{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:44:19Z","timestamp":1765824259379,"version":"3.48.0"},"reference-count":29,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T00:00:00Z","timestamp":1725062400000},"content-version":"unspecified","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Health and Social Care","award":["PR-PRU-0916-21001"],"award-info":[{"award-number":["PR-PRU-0916-21001"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,8,1]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"\n Objectives<\/jats:title>\n We investigated the hypothetical impact of mandatory alcohol calorie labelling, comparing non-drinkers, low-risk and hazardous drinkers in terms of attitudes, knowledge about calorie content and hypothetical behaviour changes should labelling be introduced.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Cross-sectional national telephone survey.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Community-dwelling adults in England between November 2022 and January 2023.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Data were collected from 4683 adults >18 years, of whom 24.7% were non-drinkers; 77.6% of alcohol drinkers were categorised as low-risk and 22.4% as hazardous drinkers according to the Alcohol Use Disorders Identification Test questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Primary outcome measures<\/jats:title>\n Attitudes to alcohol calorie labelling in shops and supermarkets and in hospitality venues, knowledge of the calorie content of alcoholic beverages (beer, wine, cider and spirits) and changes in drinking practices if calorie labelling was introduced.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Comparisons were made between non-drinkers, low-risk drinkers and hazardous drinkers, with analyses adjusted for age, gender, ethnicity, socioeconomic status and education. Attitudes to calorie labelling were generally positive, but were less favourable among alcohol drinkers than non-drinkers. Hazardous drinkers were more accurate in their estimations of the calorie content of wine, cider and spirits than non-drinkers (p<0.0001). Overall, 46.4% of drinkers indicated that they would change their drinking patterns if calorie labelling was introduced, and this response was more common among hazardous than low-risk drinkers (OR=1.43, 95% CI 1.199 to 1.699), adjusting for age, gender, ethnicity, socioeconomic status and education. Compared with low-risk drinkers, hazardous drinkers stated that they would be more likely to drink fewer alcoholic beverages, to drink alcohol less often, to choose lower calorie drinks and to do more exercise (adjusted OR 1.27, 1.009 to 1.606).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A sizeable proportion of hazardous drinkers indicated that they would change their consumption practices if mandatory calorie labelling was introduced. Promoting more positive attitudes to calorie labelling might lead to stronger intentions to reduce consumption. Mandatory calorie labelling of alcoholic beverages may make a modest contribution to energy intake and the maintenance of health weight, particularly among heavier drinkers.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087491","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T20:10:52Z","timestamp":1726690252000},"page":"e087491","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Potential impact of alcohol calorie labelling on the attitudes and drinking behaviour of hazardous and low-risk drinkers in England: a national survey"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7808-4943","authenticated-orcid":false,"given":"Andrew","family":"Steptoe","sequence":"first","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Sheen","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"},{"name":"School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Conway","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Llewellyn","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"},{"name":"Behavioural Science and Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London, London, UK"},{"name":"Behavioural Science and Health, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"2025121510365611000_14.8.e087491.1","unstructured":"Public Health England . The public health burden of alcohol and the effectiveness and cost-effectiveness of alcohol control policies: an evidence review. London: Public Health England, 2016."},{"key":"2025121510365611000_14.8.e087491.2","unstructured":"NHS Digital . Health Survey for England, 2021, 2022. Available: https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/health-survey-for-england\/2021"},{"key":"2025121510365611000_14.8.e087491.3","unstructured":"Department of Health and Social Care . Calorie labelling in the out of home sector: implementation guidance. London: DHSC, 2021."},{"key":"2025121510365611000_14.8.e087491.4","doi-asserted-by":"crossref","DOI":"10.1186\/1475-2891-12-9","article-title":"Beverage consumption habits \u201c24\/7\u201d among British adults: association with total water intake and energy intake","volume":"12","author":"Gibson","year":"2013","journal-title":"Nutr J"},{"key":"2025121510365611000_14.8.e087491.5","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1017\/S0007114518003677","article-title":"Effect of alcohol consumption on food energy intake: a systematic review and meta-analysis","volume":"121","author":"Kwok","year":"2019","journal-title":"Br J Nutr"},{"key":"2025121510365611000_14.8.e087491.6","doi-asserted-by":"crossref","first-page":"8078","DOI":"10.1080\/10408398.2021.1925221","article-title":"Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies","volume":"62","author":"Golzarand","year":"2022","journal-title":"Crit Rev Food Sci Nutr"},{"key":"2025121510365611000_14.8.e087491.7","unstructured":"Insitute of Alcohol Studies . Alcohol energy (calorie) labelling: evidence, public support, alternatives, and wider labelling considerations. 