By Dr Inge Kersbergen – Postdoctoral researcher, University of Liverpool

If you drink alcohol, you’ve seen them many times, but probably don’t pay too much attention to them: Warning labels. The UK’s current warning labels were introduced in 2011, when alcohol companies pledged to put them on 80% of alcoholic drink containers as part of the public health responsibility deal. They look something like this:

Research shows that alcohol warning labels have little to no effect on drinking behaviour. This may be because people are reading the labels, but don’t care about the potential health consequences, or it could be because people simply aren’t reading the warning labels in the first place. There is some evidence to suggest the latter, but there are many things we don’t know yet: We don’t know how much attention alcohol consumers pay to warning labels on alcohol packaging, how much their attention is related to individual differences in drinking behaviour and motivation to change it, and whether increasing attention to warning labels on packaging is likely to result in behaviour change.

I investigated alcohol warning labels as part of my PhD, and last year we published a paper to address this gap in the literature. We ran two studies to investigate how much attention is paid to alcohol warning labels, and how different viewing patterns are associated with individual differences in drinking behaviour and motivation to change it.

In both studies, participants looked at twenty alcohol products for fifteen seconds each. We had taken four pictures of each product (front, back, close-up of the front label, close-up of the back label), and participants could decide which parts they wanted to look at using the arrow keys (see gif below for an example). An eye-tracking camera measured where participants were looking at any given time. This information allowed us to calculate how long people were looking at the warning label and branding on each product.

In the first study, we looked at how much attention people pay to the warning labels in general, and whether the amount of attention people pay to the warning labels is related with how much they typically drink and how motivated they are to cut down on their drinking. We found that participants looked at the alcohol warning label for roughly one second per product (7% of the total time they could look at the product). Attention was not related with how much alcohol people typically drink, but it was associated with motivation to reduce drinking. Participants with a higher motivation to reduce drinking paid less attention to the branding on alcohol packaging, and also paid less attention to the warning labels.

Because this study looked at correlations, we don’t know whether motivation to reduce drinking causes people to pay less attention to alcohol branding and warning labels, or the other way around. For example, it is possible that someone who is motivated to reduce drinking avoids alcohol-related content (branding and warning labels), but it is also plausible that someone who typically pays more attention to alcohol-related content is less motivated to reduce drinking than someone who doesn’t pay as much attention to alcohol-related content. In the second study, we investigated these two potential causal mechanisms.

To find out if motivation to reduce drinking had a causal influence on attention, we gave half of our participants an alcohol brief intervention to increase their motivation to reduce drinking, and the other half a control intervention that was not related to alcohol. After the intervention, we measured how much attention people paid to warning labels and branding in the task I described earlier. We found that participants who received the alcohol intervention paid less attention to alcohol branding than those in the control condition. There were no differences with regard to attention to health warnings. Then, to find out if viewing patterns had a causal influence on intentions to drink, we manipulated attention to alcohol packaging in such a way that participants either had to attend to warning labels or branding, before asking participants how much they intended to drink in the next week. We found no differences in how much people intended to drink after paying attention to the warning labels compared to the branding.

Across these two studies, we showed that people paid minimal attention to warning labels on alcohol packaging, even if they were motivated to reduce drinking. A possible explanation is that people do not particularly notice warning labels, due to their current design. We measured how large the warning labels were in our study, and we found that they take up less than 5% of the packaging. This suggests that the amount of attention they receive is roughly proportional to their size. A closer look at our findings suggest that larger alcohol warning labels attracted more attention, and this is in line with research on tobacco warning labels that showed that people remembered larger warning labels better than smaller labels.

Another explanation is that participants pay little attention to the warning labels, because they don’t think they are relevant for them. The UK labels do not show the risks associated with drinking more than the recommended guidelines, and research suggests that “drink responsibly” messages are used to encourage drinking instead of raising awareness of the harmful consequences of alcohol consumption. Therefore, participants who are motivated to reduce drinking might view the warning labels as another part of the product’s branding, and subsequently avoid them.

Based on these two possible explanations, it would be useful to change both the label content and design to make the label better at attracting and maintaining attention. This echoes the advice of other researchers who have argued that alcohol warning labels should be more like tobacco labels and provide clear information about risks and unambiguous recommendations for healthy behaviour.

We did this research before the change in the drinking guidelines in January 2016, when the old guidelines were still in use. The change in the guidelines would have been an excellent opportunity to improve the warning label. Sadly, that didn’t happen. A few months ago, the Portman Group published new labelling guidance for alcohol producers. Instead of updating the labels to include the new guidelines, they removed any reference to the drinking guidelines from the minimum requirements, so warning labels will be even less informative than before.

Meanwhile, researchers are developing new alcohol warning messages that look promising (such as information about the cancer risks associated with alcohol) and I’m hopeful that one day we’ll see them clearly displayed on our alcohol products.