Illustration of no alcohol for pregnant women sign on white background

Alcohol consumption among pregnant women has dropped 11 percent in states with point-of-sale warning signs, according to a new study conducted by a health economist at the University of Oregon.

The benefits show up in fewer extremely premature births (less than 32 weeks gestation) and very-low-birth-weight babies (less than 3.5 pounds). The greatest effects were found among women aged 30 and older.

Health economist Gulcan Cil published her findings in the Journal of Health Economics. Her complex breakdown of extensive data points to reduced drinking by pregnant women in areas with required warning signs and suggests a likely causal relationship between drinking while pregnant and birth outcomes.

“The signage is working,” said Cil, a visiting instructor in the Department of Economics and postdoctoral fellow in the department’s Mikesell Environmental and Resource Economics Research Lab. “Drinking alcohol while pregnant has been an issue that many policies have tried to address over the last few decades. An 11 percent change in the prevalence of drinking is not trivial. It is big enough to show up in the birth outcomes.”

The study involved regression analyses of data available in two national sources and information from the 23 states and Washington, D.C., which have adopted such signage, and a group of states that have not. The study’s control group included women who had lived in non-adopting states and women who lived in adopting states before signage requirements were implemented.

Comparing data from sign-adopting states and those not using signage allowed Cil to identify the direct relationship between drinking while pregnant and birth outcomes, reducing the likelihood that other factors such as cigarette smoking, drug abuse, nutritional deficiencies, and other risky life choices were at play in behavioral changes.

“It’s very hard to isolate one thing from another,” she said. “One thing that we do in empirical economics, in general, or applied econometrics is to try to find something that changes one variable at a time.”

Overall, point-of-sale signage, said Cil, appears to be an effective, low-cost approach to protect the health of pregnant women and their babies.

“Some people never get exposed to these kinds of educational campaigns,” Cil said. “I found that the issue has never been studied and evaluated as a public education program or public awareness program.”

The idea for the study was sparked when Cil noticed a sign in a Eugene, Oregon grocery store. She added that the signage used in Oregon contains an eye-catching graphic depicting a pregnant woman, while signs used in other states do not. All contain similar language. A future study might explore whether variations in signage — graphics, fonts, colors, and language — may best influence behavioral change.

Source: University of Oregon