Fifteen words are disrupting the global alcohol industry.
From 2026, containers of beer, wine and spirits sold in Ireland will be required by law to carry a label in red capital letters with two warnings: “THERE IS A DIRECT LINK BETWEEN ALCOHOL AND DEADLY CANCER” and “ALCOHOL PUNISHMENT IS JUSTIFIED.”
The requirement, signed into law last year, is backed by decades of scientific research and goes much further than any country has so far communicated the health risks of drinking alcohol. It has sparked a backlash from alcohol businesses worldwide, but is also inspiring a push in some other countries to pursue similar measures.
“It’s an important step,” said Dr. Timothy Naimi, director of the Canadian Institute for Substance Use Research at the University of Victoria. “People who drink should have the right to know basic information about alcohol, just like other food and drink products.”
In Thailand, the government is in the final stages of drafting a regulation that would require alcohol products to carry graphic images accompanied by text warnings such as “alcoholic beverages may cause cancer.” according to the Bangkok Post.
An account has been introduced in the Canadian Parliament that would require labels on all alcoholic beverages to communicate a “direct causal link between alcohol consumption and the development of fatal cancers.”
Last week, the Alaska State Legislature held a committee hearing on a bill which would require businesses that sell alcohol to post cancer warning signs.
Norway, which already heavily regulates the sale of alcohol, is development proposals to introduce cancer warning labels. The country’s deputy minister, Ole Henrik Krat Bjorkholt, who watched Ireland’s effort with great interest, said in an interview: “I think it is possible that we will implement something similar.”
Ireland has been a pioneer in setting aggressive public health policies in the past. In 2004, it became the first country to ban smoking in indoor workplaces, including bars and restaurants, a policy that has since been adopted in more than 70 countries. The alcohol warning label requirement could be the start of a similar change in the way drinks are packaged and a means of raising awareness of the dangers of drinking, no matter how small the amount.
Long fight
The evidence linking drinking and cancer is well documented. In 1988, the World Health Organization’s International Agency for Research on Cancer concluded that alcohol is carcinogenic to humans. The decades of research since then have only strengthened the conclusion, including cancers of the breast, liver, colon and esophagus. In November, WHO and IARC announced in a joint statement: “A safe amount of alcohol consumption for cancers cannot be determined.”
However, the relationship between alcohol and cancer is not well known. In the United States, a recent nationwide survey found that about one in three Americans knew that drinking alcohol increases the risk of cancer.
Globally, only a quarter of countries require any kind of health warning for alcohol, according to a recent study, and mandatory language is generally imprecise. The United States last amended 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, Chief Executive of the advocacy group Alcohol Action Ireland, who described it as “the most controversial piece of legislation in Irish history”. He said the effort began in 2012, when a steering group tasked with addressing the country’s high rate of alcohol-related deaths recommended a series of measures, including warning labels.
Many of the recommendations have been watered down since becoming law in 2018, but the labeling requirement made it through intact. It took another four years for lawmakers to come up with the specific wording and planning that would be required.
As these details were decided, the alcohol companies stepped up their protests. In late 2022, a group of major 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 its harm reduction objective. alcohol.
When the committee did not object, Antonio Tajani, Italy’s foreign minister, called the Irish proposal “an attack on the Mediterranean diet”. The language on the labels “doesn’t take into account the difference between moderate consumption and abuse of alcohol,” he said. he said on Twitter.
Coordinated industry opposition
Alcohol businesses are fighting on multiple fronts to prevent the Irish labeling requirement from coming into force. At World Trade Organization committee meetings in June and November, trade groups and eleven alcohol-exporting countries, including the United States, raised concerns, questioned the scientific validity of the cancer warning and argued that Ireland’s labels would infringe on the free trade.
In comments submitted to the World Trade Organization, the United States Distilled Spirits Council called the labels “inaccurate” and “misleading.” The team also suggested that “this important public health objective could be better addressed” as part of a parallel effort to tackle cancer in the European Union, an area where the alcohol industry has proven to be most influential.
The European Commission had to propose language for health warnings on alcohol as part of it Plan to fight cancer until the end of 2023, but did not meet this deadline. It ended in December the objections of the World Health Organizationthe European Parliament approved a report that did not confirm the need for warning labels, but called for information on “moderate and responsible alcohol consumption”.
In the final report, its authors repeatedly watered down the language about alcohol’s role in disease, limiting warnings to only “harmful” or “excessive.” of consumption.
Size and design
Cormac Healy, director of Drinks Ireland, a trade group, said his organization was not completely against the health warnings. However, he said the mandatory label size would be impractical for use on smaller products, holding up a 50 milliliter bottle from his desk to demonstrate. And the warning language itself was “disproportionate and imprecise”, he said, and aimed mainly at scaring people.
“To inform, to educate — you can’t do that in a label,” he added.
In the United States, alcohol warning labels are usually located on the back of the bottle or can, where they are combined with other graphic features. Dr. 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 at catching a shopper’s eye if they were on the front, including an image or icon. and featured one of a rotating group of short messages.
Dr. Hall recently received a grant from the National Institutes of Health to test the impact of stronger design features. When she tells friends about her research, many are surprised to learn that the United States doesn’t require warning labels at all, she said, because the existing ones are too easily overlooked.
“They have no idea,” he said.
Over the past 15 years, some countries have proposed stronger alcohol warning labels, but each has been met with fierce 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 quality mark for alcohol labelling”. But at the World Trade Organization, other countries raised concerns that the labels would limit free trade and the measure was stalled.
In 2016, South Korea overcame similar objections to impose a group of warning labels, some of which link alcohol to cancer, that alcohol producers can choose from to put on their products.
Even the research on the matter was controversial. In 2017, the Yukon, a sparsely populated region in northwestern Canada, formed a partnership with scientists to introduce and test the impact of brightly colored warning labels, one of which included the phrase “alcohol can cause cancer.” But after complaints from alcohol trade groups, the local government halted the study for fear it would face a lawsuit it could not afford to fight.
“I was a little surprised at the strength of the response,” said Dr. Erin Hobin, a scientist at Public Health Ontario who led the Yukon project.
When the researchers continued the study several months later, under the condition that the cancer warning be omitted, they found that people who bought alcoholic beverages with the labels were more likely to notice the messages and reported reducing their alcohol consumption. Sales of products bearing the tags as well decreased by about 7 percent during the intervention and several months after.
More importantly, Dr. Hobin said, as drinkers became more informed about the link between alcohol and cancer, they also became they are more likely to support policies to control alcohol availability, pricing and marketing, which have been shown to further reduce alcohol consumption.
If the alcohol industry discouraged the European Union from adopting warning labels, it would keep Ireland isolated and out of step with European law. That could eventually form the basis of challenging the labeling requirement in Irish courts, said Dr Ollie Bartlett, assistant professor of law at Maynooth University in Ireland. But he said such efforts were unlikely to prevail because Ireland’s alcohol warning labels were “proportionate to the objective of protecting public health”.
Observers say the European Union is unlikely to take further action until after parliamentary elections this summer. And there is no sign that Ireland will back down from its commitment to require the labels from May 2026.
Dr. Gauden Galea, a strategic adviser at the World Health Organization, said he was confident that broader labeling efforts would eventually succeed. At 63, he is old enough to remember how cigarette companies once advertised on the front pages of newspapers, he added.
Eventually, he hopes, “People won’t remember the time when you needed a pesticide warning, but you could sell an unlabeled carcinogen like alcohol with impunity.”