Health warning labels and alcohol selection: an experiment in a naturalistic shopping laboratory

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.DesignA between-subjects randomised experiment with three groups: Group 1: image-and-text HWL; Group 2: text-only HWL; Group 3: no HWL.SettingA commercial-standard naturalistic shopping laboratory. Participants Adults (n=399) over the age of 18, who purchased beer or wine weekly to drink at home. InterventionsParticipants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: i. image-and-text HWL; ii. text-only HWL; iii. no HWL. Participants completed a shopping task, selecting items from a range of alcoholic and non-alcoholic drinks, and snacks. MeasurementThe primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability.FindingsThere 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% (OR=1.08, 95%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. ConclusionsIn a naturalistic shopping laboratory, health warning labels describing the adverse health consequences of excessive alcohol consumption did not change selection behaviour.

Download Full-text

Image-and-text health warning labels on alcohol and food: potential effectiveness and acceptability

10.21203/rs.2.23468/v2 ◽

2020 ◽

Author(s):

Emily Pechey ◽

Natasha Clarke ◽

Eleni Mantzari ◽

Anna Blackwell ◽

Katie De-loyde ◽

...

Keyword(s):

Emotional Arousal ◽

Field Studies ◽

Tobacco Consumption ◽

Bowel Cancer ◽

Free Text ◽

Label Free ◽

Warning Labels ◽

Potential Effectiveness ◽

Health Warning ◽

Alcoholic Drinks

Abstract Background Health 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. Methods Two 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. Results For 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. Conclusions Image-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.

Download Full-text

Image-and-text health warning labels on alcohol and food: potential effectiveness and acceptability

10.31234/osf.io/gxynw ◽

2019 ◽

Author(s):

Emily Pechey ◽

Natasha Clarke ◽

Eleni Mantzari ◽

Anna Katherine Mary Blackwell ◽

Katie De-loyde ◽

...

Keyword(s):

Emotional Arousal ◽

Field Studies ◽

Tobacco Consumption ◽

Bowel Cancer ◽

Free Text ◽

Label Free ◽

Warning Labels ◽

Potential Effectiveness ◽

Health Warning ◽

Alcoholic Drinks

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 effectiveness and acceptability for reducing consumption of alcoholic drinks and energy-dense foods. AimTo describe 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.Methods Two online studies were conducted using between-subjects designs with representative UK 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. Conclusions Image-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.

Download Full-text

Impact of Image-and-text and Text-only Health Warning Labels on Selection and Consumption of Food and Alcohol Products: Systematic Review with Meta-analysis

10.31234/osf.io/jt52m ◽

2019 ◽

Cited By ~ 3

Author(s):

Natasha Clarke ◽

Emily Pechey ◽

Daina Kosīte ◽

Laura M König ◽

Eleni Mantzari ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Experimental Studies ◽

Control Group ◽

Warning Labels ◽

Health Warning ◽

Alcoholic Drinks ◽

Randomised Controlled ◽

The Impact ◽

Selection Of

Reducing harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks would prevent much disease. Evidence from tobacco control shows that placing health warning labels (HWLs) on these products reduces their selection and consumption. A systematic review with meta-analysis was conducted using Cochrane methods to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drinks with image-and-text (sometimes termed ‘pictorial’) and text-only HWLs placed on these products. Studies were required to be randomised or quasi-randomised controlled trials. Fourteen studies were included, three on alcohol, eleven on food. For our primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared to a control group with no HWL (RR=0.74 (95% CI 0.68 to 0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger effect on selection of image-and-text HWLs (RR=0.65 (95% CI 0.54 to 0.80)) than text-only HWLs (RR=0.79 (95% CI 0.74 to 0.85)), but this difference was not statistically significant. These findings suggest significant potential for HWLs to reduce selection of food and alcohol, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and more naturalistic laboratory settings are urgently needed to estimate the potential effects of HWLs on food and alcohol.

Download Full-text

Image-and-text health warning labels on alcohol and food: potential effectiveness and acceptability

10.21203/rs.2.23468/v1 ◽

2020 ◽

Author(s):

Emily Pechey ◽

Natasha Clarke ◽

Eleni Mantzari ◽

Anna Blackwell ◽

Katie De-loyde ◽

...

Keyword(s):

Emotional Arousal ◽

Field Studies ◽

Tobacco Consumption ◽

Bowel Cancer ◽

Free Text ◽

Label Free ◽

Warning Labels ◽

Potential Effectiveness ◽

Health Warning ◽

Alcoholic Drinks

Abstract Background Health 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 effectiveness and acceptability for reducing consumption of alcoholic drinks and energy-dense foods. Aim To describe 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. Methods Two 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. Results For 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. Conclusions Image-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.

