Can a health warning label diminish the persuasive effects of health-oriented nutrition advertising on ready-to-drink alcohol product packaging? A randomized experiment.

BACKGROUND AND AIMS: A health warning label (HWL) cautioning about the link between alcohol and cancer may be able to communicate alcohol risks to consumers and potentially counter health-oriented nutrition advertising on ready-to-drink alcoholic beverages. This study aimed to examine the independent and combined effects of nutrient content claims (e.g. 0 g sugar) and a HWL on perceived product characteristics and intentions to consume, and whether these effects differed by gender and age. DESIGN: A between-subjects randomized experiment. Participants were randomized to view one of six experimental label conditions: nutrient content claims plus nutrition declaration (NCC + ND), ND only, NCC + ND + HWL, ND + HWL, HWL only and no NCC, ND or HWL, all on a ready-to-drink (RTD) vodka-based soda container. SETTING AND PARTICIPANTS: Alcohol consumers (n = 5063; 52% women) in Canada aged 18-64 recruited through a national online panel. MEASUREMENTS: Participants completed ratings of perceived product characteristics, perceived product health risks, and intentions to try, buy, binge and drink the product. FINDINGS: Compared with the reference condition NCC + ND (current policy scenario in Canada), the other five experimental label conditions were associated with lower ratings for perceiving the product as healthy. All experimental conditions with a HWL were associated with lower product appeal, higher risk perceptions and reduced intentions to try, buy and binge. The experimental condition with a HWL only was associated with intentions to consume fewer cans in the next 7 days (ß = -0.72, 95% confidence interval [CI] = -1.37,-0.08) versus the reference. Few interactions were observed, suggesting that label effects on outcomes were similar by gender and age. CONCLUSIONS: Health warning labels on alcohol packaging appear to be associated with lower product appeal, higher perceived health risks and reduced consumption intentions, even in the presence of nutrient content claims.

Nutrition cues on ready-to-drink alcoholic beverage containers sold in grocery stores in Québec City, Canada.

Nutrition cues on ready-to-drink alcoholic beverages (RTDs) may create an illusion of healthfulness; however, nutrition information on alcohol in Canada is seldom regulated. This research aimed to systematically record the use of nutrition cues on a subsample of RTDs sold in grocery stores. In July 2021, all available RTDs were purchased from three major grocery store banners in Québec City, Canada. Data regarding container size, purchase format, alcohol-by-volume (ABV), presence of nutrition cues (nutrient claims, other food-related claims and nutrition facts tables [NFTs]) and container surface occupied by nutrition cues were recorded. RTDs were classified as hard seltzers or pre-mixed cocktails and their ABV as "light-strength" (3.5%-4.0% ABV) and "regular-strength" (>4.0%-7.0% ABV). In total (n = 193), 23% were hard seltzers and 17% light-strength. Most RTDs (68%) had ≥1 type of nutrition cue, most often natural flavour claims (45%), an NFT (38%), and calorie claims (29%). Light-strength beverages were more likely than regular-strength to carry any nutrient claim (97% vs. 19%, p < 0.0001), an NFT (97% vs. 26%, p < 0.0001) and other food-related claims (e.g., natural flavour) (88% vs. 52%, p = 0.0002). In adjusted regression analyses, hard seltzers were more likely than pre-mixed cocktails to carry any nutrient claim (AOR = 19.1, 95% CI:7.5,48.7), any other food-related claim (AOR = 7.5, 95% CI:2.9,19.4), and an NFT (AOR = 45.5, 95% CI:12.6,163.9). The mean container surface occupied by nutrition cues was higher for hard seltzers compared to pre-mixed cocktails (13% vs 3%, p < 0.0001). The high proportion of RTDs carrying nutrition cues supports the need to further regulate labelling and marketing of RTDs.

Adolescents' media usage and self-reported exposure to advertising across six countries: implications for less healthy food and beverage marketing.

OBJECTIVES: The study objectives were to examine: (1) adolescents' media viewing habits, (2) associations with media viewing and self-reported exposure to unhealthy food and beverage advertising and (3) differences in trends among younger and older adolescents in six high and upper middle-income countries. DESIGN: Repeat cross-sectional online survey. SETTING: Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States of America (USA). PARTICIPANTS: Respondents to the International Food Policy Study who provided information on all variables of interest in November-December 2019 aged 10-17 years (n=9171). OUTCOME MEASURES: Self-reported exposure to screen-based media (screen time by media channel), use of social media platforms and self-reported location and frequency of exposure to unhealthy food and beverage advertising. RESULTS: The average amount of time spent in front of various screens ranged from 7.6 hours to 10.2 hours across countries per week day, which may include possible viewing of multiple media channels simultaneously. Overall, Instagram was the most popular social media platform (52%-68% by country), followed by Facebook (42%-79%) and Snapchat (28%-52%). The percentage of respondents who self-reported having seen unhealthy food advertisements in the past 30 days was highest on television (43%-69%), followed by digital media (27%-60%) and gaming applications (10%-17%). Self-reported daily exposure to advertising varied between countries for sugary drinks (10%-43%) and fast food (19%-44%) and was positively associated with self-reported screen time. Self-reported exposure to screen-based media and social media platforms differed by sociodemographic characteristics and was higher among older adolescents than younger adolescents. CONCLUSIONS: The important amount of time spent on screen-based media reported by adolescents and large percentage of adolescents reporting social media usage, coupled with high rates of self-reported advertising exposure, support the need for policies to restrict marketing of unhealthy food and beverages appealing to adolescents on screen-based media.