Category: Uncategorized

By Natasha Clarke – Research Associate, UCL

Imagine you went up to a bar, ordered a large glass of wine and it was served to you in a pint glass. People would look at you funny. The wine might not taste the same. You might not enjoy the drinking experience. We associate wine glasses with drinking wine, whisky glasses with whisky, pint glasses with beer… You get the gist. Often when we go to a pub and ask for a beer, they have a unique glass to serve each brand in. Different shapes and sizes of glasses are associated with specific drinks and many of us may perceive this as adding to the drinking session. Often, branding is displayed on glassware too, in case you’re so drunk during that fifth Guinness you need a reminder of what you’re drinking.

The point here is, from a marketing perspective, the glass is an integral tool which has been described as “integral to the moment of consumption”, suggested to have equal importance to other marketing methods (e.g. product design, sponsorship, packaging). Alcohol research indicates different sizes and shapes impact on drinking rates, yet glasses are not subject to the same scrutiny and control from a public health, harm-reduction perspective as other marketing techniques.

Currently in the UK, alcohol labels with unit guidelines are displayed (if you look hard enough) on alcohol products. A recent study suggested people pay minimal attention to these labels, and that is if they have the chance to be seen. What if you arrive at a house party and your friend pours you a vodka and lemonade? Or you are in a pub and you’re served a pint of draught beer? In addition, if labels in their current form are displayed and noticed they are unlikely to impact on our behaviour; many people lack knowledge of units, with knowledge lowest in those who drink heavily. Even in those who are aware of the concept of a unit, units are often not used to reduce drinking.

For a section of my PhD studies* I decided to investigate the impact of labelled glasses on drinking behaviour, in a population of majority undergraduate students. For my first glass label study I used a pre-existing measurement tool available from the drink charity Drink Wise to see whether glass labels with unit and warning labels, and safe daily guidelines** could reduce consumption compared to a plain glass of the same size and shape. I investigated this in a bar-laboratory with pairs of student social drinkers, to create an environment as close to a ‘typical’ drinking setting as possible. Results indicated the glasses did not influence drinking behaviour, consumption of beer and wine was roughly the same in each group over a 20 minute period.

I conducted focus groups to explore the potential reasons for the lack of differences between groups. The majority of participants stated that they could not relate to, and often did not use units to guide behaviour. Units were described as ‘not being taken too seriously’ anymore, with an emphasis on the message being boring and repetitive. This shows that even when unit labels are displayed and noticed at the moment of consumption, they are unlikely to be utilised to change behaviour, supporting previous research.

Another point raised in these focus groups (by female participants especially) was that calorie information would be more likely to change behaviour than unit information. Calorie information is mandatory on food, but is not required on alcohol products, which doesn’t make a lot of sense.

Appetite research indicates that the provision of calorie information alone has inconsistent effects on eating behaviour, but including exercise information (i.e. you will have to walk for 1 hour to burn off this pint) can be effective in reducing consumption and impacting food choice. In addition, websites/phone apps with drinking reduction tools, often include food equivalent information on their unit calculators (i.e. the calories in this pint equate to half a burger), a form of information that may be particularly useful for individuals who are more sedentary. Therefore, for my next study I investigated glass labels displaying calorie information with the addition of exercise or food equivalent information.

Another point raised in the focus groups was that the glasses were not aesthetically pleasing, and participants emphasised that they would not drink wine out of half pint glasses with ‘childlike’ labels. So for this study I used pint glasses and designed my own labels that were more simplistic (but large enough to be noticed). I investigated these glasses in the bar-lab, but this time I tested participants individually, as I found a very high modelling effect when testing in pairs, supporting research showing the same.

I found that for participants overall, these glass labels did not reduce drinking. However, when I explored this further and separated groups by gender, exercise labels significantly reduced drinking in female participants. This indicates calorie and unit labels alone do not reduce consumption, supporting recent findings by Maynard and colleagues in Bristol, in which displaying this information on a slip of paper also did not influence consumption. However, exercise equivalent labels show promise and this is an area that should definitely be investigated further, along with alternative forms of displaying nutritional information.

