LABEL SURVEY REPORT 20 September, 2019 ALCOHOL WARNING

ALCOHOL WARNING LABEL SURVEY

Australia and New Zealand

20 September 2019

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Contents

1	Executive Summary	1

1.1	Alcohol warning label evaluations	2

1.2	Label best conveying the message	6

1.3	Perceptions of drinking alcohol while pregnant	8

2	Introduction	10

2.1	Background	10

2.2	Methodology	10

3	Sample and Demographics	13

3.1	Sample	13

3.2	Demographics	14

3.2.1 Region lived	14

3.2.2 Maori/Pacific Islander Status	14

3.2.3 Employment	15

3.2.4 Occupation	16

3.2.5 Education	16

3.2.6 Personal annual income and main income earner	17

3.2.7 Socio-economic quintile	19

3.3	Diagnostic Variables	19

3.3.1 Self-assessed level of reading/understanding English	20

3.3.2 Proximity to Pregnancy	20

3.3.3 Alcohol consumption	21

4	Research Findings	25

4.1	Warning labels tested	25

4.2	Message label conveys - Unprompted	27

4.3	Statement best reflecting understanding of the label	31

4.4	Warning label evaluations	36

4.4.1 Extent label conveys message	37

4.4.2 Extent label is believable	41

4.4.3 Extent label is credible	44

4.4.4 Extent label applies to me	47

4.4.5 Extent label is convincing	50

4.5	Evaluation of the four labels	54

4.5.1 Label considered to best convey message	54

4.5.2 Reason for choosing label	61

4.6	Perceptions of drinking alcohol while pregnant	63

4.6.1 Drinking a small amount of alcohol while pregnant	64

4.6.2 Drinking a larger amount of alcohol while pregnant	65

5	Appendix A – Questionnaire	67

6	Appendix B – Maori/Pacific Islander Perceptions	79

7	Appendix C – Socio-economic Quintiles	80

Executive Summary

Food Standards Australia New Zealand (FSANZ) commissioned Roy Morgan to conduct an online survey in Australia and New Zealand to determine which of four statements would be the most appropriate to be included in a pregnancy warning label on alcoholic beverage containers. Ethics approval for the methodological approach was obtained from Bellberry Ltd before the research proceeded.

A total of 1,002 online interviews were obtained in each country, 200 with males aged 18 to 45 years and 802 with females aged 18-45 years. Quotas were set to obtain a representative proportion of each country’s population based on three age categories and eight regions across Australia and nine regions across New Zealand. Sample was weighted to reflect the population profile of each country.

Diagnostic questions were asked in the survey to determine proximity to pregnancy (i.e. ±18 months from the day survey) and degree of personal risk in consuming alcohol. These diagnostic questions were asked after the key label effectiveness questions were asked, so as to not bias response to those key questions. Survey results were also analysed by sex, sex by age and socio-economic quintile for each country.

Four identical labels except for the warning statement were tested. This enabled the influence of each statement on participants’ evaluations to be compared. The labels used were as follows:

It’s Safest	Any Amount Can Harm

Lifelong Harm	Alcohol Can Harm

Each respondent was initially randomly selected to view one label and answer a series of questions in relation to their perceptions of that label. They were then shown all four labels and asked to select the label that best conveyed the message “to not drink any alcohol while pregnant”.

When initially shown each label respondents were asked to state what the label conveys to them via an open-ended question. They were then asked to select the statement that best matched their understanding of the label message. These questions were asked to determine initial comprehension of the message conveyed on the label and provide context for analysis. Respondents demonstrated that they clearly understood the statement included on each label.

Alcohol warning label evaluations

A set of questions were used to assess respondents’ comprehension of the warning statement, followed by ratings of the statement’s believability, credibility, relevance and the extent to which each respondent finds the statement convincing. Label rating questions were rated on a 5 point Likert scale with a degree of positivity at one end of the scale and a degree of negativity at the other end of the scale a mean score was calculated using values of +2, +1, 0, -1 and -2. The closer the mean is to +2 the higher the degree of positivity.

Across the major sub-segments of sex and proximity to pregnancy (proximate pregnant) by country, respondents shown the label “It’s safest not to drink while pregnant” generally obtained significantly lower mean scores in conveying the message ‘Not to drink alcohol during pregnancy’ than did respondents shown the other three labels (see Table A). Those shown the label “Alcohol can harm your baby” had significantly lower mean scores than those shown the label “Any amount of alcohol can cause lifelong harm to your baby” across the majority of sub-segments and across a small number of sub-segments for those shown the label “Any amount of alcohol can harm your baby”. Respondents shown the label “Any amount of alcohol can harm your baby” had significantly lower mean scores than those shown the label “Any amount of alcohol can cause lifelong harm to your baby” amongst Australian males and Australians not proximate to pregnancy. Based on this information it can be concluded that the label “Any amount of alcohol can cause lifelong harm to your baby” has the strongest claims that it best conveys the message ‘Not to drink alcohol during pregnancy’.

Table A Extent label conveys message not to drink any alcohol during pregnancy – Mean Score for label shown by sex and proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand females n=200, Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

Green Text = Significantly higher for means in that column at the 95% confidence level. Red text = Significantly lower for means in that column at the 95% confidence level

Aside from proximate pregnant New Zealanders, respondents shown the label “It’s safest not to drink while pregnant” obtained significantly lower mean scores than those shown any of the other three labels in relation to the label being ‘believable’ (see Table B). New Zealand females shown the label “Alcohol can harm your baby” attained a significantly higher mean score for believability than did New Zealand females shown the other three labels. Those shown the label “Any amount of alcohol can harm your baby” had significantly lower mean scores amongst Australian males and Australians not in proximity to pregnancy than did those shown the labels “Any amount of alcohol can cause lifelong harm to your baby” and “Alcohol can harm your baby”, with those shown the latter label also having a significantly higher mean score amongst New Zealanders not proximate pregnant shown the label “Any amount of alcohol can harm your baby”. It can be concluded that the two labels “Alcohol can harm your baby” and “Any amount of alcohol can cause lifelong harm to your baby” were the best rated in terms of believability.

Table B Extent label is believable to me – Mean Score for label shown by sex and proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand females n=200, Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

Green Text = Significantly higher for means in that column at the 95% confidence level. Red text = Significantly lower for means in that column at the 95% confidence level

The three labels “Any amount of alcohol can cause lifelong harm to your baby”, “Any amount of alcohol can harm your baby” and “Alcohol can harm your baby” were rated almost equally in terms of their ‘credibility’, with only those shown the label “It’s safest not to drink while pregnant” attaining significantly lower mean scores across all sub-groups, except New Zealanders in proximity to pregnancy (see Table C). New Zealand females shown the label “Alcohol can harm your baby” had significantly a higher mean score for credibility than did those in this segment shown any of the other three labels, perhaps giving it a slight edge on the other labels in terms of credibility overall.

Table C Extent label is credible to me – Mean Score for label shown by sex and proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand females n=200, Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

Green Text = Significantly higher for means in that column at the 95% confidence level. Red text = Significantly lower for means in that column at the 95% confidence level

Respondents were then asked to think about their situation now and into the next few years and to indicate the extent to which the label shown “applies to them”. This preface was used to assist respondents in determining whether the label shown would or would not be more pertinent to them in based on their stage of life (i.e. likelihood of being pregnant/having children).

As can be seen in Table D negative mean scores were achieved for males, females and those not in proximity to pregnancy, irrespective of the label shown, indicating that the label did not directly apply to them. The only segments with mostly positive mean scores were Australians and New Zealanders in proximity to pregnancy. For proximate pregnant Australians those shown the label “It’s safest not to drink while pregnant” and “Any amount of alcohol can cause lifelong harm to your baby” labels had significantly higher mean scores than those shown the label Alcohol can harm your baby”, while for the New Zealand proximate pregnant group those shown the label “Any amount of alcohol can harm your baby” achieved a significantly lower mean score than those in this segment shown any of the other three labels.

Mean scores were significantly higher in terms of applicability to them for those shown the label “Any amount of alcohol can cause lifelong harm to your baby” amongst Australian males and females and Australians not in proximity to pregnancy, while those shown the label “Alcohol can harm your baby” achieved a significantly higher mean score amongst New Zealand females compared with those shown the other three labels. It can be concluded that amongst Australians the label “Any amount of alcohol can cause lifelong harm to your baby” rated best in terms of applicability, but no one label could be assessed as being the preferred label amongst New Zealanders.

Table D Extent label directly applies to me – Mean Score for label shown by sex and proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand females n=200, Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

Green Text = Significantly higher for means in that column at the 95% confidence level. Red text = Significantly lower for means in that column at the 95% confidence level

The fifth rating asked whether the label shown was ‘convincing’ to them. Australian males, proximate pregnant and not proximate pregnant shown the label “Any amount of alcohol can cause lifelong harm to your baby” had significantly high mean scores compared with those in these segments shown the other three labels, and it also had a significantly high mean score amongst Australian males (along those shown the label “Any amount of alcohol can harm your baby”. Therefore this label could be regarded as the most convincing among Australians (see Table E). No one label was clearly rated as the most credible amongst New Zealanders, although those shown the label “Alcohol can harm your baby” obtained a significantly high mean score compared with the other labels shown for New Zealand females.

Table E Extent is convincing to me – Mean Score for label shown by sex and proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand females n=200, Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

Green Text = Significantly higher for means in that column at the 95% confidence level. Red text = Significantly lower for means in that column at the 95% confidence level

The label “Any amount of alcohol can cause lifelong harm to your baby” had consistently and significantly high mean scores amongst Australians across all five rating questions, with a slight preference for this label also evident amongst the key target segment of Australians in proximity to pregnancy. In New Zealand there was no clear evidence that any specific label was preferred over the others, although there appeared to be a slight preference for the label “Alcohol can harm your baby” in terms of significance of mean scores attained. No preferred label was evident amongst the New Zealand proximate pregnant segment however.

Label best conveying the message

A final question was used to help clarify which of the four labels best conveys the message ‘to not drink alcohol while pregnant’. Respondents were shown all four label options on the one screen (with the order of display randomized to minimize order bias). Respondents were then asked to read the four labels and select the label that they considered best conveyed the message “to not drink any alcohol while pregnant”.

No matter which label was originally shown to respondents across both countries significantly higher proportions selected the label “Any amount of alcohol can cause lifelong harm to your baby” as the one that best conveyed the message “to not drink any alcohol while pregnant” (see Chart A).

Chart A analyses the label best conveying the message by sex across the two countries. More than 50% of females and males in each country selected the label “Any amount of alcohol can cause lifelong harm to your baby” as the one that best conveyed the message “to not drink any alcohol while pregnant”, significantly higher proportions than those naming any of the other three labels.

Results were also analysed by proximity to pregnancy in each country in Chart B. This chart again shows that more than 50% of those in proximity to pregnancy and not in proximity to pregnancy selected the label “Any amount of alcohol can cause lifelong harm to your baby” as the one that best conveyed the message.

Chart A Label best in conveying message ‘not to drink any alcohol while pregnant ‘for sex by country

1

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand males n=200.

Significantly higher at the 95% confidence level	Significantly lower at the 95% confidence level

Chart B Label best in conveying message ‘not to drink any alcohol while pregnant’ for proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

Significantly higher at the 95% confidence level	Significantly lower at the 95% confidence level

Respondents were then asked why their preferred label was chosen. For those selecting “Any amount of alcohol can cause lifelong harm to your baby”, the main reason was “The word 'lifelong'/ 'lifelong harm'/ Alcohol can cause lifelong harm or damage/ long term permanent health effects” in the label (39.5% Australia and 28.5% New Zealand) followed by the response that the label was “Clear/ Explicit/ Specific/ Clearest explanation/ Conveys message clearly/ Spells it out” (21.7% Australia and 17.2% New Zealand).

Perceptions of drinking alcohol while pregnant

Finally respondents were asked about their views on drinking alcohol while pregnant. Respondents were again asked to use a 5 point Likert scale from ‘not at all harmful’ to ‘very harmful’ and indicated how harmful they believed the actions would be to an unborn baby. A -2 to +2 mean score on degree of harm was calculated for these questions.

Firstly respondents were asked how harmful it was to drink a small amount of alcohol while pregnant (e.g. no more than 1-2 standard drinks in a month). Table F shows that New Zealand respondents gave significantly higher mean scores than their Australian counterparts for perceived level of harm to an unborn baby than did Australians, with the exception of those not in proximity to pregnancy. It also shows that the perceived level of harm to an unborn baby has an inverse relationship with the level of risk of personal harm that a respondent has from their own drinking habits. Respondents with high risk of personal harm obtained the lowest mean scores for perceived harm to an unborn baby when drinking a small amount of alcohol while pregnant, while those with no risk of personal harm attained the highest mean scores. This trend was evident across both counties.

