Alcohol warning labels increase awareness of drinking harms

A series of Canadian studies in the Journal of Studies on Alcohol and Drugs has found that alcohol bottles with labels providing information on the risks of alcohol consumption or drinking guidelines may inform consumers about the risks of alcohol consumption and cut down their drinking.

“The results provide the first real-world evidence that relatively large, bright yellow alcohol labels with rotating health messages get noticed by consumers and can increase awareness of national drinking guidelines; improve knowledge of alcohol-related health risks, such as cancer; and reduce alcohol sales compared to control sites without the labels,” said Erin Hobin, PhD, principal investigator and senior author on the studies in this series.

The study, called the Northern Territories Alcohol Label Study, involved placing bright-coloured labels on bottles of beer, wine and distilled spirits with one of three brief messages: one displaying the link between alcohol and cancer, the second containing the Canadian government’s low-risk drinking guidelines and the third providing information about the number of standard drinks in the container.

One of the studies found that adding such labels to alcohol bottles (300,000 labels in all) decreased total sales of alcohol by 6.9% compared with sales in regions without the new labels. In another article, researchers found that among 2049 participants, awareness of Canada’s low-risk drinking guidelines increased nearly three times compared with a control location. Canada recommends no more than two drinks a day for women, three for men and at least two alcohol-free days per week.

A third study queried the same 2049 participants about their knowledge of the link between alcohol consumption and cancer, with the label reading “Chief Medical Officer of Health advises that alcohol can cause cancer, including breast and colon cancer”. Prior to the label intervention, 25% of participants knew alcohol consumption can cause cancer. After the labelling, awareness in the Yukon rose to 42%, a 10% greater increase in awareness of the alcohol-cancer link relative to the control site in neighbouring Northwest Territories.

However, the cancer label part of the study was cut short, because the alcohol industry protested about the placement of labels on their products. The industry complained that the Yukon government, which helped coordinate the study and is responsible for alcohol distribution and sales in the territory, did not have legal authority to place such labels, that the labels violated the industry’s freedom of expression and that the government was defaming alcohol manufacturers. The Yukon government subsequently shut down the cancer label research only a month after its launch.

“I'd describe this study as a David versus Goliath scenario. Our Yukon partners and research team members worked tirelessly to execute this study and persevered, despite tremendous adversity,” Hobin said.

After consultation with legal experts, the researchers concluded that none of the industry's claims had any merit. In fact, provincial and territorial governments in Canada could be held liable if they do not warn consumers about the link between alcohol and cancer. (The World Health Organization declared alcohol as a human carcinogen more than 30 years ago.)

“Warning labels help drinkers to be better informed about alcohol’s health risks and prompted many to cut down their drinking. This is an especially vital public health intervention now, as we see people at risk of increasing their alcohol intake as they isolate at home during the COVID-19 outbreak,” said Tim Stockwell, PhD, from the Canadian Institute for Substance Use Research at the University of Victoria.

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