Again, I conducted focus groups to gain further insights into these findings. Participants were a lot more accepting of these labelled glasses (compared to the unit glasses used in the previous study) and the majority indicated that they could be effective in reducing drinking. Specifically they emphasised that they found it much easier to relate to and understand information when presented in this form. However, they did make it clear that this may change once in a drinking occasion and that I was ruining their fun. Fair enough. Many students do drink for sociability reasons, or for enhancement, and the majority do mature out of this. It may be that different populations are looking to change and are ready for their fun to be ruined. These types of labels may have increased impact in those who want to cut down, and therefore this form of information warrants further research in a variety of populations.

Another worrying finding from the focus groups was the potential of this type of information in increasing ‘drunkorexia’ behaviours, which I have previously written a blog about (see here). ‘Drunkorexia’ is a non-medical term used to describe diet related behaviours that are related to and used to compensate for the consumption of alcohol and its calories, such as skipping meals and excessively exercising. This does not necessarily mean nutritional information should not be provided as we have a right to know it, but measures to decrease the likelihood of these behaviours should be provided alongside.

To conclude, key findings from these studies were that:

1) Unit information alone is not sufficient for behaviour change. Nutritional information (alongside relatable equivalents) could be useful; participants were accepting of it and there is no reason for it not to be displayed. However, it is not a standalone intervention, and should be provided alongside other harm-reduction methods.

2) Glasses are an accepted and potentially effective method to display this information.

3) Focus group findings suggest that the drinking culture of students and their predetermined intoxication levels are very robust to change.

*Studies currently being written up for publication- contact author for further information.

**Note: previous guidelines (of 2-3 units per day for women and 3-4 units per day for men) as these studies were conducted before new guidelines were introduced.

By Craig Gunn – PhD student, University of Bath

We’ve all been there – the headache, the fatigue, and the sickness – the inevitable hangover that follows after heavy alcohol consumption on a night out.

Trying to work the next day, if we even feel up to going in, can be near-impossible, and even driving to get there can feel unsafe. With vast implications for public safety, the economy and the workplace, understanding how a hangover effects cognition and behaviour is vitally important. However, studying the next-day effects of a night of heavy drinking is not as straightforward as it may seem.

An experimentally induced hangover

Studies that explore the cognitive effects of acute alcohol intoxication use the ‘gold-standard’ double-blind, placebo-controlled experimental approach. In these studies, participants receive either alcohol (usually vodka and orange), or a placebo (orange juice with a small amount of vodka ‘floated’ on top). Both the researcher and the participant are not aware of which drink is being consumed until the end of the study. This manipulation is intended to prevent participant’s expectancy about alcohol (e.g. feelings of relaxation) and the bias of the experimenter influencing the effects of alcohol on the measured outcome.

During these studies, the amount of alcohol given to each participant is controlled so that individuals reach a similar blood alcohol concentration. Studies are typically conducted in the laboratory where other variables that may influence performance are controlled, such as noise. This model can also be applied to studies of alcohol hangover. A set dose of alcohol can be administered in an evening using the double-blind placebo controlled method, and participants can either go home and return the next morning or sleep in the laboratory (if facilities are available).

Unfortunately, there is a problem with this approach when studying the effects of alcohol hangover. The condition assigned (alcohol or placebo) is readily guessed by participants, and the large amounts of alcohol needed to induce a hangover, may leave ethics committees feeling uneasy. For example, in studies of acute alcohol intoxication a ‘high dose’ of alcohol which is usually approved by ethics committees is around 2.5 pints of a 5% ABV lager consumed within 30 minutes. However, to replicate the levels of drinking typically seen prior to experience of a hangover, participants would need to drink the equivalent of 4.5 pints in 30 minutes.

A naturally induced hangover     

Perhaps unsurprisingly, the higher the amount of alcohol an individual consumes, the more likely they are to report having a hangover the next morning. Higher levels of alcohol consumption are associated with greater reports of hangover severity and poorer performance on tests of attention. The association between levels of alcohol consumption and performance on cognitive tests during hangover has created a lot of debate between researchers on how to conduct hangover studies. Clearly the dose of alcohol is important, and higher doses in studies may increase the likelihood of cognitive impairment being detected during hangover. In order to effectively measure cognition the morning after a night of heavy drinking, participants may need to consume higher amounts of alcohol than are possible in an experimental model of hangover induction. To address this, some researchers have adopted a ‘naturalistic’ method, which asks participants to attend a test session the morning after a night where they had planned to go out drinking, and participants are free to drink the amount and type of alcohol they normally would. This approach has enabled researchers to explore hangover effects after participants have consumed more alcohol than has been possible using an experimental approach (around 5 pints compared to 2.5 pints).

