PDF(Pubmed)
Abstract：
BACKGROUND: Alcohol health-warning labels are a policy option that can contribute to the reduction of alcohol-related harms, but their effects and public perception depend on their content and format. Our study aimed to investigate the effect of health warnings on knowledge that alcohol causes cancer, the perceptions of three different message topics (responsible drinking, general health harm of alcohol, and alcohol causing cancer), and the role of images included with the cancer message.
METHODS: In this online survey experiment, distributed in 14 European countries and targeting adults of the legal alcohol-purchase age who consumed alcohol, participants were randomly allocated to one of six label conditions using a pseudorandom number generator stratified by survey language before completing a questionnaire with items measuring knowledge and label perceptions. Effect on knowledge was assessed as a primary outcome by comparing participants who had increased knowledge after exposure to labels with the rest of the sample, for the six label conditions. Label perceptions were compared between label conditions as secondary outcomes.
RESULTS: 19 110 participants completed the survey and were eligible for analysis. Our results showed that a third of the participants exposed to the cancer message increased their knowledge of alcohol causing cancer (increase for 1131 [32·5%, 95% CI 29·8 to 35·2] of 3409 participants [weighted percentage] for text-only message; increase for 1096 [33·3%, 30·4 to 36·2] of 3198 [weighted percentage] for message inlcuding pictogram; and increase for 1030 [32·5%, 29·6 to 35·4] of 3242 [weighted percentage] for message including graphic image), compared with an increase for 76 (2·4%, -1·2 to 6·0) of 3018 participants who viewed the control message. Logistic regression showed that cancer messages increased knowledge compared with the control label (odds ratio [OR]text only 20·20, 95% CI 15·88 to 26·12; ORpictogram 21·16, 16·62 to 27·38; ORgraphic-image 20·61, 16·19 to 26·68). Cancer messages had the highest perceived impact and relevance, followed by general health harm and responsibility messages. Text-only and pictogram cancer messages were seen as clear, comprehensive, and acceptable, whereas those including an image of a patient with cancer had lower acceptability and the highest avoidance rating of all the labels. The only identified interaction between perceptions and experimental conditions (with gender) indicated higher comprehensibility and acceptability ratings of cancer labels than responsibility messages and control labels by women, with the results reversed in men.
CONCLUSIONS: Health warnings are an effective policy option to increase knowledge of alcohol causing cancer, with a generalisable effect across several countries. Europeans consider alcohol health-warning labels to be comprehensible and acceptable, with cancer-specific health warnings having the highest perceived impact and relevance.
BACKGROUND: EU4Health.
METHODS: In this online survey experiment, distributed in 14 European countries and targeting adults of the legal alcohol-purchase age who consumed alcohol, participants were randomly allocated to one of six label conditions using a pseudorandom number generator stratified by survey language before completing a questionnaire with items measuring knowledge and label perceptions. Effect on knowledge was assessed as a primary outcome by comparing participants who had increased knowledge after exposure to labels with the rest of the sample, for the six label conditions. Label perceptions were compared between label conditions as secondary outcomes.
RESULTS: 19 110 participants completed the survey and were eligible for analysis. Our results showed that a third of the participants exposed to the cancer message increased their knowledge of alcohol causing cancer (increase for 1131 [32·5%, 95% CI 29·8 to 35·2] of 3409 participants [weighted percentage] for text-only message; increase for 1096 [33·3%, 30·4 to 36·2] of 3198 [weighted percentage] for message inlcuding pictogram; and increase for 1030 [32·5%, 29·6 to 35·4] of 3242 [weighted percentage] for message including graphic image), compared with an increase for 76 (2·4%, -1·2 to 6·0) of 3018 participants who viewed the control message. Logistic regression showed that cancer messages increased knowledge compared with the control label (odds ratio [OR]text only 20·20, 95% CI 15·88 to 26·12; ORpictogram 21·16, 16·62 to 27·38; ORgraphic-image 20·61, 16·19 to 26·68). Cancer messages had the highest perceived impact and relevance, followed by general health harm and responsibility messages. Text-only and pictogram cancer messages were seen as clear, comprehensive, and acceptable, whereas those including an image of a patient with cancer had lower acceptability and the highest avoidance rating of all the labels. The only identified interaction between perceptions and experimental conditions (with gender) indicated higher comprehensibility and acceptability ratings of cancer labels than responsibility messages and control labels by women, with the results reversed in men.
