Consumer engagement with the US alcohol health warning: A nationally representative study

The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning.

We recruited a nationally representative sample of 1,036 US alcohol consumers ages 21 + years. Participants completed an online survey in 2024 that assessed whether they had noticed or read the current US alcohol health warning, as well as aided recall of the topics in the warning. Analyses used multivariable logistic regression to examine correlates of reading the warning.

About half of participants (52 %) reported noticing the alcohol health warning the last time they saw an alcohol container and 27 % reported reading the warning in the past month. Reading the warning was more common among Black people (vs. white, 43 % vs. 23 %, p = 0.02). When prompted with a list of possible warning topics, only 4 % of participants correctly recalled all five topics in the warning. Most (60 %) recalled that the warning discussed pregnancy, but less than half recalled the remaining topics in the warning (46 % driving a car, 44 % operating machinery, 41 % birth defects, and 33 % health problems). Recall was modestly higher among those who read the warning in the past month (improvements of 5-16 percentage points) compared to those who did not. However, fewer than two-thirds of people who said they had read the warning recalled each topic.

The current US alcohol warning fails to actively engage many alcohol consumers. The US should require new, rotating alcohol warnings designed to heighten engagement and better inform consumers.