Implementation of health warnings on alcoholic beverages in Spain

The objective of this study is to estimate the frequency and characteristics of health warning labeling on alcoholic beverages in Spain. Cross-sectional study conducted in Madrid, Spain, between March and April 2023. A convenience sample was designed by selecting four supermarket chains with a 40 % share of food distribution and two specialized alcohol stores. A total of 627 products were examined: 170 beers, 306 wines and sparkling wines, 68 liquors, 48 vermouths and aperitifs, and 35 other types of alcoholic beverages. Fisher's exact test statistically evaluated differences in labeling across beverage types. One or more health warnings were observed on 63.0 % of the products, with the most frequent being a recommendation against consumption during pregnancy (56.5 %), followed by recommendations against consumption by minors (19.0 %), and while driving (9.1 %). Only 9.1 % of the labels displayed two warnings, and 6.2 % displayed three. Significant differences were observed according to beverage type (p < 0.001), with the beer products presenting the highest frequency of displaying at least one warning (81.8 %), and liquors presenting the lowest frequency (50 %). In Spain, alcohol industry's adherence to its own voluntary labeling guidelines of health warnings is low and inconsistent across type of beverages.