Countries want to label alcoholic drinks for cancer – 04/11/2024 – Equilíbrio

From 2026, bottles of beer, wine and spirits sold in Ireland will have a label in red block letters with two warnings: “There is a Direct Link Between Alcohol and Fatal Cancers” and “Drinking Alcohol Causes Liver Disease”.

The requirement, signed into law last year, is backed by decades of scientific research and goes far beyond what any country has communicated to date about the health risks of alcohol consumption. This has generated strong opposition from alcohol companies around the world, but is also inspiring a movement in some other countries to adopt similar measures.

“It’s an important step,” says Timothy Naimi, director of the Canadian Institute of Substance Use Research at the University of Victoria. “People who drink should have the right to know basic information about alcohol, just as they do for other food and beverage products.”

In Thailand, the government is in the final stages of drafting regulations that will require alcoholic products to carry graphic images accompanied by text warnings, such as “alcoholic drinks may cause cancer,” according to the Bangkok Post.

A bill has been introduced in the Canadian parliament that would require labels on all alcoholic beverages to report a “direct causal association between alcohol consumption and the development of fatal cancers.”

Last week, the Alaska Legislature held a committee hearing on a bill that would require businesses that sell alcohol to display signs with a cancer warning.

Norway, which already heavily regulates the sale of alcohol, is developing proposals to introduce cancer warning labels. The country’s Secretary of State, Ole Henrik Krat Bjorkholt, who has followed Ireland’s effort with great interest, said in an interview: “I think it’s likely that we will implement something similar.”

Ireland has been a pioneer in setting aggressive public health policies before. In 2004, it became the first country to ban smoking in indoor workplaces, including bars and restaurants, a policy since adopted in more than 70 countries. Requiring warning labels for alcohol could be the start of a similar change in the way drinks are packaged and a way to raise awareness about the dangers of drinking alcohol, no matter how small the quantity.

Long Fight

The evidence linking alcohol consumption and cancer is well established. In 1988, Iarc, the cancer research agency of the WHO (World Health Organization) concluded that alcohol is carcinogenic to humans.

Research in the following decades only strengthened the conclusion, including for breast, liver, colorectal and esophageal cancers. In November, the WHO and IARC stated in a joint statement: “A safe amount of alcohol consumption for cancers cannot be established.”

Despite this, the connection between alcohol and cancer is not well known. In the United States, a recent national survey found that about 1 in 3 Americans were aware that drinking increased their risk of cancer.

Globally, only a quarter of countries require some type of health warning on alcohol packaging, according to a recent study, and the required language is often imprecise. The United States last changed its warning labels in 1989, when it introduced language that discouraged drinking during pregnancy, or before driving or operating heavy machinery, and that vaguely acknowledged that alcohol “may cause health problems.”

It took more than a decade for Ireland’s labeling requirement to become a reality, according to Sheila Gilheany, CEO of advocacy organization Alcohol Action Ireland, who described it as “the most contested legislation in Irish history.” She said the effort began in 2012, when a working group assigned to address the country’s high rate of alcohol-related deaths recommended a series of measures, including warning labels.

Many of the recommendations were watered down until they became law in 2018, but the labeling requirement went unscathed. It took another four years for lawmakers to agree on the specific wording and design that would be required.

While these details were being decided, the alcohol industry intensified its protests. In late 2022, a group of European alcohol-exporting countries lodged formal objections with the European Commission, the executive arm of the European Union, arguing that Ireland’s labels impeded free trade and were not appropriate or proportionate to the aim of reducing alcohol harm. alcohol.

When the commission raised no objection, Antonio Tajani, Italy’s foreign minister, called the Irish proposal “an attack on the Mediterranean diet.” The language on labels “does not take into account the difference between moderate drinking and alcohol abuse,” he said on X (formerly Twitter).

Coordinated Industry Opposition

Alcohol companies are fighting on multiple fronts to stop the Irish labeling requirement from coming into effect. At World Trade Organization (WTO) committee meetings in June and November, trade groups and 11 alcohol-exporting countries, including the US, expressed concerns, questioned the scientific validity of the cancer warning and argued that Ireland’s labels contravened the free Comerce.

