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Still no message on a bottle for Australian Women

In the late nineteen fifties and early sixties, more than 10,000 Australian children – and by some estimates, as many as 100,000 children in 46 countries – were born with devastating deformities as a consequence of thalidomide, a drug prescribed to pregnant women to alleviate morning sickness.

From that great tragedy came sweeping changes to drug regulation, with more vigorous pre-licence testing for efficacy and safety, and the requirement to disclose all potential adverse effects.

Today in Australia, prescription medications that might harm the unborn baby carry strong, prominent health warnings that are easily understood.

Take for instance, Roaccutane. A common prescription drug for the treatment of severe acne that carries an unequivocal, easily understood, front of pack health warning.


Roaccutane will damage an unborn baby

You must not take Roaccutane if you are pregnant or think you might be pregnant

Consumers have the right to be informed about products that are harmful.

So it may come as some surprise that a far more widely consumed legal drug that causes brain injury and birth defects carries no such health warning for pregnant women.

Alcohol consumption during pregnancy can cause irreversible damage to the fetus, resulting in a range of harms including Fetal Alcohol Spectrum Disorder (FASD).

In fact, FASD is the leading preventable non-genetic cause of intellectual disability in Australia and its impact on learning behaviour and health are lifelong.

Yet despite this, there is no legal requirement in Australia or any form of pregnancy health warning information on alcohol products.

In this we lag behind the rest of the world. Internationally, at least eighteen countries or territories including the United States and France have introduced laws requiring the compulsory use of health warning labels on alcohol products, and demonstrated the capacity of a regulated labelling regime to raise awareness as well as modify behaviours.

Instead, the alcohol industry has been left to develop its own ‘solution’.

The result?

A weak consumer information label that is the antithesis of an effective health warning label.

Rather than being prominently displayed and legible, the alcohol industry messaging is hidden and hard to read.

Instead of being clear and easily understood, the alcohol industry’s messaging is instead vague and misleading.

In 2011, the former Commonwealth Health Minister Neil Blewett recommended the introduction of government mandated alcohol warning labels.

In the six years since, our State and Commonwealth health ministers have met regularly with their New Zealand counterparts at the Australia and New Zealand Ministerial Forum on Food Regulation (the Forum).

And at every meeting they have put off a decision on the introduction of mandatory alcohol health warning labels, deferring that decision to the next meeting, and the next; an unnecessary delay that endangers the health and lives of future generations.

In fact, in the six years of feet dragging by the Forum, there have been 450,000 alcohol-exposed pregnancies.

However, the failure to act is not for lack of very clear signposts pointing to the best way forward.

In 2010 a comprehensive review of product labelling was undertaken by Dr Neal Blewett. The subsequent report, Labelling logic, released in 2011 recommended that alcohol pregnancy warning labels be mandated in Australia.

Instead, in 2011, Forum ministers elected to allow the industry two years to implement its own voluntary initiative, which they had launched a few months before any government decision was made.

Six years on and we’re still stuck with an ineffective industry effort, with industry granted more time to get its house in order despite FoFR commissioned independent evaluations criticising industry’s efforts.

The first evaluation by Siggins Miller in 2014 was a damning indictment of industry’s efforts. At that time only 38 per cent of alcohol products carried a pregnancy message of some type, and only six per cent of women had seen any messages on alcohol products, and pregnancy specific warnings even less (four per cent).

In 2016 the Department of Health commissioned Siggins Miller to undertake a second evaluation of voluntary use of pregnancy warning labels.

This report will be considered at Friday’s Forum meeting.

Given that the industry’s DrinkWise warning information is unchanged, no more prominent, and no clearer or more easily understood than at the time of the previous evaluation, the findings of the evaluation are predictable.

A study examining consumer awareness of pregnancy warning labels in NZ, conducted by the Health Promotion Agency provides a further clue. An online survey of 1,488 consumers found that the unprompted recall of existing messaging was only three per cent, and that 38 per cent surveyed misinterpreted the DrinkWise messaging.

Luckily, there is a clear way forward for Forum members, with a regulatory process already in place for implementing well overdue labelling reform in Australia. The Forum must task Food Standards Australia New Zealand (FZANZ) to immediately commence the process of developing and implementing mandatory alcohol health warning labels.

For the sake of our future generations, this legislation is critical.

Elizabeth Elliott

Elizabeth Elliott AM is Professor of Paediatrics and Child Health, University of Sydney and Consultant Paediatrician, at the Children’s Hospital at Westmead, Sydney.

Michael Thorn

Michael was was Chief Executive of the Foundation for Alcohol Research and Education (FARE) from January 2011 until November 2019


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