Warning labels on alcoholic beverage containers: a pilot randomized experiment among young adults in Mexico.
Alcohol
Health warning label
Mexico
Pilot study
Randomized controlled trial
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
15 06 2023
15 06 2023
Historique:
received:
03
01
2023
accepted:
07
06
2023
medline:
19
6
2023
pubmed:
16
6
2023
entrez:
15
6
2023
Statut:
epublish
Résumé
Little is known about the potential impacts of visible and up-to-date health warning labels on alcoholic beverage containers on a range of outcomes in low- and middle-income countries. We conducted an experimental study to test the potential impacts of visible health warning labels (on the principal panel of the package) on thinking about health risks, product attractiveness, visual avoidance, and intention to change alcohol use among students in Mexico aged 18-30 years. A double-blind, parallel-group, online randomized trial was conducted from November 2021 to January 2022 in 11 states in Mexico. In the control group, participants were presented with the image of a conventional beer can with a fictional design and brand. In the intervention groups, the participants observed pictograms with a red font and white backgrounds (health warning label in red-HWL red) or with a black font and yellow backgrounds (health warning label in yellow-HWL yellow), located at the top, covering around one-third of the beer can. We used Poisson regression models -unadjusted and adjusted for covariates- to assess differences in the outcomes across study groups. Using intention-to-treat analysis (n = 610), we found more participants in groups HWL red and HWL yellow thought about the health risks from drinking beer compared to the control group [Prevalence Ratio (PR) = 1.43, CI95%:1.05,1.93 for HWL red; PR = 1.25, CI95%: 0.91, 1.71 for HWL yellow]. A lower percentage of young adults in the interventions vs control group considered the product attractive (PR 0.74, 95%CI 0.51, 1.06 for HWL red; PR 0.56, 95%CI 0.38, 0.83 for HWL yellow). Although not statistically significant, a lower percentage of participants in the intervention groups considered buying or consuming the product than the control group. Results were similar when models were adjusted for covariates. Visible health warning labels could lead individuals to think about the health risks of alcohol, reducing the attractiveness of the product and decreasing the intention to purchase and consume alcohol. Further studies will be required to determine which pictograms or images and legends are most contextually relevant for the country. The protocol of this study was retrospectively registered on 03/01/2023: ISRCTN10494244.
Sections du résumé
BACKGROUND
Little is known about the potential impacts of visible and up-to-date health warning labels on alcoholic beverage containers on a range of outcomes in low- and middle-income countries. We conducted an experimental study to test the potential impacts of visible health warning labels (on the principal panel of the package) on thinking about health risks, product attractiveness, visual avoidance, and intention to change alcohol use among students in Mexico aged 18-30 years.
METHODS
A double-blind, parallel-group, online randomized trial was conducted from November 2021 to January 2022 in 11 states in Mexico. In the control group, participants were presented with the image of a conventional beer can with a fictional design and brand. In the intervention groups, the participants observed pictograms with a red font and white backgrounds (health warning label in red-HWL red) or with a black font and yellow backgrounds (health warning label in yellow-HWL yellow), located at the top, covering around one-third of the beer can. We used Poisson regression models -unadjusted and adjusted for covariates- to assess differences in the outcomes across study groups.
RESULTS
Using intention-to-treat analysis (n = 610), we found more participants in groups HWL red and HWL yellow thought about the health risks from drinking beer compared to the control group [Prevalence Ratio (PR) = 1.43, CI95%:1.05,1.93 for HWL red; PR = 1.25, CI95%: 0.91, 1.71 for HWL yellow]. A lower percentage of young adults in the interventions vs control group considered the product attractive (PR 0.74, 95%CI 0.51, 1.06 for HWL red; PR 0.56, 95%CI 0.38, 0.83 for HWL yellow). Although not statistically significant, a lower percentage of participants in the intervention groups considered buying or consuming the product than the control group. Results were similar when models were adjusted for covariates.
CONCLUSIONS
Visible health warning labels could lead individuals to think about the health risks of alcohol, reducing the attractiveness of the product and decreasing the intention to purchase and consume alcohol. Further studies will be required to determine which pictograms or images and legends are most contextually relevant for the country.
TRIAL REGISTRATION
The protocol of this study was retrospectively registered on 03/01/2023: ISRCTN10494244.
Identifiants
pubmed: 37322503
doi: 10.1186/s12889-023-16069-w
pii: 10.1186/s12889-023-16069-w
pmc: PMC10268389
doi:
Substances chimiques
Alcohols
0
Banques de données
ISRCTN
['ISRCTN10494244']
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1156Informations de copyright
© 2023. The Author(s).
Références
Aust N Z J Public Health. 2012 Dec;36(6):524-9
pubmed: 23216492
PLoS One. 2016 Apr 22;11(4):e0153027
pubmed: 27105210
Drug Alcohol Depend. 2018 Nov 1;192:163-170
pubmed: 30265999
BMC Public Health. 2020 Apr 2;20(1):376
pubmed: 32238154
Addiction. 2021 Dec;116(12):3333-3345
pubmed: 33861881
Bull World Health Organ. 2020 Mar 1;98(3):222-223
pubmed: 32132758
Addiction. 2021 Jan;116(1):41-52
pubmed: 32267588
BMC Med Res Methodol. 2020 Sep 30;20(1):244
pubmed: 32998683
Health Commun. 2022 Sep;37(10):1345-1353
pubmed: 33601986
J Stud Alcohol Drugs. 2017 Jan;78(1):79-87
pubmed: 27936367
Int J Behav Nutr Phys Act. 2019 Apr 25;16(1):36
pubmed: 31023328
Nature. 2022 Aug;608(7924):S39-S41
pubmed: 36002499
Health Educ Res. 2016 Feb;31(1):60-9
pubmed: 26787351
J Stud Alcohol Drugs. 2020 Mar;81(2):225-237
pubmed: 32359054
Prev Med Rep. 2021 Jun 09;23:101433
pubmed: 34189021
Health Educ Res. 2018 Oct 1;33(5):351-360
pubmed: 30085037
Appetite. 2014 Dec;83:10-18
pubmed: 25108238
Nutrients. 2021 Aug 31;13(9):
pubmed: 34578942
Addiction. 2021 Oct;116(10):2685-2696
pubmed: 33844362
BMC Med Res Methodol. 2008 Feb 28;8:9
pubmed: 18307814
Int J Environ Res Public Health. 2022 Sep 16;19(18):
pubmed: 36141951
Tob Control. 2002 Sep;11(3):183-90
pubmed: 12198266