A National Campaign for Alcohol Health Warning Signs

Background

For the past fifteen years public health and safety advocates have promoted policies to balance information about alcoholic beverages. Those efforts have included a successful campaign requiring container warnings and current proposals for health and safety messages in advertisements. These measures are needed to counter $2 billion in advertising and promotion -- the most common form of alcohol education.

Many states and localities also require the posting of warning signs where alcoholic beverages are sold. This health strategy provides an ideal means of educating communities about health and safety risks associated with drinking. Signs posted at point of purchase reach most consumers, including moderate, heavy, and potential drinkers. Warning posters effectively supplement ongoing alcohol-education programs and reinforce the federally required health notices on alcoholic-beverage containers.

Mandated since 1989, the Surgeon General's warnings have a number of limitations. Although they contain useful information, they caution specifically only about drinking during pregnancy and drinking and driving. On many containers the messages are barely legible, printed in small type, positioned vertically, often blending into the background label color. Because the message never changes, consumers lose interest. Over time, the effect of the warning diminishes. Also, since the warning is found only on containers, consumers served in bars or restaurants by the glass or pitcher don't receive the benefits of the container warning. Beyond reinforcing current health messages, warning posters can expand on them, providing additional information tailored to community needs. For these reasons, warning messages, especially those which periodically change, can play an important role in increasing public awareness of alcohol problems.

Several small studies indicate that warning posters boost knowledge of alcohol risks. Follow-up surveys in Lake County, Florida showed a dramatic increase in awareness of alcohol addiction among middle and high school students -- from 25 percent to 95 percent -- after warnings about addiction were introduced in the mid-1980s.

Alcohol warning signs provide an effective and low cost means of educating the public. The average black and white poster costs about ten cents and a laminated version runs a little more than $1. When posted at point of purchase, posters deliver their message at a cost-per-thousand rate of less than a penny. Even the enforcement of the signs is inexpensive. In Florida, food inspectors monitor the placement of signs on their regular rounds at no extra cost to taxpayers.

To date, a minority of states use alcohol health warning signs as part of an overall alcohol-prevention strategy. Sixteen (16) states and fifteen (15) localities require warning signs or have programs that encourage voluntary posting. As of February 1996, three more states have legislation pending. This guide will help you work for alcohol health warning signs in your community. Please keep us posted on your efforts and successes.

Taking Action to Promote Alcohol Health Warning Posters

1. Build a citizens action group or coalition. Gather a diverse array of groups to increase the level of skills, resources, and base of public and political support for your efforts. Include members from the public health field, parents' groups, law enforcement, churches, civic organizations, and youth groups, among others.

2. Draft a bill that will interest potential sponsors on the statewide, county and/or city level. Statewide bills can take years to advance. Therefore a city or county-wide effort may be the best place to begin your strategy. City or county laws tend to be stronger then statewide bills, and ordinances passed on the local level will strengthen a statewide campaign.

3. Recruit sponsors. When preparing to interest local legislators, research their past voting records, attend commission meetings and read community newspapers. Appeal to his/her personal, professional, and legislative concerns. Members of the coalition may know the legislator and his/her interests. Meet with the strongest potential sponsors. Develop materials and fact sheets to support the legislation.

4. Publicize your efforts. Good news coverage generated from newspaper articles, television stories, and radio talk shows will increase citizen participation and put pressure on legislators to support the bill.

5. Mobilize support. As the coalition drafts a bill and recruits sponsors, begin mobilizing grassroots support. Collect endorsements and letters from public health and medical experts, community and neighborhood organizations, churches, synagogues, parents' groups, and police organizations, even those which are not part of the coalition. Recruit community leaders to testify for the bill at public hearings. Each group in the coalition should solicit members to send letters and make phone calls to their legislators.

6. Push for a public hearing. Your presentation should include information about the ordinance -- purpose, applicability, exemptions, sign placement, cost, and enforcement. Demonstrate the breadth and strength of community interest in the bill. Expect questions about the legislation.

7. Demand a mandate. Legislators may recommend a resolution that encourages businesses to post the warning sign voluntarily. An ordinance that requires sign posting is far preferable to voluntary compliance. Vendors may be reluctant to post signs unless their competitors are also required to do so.

These national organizations have endorsed legislation to require health and safety messages in alcohol advertising and their members may provide support on the local level:

  • American Medical Association
  • The Association of Retarded Citizens (ARC)
  • National PTA
  • American Academy of Family Physicians
  • American Academy of Pediatrics
  • National Council on Alcoholism and Drug Dependence

Pass the Best Law You Can:

1. Require posters wherever alcoholic beverages are sold (bars, liquor stores, restaurants, convenience stores, supermarkets, and hotels). Exception: Florida advocates chose to exempt bars and taverns to eliminate their political opposition.

