I am currently in Ireland, and I decided to share some valuable information regarding the recent introduction of legislation aimed at labelling alcoholic products. On May 22, 2023, Ireland introduced legislation mandating the labelling of alcohol products. This new law requires alcohol manufacturers to include specific information on labels to educate consumers about the health risks associated with alcohol consumption.
The labels on alcohol products will contain essential information, including:
- Calorie Content: Consumers will now have access to information about the calorie content of alcoholic beverages. This will help individuals make informed decisions about their dietary choices, especially when it comes to managing their calorie intake.
- Alcohol Content: The labels will also provide the number of grams of alcohol contained within the product. This information is crucial for consumers to understand the strength of the beverage they are consuming, enabling them to better manage their alcohol consumption.
- Pregnancy Warning: A prominent warning about the dangers of drinking alcohol while pregnant will be displayed on these labels. This serves as a crucial reminder to expectant mothers to avoid alcohol, safeguarding the health of both mother and child.
The labels will emphasize the heightened risk of several types of cancer associated with alcohol consumption. With this information, it is expected to help consumers be more aware of the potential long-term health consequences. The labels will also draw attention to the link between alcohol consumption and liver disease. According to the government, this awareness can encourage moderation and responsible drinking. Stephen Donnelly, Ireland’s Minister for Health, emphasized the purpose of this legislation, stating, “This law is designed to give all of us as consumers a better understanding of the alcohol content and health risks associated with consuming alcohol.” This initiative underscores the government’s commitment to public health and providing consumers with the knowledge they need to make informed choices.
Many European consumers have been found to reject the use of warning labels as a policy intervention, especially for wine, perhaps due to its cultural and economic importance. I looked for scientific studies about it and o found one titled “How health warning labels on wine and vodka bottles influence perceived risk, rejection, and acceptance” very interesting and from which I present here a short version. Read the paper here: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12564-8
The production of alcoholic beverages is an important sector in many European economies, and wine, beer, and spirits are central to many European cultures.
Per capita, European citizens—including Swiss—consume twice as much alcohol as the world average [2]. It is thus unsurprising that Europeans’ norms of drinking alcohol correlate with alcohol-related diseases, accidents, and dependency [3].
Extensive literature has demonstrated alcohol’s harmfulness in terms of health risks (for a summary, see, e.g., [4]). However, several studies have reported that only a minority of consumers are aware of the threat that regular or excessive alcohol consumption poses to their health, such as cancer risk, and they are unfamiliar with recommended drinking guidelines to reduce such risks [5,6,7]. Risk perception is an important factor in determining the degree to which someone engages in a risky behavior, such as alcohol consumption [8, 9]. Rehm, Lachenmeier [10] suggested that the lack of knowledge about alcohol’s adverse effects has led to a high level of risk acceptance. Moreover, they suggested that educating people about the risks of alcohol consumption can change drinking behavior.
Interventions to increase consumers’ knowledge about alcohol have faced several challenges, however. First, previous research has found that consumers believe themselves to be well informed about alcohol’s health risks [11]. Therefore, they may not feel that they need more information about these risks. Second, young consumers especially often feel that they are not susceptible to long-term risks such as cancer, which may reduce the effectiveness of alcohol-risk information campaigns that communicate cancer risk [12]. Third, many consumers have been found to believe that wine offers beneficial health effects if consumed in moderation [7] and that other factors—such as genetic predisposition—may more decisively lead to cancer than lifestyle choices [13]. Such pre-existing beliefs are particularly widespread among people who consume large amounts of alcohol [14], which presents a challenge for the effectiveness of consumer-information interventions. In countries such as Italy or France, where drinking wine is part of social norms [15], it has been found that consumers associate adverse outcomes with other alcoholic beverages but not with wine [16].
The dilemma of alcohol consumption is often compared to the problems of smoking. Many researchers have suggested that instead of informing people about the risks of alcohol with information campaigns, consumption-deterring warning labels—such as the labels that have proven effective on tobacco products—may be a more promising, low-cost approach to decrease alcohol consumption [5, 17, 18]. Several countries have already introduced some sorts of health warning labels (HWLs) on alcohol containers, such as the United States, Australia, and France. These labels have repeatedly proven ineffective since consumers do not notice them due to their size and position or have remained unchanged after their implementation [19, 20]. Consequently, several studies have tested whether more salient, tobacco-like HWLs effectively deter consumers and affect drinking behavior. Front labels including warning text or even frightening images can increase consumers’ fear or negative emotions [13, 17]. Clarke, Pechey [21] reported that cancer warning statements increase consumers’ cancer risk perception but also increase their reactance to or rejection of such labels. Staub, Fuchs [22] found that HWLs increase wine-consumption risk perception whether they are only textual or use both text and images—but only if these HWLs do not specify consumption quantities. Other studies have found that such labels do not change alcohol-related outcome expectancies [23] and are unlikely to change behavior since these labels’ effects depend on whether consumers feel susceptible to the presented risks in the first place [24].