Respondents were then asked to assess how harmful it was to drink a larger amount of alcohol while pregnant (e.g. 2 or more standard drinks per day). Virtually all respondents across all segments in each country considered such alcohol intake to be ‘very harmful’, with means scores ranging from 1.74 to 1.88. Again, the inverse relationship for perceived level of harm to an unborn baby with the level of risk of personal harm that a respondent has from their own drinking habits was observed, but it was not as marked as that found for drinking a small amount of alcohol while pregnant.

Table F Perceived level of harm to the unborn child of drinking alcohol while pregnant – Mean Score for label shown by sex and proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802, Australia males n=200, New Zealand females n=200, Australia proximate pregnant n=200, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764, Australia high risk n=220, New Zealand high risk n=275, Australia medium risk n=309, New Zealand medium risk n=271, Australia low risk n=312, New Zealand low risk n=287, Australia no risk n=161, New Zealand no risk n=169,

Significantly higher for means in that row at the 95% confidence level	Significantly lower for means in that row at the 95% confidence level

Introduction

Food Standards Australia New Zealand (FSANZ) is a statutory authority in the Australian Government’s health portfolio. FSANZ develops food standards that establish the requirements for composition and labelling of food for sale in Australia and New Zealand. FSANZ commissioned Roy Morgan to conduct an online survey of males and females aged 18-45 years in both Australia and New Zealand to assess warning statements that could be included in new pregnancy warning label on packaged alcohol. The main survey was conducted from 29 July to 9 August 2019.

Background

The compilation of food standards is known as the Australia and New Zealand Food Standards Code (the Code). Staff of FSANZ undertake research and develop assessments under legislation for proposals to change the Code.

At the October 2018 meeting of the Australia and New Zealand Ministerial Forum on Food Regulation the Forum), FSANZ was asked by the Forum to consider developing a mandatory labelling standard for pregnancy warning labels (PWL) on packaged alcoholic beverages. The warning label is to include a pictogram and a statement. The Forum recognised that Fetal Alcohol Spectrum Disorder (FASD) is a life-long disability which can be prevented if pregnant women do not consume alcohol. The Forum noted that PWL on packaged alcoholic beverages can raise awareness and prompt discussions about the risks of consuming alcohol during pregnancy, and may also support the establishment of cultural norms in relation to pregnant women not drinking alcohol. In response to the request of the Forum, FSANZ commenced assessment of Proposal P1050 – Pregnancy warning labels on alcoholic beverages. The assessment encompasses consideration of the warning statement to be included in the PWL.

FSANZ commissioned Roy Morgan Research Ltd. to assist with consumer testing of four statements that could be included in PWL for packaged alcohol. The key aspect being tested in the study relates to comprehension and judgement of warning statements. The study objectives are to measure the response of Australian and New Zealand women and men of childbearing age to four PWL variants. The results will contribute to the evidence base that will support FSANZ’s development of PWL. Ethics approval for the methodological approach was obtained from Bellberry Ltd before the research proceeded.

Methodology

Ethics approval for the study was obtained from Bellberry Limited in June 2019 (application number 2019-04-323).

FSANZ provided Roy Morgan Research with an initial draft of the questionnaire, and this was then developed collaboratively between the two organisations, resulting in separate (though substantially similar) questionnaires for Australian and New Zealand audiences. These questionnaires were programmed and then subjected to cognitive testing with 14 respondents in Australia and 15 in New Zealand.

Cognitive testing participants were recruited by Roy Morgan Research via telephone, using Roy Morgan’s consumer panel as the sample frame. Quotas were set to obtain a reasonable spread of recruits across the following dimensions: gender, age, household income, proximate pregnant (yes/no), alcohol consumption (heavy/medium/light), Maori status (NZ only).

For Australian participants, the cognitive testing process involved the participant attending Roy Morgan’s Melbourne office and completing the online survey either on a provided laptop computer or, if they preferred, on their own mobile telephone. A Roy Morgan researcher observed, but did not assist, the participant during the completion of the survey, noting for later exploration any instances where they appeared to have any difficulty providing their answer. Upon completion of the online survey, the researcher spent approximately 40 minutes conducting a semi-structured interview designed to explore the participant’s thought process while they were completing the survey. At the conclusion of the interview, participants were provided with 75AUD in cash in appreciation of their time and assistance.

For New Zealand participants, the cognitive testing process involved the participant receiving at an appointed time a link to access the online survey via their own computer, and a Roy Morgan researcher contacting them by telephone immediately after completion to conduct a semi-structured interview of approximately 30 minutes. Participants subsequently received a payment by bank transfer of 50NZD in appreciation of their time and assistance.

As in the main survey, the 4 messages were randomly allocated, so that each message was viewed by approximately one quarter of cognitive testing participants. Towards the end of the interview, all participants were shown all 4 messages and asked to nominate which one they thought was most effective at conveying the message to not drink any alcohol while pregnant, and why.

On the basis of the cognitive testing Roy Morgan made a number of recommendations to FSANZ on potential improvements to the questionnaires, and the two organisations then collaborated to design the final versions for the main survey.

Respondents to Roy Morgan’s online panel were invited to complete the main survey. Survey quotas were set to obtain 800 females and 200 males in each country, for a total of 1,000 completed interviews. Sub-quotas were set for sex by age (three age categories – 18-25, 26-35, 36-45 years) and sex by region (eight Australian regions and nine New Zealand regions). The sample was supplemented by ISO accredited sample provider Dynata, primarily for New Zealand sample, although a small proportion of sample was provided by Dynata in Australia to fill quotas (generally the younger age groups). A total of 1,002 completed interviews were attained in each country.

A total of 33,326 emails invitations were emailed to Australian sample and 16,441 invitations to New Zealand sample, obtaining a total of 1,002 completed surveys in each country, representing a strike rate of 3.0% in Australia and 6.1% in New Zealand. In Australia 1,296 people clicked on the survey link to open the survey, while 1,490 did so in New Zealand. Of these 77.3% of Australian sample and 67.2% of New Zealand sample completed the survey (see Table 1).

Table 1 Response outcome by country

Source: Alcohol Warning Label Survey 2019.

A total of 106 people in Australia and 129 people in New Zealand opened the survey link, but did not qualify for the survey (e.g. were under 18 or over 45 years, or did not live in in Australia or New Zealand). A further 119 people in Australia and 194 in New Zealand attempted to complete the survey, but could not do so as they did not fit the interviewing quota (i.e. males or females by age category or males or females by region) i.e. they were screened out of the survey. A total of 69 people in Australia and 165 people in New Zealand were eligible to complete the survey, but did not complete it. Of those who proceeded to work through the survey 84.2% of the Australian sample and 73.6% of the New Zealand sample completed the survey (see Table 2).

Table 2 Completion rate by country

Source: Alcohol Warning Label Survey 2019.

On average, the Australian sample took 8.71 minutes to complete the survey compared with 8.19 minutes for the New Zealand sample. A copy of the questionnaire is provided in the Appendix to this report.

Sample and Demographics

Sample

For each country a total of 802 females and 200 males aged 18-45 were surveyed, totalling 1,002 completed interviews. Interviewing quotas were set for sex by age and sex by geographic region to ensure that minimum sample sizes were achieved and that robust statistical analysis could be undertaken. Data was weighted to the most recent ABS and StatsNZ population estimates for sex by age and sex by region in each country as at December 2018, so that survey results accurately reflected the population in each country.

It should be noted that females were the primary target group for this survey and were hence over-sampled. This means that higher weighting factors were applied to males in each country. As consequence, analysis has primarily focussed on males and females in each country separately, rather than males and females combined. Table 3 shows the sample achieved by sex by age in each country and the populations they were weighted to represent.

Table 3 Sample breakdown for age by sex by country of survey

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

Weighted counts are rounded to the nearest thousand. As such, the sum of cells may differ slightly from the total shown.

Demographics

The following section provides a summary of the demographic profile of survey respondents in each country.

3.2.1 Region lived

Region lived was asked based on standard geographical regions in each country. In order to ensure that sample sizes were robust for analysis, some regions were amalgamated i.e. For the Australian sample the ‘Remainder City’ category was the sum of respondents living in Adelaide, Perth, Hobart, Darwin and the ACT, while the ‘Remainder Country’ category was the sum of non-capital city respondents living in South Australia, Western Australia, Tasmania and the Northern Territory. For the New Zealand sample ‘Remainder North Island’ was the sum of respondents living in the Northland, Gisborne, Hawkes Bay and Taranaki regions, while ‘Remainder South Island’ was the sum of respondents from the Tasman, Nelson, Marlborough, West Coast and Southland regions.

Survey respondents were weighted to reflect the actual populations aged 18-45 years in each region using the most recent population estimates in each country (See Table 4).

Table 4 Sample breakdown for region by country of survey

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

3.2.2 Maori/Pacific Islander Status

For the New Zealand sample a question was included asking respondents which one ethnic group they belong to. No interviewing quotas were set for this question, so respondents fell into the ethnicity they recorded. A total of 141 respondents identified as Maori/Pacific Islander, providing a sufficient sample size from which to conduct robust analysis. Please note that respondents have not been weighted to accurately reflect Maori/Pacific Islander status in the New Zealand 18-45 year population. If this was the case, they would represent 20.8% of the population, where for this survey they only represent 14.6% of the weighted population (See Table 5).

Analysis of key survey questions by Maori/Pacific Islander status can be found in Appendix B.

Table 5 Sample breakdown for ethinicity – New Zealand

Source: Alcohol Warning Label Survey 2019.

Base: New Zealand n=1,002.

3.2.3 Employment

Of the sample surveyed 74.4% of respondents in Australia were in paid employment, as were 70.0% of New Zealanders. These results are close to the proportions employed for the 2018 calendar year, based on Roy Morgan Single Source survey estimates (75.6% and 72.3% respectively).

Chart 1 shows that the Australian sample had slightly higher proportions of those in part-time employment (20.0% c.f. 14.7%) and students (12.0% c.f. 9.0%), while the New Zealand sample had slightly higher proportions undertaking home duties (9.9% c.f. 5.2%) and non-workers (4.4% c.f. 1.1%)

Chart 1 Employment status by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

3.2.4 Occupation

For both samples, the largest occupation group was professionals (28.5% Australia: 22.3% New Zealand – Chart 2). The Australian sample tended to have slightly greater proportions of other professionals (14.1% c.f. 11.3%) and sales representatives/shop workers (10.1% c.f. 7.4%), while the New Zealand sample tended to have slightly greater proportions of manual workers (7.5% c.f. 1.6%) and managing directors/senior executives (5.3% c.f. 2.7%).

Chart 2 Occupation status by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

3.2.5 Education

Chart 3 compares the educational status of the Australian and New Zealand samples. Please note that the educational categories for the Australian and New Zealand samples vary slightly, with the New Zealand sample having an additional category, but for the most part educational status can be compared across each country’s sample.

The Australian sample tended to have higher proportions of tertiary qualified respondents, while the New Zealand sample had higher proportions of secondary qualified respondents.

Chart 3 Education status by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

3.2.6 Personal annual income and main income earner

As can be seen on Chart 4 the Australian sample tended to have high proportions of respondents with personal incomes of $70,000 or more (35%) compared with NZ respondents (25%), while the New Zealand sample had greater proportions with personal incomes of $30,000 to less than $70,000 per annum (36% compared with 28% in Australia).

Chart 5 shows that the proportion of respondents who are the main income earner for their household was virtually identical for the sample in each country.

Chart 4 Personal annual income by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

Chart 5 Incidence of respondent being main income earner by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

3.2.7 Socio-economic quintile

A series of questions were asked of respondents to determine socio-economic quintile. A standardised formula was used to calculate socio-economic quintile in each country, based on a 14 years and over population (see Appendix C). As the sample surveyed is confined to 18-45 year olds for this study, the socio-economic calculation was unlikely produce precisely 20% of the sample in each quintile. As can be seen in Chart 6, the New Zealand sample had three in ten respondents in the AB quintile (30.2%) and one in thirteen respondents in the FG quintile (7.6%). The Australian sample tended to be more evenly spread across the quintiles.

Chart 6 Socio-economic quintile by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

Diagnostic Variables

For this survey a series of questions were asked to enable analysis of responses to key questions by specific sub-groups. These questions included:

Respondent assessment of their level of reading an understanding English, which is pertinent when reading text on alcohol warning labels.

A series of questions to determine whether the respondent (or the respondent’s partner/spouse) was currently pregnant, had had a child in the 18 months prior to the survey or likely to be pregnant in the 18 months after the survey. This group was called ‘proximate pregnant’ for this survey; they are a key group for which the alcohol warning labels are targeted.

The Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) comprising three alcohol consumption questions were asked to allocate respondents to one of four levels of risk of personal harm from alcohol.

