Given the enormous public health burden related to alcohol, many countries are moving to restrict alcohol advertising and add health warning labels to alcohol advertisements and products as typically done for tobacco. This study assessed how restricting advertisement context and adding health warning labels influenced perceptions of alcohol and drinking motivation.
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Given the massive global burden of disease associated with alcohol use, the World Health Organization recommends that all countries restrict alcohol advertising. Some countries, like Ireland, are also experimenting with requiring health warning labels on alcohol products, similar to those already required on tobacco products in many countries.
Previous studies have shown that including health warnings in alcohol advertising and packaging increases knowledge and awareness of risk, and drinking behavior. Studies to date, however, have tended to focus on young people, and few studies have explored potential interactions between restricting advertisement content like the use of positive imagery, and health warning labels. In this study, the researchers tested experimentally whether and to what degree removing positive contextual features from an alcohol advertisement and including text health warnings affected the reactions of a representative sample of adults in the United Kingdom (UK).
This was a 2 x 2 between-group factorial experiment with 2,421 UK adults aged 18+ years. Each condition varied by context with either a fictitious advertisement with no context (i.e., blank background) or positive social context (i.e., young people shown smiling and enjoying themselves), and message (i.e., a multiple text health warning about liver disease, cancers, and drinking during pregnancy) or a generic ‘drink responsibly’ message. Data were collected through an online survey over a 1-week period in 2023.
Participants were individuals empaneled with an established UK survey company, who were invited to participate in this study. To recruit a sample of people reflecting the population exposed to and potentially influenced by alcohol advertising, everyone 18+ was invited to participate, regardless of their current alcohol use habits or preferences. The sample was “broadly representative” of adults in the UK, and they were part of a panel that receives rewards for completing surveys, including the one in the current study.
Upon entering the study, participants completed the 3 question Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to gauge their alcohol use. To reduce the potential for participant drinking patterns to bias into the results, participants were then randomly allocated to an experimental condition based on their AUDIT-C score, so that every participant had an equal probability of being allocated to each of the four conditions. After randomization, participants were presented with a prompt stating, “Please look at the advertisement shown below carefully before answering the questions that follow.”
Participants then saw 1 of 4 advertisements depending on their condition assignment. These included: 1) no advertisement context + generic ‘drink responsibly’ message; 2) positive social context + generic ‘drink responsibly’ message; 3) no advertisement context + text health warnings; 4) positive social context + text health warnings.
The advertisements with no context simply showed a bottle of vodka without any visual context or background. Conversely, the advertisements with positive social context included two young female and one male character smiling as if they were celebrating or enjoying themselves. The health warning shown included 3 brief messages as well as a URL link to a mock public health web address based on the kinds of links shown on tobacco packaging in the UK. Rather than having a no-warning condition, the researchers chose to include a generic ‘drink responsibly’ label as most alcohol advertisements in the UK include this voluntary wording.
After viewing the advertisement, participants rated the advertisement’s attractiveness, appeal, how likely they’d be to try the product, how harmful it would be to your health, and whether the advertisement made drinking alcohol appear enjoyable.
The sample was 52% female, and most participants were current drinkers (85%), living in England (84%), of higher social grade (57%; i.e., middle and upper classes vs. working classes and non-working), and had less than degree-level education (58%). Most of the sample indicated they were drinkers (85%), and 14% stated they were non-drinkers. Of the drinkers in the sample, 49% were classified as higher-risk on the AUDIT-C, and 48% were categorized as lower-risk. On average, the experimental groups were not different on drinking or demographic measures, nor were there between group differences in alcohol preferences (i.e., spirits vs. beer vs. wine), suggesting the researchers’ randomization strategy was effective.
Advertisement context influenced perceptions
Ratings differed between those seeing the advertisement without social context, vs. those seeing the advertisement with social context, with lower scores for attractiveness, product appeal, intention to try, and making alcohol seem enjoyable in the ‘without social context’ condition. However, effect sizes were generally small, with the exception of ‘reducing perceptions that the advertisement made drinking alcohol seem enjoyable’, which had a large effect size difference.
Health warnings also influenced perceptions
The researchers also found that, on average, scores for advertisement attractiveness, product appeal, intention to try the product, and making alcohol seem enjoyable were lower in participants who received the text health warning relative to those who viewed the generic ‘drink responsibly’ message, though again, effect sizes were small.
Effects of advertisement context and health warning were not additive or synergistic
Advertisement context (i.e., social context vs. no context) and health warning label (yes/no), did not interact to influence advertisement attractiveness, product appeal, intent to try product, perceived product harm, or making alcohol appear enjoyable, suggesting that the effect of warning vs. no waring on participant perception was not dependent on the advertisement’s context and vice versa.
