WHO calls for mandatory alcohol labels warning of cancer risk

The World Health Organization (WHO) has called on countries to ensure mandatory health warning labels on alcohol packaging showing that alcohol consumption is linked to cancer. 

The label, says WHO, will help raise awareness on the dangers of alcohol consumption, and help people make informed choices. This follows a research conducted by the organisation involving nearly 20 000 participants from 14 European Region countries, which found that cancer warnings on alcohol labels significantly boosted awareness of alcohol’s cancer risks. 

Labels featuring cancer warnings, says WHO, are “more likely to spark conversations about alcohol risks and discourage consumption compared to other types of health messages.”

“Clear and prominent health warning labels on alcohol, which include a specific cancer warning, are a cornerstone of the right to health because they empower individuals with vital information to make informed choices about the harm alcoholic products can cause. Providing this information does not take anything away from consumers. On the contrary, it arms them with knowledge, and knowledge is power,” said Dr Hans Henri, WHO regional director for Europe.

“Alcohol health warning labels are an important part of alcohol policy, serving multiple functions. They empower consumers to make informed decisions, raise awareness of alcohol-attributable health risks, can increase public support for alcohol policies, and reduce the overall appeal of alcohol products, ultimately influencing social norms around drinking. For younger generations especially, mandatory alcohol health warning labels could help shape healthier behaviours and attitudes towards alcohol,” explained Dr Gauden Galea, strategic adviser to the regional director, Special Initiative on Non communicable Diseases and Innovation at WHO. 

The global health organisation says the mandatory labelling should be clear and prominent on the packaging. It is also calling for visible, on-pack labeling that goes beyond QR codes, based on a pilot study that found that very few shoppers scanned the codes for health information. 

“The impact of health warnings depends on design, content and placement on the labels. Countries should mandate health warning labels on alcohol products rather than rely on self-regulation of alcohol producers, as these may opt for inconspicuous placement and ambiguous messaging,” says WHO.

The health agency notes that the clear and prominent health warnings can be presented in text-only format or combined with pictograms to maximise reach and empower consumers with clear, accurate information.

Seven types of cancer

According to the Centers for Disease Control(CDC), alcohol consumption is linked to seven types of cancer, including cancer of the mouth, throat, voice box, esophagus, colon and rectum, liver and breast in women. 

The CDC adds that there are studies that show that “drinking three or more drinks that contain alcohol per day increases the risk of stomach and pancreatic cancers, (and that) drinking alcohol may also increase prostate cancer risk.”

“Alcohol may increase cancer risk in several ways. Alcohol can disrupt cell cycles, increase chronic inflammation, and damage your DNA. DNA is the cell's "instruction manual" that controls how a cell grows and does its job. When DNA is damaged, a cell can grow out of control and become cancer,” says the CDC.

It notes that alcohol can increase levels of hormones, including estrogen. Estrogen plays a role in breast cancer development.” Alcohol makes it easier for the cells in our mouth to absorb cancer-causing chemicals (called carcinogens). For example, when you use both alcohol and tobacco, the alcohol increases the absorption of carcinogens from the tobacco,” adds CDC.

Globally, WHO records a total of 2.6 million deaths resulting from alcohol consumption.  There is no specific information about how many people in Kenya die annually from alcohol consumption, but alcohol abuse is a significant problem in the country. 

According to the Kenyan National Campaign Against Drug Abuse Authority (Nacada), alcohol-related deaths are common in Kenya, with hundreds of people dying each year from poisoned liquor. 

In its latest report released in 2022, Nacada shows that 3,199,119 Kenyans aged between 15 and 65 years use alcohol; 2,511,763 males  aged between 15 and 65 years and 687,356 females were currently using alcohol. 

The Western region had the highest  revalence of current use of alcohol  (23.8 per cent) followed by Coast (13.9 per cent) and Central (12.8 per cent). Nairobi region had the highest prevalence of   manufactured legal alcohol (10.3 per cent) followed by Central (10.0 per cent) and Eastern (8.4 per cent). 

