Evaluating and optimising mandatory health labels on alcohol including a world-first cancer warning

Alcohol consumption is a major driver of preventable disease and mortality in the UK, causing over 22,000 deaths and 1 million hospital admissions annually in England. Public awareness of alcohol-related health risks—particularly cancer—remains low, especially in deprived groups who experience higher rates of harm. In July 2025, the UK Government committed to introducing mandatory health labelling on alcoholic drinks in their 10-Year Health Plan for England. Labels are a low-cost, high-reach public health intervention that can change knowledge, attitudes, and consumption, ultimately reducing alcohol-related harms. Any mandatory health labels which are introduced in the UK must be underpinned by robust development and testing. Decisions around the design, format, content, and positioning of mandatory labels should be co-designed with the public and stakeholders. Identified options for mandatory labelling should then be robustly and iteratively tested to identify those most likely to deliver public health benefits. Development and testing should also fully explore the causal pathways by which labels have impact (e.g. salience, attitudes, knowledge, norms, or intentions) and assess how these vary across subgroups. PHASE A of our theory-driven, systems-informed programme will deliver this robust development and testing. We will draw on evidence and engagement with the public, stakeholders, and experts to design and optimise UK alcohol health labels, examining their effects on purchasing and key drivers of impact. Phase A has 3 work packages (WPs): WP1: Context – repeat surveys with a nationally representative sample of adults (1a) and examining industry perspectives on alcohol labelling (1b) WP2: Optimisation – evidence synthesis (4a), deliberative public workshops (4b), stakeholder interviews (4c), and expert input (4d) WP3: Testing – mixed-method ‘pre-testing’ (3a-c), in-depth longitudinal/eye-tracking experiments with the ‘best-performing’ labels (3d–e). Finally, WP3 will include focus groups to explore public perceptions of real-world alcohol warning labels in Ireland where labels are set to be introduced before the UK (3f). All activities are underpinned by WP0. This includes ongoing synthesis, an evolving logic model, and public/other stakeholder engagement, to guide data collection, analysis, and synthesis. The progress and design of Phase B will be subject to a mid-programme checkpoint. Decisions at this checkpoint will take into account findings from Phase A and policy developments in the UK and elsewhere. Ideally, Phase B would involve evaluation of the implementation and impact of real-world labels in the UK. This evaluation could include: • examining the implementation of a national mandatory label programme, including related media reporting • pre/post comparative surveys in the UK, ideally with matched data from another jurisdiction, to examine label impacts and drivers of impact, • interrupted time series analysis (ideally controlled) of impact on alcohol sales, and, if possible, • modelling of the potential longer-term health and health economic impacts of mandatory health labels. INNOVATION & IMPACT: This programme includes world-leading iterative collaborative label development and testing in the UK. Programme outputs will directly inform UK and global alcohol health labelling policy development, legislation, regulatory approvals and implementation, reduce alcohol harms, and improve health equity.