Systematically informing the development of alcohol warning messages for health promotion

Abstract

Background: Harm from alcohol is a serious public health issue and governments are calling for alcohol warning labels. However, research informed label development is limited. Alcohol Expectancy Theory offers a framework for informing label development; however the reliance on a narrow range of survey dependent expectancies has limited findings. This study aims to extend alcohol expectancy theory and inform the development of warning labels, by identifying negative expectancies that are participant derived and salient to drinkers from specific segments. Method: Drinkers’ negative alcohol-related expectancies were identified through a qualitative study of a nationally representative sample of the New Zealand population (1168 drinkers). Thematic analysis resulted in 13 salient negative alcohol expectancies and the percentage of drinkers from each segment (age, gender, heavier drinkers versus lighter drinkers) who mentioned each expectancy, was examined. Findings: Chi-square analysis revealed expectancies varied between segments: Heavy drinkers and emerging adults were characterised by concerns for self (e.g., blacking out, being hungover); lighter drinkers and older adults by consequences of harm to others (e.g., drunk driving, violence,); females reported greater concern than males with the majority of expectancies. Discussion: This study is the first to identify participant derived negative alcohol expectancies pertinent to drinkers, from different segments, using a representative sample. The results demonstrate that warnings based on a ‘one size fits all’ approach will not be salient to all drinkers, and is unlikely to be a successful intervention. The value of analysing expectancies pertinent to individual segments is discussed, using specific examples of warning labels.