In comments sent to the WTO, the Distilled Spirits Council of the United States called the labels “inaccurate” and “misleading.” The group also suggested that “this important public health objective would be better managed” as part of a parallel effort to address cancer in the EU, an area where the alcohol industry has the most influence.

The European Commission was supposed to propose text for alcohol health risk warnings as part of its Cancer Plan by the end of 2023, but it failed to meet that deadline. In December, over objections from the WHO, the European Parliament approved a report that did not state the need for warning labels, instead calling for information on “moderate and responsible consumption.”

In the final report, the authors repeatedly softened the language about alcohol’s role in disease, restricting warnings to only “harmful” or “excessive” drinking.

Size and Design

Cormac Healy, director of Drinks Ireland, a trade group, said his organization was not completely against the health warnings. But he said the mandatory label size would be impractical for use on smaller products, taking a 50-milliliter bottle from his desk to demonstrate. And the warning itself was “disproportionate and inaccurate,” he claims, and mostly aimed at scaring people.

“To inform, to educate — you can’t really do that on a label,” he added.

In the US, alcohol warning labels are usually on the back of the bottle or can, where they blend in with other graphic features. Marissa Hall, an assistant professor in the department of health behavior at the University of North Carolina at Chapel Hill, said labels would be more effective in catching a shopper’s attention if they were on the front, included an image or icon, and featured one of a group. rotating brief messages.

Hall recently received a grant from the NIH to evaluate the impact of stronger design features on reducing consumption. When she tells friends about her research, many are surprised to learn that the U.S. requires warning labels because existing ones go so easily unnoticed.

“They have no idea,” she said.

Over the past 15 years, some countries have proposed more direct alcohol warning labels, but each has been met with strong opposition, said Paula O’Brien, a law professor at the University of Melbourne. In 2010, Thailand proposed requiring a rotating group of warnings accompanied by graphic color images; O’Brien called it “the high point for alcohol labeling.” But at the WTO, other countries raised concerns that the labels would restrict free trade, and the measure stalled.

In 2016, South Korea overcame similar objections to require a group of warning labels — some of which link alcohol to cancer — that alcohol manufacturers can choose to place on their products.

Even research on the topic has been controversial. In 2017, Yukon, a sparsely populated territory in northwestern Canada, partnered with scientists to introduce and test the impact of bright, colorful warning labels, one of which included the phrase “alcohol can cause cancer.” But after alcohol trade groups complained, the local government halted the study for fear of facing a lawsuit it could not afford.

“I was a little surprised by the strength of the reaction,” says Erin Hobin, a Public Health Ontario scientist who led the project in Yukon.

When researchers resumed the study several months later, with the condition that the cancer warning was omitted, they found that people who purchased alcoholic beverages with the labels were still more likely to notice the messages and reported reducing their consumption. Sales of products bearing the labels also fell by around 7% during the intervention and in the following months.

Most importantly, says Hobin, as drinkers became more informed about the link between alcohol and cancer, they also became more likely to support policies to control the availability, pricing, and marketing of alcohol, which have been shown to further reduce consumption. .

If the alcohol industry dissuades the EU from adopting warning labels, it would keep Ireland isolated and out of harmony with European law. This could ultimately provide the basis for challenging the labeling requirement in Irish courts, said Ollie Bartlett, assistant professor of law at Maynooth University in Ireland. But he said such efforts were unlikely to be successful because Ireland’s alcohol warning labels are “proportionate to the objective of protecting public health”.

Some experts say the EU should not take any further action until after this summer’s parliamentary elections. And there is no indication that Ireland will back down from its commitment to require the labels from May 2026.

Gauden Galea, strategic advisor to the WHO, said he is confident that broader labeling efforts will eventually succeed. At 63, he is old enough to remember how cigarette companies used to advertise on the front pages of newspapers, he added.

Eventually, he hopes that “People won’t remember the time when a pesticide warning was required, but they could sell an unlabeled carcinogen like alcohol with impunity.”

This article was originally published in The New York Times.