New alcohol warnings outperform the current U.S. warning in a national survey experiment

Objective: To identify which topics for alcohol warnings most motivate people to reduce their drinking and best inform them of alcohol's harms. Methods: A nationally representative sample US adults (n=1,036) aged ≥21 years who drink alcohol completed an online survey in September–October 2024. Participants viewed 10 messages (one control message and nine warning messages) in random order. The nine warning messages were the current US warning plus eight new warning topics (e.g., colorectal cancer, dementia). Participants rated each message on the extent to which it encouraged them to drink less alcohol (perceived message effectiveness, 1–5 scale, primary outcome), the extent to which it reminded them of the harms of alcohol consumption (1–5 scale), and whether they learned something new. Results: Compared to control, all nine warning topics were perceived as more effective (range of predicted means: 1.93–2.66 for warnings vs. 1.35 for control, ps<.001), better reminded participants of alcohol's harms (range of predicted means: 2.33–3.15 for warnings vs. 1.40 for control, ps<.001), and were more likely to help participants learn something new (range of predicted probabilities: 18%–54% for warnings vs. 14% for control, ps<.05). All new warning topics except for drinking guidelines were perceived as more effective than the current US warning (ps<.001). Among new warning topics, cancer, dementia, liver disease, and hypertension showed the most promise. Conclusions: New alcohol warnings are a promising strategy for informing people and encouraging them to drink less, especially warnings focused on cancer, dementia, liver disease, or hypertension.