Improving the formatting of existing industry standard labels to display unit and calorie information per serving, and as proportions of recommended low-risk guidelines, can enhance understanding about the health impact of alcohol consumption.

As part of research funded by the Medical Research Council (MRC) and Alcohol Research UK, researchers in the Tobacco and Alcohol Research Group, part of Bristol’s School of Experimental Psychology and MRC Integrative Epidemiology Unit (MRC IEU), have been exploring how alcohol labels could improve understanding of alcohol and its risks.

The MRC project addressed three key questions:

1)      What information should be added to labels?

2)      Who is likely to attend to, and benefit from, this information?

3)       How can we present this information in different ways?

The Alcohol Research UK project investigated more specifically how calorie, unit and health information should be presented to maximise effectiveness.

Key findings from the MRC project include:

• Calorie and unit content of alcohol products is poorly understood. While there is generally good knowledge of the links between alcohol and liver disease, drinkers are less sure about other health outcomes, such as increased risk of several cancers
• Only half of weekly drinkers felt that reducing their alcohol consumption would improve their health despite many drinking above current recommended low risk levels
• Only one-in-three drinkers who consume above the Chief Medical Officer’s low risk guidelines reported confidence that they could reduce their alcohol consumption
• Labelling should be implemented within a broader alcohol communication strategy, and other methods of delivery such as beer mats and marked glassware would maximise the reach and effectiveness of health messages
• Legislative changes should make labelling mandatory and not self-regulated by the industry, but the effects of changes on small business such as local microbreweries need to be carefully considered.

Key findings from the Alcohol Research UK project include:

• There is strong support for calorie and unit information to be displayed on alcohol products
• Labels that present unit and calorie information in a clear and accessible way – displayed within the context of the Chief Medical Officer’s low-risk drinking guidelines – improves consumer understanding of the risks associated with drinking and could lead to positive changes in drinking behaviour
• Current labels developed by the alcohol industry within the remit of the Responsibility Deal are low in effectiveness, which supports calls for introducing changes to legislation and making labels mandatory
• Health warnings that present the negative impacts of drinking – particularly those highlighting the risk of cancer – could be an effective means of changing drinking behaviour, especially when set alongside unit information.

Alcohol use is ingrained in many cultures, often playing a key role when people socialise or celebrate. In fact, it is one of the few drugs that has more users than non-users in many societies. While consumers may be aware of the dangers of excessive use, there is a common belief that alcohol consumption is probably OK in moderation. But what does moderation look like?

In the UK, the Chief Medical Officer has issued low-risk guidelines of no more than 14 units of alcohol per week. However, understanding of units and other important information – such as the number of calories in alcoholic drinks and alcohol’s links with cancer – is poor, which means people may be unknowingly drinking excessively. Alcohol product labels may be an effective way to deliver this important information to users at the point of consumption.

In 2011, the alcohol industry pledged to place clear labelling on at least 80 percent of products to promote responsible drinking. However, the alcohol industry has fallen short of this target both in terms of the extent and quality of this voluntary labelling scheme. Improvements still need to be made to address the European Parliament’s call for ‘clear, concise and effective information on the effects of alcohol consumption and its health risks’.

Dr Angela Atwood, of the MRC Integrative Epidemiology Unit and lead researcher of the MRC project, said: “We did not set out on this project to prove better alcohol labelling was the way forward. We were aware that any labelling changes would take time and resources.

“We wanted to explore whether making changes to labels was worthwhile, and if so, how these could be optimised.

“Our findings confirmed that public understanding of alcohol and its potential harms could be a lot better. Given that around one-in-five of our survey respondents reported drinking above the recommended low risk weekly guidelines, better understanding of units is vital for improving public health long-term.

“Adding clear and consistent information to alcohol product labels is a useful way to achieve this, but should be part of a wider approach. We have explored new ways of delivering this information, including novel designs of glasses and beer mats.”

Dr Olivia Maynard, lead researcher of the ARUK project, added: “We find that including unit information per serving and providing this information in the context of low-risk drinking guidelines, improves understanding of the content of alcoholic drinks and the harms associated with consumption.

“Voluntary labelling schemes by the alcohol industry have considerable room for improvement. Clear and consistent labelling could help consumers monitor their drinking and be aware of the extent to which this differs from the guidelines.”

Dr Richard Piper, Chief Executive of Alcohol Research UK and Alcohol Concern, said: “Drinkers have a poor understanding of the concept of units and the harms associated with drinking’.

“The voluntary labelling scheme clearly hasn’t worked. We need a strong and effective alcohol labelling system that provides consumers with the information they need to make informed lifestyle choices about their health.

“It is absolutely common sense for alcohol drinks to contain on their packaging clear information about calories, ingredients and the health risks of the alcohol content. There is no longer any good argument for withholding this from the consumer or forcing people to search for it online.”

The Alcohol Research UK research report ‘Know your limits: Labelling interventions to reduce alcohol consumption’ is available here.

Dr Joe McNamara, Head of Population & Systems Medicine at the MRC, said: “This research is important as drinking has been normalised and alcohol is ubiquitous in our society. The scientific community is still working to better understand how alcohol affects our long-term health.

“Gaining insight into how best to inform consumers about the risks of consuming alcohol enables them to make better decisions in the interest of their long-term health.

Evaluating novel ways to inform the public about alcohol consumption guidelines could ultimately aid in shaping new public health policies.”

To find out more and follow project updates visit the project website and view our animation describing the project at: https://labelling.blogs.ilrt.org/

You can also follow the project on Twitter - @AlcohoLabelling