Alcohol industry accused of delaying mandatory pregnancy warnings on labels

Less than two-thirds of alcohol products displayed pregnancy warnings around the time labelling was made mandatory, despite the alcohol industry being given three years to comply, Australian research has found.

The government-mandated warning labels, introduced in July 2020, are intended to inform consumers that drinking while pregnant increased the risk of potential life-long health issues in unborn children.

All newly labelled products were required to display the warnings from August 2023.

But an analysis of almost 6,000 alcohol beverages sold in four large Sydney stores between June and November 2023 found only 63 per cent included the new warnings.

Head of health promotion at the George Institute for Global Health Simone Pettigrew said the study’s findings suggested the alcohol industry may be deliberately delaying putting pregnancy warnings on products for fear of losing sales.

“This [research] needs to be seen in the context of 25 years of work to get the pregnancy warning label introduced — the alcohol industry fought it tooth and nail,” Professor Pettigrew, who led the study, said.

Professor Pettigrew said a small number of products surveyed, including vintage wines and spirits, were packaged prior to 2020, and would not be expected to carry pregnancy warning labels.

But most would, she said, suggesting a substantial number of alcohol companies decided to delay using the warnings until very late in the transition period, or failed to comply after they became mandatory.

“We did subsequent analyses where we only included products that had been collected post that three-year point [August 1, 2023], and it was almost exactly the same … still 63 per cent,” she said.

A spokesperson for the Department of Health said it was very likely, especially for products with a shorter shelf life – such as beer, cider and pre-mix drinks – that compliance had risen above 63 per cent since the mandatory labelling requirements came into effect.

“Some alcoholic beverages produced and labelled before 31 July 2023 may still be in circulation and not have the labels that are now required under the current Food Standards Code. There is no requirement for these products to be removed from circulation.”

But the study, published today in the Australian and New Zealand Journal of Public Health, emphasised the need for ongoing monitoring of alcohol health warnings to improve industry compliance and accountability, the authors wrote.

“To our knowledge, the government isn’t actually monitoring uptake of the mandatory label … the [alcohol] industry would be aware of that, and in that context, wouldn’t sense an urgency to comply with the regulation,” Professor Pettigrew said.

“We would really like to see that change and there be some kind of systematic monitoring.”

Voluntary, industry-led health messages ‘ineffective’

While the study found mandatory pregnancy warnings were present on only 63 per cent of products, there was high compliance with other government-mandated health labels, including container volume, alcohol content, and standard drinks per container.

It also found a quarter of beverages carried their own versions of pregnancy warnings, and two-thirds featured voluntary health messages. These messages were usually statements from DrinkWise, an industry-funded organisation “dedicated to transforming the Australian drinking culture”.

But according to the researchers, the widespread use of industry-designed warnings was a “concern” given previous research which has shown they are less effective and have the potential to confuse and mislead consumers.

“Even the name [DrinkWise] suggests there is a wise way to drink, and there isn’t,” Professor Pettigrew said.

In contrast with government-mandated warnings, which state that “alcohol can cause lifelong harm to your baby”, DrinkWise messages include statements such as “it’s safest not to drink while pregnant”.

“We need really important warnings that tell people useful information, but the DrinkWise ones don’t tend to,” Professor Pettigrew said.

She added the study found most pregnancy warnings were not immediately obvious to shoppers perusing shelves.

“So 99 per cent of standard bottles and cans put it on the back … which means when people are looking across the shelf, that’s not featuring in their decision-making at all.

“We need to have some strict rules about how [labels] are implemented to make sure [alcohol companies] don’t take these kinds of short-cuts.”

Industry rejects claims it deliberately delayed warnings

Alistair Coe, executive director of Alcohol Beverages Australia, said the government had put in place sensible arrangements for the pregnancy warning phase-in period that “functioned exactly as they were intended”.

“The rules are that bottles of alcohol produced after August 1 2023 need to carry the warning,” he told the ABC.

“The study in question was based on a survey undertaken in the weeks immediately before and after this date. As such, almost every bottle in the store would have been produced and labelled before August 1, meaning that these warnings weren’t mandatory at the time.

“Despite this, an extremely high percentage of the non-aged alcohol complied with the rules.”

Spirits and Cocktails Australia chief executive Greg Holland said its members took their regulatory responsibilities “extremely seriously” and had been proactive in adopting mandatory pregnancy warning labels.

“Full-strength bottled spirits have an almost indefinite shelf life. Store depletions of spirits tend to be slower, so it is not surprising that there was still some old stock on shelves when the researchers visited in 2023,” Mr Holland said.

“This study provides no evidence to support the allegation that spirits manufacturers intentionally delayed introducing the new label.”

A third of pregnant women still drink some alcohol

James Smith, a professor of health and social equity at Flinders University who was not involved in the research, said the study was “very comprehensive” and illustrated the need for improved compliance and monitoring.

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Professor Smith said there was a lot of “disinformation” in the community and, in some cases, poor awareness about the harms of alcohol consumption.

“What we need to do from a public health perspective is make sure we help those that don’t necessarily understand.”

Alcohol consumption during pregnancy can harm an unborn baby’s developing brain and lead to low birth weight, premature birth, miscarriage and stillbirth.

It can also cause a range of physical, mental, behavioural and developmental problems, collectively called foetal alcohol spectrum disorder, Professor Pettigrew said.

“Knowledge has definitely improved over the years, and we know that virtually all health providers now recommend not drinking alcohol,” she said.

“But still almost a third of women are drinking some alcohol during pregnancy, and it’s often in that first trimester.”

Research shows that giving women warning information can motivate them to avoid drinking while pregnant.

“There’s definitely a need to make sure that this information is salient on products, so those who are trying to conceive or contemplating starting a family are aware from day one that they really should stop drinking alcohol,” Professor Pettigrew said.

Health experts call for improved monitoring

Terry Slevin, CEO of Public Health Association of Australia, said the study confirmed that governments should take stronger action on alcohol warnings to help people make informed choices about drinking.

“When it comes to alcohol and health, it’s time to stop leaving the fox in charge of the henhouse,” Mr Slevin, an adjunct professor at Curtin University and the Australian National University, said.

“This latest research shows that the alcohol industry has no interest in protecting the health of Australians and will avoid and delay introducing mandated health warnings until the last minute and beyond.”

Professor Smith said he’d like to see research include alcohol product surveys in other states and territories, including non-metropolitan areas, to see whether labelling adherence differs.

“Alcohol that’s available in more regional, rural and remote areas of Australia, is it worse or better? Because we know the alcohol harms we see in Australia are higher in those areas.”