Would you be more likely to cut back on drinking if you knew that alcohol raises the risk of cancer? A new study that tested updated designs for alcohol warning labels with consumers suggests the answer is yes.
The current alcohol warning labels have been in place since 1989, and they warn of the risks of drinking during pregnancy or while driving or operating heavy machinery. They also include a vague notice that alcohol "may cause health problems."
But research suggests people tend to tune out these labels, says Anna Grummon, an assistant professor at the Stanford University School of Medicine. And she says the labels haven't kept pace with mounting evidence about other serious health harms linked to drinking.
"For example, we've known for many years that alcohol contributes to cancer, but most Americans aren't aware of that link," Grummon says. Alcohol is the third leading preventable cause of cancer, behind tobacco and obesity.
Testing new language
Grummon and her colleagues wanted to see if more specific messages about the health harms of alcohol would do a better job of spreading awareness and motivating people to drink less.
So they came up with eight new labels warning about a range of health harms linked to drinking – like cancer, liver disease, dementia and hypertension. They then had more than 1,000 U.S. adults read them in random order along with a control message and with the current warning. All of the participants were of legal drinking age and said they had at least one drink a week.
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The researchers found that all of the new messages did a better job than the current warning when it came to teaching the study participants something they didn't know about the health risks of drinking, and nearly all were more effective at motivating them to want to cut back.
"And the warnings that especially resonated with consumers tended to be about cancer," Grummon says.
The study, which appears in the Journal of Studies on Alcohol and Drugs, did not measure whether people actually did drink less after viewing the labels – it only surveyed their motivation to cut back. Grummon says that's the next phase of the research that she and her colleagues are currently recruiting participants for.
But prior research has found that stronger messages like the ones used in this study can result in behavior change, says Johannes Thrul, a substance abuse researcher at the Johns Hopkins Bloomberg School of Public Health. He was not involved in the new study. He points to a real-world experiment conducted in Canada that found that labels that warned that alcohol can cause cancer resulted in reduced alcohol sales. That study ended early after complaints from the alcohol industry.
"So it is reasonable to expect that the warning labels that did well here in the study also would perform well if they were implemented," Thrul says.
In a statement, Amanda Berger, senior vice president for science and research at the Distilled Spirits Council, a major alcohol industry trade group, said, "The United States' current health warning has informed consumers for decades about health risks broadly. It is the federal government's role to determine changes to the warning statements based on the entire body of scientific research, and the industry is committed to following all laws and regulations that govern our labeling."
Growing calls for stronger health warnings
The study comes at a time when public health researchers are increasingly emphasizing the health harms linked to drinking.
Just before he left his post early last year, former Surgeon General Vivek Murthy called for requiring alcohol labels to inform consumers about the risks of cancer. He issued an advisory detailing how alcohol increases the risk of seven different types of cancer – including breast, colorectal, and mouth cancer.
And last summer, some two dozen consumer and public health groups called on the Trump administration to add a cancer warning to alcohol labels.
Meanwhile, the Trump administration has moved to loosen its guidance on alcohol. It pulled a major report on the health harms of alcohol after criticism from the alcohol industry. That study had been commissioned under the Biden administration to help inform the latest update to the federal Dietary Guidelines for Americans.
"We found that risks of various chronic disease outcomes begin even at levels – as low as one drink or two drinks a day," says Katherine Keyes, an epidemiologist at Columbia University and one of the authors of that disregarded study.
When the Trump administration released the new guidelines in January, it removed specific daily limits on alcohol. Instead, the guidelines simply advise to "consume less alcohol for better health," without specifying any amounts.
Action at the state level
Thomas Gremillion is director of food policy at the Consumer Federation of America, one of the groups that petitioned the Trump administration to strengthen the health warning on alcohol labels. He doesn't expect that to happen anytime soon.
"I would be shocked if a bill to update the health warning on alcohol moved in the current Congress," Gremillion says.
However, he says there has been some movement at the state level. "A bill passed in Alaska, for example, that requires a cancer warning at the point of sale for alcohol retailers," he notes. "And a similar bill has been introduced in Massachusetts."
Keyes of Columbia University says she welcomes moves to better inform consumers. "We know that the risk of cancers increases pretty much in a dose-response fashion with alcohol use," she says. In other words, the more people drink, the higher the risks.
"I'm mostly concerned about making sure that the American people have accurate information so that they can make clear and conscious decisions, having all of the information available to them," Keyes says. "I think that's what the American public wants and what they deserve."
Amanda Berger of the Distilled Spirits Council said like many things, alcohol comes with potential risks and benefits. She added, "We do not recommend that anyone drink to achieve health benefits."
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