Alcohol container labels might reduce population-level alcohol-related harms, but investigations of their effectiveness have varied in approach and quality. A systematic synthesis is needed to adjust for these differences and to yield evidence to inform policy. Our objectives were to establish the effects of alcohol container labels bearing one or more health warnings, standard drink information, or low-risk drinking guidance on alcohol consumption behaviour, knowledge of label message, and support for labels. We completed a systematic review according to Cochrane and synthesis without meta-analysis standards. We included all peer-reviewed studies and grey literature published from Jan 1, 1989, to March 6, 2024, in English, French, German, or Spanish that investigated the effects of alcohol container labels compared with no-label or existing label control groups in any population on alcohol consumption behaviour, knowledge of label message, or support for labels. Data were synthesised narratively as impact statements and assessed for risk of bias and certainty in the evidence. A protocol was preregistered (PROSPERO CRD42020168240). We identified 40 publications that studied 31 labels and generated 17 impact statements. 24 (60%) of 40 publications focused on consumption behaviour and we had low or very low certainty in 13 (59%) of 22 outcomes. Alcohol container labels bearing health warnings might slow the rate of alcohol consumption (low certainty), reduce alcoholic beverage selection (moderate certainty), reduce consumption during pregnancy (low certainty), and reduce consumption before driving (moderate certainty). Interventions with multiple types of rotating alcohol container labels likely substantially decrease alcohol use (moderate certainty) and reduce alcohol sales (high certainty). To the best of our knowledge, this is the first systematic review on multiple types of alcohol container labels assessing their effects for certainty in the evidence. Limitations included heterogeneity in label designs and outcome measurements. Alcohol container labels probably influence some alcohol consumption behaviour, with multiple rotating messages being particularly effective, although effects might vary depending on individual health literacy or drinking behaviour. Alcohol container labels might therefore be effective components of policies designed to address population-level alcohol-related harms.

中文翻译：

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酒类容器标签对消费行为、知识和标签支持的影响：系统评价


酒精容器标签可能会减少人群中与酒精相关的危害，但对其有效性的调查方法和质量各不相同。需要进行系统综合来调整这些差异并提供证据来为政策提供信息。我们的目标是确定带有一项或多项健康警告、标准饮料信息或低风险饮酒指南的酒精容器标签对酒精消费行为、标签信息知识和标签支持的影响。我们根据 Cochrane 和综合完成了系统评价，没有荟萃分析标准。我们纳入了 1989 年 1 月 1 日至 2024 年 3 月 6 日期间以英语、法语、德语或西班牙语发表的所有同行评审研究和灰色文献，这些研究调查了酒精容器标签与无标签或现有标签对照组的影响任何人群的饮酒行为、标签信息知识或对标签的支持。数据被叙述性地综合为影响陈述，并评估证据中的偏见风险和确定性。已预先注册协议 (PROSPERO CRD42020168240)。我们确定了 40 份出版物，研究了 31 个标签并生成了 17 份影响陈述。 40 份出版物中有 24 份 (60%) 关注消费行为，而 22 份结果中有 13 份 (59%) 的确定性较低或非常低。带有健康警语的酒精容器标签可能会减慢饮酒速度（低确定性）、减少酒精饮料的选择（中等确定性）、减少怀孕期间的饮酒（低确定性）以及减少开车前的饮酒（中等确定性）。 对多种类型的旋转酒精容器标签进行干预可能会大大减少酒精的使用（中等确定性）并减少酒精销售（高确定性）。据我们所知，这是对多种类型的酒精容器标签的首次系统审查，评估其对证据确定性的影响。局限性包括标签设计和结果测量的异质性。酒精容器标签可能会影响一些酒精消费行为，多种轮换信息尤其有效，尽管影响可能因个人健康素养或饮酒行为而异。因此，酒精容器标签可能是旨在解决人口层面酒精相关危害的政策的有效组成部分。