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 vivre
that 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 here
before. 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).
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