Impact of health warning labels and calorie labels on selection and purchasing of alcoholic and non-alcoholic drinks: A randomized controlled trial

Natasha Clarke*, Jennifer Ferrar, Emily Pechey, Minna Ventsel, Mark A Pilling, Marcus R Munafò, Theresa M Marteau*, Gareth J Hollands*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)

Abstract

AIMS: To estimate the impact on selection and actual purchasing of (a) health warning labels (text-only and image-and-text) on alcoholic drinks and (b) calorie labels on alcoholic and non-alcoholic drinks.

DESIGN: Parallel-groups randomised controlled trial.

SETTING: Drinks were selected in a simulated online supermarket, before being purchased in an actual online supermarket.

PARTICIPANTS: Adults in England and Wales who regularly consumed and purchased beer or wine online (n = 651). Six hundred and eight participants completed the study and were included in the primary analysis.

INTERVENTIONS: Participants were randomized to one of six groups in a between-subjects three [health warning labels (HWLs) (i): image-and-text HWL; (ii) text-only HWL; (iii) no HWL] × 2 (calorie labels: present versus absent) factorial design (n per group 103-113).

MEASUREMENTS: The primary outcome measure was the number of alcohol units selected (with intention to purchase); secondary outcomes included alcohol units purchased and calories selected and purchased. There was no time limit for selection. For purchasing, participants were directed to purchase their drinks immediately (although they were allowed up to 2 weeks to do so).

FINDINGS: There was no evidence of main effects for either (a) HWLs or (b) calorie labels on the number of alcohol units selected (HWLs: F (2,599)  = 0.406, P = 0.666; calorie labels: F (1,599)  = 0.002, P = 0.961). There was also no evidence of an interaction between HWLs and calorie labels, and no evidence of an overall difference on any secondary outcomes. In pre-specified subgroup analyses comparing the 'calorie label only' group (n = 101) with the 'no label' group (n = 104) there was no evidence that calorie labels reduced the number of calories selected (unadjusted means: 1913 calories versus 2203, P = 0.643). Among the 75% of participants who went on to purchase drinks, those in the 'calorie label only' group (n = 74) purchased fewer calories than those in the 'no label' group (n = 79) (unadjusted means: 1532 versus 2090, P = 0.028).

CONCLUSIONS: There was no evidence that health warning labels reduced the number of alcohol units selected or purchased in an online retail context. There was some evidence suggesting that calorie labels on alcoholic and non-alcoholic drinks may reduce calories purchased from both types of drinks.

Original languageEnglish
Pages (from-to)2327-2341
Number of pages15
JournalAddiction
Volume118
Issue number12
Early online date1 Aug 2023
DOIs
Publication statusE-pub ahead of print - 1 Aug 2023

Bibliographical note

Funding Information:
This research was funded in whole or in part by the Wellcome Trust (ref: 206853/Z/17/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. The funder had no involvement in any part of the study, including in the writing of the manuscript and the decision to submit it for publication. The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust.

Publisher Copyright:
© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

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