3.3.1 Self-assessed level of reading/understanding English

As detailed in Chart 7 almost all respondents in each country claimed to have a good or very good level of reading or understanding English (97.6% Australia: 96.0% New Zealand). As a consequence, assessment of alcohol warning labels by level of English proficiency could not be validly undertaken for this study due to small sample sizes for those with average, poor or very poor English proficiency.

Chart 7 Self-assessed level of reading/understanding English by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia n=1,002; New Zealand n=1,002.

3.3.2 Proximity to Pregnancy

Chart 8 shows that more than one in four respondents in the New Zealand sample (26.4%) and almost one in five respondents in the Australian sample (18.7%) were categorised as being ‘proximate pregnant’ for this study. Only small proportions were currently pregnant (3.6% Australia: 5.6% New Zealand), while at least one in ten respondents in each country currently had a child aged 18 months or younger (10.1% Australia: 13.6% New Zealand). A further one in ten respondents in New Zealand (10.1%) and 7.0% in Australia were planning to have a child in the next 18 months. Please note that this is a multiple response question, so the sum of the respective sub-categories for the proximate pregnant category will be larger than the total classified as proximate pregnant. Breakdown by sex in each country are provided in the chart.

Chart 8 Proximity to pregnancy for sex by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia Females n=802, New Zealand Females n=802, Australia Males n=200, New Zealand Males n=200, Australia n=1,002; New Zealand n=1,002.

3.3.3 Alcohol consumption

Alcohol consumption was measured by AUDIT-C, comprising three questions:

Frequency of drinking alcohol.

The number of standard drinks consumed on a typical drinking day (of those who drink alcohol). A prompt was provided for respondents to determine how much a standard drink is.

Frequency of drinking five or more standard drinks on one drinking occasion (of those who drink alcohol).

Four levels of risk of harm were derived from these questions following AUTID-C scoring: high risk, medium risk, low risk and no risk.

Frequency of consuming alcohol

More than eight in ten survey respondents in each country consumed alcohol (84.1% Australia: 82.9% New Zealand – See Chart 9). Not surprisingly, males tended to have a higher frequency of consumption of alcohol than did females, with 28.1% of Australian males and 25.1% of New Zealand males consuming alcohol at least 2-3 times a week, compared with 18.7% of Australian females and 17.8% of New Zealand females.

Chart 9 Frequency of drinking alcohol for sex by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia Females n=802, New Zealand Females n=802, Australia Males n=200, New Zealand Males n=200, Australia n=1,002; New Zealand n=1,002.

Standard drinks consumed on a typical drinking day and Frequency of drinking 5 or more standard drinks

Interestingly, Chart 10 shows that a higher proportion of New Zealand females drank at least 5-6 standard drinks per day on a typical drinking day compared with Australian females (22.2% c.f. 11.0%). In fact, this proportion was higher than for Australian and New Zealand males (20.7% and 21.1% respectively).

A similar trend was also reflected in the higher proportion of New Zealand females who consume at least five standard drinks at least monthly, than their Australian counterparts (25.5% c.f. 18.0), though not as high as males in each country (Australian males 30.4%: New Zealand males 39.1% - see Chart 11).

Chart 10 Standard drinks consumed on a typical drinking day for sex by country

Source: Alcohol Warning Label Survey 2019 – Those who drink alcohol.

Base: Australia Females n=671, New Zealand Females n=667, Australia Males n=166, New Zealand Males n=170, Australia n=833; New Zealand n=841.

Chart 11 Frequency of drinking 5 or more standard drinks for sex by country

Source: Alcohol Warning Label Survey 2019 – Those who drink alcohol.

Base: Australia Females n=671, New Zealand Females n=667, Australia Males n=166, New Zealand Males n=170, Australia n=833; New Zealand n=841.

Risk of harm from drinking alcohol

Across the four levels of harm, almost three in ten New Zealanders were classified as high risk (29.5%), comprising 25.4% of New Zealand females and 33.5% of New Zealand males. Just over one quarter of Australians surveyed were classified as high risk (25.4), comprising 18.7% of Australian females and 32.2% of Australian males.

Over eight in ten Australians and New Zealanders were at risk of some alcohol harm (Australia 84.1%: New Zealand 82.9% - see Chart 12).

Chart 12 Level of risk of harm from drinking alcohol by sex by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia Females n=802, New Zealand Females n=802, Australia Males n=200, New Zealand Males n=200, Australia n=1,002; New Zealand n=1,002.

Research Findings

Warning labels tested

The survey was designed to test the warning statement with a between-subjects design. Accordingly respondents were randomly allocated to one of the four label conditions and asked a series of questions with respect to that label, and without seeing the remaining three labels. After this testing respondents were then shown all four labels and asked to select the label that best conveyed the message to not drink any alcohol while pregnant. Allocation across labels was relatively even by sex across countries (see Table 6).

It’s Safest	Any Amount Can Harm

Lifelong Harm	Alcohol Can Harm

Table 6 Label shown to respondents for label effectiveness dimensions

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802; Australia males n=200; New Zealand males n=200.

Tables 7 to 10 highlight sample sizes of less than 50 for each label shown by specific demographic or diagnostic (i.e. red numbers). Caution should be taken when comparing weighted survey estimates for these segments for each label shown, specifically males in each country, males by age in each country, Maori/Pacific Islanders, selected socio-economic quintiles in each country, those with no risk of alcohol harm and those in close proximity to pregnancy in the Australian sample.

Table 7 Label shown by males and age of males

Source: Alcohol Warning Label Survey 2019.

Base: Australia males n=200; New Zealand males n=200; New Zealand males 18-25 n=62; New Zealand males 26-35 n=79: New Zealand males 36-45 n=59.

Table 8 Label shown by sex by age - Australia

Source: Alcohol Warning Label Survey 2019.

Base: Australia males 18-25 n=38; Australia males 26-35 n=83: Australia males 36-45 n=79; Australia females 18-25 n=213.

Table 9 Label shown by socio-economic quintile

Source: Alcohol Warning Label Survey 2019.

Base: Australia AB n=189; Australia C n=207; Australia FG n=162; New Zealand D n=198; New Zealand E n=206; New Zealand FG n=56..

Table 10 Label shown by risk of alcohol harm, proximity to pregnancy and Maori/ Pacific Islander Status

Source: Alcohol Warning Label Survey 2019.

Base: Australia High Risk n=220; Australia No Risk n=161; New Zealand No Risk n=169; Australia Proximate Pregnant n=200; New Zealand Maori/Pacific Islander n=141.

Message label conveys - Unprompted

After being shown one of the four labels, respondents were asked “Thinking about this label, please explain clearly in your own words what message this label conveys to you”. The clearly dominant response across all four labels shown was that the label conveys the message “Do not drink alcohol while pregnant/it should not be consumed while pregnant or while trying to fall pregnant/it recommends or advises not to drink when pregnant” (Chart 13). This message was named by 46.3% to 57.5% of respondents, depending on what label was shown in each country.

Chart 13 Message label conveys by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

Significantly higher at the 95% confidence level for the 8 segments tested	Significantly lower at the 95% confidence level for the 8 segments tested

The second most common message that the label conveyed was that “Drinking alcohol can be harmful while pregnant/it is or can be harmful to the growth and development of the baby/it can hurt the baby/it’s harmful to the baby and/or mother/even a small amount can or will ham the baby”. The highest proportion offering this response were those in both Australia and New Zealand who were shown the label “Alcohol can harm your baby” (36.1% and 34.6% respectively), followed by those in both countries who were shown the label “Any amount of alcohol can harm your baby” (30.4% and 28.6% respectively), then those shown the label “Any amount of alcohol can cause lifelong harm to your baby” (24.4% and 20.1% respectively). These proportions were significantly higher than the proportion of participants shown the label “It’s safest not to drink while pregnant” in interpreting the label in this manner.

“It’s safest” label shown

For respondents shown the “It’s safest not to drink while pregnant” label the dominant response conveyed by the message was “Do not drink alcohol while pregnant/it should not be consumed while pregnant or while trying to fall pregnant/it recommends or advises not to drink when pregnant”. This response was significantly higher among Australian females (62.1%) than Australian males (49.9%).

The second most common response among males in both Australia and New Zealand shown this label was “alcohol’s impact on health during pregnancy/not good for health/there are health risks/can have a negative affect on the baby’s health and development/adverse health consequences for baby and/or mother” (15.6% and 12.4% respectively). However, the second most nominated response amongst females in both countries was “It’s not safe to drink alcohol while pregnant/safer to avoid alcohol/it may not be safe/it’s unsafe for the baby and/or mother” (16.8% and 19.9% respectively) – the only response to mention the word “safe”, the term included in the label (see Chart 14).

Chart 14 Message label conveys by “It’s safest” label shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label – top six responses.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the 4 segments tested

“Lifelong harm” label shown

Respondents shown the “Any amount of alcohol can cause lifelong harm to your baby” label had the highest proportions stating that “Do not drink alcohol while pregnant/it should not be consumed while pregnant or while trying to fall pregnant/it recommends or advises not to drink when pregnant” as the message which was conveyed to them (Chart 15). This response was significantly higher among Australian females (3.9%), New Zealand females (58.3) and New Zealand males (56.7%) than Australian males (39.5%).

The second most nominated response directly related to the terms “harm” and “the baby” in the label shown - “Drinking alcohol can be harmful while pregnant/it is or can be harmful to the growth and development of the baby/it can hurt the baby/it’s harmful to the baby and/or the mother/ even a small amount can or will harm the baby”. This response was significantly higher for Australia and New Zealand females (26.0% and 27.2% respectively) and Australian males (22.9%), compared with New Zealand males (12.5%).

Chart 15 Message label conveys by “Lifelong harm” label shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label – top five responses.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the 4 segments tested

Of interest is the term “lifelong harm”, which is explicitly shown on the label, is only evident in the fifth most nominated response – “Alcohol consumption during pregnancy can cause lifelong harm or damage to your child’s health/has long term or permanent effects/can affect them later in life”. This response was nominated by significantly more Australian males (10.5%).

“Any amount can harm” label shown

As observed for the preceding two labels shown, the most common message conveyed when respondents were shown the label was “Any amount of alcohol can harm your baby” was “Do not drink alcohol while pregnant/it should not be consumed while pregnant or while trying to fall pregnant/it recommends or advises not to drink when pregnant”. This response was significantly higher for Australian and New Zealand females shown this label (52.0% and 53.3% respectively), but significantly lower for Australian males (41.9% - see Chart 16).

Chart 16 Message label conveys by “Any amount can harm” label shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label – top five responses.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the 4 segments tested

The second most commonly nominated response “Drinking alcohol can be harmful while pregnant/it is or can be harmful to the growth and development of the baby/it can hurt the baby/it’s harmful to the baby and/or the mother/ even a small amount can or will harm the baby” includes the terms “harm” and “the baby” which relate directly to the label shown.

The third most nominated response from respondents seeing this label was “Do not drink any alcohol while pregnant/no amount of alcohol should be consumed while pregnant/not even a small amount/ do not drink at all”. This response includes the term “any amount” which directly relates to the label shown.

“Alcohol can harm your baby” label shown

When shown the label “Alcohol can harm your baby” the most commonly nominated response was again “Do not drink alcohol while pregnant/it should not be consumed while pregnant or while trying to fall pregnant/it recommends or advises not to drink when pregnant” (see Chart 17).

Chart 17 Message label conveys by “Alcohol can harm your baby” label shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label – top five responses.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the 4 segments tested

Statement best reflecting understanding of the label

Respondents were then asked “Which of the statements below best reflects your understanding of the message being conveyed by this label?” Respondents were given a choice of five statements. The dominant statement chosen depended on the label shown, irrespective of the country lived, as follows:

It's safest not to drink while pregnant - If you are pregnant you should not drink alcohol as it can
harm your baby (Australia 38.8%; New Zealand 31.1%).

Any amount of alcohol can cause lifelong harm to your baby - If you are pregnant you should
not drink any amount of alcohol as it can cause permanent harm to your baby (Australia 60.6%;
New Zealand 51.5%).

Any amount of alcohol can harm your baby - If you are pregnant you should not drink any
amount of alcohol as it can harm your baby (Australia 52.5%; New Zealand 43.1%).

Alcohol can harm your baby - If you are pregnant you should not drink alcohol as it can harm
your baby (Australia 50.1%; New Zealand 38.1%).

It is interesting that the statement If you are pregnant you should not drink alcohol as it can harm your baby” was most commonly nominated by two sets of respondents that were shown different labels, namely “Alcohol can harm your baby” and “It's safest not to drink while pregnant”. It is clear how the former label can be linked to this statement as it specifically refers to the term “harm your baby” on the label, while it is less clear how the statement relates to the latter label, as the statement relates to “harm” and the label refers to “safety”.

The link of the statement “If you are pregnant you should not drink any amount of alcohol as it can cause permanent harm to your baby” to the label “Any amount of alcohol can cause lifelong harm to your baby” appears logical based on the term “permanent harm” in the statement and “lifelong harm” on the label.