The naturalistic method is not without its criticism. Although higher doses of alcohol are consumed which may make this approach more sensitive to measuring hangover effects, the lack of control (i.e. placebo) makes it difficult to discover the mechanisms underlying the cognitive effects of hangover. Another line of research suggests that the type of beverage consumed may be important when considering the next-day effects of alcohol. Unlike the experimental method, the naturalistic approach does not allow the type of drink consumed to be controlled for (e.g. vodka). In real-life drinking situations people often mix drinks. This is potentially problematic as different drinks have different congener content (e.g. dark drinks such as red wine have a larger amount of congeners than lighter coloured drinks such as gin). Congeners are bi-products of the alcohol fermentation process, such as methanol, which have implicated to be important in the development of hangover. Similarly, it is not possible to control for differences in activity in the naturalistic method, and physical activity, such as dancing, may influence cognitive abilities during hangover. Another factor which is known to impact performance is sleep, and in real-life situations it is not uncommon that sleep time is sacrificed for drinking time.

The future of inducing a hangover

Some of these criticisms could be addressed with the use of wearable technologies, where sleep and activity could be monitored. However, a hangover consists of a combination of symptoms (e.g. nausea, anxiety etc.), which may be influenced by many complex and interacting mechanisms. Therefore, an approach which incorporates and examines a range of contributory factors (e.g. mixing drinks, physical activity) may be needed to understand the influence of hangover on cognition and behaviour. For this, the naturalistic approach is ideal. With improvements in hangover research methodology, greater understanding of the mechanisms which underlie hangover effects can be achieved, which in turn could improve public safety, workplace dynamics, and the economy.

Exploration of how hangover effects our thoughts and behaviours is a fascinating area of research with vast implications for everyday life, such as work performance and driving. Researchers are now beginning to use a range of methods to unravel the effect hangover has on our attention, memory and psychomotor abilities, and the development of more robust and relevant methodology to study this field will only strengthen the validity of results.

By David Troy – Research Associate, Tobacco and Alcohol Research Group, University of Bristol

In 2016, the UK chief medical officers revised their low-risk drinking guidelines, which followed a review of the latest evidence of the health effects related to alcohol consumption. The Portman Group, the organisation established by the alcohol industry to promote responsible drinking is no longer advising its members to include these low-risk guidelines on their products as a minimum requirement. Their position is that labels should include information about drinking in pregnancy, the number of alcohol units in per container and the Drinkaware website as three key priorities. Other information is outlined as optional additions. John Timothy, CEO of the Portman Group, has explained this decision by suggesting that the health information drinkers need is already available to them. He has said that “Producers are encouraged to feature proactive signposting to Drinkaware.co.uk where consumers can find a full range of health information including calories, lifestyle advice and smart apps”. Drinkaware is an industry-supported charity that argues that it is autonomous, although its independence has been called into question by an independent review and the UK Parliament’s Health Select Committee. The new Portman Group line appears to be a departure from recent policy, which has seen them support voluntary initiatives that promote corporate social responsibility. The most prominent of these is the ‘Public Health Responsibility Deal’. In this deal, industry members pledged to include labels with clear unit content, NHS drinking guidelines and warnings about drinking in pregnancy on 80% of their products in the off-trade among other pledges.

The Wine and Spirit Trade Association, the British Beer and Pub Association, the National Association of Cider Makers, and the Scotch Whisky Association also support the Portman Group’s guidance. Miles Beale, chief executive of the Wine and Spirit Trade Association, defended the decision not to advise firms to include the guidance on labels, arguing that all health information is available on the Internet: “We are providing more information than ever before online, including guidance on health information and calorie content, alongside the revised Chief Medical Officers’ guidelines”. However, some organisations, such as the British Retail Consortium and the brewer Tennant’s, have already updated labels on their products to include the new government guidelines.

A new alcohol consumer organisation, Drinkers’ Voice, has come out against having the new guidelines on alcohol products. Drinkers’ Voice claims to represent moderate drinkers but in a recent survey of 972 drinkers carried out a month after the new guidelines were released, 63% strongly agreed or agreed with the statement “The government has a responsibility to release guidance on how drinkers can minimise health risks”, while 11% strongly disagreed/disagreed and 26% responded neither/don’t know. This seems to contradict Drinkers’ Voice director Byron Davies claim that “People just don’t want to listen to the government when it comes to alcohol advice anymore”. Also, 71% of respondents were aware of the new guidelines, but only 8% knew what the recommended limits were. So, it appears that drinkers do want the government to inform them of ‘low-risk drinking levels’ and are aware of the information when it is released, but are unable to recall the new limits. What better place to communicate this information that is wanted by drinkers than on alcohol products they consume on a regular basis?

