The
Centre for Addiction and Mental Health (CAMH) supports providing the public
with information to help them make informed choices about the use of alcohol.
The Centre's position on warning labels has remained consistent since
we addressed this subject to the House of Commons Standing Committee on
Health in 1996.
Alcohol
is not like other products. There are risks associated with its use, risks
that are largely preventable.
Alcohol
affects the nervous system, impairing mental judgement and coordination,
making accidents and injuries the prime cause of alcohol-related deaths.
Long-term use of alcohol can cause neurologic disorders and damage to
the liver, heart and other organs. Alcohol has been linked to several
types of cancer. Chronic alcohol use is a major cause of disability and
death in Canada, and the associated economic costs are substantial. Alcohol
is also a human teratogen which causes damage to infants heavily exposed
before birth. In extreme cases this is described as fetal alcohol syndrome,
characterized by impaired growth, physical malformations and developmental
delay.
The
public interest in warning labels lies in the potential of such warnings
to prevent illness, injury or death if consumers do not use the product
in a hazardous way.
Alcoholic
beverages contain the psychoactive drug ethanol. They should therefore
be treated like other products that contain psychoactive elements. Cough
remedies containing alcohol are required to include warnings about exceeding
a recommended dose, driving and operating machinery, and medical contraindications,
while beverages containing this same drug carry none of these warnings.
People
who should not use alcohol or who should restrict their use may include
any of the following:
1) those with a history of uncontrolled drinking or drug use,
2) those with medical conditions which may be aggravated by alcohol
or who are taking medications,
3) pregnant women, and
4) those who need to remain alert for safety reasons.
Canadian
brewers and distillers and Health Canada have recognized the hazards associated
with alcohol. Their frequent public education campaigns have aimed to
inform the public about the potential hazards of drinking, particularly
as related to drinking and driving and drinking during pregnancy. In this
context, it would be consistent for the Canadian government to require
warning labels on alcoholic beverages to ensure that consumers have the
information they need about a product that has potential risks.
If
alcohol warning labels are mandated CAMH would recommend that the following
be considered:
(1) Warning labels must not be considered in isolation, since knowledge
alone rarely results in changed behaviour. Warning labels reinforce,
rather than replace other forms of education. Labelling should be seen
as just one part of a broader public health effort to reduce alcohol-related
harm. That effort should also include ongoing public education, responsive
public policy and availability of effective treatment services.
(2) Warning labels should not focus on alcohol-related birth defects
alone, since they represent a small part of the harm to the health and
wellbeing of Canadians caused by alcohol. Far greater are the hospitalizations,
disabilities and early deaths that arise from alcohol-related injuries,
liver disease, neurological disorders, and addiction. Similarly, pregnant
women make up only a very small percentage of those who are at increased
risk of alcohol-related problems, or who should be made aware of the
potential hazards of drinking. However, warnings about drinking during
pregnancy should focus on what the public doesn't know. Pregnant women
need to be informed that they can reduce the risk by cutting down now.
There should also be an emphasis on directing pregnant women to seek
medical/addiction-related treatment service.
(3) Evidence from the tobacco sector shows that the design of warning
labels greatly influences their impact and effectiveness, including
type and number of messages and specific wording. Regulations on size,
placement, font, and colour are needed to ensure labels are seen and
read.
(4) Messages most likely to be recalled contain new information, a
rationale for rotating warning messages and periodically changing them.
Messages are also more convincing if they are personalized and relevant
to the consumer.
(5) Research for cigarette warnings reveals a number of techniques
to make the messages more effective. Not using words such as 'can' and
'may,' personalizing the message and citing a government health authority
such as Health Canada strengthens public acceptance of the health consequences
presented. A government health warning also serves to underscore information
obtained from other sources.
(6) Research on tobacco labels suggests that warning labels will have
greater impact if the specific message is not well known. However newer
and more specific messages should be evaluated as well as those with
more positive behaviour-oriented advice. Examples of more novel messages
might include:
-- Alcohol causes high blood pressure
-- Alcohol should not be used by people with bleeding disorders
-- It may be dangerous to use alcohol with certain medicines
-- Reducing alcohol use early in pregnancy greatly increases the chance
of a healthy baby
(7) Labels that incorporate messages about potential health benefits
should not be permitted. This is a complex medical issue and only certain
individuals, at high risk for heart disease, are expected to achieve
any net health benefit from moderate drinking relative to abstinence.
(8) Consumer information about the alcohol content of standard drinks
should be considered for inclusion on the label along with the warnings.
The public is often unaware of standard serving sizes and typically
underestimates the amount of alcohol consumed. CAMH has addressed this
through the promotion of the "Low Risk Drinking Guidelines".
(9) As warning notices on consumer products become commonplace, the
lack of a government warning on alcoholic beverages potentially sends
an unintended message, and may make other information about harmful
effects less believable.
(10) Evaluation should be conducted throughout the development, implementation
and use of warning labels in order to assess their effectiveness. To
guarantee that the labels are effective, we recommend that labels be
subjected to formal pre-testing and subsequently their format be specified
in regulations.
The greatest value in this approach of using warning labels on alcoholic
beverage containers is that exposure to alcohol and to the warnings
are linked. Frequent users repeatedly see the warning and are reminded
of the potential risks they may be taking each time they drink.
In
summary, because the warning labels represent a minimal public expenditure,
they can be a cost-effective prevention tool, even if their impact is
small. The Centre for Addiction and Mental Health supports efforts to
place this type of product information on alcoholic beverages, but recommends
that warning labels be a part of a more comprehensive prevention strategy.
|
1-800-463-6273