Moreover, the HWLs that most affected fear or consumption intentions also provoked the strongest reactance [21, 25]. Furthermore, few consumers perceived HWLs as acceptable, especially for wine [26, 27]. Rehm, Lachenmeier [10] argued that this lack of acceptance of and rejection of HWL is likely due to a lack of knowledge about alcohol’s risks. Furthermore, they suggested that other factors influence reactions to warning labels. One such factor may be attitudes toward alcohol and alcohol-related behaviors, which differ between cultures [12].
Many studies have used different alcoholic beverages to assess HWLs’ effect but have not reported on any differences in outcome variables between beverage types [21, 23, 27, 28]. Annunziata, et al. [29] suggested that consumers’ receptiveness of warning labels depends on the type of beverage. For example, warnings on beer were accepted more than warnings on wine. Moreover, Annunziata, Agnoli [16] stressed that future research should investigate beverage types’ role on reactions to HWLs and whether wine’s cultural role in many European countries causes consumers’ lack of HWL acceptance. Thus, HWLs on wine may be less accepted than HWLs on other alcoholic beverages, such as vodka, which is not as deeply rooted in western European cultures and economies as wine.
The effectiveness of interventions such as HWLs in changing drinking behavior varies between individuals. For example, consumers who consume large amounts of alcohol were found to have lower risk perceptions for alcohol consumption [14], so HWLs may be less effective for these consumers. Furthermore, the reaction to and acceptance of government interventions are also affected by personal opinions of governments’ roles in restricting individual rights to protect citizens, which are called individualistic values [30]. Staub, Fuchs [22] found that individualistic values are a major determinant of consumers’ acceptance of HWLs on wine bottles.
The present paper aims to address the following gaps in the literature. First, this study assesses HWLs’ potential to alter the perceived risk of alcohol consumption among a sample of Swiss consumers. Second, the study aims to investigate whether the HWLs’ effects on perceived risk and the acceptance of HWLs differ for alcoholic beverages with varying cultural significance to Swiss consumers, particularly wine and vodka.
Authors hypothesized that the perceived risk of regular alcohol consumption is higher among people exposed to HWLs on alcohol containers than people who are not exposed to HWLs. Based on widespread health beliefs about wine, authors also assumed that the perceived risk of wine consumption is lower than the perceived risk of vodka consumption. Due to wine’s cultural significance in Switzerland, authors hypothesized that HWLs on wine are perceived as less acceptable than HWLs on vodka. Furthermore, authors sought to estimate how such factors as drinking norms, individualistic values, and alcohol consumption influence the rejection of HWLs on wine and vodka. This results provide insights into the HWLs’ potential to increase consumers’ risk perceptions and, therefore, affect drinking behavior. Additionally, the present study adds to the knowledge of alcohol HWLs and how factors other than the labels themselves influence consumers’ HWL perceptions and reactions.
An online study with a between-subjects design was conducted in Switzerland (N = 506) to assess whether HWLs can influence the perceived risk associated with drinking wine and vodka, a beverage insignificant to Swiss culture. Participants were presented an image of either a wine or vodka bottle with or without an HWL presenting a liver cancer warning statement. They were then asked to indicate their perceived risk of regularly consuming the depicted beverage. Acceptance and rejection of HWLs were also assessed.
Procedure of questionnaire with group assignment according to alcohol consumption. From: How health warning labels on wine and vodka bottles influence perceived risk, rejection, and acceptance
Alcohol bottle images presented to the four experimental groups.From: How health warning labels on wine and vodka bottles influence perceived risk, rejection, and acceptance
The results suggest that the perceived risk of regular alcohol consumption is determined by the type of alcoholic beverage but not altered by bottles’ inclusion of an HWL. Increasing risk perceptions has been suggested to effectively influence drinking behavior [34]. This study indicates that HWLs may not be the right approach for such interventions. WIt was not possible to replicate the findings of an earlier study in which the same kind of cancer HWLs on wine bottles increased perceived consumption risks compared to HWL-free bottles [22]. The reason for this difference may be that the previous study assessed the perceived risk of developing cancer, while the present study measured both personal risk and the likelihood of suffering negative consequences due to regular consumption. Therefore, HWLs may be able to raise risk perceptions of a specific threat but not perceived consumption risks in general.