CONCLUSIONS: Health warnings are an effective policy option to increase knowledge of alcohol causing cancer, with a generalisable effect across several countries. Europeans consider alcohol health-warning labels to be comprehensible and acceptable, with cancer-specific health warnings having the highest perceived impact and relevance.
BACKGROUND: EU4Health.
摘要：
背景：酒精健康警告标签是一种政策选择，可以有助于减少与酒精有关的危害，但是它们的效果和公众的看法取决于它们的内容和格式。我们的研究旨在调查健康警告对酒精导致癌症的知识的影响，对三个不同信息主题的看法(负责任的饮酒，酒精对健康的一般危害，和酒精导致癌症)，以及癌症信息中包含的图像的作用。
方法：在这个在线调查实验中，分布在14个欧洲国家，针对法定饮酒年龄的成年人，在完成包含测量知识和标签感知的项目的问卷之前,使用按调查语言分层的伪随机数发生器将参与者随机分配到6种标签条件之一.通过将暴露于标签后知识增加的参与者与其他样本进行比较，将对知识的影响评估为主要结果。六个标签条件。在作为次要结果的标签条件之间比较标签感知。
结果：19110名参与者完成了调查，符合分析条件。我们的结果显示，三分之一的参与者暴露于癌症信息增加了他们对酒精致癌的知识（增加了1131[32·5%，3409名参与者[加权百分比]中的95%CI29·8至35·2]，用于纯短信；增加1096[33·3%，30·4到36·2]的3198[加权百分比]的消息包括象形图；并增加1030[32·5%，29·6至35·4]3242[加权百分比]的消息，包括图形图像），与增加76人(2·4%，查看控制消息的3018名参与者中的-1·2至6·0）。Logistic回归显示，与对照标签相比，癌症信息增加了知识（比值比[OR]文本仅为20·20，95％CI15·88至26·12；OR象形图21·16，16·62至27·38；ORgraphic-image20·61，16·19至26·68）。癌症信息具有最高的感知影响力和相关性，其次是一般的健康危害和责任信息。纯文本和象形图癌症信息被认为是清晰的，全面,并且可以接受,而在所有标签中,包括癌症患者的图像的可接受性较低,回避等级最高.感知与实验条件（与性别）之间唯一确定的相互作用表明，与女性的责任信息和控制标签相比，癌症标签的可理解性和可接受性等级更高。结果在男性中相反。
结论：健康警告是增加对酒精致癌知识的有效政策选择，在几个国家有普遍的影响。欧洲人认为酒精健康警告标签是可理解和可接受的，癌症特异性健康警告具有最高的感知影响和相关性。
背景：EU4Health。
方法：在这个在线调查实验中，分布在14个欧洲国家，针对法定饮酒年龄的成年人，在完成包含测量知识和标签感知的项目的问卷之前,使用按调查语言分层的伪随机数发生器将参与者随机分配到6种标签条件之一.通过将暴露于标签后知识增加的参与者与其他样本进行比较，将对知识的影响评估为主要结果。六个标签条件。在作为次要结果的标签条件之间比较标签感知。
结果：19110名参与者完成了调查，符合分析条件。我们的结果显示，三分之一的参与者暴露于癌症信息增加了他们对酒精致癌的知识（增加了1131[32·5%，3409名参与者[加权百分比]中的95%CI29·8至35·2]，用于纯短信；增加1096[33·3%，30·4到36·2]的3198[加权百分比]的消息包括象形图；并增加1030[32·5%，29·6至35·4]3242[加权百分比]的消息，包括图形图像），与增加76人(2·4%，查看控制消息的3018名参与者中的-1·2至6·0）。Logistic回归显示，与对照标签相比，癌症信息增加了知识（比值比[OR]文本仅为20·20，95％CI15·88至26·12；OR象形图21·16，16·62至27·38；ORgraphic-image20·61，16·19至26·68）。癌症信息具有最高的感知影响力和相关性，其次是一般的健康危害和责任信息。纯文本和象形图癌症信息被认为是清晰的，全面,并且可以接受,而在所有标签中,包括癌症患者的图像的可接受性较低,回避等级最高.感知与实验条件（与性别）之间唯一确定的相互作用表明，与女性的责任信息和控制标签相比，癌症标签的可理解性和可接受性等级更高。结果在男性中相反。
结论：健康警告是增加对酒精致癌知识的有效政策选择，在几个国家有普遍的影响。欧洲人认为酒精健康警告标签是可理解和可接受的，癌症特异性健康警告具有最高的感知影响和相关性。
背景：EU4Health。
