Labels on alcoholic drinks warn US drinkers against excessive consumption. It is time the UK followed suit, say Chris Record and Hanan Mardini

Published: 15/01/2004, Volume II4, No. 5888 Page 23

The British Society of Gastroenterology and the British Association for the Study of the Liver are the professional societies for the 600 consultant physicians in gastroenterology and hepatology in the UK. They are campaigning for health warnings on alcohol products to be included in the national alcohol harm reduction strategy, which is being formulated by the Cabinet Office.

Around 500 members have signed a petition requesting a label which would read: 'HM government health warning. This product contains x units of alcohol. Consumption of more than 21units/week for men and 14 units/week for women can damage your health.'

The US introduced alcohol warning legislation in 1989, stating:

'According to the surgeon general, women should not drink alcoholic beverages during pregnancy because of the risks of birth defects. Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery and may cause health problems.'

Annual surveys conducted after the warning's introduction show that by 1994, around half of drinkers were reached by at least some of the messages.More importantly, four-fifths of the heaviest consumers saw the label. Those recalling the label's drink driving message were significantly more likely to avoid drink driving.

Ninety-two per cent of the public supported the warning, and 53 per cent believed it was an effective way to change behaviour.

Since 1987, the medical royal colleges have recommended the safe limits for alcohol consumption to be 21 units or less per week for men, and 14 for women (one unit is 10 ml or 8g alcohol). They also recommend two alcohol-free days a week. Recognising the culture of binge drinking, in 1995 the Department of Health recommended the maximum daily intake should be no more than 3-4 units for men and 2-3 units for women.

Unfortunately, these safe limits are not widely known among the population at risk of alcohol harm.More importantly, the strength of alcohol products has substantially increased over the years.

Australian studies in the early 1990s show that when offered containers with labels printed with only the percentage alcohol content by volume, drinkers significantly underestimated the number of standard units in their preferred drink. Studies showed the addition of standard unit labelling significantly reduced these errors. Unit labelling was adopted in Australia in 1995.

The public has the right to know the alcohol content of products and the health risks of excessive consumption.With alcohol, most of the damage has happened before the patient seeks medical attention.

With the number of excessive or binge drinkers in the country numbering around 20 million, just a 1 per cent effectiveness rate for the warnings will benefit 200,000 people. Even if all interventions in all patients attending hospital with alcoholrelated problems were 100 per cent effective, this would still only benefit 150,000 - at a cost of£1.4bn.

Dr Chris Record is consultant physician in gastroenterology, Newcastle upon Tyne Hospitals trust; Dr Hanan Mardini works in department of medicine at the trust's Royal Victoria Infirmary.