Rapid Literature Review on the Impact of Health Messaging and Product Information on Packaging of Alcohol and Other Unhealthy Commodities

• Alcohol labelling provides a high-reach opportunity to provide important health information and guidance to consumers at the point of sale and consumption, and helps them to make decisions about what products to purchase and how much to consume.
• Current alcohol labels in the UK do not fully meet the former voluntary agreement between the Government and the alcohol industry to include information on units, the lower-risk drinking guidelines and the Chief Medical Officer’s advice on drinking during pregnancy.
• To ensure that labels can quickly and effectively achieve their intended purpose, it is important that their placement and content are underpinned by up-to-date robust and objective research.
• This report presents findings from a rapid review that brought together evidence on communicating health messaging and product information on the packaging of alcohol, with a secondary focus on tobacco and foods high in fat, sugar and/or salt.
• The rapid review provides mixed support for the impact of health messaging information on consumer knowledge and comprehension. It found that consumers’ ability to spontaneously recall existing warning messages varies across studies and across countries. Lessons could be learned from research in the tobacco field that shows that knowledge of smoking-related health risks increases after exposure to health warnings.
• Although the review found mixed evidence on the impact of product information on consumer knowledge and comprehension, it showed that specific label content may increase comprehension. For example, people’s ability to interpret standard drink/unit information may be improved if such information is presented alongside low-risk drinking guidelines. The review found limited evidence for the positive impact of nutrition information on consumers’ knowledge and comprehension in relation to alcohol, with one recent study suggesting that energy labels increase the accuracy of energy content estimates in alcohol products. Lessons may be drawn from research on foods high in fat, sugar and/or salt that show nutritional information can increase consumers’ content understanding. The rapid review did not identify studies looking at the impact of ingredients lists on consumer-related outcomes in relation to alcohol.
• Previous research, included in this review, provides preliminary support for the impact of health messaging on consumer decision-making and behaviour. The inclusion of health warnings on alcohol product labels can lead to increased intention to reduce drinking in experimental studies. Research in real-world settings shows promising results that if labels are well-designed they can lead to reduced alcohol consumption.
• Evidence on the impact of product information on consumer decision-making and behaviour is inconclusive, with studies suggesting that the provision of alcohol content and calorie information may not influence consumer behaviour. Lessons could be learned from the research in the field of foods high in fat, sugar and/or salt, which provides support for the importance of including nutrition information on product labels.
• The review shows that large, colourful labels on the front of alcohol products increase label visibility. Similar findings emerge from the field of foods high in fat, sugar and/or salt. There is also support for the use of plain packaging of alcohol products as a way to increase visibility of health messaging. The effectiveness of plain packaging is well established in the tobacco field.
• Evidence in the current review provides support for the effectiveness of health warnings that link alcohol to a specific disease (e.g. cancer) in increasing people’s awareness of alcohol as a risk factor for the disease. Cancer warnings may be particularly effective in prompting people to reduce alcohol consumption. It also supports the use of explicit, negatively framed statements to communicate health risk information.
• The rapid review provides support for the impact of pictorial warnings on reducing alcohol consumption. Pictorial warnings have also been shown to be effective in increasing smoking cessation.
• Evidence in this review shows that the use of colour-coded schemes, such as traffic light systems, on alcohol labels may be effective in helping people to estimate alcohol serving limits. Drawing from research on foods high in fat, sugar and/or salt, the most effective way to help consumers make healthier choices may be to communicate standard drink and calorie information per serving, in addition to a graphical representation of what percentage of the weekly recommended amount a serving size represents.
• The review does not provide support for the use of descriptors indicating low alcohol content as a way to reduce alcohol consumption. Similarly, in the fields of tobacco and foods high in fat, sugar and/or salt, research shows that certain descriptors may mislead consumers to believe products are healthy or less harmful (e.g. use of “light” on cigarette packs).
• The findings of this review suggest that for alcohol labels to be effective in influencing consumers’ behaviour, they need to use a combination of health messaging and product information, and consider optimal label design to increase visibility.
• The above findings have implications for alcohol labelling in the UK and these are discussed in more detail in the current rapid review.