Limitations on tobacco advertising and the use of health warnings on tobacco products is now widespread. Given the massive public health burden of alcohol, public health experts are increasingly calling for similar restrictions and warnings on alcohol products. Using a controlled experimental design, the researchers in this study explored how manipulating an alcohol advertisement and adding a health warning label affected viewers’ perceptions of the product.
Though the magnitude of improvements were relatively small, the researchers observed differences in perceptions of the alcohol product in their mock advertisements based on the manipulation of the advertisement contact (social context vs. no context), and the presence or absence of a health warning label similar to the one now being used in Ireland. Notably, however, there was no interaction associated with these manipulations. In other words, the combination of no social context + inclusion of the health warning didn’t amplify the observed effects – they are each independently useful.
This study utilized an online experimental setting with manipulation of a single advertisement. Though it produced generally small changes in perception and no interaction effect was observed, these findings are still notable. If laws were introduced limiting the context used in alcohol advertising and health warning labels became required, the cumulative effects across exposures to many advertisements and at the population-level could be meaningful. More research will be needed, however, to determine if these small effects will in fact translate into changes in real-world drinking behaviors and subsequent public health benefits.
Removing background context from alcohol advertisements may reduce product attractiveness and appeal, while also reducing people’s intention to try a product and its perceived enjoyability. The inclusion of health warning labels on alcohol advertisements appears to have similar benefits, while also increasing perceived product harm. Though the experiment generally produced small effects, the cumulative impact of regulating alcohol advertising in these ways could be large given the many alcohol advertisements people see every day, and the sheer number of people affected by alcohol related harms globally. Even small magnitude changes in alcohol use can have large public health effects in a global population.
Critchlow, N., Moodie, C., & Gallopel-Morvan, K. (2024). Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom. Alcoholism, Clinical and Experimental Research, 48(6), 1155-1167. doi: 10.1111/acer.15327.
l
Given the massive global burden of disease associated with alcohol use, the World Health Organization recommends that all countries restrict alcohol advertising. Some countries, like Ireland, are also experimenting with requiring health warning labels on alcohol products, similar to those already required on tobacco products in many countries.
Previous studies have shown that including health warnings in alcohol advertising and packaging increases knowledge and awareness of risk, and drinking behavior. Studies to date, however, have tended to focus on young people, and few studies have explored potential interactions between restricting advertisement content like the use of positive imagery, and health warning labels. In this study, the researchers tested experimentally whether and to what degree removing positive contextual features from an alcohol advertisement and including text health warnings affected the reactions of a representative sample of adults in the United Kingdom (UK).
This was a 2 x 2 between-group factorial experiment with 2,421 UK adults aged 18+ years. Each condition varied by context with either a fictitious advertisement with no context (i.e., blank background) or positive social context (i.e., young people shown smiling and enjoying themselves), and message (i.e., a multiple text health warning about liver disease, cancers, and drinking during pregnancy) or a generic ‘drink responsibly’ message. Data were collected through an online survey over a 1-week period in 2023.
Participants were individuals empaneled with an established UK survey company, who were invited to participate in this study. To recruit a sample of people reflecting the population exposed to and potentially influenced by alcohol advertising, everyone 18+ was invited to participate, regardless of their current alcohol use habits or preferences. The sample was “broadly representative” of adults in the UK, and they were part of a panel that receives rewards for completing surveys, including the one in the current study.
Upon entering the study, participants completed the 3 question Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to gauge their alcohol use. To reduce the potential for participant drinking patterns to bias into the results, participants were then randomly allocated to an experimental condition based on their AUDIT-C score, so that every participant had an equal probability of being allocated to each of the four conditions. After randomization, participants were presented with a prompt stating, “Please look at the advertisement shown below carefully before answering the questions that follow.”
Participants then saw 1 of 4 advertisements depending on their condition assignment. These included: 1) no advertisement context + generic ‘drink responsibly’ message; 2) positive social context + generic ‘drink responsibly’ message; 3) no advertisement context + text health warnings; 4) positive social context + text health warnings.
The advertisements with no context simply showed a bottle of vodka without any visual context or background. Conversely, the advertisements with positive social context included two young female and one male character smiling as if they were celebrating or enjoying themselves. The health warning shown included 3 brief messages as well as a URL link to a mock public health web address based on the kinds of links shown on tobacco packaging in the UK. Rather than having a no-warning condition, the researchers chose to include a generic ‘drink responsibly’ label as most alcohol advertisements in the UK include this voluntary wording.
After viewing the advertisement, participants rated the advertisement’s attractiveness, appeal, how likely they’d be to try the product, how harmful it would be to your health, and whether the advertisement made drinking alcohol appear enjoyable.
