Skip to main content

Research Repository

Advanced Search

Effect of alcohol label designs with different pictorial representations of alcohol content and health warnings on knowledge and understanding of Low Risk Drinking Guidelines: A randomized controlled trial

Gold, Natalie; Egan, Mark; Londakova, Kristina; Mottershaw, Abigail; Harper, Hugo; Burton, Robyn; Henn, Clive; Smolar, Maria; Walmsley, Matthew; Arambepola, Rohan; Watson, Robin; Bowen, Sarah; Greaves, Felix

Effect of alcohol label designs with different pictorial representations of alcohol content and health warnings on knowledge and understanding of Low Risk Drinking Guidelines: A randomized controlled trial Thumbnail


Authors

Natalie Gold

Mark Egan

Kristina Londakova

Abigail Mottershaw

Hugo Harper

Robyn Burton

Clive Henn

Maria Smolar

Matthew Walmsley

Rohan Arambepola

Robin Watson robin.o.watson@durham.ac.uk
PGR Student Doctor of Philosophy

Sarah Bowen

Felix Greaves



Abstract

Background and aims: The UK Low Risk Drinking Guidelines (LRDG) recommend not regularly drinking more than 14 units of alcohol per week. We tested the effect of different pictorial representations of alcohol content, some with a health warning, on knowledge of the LRDG and understanding of how many drinks it equates to. Design: Parallel randomized controlled trial. Setting: Online, 25 Jan ‐ 1 Feb 2019. Participants: Participants (n = 7,516) were English, over 18 years, and drink alcohol. Interventions: The control group saw existing industry‐standard labels; six intervention groups saw designs based on: food labels (serving or serving & container), pictographs (servings or containers), pie charts (servings), or risk gradients. A total of 500 participants (~70 per condition) saw a health warning under the design. Measurements: Primary outcomes: (i) knowledge: proportion who answered that the LRDG is 14 units; (ii) understanding: how many servings/containers of beverages one can drink before reaching 14 units (10 questions, average distance from correct answer). Findings: In the control group, 21.5% knew the LRDG; proportions were higher in intervention groups (all p < 0.001). The three best‐performing designs had the LRDG in a separate statement, underneath the pictograph container, 51.1% (AOR = 3.74, 95% CI 3.08‐4.54), pictograph serving 48.8% (AOR = 4.11, 95% CI 3.39‐4.99), and pie chart serving, 47.5% (AOR = 3.57, 95% CI 2.93‐4.34). Participants underestimated how many servings they could drink: control M = ‐4.64, SD =3.43; intervention groups were more accurate (all p < 0.001), best performing was pictograph serving (M= ‐0.93, SD = 3.43). Participants overestimated how many containers they could drink: control M = 0.09, SD =1.02; intervention groups overestimated even more (all p< 0.007), worst performing was food label serving (M = 1.10, SD = 1.27). Participants judged the alcohol content of beers more accurately than wine or spirits. The inclusion of a health warning had no statistically significant effect on any measure. Conclusions: Labels with enhanced pictorial representations of alcohol content improved knowledge and understanding of the United Kingdom’s Low Risk Drinking Guidelines (LRDG) compared with industry‐standard labels; health warnings did not improve knowledge or understanding of LRDG. Designs that improved knowledge most had the LRDG in a separate statement located underneath graphics.

Journal Article Type Article
Acceptance Date Nov 2, 2020
Online Publication Date Nov 9, 2020
Publication Date May 17, 2021
Deposit Date Nov 10, 2020
Publicly Available Date Nov 9, 2021
Journal Addiction
Print ISSN 0965-2140
Electronic ISSN 1360-0443
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 116
Issue 6
Pages 1443-1459
DOI https://doi.org/10.1111/add.15327
Public URL https://durham-repository.worktribe.com/output/1257518

Files

Accepted Journal Article (6.9 Mb)
PDF

Copyright Statement
This is the peer reviewed version of the following article: Gold, Natalie, Egan, Mark, Londakova, Kristina, Mottershaw, Abigail, Harper, Hugo, Burton, Robyn, Henn, Clive, Smolar, Maria, Walmsley, Matthew, Arambepola, Rohan, Watson, Robin, Bowen, Sarah & Greaves, Felix (2021). Effect of alcohol label designs with different pictorial representations of alcohol content and health warnings on knowledge and understanding of Low Risk Drinking Guidelines: A randomized controlled trial. Addiction 116(6): 1443-1459., which has been published in final form at https://doi.org/10.1111/add.15327. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.






You might also like



Downloadable Citations