OBJECTIVE This study tested the initial and continued effects of cancer warning labels on drinkers' recall and knowledge that alcohol can cause cancer. METHOD A quasi-experiment was conducted to examine changes in the intervention versus comparison site for three outcomes: unprompted and prompted recall of the cancer warning, and knowledge that alcohol can cause cancer. The intervention site applied cancer warning labels to alcohol containers in its liquor store for 1 month, and the two liquor stores in the comparison site did not apply cancer labels. In total, 2,049 unique cohort participants (1,056 male) were recruited at liquor stores in the intervention and comparison sites to participate in surveys 4 months before labels were applied and 2 and 6 months after the cancer label was halted because of alcohol industry interference. Generalized estimating equations tested differences in outcomes between sites over time adjusting for socio-demographics and other covariates. RESULTS Two months after the cancer label, unprompted (+24.2% vs. +0.6%; adjusted odds ratio [AOR] = 32.7, 95% CI [5.4, 197.7]) and prompted (+35.7% vs. +4.1%; AOR = 6.2, 95% CI [3.6, 10.9]) recall increased to a greater extent in the intervention versus comparison site. There was a 10% greater increase in knowledge (+12.1% vs. +11.6%; AOR = 1.1, 95% CI [0.7, 1.5]) 2 months after the cancer label in the intervention versus comparison site. Similar results were found 6 months after the cancer label for all three outcomes. CONCLUSIONS In a real-world setting, cancer warning labels get noticed and increase knowledge that alcohol can cause cancer. Additional cancer label intervention studies are required that are not compromised by industry interference.

中文翻译：

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测试酒精标签作为向饮酒者传达癌症风险的工具：一项现实世界的准实验研究

目的本研究测试了癌症警告标签对饮酒者的回忆和酒精可引起癌症的认识的最初和持续影响。方法进行了一项准实验，以检查干预与比较部位的变化，以得出以下三个结果：无提示和及时召回癌症警告，以及对酒精可致癌的认识。干预站点在其酒类商店的酒类容器上贴了癌警告标签1个月，比较站点中的两个酒类仓库均未贴有癌症标签。总共有2049名独特的队列参与者（1,056名男性）在干预和比较站点的酒类店中招募，以在应用标签之前4个月以及由于酒精行业的干扰而中止癌症标签之后2和6个月参加调查。广义估计方程测试了随时间推移针对社会人口统计学和其他协变量进行调整后，站点之间结果的差异。结果在癌症标记后两个月，无提示（+ 24.2％比+ 0.6％；调整后的优势比[AOR] = 32.7，95％CI [5.4，197.7]）并提示（+ 35.7％比+ 4.1％； AOR = 6.2，95％CI [3.6，10.9]）在干预组和比较组中的召回率均有较大提高。在干预组和比较组中的癌症标记后两个月，知识增加了10％（+ 12.1％对+ 11.6％； AOR = 1.1，95％CI [0.7，1.5]）。在所有三个结果的癌症标记后6个月发现了相似的结果。结论在现实世界中，癌症警告标签受到关注，并增加了酒精可导致癌症的知识。