Earlier studies about HWLs found that HWLs may provoke negative emotional arousal, stronger intentions to reduce drinking, slower consumption, or avoidance [18, 21, 25, 27]. While previous research has found that HWLs affect consumers in several different ways, the current study yielded no such findings, perhaps because the previous studies used different HWLs (e.g., image-and-text labels) [21, 25, 27] or young-adult or adolescent participants, rather than adult participants [12, 16, 18, 23, 35,36,37,38]. Wine is mainly consumed by older consumers, and wine HWLs’ effect on younger consumers may not be comparable to their effect on older consumers. Furthermore, some studies have collected data in countries such as the United States or Australia with different alcohol cultures [14, 17, 28]. Many European countries have particularly alcohol-friendly cultures, which influence how consumers react to interventions seeking to change their drinking behavior [16].
Much research has evaluated HWLs’ design and framing to determine the greatest effect on consumers (see, e.g., [13, 38]) but neglected beverage types’ influence. The present study successfully showed that a deeply culturally rooted beverage (such as wine in Switzerland) does not elicit the same level of risk perception as a beverage without such a cultural significance (such as vodka in Switzerland), so consumption of the former is, therefore, unaffected by HWLs. Some readers might argue that such differences in perceived risk are due to the beverages’ different alcoholic strengths. A standard unit of an alcoholic drink refers to a specific amount of pure alcohol [2], so regardless of whether a person drinks a glass of wine or a small shot of vodka, the effect of the servings’ ethanol is comparable [4]. However, consumers seem to perceive different levels of consumption risk for different types of alcoholic beverages. The reason for this difference in the current study may be Swiss consumers’ associating wine with traditional drinking norms, whereas they associate spirits consumption more with adverse health effects [29, 39]. Although beverage-specific variations in risk perception have been reported [40], the probability of experiencing negative outcomes of alcohol consumption was also found to be better predicted by alcohol consumption level than preferred beverage types [39].
The notion revealed in the current study that wine is a “healthy” alcoholic beverage confirms earlier findings that people believe other beverages have more detrimental effects on health than wine [15, 41]. Consumers’ convictions about wine’s positive health effects were found to be unaffected by HWLs, but these convictions may differ between countries, depending on wine’s role in their cultures [14]. These results suggest that health beliefs are an important driver of perceived consumption risks and how consumers react to HWLs. Policy-makers must account for consumers’ associations with different alcoholic beverages’ harmfulness or perceived positive health effects, which determine their perceived risk and—eventually—their drinking behavior [40].
The awareness of the link between alcohol consumption and disease was found to be associated with increased support for alcohol policies [6]. Consumers who are aware of the negative consequences of drinking alcohol show a lower rejection of measures such as HWLs on alcohol containers. However, Peadon et al. [34] argued that increasing consumers’ risk perceptions of drinking alcohol may be more effective than traditional awareness campaigns. That is, an alcohol policy such as including HWLs on alcohol containers may be more effective in reducing consumers’ alcohol intake if it increases the perceived risk of consumption as opposed to being used as a mean to increase their awareness that drinking alcohol can cause cancer. These findings indicate that consumers may not be aware of the link between alcohol and health risks and that HWLs may not prove effective in enhancing the perceived risk of consumption. Therefore, campaigns that correctly inform people about alcohol’s influence on their health and address the “wine is healthy” attitude may be more accepted and successfully increase consumers’ perceived risk compared to interventions such as HWLs [42]. Addressing such health beliefs may be an effective step in raising awareness of the risks associated with drinking alcohol.
The current study’s findings indicate that a lack of (perceived) effectiveness is a major driver of people’s HWLs rejections. Previous research found that consumers perceive warning labels as ineffective and do not believe their drinking behavior would change after HWLs were implemented [16, 28]. Reynolds et al. [26] suggest that emphasizing the effectiveness of an intervention (such as a warning label) could increase its acceptability. Although participants in the current study perceived HWLs as more effective on vodka bottles than on wine bottles, this study does not provide evidence suggesting that HWLs raise risk perceptions and may, therefore, effectively alter drinking behavior.
