A systematic review of the efficacy of alcohol warning labels: Insights from qualitative and quantitative research in the new millennium

The placement of warning labels on alcoholic beverages is a policy area with renewed interest, yet a strong evidence base regarding the efficacy of text-based or pictorial warning labels has still to emerge. Increased interest by policymakers has spurred research into potential alcohol warning label designs and messages. The purpose of this article is to draw together recearch in the alcohol warnings literature.

The current study seeks to review research that has sought to examine the effectiveness of alcohol warning labels. Searches for English-language articles (since 2000) using the terms “alcohol” and “warning label*” were conducted in 2015 across four databases (Web of Science, PubMed, PsycInfo and Cochrane). Articles were included if they empirically assessed the effectiveness and/or design of alcohol warning labels. Only studies that addressed the targeted individual consumer (consistent with downstream social marketing) were included. A narrative analysis approach was used for the 15 articles identified.

Findings are reported on five themes covering the design of the warning, starting with the use of imagery or recommendations, followed by a focus on the warning messages and whether they are specific, use signal words and are based on qualitative or quantitative information.

Overall, there was little consistency in approach and measures, with very limited research having explored the potential of pictorial warning labels. Numerous research gaps are identified; thus, much more research is needed in this area. The evidence base is weak and caution is needed by policymakers regarding the introduction and implementation of alcohol warning labels. Limitations are discussed.

The review provides a timely up-to-date evaluation of the alcohol warning labels literature that has seen a recent resurgence but has not been critically reviewed.