Irish plan to put cancer warnings on alcohol being closely watched

Scotland ‘happy’ Ireland to fore in campaign to be first in EU to have such labels

It is a quirk of law that a bottle of alcohol-free beer must list its ingredients but there is no such requirement for a bottle containing actual alcohol.

"It makes no sense," says Dr Peter Rice of NHS Tayside in Scotland.

Dr Rice, a consultant psychiatrist and chairman of Scottish Health Action on Alcohol Problems, was a leader in the campaign there to introduce minimum unit pricing, a “floor price” below which a unit of alcohol cannot be sold.

The measure has been brought in, from May 1st, to reduce harmful drinking caused by the strongest and cheapest alcohol, and last month the parliament in Wales passed similar legislation.


Introducing it took six years from the time the Scottish parliament passed the legislation.

Now Scotland and the rest of the EU are watching the very slow passage of the Public Health (Alcohol) Bill through the Dáil – the State’s attempt to deal with Ireland’s problem drinking. The latest row is over labelling and the provisions to include health warnings on labels linking alcohol to cancer.

Ireland will be the first EU state to have such labelling if it gets the green light from the European Commission. The changes had to be notified to the commission, which is expected to make a decision next month.

The legislation has taken almost three years to date, since it was first introduced in December 2015 by then minister for health Leo Varadkar.

The Scottish legislation was delayed by a legal challenge from the Scotch Whisky Association.

I'm happy to say as a consumer I noticed that a week after minimum price came in, multipacks shifted from being 440ml cans to 330ml bottles

“The association took the view that the measure was illegal under EU trade law – the Treaty of Lisbon essentially – that it was a restriction on trade,” the NHS consultant says.

It took six years – a series of judgments in Scottish courts, appeals to the EU and back to the UK supreme court before it got the go ahead.

Cider shift

Two months in and the biggest price change has been with cider.

“This is a category of very cheap drinks – strong white ciders – which are so inexpensive because of an anomaly in the taxation system. It’s really that drinks category where the price was transformed by the minimum unit pricing,” says Dr Rice.

“The amount of alcohol you could get hold of before May 1st cheaply through white cider was far greater than any other category in this very anomalous tax system. You could buy 15 UK units of alcohol – the equivalent of a half bottle of spirits – for £2.50 or £3. The price of that category has jumped to £7.50.

“The other category that changed was the below-cost supermarket own-brand vodkas. They would have been kicking around £10.50 and they were going up to around £13.

“Beer prices weren’t transformed in the way cider prices were. For beers the price changes were really in the large multipacks of 18 or 24 cans. They went up by something like 10 per cent.”

But he was pleased to see how the drinks industry reacted – and how quickly.

“I’m happy to say as a consumer I noticed that a week after minimum price came in, multipacks shifted from being 440ml cans to 330ml bottles.

“The beer companies responded by actually lowering the size of the container, and from our point of view, if that leads to people drinking less then that’s a move in the right direction.”

Two months in and the reports are good. “We’ve heard accounts of many of the heaviest drinkers who were drinking those products, shifting on to regular-strength beer, reducing their consumption through doing that.

“That will be a benefit to their health that may be a precursor to them stopping altogether. Or it may just be to stabilise their level of consumption, but either way that’s a move in the right direction.”

Forcing change

Doctors have reported no major problems in terms of increases of numbers of people with alcohol withdrawal or alcohol seizures.

“Any negative effects on health were going to be in the short-term of heavier drinkers suddenly being forced to change their drinking from heavy consumption,” Dr Rice said. “In due course we’ll see how liver disease admissions and other things that you might expect in the medium to long term [will change].”

But he is happy with the early reaction of patients affected by the change, who are saying they know they need to change their drinking and are glad something is happening to force them to make that change.

And he is watching what is happening in Ireland on the Public Health Alcohol Bill, specifically the measures over labelling and cancer warnings.

“Scotland does not have the right to set labelling guidelines.” That has to be a UK-wide decision and that is why “we are in the ridiculous situation where there is a requirement to state the ingredients on alcohol-free beer but not on alcohol itself”.

He noticed that beer manufacturers “have less of a problem listing ingredients than wine producers”.

Drinks manufacturers have complained of the costs involved in putting warning labels on alcohol for sale in Ireland

Eight EU member states carry health warnings on their alcohol products but none of the warnings link alcohol to cancer.

Third of label

The Seanad voted to introduce cancer warnings on alcohol products and to ensure they made up at least one-third of the label.

The Upper House also voted to introduce a 9pm watershed before which alcohol advertising cannot be broadcast.

These changes had to be notified to the European Commission, which is expected to make a decision next month, although the label size element has been dropped after the commission indicated it was “disproportionate”. The Minister will still have power to ensure warnings are “prominent and conspicuous”, but it will be next month before he knows if those warnings can include cancer.

Drinks manufacturers have complained of the costs involved in putting warning labels on alcohol for sale in Ireland and different labels elsewhere.

But a number of countries selling Irish alcohol oblige them to carry health warnings on their labels.

If the commission looks favourably at the changes, the legislation is expected to be passed by the Dáil early in the autumn term.

Irish health authorities – and drinks companies – once watched Scotland. Now the authorities – and the drinks companies – are watching Ireland.

Dr Rice points out that the international health community is looking to Ireland and “happy to see it to the fore” in pushing for the clear, “evidence-based” links to cancer.