Drinking guidelines for alcohol are used to inform the public of the consumption levels for low-risk drinking. The UK alcohol guidelines were revised in 2016 and recommend that alcohol consumption should not exceed 14 units per week for both men and women, with drinking spread over three or more days per week. In the UK, one unit of alcohol is equivalent to 10ml or 8g of pure ethanol. Alcohol guidelines are implemented with the intention of informing the public’s decision making around alcohol, and as a tool to reduce alcohol-related harm.
In the UK, labelling of alcoholic beverages has been part of the Public Health Responsibility Deal, a voluntary partnership between government and the alcohol industry, launched in 2011. The voluntary code recommended by industry includes containing alcohol content in units; recommended low risk drinking guidelines from Government and warnings about consumption during pregnancy.
The problem with current alcohol labelling
Research suggests that knowledge of alcohol guidelines in the UK is low, with as few as one in four drinkers able to accurately identify recommended drinking limits. Research with older adults suggests that almost three-quarters of people are unable to identify recommended drink limits and have limited knowledge on how to calculate alcohol units. The introduction of new guidelines in 2016 has done little to improve knowledge, with only 8% of people surveyed able to correctly identify drinking limits. Perhaps more importantly, there is little evidence to support the effectiveness of drinking guidelines as a public health intervention, and recent research suggests that alcohol consumption has remained largely unchanged after the release of new UK guidelines.
As well as the content of current alcohol warning labels there are also concerns around the formatting and presentation, as health information is not presented in an easily readable manner. As commented elsewhere, in many cases the font size of existing warning labels is well below the standard ‘10/11’ for comfortable readability. Additionally, the information on the risks during pregnancy are often on the back label and the size is smaller on wine compared to beer bottles, which is significant, considering that females are more likely to drink wine. Given this information it is perhaps not surprising that a recent study showed that 70% of participants said they rarely or never read the health-related warnings on current alcohol packaging.
Alcohol labels: how could they be improved?
There are more effective warning labels which could be included on beverages. One option would be to highlight the known links of alcohol consumption and disease. An early experimental study in this area found health warning labels that provide information on alcohol and risk of cancer resulted in increased perceptions of health risk and intentions to reduce consumption. Though the effects were stronger for labels with images and text versus text alone, there was still a marked difference for the latter compared to standard health warnings; perhaps offering a compromise to industry concerns of adverse public reaction to such warnings. In all cases, the observed effects were related to individuals’ level of fear which suggests that health labels with stronger health warnings are an important mechanism in the perception of health risks and motivation to change drinking behaviour.
Furthermore, in addition to health information, current alcohol labelling does not include information on the number of calories contained in the alcohol beverage. One recent study found that including such information reduced drinking intentions, and related research suggests that alcohol calories would also be influential in the amount of food consumed. Given the health risks attached to both obesity and alcohol consumption, and the lack of understanding of the number of calories in common drinks, it would appear difficult to argue against including such information.
Lessons could also be learnt from other fields of research. There is strong evidence that health warning labels on tobacco products are a feasible and effective population-level intervention. Research also demonstrates that larger labels on tobacco products featuring both images and text are more effective than those using text alone. Similarly, including a range of different health warning labels highlighting known links between alcohol consumption and different health conditions, as with smoking labels, may be more effective.
Health warning labels can be used to create targeted harm reduction messages. Current alcohol labelling is ineffective in communicating known risks of alcohol to health. Alternative approaches discussed here include drawing a link between alcohol and specific health conditions such as cancers, including calorie information and having larger or pictorial labels. Given the importance of this issue in terms of public health and economic costs, more standardised and effective labelling would be achieved by introducing mandatory health warning labels.
Written by Dr Jennifer Seddon1, Dr Lorenzo Stafford2, and Dr Melissa Oldham3
- Centre for Psychological Research, Oxford Brookes University, Oxford.
- Department of Psychology, University of Portsmouth, Portsmouth
- Department of Behavioural Science and Health, University College London, London
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.