Earlier work found that the acceptance of an intervention may not depend on intrusiveness [43]. Furthermore, food labels have been found to be a well-accepted policy intervention [44]. The present study found that, when consumers are confronted with an intervention in a realistic scenario—such as confronting HWLs on alcohol containers—such interventions may be perceived as too intrusive. This perception is especially likely in the case of culturally important products, such as wine in Switzerland, and acceptance of such interventions may be low. Individualistic values were found to be an important driver of consumers’ HWL rejection, in line with an earlier study that found the acceptance of wine HWLs to be lower among consumers with individualistic values [22]. These cultural values have been reported to affect support for policies in other contexts, such as climate change [45].
Drinking alcohol is customary in many European countries. The social norms of drinking and its high acceptance in western societies have grown historically, supported by the alcohol industry’s strong political influence [10]. The perceived pleasure and benefits that people associate with wine drinking may be so high that wine’s risks are considered “reasonable,” resulting in consumers’ rejection of approaches such as HWLs to warn them about alcohol consumption’s potential negative effects. Consequently, governments face little pressure to change their alcohol policies.
Limitations and implications for future research
This study faced several limitations. Participants were assigned to either vodka or wine groups. Therefore, authors did not determine whether a low acceptance and strong rejection of wine HWLs could also be found if the wine-group participants had also evaluated vodka HWLs. Authors did not include beer, a popular alcoholic beverage in Switzerland that accounts for a large part of the consumed alcohol, due to the absence of health benefits associated with beer consumption. Authors do not know whether the perceived risk of beer would be more similar to the perceived risk of wine or of vodka. Moreover, it was used a single, text-only HWL in this study and risk perception was assessed after short exposure to the HWL. Authorsdid not assess what regular consumption meant to participants, so their risk perceptions may have referred to different consumption levels. Additionally, this study was conducted in Switzerland, limiting these findings’ generalizability. Consumers in other countries with different alcohol cultures and preferred beverages may not react the same way that this study’s Swiss participants reacted. Finally, this study used an online format to assess respondents’ perceptions of HWLs. However, authors do not know how such labels would be perceived and reacted to in real-life situations, such as restaurants or grocery stores. Repeated and widespread exposure to HWLs may result in different reactions and behavior of consumers.
Despite these limitations, this study’s findings offer several important implications. The study’s HWLs, with a text-only cancer warning statement, did not increase respondents’ risk perceptions, and health beliefs were found to be major predictors of risk perceptions. Therefore, future studies should investigate whether HWLs may effectively raise risk perceptions of drinking alcohol in societies with different alcohol cultures, where beliefs about wine consumption’s positive health effects are less abundant. This study found that risk perceptions for alcohol consumption were higher for vodka than wine. Researchers should, accordingly, examine how different associations for various beverages influence behavior and how these findings could be used to reduce the negative outcomes of alcohol consumption through communication. For example, researchers could use a specific alcoholic beverage, such as vodka, to inform about the risk of consuming one standard unit of a drink. Policy-makers should address the widespread belief that wine consumption can offer positive health effects so that consumers can correctly assess their consumption risk and understand that alcohol’s damage primarily stems from consumption patterns, not beverage types.
Conclusion
The present study investigated the acceptance of HWLs and their effectiveness on wine and vodka bottles as a potential policy intervention to increase consumers’ perceptions of alcohol consumption risks. It was found that risk perceptions did not increase when alcohol containers included an HWL but, rather, were determined by the beverage types that consumers considered drinking. The risk of drinking wine was perceived to be lower than the risk of drinking vodka. Consumers who believe in positive health effects from drinking wine or vodka had lower risk perceptions and rejected HWLs. The acceptance of HWLs was higher among participants who thought HWLs were effective but lower among participants with individualistic values who refused governmental restrictions to individual rights. Drinking wine is part of social norms in Switzerland, but drinking vodka is less socially normative in this country. This difference is reflected in participants’ negative reaction toward and low acceptance of HWLs on wine bottles. Therefore, policy-makers must account for such interventions’ effectiveness and—more importantly—acceptance possibly varying, depending on beverage types. Europe’s drinking culture is linked to specific beverages, and this study’s findings may not be reproduced through similar assessments in other regions where wine is less abundant. Risk perception is important in determining the degree to which someone engages in a risky behavior, such as alcohol consumption, but it may not be affected by interventions such as HWLs on alcohol containers. This study’s findings add to the knowledge about HWLs and risk perception related to alcohol consumption. Furthermore, this study has highlighted the importance of beliefs about alcohol consumption’s positive health effects and their influence on perceptions of risky drinking behaviors.