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A real-life alcohol labelling intervention study was implemented in Yukon, Canada to test the impact of labels on consumer awareness of alcohol-related health harms such as cancer and drinking behaviours. Conducted among a sample of drinkers in two jurisdictions with the highest per capita alcohol consumption and cost due to alcohol-related harm in Canada, this study examined whether increases in individual-level knowledge that alcohol is a carcinogen following an alcohol labelling intervention are associated with support for alcohol policies.
The study finds that knowledge that alcohol is a risk factor for cancer was associated with greater support for policies controlling price, marketing and availability. Alcohol is the most used psychoactive substance in Canada (excluding caffeine) with 78% of the adult population consuming alcohol in the past year and an annual per capita consumption more than double the global average (8.2 litres).
The alcohol labelling intervention consisted of three rotating labels: (1) a cancer warning including specific references to breast and colon cancer, (2) Canada`s low-risk drinking guidelines and (3) standard drink information (four separate labels for wine, spirits, coolers and beers). The labels were relatively large and in full colour with a red border and yellow background, so they stand out on the container. The study consisted of two waves of longitudinal surveys among cohort participants in the intervention and comparison sites four months before and eight months after. The participants were recruited from liquor stores in the city centres with a total of 1730 participants. The two interventions labels were applied to all alcohol containers in the intervention site starting from 20 November 2017, apart from 3%-products. One month into the eight-month study period the government discontinued its participation due to significant pressure from alcohol producers. By this time 47, 000 cancer warning labels and 53, 000 national drinking guidelines labels were applied to alcohol containers. In April 2018 the government resumed their participation in the study under the condition that the cancer warning label was excluded from rotation.
Logistic regression was used to examine the association between increases in knowledge and support for polices. The response rate to the study was 8.6 % and at the time of initial recruitment 32 % were aware of the link between alcohol and cancer, in the participants last survey this number increased to 37,0-37,2 %. Levels of support for alcohol pricing and availability were low overall with more participants being opposed than supporting restrictions. The existing alcohol policies in these two jurisdictions are relatively weak compared to the rest of Canada. The participants who became aware of the link between alcohol and cancer were two times more likely to support alcohol pricing policies than individuals with no change in knowledge, and were specifically in high levels of support for setting a minimum unit price per standard drink of alcohol.
Knowledge that alcohol is a risk factor for cancer was associated with greater support for alcohol policies controlling price, marketing and availability. This is largely consistent with previous cross-sectional research that knowledge of alcohol as carcinogen was significantly associated with support for policies controlling alcohol, availability, pricing and marketing. Other characters associated with support for alcohol policies in this study was being female, older age, high levels of education and consuming lower levels of alcohol. Improving knowledge of alcohol consumptions health risks using alcohol warning labels may be an effective strategy for increasing public support for alcohol control policies that are currently now well supported.
Alcohol container labels are one potentially effective information strategy to consumers and is recommend by the World Health Organisation. Labels are cost efficient and keep the messaging in consumers’ minds through repeated exposure to the consumer at point-of-purchase and point-of-pour.