2. Demand that signs be posted conspicuously. In Florida, the 11" x 17" signs appear on the windows of beer coolers. In California, 10" x 10" black and white signs hang at the entrances to bars and restaurants. 5" x 5" red signs are displayed at grocery and liquor-store checkout counters.

3. Require a regular monitoring program. In many places, the city health department is responsible for distributing the posters and enforcing the law.

4. Localize the sign for your community and its special concerns. Is your community multi- cultural? Dade County, Florida requires warnings in three languages -- English, Spanish, and Creole. Is your community located near recreational waterways? Add a line such as, "Do not drink and drive a car or boat." Use the sign to address high-risk audiences in the community -- for example, college students (binge drinking), the elderly (combination of alcohol and prescription drugs), and African-Americans (higher incidence of hypertension and stroke).


Alcohol warning signs are the law in:

Alaska, Arizona, California, Delaware, Florida*,Georgia, Illinois, Kentucky, Minnesota, Nebraska, New Jersey, New Mexico, New York, South Dakota, Utah, Washington.

Cities include: Washington, D.C.; Racine, Wisconsin; Philadelphia, Pennsylvania; Lakewood and Columbus, Ohio; New Orleans, Alexandria/Pineville, and Monroe, Louisiana.

* Eleven (11) Florida counties require that warning signs be posted where alcoholic beverages are sold. The state provides funding for signs to be voluntarily posted in other counties. As an inducement to getting the signs posted statewide, the Department of Business and Professional Regulation pledged to reduce fines for liquor law violations for those vendors who choose to post them.

Facts about alcohol-related problems

  • Drinking during pregnancy has been linked to birth defects and is the leading known preventable cause of mental retardation. Fetal Alcohol Syndrome (FAS) is characterized by a cluster of congenital birth defects which include low birth weight, physical deformities, neurological and other major organ disorders.
  • Since 1979, when the Centers for Disease Control began tracking the number of Fetal Alcohol Syndrome cases, the rate of FAS has jumped from one per 10,000 births to 6.7 per 10,000 births in 1993.
  • Treating a child suffering from Fetal Alcohol Syndrome costs an estimated $750,000 from birth to age 18. The 1990 national economic cost of FAS totaled more than $2 billion.
  • Pregnant women who consume 1-2 drinks per day are twice as likely as nondrinkers to have a growth-retarded infant weighing less than 5.5 pounds.
  • Alcohol use results in economic costs of more than $112 billion each year, or nearly $400 for each person in the United States.
  • Nearly one-fourth of all persons admitted to general hospitals have alcohol problems or are undiagnosed alcoholics being treated for the consequences of their drinking. Up to 25% of emergency room visits involve alcohol. In 1990, Federal payments for alcohol-related health-care costs amounted to more than $21 billion.
  • In 1995, alcohol and other substance abuse costs imposed $60.3 billion on Medicare and Medicaid, veterans, and other major health benefits.
  • In 1994, alcohol was a factor in more than 40% of traffic fatalities (16,589).
  • Approximately 35% of fatalities from falls and 43% from burns are alcohol-related.
  • Forty-seven percent (47%) to 65% of adult drownings involve alcohol.
  • Up to 40% of industrial fatalities and 47% of industrial injuries can be linked to alcohol consumption and alcoholism.
  • A 1993 study of boating fatalities in four states found that 51% of the fatalities involved a Blood Alcohol Content (BAC) of .04 or more. Thirty-one percent (31%) had BACs over .10.
  • Alcohol is the leading cause of death and injury (e.g., motor-vehicle crashes, homicides, and suicides) among teenagers and young adults ages 15-24.

The case for Alcohol Health Warning signs:

1. Alcohol warning signs recognize that excessive alcohol consumption is America's costliest drug problem.

2. Warning signs supplement ongoing alcohol-education programs and reinforce federally required health notices on alcoholic-beverage containers.

3. Alcohol warning signs can contain valuable and accurate information about community alcohol health risks.

4. Warning signs reach most consumers - moderate, heavy, and potential drinkers - before they drink.

5. Warning signs help balance the glamorized view of drinking promoted in alcohol advertising.

6. Warning signs provide a low cost, effective means of educating the community.

[ Primary Campaign Literature ] [ Sample Testimony ] [ Sample Op-ed ] [ Sample Newsletter Articles ]
[ Question and Answer Sheet ] [ Selected Research on Health Warning Signs ]

(1996)