Alcohol is the leading cause of poor health, illness, and mortality amongst adults in the UK. The NHS is spending around £3.5 billion every year on alcohol-related harms, suggesting that it is a major public health challenge currently faced in England.

In 2011, the Department of Health (DoH) launched the Responsibility Deal to promote better health, including tackling the alcohol ‘epidemic’.

One main issue the government aimed to address was ensuring for clear alcohol labelling (to include alcohol units, NHS guidelines, and a warning about drinking when pregnant), to raise awareness of the unit content in alcoholic drink, and health harms associated with exceeding the Chief Medical Officers’ low-risk guidelines (to consume less than 14 units per week).

However, many public health organisations and academic researchers have been skeptical about its effectiveness in reducing alcohol consumption and alcohol-related harms.

Knai and her colleagues conducted a systematic review in 2015 to assess the pledges (we will focus on alcohol labelling) by examining 14 articles.

They concluded that while alcohol unit labelling effectively helps drinkers assess the amount of alcohol they consume, labels promoting drinking guidelines and warning labels during pregnancy did not seem to influence drinking behaviour.

In addition, a group of researchers looked at the impact of current alcohol labels in comparison with some novel labels. Participants were randomised into one of four conditions for unit labels: (1) basic ABV, (2) Responsibility Deal label (using units), (3) food label equivalent, and (4) pie chart.

Photograph: Blackwell et al. (2018)

They found that participants generally underestimated the number of drinks they could consume to stay within the recommended low-risk guidelines, with the basic ABV and Responsibility Deal conditions receiving the lowest accuracy scores.

This suggests that people do not know how to interpret the Responsibility Deal labels into useful information to inform their drinking choices.

As the food equivalent label and the pie chart label received higher scoring, it is possible that presenting units per serving allows a more accurate estimation of how much alcohol drinkers are consuming.

The Institute of Alcohol Studies published a report, titled Dead on Arrival? Evaluating the Public Health Responsibility Deal for Alcohol in 2015.

They wrote, “the Responsibility Deal has pursued initiatives known to have limited efficacy in reducing alcohol-related harm”.

This is reflected in my aforementioned argument. In addition to the lack of impact alcohol labels may have on changing the amount of alcohol people consume, The DoH never asked what labels will attract the public, whether people will accept it, and whether people will believe it.

The Royal Society of Public Health’s survey concluded that “ while there was some awareness of the presence of alcohol unit information, this was not generally well enough understood to facilitate its practical use.

There was confusion regarding the connection between units and individual alcohol tolerance and over what a unit equated to in practice, combined with a lack of knowledge of low risk guidelines”.

It seems pretty obvious that the public fail to understand their consumption levels in units, and the fact that units are printed on the back labels makes it even more inconspicuous: only 29% of respondents believed that units are printed on alcohol labels.

This survey identified a big problem of the Responsibility Deal: the public’s opinions were not considered prior to launching the deal.

How can you win over the public if you don’t inquire the type of information they would like to see and the preferred method of presentation that would appeal to the public? Behaviour change is difficult enough on its own.

The fact that people don’t seem to acknowledge nor understand the Responsibility Deal label proves its failure from the beginning. To implement something with insufficient evidence on its successfulness seems unscholarly.

Although it is likely that adjusting alcohol labels to drinkers’ needs may only lead to a modest change in awareness of health harms and consumption levels,

it is still important to provide the public with such information in an easy and understandable way so that drinkers can make informed choices about their drinking behaviour.

This article was originally published by Anna pun on medium.