Project Summary Alcohol consumption is a major modifiable risk factor for cancer, along with tobacco use and excess body weight. However, knowledge about the link between alcohol and cancer risk is poor in the United States. Research on tobacco labels has shown that placing pictorial warning labels (PWLs) improves consumer awareness of risks and decreases consumption. These results suggest that a similar approach to using PWLs on alcohol-containing products would raise awareness of risks and decrease alcohol consumption. Yet, one standing issue is that the typical graphic or shocking images used in such warnings can cause avoidance and reactance, which can lower message effectiveness and public support for pictorial warnings. A potential solution is to design PWLs that feature narrative content focused on people, such as cancer patients in medical settings, to capture attention and counteract reactance. The proposed project aims to develop and evaluate the impact of narrative PWLs on visual attention, message reactance, risk perceptions, and intentions to reduce and stop drinking. To accomplish these aims, the proposed project will include two phases: (1) Developing alcohol PWLs in narrative and conventional, non-narrative formats using existing research and focus group methods; and (2) Experimentally testing the effect of narrative versus non-narrative PWLs among adult alcohol users using objective measures of attention (eye tracking) and self-report measures of reactance, risk perceptions, and intentions. The approach is innovative because we will explicitly test the impact of visual narrative warnings on attention and message reactance, and provide an objective and direct measurement of attention by using eye tracking. With these approaches, this study will lay the groundwork for understanding the mechanisms by which visual narrative warnings communicate health risks and promote behavioral change. Findings of this early-stage project will also provide the foundation for a controlled trial of effective warning labels designed to increase public awareness of risks and decrease the overall alcohol consumption in the United States.