Cancer warning labels could be coming to alcoholic beverages near you
Fifteen words are roiling the global alcohol industry.
Beginning in 2026, containers of beer, wine and liquor sold in Ireland will be required by law to bear a label in red capital letters with two warnings: “There Is a Direct Link Between Alcohol and Fatal Cancers” and “Drinking Alcohol Causes Liver Disease.”
The requirement, signed into law last year, is backed by decades of scientific research and goes much further than any country has thus far communicated the health risks of alcohol consumption. It has sparked fierce opposition from alcohol businesses worldwide, but it 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 as they do for other food and beverage products.”
In Thailand, the government is in the final stages of drafting a regulation requiring alcohol products to carry graphic images accompanied by text warnings such as “alcoholic beverages can cause cancer,” according to The Bangkok Post.
A bill 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.”
This month, the Alaska Legislature held a committee hearing on a bill that would require businesses selling alcohol to post signs carrying a cancer warning.
Ireland has been a trailblazer in setting aggressive public health policies before. In 2004, it became the first country to ban smoking in indoor workplaces, including bars and restaurants, a policy since adopted in more than 70 countries. The warning label requirement for alcohol could be the start of a similar change in how beverages are packaged, and a vehicle for raising awareness about the dangers of drinking, however small the amount.
Long fight
The evidence linking drinking and cancer is well established. In 1988, the World Health Organization’s International Agency for Research on Cancer concluded that alcohol is carcinogenic to humans. Research in the decades since has only strengthened the conclusion, including for breast, liver, colorectal and esophageal cancers. In November, the WHO and the IARC declared in a joint statement: “No safe amount of alcohol consumption for cancers can be established.”
Despite this, the connection between alcohol and cancer isn’t well known. In the United States, a recent nationwide survey found that about 1 in 3 Americans was aware that drinking increased the risk of cancer.
Globally, only one-fourth of countries require any kind of health warning on alcohol, according to a recent study, and the mandated language is generally imprecise. The United States last altered 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, CEO of the advocacy organization Alcohol Action Ireland, who described it as “the most contested piece of legislation in Irish history.” She said the effort began in 2012, when a steering group assigned to address the country’s high rate of alcohol-related deaths recommended a raft of measures, including warning labels.
Many of the recommendations
were watered down by the time they became law in 2018, but the labeling requirement made it through unscathed. It took another four years for lawmakers to hammer out the specific wording and the design that would be required.
As those details were decided, alcohol companies stepped up their protests. In late 2022, a group of major alcohol-exporting European countries submitted formal objections to the European Commission, the European Union’s executive branch, arguing that Ireland’s labels impeded free trade and were not appropriate or proportionate to the objective of reducing alcohol’s harms.
When the commission raised no objection, Antonio Tajani, Italy’s foreign minister, called the Irish proposal “an attack on the Mediterranean diet.” The language in the labels “doesn’t take into account the difference between moderate consumption and alcohol abuse,” he said on Twitter.
Coordinated industry opposition
Alcohol businesses are fighting on multiple fronts to keep the Irish labeling requirement from taking effect. At committee meetings of the World Trade Organization in June and November, trade groups and 11 alcohol-exporting countries, including the United States, expressed concerns, questioned the scientific validity of the cancer warning and argued that Ireland’s labels would infringe on free trade.
In comments submitted to the WTO, the Distilled Spirits Council of the United States called the labels “inaccurate” and “misleading.” The group also suggested that “this important public health objective would be best managed” as part of a parallel effort to address cancer in the EU, an area where the alcohol industry has proved to have greater influence.
The European Commission was supposed to propose language for alcohol health warnings as part of its Beating Cancer Plan by the end of 2023 but failed to meet that deadline. In December, over the objections of the WHO, the European Parliament approved a report that did not affirm the need for warning labels, instead calling for information on “moderate and responsible drinking.”
In the final report, its authors repeatedly watered down language about alcohol’s role in disease, narrowing warning only about “harmful” or “excess” of consumption.
Dr. Gauden Galea, a strategic adviser at the WHO, said he was confident that broader labeling efforts would eventually succeed. At 63, he’s old enough to recall how cigarette companies once advertised on the front pages of newspapers, he added.
Eventually, he hopes, “People will not remember the time when you needed a warning on pesticides, but could sell an unlabeled carcinogen like alcohol with impunity.”