The government has responded, with a Department of Health spokesman saying: “We have been clear to the industry that we expect the UK Chief Medical Officers’ guidance be reflected on alcohol labels, and have provided clear advice and examples of how best to display the message. They can be reflected simply by a reference to the weekly recommendation of 14 units, the no drinking in pregnancy logo and the Drinkaware logo”. The Department of Health has given manufacturers until September 2019 to remove the old advice on drinking levels from their products. However, without legislation compelling drinks manufacturers to include the new drinking guidelines on their products, we will have no drinking guidelines on the majority of alcohol products.

In the service of clarity, the new guidelines are that men and women who drink regularly are safest if they drink no more than 14 units per week, that it is best to spread the 14 units over a period of 3 days or more, and that the safest approach for women who are pregnant is not to drink at all. Having labels on alcohol products that include these guidelines is motivated by a principle that consumers have a right to know what harms can come from what they consume rather than wanting drinkers to consume less. The limited evidence available suggests that while promotion of alcohol guidelines might raise awareness of recommended drinking limits, they do not reduce alcohol consumption. This position is shared by the four UK Chief Medical Officers (from England, Wales, Scotland and Northern Ireland) who carried out the review of the lower risk drinking guidelines. Their rationale behind the new guidelines was that everybody has a right to accurate information regarding health risks associated with alcohol consumption and it is the government’s responsibility to provide such information so the public can make informed choices about their drinking.

 

By Krystian Przydzial – 3rd year Experimental Psychology undergraduate student, University of Bristol

During my second year of university, I was considering different summer opportunities to gain valuable work experience in a field that I may want to work in. I approached a number of staff members in the psychology department who could offer a summer research project for me work on. After approaching the Tobacco and Alcohol Research Group (TARG) in the psychology department, it struck me as group which could offer an insightful opportunity into research. I was told about the Alcohol Labelling project, and after reading more papers that have been published by the staff – including Angela Attwood, Marcus Munafó, and many other talented research members – I decided that this was an opportunity that I wanted to be part of.

The next step was looking into vacation studentship schemes for a grant which would fund my time during the summer that I would be working. Angela Attwood (my supervisor) and I mutually agreed on the Wellcome Trust: a biomedical research charity, which offered funding for students wanting to engage in research in the summer before their final year of university.

The application entailed sections about my career aspirations and interests in research which was quite a daunting yet useful process which made me really consider post-university plans. A research proposal also needed to be submitted, which I was able to complete after guidance from Angela to inform me more about the Alcohol Labelling project.

Completing 8 weeks as a research member in TARG has been very eye-opening and rewarding. Psychology at Bristol really focuses on the experimental element – so I’ve developed a solid understanding of different research methods. But I was also aware that I didn’t know what it really meant to work in research. I was exposed to the ins and outs of running an experiment – which is especially disciplined within TARG due to drug administration and a comprehensive list of things that must be done with every study. Seeing the entire process of an idea for a research study develop and reach a point of recruitment is not really something that I was ever taught or exposed to on a detailed level (nor is it really something that can be taught by just sitting in a lecture). By seeing the whole process, I felt a real sense of reward from turning an idea to a study being run. This practical experience is invaluable and will make me feel more confident entering my own experiment that I will have to run as my final year project. TARG also seems to have a real emphasis on the importance of teamwork. All the dedicated research members are consistently working together and sharing ideas to create something far better than a single person could ever achieve. Teamwork has also given me the opportunity to learn even more about psychology; as everyone was happy to share their knowledge and current research that they are a part of.

The specific project which I was responsible for was designing and testing a pilot study which involved assessing the feasibility of group procedures. The aim was to create a more sociable environment which more accurately depicted a setting that people would consume alcohol in. People had a pint of lager in groups of 3-5 people and were exposed to novel interactive beer mats. These beer mats displayed information about how many calories and units are in their alcoholic drink, alongside with health warnings about the dangers of alcohol. It was my responsibility to design measures of quantitatively assessing participant’s responses the beer mats and if they believe that it is an effective way of conveying more information about alcohol which could potentially be available in pubs/bars.

