Acceptability and perceived effectiveness of health warnings and calorie labels on alcohol products: An online experimental study

Aims Improved alcohol labels are a population-level intervention with the potential to reduce selection and consumption of alcohol. The primary aim of this study was to assess the acceptability of implementing (i) alcohol calorie labelling, (ii) alcohol health warning labels (HWLs), and (iii) both types of labels combined, each presented with or without images. The specific labels used were based on those being proposed for national implementation in Ireland. Methods Participants (n=994) were randomly assigned to one of six groups in an online experiment with a between subject 3 (Label Type: HWL only; calorie labelling only; combined label [HWLs and calorie labelling]) x 2 (Message Type: description; description plus example image) factorial design. The primary outcome was acceptability of implementing the labelling policy. Secondary outcomes were perceived effectiveness and potential harms. Free-text comments were analysed using content analysis. Results There was a significant main effect of Label Type (F(2, 990)=4.27, p=0.014, ηₚ²=0.01), with acceptability lower for HWLs (p=0.01, d=0.23). There was no main effect of Message Type or interaction. All types of labels were perceived as relatively acceptable. There were no overall differences in perceived effectiveness or harms of the labels. Conclusions HWLs and calorie information were both perceived as relatively acceptable, although HWLs were less accepted. The way the labelling policy was presented did not affect acceptability. Although further evaluation with other labelling interventions is warranted, this suggests giving the public more detailed and visual information about a labelling policy does not decrease acceptability of the policy. Trial registration: https://osf.io/h6bzx