Department of Industrial Engineering, University of Chile and Instituto Sistema Complejos de Ingeniería, Av. Beauchef, 851 Santiago, Chile.
Department of Economics, University of Southern California, Kaprielian Hall, 3620 S Vermont Ave, Los Angeles, CA, United States.
Prev Med. 2024 Oct;187:108087. doi: 10.1016/j.ypmed.2024.108087. Epub 2024 Aug 2.
The World Health Organization recommends using health-risk warnings on alcoholic beverages. This study examines the impact of separate or combined warning labels for at-risk groups and the general population on alcohol purchase decisions.
In 2022, 7758 adults who consumed alcohol or were pregnant/lactating women (54.0 % female, mean age = 40.6 years) were presented with an online store's beverage section and randomly assigned to one of six warning labels in a between-subjects experimental design: no-warning, pregnant/lactating, drinking-driving, general cancer risk, combined warnings, and assorted warnings across bottles. The main outcome, the intention to purchase an alcoholic vs. non-alcoholic beverage, was examined with adjusted risk differences using logistic regressions.
Participants exposed to the general cancer risk warning decreased their alcoholic choices by 10.4 percentage points (pp.) (95 % CI [-0.139, -0.069], p < 0.001, OR = 0.561), while those in the pregnancy/lactation warning condition did it by 3.8 pp. (95 % CI [-0.071, -0.005], p = 0.025, OR = 0.806). The driving-drinking warning had no significant effect. Participants exposed to the combined warnings label, or the assorted warnings reduced alcohol purchase decisions by 6.1 pp. (95 % CI [-0.095, -0.028], p < 0.001, OR = 0.708) and 4.3 pp. (95 % CI [-0.076, -0.010], p = 0.011, OR = 0.782), respectively. Cancer warning outperformed other labels and was effective for subgroups such as pregnant/lactating women, young adults, and low-income individuals.
General cancer risk warnings are more effective at reducing alcohol purchase decisions compared to warning labels for specific groups or labels using multiple warnings. In addition to warning labels, other policies should be considered for addressing well-known alcohol-related risks (e.g., drinking and driving).
世界卫生组织建议在酒精饮料上使用健康风险警告。本研究旨在检验针对高危人群和普通人群的单独或联合警告标签对酒精购买决策的影响。
2022 年，7758 名饮酒或处于孕期/哺乳期的成年人（54.0%为女性，平均年龄为 40.6 岁）被展示在线商店的饮料区，并以被试间实验设计的方式随机分配到六种警告标签中的一种：无警告、孕期/哺乳期、酒后驾车、一般癌症风险、联合警告和各种警告标签。主要结果是购买酒精饮料与非酒精饮料的意向，使用逻辑回归检验调整后的风险差异。
接触一般癌症风险警告的参与者减少了 10.4 个百分点（pp.）的酒精选择（95%CI [-0.139, -0.069]，p<0.001，OR=0.561），而处于孕期/哺乳期警告条件的参与者减少了 3.8 个百分点（95%CI [-0.071, -0.005]，p=0.025，OR=0.806）。酒后驾车警告没有显著效果。接触联合警告标签或各种警告标签的参与者减少了 6.1 个百分点（95%CI [-0.095, -0.028]，p<0.001，OR=0.708）和 4.3 个百分点（95%CI [-0.076, -0.010]，p=0.011，OR=0.782）的酒精购买决策。癌症警告比其他标签更有效，对孕妇/哺乳期妇女、年轻成年人和低收入人群等亚组也有效。
与针对特定群体的警告标签或使用多个警告标签的标签相比，一般癌症风险警告更能有效减少酒精购买决策。除了警告标签外，还应考虑其他政策来解决众所周知的与酒精相关的风险（例如，酒后驾车）。
