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Warnings on alcohol reduce consumption, increase awareness

Photo credit: Eaters Collective via Unsplash

In Canada, warning labels are required on tobacco and cannabis products, but for years, the alcohol industry has prevented them from being applied to beverage alcohol. Data collected following a series of studies in Northern Canada suggests that highly visible warning labels on liquor not only lead people to consume less alcohol, but increases awareness among consumers about the harms associated with its consumption.

The Northern Territories Alcohol Labels Study was conducted by the Canadian Institute for Substance Use Research (CISUR) and Public Health Ontario (PHO), and is one of the first studies of its kind. It looks at data collected in 2017 and 2018, when the organization implemented a warning label program in Whitehorse, Yukon.

"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, Ph.D, co-lead author of the study in a release.

As part of the investigation, the Yukon Liquor Corporation began attaching bright warning labels to spirits, beer, and wine in late 2017. According to CISUR data, approximately 300,000 labels were attached to 98 per cent of all alcohol bottles during the study period.

Labels included one of three warnings: one linked evidence between cancer and alcohol, a second explained Canada’s low-risk drinking guidelines, and a third informed the consumer of the number of drinks in the bottle.

A standard label read as follows: “The Chief Medical Officer of Health advises: Alcohol can cause cancer, including breast and colon cancers. To reduce risks, drink no more than 2 stand drinks a day for women (3 for men); plan two or more non-drinking days each week.”

Not only did study results show that the use of warnings encouraged some to cut back on their drinking; it also helped keep low-risk guidelines and cancer advisories fresh in the minds of consumers.

CISUR director and co-lead on the study Tim Stockwell and CISUR scientist Jinhui Zhao found that when compared to a control site where labelling was not used—in this case, Yellowknife, Northwest Territories—per capita sales of labelled products fell by 6.6 per cent.

Baseline survey data was also collected as part of the study. Based on feedback from 836 liquor store patrons, just one quarter of patrons were aware of the link between alcohol and cancer, while 29 per cent could estimate the number of standard drinks in their beverage of choice. Less than half knew about Canada’s low-risk drinking guidelines.

Unfortunately, just four weeks after the study began, it was halted after the liquor industry complained that the Yukon Liquor Corporation did not have jurisdiction to place labels on products. The study was later restarted, but warning labels mentioning cancer were no longer included. (After consultation with legal experts it was later found by Stockwell and his colleagues at CISUR that the industry’s complaints had no merit, and that provincial and territorial governments “could be held liable” for not informing consumers that alcohol is a carcinogen.)

Researchers with CISUR argue that the data shows use of such labels is an effective public health intervention, and something that should be considered in light of increased drinking during the coronavirus pandemic.

“Despite the best efforts of Canada’s alcohol-industry lobbyists to shut down our study and keep consumers in the dark, we found evidence the warning labels helped drinkers in Yukon to be better informed about alcohol’s health risks, and prompted many to cut down their drinking,” said Stockwell. “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.”