Abstract

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.

摘要

关于酒精警告标签 (AWL) 作为减少危害工具的效果的研究结果好坏参半。本系统综述综合了关于 AWL 对酒精使用指标影响的现有文献。PsycINFO、Web of Science、PubMED 和 MEDLINE 数据库以及符合条件的文章的参考列表。根据 PRISMA 指南，通过数据库检索了 2020 年 7 月之前发表的 1,589 篇文章，其中 45 篇是通过参考列表（重复删除后的 961 个）。筛选了文章标题和摘要，留下 96 篇全文供审查。全文审查确定了 77 篇符合纳入/排除标准的文章，纳入此处。使用证据项目偏倚风险工具检查纳入研究的偏倚风险。研究结果分为五类酒精使用指标，包括知识/意识、感知、注意力、回忆/识别、态度/信念和意图/行为。现实世界的研究强调了 AWL 意识、酒精相关风险认知（有限的研究结果）以及 AWL 实施后 AWL 回忆/识别的提高；随着时间的推移，这些发现有所减少。相反，实验研究的结果好坏参半。AWL 内容/格式和参与者的社会人口因素似乎也会影响 AWL 的有效性。研究结果表明，根据所使用的研究方法，结论有所不同，有利于现实世界研究而不是实验研究。未来的研究应考虑 AWL 内容/格式和参与者的社会人口因素作为调节因素。AWL 似乎是支持更知情的饮酒的一种有前景的方法，应被视为全面酒精控制策略的一个组成部分。