This was the link to the bigger Alcohol Labelling project of assessing ways of conveying more information about alcohol to the general public, just like food items have calorie information and cigarettes display health warnings. The project is ongoing and I was happy to be a part of a project which could potentially help the general public to be more informed and perhaps consider a more controlled and healthy lifestyle.

By Dr Inge Kersbergen – Postdoctoral researcher, University of Liverpool

If you drink alcohol, you’ve seen them many times, but probably don’t pay too much attention to them: Warning labels. The UK’s current warning labels were introduced in 2011, when alcohol companies pledged to put them on 80% of alcoholic drink containers as part of the public health responsibility deal. They look something like this:

Research shows that alcohol warning labels have little to no effect on drinking behaviour. This may be because people are reading the labels, but don’t care about the potential health consequences, or it could be because people simply aren’t reading the warning labels in the first place. There is some evidence to suggest the latter, but there are many things we don’t know yet: We don’t know how much attention alcohol consumers pay to warning labels on alcohol packaging, how much their attention is related to individual differences in drinking behaviour and motivation to change it, and whether increasing attention to warning labels on packaging is likely to result in behaviour change.

I investigated alcohol warning labels as part of my PhD, and last year we published a paper to address this gap in the literature. We ran two studies to investigate how much attention is paid to alcohol warning labels, and how different viewing patterns are associated with individual differences in drinking behaviour and motivation to change it.

In both studies, participants looked at twenty alcohol products for fifteen seconds each. We had taken four pictures of each product (front, back, close-up of the front label, close-up of the back label), and participants could decide which parts they wanted to look at using the arrow keys (see gif below for an example). An eye-tracking camera measured where participants were looking at any given time. This information allowed us to calculate how long people were looking at the warning label and branding on each product.

http://gph.is/2z9C1rH

In the first study, we looked at how much attention people pay to the warning labels in general, and whether the amount of attention people pay to the warning labels is related with how much they typically drink and how motivated they are to cut down on their drinking. We found that participants looked at the alcohol warning label for roughly one second per product (7% of the total time they could look at the product). Attention was not related with how much alcohol people typically drink, but it was associated with motivation to reduce drinking. Participants with a higher motivation to reduce drinking paid less attention to the branding on alcohol packaging, and also paid less attention to the warning labels.

Because this study looked at correlations, we don’t know whether motivation to reduce drinking causes people to pay less attention to alcohol branding and warning labels, or the other way around. For example, it is possible that someone who is motivated to reduce drinking avoids alcohol-related content (branding and warning labels), but it is also plausible that someone who typically pays more attention to alcohol-related content is less motivated to reduce drinking than someone who doesn’t pay as much attention to alcohol-related content. In the second study, we investigated these two potential causal mechanisms.

To find out if motivation to reduce drinking had a causal influence on attention, we gave half of our participants an alcohol brief intervention to increase their motivation to reduce drinking, and the other half a control intervention that was not related to alcohol. After the intervention, we measured how much attention people paid to warning labels and branding in the task I described earlier. We found that participants who received the alcohol intervention paid less attention to alcohol branding than those in the control condition. There were no differences with regard to attention to health warnings. Then, to find out if viewing patterns had a causal influence on intentions to drink, we manipulated attention to alcohol packaging in such a way that participants either had to attend to warning labels or branding, before asking participants how much they intended to drink in the next week. We found no differences in how much people intended to drink after paying attention to the warning labels compared to the branding.

Across these two studies, we showed that people paid minimal attention to warning labels on alcohol packaging, even if they were motivated to reduce drinking. A possible explanation is that people do not particularly notice warning labels, due to their current design. We measured how large the warning labels were in our study, and we found that they take up less than 5% of the packaging. This suggests that the amount of attention they receive is roughly proportional to their size. A closer look at our findings suggest that larger alcohol warning labels attracted more attention, and this is in line with research on tobacco warning labels that showed that people remembered larger warning labels better than smaller labels.

Another explanation is that participants pay little attention to the warning labels, because they don’t think they are relevant for them. The UK labels do not show the risks associated with drinking more than the recommended guidelines, and research suggests that “drink responsibly” messages are used to encourage drinking instead of raising awareness of the harmful consequences of alcohol consumption. Therefore, participants who are motivated to reduce drinking might view the warning labels as another part of the product’s branding, and subsequently avoid them.