2021. Available: https:\/\/www.ias.org.uk\/wp-content\/uploads\/2021\/10\/Calorie-Labelling-Report-21-10-21-Final.pdf"},{"key":"2025121510365611000_14.8.e087491.8","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ypmed.2017.06.031","article-title":"Restaurant menu labeling laws and alcohol use","volume":"102","author":"Restrepo","year":"2017","journal-title":"Prev Med"},{"key":"2025121510365611000_14.8.e087491.9","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/alcalc\/agx066","article-title":"No Impact of Calorie or Unit Information on Ad Libitum Alcohol Consumption","volume":"53","author":"Maynard","year":"2018","journal-title":"Alcohol Alcohol"},{"key":"2025121510365611000_14.8.e087491.10","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1111\/add.16288","article-title":"Impact of health warning labels and calorie labels on selection and purchasing of alcoholic and non-alcoholic drinks: A randomized controlled trial","volume":"118","author":"Clarke","year":"2023","journal-title":"Addiction"},{"key":"2025121510365611000_14.8.e087491.11","unstructured":"Packer J , Stansfield C , Sifaki M , et al . Assessing the impact of alcohol calorie and unit labelling on consumer behaviours: findings from a systemic review, Available: https:\/\/www.ucl.ac.uk\/obesity-policy-research-unit\/sites\/obesity_policy_research_unit\/files\/opru_acl_final_version.pdf"},{"key":"2025121510365611000_14.8.e087491.12","doi-asserted-by":"crossref","DOI":"10.1111\/obr.13198","article-title":"Alcohol, calories, and obesity: A rapid systematic review and meta-analysis of consumer knowledge, support, and behavioral effects of energy labeling on alcoholic drinks","volume":"22","author":"Robinson","year":"2021","journal-title":"Obes Rev"},{"key":"2025121510365611000_14.8.e087491.13","doi-asserted-by":"crossref","first-page":"363","DOI":"10.17269\/s41997-021-00599-0","article-title":"Efficacy of calorie labelling for alcoholic and non-alcoholic beverages on restaurant menus on noticing information, calorie knowledge, and perceived and actual influence on hypothetical beverage orders: a randomized trial","volume":"113","author":"Hobin","year":"2022","journal-title":"Can J Public Health"},{"key":"2025121510365611000_14.8.e087491.14","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1111\/add.15327","article-title":"Effect of alcohol label designs with different pictorial representations of alcohol content and health warnings on knowledge and understanding of low-risk drinking guidelines: a randomized controlled trial","volume":"116","author":"Gold","year":"2021","journal-title":"Addiction"},{"key":"2025121510365611000_14.8.e087491.15","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/bjhp.12527","article-title":"The effect of calorie and physical activity equivalent labelling of alcoholic drinks on drinking intentions in participants of higher and lower socioeconomic position: An experimental study","volume":"27","author":"Robinson","year":"2022","journal-title":"Br J Health Psychol"},{"key":"2025121510365611000_14.8.e087491.16","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/osp4.638","article-title":"Energy labelling of alcoholic drinks: An important or inconsequential obesity policy?","volume":"9","author":"Robinson","year":"2023","journal-title":"Obes Sci Pract"},{"key":"2025121510365611000_14.8.e087491.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb02093.x"},{"key":"2025121510365611000_14.8.e087491.18","doi-asserted-by":"crossref","first-page":"102382","DOI":"10.1016\/j.ejpoleco.2023.102382","article-title":"Can internet surveys represent the entire population? A practitioners\u2019 analysis","volume":"78","author":"Grewenig","year":"2023","journal-title":"Eur J Polit Econ"},{"key":"2025121510365611000_14.8.e087491.19","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-16327-x","article-title":"The effectiveness of alcohol label information for increasing knowledge and awareness: a rapid evidence review","volume":"23","author":"Edmunds","year":"2023","journal-title":"BMC Public Health"},{"key":"2025121510365611000_14.8.e087491.20","unstructured":"McCance RA , Widdowson EM . McCance and widdowson\u2019s the composition of foods. London: Royal Society of Chemistry, 2014."},{"key":"2025121510365611000_14.8.e087491.21","doi-asserted-by":"crossref","DOI":"10.3390\/nu8070416","article-title":"Do consumers want more nutritional and health information on wine labels? Insights from the EU and USA","volume":"8","author":"Annunziata","year":"2016","journal-title":"Nutrients"},{"key":"2025121510365611000_14.8.e087491.22","doi-asserted-by":"crossref","DOI":"10.1016\/j.ypmed.2019.05.010","article-title":"Can a mass media campaign raise awareness of alcohol as a risk factor for cancer and public support for alcohol related policies?","volume":"126","author":"Christensen","year":"2019","journal-title":"Prev Med"},{"key":"2025121510365611000_14.8.e087491.23","unstructured":"Belgium G . n.d. Knowledge of ingredient and nutrition information of alcoholic beverages off-label information and its use 2014. Available: https:\/\/brewersofeurope.org\/uploads\/mycms-files\/documents\/publications\/2015\/GfK%20report%20-%20CONSUMER%20INSIGHTS%20-%20FINAL.pdf"},{"key":"2025121510365611000_14.8.e087491.24","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-1297","article-title":"Drinking pattern is more strongly associated with under-reporting of alcohol consumption than socio-demographic factors: evidence from a mixed-methods study","volume":"14","author":"Boniface","year":"2014","journal-title":"BMC Public Health"},{"key":"2025121510365611000_14.8.e087491.25","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-479","article-title":"\u201cThe smoking toolkit study\u201d: a national study of smoking and smoking cessation in England","volume":"11","author":"Fidler","year":"2011","journal-title":"BMC Public Health"},{"key":"2025121510365611000_14.8.e087491.26","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.10161","article-title":"Comparison of Trends in Self-reported Cigarette Consumption and Sales in England, 2011 to 2018","volume":"2","author":"Jackson","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2025121510365611000_14.8.e087491.27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001990","article-title":"Why are some population interventions for diet and obesity more equitable and effective than others? The role of individual agency","volume":"13","author":"Adams","year":"2016","journal-title":"PLoS Med"},{"key":"2025121510365611000_14.8.e087491.28","unstructured":"World Health Organization . The SAFER initiative Secondary The SAFER initiative. 2018."},{"key":"2025121510365611000_14.8.e087491.29","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004313","article-title":"Impact on wine sales of removing the largest serving size by the glass: An A-B-A reversal trial in 21 pubs, bars, and restaurants in England","volume":"21","author":"Mantzari","year":"2024","journal-title":"PLoS Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-087491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:37:05Z","timestamp":1765823825000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-087491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":29,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,9,18]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bmjopen-2024-087491"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-087491","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}