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The failure of the Surgeon General: Eliza Dumais on the irrelevance of warning labels

Decanter columnist Eliza Dumais considers the impact of warning labels, her own admittedly curious smoking behaviours, and what stamped out claims about health really mean to consumers.

My cigarette principles are as follows: I only smoke after midnight or in France – whereby packs of Marlboro Gold come plastered with close-up shots of blackened lungs or chains of rotting teeth. And while yes, I belong to the absolute lowest common denominator of smoker (neither debaucherous enough to lean in, nor righteous enough to properly abstain) my point is that such warning labels, even at their most graphic, have done little to scare me off (even sans the chemical draw of addiction).

So what, then, is to be suspected of the Surgeon General’s new motion to label alcohol bottles (beer, wine and liquor) with cancer warnings?

‘All the Parisian girls are still smoking with their hazard-tumour-image packs face-up on the table,’ a friend mused when I mentioned the bottle disclaimers. ‘Everyone knows the risk – they’re just making their own choices anyway. Why should alcohol be any different?’

There’s some wisdom there. Vices are just that: vices. And for the most part, we’re well aware of the depravity therein – perhaps enticed, even. If everything will kill you at varying paces or degrees of violence (microwaves, cured meats, aeroplanes, pollution, sugar, screen time, heartbreak), we might as well be selective in our vice-opting. And for plenty of folks, no warning label – graphic or otherwise – will change that.

‘What doesn’t give you cancer?’ another friend quipped on the subject. ‘Wait, there aren’t health warning labels on liquor bottles?’ asked one more. Technically, there are advisories against drinking while pregnant and driving. It’s worth mentioning, however, that not one person I polled looked at me and said: ‘Gasp, alcohol increases cancer risk?!’

Now, I don’t mean to imply that the Surgeon General’s claims don’t carry immense gravity. The advisory dictates that alcohol is the third leading preventable cause of cancer behind tobacco and obesity – thus, according to Dr Vivek Murthy (Mr Surgeon General himself, or at least the outgoing one), the stuff is responsible for about 100,000 cases of cancer in the United States each year.

That’s no small thing: Alcohol-related risk factors are many – and plenty damning. Still, the idea is that educating the public properly about that kind of risk requires far more thoughtful messaging than a 10-word, fine-print directive. ‘Unfortunately, so many public health officials still think fear is the best way to motivate people – but most studies show the opposite,’ says Jessica S. Kruger, PhD, a health educator at the University of Buffalo whose research focuses on consumption and addiction behaviours. ‘ A more positive approach – what we call a gain-frame message versus a loss-frame message – is far more effective.’

As Kruger explains, there are ways of spurring meaningful change in this arena. Collective behaviours or movements like Dry January do, indeed, shift social patterns.

The inclusion of thoughtful, well-curated, non-alcoholic drinks on bar and restaurant menus helps normalise sobriety. ‘It’s no secret that a warning label is not the most effective way to impart change – but research in these fields comes from grant money, and grant money isn’t going into messaging,’ says Kruger.

‘Those “smoking kills” labels are not the thing that got anyone to quit smoking. Anyone who quit had other forces in their life that helped get them to that place. Drinking is the same. We must commit more time and energy to figuring out how to reach people if we want things to change.’

There is something to be said for the whole gain-frame messaging approach.

You see, I already know that each piece of bacon I eat brings me one inch closer to death. That riding my bike in New York is a precarious choice.

That each intoxicant I ingest is poisoning me slowly from the inside, the risk-reward mechanism already whirrs in my brain. But, rather than fear-mongering, what if Big Health Care told me that abstaining from alcohol would make my skin immaculately clear and improve my sleep quality?

That I’d have better sex and write better sentences. ‘Listen, being alive gives you cancer. The cumulative effects of life give you cancer,’ says Kruger. ‘That’s not to say that alcohol isn’t metabolised as a very negative thing and that this is a very real health concern. It’s just that people aren’t gonna turn around and stop drinking without engaging with real, impactful learnings or behavioural and social shifts.’

There are, of course, other business factors to consider here. The inconveniences that come with slapping a label on bottles are substantial for importers, producers and distributors. ‘Do you know how much time my team will spend relabelling bottles to ensure they meet legal standards before they go to shops and restaurants?’ laments wine-importing magnate Zev Rovine.

‘I don’t think we’ve ever seen warning labels make a big difference, and I highly doubt these will change people’s habits – as an importer, I’m not worried it’ll impact business,’ adds Rovine. ‘Gen Z is already not drinking… and that’s got nothing to do with the Surgeon General.’

He’s right: We have seen positive trends in alcohol moderation. It’s no secret that Gen Z is substantially less interested in drinking than generations prior – a product of many things that have absolutely nothing to do with inflammatory language and bottle disclaimers.

Generational shifts are potent things – resets brought on by comprehensive education (via TikTok, even!), non-alcoholic marketing and normalised social behaviours that need not centre alcohol. But convincing life-long drinkers that now, they ought to rethink their vices – with a case that rests upon bottle stickers – seems far less optimistic a principle.


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