Current Information Provision is Inadequate: Let's Put Salient Warnings on Alcoholic Beverages

Link to the article shown above

Alcohol causes health harms of the same order of magnitude as tobacco, but health warnings on alcohol are much less salient than those on tobacco. It is past time to rectify that. The New England Journal of Medicine “Perspective” piece shown above has useful points to make. Here are some passages, separated by added bullets:

• … alcohol consumption now accounts for more than 140,000 deaths per year in the United States, or more than 380 deaths per day. The Covid-19 pandemic has exacerbated alcohol-associated harm in the United States, with alcohol-related deaths increasing by 25% during the first year of the pandemic as compared with the previous year.

• In addition to the data on fatal and nonfatal injuries resulting from acute intoxication (including injuries caused by motor vehicle crashes), mounting research links longer-term alcohol consumption to chronic diseases including hypertensive heart disease, cirrhosis, and several types of cancer.2 Even light or moderate drinking increases the risk of these conditions, particularly cancer.2

• Warning labels are most effective when they are displayed prominently on the front of product packaging, include pictorial elements such as photographs or icons, and rotate the content of their messages to avoid any one message becoming “stale.” A randomized trial involving 2149 smokers, for example, found that large, front-of-pack, pictorial warning labels for cigarettes increased smoking quit rates by 50% (from 3.8 to 5.7%) over 4 weeks as compared with smaller, side-of-pack, text-only warning labels.4 Similar benefits have been documented in longitudinal studies examining smoking behaviors after countries implemented well-designed cigarette-package warning labels and in quasi-experiments evaluating grocery purchases after implementation of prominent front-of-package warning labels for unhealthy foods and beverages.

• The current alcohol warning in the United States lacks all the key elements of evidence-based warning design: it uses small text, typically appears on the back or side of product packaging, and doesn’t include any pictorial elements (see figure). The warning message is also static, having remained unchanged since the label was first implemented more than three decades ago.

• … when large, pictorial warnings about cancer risk were temporarily added to the front of alcohol containers in some stores in Yukon, Canada, alcohol sales dropped by 6 to 10%.5

The pleasing idea that a little alcohol is good for health has done a lot to maintain a positive image for alcohol. Unfortunately, that idea is false. I lay out one of the most telling pieces of evidence damning alcohol in “Data on Asian Genes that Discourage Alcohol Consumption Explode the Myth that a Little Alcohol is Good for your Health.”

Warnings are likely to substantially reduce alcohol consumption. And we should not stop there. It would help protect people if every instance of alcohol consumption was considered an indulgence and social disapproval of more than minimal alcohol consumption gradually increased.