France’s health minister Agnès “buzzkill” Buzyn has again provoked the ire of the wine industry with a new proposal to require a large red warning label on all bottles, admonishing pregnant women to avoid all alcohol and reminding buyers of the legal age limit (18) for drinking. A coalition of 64 of France’s top winemakers are pushing back, declaring in a letter to Le Figaro that this is nothing less than an affront to the soul of their country. As translated by British newspaper The Telegraph, the letter implores their countrymen to recognize the importance of the “thousands of tourists [who] come to discover this France, bosom of the art de vivrethat is the envy of the world and where wine plays a leading role.” They mourn the prospect of bottles defaced “with labels covered in lugubrious and deathly signs.” Warning labels are already required in France as in many other countries, but the size is not specified; Buzyn want a 2 cm (about an inch) wide red banner. I cringe at the thought.
Whether the labels will be of any benefit to public health is the overriding question. Buzyn’s rationale is her claim that wine is like any other form of alcohol from a health perspective, and the fact that a quarter of pregnant women continue to drink. On the first point, she is wrong, and I have detailed the evidence herebefore. The second point is obviously a sensitive one; no one in their right mind would encourage women to drink while pregnant. But having said that, Dr. Buzyn hasn’t presented evidence that France has a disproportionate problem with alcohol abuse during pregnancy, or that it is in the form of wine. In general, wine drinkers have healthier drinking habits, and indications are that alcohol abusers are unlikely to take notice of the labels anyway.
The use of warning labels has its roots in tobacco packaging. But speaking for the French wine industry, Pierre-Henri Gaget of Maison Louis Jadot, has said “We don’t carry the plague and don’t want to be tarred with the same brush as cigarette manufacturers.” Those in Buzyn’s camp, like her British counterpart Sally Davies, see no benefit of moderate drinking and thereby equate wine to smoking. But even if that were true, do warning labels affect consumer behavior? It’s surprisingly hard to prove. Most of the research tracks short term responses to the labels, with focus groups, eye tracking, and surveys. A recent study[i]from University of Liverpool and the UK Centre for Tobacco and Alcohol Studies, evaluating enhanced labels like the ones proposed in France, concluded “Alcohol consumers allocate minimal attention to warning labels on alcohol packaging and even if their attention is directed to these warning labels, this has no impact on their drinking intentions.” This mirrored the findings of an earlier Australian study[ii] that looked at the effect of warning labels on adolescents, which concluded that while the introduction of alcohol warning labels increased initial awareness, “little change was observed in terms of beliefs about the risks of alcohol use or participation in risky alcohol-related behaviours. These findings are similar to those reported among adult samples.” A study on university students in Italy[iii]identified a key aspect of the issue, noting that “Italian young adults with moderate consumption behaviour view label warnings positively, while this attitude is weaker among younger adults and those with riskier consumption behaviours.” So by inference, teenagers and pregnant women – the target audience for the warning labels – will be least influenced if at all.
We can only conclude that this latest salvo is at the very least misinformed, certainly misguided, and will probably do more harm than good.
[i]Kersbergen I, Field M. Alcohol consumers’ attention to warning labels and brand information on alcohol packaging: Findings from cross-sectional and experimental studies. BMC Public Health. 2017 Jan 26;17(1):123.
[ii]Scholes-Balog KE, Heerde JA, Hemphill SA. Alcohol warning labels: unlikely to affect alcohol-related beliefs and behaviours in adolescents. Aust N Z J Public Health. 2012 Dec;36(6):524-9.
[iii]Annunziata A, Vecchio R, Mariani A. Alcohol Warnings and Moderate Drinking Patterns among Italian University Students: An Exploratory Study. Nutrients. 2017 Jun 17;9(6).