Abstract
Health warning labels (HWLs) could reduce harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks. A systematic review with meta-analysis using Cochrane methods was conducted to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drink products displaying image-and-text (sometimes termed ‘pictorial’) and text-only HWLs. Fourteen randomised controlled trials were included, three for alcohol, eleven for food. For the primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared with no HWL (RR=0.74 (95%CI 0.68–0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger (although not statistically significant) effect on selection of image-and-text HWLs (RR=0.65 (95%CI 0.54–0.80)) than text-only HWLs (RR=0.79 (95%CI 0.74–0.85)). These findings suggest significant potential for HWLs to reduce selection of food and alcoholic drinks, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and naturalistic laboratory settings are needed to estimate the potential effects of food and alcohol HWLs. Study registration: PROSPERO 2018 (registration number: CRD42018106522).
| Original language | English |
|---|---|
| Pages (from-to) | 1-24 |
| Number of pages | 24 |
| Journal | Health Psychology Review |
| DOIs | |
| Publication status | Published - 31 Dec 2020 |
Bibliographical note
Funding Information:This work was funded by a Collaborative Award in Science from Wellcome Trust (Behaviour Change by Design: 206853/Z/17/Z: PIs: Theresa Marteau, Paul Fletcher, Gareth Hollands and Marcus Munafò). The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust. We are grateful to Professor Susan Jebb for helpful comments on an earlier draft of this manuscript. NC, TMM and GJH conceived the review. NC, EP, EM, AKMB, TMM and GJH developed the protocol for the review. NC, EP, DK and LK conducted the searches and data extraction. NC and GJH analysed the data. NC drafted the initial draft of the manuscript, TMM and GJH significantly contributed to amending and drafting the final version. All authors read and approved the final version of the manuscript.
Publisher Copyright:
© 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Funding
This work was funded by a Collaborative Award in Science from Wellcome Trust (Behaviour Change by Design: 206853/Z/17/Z: PIs: Theresa Marteau, Paul Fletcher, Gareth Hollands and Marcus Munafò). The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome Trust. We are grateful to Professor Susan Jebb for helpful comments on an earlier draft of this manuscript. NC, TMM and GJH conceived the review. NC, EP, EM, AKMB, TMM and GJH developed the protocol for the review. NC, EP, DK and LK conducted the searches and data extraction. NC and GJH analysed the data. NC drafted the initial draft of the manuscript, TMM and GJH significantly contributed to amending and drafting the final version. All authors read and approved the final version of the manuscript.
Keywords
- alcohol
- food
- Health warning labels
- meta-analysis
- sugar sweetened beverages
- systematic review
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health