Western region had the highest prevalence of current use of chang’aa (11.4 per cent) followed by Nyanza (6.3 per cent) and Rift Valley (3.6 per cent). The Western  region had the highest prevalence of current use of  traditional liquor (12.9 per cent) followed by Coast (7.4 per cent) and Nyanza (2.2 per cent). Central region had the highest prevalence of potable spirits (4.1 per cent) followed by Coast (3.2 per cent) and Rift Valley (3.1 per cent).

According to WHO, alcohol consumption causes over 200 health conditions, including liver diseases, road injuries, violence, cancers, cardiovascular diseases, suicides, tuberculosis, and HIV/Aids. WHO also states that “there are at least 30 health conditions that would not exist without alcohol consumption, such as alcoholic liver disease, fetal alcohol spectrum disorders, alcoholic pancreatitis or alcohol poisoning.

“For these conditions, there’s a direct link between the amount of alcohol consumed and the risk of developing the disease or dying from it – the more alcohol you drink, the higher the risk. Alcohol use can impact mental health by increasing the risk of disorders like depression and anxiety, and worsening existing conditions. It can lead to mood swings, impulsive behaviour, and elevate the risk of self-harm and suicide. Additionally, alcohol can disrupt sleep patterns and affect social and occupational functioning, which can aggravate mental health issues and create a cycle of deterioration,” says WHO. 

WHO, through the 2022-2030 Global Alcohol Action Plan, called on its members to “ensure appropriate consumer protection measures through development and implementation of labelling requirements for alcoholic beverages that display essential information for health protection”. 

The strategy was developed to promote and support local, regional and global actions to prevent and reduce the harmful use of alcohol, and remains the only global policy framework for reducing deaths and disabilities due to alcohol consumption in their entirety – from mental health conditions and no communicable diseases  to injuries and alcohol attributable infectious diseases. 

However, only South Korea and Ireland have legislated the inclusion of cancer warning messages on alcohol labels. In South Korea, the manufacturers can opt to apply alternative labels that do not mention cancer on their products. 

Despite plenty of data showing the harm that alcohol causes on the body, WHO says that alcohol producers have in the past 20 years, “strongly opposed the introduction of mandatory cancer warning labels on alcohol beverage containers in various jurisdictions.” 

“This opposition has even resulted in termination of research examining the use of cancer warning labels,” notes WHO, adding that public health advocates must be prepared to face expected similar interference in the future.

The strategy notes that the impact of harmful use of alcohol goes beyond one’s health and well-being, to social and economic losses relating to costs in the justice sector, costs from lost workforce productivity and unemployment and the costs assigned to pain and suffering, especially to family members, friends, co-workers and strangers. 

“Among the most dramatic manifestations of harm to persons other than drinkers are road traffic injuries and the consequences of prenatal alcohol exposure, which may result in the development of fetal alcohol spectrum disorders. There is no safe limit established for alcohol consumption at any stage of pregnancy. The harms to others may be very tangible, specific and time-bound (such as injuries or damage) or may be less tangible and result from suffering, poor health and well-being and the social consequences of drinking (such as being harassed or insulted or feeling threatened),” states the strategy.

The strategy also explains that decision-makers and general public low awareness about the negative impact of alcohol consumption on their health and safety has been influenced by commercial messaging and poorly regulated marketing of alcoholic beverages. This deprioritises efforts to counter the harmful use of alcohol in favour of other public health issues. 

A regional strategy was developed and adopted in the WHO African Region in 2013 to reduce the harmful use of alcohol in the WHO African Region, address the increasing use of alcohol in the region, especially among women and youth, and to strengthen alcohol policy responses in the region.

The action plans included addressing the availability of unlicensed liquor outlets and unrecorded production, enforcing drink-driving legislation such as setting and enforcing blood alcohol concentration limits, conducting random breath testing by the police, setting up sobriety check-points and conducting public awareness and information campaigns.

Other action plans for reducing alcohol misuse included developing or strengthening national systems for monitoring alcohol consumption, supporting research activities among vulnerable populations, combatting the use of other addictive behaviours, implementing prevention education and providing alternatives.

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