A national survey in England found mandatory alcohol calorie labeling could potentially influence drinking behaviors, with hazardous drinkers more likely than low-risk drinkers to adjust their behaviors.

The study published in BMJ Open surveyed 4,683 adults (2,264 men and 2,419 women), classifying them as non-drinkers (24.7%), low-risk drinkers (58.4%), or hazardous drinkers (16.9%) based on their Alcohol Use Disorders Identification Test (AUDIT) scores. The participants' mean age was 50.95 ± 19.06 years, and 79.4% identified as White British.

Overall, 57.9% of respondents indicated alcohol calorie labeling would be useful, 63.6% agreed it should be provided in shops and supermarkets, and 51.7% supported its availability in hospitality venues such as pubs and bars. Non-drinkers were the most supportive of adding calorie labels across all venues, but the two drinking cohorts were also largely supportive of the move.

The researchers reported that 53.5% of hazardous drinkers would change their drinking patterns if calorie labeling was introduced, compared to 44.4% of low-risk drinkers. The hazardous drinker cohort was more likely than the low-risk drinker cohort to make specific changes as well, with 16.8% saying that if calorie labeling was introduced, they would drink fewer alcoholic drinks, 17.7% saying they would drink less often, 27% saying they would choose lower-calorie drinks, and 17.7% saying they would do more exercise. 

Among all drinkers the most commonly selected behavioral change was choosing lower calorie drinks, followed by drinking alcohol less frequently, consuming fewer alcoholic drinks, doing more exercise, choosing smaller servings of alcohol, and eating smaller meals or fewer snacks.

Knowledge of calorie content was generally higher among drinkers, with overestimation more common than underestimation. Accuracy rates for different beverages were spirits (51.5%), white wine (41.3%), cider (33.5%), and beer (28.1%). For example, 44.8% of hazardous drinkers overestimated beer calorie content.

The study used data from the Ipsos Mori Omnibus Survey collected between November 2022 and January 2023. Participants were categorized based on AUDIT scores: non-drinkers (0), low-risk drinkers (1-7), and hazardous drinkers (≥8). AUDIT scores averaged 3.50 ± 1.81 for low-risk drinkers and 11.30 ± 3.95 for hazardous drinkers.

Demographic analysis revealed that men were more likely to be hazardous drinkers than women (22.5% vs 11.7%). Hazardous drinkers were on average 8.42 years younger than low-risk drinkers. Alcohol consumption and hazardous drinking were positively associated with education and socioeconomic position.

The study's findings were comparable to the Health Survey for England, with 29.1% of men and 15.9% of women classified as hazardous drinkers in the study sample, compared to 28% of men and 15% of women drinking above recommended levels in the Health Survey.

The study's limitations included reliance on self-reported data, potential recall bias, and the hypothetical nature of behavior change questions. The sample included relatively few individuals reporting very high levels of alcohol consumption.

The authors declared having no competing interests.