The sample was 52% female, and most participants were current drinkers (85%), living in England (84%), of higher social grade (57%; i.e., middle and upper classes vs. working classes and non-working), and had less than degree-level education (58%). Most of the sample indicated they were drinkers (85%), and 14% stated they were non-drinkers. Of the drinkers in the sample, 49% were classified as higher-risk on the AUDIT-C, and 48% were categorized as lower-risk. On average, the experimental groups were not different on drinking or demographic measures, nor were there between group differences in alcohol preferences (i.e., spirits vs. beer vs. wine), suggesting the researchers’ randomization strategy was effective.
Advertisement context influenced perceptions
Ratings differed between those seeing the advertisement without social context, vs. those seeing the advertisement with social context, with lower scores for attractiveness, product appeal, intention to try, and making alcohol seem enjoyable in the ‘without social context’ condition. However, effect sizes were generally small, with the exception of ‘reducing perceptions that the advertisement made drinking alcohol seem enjoyable’, which had a large effect size difference.
Health warnings also influenced perceptions
The researchers also found that, on average, scores for advertisement attractiveness, product appeal, intention to try the product, and making alcohol seem enjoyable were lower in participants who received the text health warning relative to those who viewed the generic ‘drink responsibly’ message, though again, effect sizes were small.
Effects of advertisement context and health warning were not additive or synergistic
Advertisement context (i.e., social context vs. no context) and health warning label (yes/no), did not interact to influence advertisement attractiveness, product appeal, intent to try product, perceived product harm, or making alcohol appear enjoyable, suggesting that the effect of warning vs. no waring on participant perception was not dependent on the advertisement’s context and vice versa.
Limitations on tobacco advertising and the use of health warnings on tobacco products is now widespread. Given the massive public health burden of alcohol, public health experts are increasingly calling for similar restrictions and warnings on alcohol products. Using a controlled experimental design, the researchers in this study explored how manipulating an alcohol advertisement and adding a health warning label affected viewers’ perceptions of the product.
Though the magnitude of improvements were relatively small, the researchers observed differences in perceptions of the alcohol product in their mock advertisements based on the manipulation of the advertisement contact (social context vs. no context), and the presence or absence of a health warning label similar to the one now being used in Ireland. Notably, however, there was no interaction associated with these manipulations. In other words, the combination of no social context + inclusion of the health warning didn’t amplify the observed effects – they are each independently useful.
This study utilized an online experimental setting with manipulation of a single advertisement. Though it produced generally small changes in perception and no interaction effect was observed, these findings are still notable. If laws were introduced limiting the context used in alcohol advertising and health warning labels became required, the cumulative effects across exposures to many advertisements and at the population-level could be meaningful. More research will be needed, however, to determine if these small effects will in fact translate into changes in real-world drinking behaviors and subsequent public health benefits.
Removing background context from alcohol advertisements may reduce product attractiveness and appeal, while also reducing people’s intention to try a product and its perceived enjoyability. The inclusion of health warning labels on alcohol advertisements appears to have similar benefits, while also increasing perceived product harm. Though the experiment generally produced small effects, the cumulative impact of regulating alcohol advertising in these ways could be large given the many alcohol advertisements people see every day, and the sheer number of people affected by alcohol related harms globally. Even small magnitude changes in alcohol use can have large public health effects in a global population.
Critchlow, N., Moodie, C., & Gallopel-Morvan, K. (2024). Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom. Alcoholism, Clinical and Experimental Research, 48(6), 1155-1167. doi: 10.1111/acer.15327.
l
Given the massive global burden of disease associated with alcohol use, the World Health Organization recommends that all countries restrict alcohol advertising. Some countries, like Ireland, are also experimenting with requiring health warning labels on alcohol products, similar to those already required on tobacco products in many countries.
Previous studies have shown that including health warnings in alcohol advertising and packaging increases knowledge and awareness of risk, and drinking behavior. Studies to date, however, have tended to focus on young people, and few studies have explored potential interactions between restricting advertisement content like the use of positive imagery, and health warning labels. In this study, the researchers tested experimentally whether and to what degree removing positive contextual features from an alcohol advertisement and including text health warnings affected the reactions of a representative sample of adults in the United Kingdom (UK).
This was a 2 x 2 between-group factorial experiment with 2,421 UK adults aged 18+ years. Each condition varied by context with either a fictitious advertisement with no context (i.e., blank background) or positive social context (i.e., young people shown smiling and enjoying themselves), and message (i.e., a multiple text health warning about liver disease, cancers, and drinking during pregnancy) or a generic ‘drink responsibly’ message. Data were collected through an online survey over a 1-week period in 2023.
Participants were individuals empaneled with an established UK survey company, who were invited to participate in this study. To recruit a sample of people reflecting the population exposed to and potentially influenced by alcohol advertising, everyone 18+ was invited to participate, regardless of their current alcohol use habits or preferences. The sample was “broadly representative” of adults in the UK, and they were part of a panel that receives rewards for completing surveys, including the one in the current study.
