Bottles of beer, wine and spirits should carry cigarette-style graphic health warnings to make clear that alcohol is linked to cancer, infertility and violence, doctors are urging.
The UK Faculty of Public Health (FPH) says harmful drinking has become so common that “no nonsense” warnings displayed in a prominent place on alcohol products are needed to overcome widespread public ignorance about the dozens of medical conditions excessive consumption can cause.
Arresting images, such as a liver after years of alcohol-related cirrhosis or a victim of violence, could force drinkers to realise the risks they take with their health, says the FPH, which represents 3,300 public health specialists working in the NHS, local government and academia.
“At the moment when people think about the dangers associated with alcohol they are more likely to think of a city centre disturbance rather than breast cancer, for example,
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so these health warnings would help educate the public and give them key information before they decide to buy a can or bottle of alcohol”, said Professor Mark Bellis, the FPH’s spokesman on alcohol who is also the director of the NHS’s regional public health observatory in Liverpool, which specialises in drinking and drug-taking, and director of the centre for public health research at Liverpool John Moores University.
“The evidence linking alcohol to over 60 medical conditions is unarguable, so they would need to be factual warnings, not sensational. People don’t realise that drink is associated with a whole range of health harms that it increases your risk of, such as injury, a stroke, heart disease, liver disease and many forms of cancer, and don’t realise its potential long-term implications for them. This is not the nanny state. This is simply to help the public understand the risks.”
The warnings could say things like “Alcohol increases risks of violence and abuse”, “Alcohol causes over 15,000 deaths a year in the UK” and “Alcohol increases risks of mouth, throat and other cancers”, suggested Bellis. Others could warn that alcohol raises the risk of breast cancer for women, is involved in 25% of deaths of young men aged 16 to 24 and reduces both men’s and women’s fertility.
Ministers would need to stipulate the size of the warnings on the label of all cans and bottles. “The health messages that are most important for people to see are the ones that drinks manufacturers are least likely to want to put on their products.”
Moves by the industry, such as putting the words “drink responsibly” or the website of the industry-backed charity Drinkaware on advertisements, were nowhere near enough given the huge cost to individuals and the NHS from alcohol abuse, Bellis added. Warnings would “help to redress the balance between the need for this information and the bombardment of positive images of alcohol manufacturers we get from their association with big sporting and cultural events like the Olympics and Champions League”.
The introduction of text-only warnings on cigarette packets in 1991, followed by picture warnings in 2007, is widely credited with helping reduce the number of smokers to about one in five of the population.
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The drinks industry criticized the FPH’s plan as disproportionate and unnecessary. “Given that 78% of people drink within the chief medical officer’s guidelines [of 21 units a week for men and 14 units for women], it wouldn’t be proportionate to have these more graphic warnings,” said Henry Ashworth, chief executive of the Portman Group, a drinks industry-funded social responsibility body. “There’s no comparison between alcohol and tobacco. The advice with tobacco is don’t smoke but with alcohol it’s not to exceed three or four units a day.”
Already 60% of all cans and bottles of alcohol in the UK carry three types of health information agreed between producers and ministers as part of a pledge that 80% will do so by the end of 2013, he said. These set out official sensible drinking advice, and a warning to pregnant women not to drink at all.
Dr Daniel Poulter MP, a hospital doctor and Conservative member of the Commons health select committee, backed the idea. “At the moment the medical consequences of alcohol abuse, such as its links to fertility and many types of cancer, are under-appreciated by the public. We do need to up the game in terms of raising awareness among drinkers both about these risks and about how much they are drinking. Proper labeling is important and having health warnings as part of that would be most welcome”, he said.
The British Medical Association, which represents 140,000 of the UK’s 200,000 doctors, also endorsed the FPH’s call. “We support the use of written health warnings on alcohol products”, said Dr Vivienne Nathanson, its director of professional activities. But the wording of warnings was crucial as moderate drinking is harmless but alcohol misuse causes serious ill-health, premature death and violence, she added.
While countries such as France use written warnings to deter alcohol consumption by mothers-to-be, in other places such as Thailand they warn about the increased risk of suicide, family break-up and drink-driving. South Africa plans to follow suit, while the Kenyan government’s plan for warnings that would cover 30% of the surface area of alcoholic product containers is being challenged in the country’s high court by East African Breweries.
Government action looks unlikely. The Department of Health said it agreed information should be provided to help people make healthy choices. But a spokesman added: “Cigarette-style health warnings are not applicable to alcohol. All levels of smoking are bad for your health, but the same cannot be said for alcohol consumption.”
Ministers are working with the industry to encourage greater production of lower-strength drinks, and planned to introduce a minimum unit price, he added.
Ministers who did order the use of labels could face legal challenges from drinks producers and foreign governments under laws regulating trademarks. intellectual copyright and the free movement of goods in the EU, said Philip Pfeffer, a partner specializing in products liability and international trade law at the London solicitors Chadbourne and Parke.
originally published at guardian.co.uk, Friday 13 July 2012