Based on these two possible explanations, it would be useful to change both the label content and design to make the label better at attracting and maintaining attention. This echoes the advice of other researchers who have argued that alcohol warning labels should be more like tobacco labels and provide clear information about risks and unambiguous recommendations for healthy behaviour.

We did this research before the change in the drinking guidelines in January 2016, when the old guidelines were still in use. The change in the guidelines would have been an excellent opportunity to improve the warning label. Sadly, that didn’t happen. A few months ago, the Portman Group published new labelling guidance for alcohol producers. Instead of updating the labels to include the new guidelines, they removed any reference to the drinking guidelines from the minimum requirements, so warning labels will be even less informative than before.

Meanwhile, researchers are developing new alcohol warning messages that look promising (such as information about the cancer risks associated with alcohol) and I’m hopeful that one day we’ll see them clearly displayed on our alcohol products.

By Olivia Maynard – Senior Research Associate, Tobacco and Alcohol Research Group, University of Bristol

Over the past two years we’ve invited hundreds of people into the lab to drink beer. Unfortunately, we weren’t there to socialise; this was in the name of science. We wanted to know whether giving people information about the number of units and or calories in their beer influenced how much they drank and their perceptions of drinking.

There are strong arguments for including this information: providing unit information may increase knowledge about alcohol consumption and calorie information may help drinkers choose lower calorie (and as a result lower unit) beverages. However, we also wondered whether there might be some unintended consequences of providing this information, particularly for those who are highly motivated to drink. What if unit information simply allows these drinkers to choose higher strength drinks and calorie information only discourages them from eating more, not drinking less? What if discussion around mandatory unit and calorie labelling is distracting us from the bigger issues: health warnings, minimum unit pricing, improving treatment for alcohol dependence and stopping alcohol advertising to young people, to name a few?

So, with this healthy level of scepticism, we set about inviting 264 regular alcohol consumers (mostly undergraduate students) to attend a lab session where they were given some beer and completed some taste ratings. What participants didn’t know was that they had been randomly assigned to one of four conditions. One group had information about the calorie and unit content of the beers, one group just got calorie information, another had just unit information, and the final group got no information at all. As well as measuring how much beer they drank, we also asked participants to reflect on the likely impact of unit and calorie information on their drinking behaviour.

You can read all the results in our (open access) paper that was published this week in the journal Alcohol and Alcoholism. If you want the concise version: we found no evidence that either unit or calorie information influenced how much beer people consumed and we found a lot of variation in the amount people drank.

However, it was our analysis of participants’ thoughts on unit and calorie information that proved vital to understanding what was going on here. Our participants told us that their main motivation for drinking alcohol was usually to get drunk; where unit information was perceived as being helpful, this was to help them choose the highest strength drink. Unit and calorie information was seen as distracting from the social aspect of drinking, and although some participants felt that calorie information might reduce consumption, most thought it would affect others, not themselves. Some people thought that calorie information could be misused by encouraging people to eat less (to compensate), rather than drink less.

It’s interesting that even though the unit and calorie information was very visible in our study (on a piece of paper, presented for 10 minutes), those who had received this information were still very inaccurate when it came to reporting how many units and calories were in their drinks. They basically didn’t seem to have read or engaged with it. If they’re not reading it in this context, is it likely that drinkers will read this information when it’s printed in tiny font on the back of the bottle?

So, what does this all mean for any plans to introduce unit and calorie information? Our study only really tells us about the potential impact of unit and calorie information among young adults (many of whom were students) who tend to drink to get drunk. However, our findings do call into question whether mandatory unit and calorie labelling on its own would reduce how much people drink, and also highlights potential negative unintended consequences of providing this information.

Despite some of these potential unintended consequences, there are still reasons to include unit and calorie information, if only because it’s a consumer right (you know how many calories are in just about everything else you consume). However, perhaps more effort needs to be placed on making this information more engaging and embedding it into public understanding of recommended drinking levels. Coincidentally, an analysis of the public’s awareness of new national alcohol guidelines was also published yesterday. This report argues that although the public have a relatively high awareness of what the guidelines are, they should be put into context by increasing the public’s awareness of the links between alcohol and cancer. Perhaps using health messages such as ‘Drinking alcohol regularly is linked to long-term risks such as cancer’, alongside unit and calorie information, might result in more meaningful changes in attitudes and behaviours around drinking. I feel another study coming on….

Olivia Maynard can be found on Twitter at @OliviaMaynard17