Testing the Effectiveness of Enhanced Alcohol Warning Labels and Modifications Resulting From Alcohol Industry Interference in Yukon, Canada: Protocol for a Quasi-Experimental Study

• Published in: JMIR Research Protocols
• Main Authors: Vallance, Kate, Stockwell, Timothy, Hammond, David, Shokar, Simran, Schoueri-Mychasiw, Nour, Greenfield, Thomas, McGavock, Jonathan, Zhao, Jinhui, Weerasinghe, Ashini, Hobin, Erin
• Format: Text
• Language: English
• Published: JMIR Publications 2020
• Subjects: Protocol; Canada; Northwest Territories; Yellowknife; Yukon; Whitehorse
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996737/; http://www.ncbi.nlm.nih.gov/pubmed/31922493; https://doi.org/10.2196/16320

BACKGROUND: Alcohol warning labels are a promising, well-targeted strategy to increase public awareness of alcohol-related health risks and support more informed and safer use. However, evidence of their effectiveness in real-world settings remains limited and inconclusive. OBJECTIVE: This paper presents a protocol for a real-world study examining the population-level impact of enhanced alcohol warning labels with a cancer message; national drinking guidelines; and standard drink information on attention, processing, and alcohol-related behaviors among consumers in Canada. Postimplementation modifications to the original protocol due to interference by national alcohol industry representatives are also described. METHODS: This quasi-experimental study involved partnering with local governments in two northern Canadian territories already applying alcohol warning labels on alcohol containers for sale in liquor stores. The study tested an 8-month intervention consisting of three new enhanced, rotating alcohol warning labels in an intervention site (Whitehorse, Yukon) relative to a comparison site (Yellowknife, Northwest Territories) where labelling practices would remain unchanged. Pre-post surveys were conducted at both sites to measure changes in awareness and processing of label messages, alcohol-related knowledge, and behaviors. Liquor store transaction data were collected from both sites to assess changes in population-level alcohol consumption. The intervention was successfully implemented for 1 month before it was halted due to complaints from the alcohol industry. The government of the intervention site allowed the study to proceed after a 2-month pause, on the condition that the cancer warning label was removed from rotation. Modifications to the protocol included applying the two remaining enhanced labels for the balance of the intervention and adding a third wave of surveys during the 2-month pause to capture any impact of the cancer label. RESULTS: This study protocol describes a real-world ...