26 April 2017 In Drinking & Eating Patterns

OBJECTIVE: The present study is a systematic review of the literature examining the relationship between alcohol mixed with energy drinks (AmED) and injury. The study provides a summary and critical analysis of the current literature.

METHOD: The review was conducted using PRISMA guidelines for systematic reviews. Studies included in the review were those that quantified the relationship between AmED use and injury risk relative to alcohol only. Records were considered along the following theme areas: controlled for drinking behaviors, controlled for impulsivity or risk-taking propensity, examined sex differences, and self-reported injury outcomes for (a) AmED versus alcohol consumers and (b) AmED versus alcohol sessions.

RESULTS: The results support the association between AmED and increased risk of injury; however, substantial variability in harm outcomes and methodology makes it difficult to determine the extent of this risk.

CONCLUSIONS: There is significant need for further examination of the role of AmED use in the risk of injury. A better understanding of the relationship between AmED use and injury and of the potential underlying mechanisms is crucial for informing effective preventive intervention strategies. This review can be used to inform the public and health practitioners of the risks associated with AmED use. Further, translating this knowledge to policy makers could inform regulations on the availability of AmED, with the goal of reducing injury-related outcomes.

27 February 2017 In Social and Cultural Aspects

BACKGROUND: Many countries use warnings in an attempt to regulate alcohol consumption. However, there is a lack of conclusive evidence in the research on alcohol warnings to support decision-making on effective health policies. This study explores the effectiveness of two mandatory warnings introduced in France in 1991 and 2007: the first ("Alcohol abuse is harmful") is displayed on advertisements; the second (a pictogram) on bottles. Given that advertising content regulations have been implemented in some countries to reduce the attractiveness of alcohol marketing (e.g., the Evin law in France), this research also aims to explore whether such regulations can improve the effectiveness of warnings.

METHOD: In-depth interviews were conducted with 26 French people aged 15-29. The effectiveness of health warnings was assessed in terms of recall, noticeability, credibility, comprehension, responsiveness and ability to encourage moderate drinking and abstinence during pregnancy. Participants were shown advertisements and bottles that either followed or challenged content regulations. The data was analysed using double manual coding and NVivo software.

RESULTS: While both warnings suffered from a lack of visibility and noticeability due to their size, location, outdatedness and because of competition from marketing design elements, the warning on the advertisement that followed content regulations was most visible. Both warnings were considered to be informationally vague, lacking in credibility and ineffective in terms of making participants feel concerned and influencing consumption habits.

CONCLUSION: Current French warnings are ineffective and require modification. Improvements are suggested regarding the design and content of warnings to help increase their effectiveness.

01 February 2017 In General Health

BACKGROUND: Explicit labelling of lower strength alcohol products could reduce alcohol consumption by attracting more people to buy and drink such products instead of higher strength ones. Alternatively, it may lead to more consumption due to a 'self-licensing' mechanism. Equivalent labelling of food or tobacco (for example "Low fat" or "Low tar") could influence consumption of those products by similar mechanisms. This systematic review examined the effects of 'Low alcohol' and equivalent labelling of alcohol, food and tobacco products on selection, consumption, and perceptions of products among adults.

METHODS: A systematic review was conducted based on Cochrane methods. Electronic and snowball searches identified 26 eligible studies. Evidence from 12 randomised controlled trials (all on food) was assessed for risk of bias, synthesised using random effects meta-analysis, and interpreted in conjunction with evidence from 14 non-randomised studies (one on alcohol, seven on food and six on tobacco). Outcomes assessed were: quantities of the product (i) selected or (ii) consumed (primary outcomes - behaviours), (iii) intentions to select or consume the product, (iv) beliefs associated with it consumption, (v) product appeal, and (vi) understanding of the label (secondary outcomes - cognitions).

RESULTS: Evidence for impacts on the primary outcomes (i.e. amounts selected or consumed) was overall of very low quality, showing mixed effects, likely to vary by specific label descriptors, products and population characteristics. Overall very low quality evidence suggested that exposure to 'Low alcohol' and equivalent labelling on alcohol, food and tobacco products can shift consumer perceptions of products, with the potential to 'self-licence' excess consumption.

CONCLUSIONS: Considerable uncertainty remains about the effects of labels denoting low alcohol, and equivalent labels, on alcohol, food and tobacco selection and consumption. Independent, high-quality studies are urgently needed to inform policies on labelling regulations.

02 August 2016 In General Health

The global strategy to reduce the harmful use of alcohol launched in 2010 by the World Health Organization includes, amongst several areas of recommended actions, providing consumer information about, and labelling, alcoholic beverages to indicate alcohol-related harm. Labelling requirements worldwide for alcoholic drinks are currently quite diverse and somewhat limited compared to labelling on food products and on tobacco. In this context, the current paper contributes to the academic and political debate on the inclusion of nutritional and health information on wine labelling, providing some insights into consumer interest in, and preferences for, such information in four core wine-producing and -consuming countries: Italy, France, Spain, and the United States of America. A rating-based conjoint analysis was performed in order to ascertain consumer preferences for different formats of additional information on wine labels, and a segmentation of the sample was performed to determine the existence of homogeneous groups of consumers in relation to the degrees of usefulness attached to the nutritional and health information on wine labels. Our results highlight the interest expressed by European and United States consumers for introducing nutrition and health information on wine labels. However, the results of conjoint analysis show some significant differences among stated preferences of the information delivery modes in different countries. In addition, segmentation analysis reveal the existence of significant differences between consumer groups with respect to their interest in receiving additional information on wine labels. These differences are not only linked to the geographic origin of the consumers, or to socio-demographic variables, but are also related to wine consumption habits, attitudes towards nutritional information, and the degree of involvement with wine. This heterogeneity of consumer preferences indicates a need for a careful consideration of wine labelling regulations and merits further investigation in order to identify labelling guidelines in terms of the message content and presentation method to be used.

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