health information labels (topics were heart disease, liver, cancer, calories, violence, taking two days off and myth of benefits of moderate drinking). They were asked if the information was new, believable, personally relevant, and if it would change their drinking. A multivariate multilevel Bayesian logistic regression model was used to estimate predicted probabilities for newness, believability, relevance and if messages would change drinking behaviour by country and information label. FINDINGS Predicted probabilities showed substantial variability in responses across countries. Respondents from Colombia, Brazil and Mexico were more likely to consider drinking less as well as have lower levels of previous awareness. Those from Denmark and Switzerland were not as likely to say the labels would make them consider drinking less. The cancer message was consistently the newest and most likely to make people consider drinking less across countries. CONCLUSIONS Country differences in responses to messages can be used to create targeted harm reduction measures as well as inform what should be on labels. The provision of such health information on alcohol product labels may play a role in raising awareness of the risk of drinking. Global comparisons of responses to alcohol health information labels: a cross sectional study of people who drink alcohol from 29 countries.
Collapse
Affiliation(s)
- Emma L Davies
- Faculty of Health and Life Sciences, Oxford Brookes University, UK.
| | - David R Foxcroft
- Faculty of Health and Life Sciences, Oxford Brookes University, UK
| | - Cheneal Puljevic
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia; School of Public Health, The University of Queensland, Brisbane, Australia
| | - Jason A Ferris
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Adam R Winstock
- University College London, UK; Global Drug Survey, London, UK
| |
Collapse
|
12
|
Peddireddy S, Boniface S, Critchlow N, Newberry Le Vay J, Severi K, Vohra J. Factors Associated with Adolescents' Support for Product Information and Health Messaging on Alcohol Packaging: A Cross-Sectional Study in the United Kingdom. Alcohol Alcohol 2022; 57:364-371. [PMID: 34875686 DOI: 10.1093/alcalc/agab080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS Adolescents in the UK are among the heaviest drinkers in Europe. The World Health Organization recommends alcohol product labelling to inform consumers about product information and health risks associated with alcohol use. This study investigates support for product information and health messaging on alcohol packaging among UK adolescents. METHODS The 2019 UK Youth Alcohol Policy Survey was an online cross-sectional survey among 3388 adolescents aged 11-19. Participants indicated their support for seven forms of messaging on packaging (e.g. number of alcohol units, links to health conditions). Logistic regression models investigated associations between support for each of the seven forms and alcohol use, perceived risks of alcohol use, and previous exposure to messaging. RESULTS Between 60 and 79% of adolescents were supportive of different aspects of product labelling. Compared to lower-risk drinkers, higher-risk drinkers (AUDIT-C 5+) had higher odds of supporting including the number of alcohol units (OR: 1.82, 95% CI: 1.31-2.54), calories (OR: 1.52, 95% CI: 1.04-1.68), and strength of the product (OR: 1.73, 95% CI: 1.19-2.52) but lower odds of supporting including information on alcohol-related health conditions (OR: 0.68, 95% CI: 0.53-0.87). Adolescents who perceived risks of alcohol use more strongly were more likely to support all forms of product information and messaging. CONCLUSIONS The majority of adolescents supported improved alcohol labelling. Higher-risk drinkers were supportive of improved product information but less supportive of health-related messaging. Adolescents who believe alcohol carries health risks were more likely to support messaging.
