New research supports graphic health warnings on alcohol bottles — including photos of diseased livers

New research supports graphic health warnings on alcohol bottles — including photos of diseased livers

Tom Blackwell | December 16, 2015 2:39 PM ET
More from Tom Blackwell | @tomblackwellNP

Alcohol health warning labels from a presentation from EuroCare, the  European Alcohol Policy Alliance.

New research is adding fuel to the movement for graphic, cigarette-style health warnings on alcohol bottles — and at least one Canadian jurisdiction is reportedly poised to turn the contentious idea into reality.

A study to be published Thursday found that people’s perceptions of prominent wine, beer and liquor brands diminished significantly when the containers were adorned with an alert about liver cancer and a photo of a diseased organ.

That’s an indication such labels might help curb problem drinking, the study’s Halifax-based authors say.

A much larger Ontario government study recently tested a variety of graphic health labels, also finding they had a potent impact.

 And Tim Stockwell, a prominent alcohol researcher in B.C., says he is working with an unnamed Canadian government on a plan to mandate labels that outline the number of drinks in a bottle, and safe drinking limits.

“I think it’s going to happen more and more,” he said. “We’re on the verge of seeing much more pointed and direct health information about risks of drinking on alcohol containers.”

A few provinces have agreed in principle to be part of a real-world study that will see health labels on all alcohol containers in certain places, said Erin Hobin, a Public Health Ontario scientist working with Stockwell.

Neither researcher would reveal which jurisdictions are involved as plans have yet to be finalized.

The Ontario agency has already exposed a panel of 2,000 people to proposed labels, including one that features a photograph of a dying liver-disease patient, her skin yellowed by jaundice.

Results of the study have yet to be published, but Hobin said the reactions to such images were strong, likely because surveys have shown 70 per cent of Canadians are simply unaware drinking is a risk factor for cancer.

“Canadians perceive this kind of information as new and shocking and frightening,” she said.

A spokesman for the country’s liquor industry, however, voiced skepticism at the research, saying he has yet to see any empirical evidence that health labels can actually change behaviour.

European Alcohol Policy Alliance

European Alcohol Policy AllianceAlcohol health warning labels from a presentation from EuroCare, the European Alcohol Policy Alliance.

“When people are consuming the products, whether at home or in a bar, how closely do you think that correlates to the kind of experimentation and testing they’re doing?” said Jan Westcott, head of Spirits Canada. “Come on … A lot of these (studies) attempt to mimic what goes on in real life, and fail.”

Meanwhile, most global alcohol corporations are already in the process of voluntarily introducing symbols on their product that discourage impaired driving, or drinking while pregnant, he said.

The World Health Organization has rated alcohol as the second biggest source of death and disease, causing accidents, violence, chronic illness, birth defects and terminal cancers.

The notion of labelling alcohol with health alerts is not new, with countries such as the United States long requiring discreet messages about, for instance, the risk of drinking during pregnancy.

Canada has never had any such regulation, perhaps reflecting societal resistance to interfering in a widely enjoyed pleasure.

“As soon as I bring up alcohol labeling, it often causes a fight, so I’ve sort of made a rule for myself not to bring it up at dinner parties,” said Hobin. “People are very sensitive about alcohol.”

Regardless, earlier research suggests simple black-and-white text labels like those in the U.S. have relatively little impact.

Mohammed Al-hamdani, a doctoral student in occupational psychology at Halifax’s St. Mary’s University, and St. Mary’s professor Steve Smith decided to study whether stronger, cigarette-style warnings could have a greater effect.

In an online survey, just under 100 respondents were asked to rate their reaction to prominent wine, beer and liquor containers without health warnings; with text-only warnings; with warnings that included pictures; and with warnings that included pictures on otherwise plain packaging.

Those bearing the text-and-image labels about liver cancer made the greatest impact, with subjects less likely to rate positively the product and the type of person who would drink it, says the study to be published Thursday in the Canadian Journal of Public Health.

More research is needed, but the findings suggest there could be value in the idea, said Al-hamdani.

Stockwell said the jurisdiction he’s working with is considering mandating labels that indicate not just the percentage of alcohol, but the number of standard drinks in a bottle. And they would summarize Canada’s “low-risk drinking guidelines,” indicating how many drinks would increase someone’s risk of a disease like cancer.

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