More detailed alcohol warning labels could reduce health harms, researchers suggest

When we do picture health harms from drinking, we're more likely to think of car crashes than cancer. This is largely because the alcohol industry has suppressed efforts to educate consumers about drinking-related health risks while championing the idea that alcohol can be beneficial to health, say two researchers with ties to the University of North Carolina at Chapel Hill.

In a New England Journal of Medicine perspective piece, co-authors Anna H. Grummon, PhD, and Marissa G. Hall, PhD, propose updating alcohol container warning labels as a strategy to help consumers make more informed decisions about how much they imbibe.

In April 2022, the U.S. Centers for Disease Control and Prevention published statistics showing that alcohol consumption is responsible for more than 140,000 deaths per year -- that's over 380 deaths every day. COVID-19 has exacerbated the situation, with alcohol-related deaths increasing by 25% during just the first year of the pandemic.

Still, a recent national survey found that almost 70% of U.S. adults have no idea that even light or moderate alcohol consumption can increase their risk of cancer.

"Many people are unaware of the full range of risks from alcohol consumption," said Grummon, the study's lead author and a Gillings alum -- now a research scientist in the Department of Nutrition at Harvard University's T.H. Chan School of Public Health. "For example, there is now scientific consensus that alcohol increases the risk of several types of cancer, including head and neck cancer, breast cancer and colorectal cancer. But two-thirds of Americans are not aware of these risks."

One strategy for addressing these knowledge gaps could be to update the required warning labels on alcohol containers. Such warnings are a low-cost, sustainable public health strategy for informing consumers and encouraging healthier behaviors.

For example, more than 150 countries require warning labels on cigarette packages, and the policy has contributed to remarkable decreases in smoking rates over the past several decades.

Based on previous research findings, the most effective warnings labels are shown prominently on the front of product packaging, include visual elements like photos or illustrations, and come in a variety of rotating designs so they avoid becoming "stale" to consumers.

The alcohol warning currently used in the U.S. has none of these elements and was written when there was far less evidence about the harms associated with alcohol consumption.

"The current U.S. warning label hasn't been updated in more than 30 years and largely goes unnoticed," said Hall, the study's senior author and an assistant professor in the Gillings School's Department of Health Behavior. (She is also a member of the Lineberger Comprehensive Cancer Center and a faculty fellow at the Carolina Population Center.) "Also, the warning says that alcohol 'may cause health problems,' a phrase so vague that it borders on being misleading. Given the mounting evidence about the harms caused by alcohol, the government has a duty to inform its citizens about these risks."

The warning label strategy has strong precedent: Remember those two thirds of American adults -- most of us! -- who were unaware alcohol has ties with cancer? Research also has found that two thirds of Americans also support requiring new, more specific health-related warning labels for alcohol products.