Alcohol warning labels reduce sales, change minds

Press release by University of Victoria

Colourful, highly visible warning labels applied to bottles and cans of alcohol in Yukon’s largest liquor store prompted many people in Canada’s highest-alcohol-consuming region to cut back on their drinking.  

This was one of the major findings from the Northern Territories Alcohol Labels Study—a real-world study of alcohol warning labels launched in Whitehorse, Yukon, in 2017—published this month in a special section of the Journal of Studies on Alcohol and Drugs.

The world-first research from the Canadian Institute for Substance Research (CISUR) at the University of Victoria shows that well-designed warning labels are an effective public health intervention, and can play a role in curbing alcohol intake at home during the COVID-19 outbreak. 

Researchers also found that people who bought alcohol with the labels better remembered national drinking guidelines and warning risks about cancer.

“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,” says Tim Stockwell, director of CISUR and co-lead of the study. “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.”

An analysis of sales data* led by Stockwell and CISUR scientist Jinhui Zhao found that per capita sales of labelled products dropped by 6.6 per cent compared to the products in control sites that didn’t get the new labels.

CISUR research associate Kate Vallance, lead author on an evaluation of baseline survey data*, found that initially only a quarter of respondents were aware of the alcohol-cancer link, 29 per cent could estimate the number of standard drinks in their preferred drink and less than 50 per cent were aware of Canada’s Low-Risk Drinking Guidelines.

Two papers led by study co-lead Erin Hobin, scientist at Public Health Ontario and assistant professor at the University of Toronto’s Dalla Lana School of Public Health, looked at how people retained the labels’ messages. She found consumers exposed to the new labels were 10 per cent more likely to recall the causal link between alcohol and cancer*,three times more likely to be aware of Canada’s low-risk drinking guidelines, and 50 per cent more likely to remember daily low-risk drinking limits.*

The study attracted a lot of attention—and controversy—when the labelling intervention was launched in the liquor store in Whitehorse in late 2017. Approximately 300,000 labels were applied to 98 per cent of alcohol containers during the study period. Canadian alcohol industry lobby groups objected to the study, questioned the government’s authority to place the labels on the containers in the first place, and challenged the link between alcohol and cancer despite decades of scientific evidence. After just one month, the study was halted for three months and the cancer labels removed. The study continued, with standard drink and low-risk drinking guideline labels, until July 2018.

Two of the papers in the journal—a media analysis led by Vallance, and a legal analysis led by Stockwell—look at industry claims. Stockwell collaborated with legal experts toanalyze the alcohol lobby’s arguments* around Yukon’s right to affix the labels on alcohol containers, and found that their arguments held no water and governments had a duty to inform citizens they were selling a product that could cause cancer or risk leaving themselves exposed to future civil lawsuits. Vallance’s analysis found that 68 per cent of news stories* supported use of the labels in Yukon.

“We found some striking similarities with the tobacco industry in the way the alcohol lobby groups consistently downplayed or outright denied the link between alcohol and cancer in news coverage,” says Vallance. “That’s worrying because they are not providing accurate information to the public and there are still no evidence-based warning labels available on alcohol containers in Canada, even though people support them.”

“We recommend that all alcohol containers be required to carry health warning labels, including health risk information such as a cancer warning, Canada’s Low-Risk Drinking Guidelines, and the number of standard drinks per container,” says Stockwell, adding that these changes could be achieved variously at the federal, provincial and/or territorial levels of government.

The Northern Territories Alcohol Labels Study was funded by Health Canada’s Substance Use and Addictions Program. 

More info on the Northern Territory Alcohol Labels Study: http://alcohollabels.cisur.ca/