Collapse
Affiliation(s)
- Snigdha Peddireddy
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Sadie Boniface
- Institute of Alcohol Studies, Alliance House, 12 Caxton Street, London SW1H 0QS, UK
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Nathan Critchlow
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, UK
| | | | - Katherine Severi
- Institute of Alcohol Studies, Alliance House, 12 Caxton Street, London SW1H 0QS, UK
| | - Jyotsna Vohra
- Cancer Policy Research Centre, Cancer Research UK, 2 Redman Place, London E20 1 JQ, UK
| |
Collapse
|
13
|
Jones D, Moodie C, Purves RI, Fitzgerald N, Crockett R. The role of alcohol packaging as a health communications tool: An online cross-sectional survey and experiment with young adult drinkers in the United Kingdom. Drug Alcohol Rev 2022; 41:1206-1215. [PMID: 35385591 DOI: 10.1111/dar.13469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 03/05/2022] [Accepted: 03/16/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Alcohol packaging is a potentially valuable means of communicating product and health-related information, with growing academic and political interest in its role as a health communications vehicle. METHODS An online cross-sectional survey and experiment were conducted with a non-probability sample of 18-35-year-old drinkers in the United Kingdom (n = 1360). The survey assessed exposure to, and engagement with, current messaging on packs, and support for displaying product and health-related information. For the randomised experiment, participants were shown, and asked questions about, a vodka bottle with either no warnings (control), small text warnings, large text warnings or pictorial (image-and-text) warnings; the main binary outcome measures were negative product appeal and social acceptability, and positive cognitive and behavioural impact. RESULTS Two-fifths of the sample rarely or never saw on-pack health-related information, with almost three-quarters rarely or never reading or looking closely at this. There was strong support for displaying a range of product and health-related information (e.g. units, ingredients) on packs. Relative to the control, products with warnings were more likely to be perceived as unappealing and socially unacceptable, and to positively impact alcohol-related cognitions and behaviours. For example, pictorial warnings were 10 times as likely to positively influence cognitions and behaviours (AOR = 10.01, 95% CI: 8.09, 17.46). DISCUSSION AND CONCLUSIONS Alcohol packaging could have an important role in delivering health messaging. Large pictorial or text warnings may help counteract the appeal and social acceptability of alcohol products and increase awareness of risks, potentially supporting a reduction in consumption and related harms.
Collapse
Affiliation(s)
- Daniel Jones
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Richard I Purves
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.,SPECTRUM Consortium, Edinburgh, UK
| | - Rachel Crockett
- Psychology Department, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| |
Collapse
|
14
|
Davies EL, Puljevic C, Gilchrist G, Potts L, Zhuparris A, Maier LJ, Barratt MJ, Winstock AR, Ferris JA. Impacts of changes in alcohol consumption patterns during the first 2020 COVID-19 restrictions for people with and without mental health and neurodevelopmental conditions: A cross sectional study in 13 countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 101:103563. [PMID: 34952280 PMCID: PMC8692164 DOI: 10.1016/j.drugpo.2021.103563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 02/07/2023]
Abstract
Background The initial period of COVID-19-related restrictions affected substance use in some population groups. We explored how changes in alcohol use at the beginning of the pandemic impacted the health and wellbeing of people with and without mental health and neurodevelopmental conditions (MHDCs). Methods Data came from the Global Drug Survey Special Edition on COVID-19 conducted in May-June 2020. Measured were; changes in drinking compared to February 2020 (pre-COVID-19 restrictions), reasons for changes, and impact on physical health, mental health, relationships, finances, work/study, and enjoyment. This study included 38,141 respondents (median age = 32 IQR 25-45; 51.9% cis man; 47.8% cis woman; 1.2% trans/non-binary; 30.2% with MHDCs e.g. depression 20.0%, anxiety 16.3%, ADHD 3.8%, PTSD 3.3%). Results A third (35.3%) of respondents with MHDCs and 17.8% without MHDCs indicated that increased drinking affected their mental health negatively (p<.001); 44.2% of respondents with MHDCS compared to 32.6% without MHDCs said it affected their physical health negatively (p<.001). Reduced drinking was associated with better mental health among a fifth (21.1%) of respondents with MHDCS and 14.4% without MHDCs (p<.001). Age, relationship status, living arrangements, employment, coping and distress were significant predictors of increases in drinking. Conclusion Among people with MHDCS, reduced alcohol consumption was associated with better mental health, while the negative effects of increased drinking were more pronounced when compared to people without MHDCS. When supporting people in reducing alcohol consumption during uncertain times, people with MHDCS may need additional support, alongside those experiencing greater levels of distress.