Upon entering the study, participants completed the 3 question Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to gauge their alcohol use. To reduce the potential for participant drinking patterns to bias into the results, participants were then randomly allocated to an experimental condition based on their AUDIT-C score, so that every participant had an equal probability of being allocated to each of the four conditions. After randomization, participants were presented with a prompt stating, “Please look at the advertisement shown below carefully before answering the questions that follow.”
Participants then saw 1 of 4 advertisements depending on their condition assignment. These included: 1) no advertisement context + generic ‘drink responsibly’ message; 2) positive social context + generic ‘drink responsibly’ message; 3) no advertisement context + text health warnings; 4) positive social context + text health warnings.
The advertisements with no context simply showed a bottle of vodka without any visual context or background. Conversely, the advertisements with positive social context included two young female and one male character smiling as if they were celebrating or enjoying themselves. The health warning shown included 3 brief messages as well as a URL link to a mock public health web address based on the kinds of links shown on tobacco packaging in the UK. Rather than having a no-warning condition, the researchers chose to include a generic ‘drink responsibly’ label as most alcohol advertisements in the UK include this voluntary wording.
After viewing the advertisement, participants rated the advertisement’s attractiveness, appeal, how likely they’d be to try the product, how harmful it would be to your health, and whether the advertisement made drinking alcohol appear enjoyable.
The sample was 52% female, and most participants were current drinkers (85%), living in England (84%), of higher social grade (57%; i.e., middle and upper classes vs. working classes and non-working), and had less than degree-level education (58%). Most of the sample indicated they were drinkers (85%), and 14% stated they were non-drinkers. Of the drinkers in the sample, 49% were classified as higher-risk on the AUDIT-C, and 48% were categorized as lower-risk. On average, the experimental groups were not different on drinking or demographic measures, nor were there between group differences in alcohol preferences (i.e., spirits vs. beer vs. wine), suggesting the researchers’ randomization strategy was effective.
Advertisement context influenced perceptions
Ratings differed between those seeing the advertisement without social context, vs. those seeing the advertisement with social context, with lower scores for attractiveness, product appeal, intention to try, and making alcohol seem enjoyable in the ‘without social context’ condition. However, effect sizes were generally small, with the exception of ‘reducing perceptions that the advertisement made drinking alcohol seem enjoyable’, which had a large effect size difference.
Health warnings also influenced perceptions
The researchers also found that, on average, scores for advertisement attractiveness, product appeal, intention to try the product, and making alcohol seem enjoyable were lower in participants who received the text health warning relative to those who viewed the generic ‘drink responsibly’ message, though again, effect sizes were small.
Effects of advertisement context and health warning were not additive or synergistic
Advertisement context (i.e., social context vs. no context) and health warning label (yes/no), did not interact to influence advertisement attractiveness, product appeal, intent to try product, perceived product harm, or making alcohol appear enjoyable, suggesting that the effect of warning vs. no waring on participant perception was not dependent on the advertisement’s context and vice versa.
Limitations on tobacco advertising and the use of health warnings on tobacco products is now widespread. Given the massive public health burden of alcohol, public health experts are increasingly calling for similar restrictions and warnings on alcohol products. Using a controlled experimental design, the researchers in this study explored how manipulating an alcohol advertisement and adding a health warning label affected viewers’ perceptions of the product.
Though the magnitude of improvements were relatively small, the researchers observed differences in perceptions of the alcohol product in their mock advertisements based on the manipulation of the advertisement contact (social context vs. no context), and the presence or absence of a health warning label similar to the one now being used in Ireland. Notably, however, there was no interaction associated with these manipulations. In other words, the combination of no social context + inclusion of the health warning didn’t amplify the observed effects – they are each independently useful.
This study utilized an online experimental setting with manipulation of a single advertisement. Though it produced generally small changes in perception and no interaction effect was observed, these findings are still notable. If laws were introduced limiting the context used in alcohol advertising and health warning labels became required, the cumulative effects across exposures to many advertisements and at the population-level could be meaningful. More research will be needed, however, to determine if these small effects will in fact translate into changes in real-world drinking behaviors and subsequent public health benefits.
Removing background context from alcohol advertisements may reduce product attractiveness and appeal, while also reducing people’s intention to try a product and its perceived enjoyability. The inclusion of health warning labels on alcohol advertisements appears to have similar benefits, while also increasing perceived product harm. Though the experiment generally produced small effects, the cumulative impact of regulating alcohol advertising in these ways could be large given the many alcohol advertisements people see every day, and the sheer number of people affected by alcohol related harms globally. Even small magnitude changes in alcohol use can have large public health effects in a global population.
Critchlow, N., Moodie, C., & Gallopel-Morvan, K. (2024). Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom. Alcoholism, Clinical and Experimental Research, 48(6), 1155-1167. doi: 10.1111/acer.15327.
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