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Introduction Methods Results Discussions and Conclusions As part of several measures to inform consumers about the health risks of alcohol, the Irish Government signed into law the Public Health (Alcohol) Act 2018, with Section 13 requiring the implementation of multiple health warnings in all alcohol ads. Although health warnings on product labels have been subject to intensive political discussion and academic research, health warnings in alcohol ads have received little attention.A between‐subject factorial survey experiment was conducted with a convenience sample of adults in Ireland (n = 932) to compare single‐text, multiple‐text and shocking image‐and‐text health warnings displayed on two types of static alcohol ads—an ad with social imagery featuring people drinking alcohol and an ad featuring only the alcohol product. Believability of health warnings, negative emotions, perceived risks of alcohol use and self‐efficacy to drink less were measured after viewing each alcohol ad with or without health warnings.Single‐text health warnings, with and without shocking imagery, were more effective in increasing negative emotions than multiple‐text health warnings (p ≤ 0.001), whereas multiple‐text warnings were found to be more believable than single‐text warnings (p ≤ 0.001). No significant effects were found on perceived risks of alcohol use and self‐efficacy to drink less (p > 0.05). The warnings did not differ across demographic groups and the type of alcohol ads on all outcomes (p > 0.05).A single health warning emphasising cancer risk could be a useful starting point for policymakers when implementing health warnings in alcohol ads. [ABSTRACT FROM AUTHOR]

Findings on the effects of alcohol warning labels (AWLs) as a harm reduction tool have been mixed. This systematic review synthesized extant literature on the impact of AWLs on proxies of alcohol use. PsycINFO, Web of Science, PubMED, and MEDLINE databases and reference lists of eligible articles. Following PRISMA guidelines, 1,589 articles published prior to July 2020 were retrieved via database and 45 were via reference lists (961 following duplicate removal). Article titles and abstracts were screened, leaving the full text of 96 for review. The full-text review identified 77 articles meeting inclusion/exclusion criteria which are included here. Risk of bias among included studies was examined using the Evidence Project risk of bias tool. Findings fell into five categories of alcohol use proxies including knowledge/awareness, perceptions, attention, recall/recognition, attitudes/beliefs, and intentions/behavior. Real-world studies highlighted an increase in AWL awareness, alcohol-related risk perceptions (limited findings), and AWL recall/recognition post-AWL implementation; these findings have decreased over time. Conversely, findings from experimental studies were mixed. AWL content/formatting and participant sociodemographic factors also appear to influence the effectiveness of AWLs. Findings suggest conclusions differ based on the study methodology used, favoring real-world versus experimental studies. Future research should consider AWL content/formatting and participant sociodemographic factors as moderators. AWLs appear to be a promising approach for supporting more informed alcohol consumption and should be considered as one component in a comprehensive alcohol control strategy. [ABSTRACT FROM AUTHOR]

Background: Statutory options for restricting alcohol advertising include limiting it to product‐orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). Methods: We conducted a 2 × 2 online between‐group experiment with adults (18+) (n = 2421) recruited from a non‐probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. "drink responsibly"). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol‐related information and support. The "drink responsibly" control reflected the self‐regulatory messages commonly used by alcohol companies. Participants rated the advert on 7‐point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. Results: Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: −1.57 [makes drinking alcohol seem enjoyable] to −0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: −0.55 [advert attractiveness] to −0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. Conclusions: Restricting content and including a multiple text health warning (compared to a "drink responsibly" message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups. [ABSTRACT FROM AUTHOR]

