Document Type

Theses, Ph.D


Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence


Business and Management.

Publication Details

Thesis submitted in the fulfilment of the requirement for the degree of Doctor of Philosophy (PhD), School of Marketing, College of Business, Technological University Dublin, December 2022.


Introduction and Aims As part of several measures to inform consumers about the health risks of alcohol and reduce alcohol consumption, the Irish Government signed into law the Public Health (Alcohol) Act 2018, with Section 13 requiring the implementation of multiple health warnings in all alcohol ads. While health warnings on product labels have been subject to intensive political discussion and academic research, health warnings in alcohol ads have received little attention and empirical support. This doctoral dissertation investigates whether health warnings in alcohol ads can promote cognitive and affective reactions in consumers. Furthermore, this thesis also examines whether the exclusion of advertising social imagery makes health warnings more effective.

Method A between-subject factorial survey experiment was conducted with a convenience sample of adults (n = 932) in Ireland to compare single-text, multiple-text, and shocking image-and-text health warning designs displayed on two types of alcohol ads (an ad with social imagery featuring people drinking alcohol in a social setting and an ad featuring only the alcohol product). Recall and believability of health warnings, negative emotions, perceived personal risks of alcohol use, knowledge of the health effects of alcohol and self-efficacy to drink less were measured after viewing each alcohol ad with and without health warnings.

Results Factors yielding higher probabilities of recall include: health warning designs, gender, and drinking status. Significant differences were also found between health warning designs on negative emotions and believability, particularly that single-health warnings, with and without imagery, were more effective in increasing negative emotions than multiple health warnings, whereas multiple warnings were found more believable than single warnings. There were no significant direct effects between all three warning designs on perceived personal risks of alcohol use, knowledge of the health effects of alcohol and self-efficacy to drink less. The varied health warning designs did not differ across demographic groups, and there was no evidence to suggest that social imagery alcohol ads decrease the effectiveness of health warnings across the outcomes.

Conclusions This research makes several theoretical and practical contributions, the most important of which is the examination of multiple-text health warnings and cancer warnings, with and without shocking imagery, in an entirely new context, which is that of alcohol advertising. Overall, this thesis demonstrates that alcohol ads with cancer health warnings were the most effective warning design, which is consistent with prominent fear appeal theories suggesting that an effort should be placed to design health warnings that lead to emotional effects as one powerful health message such as cancer can be more impactful than multiple-text health messages displayed simultaneously on alcohol ads.