Similarly, respondents linking the statement “If you are pregnant you should not drink any amount of alcohol as it can harm your baby” with the label “Any amount of alcohol can harm your baby” appears consistent because of the common term “any amount” (see Chart 18).

Chart 18 Statement best reflecting label understanding by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

Significantly higher at the 95% confidence level for the 8 segments tested	Significantly lower at the 95% confidence level for the 8 segments tested

“It’s safest” label shown

For respondents shown the “It’s safest not to drink while pregnant” label a significantly higher proportion of New Zealand males (45.5%) nominated the statement “If you are pregnant you should not drink alcohol as it can harm your baby” as best reflecting the message conveyed from the label (see Chart 19). This statement was also the most commonly nominated response for Australian and New Zealand females (35.5% and 33.5% respectively), while Australian males had identical proportions nominating this statement and “If you are pregnant you should not drink any amount of alcohol as it can cause permanent harm to your baby” (each 26.3%)

The majority of sub-groups had the highest proportions nominating “If you are pregnant you should not drink any amount of alcohol as it can harm your baby” as the best statement reflecting the label shown. However, Australians with a proximity to pregnancy (43.3%) had significantly higher proportions nominating the statement “If you are pregnant you should not drink any amount of alcohol as it can harm your baby” than did New Zealanders who were proximate pregnant (25.0%) and those not proximate pregnant in both countries (22.8% Australia, 17.7% New Zealand.

Chart 19 Statement best reflecting “It’s safest” label understanding by sex by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the four segments tested

“Lifelong harm” label shown

Respondents shown the “Any amount of alcohol can cause lifelong harm to your baby” label had a clear preference for the statement “If you are pregnant you should not drink any amount of alcohol as it can cause permanent harm to your baby” reflecting the message conveyed by the label, obviously equating the terms “lifelong harm to your baby” on the label with “permanent harm to your baby” in the statement. Australian males (61.5%) and Australian females (59.7%) had the highest proportions nominating this statement, with significantly lower proportions of New Zealand males doing so (46.1%), whilst still being the most commonly nominated response for this sub-group. New Zealand females had 56.5% nominating this statement as best reflecting the message conveyed on the label by (see Chart 20).

Maori/Pacific Islanders had significantly higher proportions nominating the statement “If you are pregnant you should not drink any amount of alcohol as it can harm your baby” than did New Zealanders not of Maori/Pacific Islander origin (44.6% c.f. 23.7%).

Chart 20 Statement best reflecting “Lifelong harm” label understanding by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the four segments tested

“Any amount can harm” label shown

For the label shown “Any amount of alcohol can harm your baby” more than 50% of Australian males (50.9%), Australian females (54.1%) and New Zealand females (53.6%) selected the statement “If you are pregnant you should not drink any amount of alcohol as it can harm your baby” as the one that best reflected their understanding of the message displayed on the label. This statement clearly linked the terms “any amount of alcohol” in both the label and the statement (see Chart 21).

However, for New Zealand males, the most commonly nominated statement was “If you are pregnant you should not drink any amount of alcohol as it can cause permanent harm to your baby” (34.5%), marginally ahead of the statement “If you are pregnant you should not drink any amount of alcohol as it can harm your baby “ (34.1%). The former statement was also nominated by significantly high proportions of New Zealanders with and without proximity to pregnancy (34.6% and 30.2% respectively) compared with their Australian counterparts (18.3% and 22.0% respectively).

Chart 21 Statement best reflecting “Any amount can harm” label understanding by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the four segments tested

“Alcohol can harm your baby” label shown

When shown the label “Alcohol can harm your baby” the most commonly nominated statement reflecting the message of the label for Australian and New Zealand females (53.2% and 49.0% respectively) and Australian males (46.8%) was “If you are pregnant you should not drink alcohol as it can harm your baby”, linking the “Alcohol can harm your baby” on the label to this statement (see Chart 22).

New Zealand males however, had the highest response for the statement “If you are pregnant you should not drink any amount of alcohol as it can harm your baby” named by 40.6% of this group.

Chart 22 Statement best reflecting “Alcohol can harm your baby” label understanding by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52.

Significantly higher at the 95% confidence level for the 4 segments tested	Significantly lower at the 95% confidence level for the four segments tested

Warning label evaluations

The following section reports on the extent to which the warning statement conveys the message ‘to not drink any alcohol during pregnancy’ and the evaluations of the statements ‘believability’, ‘credibility’, ‘relevance’ and the extent to which the respondents find the statements ‘convincing’. The five questions asked were as follows:

Please indicate the extent to which this label conveys the message to not drink any alcohol during pregnancy, on the scale from ‘very poorly’ to ‘very well’.

Please indicate the extent to which this label is believable to you on the scale from ‘not at all believable’ to ‘very believable’.

Please indicate the extent to which this label is credible to you on the scale from ‘not at all credible’ to ‘very credible’.

For this question please think about your situation now and into the next few years. Please indicate the extent to which this label applies to you on the scale ‘it does not apply to me at all’ to ‘it directly applies to me’.

Please indicate the extent to which this label is convincing to you on the scale ‘not at all convincing’ to ‘very convincing’.

As each question was rated on a 5 point Likert scale with a degree of positivity at one end of the scale and a degree of negativity at the other end of the scale a mean score was calculated using values of +2, +1, 0, -1 and -2. The closer the mean is to +2 the higher the degree of positivity.

For this section survey results have been provided as tabulations. Significance testing has been conducted throughout for both percentages and mean scores. A figure highlighted in green text or within a green box …… is significantly higher than red estimates in the same row at the 95% confidence level. A figure highlighted in red text or within a red box …… is significantly lower than blue estimates in the same row at the 95% confidence level. A figure highlighted in black text or within a black box …… is not statistically different to red or blue estimates in the same row at the 95% confidence level.

4.4.1 Extent label conveys message

The highest mean score achieved in both countries for the extent to which the label conveys the message ‘not to drink any alcohol during pregnancy’ was for group shown the label “Any amount of alcohol can cause lifelong harm to your baby”, attaining a mean score of 1.46 in Australia and 1.48 in New Zealand. These mean scores were significantly higher than those achieved in each country for those shown the label “It's safest not to drink while pregnant” (0.46 Australia: 0.62 New Zealand), but were not significantly higher than mean scores achieved for those shown the other two labels (Table 11).

The highest proportion indicating that the label conveys the message ‘very well’ was attained by New Zealanders shown the label “Any amount of alcohol can harm your baby” (58.1%). However, this result was not significantly higher than any other label shown except Australians and New Zealanders shown the label “It's safest not to drink while pregnant” (16.3% and 24.4% respectively) and Australians shown the label “Alcohol can harm your baby” (31.5%).

The sum of proportions indicating that the label conveys the message ‘very well’ and ‘well’ were used to create a ‘total well’ category. The highest proportions indicating that that the label conveys the message ‘well in total’ were again Australians and New Zealanders shown the label “Any amount of alcohol can cause lifelong harm to your baby”, (94.0% and 92.8% respectively), although these proportions were only significantly higher than those shown the label “It's safest not to drink while pregnant” and not respondents shown the other two labels and not significantly higher than those shown the labels “Any amount of alcohol can harm your baby” and “Alcohol can harm your baby”.

Table 11 Extent label conveys the message not to drink any alcohol during pregnancy by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

“It’s safest” label shown

Males in Australia shown the label “It's safest not to drink while pregnant” had a significantly lower mean score for the extent to which the label conveys the message ‘not to drink any alcohol during pregnancy’ than did females in both Australia and New Zealand (0.29, 0.62 and 0.67 respectively). This was primarily due to the significantly lower proportion indicating that the label conveyed the message ‘very well’ (11.1%) and to some extent by the higher proportion rating ‘total poorly’ (30.8%). New Zealanders in proximity to pregnancy had a significantly higher proportion stating ‘very well’ than did their Australian counterparts and those not proximate pregnant (33.3%, 19.2%, 15.7% and 21.9% respectively). This resulted in a higher mean score for this group (0.81 – see Table 12).

Table 12 Extent label conveys the message not to drink any alcohol during pregnancy for “It’s safest” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43, Australia proximate pregnant n=49, New Zealand proximate pregnant n=56, Australia not proximate pregnant n=201, New Zealand not proximate pregnant n=194.

“Lifelong harm” label shown

It is clear that the label “Any amount of alcohol can cause lifelong harm to your baby” conveys the message ‘not to drink nay alcohol during pregnancy’ well, with over nine in ten male and female respondents and those both in and not in proximity to pregnancy in each country having proportions over 90% for ‘total well’.. Australian males had the highest proportions rating ‘total well’ (96.7%), significantly higher than Australian females (90.9%), while New Zealand females had significantly higher proportions than males in both countries citing that the label conveys the message ‘very well’ (63.2%). New Zealand females also had significantly higher mean scores than Australian females and New Zealand males and the highest mean score (1.55 – see Table 13).

No sub-group achieved lower than 85% in terms of the ‘total’ well’ proportions for this label in conveying the message ‘not to drink nay alcohol during pregnancy’.

Table 13 Extent label conveys the message not to drink any alcohol during pregnancy for “Lifelong harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48, Australia proximate pregnant n=58, New Zealand proximate pregnant n=55, Australia not proximate pregnant n=193, New Zealand not proximate pregnant n=196.

“Any amount can harm” label shown

The label “Any amount of alcohol can harm your baby” also appears to convey the message ‘not to drink any alcohol during pregnancy’ well, with more than nine in ten females in both countries providing the rating of ‘total well’ (91.8% Australia and 92.5% New Zealand), along with those in proximity to pregnancy in both countries (93.0% Australia and 90.9% New Zealand) and those not proximate pregnant in New Zealand (90.2%). Those not proximate pregnant in Australia and males in both countries had proportions less than 90% citing ‘total well’, with a significantly lower proportion of 82.9% of Australian males (82.9%) providing this rating than both Australian and New Zealand females (see Table 14).

Mean scores were significantly higher for Australian females (1.43), New Zealand males (1.52) and New Zealanders not proximate pregnant (1.47), than for Australian males (1.22) and Australians not proximate pregnant (1.31).

Table 14 Extent label conveys the message not to drink any alcohol during pregnancy for “Any amount can harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57, Australia proximate pregnant n=39, New Zealand proximate pregnant n=62, Australia not proximate pregnant n=212, New Zealand not proximate pregnant n=190..

“Alcohol can harm your baby” label shown

New Zealanders have a more positive perception of the label “Alcohol can harm your baby” in conveying the message ‘not to drink any alcohol during pregnancy’ ‘very well’ than do Australians, with the exception of Australians in proximity to pregnancy (see Table 15). Mean scores are higher than 1.20 for New Zealand females, males, proximate pregnant and not proximate pregnant, while Australian females and Australians not proximate pregnant had significantly lower mean scores (each 0.88), with Australian males still lower than average (1.08).

Table 15 Extent label conveys the message not to drink any alcohol during pregnancy for “Alcohol can harm your baby” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52, Australia proximate pregnant n=54, New Zealand proximate pregnant n=65, Australia not proximate pregnant n=196, New Zealand not proximate pregnant n=184.

4.4.2 Extent label is believable

The second scale that respondents were asked to rate the label on was the extent to which the label was believable to them. Those seeing the label “Alcohol can harm your baby” had the highest proportions in both countries indicating that the label was ‘very believable’ (64.9% Australia and 64.5% New Zealand), with New Zealanders seeing this label providing the highest mean score (1.52). When looking that the proportion tallying ‘total believable’, Australians shown the label “Any amount of alcohol can cause lifelong harm” attained the highest response (91.2%) along with the highest mean score (1.52). Significantly lower mean scores and proportions stating ‘very believable’ and ‘total believable’ were observed for those shown the label “It’s safest not to drink while pregnant” (see Table 16).

Table 16 Extent the label is believable by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

“It’s safest” label shown

The label “It’s safest not to drink while pregnant” is the least believable of the four labels shown to respondents. Those shown this label generally attained mean scores for believability of between 1.04 and 1.18, with only New Zealanders in proximity to pregnancy attaining a significantly high mean score (1.52 - see Table 17). Those shown other labels generally attained mean scores in the range of 1.30 to 1.60 (with only a small number of sub-groups achieving scores below 1.30). Those proximate pregnant from New Zealand attained a significantly higher mean score of 1.52 than Australia Proximate Pregnant (1.13), and Not proximate Pregnant for both Australia (1.15) and New Zealand (1.04), primarily due to a significantly high proportion from this segment indicating that the label was ‘very believable’ (70.1% compared with 44.2%, 46.1% and 42,2% respectively).

Table 17 Extent the label is believable for “It’s safest” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43, Australia proximate pregnant n=49, New Zealand proximate pregnant n=56, Australia not proximate pregnant n=201, New Zealand not proximate pregnant n=194.