Collapse
Affiliation(s)
- Emma L Davies
- Centre for Psychological Research, Oxford Brookes University, UK.
| | - Cheneal Puljevic
- Centre for Health Services Research, The University of Queensland, Australia; School of Public Health, The University of Queensland, Australia
| | | | | | | | - Larissa J Maier
- Department of Clinical Pharmacy, University of California, San Francisco, USA
| | - Monica J Barratt
- Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Vic, Australia; National Drug and Alcohol Research Centre, UNSW Sydney, NSW, Australia
| | | | - Jason A Ferris
- Centre for Health Services Research, The University of Queensland, Australia
| |
Collapse
|
15
|
Clarke N, Blackwell AKM, De-Loyde K, Pechey E, Hobson A, Pilling M, Morris RW, Marteau TM, Hollands GJ. Health warning labels and alcohol selection: a randomised controlled experiment in a naturalistic shopping laboratory. Addiction 2021; 116:3333-3345. [PMID: 33861881 DOI: 10.1111/add.15519] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/15/2020] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Health warning labels (HWLs) on tobacco products reduce smoking. There is an absence of evidence concerning the impact of alcohol HWLs on selection or purchasing in naturalistic settings. Using a commercial-standard naturalistic shopping laboratory, this study aimed to estimate the impact on selection of alcoholic drinks of HWLs describing adverse health consequences of excessive alcohol consumption. DESIGN A between-subjects randomised experiment with three groups was conducted: group 1: image-and-text HWL; group 2: text-only HWL; group 3: no HWL. SETTING A commercial-standard naturalistic shopping laboratory in the United Kingdom. PARTICIPANTS Adults (n = 399, 55% female) over the age of 18 years, who purchased beer or wine weekly to drink at home. INTERVENTIONS Participants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: (i) image-and-text HWL (n = 135); (ii) text-only HWL (n = 129); (iii) no HWL (n = 135). Participants completed a shopping task, selecting items from a range of alcoholic and non-alcoholic drinks, and snacks. MEASUREMENT The primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability. FINDINGS There was no clear evidence of a difference in the HWL groups for the percentage of drinks selected that were alcoholic compared to no HWL (44%): image-and-text HWL: 46% (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 0.82, 1.42); text-only HWL: 41% (OR = 0.87, 95% CI = 0.67, 1.14). Concordant with there being no difference between groups, there was extreme evidence in favour of the null hypothesis (Bayes factor [BF] < 0.01). Negative emotional arousal was higher (P < 0.001) and acceptability lower (P < 0.001) in the image-and-text HWL group, compared to the text-only HWL group. CONCLUSIONS In a naturalistic shopping laboratory, there was no evidence that health warning labels describing the adverse health consequences of excessive alcohol consumption changed selection behaviour.
Collapse
Affiliation(s)
- Natasha Clarke
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Anna K M Blackwell
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Katie De-Loyde
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Emily Pechey
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Alice Hobson
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Theresa M Marteau
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
16
|
Noel JK. Using social media comments to reduce alcohol purchase intentions: An online experiment. Drug Alcohol Rev 2021; 40:1047-1055. [PMID: 33677837 DOI: 10.1111/dar.13262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Alcohol advertising is prevalent on social media. The current study sought to identify effective message types to pair with social media alcohol ads to minimise purchase intentions associated with exposure. METHODS A 6 (within) × 5 (between) randomised controlled experiment was conducted with n = 723 US participants. Participants viewed six unique social media alcohol ads and were randomised to view one of four message types (i.e. pro-drinking comments, anti-drinking comments, industry responsibility messages and health warning labels) associated with the ads or the control (i.e. no messages). Purchase intentions were measured after each ad exposure. Significant main and interactive effects were determined by two-level, random intercept hierarchical linear models. RESULTS Purchase intentions were significantly lower among participants who viewed anti-drinking comments relative to the control (P = 0.022) and warning labels (P = 0.016). Purchase intentions were significantly greater among participants who viewed pro-drinking comments and had a family history of alcohol use (P = 0.032) and among those who viewed warning labels and were previously exposed to alcohol depictions through family and friends' social media posts (P = 0.033). DISCUSSION AND CONCLUSIONS Anti-drinking messages, written by social media users, may be effective at reducing alcohol purchase intentions when posted as social media comments. Current industry responsibility messages had no effect, and caution may be needed if warning labels are applied to ads in this medium.
