Policy implementation learnings from the introduction of a mandatory alcohol pregnancy warning label

Policy makers lack guidance on effective ways to introduce alcohol warnings, making it important to document the experiences of early adopter countries. Aims of this study were to (i) assess uptake of a mandated pregnancy warning label in Australia, (ii) identify the placement of the warning on products (i.e. front, back, side, top, or bottom), and (iii) compare the results for (i) and (ii) between 2023 and 2024 to provide insights into industry willingness to engage with the policy. In-store visits and web-scraping were used to capture product images that were coded for presence and location of the mandatory pregnancy warning (2023: n = 5923; 2024: n = 6666). Four years after the initial introduction of the policy, corresponding to 1 year after the end of the implementation transition period, 22% of assessed products did not display the mandatory pregnancy warning. In both 2023 and 2024, prevalence was lowest in the spirits category and among single unit and imported products. In most instances, warnings were located on the back of products, although a substantial proportion of multi-packs displayed the warning on the underneath panel of the packaging. The Australian experience offers important insights for other jurisdictions introducing health warnings on alcohol products. Clearly specified compliance deadlines and requirements for warning location could overcome the identified implementation issues.