“Lifelong harm” label shown

Those in proximity to pregnancy group in both Australia and New Zealand tallied significantly higher ‘total believable’ proportions for the label “Any amount of alcohol can cause lifelong harm to your baby” (94.8% and 94.3% respectively) than females in both Australia (86.7%) and New Zealand (87.6%). However, it should be noted that scores for ‘total believable’ above 85.0% are still extremely high across all labels shown (see Table 18).

Table 18 Extent the label is believable for “Lifelong harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48, Australia proximate pregnant n=58, New Zealand proximate pregnant n=55, Australia not proximate pregnant n=193, New Zealand not proximate pregnant n=196.

“Any amount can harm” label shown

Respondents shown the label “Any amount of alcohol can harm your baby” had varying perceptions of believability (see Table 19). Significantly higher mean scores were observed for Australian and New Zealand females (1.43 and 1.49 respectively), as well as proximate pregnant New Zealanders (1.58) than Australian males (1.17) and those not proximately pregnant in both countries (Australia 1.28, New Zealand 1.33). Maori/Pacific Islanders attained a significantly high mean score for believability compared with Non-Maori/Pacific Islanders (1.60 c.f. 1.37).

Table 19 Extent the label is believable for “Any amount can harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57, Australia proximate pregnant n=39, New Zealand proximate pregnant n=62, Australia not proximate pregnant n=212, New Zealand not proximate pregnant n=190..

“Alcohol can harm your baby” label shown

In general, respondents shown the label “Alcohol can harm your baby” attained the highest scores for believability across the four labels shown, although scores weren’t significantly higher except for those shown the “It’s safest not to drink while pregnant” label.

New Zealand females and Australian males shown the “Alcohol can harm your baby” label attained the highest mean scores for believability (1.61 and 1.64 respectively), significantly higher than the mean obtained by Australian females (1.38). A significantly higher proportion of Australian males (73.0%) than Australian or New Zealand females (57.6% and 66.7% respectively) indicated that the label was ‘very believable’ (see Table 20).

Table 20 Extent the label is believable for “Alcohol can harm your baby” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52, Australia proximate pregnant n=54, New Zealand proximate pregnant n=65, Australia not proximate pregnant n=196, New Zealand not proximate pregnant n=184.

4.4.3 Extent label is credible

Respondents in both Australia and New Zealand shown the label “Alcohol can harm your baby” had the highest proportions considering the label to be credible, with over eight in ten respondents tallying a ‘total credible’ score (82.5% and 85.1% respectively). Respondents shown this label also had the highest mean scores for credibility for each respective country (1.25 and 1.36 respectively). However, these proportions and means were only significantly higher than those shown the label “It’s safest not to drink while pregnant”. Similarly, there were no significant differences for the other two labels shown, except with “It’s safest not to drink while pregnant” (see Table 21).

The proportion identifying the label as ‘very credible’ was significantly higher for New Zealanders shown the label “Alcohol can ham your baby” (59.7%), with only New Zealanders shown the label “Any amount of alcohol can cause lifelong harm to your baby” (54.7%), not being significantly lower.

Table 21 Extent the label is credible by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

“It’s safest” label shown

The “It’s safest not to drink alcohol while pregnant” label was not rated as particularly credible when compared with the other three labels shown. Mean scores for this label across major segments ranged from 0.68 to 1.28, while the means scores for the other labels ranged from 1.10 to 1.47. Those in proximity to pregnancy had high proportions tallied a ‘total credible’ score of above seven in ten (Australia 72.9%: New Zealand 78.5%), as did Australian females (71.1% - see Table 22).

Table 22 Extent the label is credible for “It’s safest” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43, Australia proximate pregnant n=49, New Zealand proximate pregnant n=56, Australia not proximate pregnant n=201, New Zealand not proximate pregnant n=194.

“Lifelong harm” label shown

Of the respondents shown the label “Any amount of alcohol can cause lifelong harm to your baby” Australians in proximity to pregnancy had a significantly higher mean score for credibility of the label (1.39) than those in the Australian not proximate pregnancy group (1.15) (Table 23). However, mean scores were high across all major segments with proportions tallying ‘total credible’ ranging from 76.5% for New Zealand males to 85.6% for proximate pregnant New Zealanders. Proportions stating that the label was ‘very credible’ were also high with New Zealand females (55.0%), Australians and New Zealanders proximate pregnant (59.5% and 56.7% respectively) having proportions at or above 55%.

Table 23 Extent the label is credible for “Lifelong harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48, Australia proximate pregnant n=58, New Zealand proximate pregnant n=55, Australia not proximate pregnant n=193, New Zealand not proximate pregnant n=196.

“Any amount can harm” label shown

Of those shown the label “Any amount of alcohol can harm your baby” those in proximity to pregnancy in New Zealand attained the highest mean score for credibility (1.38) and the highest proportion tallying ‘total credible’ (87.0%). Those not proximate pregnant in both countries had significantly lower mean scores for credibility (each 1.14) compared with the New Zealand proximate pregnant group (Table 24). Australians in proximity to pregnancy had the highest proportions claiming that the label was ‘very credible (57.4%).

Table 24 Extent the label is credible for “Any amount can harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57, Australia proximate pregnant n=39, New Zealand proximate pregnant n=62, Australia not proximate pregnant n=212, New Zealand not proximate pregnant n=190..

“Alcohol can harm your baby” label shown

Respondents shown the label “Alcohol can harm your baby” generally had the highest proportions across all four labels shown tallying ‘total credible’ for the label, with the lowest tally being for Australian females at 79.0% for ‘total credible’ up to 87.5% for New Zealand females (see Table 25). This was also the only significant difference across groups in total credible. Only two segments across all labels attained proportions above 60% for the label being ‘very credible’, these being New Zealand females (62.5%) and New Zealanders in proximity to pregnancy (60.3%). Means scores for New Zealand females (1.47) and Australian males (1.47) were significantly higher than the mean score for Australian females (1.15).

Table 25 Extent the label is credible for “Alcohol can harm your baby” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52, Australia proximate pregnant n=54, New Zealand proximate pregnant n=65, Australia not proximate pregnant n=196, New Zealand not proximate pregnant n=184.

4.4.4 Extent label applies to me

For this question respondents were asked to “think about their own situation now and into the next few years” in order to indicate the extent to which the label applies to them. This preface was used in an attempt to ensure respondents considered any potentiality for having children or changing life stage, which would have a direct bearing on the impact of the label shown.

Proportions proximate pregnant in each country shown each label were similar. Therefore any observed differences by this variable would be due to respondent perceptions of the label rather than any disproportionate number of target respondents viewing the label. It was apparent that significantly higher proportions of those living in New Zealand shown the label “Alcohol can harm your baby” indicated that the label ‘applies to me’ (40.6%) than those shown other labels and that this was due to a difference in perceptions rather than any sample skew (see Table 26).

Table 26 Extent the label applies to me by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

“It’s safest” label shown

Those proximate pregnant in each country shown the label “It’s safest not to drink while pregnant” had the only mean score for applicability that was above zero (i.e. positive – the label does apply to me) – 0.62 for Australia and 0.48 for New Zealand. While Australians proximate pregnant tallied the highest proportions ‘total applies to me’ (69.1%), New Zealanders in the proximity to pregnancy group had the highest proportions claiming that the label ‘directly applies to me’ (43.3% - see Table 27).

Table 27 Extent the label applies to me for “It’s safest” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43, Australia proximate pregnant n=49, New Zealand proximate pregnant n=56, Australia not proximate pregnant n=201, New Zealand not proximate pregnant n=194.

“Lifelong harm” label shown

Those proximate pregnant in both countries shown the label “Any amount of alcohol can cause lifelong harm to your baby” were the only segments to attain mean scores for applicability above zero (Australia 0.61, New Zealand 0.46), with over three in ten in each country claiming that the label ‘directly applies to me’ (35.6% and 31.5% respectively – see Table 28).

Table 28 Extent the label applies to me for “Lifelong harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48, Australia proximate pregnant n=58, New Zealand proximate pregnant n=55, Australia not proximate pregnant n=193, New Zealand not proximate pregnant n=196.

“Any amount can harm” label shown

New Zealanders in the proximity to pregnancy group shown the label “Any amount of alcohol can harm your baby” had the lowest mean score for applicability of all four labels shown and the only mean score not above zero (-0.01). It was also the only segment that had a proportion lower than 50% for ‘total applies to me’ (43.5% - see Table 29). Australians with proximity to pregnancy had the only positive mean score across all sub-groups (0.25).

Table 29 Extent the label applies to me for “Any amount can harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57, Australia proximate pregnant n=39, New Zealand proximate pregnant n=62, Australia not proximate pregnant n=212, New Zealand not proximate pregnant n=190..

“Alcohol can harm your baby” label shown

Australians proximate pregnant shown the label “Alcohol can harm your baby” had the lowest mean score in relation to applicability of the label to them (-0.02), and this was the lowest score for across all warning statements for this segment. This segment also had the lowest proportion tallying ‘total applies to me’ of all proximate pregnant groups (44.2% - see Table 30). Conversely, New Zealanders who were proximate pregnant shown this label had the highest proportion of all labels shown tallying ‘total applies to me’ (63.8%).

Table 30 Extent the label applies to me for “Alcohol can harm your baby” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52, Australia proximate pregnant n=54, New Zealand proximate pregnant n=65, Australia not proximate pregnant n=196, New Zealand not proximate pregnant n=184.

4.4.5 Extent label is convincing

In terms of how convincing the label was to respondents, Australians shown the label “Any amount of alcohol can cause lifelong harm to your baby” and New Zealanders shown the label “Alcohol can harm your baby” had the highest proportions tallying ‘total convincing’ (82.4% and 84.3% respectively). These two segments also had the highest mean scores for their respective countries (1.21 and 1.31 respectively – see Table 31). However only the mean credibility score for the warning statement “It’s safest not to drink while pregnant” was significantly lower than the remaining three statements. Mean scores for the remaining three statements were not significantly different from each other.

Table 31 Extent the label is convincing by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

“It’s safest” label shown

In terms of how convincing the “It’s safest not to drink while pregnant” label was, no significant differences in mean were observed by sex across each country. Australians and New Zealanders with proximity to pregnancy shown this label had significantly higher mean scores and ‘total convincing’ tallies than did their not proximate pregnant counterparts (Australia proximate pregnant 1.07 and 74.8%; New Zealand proximate pregnant 1.37 and 84.8% c.f. Australia not proximate pregnant 0.66 and 58.6%; New Zealand not proximate pregnant 0.67 and 57.7%).

Table 32 Extent the label is convincing for “It’s safest” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43, Australia proximate pregnant n=49, New Zealand proximate pregnant n=56, Australia not proximate pregnant n=201, New Zealand not proximate pregnant n=194.

“Lifelong harm” label shown

In general, respondents shown the label “Any amount of alcohol can cause lifelong harm to you baby” had the highest mean scores and tallies for ‘total convincing’ than the other three labels shown. Those proximate pregnant in both Australia and New Zealand attained mean scores of over 1.50 and had proportions over 90% for ‘total convincing’ (Australia 1.51 and 90.9%: New Zealand 1.54 and 91.8% - see Table 33).

Table 33 Extent the label is convincing for “Lifelong harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48, Australia proximate pregnant n=58, New Zealand proximate pregnant n=55, Australia not proximate pregnant n=193, New Zealand not proximate pregnant n=196.

“Any amount can harm” label shown

Those shown the label “Any amount of alcohol can harm your baby” had high proportions finding the label convincing, but not as high as those shown the labels “Any amount of alcohol can cause lifelong harm to you baby” and “Alcohol can harm your baby”. The mean score for New Zealand females (1.23), males (1.13) and proximate to pregnancy (1.36), as well as Australian females (1.21) were significantly higher than the mean scores for Australian males (0.88), and the not proximate groups in both countries (Australia 1.02, New Zealand 1.10) (Table 34).

Maori/Pacific Islanders shown this label had significantly higher mean scores in terms of how convincing the label was to them when compared with Non-Maori/Pacific Islanders (1.45 c.f. 1.13)

Table 34 Extent the label is convincing for “Any amount can harm” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57, Australia proximate pregnant n=39, New Zealand proximate pregnant n=62, Australia not proximate pregnant n=212, New Zealand not proximate pregnant n=190..

“Alcohol can harm your baby” label shown

The label “Alcohol can harm your baby” was considered most convincing in New Zealand, with significantly higher mean scores and ‘total convincing’ proportions attained for New Zealand females (1.41 and 85.4%), New Zealand males (1.23 and 83.3%) and New Zealanders not proximately pregnant (1.27 and 85.2%) when compared with Australian females (0.97 and 73.6%), Australian males (1.06) and Australian not proximate pregnant (0.98 and 75.1%) (Table 35).

Table 35 Extent the label is convincing for “Alcohol can harm your baby” label shown by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52, Australia proximate pregnant n=54, New Zealand proximate pregnant n=65, Australia not proximate pregnant n=196, New Zealand not proximate pregnant n=184.