Collapse
Affiliation(s)
- Jonathan K Noel
- Department of Health Science, College of Health and Wellness, Johnson and Wales University, Providence, USA
| |
Collapse
|
17
|
Neufeld M, Ferreira-Borges C, Rehm J. Implementing Health Warnings on Alcoholic Beverages: On the Leading Role of Countries of the Commonwealth of Independent States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8205. [PMID: 33172090 PMCID: PMC7664423 DOI: 10.3390/ijerph17218205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 12/26/2022]
Abstract
Despite being a psychoactive substance and having a major impact on health, alcohol has to date escaped the required labeling regulations for either psychoactive substances or food. The vast majority of the countries in the WHO European Region have stricter labeling requirements for bottled water and health warning provisions for over-the-counter medications than for alcoholic beverages. However, more progress in implementing health warnings has been made in the eastern part of the WHO European Region, largely because of the recent technical regulation put in place by the newly formed Eurasian Economic Union. The present contribution provides an overview of the existing legislation regarding the placement of alcohol health warnings on advertisements and labels on alcohol containers in the countries of the Commonwealth of Independent States (CIS; Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, and Uzbekistan) and discusses their potential gaps and shortfalls. It also reviews the evolution of the Eurasian Economic Union Technical Regulation 047/2018, which is, to date, the only international document to impose binding provisions on alcohol labeling. The technical regulation's developmental process demonstrates how the comprehensive messages and strong requirements for health warnings that were suggested initially were watered down during the consultation process.
Collapse
Affiliation(s)
- Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russia; (C.F.-B.); (J.R.)
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russia; (C.F.-B.); (J.R.)
| | - Jürgen Rehm
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russia; (C.F.-B.); (J.R.)
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON M5T 1R8, Canada
- Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 3M7, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, Sechenov First Moscow State Medical University (Sechenov University), Alexander Solzhenitsyn Street 28/1, 109004 Moscow, Russia
| |
Collapse
|
18
|
Winstock AR, Lynskey MT, Maier LJ, Ferris JA, Davies EL. Perceptions of cannabis health information labels among people who use cannabis in the U.S. and Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 91:102789. [PMID: 32499118 DOI: 10.1016/j.drugpo.2020.102789] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The emergence of legal cannabis industries poses a new public health challenge. Health information labels are part of the public health strategy for tobacco and alcohol, but there is limited research on cannabis-related messaging. This study explored perceptions of cannabis health information labels among people who used cannabis in the last 12 months residing in the U.S. and Canada. METHODS The Global Drug Survey (GDS) is a large anonymous cross-sectional web-survey. In GDS2019, respondents were presented with six labels with cannabis-related health information (dependence; driving stoned; harms of smoking; harms to developing brain; lack of motivation; effects on memory), and asked if information was new, believed, would it change behavior, and about acceptability of having health labels on legal products. This paper includes 1,275 respondents from Canada and 2,224 from U.S. states where cannabis was legal at the time of the survey, and 5,230 from other U.S. states. RESULTS Few respondents said that the information was new (6.6-24.6%). Most said the information was believable (63.5-72.0%) other than for the dependence message (28.1% new, 56.8% believed), which was perceived to be the least likely to change behavior (10.2%). Driving stoned was the message perceived to be the most likely to change behavior (58.5%). Respondents living in Canada were less likely to say information was new and rated most messages more believable than those in the U.S. Respondents from legal U.S. states were less likely to say information was new compared to other states. Respondents who used cannabis daily rated acceptability of labels lower (27.8%) than those using 1-48 days (40.6%). CONCLUSIONS Novel, believable information may be more effective at changing behavior. Regular consumers may be less susceptible to messages. Information focusing on safer use strategies and benefits of reducing use may be more acceptable and should be assessed in future research.
Collapse
Affiliation(s)
| | | | - Larissa J Maier
- Department of Psychiatry, University of California, San Francisco, San Francisco, USA; Early Postdoc Mobility Grantee (P2ZHP1_174812), Swiss National Science Foundation, Bern, Switzerland
| | - Jason A Ferris
- The Centre for Health Services Research, The University of Queensland, Australia
| | - Emma L Davies
- Faculty of Health and Life Sciences, Oxford Brookes University, UK.
| |
Collapse
|
19
|
Braillon A. Perceptions of Alcohol Health Warning Labels by Governments: Too Effective for Implementation! Alcohol Alcohol 2020; 55:336. [DOI: 10.1093/alcalc/agz107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 12/31/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alain Braillon
- Alcohol treatment unit, University hospital, ave Laennec, 80000 Amiens, France
| |
Collapse
|