NEW DELHI: Less than one-third of all the countries globally have regulations mandating Alcohol Health Warning Labels (AHWLs) on alcohol containers, said a latest Lancet study, which recommended the need for mentioning well-established adverse health consequences due to alcohol consumption like fatal cancers, liver damage and other noncommunicable disease and road traffic accidents on them.
The study, published in The Lancet Regional Health - Southeast Asia on Tuesday, said harm due to alcohol use is a great public health concern for the South East Asia region (SEAR), with the annual per capita consumption expected to grow even further.
According to Dr Yatan Pal Singh Balhara, the co-author of the study, “In India, while there are health warning labels on alcohol containers and health warning labels on alcohol advertising, there are no provisions to have health warning labels on pregnancy, health warning labels on under-age drinking, and health warning labels on drink-driving.”
Dr Balhara, who is a Professor of Psychiatry at the National Drug Dependence Treatment Center and Department of Psychiatry at All India Institute of Medical Sciences (AIIMS), New Delhi, said all these are important themes to consider as alcohol is a significant contributor to road traffic accidents.
“Also, the use of alcohol during pregnancy and those who are underage is particularly problematic. There is a need to consider implementing these warning labels,” he told this paper.
The study said recommendations have been made to include cancer warning labels on alcoholic beverages.
“However, less than one-third of all the countries surveyed globally have regulations mandating Alcohol Health Warning Labels (AHWLs) on alcohol containers. Moreover, the content and its presentation are critical determinants of the potential impact of this health-related information labelling on the subsequent consumption of alcohol products,” the study said.
Ireland is on its way to becoming the first country in the world to require comprehensive health warnings on alcohol products by 2026. In the Southeast Asian region, only Thailand has adopted AHWLs.
The study found that some of the well-established adverse health consequences associated with alcohol use, such as harmful health consequences of alcohol consumption related to fatal cancers, liver damage and other noncommunicable diseases and road traffic accidents, have not yet been included in the AHWLs.
It said AHWLs relevant to populations with specific needs have not been adopted in most countries. These include health warning labels related to pregnancy and health warning labels on underage drinking.
It also added that consumer information about calories, additives (including allergens), etc., on containers is missing in most Southeast Asian countries.
While displaying the alcohol content on the container has been adopted in most countries, the practice of mentioning the number of standard alcoholic drinks on the container has yet to be adopted in many countries.
Moreover, most countries have yet to adopt the legal requirement for the size of health warning labels. “Various design factors such as size, placement, colour, pictorials, length, signal words like “warning” or “health warning” and physical interactivity have been shown to influence the consumers’ attention,” said the authors.
They also highlighted that alcohol labelling practices do not follow standard guidelines across countries. Further, even in countries where AHWLs are present on containers, they do not align with the best-practice recommendations.
“It has been recommended that use of AHWLs along with other alcohol control measures to increase awareness about various harms associated with alcohol use could help people make more informed decisions,” said the lead author, Dr Swarndeep Singh, Department of Psychiatry from Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi.
“We propose that mandatory AHWLs should be implemented along with other effective alcohol control strategies in all countries,” the authors said.
They also suggested providing QR codes on each container with a health warning message on the AHWL, which could allow people to access more elaborate infographic(s) or short audio-video messages on alcohol-related harms in various local languages.
To support their contention, they cited a recent study from Spain, which tested the effects of displaying QR codes with alcohol-related health information on prominently displayed banners in the alcohol section of a supermarket. They reported a low usage rate of 2.6 per 1000 among individuals who purchased alcohol.
The study also highlighted major barriers to the effective implementation of alcohol control policies, including the exploitation of legal loopholes by the alcohol industry, the low priority of policy implementation among responsible agencies, and insufficient experience or resources for ensuring their effective implementation.