Evaluation of the four labels

After being shown one label respondents were then shown all four labels and asked to select the one that best conveyed the message “to not drink any alcohol while pregnant”. The labels were randomised to ensure that no order bias was encountered.

4.5.1 Label considered to best convey message

When all respondents were shown all four labels it was clear that the label considered the best to convey the message “to not drink any alcohol while pregnant” was “Any amount of alcohol can cause lifelong harm to your baby”. This label was nominated by over 45% of all respondent segments irrespective of the label they originally saw (see Chart 23).

Perhaps not surprisingly, respondents in both Australia and New Zealand who were originally shown the “Any amount of alcohol can cause lifelong harm to you baby” label had the highest proportions nominating it (69.7% Australia: 62.3% New Zealand). Generally, there was some degree of retention of the label previously shown, with the highest proportions originally shown that one label nominating it as the best conveying the stated message. The only incidence where this trend was not observed was for those where the label “Any amount of alcohol can harm your baby” was originally shown. Only 27.3% of Australians originally shown this label nominated it as the best label, which was lower than that for the proportion of Australians originally shown the label “It’s safest not the drink while pregnant” (34.5%).

Chart 23 Label best conveying message by label shown by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia It’s safest not to drink while pregnant n=250; New Zealand It’s safest not to drink while pregnant n= 250; Australia Any amount of alcohol can cause lifelong harm to your baby n=251; New Zealand Any amount of alcohol can cause lifelong harm to your baby n=251; Australia Any amount of alcohol can ham your baby n=251; New Zealand Any amount of alcohol can ham your baby n=252; Australia Alcohol can harm your baby n=250; New Zealand Alcohol can harm your baby n=249.

Significantly higher at the 95% confidence level across the 8 categories	Significantly lower at the 95% confidence level across the 8 categories

“It’s safest” label originally shown

For respondents originally shown the “It’s safest not to drink while pregnant” label a significantly higher proportion of New Zealand males (57.2%) nominated “Any amount of alcohol can cause lifelong harm to you baby” as the best label to convey the message “to not drink any alcohol while pregnant” (see Chart 24), than New Zealand females (43.6%).

Chart 24 Label best conveying message for “It’s safest” label originally shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia females n=206; New Zealand females n=207; Australia males n=44; New Zealand males n=43.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

Approximately half of respondents not proximate pregnant in each country originally shown the label “It’s safest not to drink while pregnant” nominated “Any amount of alcohol can cause lifelong harm to your baby” as the best label to convey the message (Australia 50.0%, New Zealand 50.9%) (Chart 25), along with 45.1% of New Zealanders in proximity to pregnancy.

Of note is that Australians in the proximity to pregnancy group had slightly higher proportions nominating the label “Any amount of alcohol can harm your baby” (37.2%) than the label “Any amount of alcohol can cause lifelong harm to you baby”.

Chart 25 Label best conveying message for “It’s safest” label originally shown by promimity to pregnant by country

Source: Alcohol Warning Label Survey 2019 shown “It’s safest not to drink while pregnant” label.

Base: Australia proximate pregnant n=49, New Zealand proximate pregnant n=56, Australia not proximate pregnant n=201, New Zealand not proximate pregnant n=194.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

“Lifelong harm” label originally shown

At least two thirds of Australian and New Zealand females and Australian males originally shown the label “Any amount of alcohol can cause lifelong harm to you baby” indicated that this very label best conveyed the message “to not drink any alcohol while pregnant” (66.0%, 68.6% and 73.0% respectively). Whilst significantly lower than these proportions, 55.4% of New Zealand males originally shown this label concurred that it was the best label to convey the message (see Chart 26).

Similarly, over six in ten Australian proximate pregnant and Australian and New Zealand proximate pregnant originally shown the label “Any amount of alcohol can cause lifelong harm to you baby” considered that it was the best label to convey the message “to not drink any alcohol while pregnant” (69.1%. 69.9% and 64.4% respectively). New Zealanders with proximity to pregnancy had over half concurring that the label they were originally shown was the best label to convey the message (54.1% - see Chart 27).

Chart 26 Label best conveying message for “Lifelong harm” label originally shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia females n=196; New Zealand females n=203; Australia males n=55; New Zealand males n=48.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

Chart 27 Label best conveying message for “Lifelong harm” label originally shown by proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can cause lifelong harm to your baby” label.

Base: Australia proximate pregnant n=58, New Zealand proximate pregnant n=55, Australia not proximate pregnant n=193, New Zealand not proximate pregnant n=196.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

“Any amount can harm” label originally shown

While around half of females in Australia and New Zealand originally shown the label “Any amount of alcohol can harm your baby” selected “Any amount of alcohol can cause lifelong harm to you baby” as the best label to convey the message “to not drink any alcohol while pregnant” (48.1% and 50.1% respectively), almost two thirds of Australian males (65.0%) and almost six in ten New Zealand males did so 58.2% (Chart 28).

Chart 28 Label best conveying message for “Any amount can harm” label originally shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia females n=196; New Zealand females n=195; Australia males n=55; New Zealand males n=57.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

Over half of Australians and New Zealanders not proximate pregnant and New Zealanders proximate pregnant selected this same label as being the best to convey the stated message (59.9%, 55.4% and 52.1% respectively). Just under four in ten proximate pregnant Australians selected this label as being the best (39.1% - see Chart 29), marginally higher than the one third of this segment who preferred the label “Any amount of alcohol can harm your baby” (34.5%).

Chart 29 Label best conveying message for “Any amount can harm” label originally shown by proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019 shown “Any amount of alcohol can harm your baby” label.

Base: Australia proximate pregnant n=39, New Zealand proximate pregnant n=62, Australia not proximate pregnant n=212, New Zealand not proximate pregnant n=190..

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

“Alcohol can harm” label originally shown

Close to 50% of Australian and New Zealand female respondents and Australian male respondents originally shown the label “Alcohol can harm your baby” selected the label “Any amount of alcohol can cause lifelong harm to you baby” as the best label to convey the message “to not drink any alcohol while pregnant” (49.3%, 51.0% and 49.3% respectively). A significantly high six in ten New Zealand males (61.0%) also nominated this label as being the best in conveying the stated message compared with Australian females (49.3% - see Chart 30).

Six in ten of Australians and New Zealanders in the proximate pregnant group originally shown the label “Alcohol can harm your baby” selected the label “Any amount of alcohol can cause lifelong harm to you baby” as the best label to convey the stated message (61.8% and 59.1% respectively) compared with 45.7% of not proximate pregnant Australians and 54.8% not proximate pregnant New Zealanders (Chart 31).

Chart 30 Label best conveying message for “Alcohol can harm your baby” ” label originally shown by sex by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia females n=204; New Zealand females n=197; Australia males n=46; New Zealand males n=52.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

Chart 31 Label best conveying message for “Alcohol can harm your baby” ” label originally shown by proximity to pregnancy by country

Source: Alcohol Warning Label Survey 2019 shown “Alcohol can harm your baby” label.

Base: Australia proximate pregnant n=54, New Zealand proximate pregnant n=65, Australia not proximate pregnant n=196, New Zealand not proximate pregnant n=184.

Significantly higher at the 95% confidence level across the 4 categories	Significantly lower at the 95% confidence level across the 4 categories

4.5.2 Reason for choosing label

Once respondents selected the label that best conveyed the message “to not drink any alcohol while pregnant” they were then asked to explain why they chose that label. Analysis on charts 32 and 33 following highlight the reasons given by the label selected in each country.

The most common response named by people choosing the label “Any amount of alcohol can cause lifelong harm to you baby” as the best label conveying the stated message was “The word 'lifelong'/ 'lifelong harm'/ Alcohol can cause lifelong harm or damage/ long term permanent health effects” named by 39.5% of Australians and 28.5% of New Zealanders. This was followed by “Clear/ Explicit/ Specific/ Clearest explanation/ Conveys message clearly/ Spells it out” nominated by 21.7% of Australians and 17.2% of New Zealanders. The third most common response named by Australians choosing this label was “The word 'any'/ 'any amount'/ Should not drink any at all while pregnant/ not even a small amount/ Drinking any amount is risky/ bad/ can effect the baby” (13.1%), while the third most common response for New Zealanders choosing this label was .”More detailed information/ Informative/ Explains it the best/ It's more comprehensive/ descriptive/ complete/ balanced/ Sums it up well/ Covers all bases” (15.0%).

For those selecting “Any amount of alcohol can harm your baby” as the best label to convey the stated message, the top response amongst both Australians and New Zealanders was “More direct/ Straight to the point/ Upfront/ Blunt/ Forthright/ Gets the message across directly/ straight away” (40.5% and 28.0% respectively). This was closely followed by “Simple/ Easy/ Straightforward/ Easiest to understand/ It's not complicated or confusing” named by 32.3% of Australians and 26.3% of New Zealanders choosing this label. The third most common respondent nominated by both Australians and New Zealanders alike was “Short message/ Not too wordy/ Shorter than the others/ Quick message/ People are more likely to read a short message” (25.4% and 20.2%).

Respondents who chose “Alcohol can harm your baby” as the best label had differing reasons depending on the country of origin. Australian’s main reason for choice was that it was “Clear/ Explicit/ Specific/ Clearest explanation/ Conveys message clearly/ Spells it out” (25.2%), while this reason was the second most common response for New Zealanders (23.2%). The second most common response for Australians selecting this label was “The word 'any'/ 'any amount'/ Should not drink any at all while pregnant/ not even a small amount/ Drinking any amount is risky/ bad/ can effect the baby” (22.8%), which was the top response amongst New Zealanders choosing this label (23.8%). The third most commonly nominated reason amongst Australians choosing this label was “Simple/ Easy/ Straightforward/ Easiest to understand/ It's not complicated or confusing” (18.8%), while for New Zealanders the third most common response was “Short message/ Not too wordy/ Shorter than the others/ Quick message/ People are more likely to read a short message” (19.7%).

For the small proportion of respondents who selected “It's safest not to drink while pregnant” as the best label to convey the stated message, the top response amongst Australians was “More positive/ Neutral/ Put in a nicer way/ Not too harsh/ Not aggressive/ Not over-dramatic/ Not too alarmist/ Less confronting/ Less condescending” (34.4%), which was the third most commonly nominated response for this label amongst New Zealanders (16.9%). The top response amongst New Zealanders for this label was “It conveys the message better/ It's the best/ It's good/ I like it/ I prefer it/ It's okay/ It's more appealing/ Looks better/ The wording is better” (22.5%), nominated third by Australians (14.9%). The second most nominated response for Australians for this label was “Clear/ Explicit/ Specific/ Clearest explanation/ Conveys message clearly/ Spells it out” (16.3%), while for New Zealanders it was “Simple/ Easy/ Straightforward/ Easiest to understand/ It's not complicated or confusing” (9.6%).

Chart 32 Reason for choosing label by label chosen by country – Top 6 reasons

Source: Alcohol Warning Label Survey 2019

Base: Australia – chose “It’s safest not to drink while pregnant” n=79, New Zealand,- chose ”It’s safest not to drink while pregnant” n=54, Australia – chose “Any amount of alcohol can cause lifelong harm to your baby” n=541, New Zealand – chose “Any amount of alcohol can cause lifelong harm to your baby” n=544, Australia – chose “Any amount of alcohol can harm your baby” n=280, New Zealand – chose “Any amount of alcohol can harm your baby” n=271, Australia – chose “Alcohol can harm your baby” n=102, New Zealand – chose “Alcohol can harm your baby” n=133.

Significantly higher at the 95% confidence level across the 8 categories	Significantly lower at the 95% confidence level across the 8 categories

Chart 33 Reason for choosing label by label chosen by country – Reasons 7-12

Source: Alcohol Warning Label Survey 2019

Base: Australia – chose “It’s safest not to drink while pregnant” n=79, New Zealand,- chose ”It’s safest not to drink while pregnant” n=54, Australia – chose “Any amount of alcohol can cause lifelong harm to your baby” n=541, New Zealand – chose “Any amount of alcohol can cause lifelong harm to your baby” n=544, Australia – chose “Any amount of alcohol can harm your baby” n=280, New Zealand – chose “Any amount of alcohol can harm your baby” n=271, Australia – chose “Alcohol can harm your baby” n=102, New Zealand – chose “Alcohol can harm your baby” n=133.

Significantly higher at the 95% confidence level across the 8 categories	Significantly lower at the 95% confidence level across the 8 categories

Perceptions of drinking alcohol while pregnant

Finally, respondents were asked about their views on drinking alcohol while pregnant in relation to their impact on the unborn baby. Respondents were asked to use a five point scale from ‘not at all harmful’ to ‘very harmful’ to assess this impact.

