Ireland takes lead on labelling the dangers of alcohol consumption

Alcohol labelling has been signed into law – this is a huge step forward for public health

Minister for Health Stephen Donnelly recently signed into law Section 12 of the Public Health (Alcohol) Act 2018. This provides for alcohol products being sold in Ireland to have health information labels.

These regulations will ensure that no alcohol product can be sold without bearing a warning that informs the public that ‘drinking alcohol causes liver disease’; displays a health symbol on the danger of alcohol consumption when pregnant; and states ‘there is a direct link between alcohol and fatal cancers’.

The regulations also make it mandatory that the alcohol and calorie content within the product is stated, and that the public health alcohol information website (askaboutalcohol.ie) is displayed. Similar notices will also have to be placed in licensed premises. 

Dr Sheila Gilheany, CEO Alcohol Action Ireland (AAI), said that this is a very significant development in alcohol policy and commended Minister Donnelly for his leadership.

“We are very aware that many countries have been closely observing Ireland’s progress in this regard and believe, that like the smoking ban, other jurisdictions will likely adopt similar labelling measures. We can be proud that Ireland is leading the way in this regard.”

It’s almost five years since laws were passed to provide for health information labelling of alcohol product, and despite ferocious opposition from global vested interests, the groundbreaking regulations have now been successfully through the EU notification process.

Ireland was also obliged to notify the World Trade Organisation (WTO) of its labelling regulations. When the WTO standstill period ended in May, the Irish Government was then able to proceed and bring the regulations into force with a start date of May 2026. This gives industry a three-year lead-in period as required under the Public Health (Alcohol) Act.

“It is no surprise though to see reports of alcohol industry efforts seeking further delays to the implementation of these regulations by lodging a complaint with the EU Commission,” AAI stated.

In its complaint, Spirits Europe said Ireland’s plans represents a disproportionate trade barrier and would make it considerably more complex and expensive for non-Irish producers and distributors.

“For good reasons, the right to restrict the freedom of movement of goods in the single market is subject to strict rules: Trade barriers must be justified and proportionate. We believe Ireland has failed to demonstrate the admissibility of their measures on both these criteria,” said
Mr Ulrich Adam, Director General of Spirits Europe.

We are very aware that many countries
have been closely observing Ireland’s
progress in this regard and believe, that like
the smoking ban, other jurisdictions
will likely adopt similar labelling measures

European Commission

However, the European Commission, despite opposition from a number of wine-producing countries, made it clear that Ireland has demonstrated that its labelling regulations were proportionate to the scale of the public health issues caused by alcohol in this country.

Nine countries, including the US, UK, Australia, and New Zealand, are understood to have submitted comments under a WTO ‘technical barriers to trade’ process. In a WTO meeting on the issue on 21 June, it was reported that the EU defended Ireland’s regulations. In addition, the World Health Organisation spoke of the need for health information labelling.

Alcohol companies want Ireland to freeze its plans until the European Commission comes forward with EU-wide alcohol health warnings. AAI have commented that “this is very much a delaying tactic”.

“The drinks industry sought and obtained a derogation from 2011 EU-wide labelling regulations claiming they would come up with their own proposals for alcohol labelling,” according to AAI.

“Eventually the EU found that there was no good reason for such a derogation and is now considering options for the provision of nutritional information and also cancer warnings. However, the alcohol industry is seeking to have such information provided off-label via QR codes, which is of no value to the consumer. Ireland’s labelling regulations actually provide a model for the rest of the EU to follow.”

Introduction of health information on alcohol products in Ireland is particularly pertinent because of Ireland’s continued heavy reliance on both alcohol consumption and binge-drinking. The most recent Healthy Ireland survey (2022) showed that over a third (37 per cent) of Irish adults aged 15 and over drink alcohol at least once a week, with over a fifth (22 per cent) of drinkers binge-drinking on a typical drinking occasion.

Over a third (37 per cent) of 15-to-24 year olds who drink in Ireland have an alcohol disorder.

Evidence

In terms of the risk of alcohol consumption to unborn babies, the evidence shows that around 6,000 babies are born each year in Ireland with foetal alcohol spectrum disorders (FASD) and 600 with foetal alcohol syndrome, which is the most severe form.

A large systematic global review estimated that Ireland had the third highest rate of FASD globally, at 47.5 per 1,000 population.  The majority of these children will have no visible disability at birth and difficulties may not manifest until pre-school or school age. This
may be why there is less of an outcry about the huge risks of alcohol consumption during pregnancy to unborn children and Ireland’s position close to the top of the league table for FASD rates globally. 

Is this what we want for our children – almost one-in-20 babies in Ireland having a lifelong impact from alcohol exposure before they were born?

Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. And the risk increases substantially the more alcohol is consumed.

A report in The Lancet this year states that even light to moderate alcohol use, defined as one-to-two drinks per day carries a significant cancer risk – in the EU almost 23,000 new cancer cases in 2017, almost half of these cancers (approximately 11,000 cases) were female breast cancers.

Despite the evidence, AAI points out that there is a lack of awareness about the scale of the risk from alcohol. Recent research from the Health Research Board indicates that only a fifth (21 per cent) of the population correctly identify the link between alcohol and breast cancer.

Drinks Ireland, a powerful business lobby group, suggests that we shouldn’t put warning labels on alcohol to tell people about dangers to unborn babies, risks of cancer and liver disease from their products suggesting that these harms are at the extreme end of the scale.

The truth is, in fact, the exact opposite.

In a recent Lancet series in April on the commercial determinants of health, the front page started with the following words: “The shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so.”

Ireland has a continued reliance on heavy consumption and binge-drinking. Now that culture will be challenged with evidence-based facts on the bottle that state the risks to both consumers and their unborn children. 

DR CATHERINE CONLON, Senior Medical Officer with the HSE, and former Director of Human Health and Nutrition at safefood