Thursday, May 05, 2016

Why can't we tell consumers the truth about alcohol?

Reuters reported on May 3, 2016 http://www.reuters.com/article/us-johnson-johnson-talc-verdict-idUSKCN0XT20L a legal case in which Johnson and Johnson has been ordered to pay $55 million in compensatory and punitive damages for not warning customers on the risks of using of talcum powder. The company had been told to pay $72 million earlier, in a similar case. In the context of this, I look for clarity on labeling the health risks caused by alcoholic drinks.
The intention behind writing this post is to stimulate research towards quantifying risks consumers are exposed to, and discussions about adequate warnings to consumers. Is society lax in demanding warnings about the risks of alcohol consumption? If so, why?  Are consumers being fooled by statements that seem to imply that “moderate” alcohol consumption poses no cancer risk?
It is worth considering categories of risk posed by different substances, as listed by the International Agency for Research on Cancer (IARC), which is an intergovernmental agency forming part of the World Health Organization of the United Nations. The top few categories are:

Group 1: carcinogenic to humans: There is enough evidence to conclude that it can cause cancer in humans.
Group 2A: probably carcinogenic to humans: There is strong evidence that it can cause cancer in humans, but at present it is not conclusive.
Group 2B: possibly carcinogenic to humans: There is some evidence that it can cause cancer in humans but at present it is far from conclusive. 
Alcohol consumption and tobacco smoking have been labelled carcinogenic to humans (Group 1) by IARC in Press Release No 196 of 2009. Visit https://www.law.cornell.edu/uscode/text/15/1333 to see the very tough law that requires every cigarette packet to say that cigarettes are addictive, cause fatal lung disease, cancer, strokes and heart disease and that smoking can kill you. I have not given a full list, but you can read them in the reference given. 
Compare this with the warning specified by the Alcoholic Beverages ActUSA:

(1) According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects.
(2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems.

Also, compare this with the warning on my bottle of an Indian beer bottle: 
  ALCOHOL CONTENTS LESS THAN 5%V/V
  DRINKING IS INJURIOUS TO HEALTH

The World Health Organization says about cancers that "Around one third of cancer deaths are due to the 5 leading behavioural and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, alcohol use".
WHO reports that tobacco kills around 6 million people each year. More than 5 million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke.
Now consider the connection between alcohol consumption and cancer risk. Visit Alcohol and Cancer Risk put out by the (US) National Cancer Institute. It lists many types of cancer that have been shown to be linked with alcohol consumption. 
WHO says about alcohol that “in 2012, about 3.3 million net deaths, or 5.9% of all global deaths, were attributable to alcohol consumption”.

Examine all this in the light of what is reported about risks from talcum powder usage. The Wikipedia article https://en.wikipedia.org/wiki/Talc says that “Suspicions have been raised that its use contributes to certain types of disease, mainly cancers of the ovaries and lungs. It is classified in the same 2B category in the IARC listing as mobile phones and coffee”. It also says that “The US Food and Drug Administration (FDA) considers talc (magnesium silicate) to be generally recognized as safe (GRAS) for use as an anti-caking agent in table salt in concentrations smaller than 2%.

I am not saying that using talcum powder is harmless. My case is that considering the far higher risk posed by alcohol, the warnings provided to customers are inadequate. The data given above shows that cancer deaths due to tobacco smoking worldwide were approximately 1.6 million. I believe that adequate attention has been given to this and effective warnings have been made legally necessary. On the other hand, the data given above shows that “3.3 million net deaths” worldwide in 2012 were attributable to alcohol consumption. To merely warn me that “drinking is injurious to health” is gross injustice.

There is another form injustice in labeling alcoholic beverages. Visit Alcohol calorie calculator This NIH publication says that “Alcohol beverages supply calories but few nutrients and may contribute to unwanted weight gain. If you need to lose weight, looking at your drinking may be a good place to start”. If you buy lemon drop candy for a child, the nutrition information tells you that it provides 18 calories per piece, but my bottle containing a pint of beer that provides 180 calories is not required to carry any label about that.

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