As each question was rated on a 5 point Likert scale with a degree of positivity at one end of the scale and a degree of negativity at the other end of the scale a mean score was calculated using values of +2, +1, 0, -1 and -2. The closer the mean is to +2 the higher the degree of positivity.

For this section survey results have been provided as tabulations. Significance testing has been conducted throughout for both percentages and mean scores. A figure highlighted in green text or within a green box …… is significantly higher than red estimates in the same row at the 95% confidence level. A figure highlighted in red text or within a red box …… is significantly lower than blue estimates in the same row at the 95% confidence level. A figure highlighted in black text or within a black box …… is not statistically different to red or blue estimates in the same row at the 95% confidence level.

4.6.1 Drinking a small amount of alcohol while pregnant

Perceived level of harm to the unborn baby from drinking a small amount of alcohol while pregnant elicited similar scores for segments of the Australian sample (see Table 36) – females (0.76), males (0.62), proximate pregnant (0.76) and not proximate pregnant (0.67). Mean scores were significantly higher for females (0.97), males (0.94) and those proximate pregnant (1.11) in the New Zealand sample than the Australian counterparts. Proximate pregnant New Zealanders had the highest proportions claiming that a small amount of alcohol consumed while pregnant would be ‘very’ harmful’ (45.9%), though only significantly higher than Australian males (29.4%) and Australians not proximate pregnant (31.5%).

Table 36 Perceived level of harm to an unborn baby of drinking a small amount of alcohol (less than 1-2 standard drinks per month) while pregnant by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802; Australia males n=200; New Zealand males n=200, Australia proximate pregnant n=2009, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

When assessed by the respondent’s personal risk of alcohol harm a clear trend emerged. The greater the personal risk of alcohol harm to the respondent the less harmful they considered that a small amount of alcohol consumed while pregnant would be on the unborn child (see Table 37). For each degree of risk the level of harm was perceived to be greater amongst New Zealanders than Australians, though this was only significant for those in the no risk group.

Table 37 Pereceived level of harm to an unborn baby of drinking a small amount of alcohol (less than 1-2 standard drinks per month) while pregnant by personal risk of alcohol harm

Source: Alcohol Warning Label Survey 2019.

Base: Australia high risk n=220, New Zealand high risk n=275, Australia medium risk n=309, New Zealand medium risk n=271, Australia low risk n=312, New Zealand low risk n=287, Australia no risk n=161, New Zealand no risk n=169.

4.6.2 Drinking a larger amount of alcohol while pregnant

Perceptions of the level of harm to the unborn child of consuming a larger amount of alcohol while pregnant (i.e. 2 or more standard drinks per day) was generally consistent across sex and proximity to pregnancy. The proportions indicating that this level of alcohol would be ‘very harmful’ ranged from 81.8% to 91.6% across all segments, with mean scores ranging from 1.74 to 1.88 (i.e. very high). Perceptions of harm tended to be marginally lower in New Zealand than in Australia (Table 38).

Table 38 Perceived level of harm to an unborn baby of drinking a larger amount of alcohol (2+ standard drinks per day) while pregnant by sex and pregnancy proximity by country

Source: Alcohol Warning Label Survey 2019.

Base: Australia females n=802; New Zealand females n=802; Australia males n=200; New Zealand males n=200, Australia proximate pregnant n=2009, New Zealand proximate pregnant n=238, Australia not proximate pregnant n=802, New Zealand not proximate pregnant n=764.

When analysed by personal risk of alcohol harm the general trend that the greater the personal risk of alcohol harm to the respondent the less harmful they considered a larger amount of alcohol consumed while pregnant would be on the unborn child still held, but was weaker than observed for a small amount of alcohol being consumed (see Table 39).

Table 39 Pereceived level of harm to an unborn baby of drinking a larger amount of alcohol (2+ standard drinks per day) while pregnant by personal risk of alcohol harm

Source: Alcohol Warning Label Survey 2019.

Base: Australia high risk n=220, New Zealand high risk n=275, Australia medium risk n=309, New Zealand medium risk n=271, Australia low risk n=312, New Zealand low risk n=287, Australia no risk n=161, New Zealand no risk n=169.

Appendix A – Questionnaire

Consumer Testing of Pregnancy Warning Labels

Introductory text

Thank you for agreeing to complete this questionnaire.

We are undertaking some important research into labelling and what consumers think about labels. The research is being carried out on behalf of Food Standards Australia New Zealand, and your involvement will help improve the labelling of some products.

The study is about the information available on alcohol labels. However you do not need to be an alcohol drinker in order to answer the questions. Everyone’s opinions are important to us.

The study has been ethically reviewed by the Bellberry Human Research Ethics Committee (Approval number HREC2019-04-323). Your involvement is entirely voluntary and you can withdraw at any stage. However completing the survey will help us to develop more effective labelling.

Screening and Quotas

Firstly some questions about you and the household in which you live.

[Single]

S1. Are you……..?

Male

Female

Quota fail to be activated on S1

For ALL Quota fails activated by answering the following questions, use the following termination text:

Thank you for your time, however we already have enough responses from people from your demographic group.

[Single]

S2. What is your current age?

□□

Prefer not to say

IF PREFER NOT TO SAY AGE (Code 99 on S2) ASK:

[Single]

S2A. What is you approximate age?

Select one response only

Under 16

16-17

18-25

26-30

31-35

36-40

41-45

46+

99. Prefer not to say

Quota fail to be activated on S2a

IF NO AGE PROVIDED (Code 99 on S2a), SAY:

Thank you for your time, but to continue with this survey we need to know your approximate age.

IF UNDER 18 OR OVER 45 YEARS (Code 1 or 2 or Code 8 on S2a), SAY:

Thank you for your time, but to continue with this survey you must be aged 18 to 45 years of age.

IF AUSTRALIAN SAMPLE:

[Single]

S3A. In what area do you live?

Sydney

Rest of New South Wales

ACT

Melbourne

Rest of Victoria

Brisbane

Rest of Queensland

Adelaide

Rest of South Australia

Darwin

Rest of Northern Territory

Perth

Rest of Western Australia

Hobart

Rest of Tasmania

Somewhere else in Australia

I don’t live in Australia

Quota fail to be activated on S3A

TERMINATE IF CODE 15 OR 16

IF NEW ZEALAND SAMPLE:

[Single]

S3B. In what area do you live?

Northland

Auckland

Waikato

Bay of Plenty

Gisborne

Hawke’s Bay

Taranaki

Manawatu-Whanganui

Wellington

Tasman

Nelson

Marlborough

West Coast

Canterbury

Otago

Southland

Somewhere else in New Zealand

I don’t live in New Zealand

Quota fail to be activated on S3B

TERMINATE IF CODE 17 OR 18

IF NZ SAMPLE

[Single]

QETHNICITY. Which one ethnic group do you consider yourself to be to be from?

Maori

Pacific Islander – Samoan, Cook Islander, Tongan, Fijian, Niuean etc.

Asian

European or other

Part A: Warning label comprehension and evaluation.

Warnings

Warn1_Safest

Warn2_Lifelong

Warn3_Any

Warn4_Alcohol

RANDOMISE Warn1 to Warn4 – 25% to go through each label

ASK ALL

The first group of questions all relate to the label that is shown here. This is a label that could be applied to all alcohol containers, such as can and bottles. Please take a moment to read the label carefully.

This first group of questions seek your response to this label. Please answer each question thinking about this label, even if you do not like or agree with what it says. Later, you will be asked about your views on drinking alcohol during pregnancy, but for now please focus specifically on this label.

[Insert one of the 4 label options: Warn1_safest; Warn2_lifelong; Warn3_any; Warn4_alcohol]

[Open Text]

Q1. Thinking about this label, please explain clearly in your own words what message this label conveys to you.

[open ended question]

[new screen, show same label option, unable to go backwards]

[Single]

Q2. Which of the statements below best reflects your understanding of the message being conveyed by this label?

If none of the statements match your understanding of this label exactly, please choose the one that matches the best.

[randomise order of statements]

A	If you are pregnant you should not drink any amount of alcohol as it can harm your baby

B	If you are pregnant you should not drink any amount of alcohol as it can cause permanent harm to your baby

C	If you are pregnant you should not drink alcohol as it can harm your baby

D

E	If you are pregnant it’s best not to drink alcohol but drinking a small amount is OK

F

G	If you are pregnant you can drink alcohol if you want to but it’s better not to

[new screen, show same label option, unable to go backwards]

[Single]

Q3.	Please indicate the extent to which this label conveys the message to not drink any alcohol during pregnancy, on the scale from ‘very poorly’ to ‘very well’.

Very poorly	Quite poorly	Neither well nor poorly	Quite well	Very well
0	1	2	3	4

[new screen, show same label option, unable to go backwards]

[Single]

Q4.	Please indicate the extent to which this label is believable to you on the scale from ‘not at all believable’ to ‘very believable’.

Not at all believable to me	Very believable to me
0	1	2	3	4

[new screen, show same label option, unable to go backwards]

[Single]

Q5.	Please indicate the extent to which this label is credible to you on the scale from ‘not at all credible’ to ‘very credible’.

Not at all credible to me	Very credible to me
0	1	2	3	4

[new screen, show same label option, unable to go backwards]

[Single]

Q6.	For this question please think about your situation now and into the next few years.

Please indicate the extent to which this label applies to you on the scale ‘it does not apply to me at all’ to ‘it directly applies to me’.

It does not apply to me at all	It directly applies to me
0	1	2	3	4

[new screen, show same label option, unable to go backwards]

[Single]

Q7.	Please indicate the extent to which this label is convincing to you on the scale ‘not at all convincing’ to ‘very convincing’.

Not at all convincing to me	Very convincing to me
0	1	2	3	4

[new screen, show all four label options on one screen, unable to go backwards]

[randomise the position of the labels being show so each label has a 25% chance of being in each position]

SINGLE

Q7a. Please read the following four labels. In addition to the label you have already seen, there are three other versions.

Please select the label that you consider best conveys the message to not drink any alcohol while pregnant.

OPEN TEXT

Q7b. Please explain why you chose this label.

[new screen, NO label, unable to go backwards]

The next two questions are about your views on drinking alcohol while pregnant.

[Carousel Grid]

On a scale of ‘Not at all harmful’ to ‘very harmful’, please indicate how harmful you believe the following actions are to an unborn baby.

Q8_1 Drinking a small amount of alcohol (e.g. no more than 1-2 standard drinks in a month) while pregnant.

Q8_2. Drinking a larger amount of alcohol (e.g. 2 or more standard drinks per day) while pregnant

Not at all harmful	Very harmful
0	1	2	3	4

Part B: Alcohol Consumption

[new screen, NO label, unable to go backwards.

The next set of questions ask you about your level of alcohol consumption.

ASK ALL

[Single]

Q9. How often do you have a drink containing alcohol?

Never

Monthly or less often

2-4 times per month

2-3 times per week

4 or more times per week

ASK IF DRINKS ALCOHOL (Code 1-4 at Q9)

[Single]

Q10.	How many standard drinks of alcohol do you drink on a typical day when you are drinking?

A quick guide to standard drinks is below or click on this link to identify the number of standard drinks in typical alcoholic beverages.

Beer: 330ml can/bottle of regular beer = 1.4 standard drinks

330ml can/bottle of light beer = 0.7 standard drinks

Wine: 125ml ‘average’ glass = 1.3 standard drinks

750ml bottle = 7.7 standard drinks

Spirits: 30ml shot = 1 standard drink

Ready to Drink (RTDs): 330ml can/bottle = 1.4 standard drinks

Less than 1 (score 0)

1-2

3-4

5-6

7-9

10 or more

[Single]

Q11. How often do you have 5 or more standard drinks on one occasion?

A quick guide to standard drinks is below or click on this link for more information on how to calculate the number of standard drinks in typical alcoholic beverages.

Beer: 330ml can/bottle of regular beer = 1.4 standard drinks

:330ml can/bottle of light beer = 0.7 standard drinks

Wine: 125ml ‘average’ glass = 1.3 standard drinks

750ml bottle = 7.7 standard drinks

Spirits: 30ml shot = 1 standard drink

Ready to Drink (RTDs): 330ml can/bottle = 1.4 standard drinks

Never

Less than monthly

Monthly

Weekly

Daily or almost daily

Programmer - sum scores at Q9, Q10, Q11; minimum 0 maximum 12] and calculate for hidden variable below

[0 = no risk of harm

1-2 = low risk of harm

3-4 = medium risk of harm

5+=high risk of harm]

If code 0 at Q9, punch as code 1/no risk at Audit C Risk of Harm

Hidden Variable – Audit-C Risk of Harm

No Risk

Low Risk

Medium Risk

High Risk

[Multi]

ASK IF FEMALE RESPONDENT (Code 2 at S1)

Q12a. Which of the following apply to you? (Please mark all that apply)

I am currently pregnant

I have had a child within the last 18 months

I am planning to have a child in the next 18 months

I am planning to have a child in more than 18 months

I may have a child at some point in the future, but have no plans yet

None of the above

[Multi]

ASK IF MALE RESPONDENT (Code 1 at S1)

Q12b. Which of the following apply to you? (Please mark all that apply)

My partner/spouse is currently pregnant

I have a child who is 18 months old or younger

My partner/spouse and I are planning to have a child in the next 18 months

My partner/spouse and I are planning to have a child in more than 18 months

My partner/spouse and I may have a child at some point in the future, but have no plans yet

None of the above

Hidden Variable Q12 summary

Currently pregnant

One or more children 18 months or younger

Planning to have child in next 18 months

Planning to have a child in more than 18 months

May have a child in the future, but no plans yet

None of the above

Additional Demographics

Finally, just a few questions to confirm we have spoken with a wide range of people.