• Health warnings about alcohol could discourage alcohol consumption. • Health warnings – regardless of topic – are perceived as more effective at discouraging alcohol consumption than control statements. • Among the 16 warning topics tested, liver disease, cancer, dementia, and hypertension were perceived as most effective. • None of these topics are included in the current US alcohol warning. Health warnings about alcohol consumption could inform consumers and discourage alcohol consumption, but little is known about what topics these warnings should address. We sought to identify promising topics for alcohol warnings. In January 2024, we recruited a convenience sample of 2,522 US adults ages ≥ 21 years. In an online within-subjects experiment, participants viewed messages about 6 topics (5 warning topics selected from a pool of 16 topics [e.g., liver disease, liver cancer] and 1 control topic [i.e., recycling or reselling products]) shown in random order. For each topic, participants viewed and rated 2 statements about that topic on perceived message effectiveness (primary outcome) and reactance (secondary outcome). The 16 warning topics elicited higher perceived message effectiveness than the control topic (p s < 0.001). Among the warning topics, liver disease, most cancer types, dementia or mental decline, and hypertension elicited the highest perceived message effectiveness, while breast cancer, sleep, and drinking guidelines elicited the lowest. Fourteen of the 16 warning topics (all except for fetal harms and impaired driving) elicited more reactance than the control topic (p s < 0.001). Warning topics that elicited high perceived message effectiveness generally elicited high reactance, except for messages about liver disease and liver cancer, which elicited high perceived message effectiveness but only moderate reactance. Warning messages about a variety of topics hold promise for discouraging alcohol consumption. Messages about liver disease, most cancer types, dementia or mental decline, and hypertension are perceived as especially effective; however, none of these topics are included in the current US alcohol warning. [ABSTRACT FROM AUTHOR]

Introduction: According to the literature, quitting tobacco before the age of 30 years would mitigate almost all tobacco-related hazards. In this respect, understanding behavioral patterns associated with the process of individual change to a healthier behavior is likely to contribute to tobacco control and avoidance of the related health risks, as well as to promote healthier behaviors, especially during adolescence., Methods: This study is a secondary dataset analysis utilizing the 2016 Global Youth Tobacco Survey (GYTS) data for Morocco. Initially, a descriptive analysis is conducted to outline smoking prevalence and related behaviors among Moroccan youth, with a focus on gender differences, employing chi-squared tests for comparison. This is followed by bivariate and multivariate logistic regression analyses, which were adjusted for potential confounders to identify the determinants of intended smoking cessation., Results: The survey was based on a sample of 3883 adolescents, of whom 11.07% have already tried smoking cigarettes at least once during childhood and adolescence, and 1.39% are current smokers. As for those close to the surveyed subjects, 22.2% had at least one smoking parent, and 24.1% had friends who smoked. Self-efficacy (AOR=15.54; 95% CI: 3.05-79.03) and noticing health warnings on cigarette packages (AOR=5.41; 95% CI: 2.54-11.52) were found to be important determinants of the intent to quit tobacco., Conclusions: This study is a focused analysis of self-efficacy and health warnings as predictors of smoking cessation intent among Moroccan adolescents. The study elucidates the role of self-efficacy and exposure to health warnings in shaping the intent to quit smoking among Moroccan adolescents. These findings provide evidence for developing targeted interventions that support self-efficacy and impactful health warnings to promote healthier choices and reduce tobacco use among young Moroccans., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2024 Loukili H. et al.)

As cannabis policy trends toward liberalization, assessing cannabis health warning effects becomes increasingly important. This study investigated underlying mechanisms accounting for the effectiveness of cannabis health warnings on protective health intentions. A sample of 1,095 adults (21+) living in legal recreational US states who reported using cannabis in the past 12 months participated in an online experiment. Participants were randomly assigned to view cannabis health warnings that described risks of impaired driving, mental health, and smoke exposure and varied pictures and text (vs. text-only) attributes in warnings. Outcomes were message reactions (cognitive elaboration, fear, and hope), attitudes and beliefs (perceived severity of cannabis harms and perceived susceptibility to cannabis harms, and perceived response and self-efficacy to prevent cannabis harms), and protective health intentions (information-seeking about cannabis health effects and having interpersonal discussions about cannabis harms with family, friends, and medical professionals). MANCOVA results showed no significant differences between text-only vs. pictorial attributes on protective health intentions; thus, warning conditions were controlled and analyzed using structural equation modeling (SEM). SEM results showed that attention to cannabis health warnings (text-only or pictorial) elicited higher cognitive elaboration, fear, and hope—an emotion associated with coping actions that motivate positive expectations of future events. These outcomes, in turn, were associated with greater perceived severity and susceptibility and greater perceived response efficacy, respectively. Hope, perceived severity, and perceived response and self-efficacy were independently associated with greater intentions to seek information about cannabis health effects and to discuss cannabis health harms. Attention to warnings impacted emotions, attitudes, and protective health intentions. Fear is commonly associated with health warning effects, and our results suggest that hope is also an important factor. This research contributes to understanding the effects of cannabis health warnings and can inform regulatory agencies that mandate warnings on cannabis products. [ABSTRACT FROM AUTHOR]