Download Full-text

The Impact of Stressful Life Events on Excessive Alcohol Consumption in the French Population: Findings from the GAZEL Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0087653 ◽

2014 ◽

Vol 9 (1) ◽

pp. e87653 ◽

Cited By ~ 20

Author(s):

Sara L. Tamers ◽

Cassandra Okechukwu ◽

Alex A. Bohl ◽

Alice Guéguen ◽

Marcel Goldberg ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Consumption ◽

Life Events ◽

Stressful Life Events ◽

Stressful Life ◽

French Population ◽

Excessive Alcohol Consumption ◽

Excessive Alcohol ◽

The Impact

Download Full-text

The impact of a surgeon-led intervention using facial injury to discourage 14 year old pupils from excessive alcohol consumption

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2009.06.207 ◽

2009 ◽

Vol 47 (7) ◽

pp. e28-e29

Author(s):

Iain Hutchison ◽

Fran Ridout ◽

Allan Hackshaw ◽

Ken Gannon ◽

Stephen Sutton

Keyword(s):

Alcohol Consumption ◽

Facial Injury ◽

Excessive Alcohol Consumption ◽

Excessive Alcohol ◽

The Impact

Download Full-text

The revolving door to homelessness. The influence of health, alcohol consumption and stressful life events on the number of episodes of homelessness.

Anales de Psicología ◽

10.6018/analesps.35.2.297741 ◽

2019 ◽

Vol 35 (2) ◽

pp. 175-180 ◽

Cited By ~ 3

Author(s):

Pablo Roca ◽

Sonia Panadero ◽

Sara Rodríguez-Moreno ◽

Rosa María Martín ◽

José Juan Vázquez

Keyword(s):

Chronic Illness ◽

Alcohol Consumption ◽

Life Events ◽

Stressful Life Events ◽

Homeless People ◽

Revolving Door ◽

Stressful Life ◽

Excessive Alcohol Consumption ◽

Excessive Alcohol ◽

The Impact

Objectives.- To analyse the impact of different variables on repeated episodes of homelessness. Method.- The study was conducted based on data obtained from a representative sample of homeless people in Madrid (Spain) (n = 188). Results.- Suffering from a serious or chronic illness has an effect on the revolving door to homelessness, which is mediated by a highly negative subjective perception of the individual's own health, which is in turn mediated by suffering from a disability. Excessive alcohol consumption has an effect on the revolving door to homelessness, mediated by access to treatment for problems caused by alcohol consumption. Suffering from a serious or chronic illness correlates with having problems caused by excessive alcohol consumption. Experiencing multiple stressful life events has a direct effect on the revolving door to homelessness. Conclusions.- To prevent the revolving door to homelessness, it is necessary to remove the barriers that hinder access to normal health resources which are experienced by people suffering from social exclusion, while implementing ongoing support programmes for homeless people or those at risk of homelessness, which primarily deal with health issues.

Download Full-text

Emerging role of circadian clock disruption in alcohol-induced liver disease

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00010.2018 ◽

2018 ◽

Vol 315 (3) ◽

pp. G364-G373 ◽

Cited By ~ 4

Author(s):

Shannon M. Bailey

Keyword(s):

Liver Disease ◽

Circadian Clock ◽

Therapeutic Approaches ◽

Excessive Alcohol Consumption ◽

Peripheral Tissues ◽

New Therapeutic Approaches ◽

Timing System ◽

Excessive Alcohol ◽

The Impact

The detrimental health effects of excessive alcohol consumption are well documented. Alcohol-induced liver disease (ALD) is the leading cause of death from chronic alcohol use. As with many diseases, the etiology of ALD is influenced by how the liver responds to other secondary insults. The molecular circadian clock is an intrinsic cellular timing system that helps organisms adapt and synchronize metabolism to changes in their environment. The clock also influences how tissues respond to toxic, environmental, and metabolic stressors, like alcohol. Consistent with the essential role for clocks in maintaining health, genetic and environmental disruption of the circadian clock contributes to disease. While a large amount of rich literature is available showing that alcohol disrupts circadian-driven behaviors and that circadian clock disruption increases alcohol drinking and preference, very little is known about the role circadian clocks play in alcohol-induced tissue injuries. In this review, recent studies examining the effect alcohol has on the circadian clock in peripheral tissues (liver and intestine) and the impact circadian clock disruption has on development of ALD are presented. This review also highlights some of the rhythmic metabolic processes in the liver that are disrupted by alcohol and potential mechanisms through which alcohol disrupts the liver clock. Improved understanding of the mechanistic links between the circadian clock and alcohol will hopefully lead to the development of new therapeutic approaches for treating ALD and other alcohol-related organ pathologies.

Download Full-text