[Single]

SES1.Which of the following best describes your current employment situation?

1. Employed Full-time (35 hours or more per week)

2. Employed Part-time (Less than 35 hours per week)

3. Looking for full-time work (35 hours or more per week)

4. Looking for part-time work (Less than 35 hours per week)

5. Retired

6. Student

7. Non-Worker

8. Home Duties

99. Prefer not to say

[Single]

SES2. Which of the following best describes your PREVIOUS/CURRENT occupation?

USE “PREVIOUS” IF SES1 = 3,4,5,6,7,8 OTHERWISE USE “CURRENT”

1. Professional, e.g. Doctor, Dentist, Solicitor, Accountant, Chemist, Geologist, University Lecturer, IT Professional, MIS Manager, Data Manager, DP Manager, Systems/ Programme Analyst, Systems Engineer

2. Managing Director, Director, Senior Executive, General Manager, Partner, Company Secretary

3. Owner/ Manager of Small Business

4. Office Worker, e.g. Clerk, Typist, Secretary, Key Puncher, Receptionist

5. Skilled, e.g. Foreman, Electrician, Tradesman, Technician, Printer

6. Semi-Skilled, e.g. Factory Worker, Machinist, Driver, Apprentice, Waiter

7. Manual Worker, e.g. Cleaner, Council Worker, Labourer

8. Farm Owner

9. Farm worker

10. Sales Representative, Shop Worker

11. Other Professional, e.g. Nurse, Policeman, Social Worker

96. None/ No Occupation

97. Some Other Occupation (Please specify) ____________

99. Prefer not to say

[Single]

SES3. What is the highest level of education you’ve reached?

1. Some Primary School

2. Finished Primary School

3. Some Secondary School

4. Some Technical or Commercial/ TAFE

5. Passed School Certificate / Passed 4th Form / Passed Intermediate / Year 10 / Junior or Achievement certificate

6. Passed 5th Form / Year 11 / Passed Leaving or Sub-senior certificate

7. Finished Technical School / Commercial College / TAFE (including trade certificate) / other certificate or apprenticeship

8. Finished or now studying for Matriculation, Higher School Certificate (H.S.C.), V.C.E., Year 12, or Senior Certificate

9. Some University or some college of Advanced Education training

10. Diploma from College of Advanced Education or TAFE (Not Degree), Tertiary or Management Training (including Diploma other than University Degree)

11. Now at University or College of Advanced Education

12. Degree from University or College of Advanced Education

13. Higher Degree or Higher Diploma (e.g. Ph.D., Masters)

99. Prefer not to say

[Single]

SES4.	Please indicate your current approximate annual income from all sources before tax

If you are not certain, please give your best estimate.

1. Less than $6000

2. $6,000 - $9,999

3. $10,000 - $14,999

4. $15,000 - $19,999

5. $20,000 - $24,999

6. $25,000 - $29,999

7. $30,000 - $34,999

8. $35,000 - $39,999

9. $40,000 - $44,999

10. $45,000 - $49,999

11. $50,000 - $59,999

12. $60,000 - $69,999

13. $70,000 - $79,999

14. $80,000 - $89,999

15. $90,000 - $99,999

16. $100,000 - $109,999

17. $110,000 - $119,999

18. $120,000 - $129,999

19. $130,000 - $149,999

20. $150,000 - $199,999

21. $200,000 - $249,999

22. $250,000 - $299,999

23. $300,000 or more

98. Don’t know

99. Prefer not to say

[Single]

ASK IF CODE 98 or 99 at SES4

SES4a.	Could you please indicate whether your annual income from all sources before tax would be over $50,000 or under $50,000 per annum?

1. Under $50,000

2. $50,000 or More

98. Don’t know

99. Prefer not to say

[Single]

ASK ALL

SES5. Are you the main income earner in your household?

(If you and another person in the household earn the same income, and are therefore joint main income earners, please select ‘Yes’ below)

Yes

No

[Single]

ASK IF RESPONDENT NOT THE MAIN INCOME EARNER (Code 2 at SES5)

SES6.	Which of the following best describes the occupation of the main income earner in your household?

1. Professional, e.g. Doctor, Dentist, Solicitor, Accountant, Chemist, Geologist, University Lecturer, IT Professional, MIS Manager, Data Manager, DP Manager, Systems/ Programme Analyst, Systems Engineer

2. Managing Director, Director, Senior Executive, General Manager, Partner, Company Secretary

3. Owner/ Manager of Small Business

4. Office Worker, e.g. Clerk, Typist, Secretary, Key Puncher, Receptionist

5. Skilled, e.g. Foreman, Electrician, Tradesman, Technician, Printer

6. Semi-Skilled, e.g. Factory Worker, Machinist, Driver, Apprentice, Waiter

7. Manual Worker, e.g. Cleaner, Council Worker, Labourer

8. Farm Owner

9. Farm worker

10. Sales Representative, Shop Worker

11. Other Professional, e.g. Nurse, Policeman, Social Worker

96. None/ No Occupation

97. Some Other Occupation (Please specify)____________

99. Prefer not to say

[Single]

ASK IF RESPONDENT NOT THE MAIN INCOME EARNER (Code 2 at SES5)

SES7.	What is the highest level of education reached by the main income earner in your household?

1. Some Primary School

2. Finished Primary School

3. Some Secondary School

4. Some Technical Or Commercial/ TAFE

5. Passed School Certificate / Passed 4th Form / Passed Intermediate / Year 10 / Junior or Achievement certificate

6. Passed 5th Form / Year 11 / Passed Leaving or Sub-senior certificate

7. Finished Technical School / Commercial College / TAFE (including trade certificate) / other certificate or apprenticeship

8. Finished or now studying for Matriculation, Higher School Certificate (H.S.C.), V.C.E., Year 12, or Senior Certificate

9. Some University or some college of Advanced Education training

10. Diploma from College of Advanced Education or TAFE (Not Degree), Tertiary or Management Training (including Diploma other than University Degree)

11. Now at University or College of Advanced Education

12. Degree from University or College of Advanced Education

13. Higher Degree or Higher Diploma (e.g. Ph.D., Masters)

98. Don’t know

99. Prefer not to say

[Single]

ASK IF RESPONDENT NOT THE MAIN INCOME EARNER (Code 2 at SES5)

SES8,	What is the current approximate annual income from all sources before tax of the main income earner in your household?

If you are not certain, please give your best estimate.

1. Less than $6000

2. $6,000 - $9,999

3. $10,000 - $14,999

4. $15,000 - $19,999

5. $20,000 - $24,999

6. $25,000 - $29,999

7. $30,000 - $34,999

8. $35,000 - $39,999

9. $40,000 - $44,999

10. $45,000 - $49,999

11. $50,000 - $59,999

12. $60,000 - $69,999

13. $70,000 - $79,999

14. $80,000 - $89,999

15. $90,000 - $99,999

16. $100,000 - $109,999

17. $110,000 - $119,999

18. $120,000 - $129,999

19. $130,000 - $149,999

20. $150,000 - $199,999

21. $200,000 - $249,999

22. $250,000 - $299,999

23. $300,000 or more

98. Don’t know

99. Prefer not to say

[Single]

ASK IF CODE 98 or 99 at SES8

SES8a.	Could you please indicate whether the annual income from all sources before tax for the main income earner in your household would be over $50,000 or under $50,000 per annum?

1. Under $50,000

2. $50,000 or More

98. Don’t know

99. Prefer not to say

[Single]

ASK ALL

SES9. How would you rate your level of reading and understanding English?

Very poor

Poor

Average

Good

Very good

Can’t say

Thank you for taking the time for answering this questions. If you have any questions about the survey please contact us at FSANZsurvey2019@roymorgan.com

[Australian sample]

If you are pregnant and this survey has raised concerns about your alcohol consumption please see: https://www.pregnancybirthbaby.org.au/alcohol-and-pregnancy

If the survey has raised any concerns about your alcohol consumption please see: http://www.alcohol.gov.au/internet/alcohol/publishing.nsf/Content/home

You can also ring the National Alcohol and other Drug hotline on 1800 250 015 for free and confidential advice.

[New Zealand sample]

If you are pregnant and this survey has raised concerns about your alcohol consumption please see: https://www.alcohol.org.nz/alcohol-its-effects/alcohol-and-pregnancy/what-you-need-to-know

If the survey has raised any concerns about your alcohol consumption please see: https://www.alcohol.org.nz/

You can also ring the Alcohol Drug Helpline on 0800 787 797, or text 8681 for free and confidential advice.

This research will be used as part of the development of new labelling requirements for alcoholic beverages. If you would like to receive a summary report of this study please provide your email address: [field for email address]

In providing your email you are giving permission for Roy Morgan Research to pass on your contact details to Food Standards Australia New Zealand to send you a copy of the research findings. Your questionnaire responses will not be linked to this email address.

Once again thank you for your time in completing this survey.

Appendix B – Maori/Pacific Islander Perceptions

The following table details the perceptions of Maori/Pacific Islander respondents in the New Zealand sample in relation to their comprehension of the warning statement shown to them and choice of the label which best conveys the message ‘to not drink any alcohol while pregnant’. Note that survey results for Maori/Pacific Islander respondents displayed in this table have been compared with results from New Zealand respondents who are not of Maori/Pacific Islander origin, with figures highlighted where they are statistically significant at the 95% confidence level.

Table Comprehension of warning statement and choice of label best conveying message ‘to not drink any alcohol while pregnant’ for Maori/Pacific Islanders

Source: Alcohol Warning Label Survey 2019 – Maori/Pacific Islander sample – New Zealand.

Base: Shown ‘It’s safest no to drink alcohol while pregnant’ label n=27, shown ‘Any amount of alcohol can cause lifelong harm to your baby’ label n=34, shown ‘Any amount of alcohol can harm your baby’ n=39, shown ‘Alcohol can harm your baby’ label n=41, Total Maori/Pacific Islanders n=141.

Caution: small sample size for comprehension of warning statement questions (columns 1 to 5).

Appendix C – Socio-economic Quintiles

SOCIO-ECONOMIC SCALE

Each respondent is given a score of no more than 60 according to their status in each of the following categories:

1. EDUCATION LEVEL OF RESPONDENT

There are twelve possible levels of education. A score of 5 is given to those who completed only some primary school, 10 to those who finished primary school, and so on up to 60 for those who have a degree.

2. INCOME OF RESPONDENT (if respondent is a full-time worker)*

There are sixteen possible income levels. A similar scoring procedure is used giving 3 to those in the lowest income groups, up to 60 to those in the highest income group.

3. OCCUPATION OF RESPONDENT (if respondent is a full-time worker)*

There are twelve possible occupation levels. Again, each level is scored at approximately 5 point intervals. Professional people receive the highest score.

* Note - if the respondent is not a full-time worker, then the status of the main income earner is considered.

The respondent’s scores for each of these three categories are tallied to give a score out of 180.

We then look at a frequency distribution of the scores and divide the population into five even groups of 20%, i.e. quintiles.

The AB quintile is the highest level - people in this quintile have the highest scores.

Approximate breakdowns for Australian socio-economic quintiles are as follows:

Approximate breakdowns for New Zealand socio-economic quintiles are as follows:

Prepared by:

David Erickson and David Norrish

For Further information contact:

Roy Morgan

Tonic House

386 Flinders Lane, Melbourne

Ph: +61 (3) 9629 6888

E: askroymorgan@roymorgan.com

A series of questions to determine whether the respondent (or the respondent’s partner/spouse) was (a) currently pregnant; (b) had had a child in the 18 months prior to the survey; or (c) likely to be pregnant in the 18 months after the survey. This group was classified as ‘proximate pregnant’ for this survey.

https://www.health.gov.au/sites/default/files/assessing-alcohol-consumption-in-pregnancy-using-audit-c.pdf

Significance testing has been conducted separately for sex by country and proximity to pregnancy by country. An estimate for sex by country has not been texted for significance against proximity to pregnancy by country and vice versa.

Significance testing has been conducted separately for sex by country and proximity to pregnancy by country. An estimate for sex by country has not been texted for significance against proximity to pregnancy by country and vice versa.