A National Campaign for Alcohol Health Warning Signs
Questions & Answers Alcohol health warning signs educate communities about health and safety risks associated with drinking. Signs posted at the point of purchase, wherever alcoholic beverages are sold, potentially reach a vast majority of the public. These signs complement ongoing educational programs and the warning labels affixed to alcoholic-beverage containers.
Q: Why are warning signs needed?
A: Warning signs about health risks associated with drinking alcoholic beverages can reach people who might not otherwise be aware of these dangers. The average person must see or hear a message several times before the message makes a lasting impression. People will have the opportunity to become aware of Fetal Alcohol Syndrome (FAS) and other alcohol-related risks as they begin to see signs in stores, restaurants, and other places that sell alcoholic beverages.
Q: What message should go on the sign?
A: Although various health messages may be displayed, the language should be clear and concise. For example, Florida requires the following message: "HEALTH WARNING: Alcohol in beer, wine & liquor can cause intoxication, addiction, birth defects."
Q: Do warning signs really work?
A: Warnings alert consumers to dangers associated with many products, including lawnmower blades, scalding hot coffee, over-the-counter drugs, and children's toys. Studies show that clearly worded, visible warnings increase awareness of risks and lead some people to change behaviors.
There is little data available about the effect that alcohol warning signs have on drinking; however, several studies indicate that the signs provide valuable information. In New York City, 54% of persons interviewed before warning signs were required mentioned birth defects as a possible consequence of a pregnant woman's alcohol consumption. A year later, after the signs had appeared, 68% mentioned birth defects [Prugh 1989]. According to David Cleary, founder of the Lake County Citizens Committee for Alcohol Warning Signs, awareness of alcohol addiction among middle and high school students rose from 25% to 95% after warning signs were introduced in the mid-1980s in Lake County, Florida. A 1993 study evaluating Arizona's first year with warning signs found an immediate effect on college students' awareness of the sign and memory of the warning message, as well as some evidence that the warning sign led to more accurate beliefs about maternal alcohol consumption and birth defects [Fenaughty & MacKinnon 1993].
Q: Where are warning signs usually placed?
A: Warnings are displayed wherever alcoholic beverages are sold. Businesses should be required to place the sign in a prominent spot to make it visible to the public. Vendors can choose to place signs in additional locations, such as in rest rooms or on restaurant tables.
Q: Who pays for the signs?
A: The government usually covers printing costs and distributes the signs to vendors.
Q: How much will the signs cost taxpayers?
A: The average black and white sign costs about ten cents, and a laminated version may cost a little more than $1. When displayed at the point of purchase, the signs deliver their message at a cost-per-thousand rate of less than a penny. Even enforcement is inexpensive. In Florida, food inspectors monitor the signs on their regular rounds at no extra cost to the taxpayer.
Q: Will the signs hurt people who make a living selling alcohol?
A: It may actually be in alcohol vendors' best interests to post warning signs as protection against liability to consumers who suffer from alcohol-related consequences discussed on the signs. Some activists contend that restaurant, bar, and tavern owners may post the signs voluntarily as protection from liability to consumers whose drinks are served by the glass, without the government warning label that is affixed to alcoholic-beverage containers.
Q: How many states require warning signs?
A: As of June 1996, at least 16 states and numerous localities require or officially support some form of warning sign.
Q: Since heavy drinkers are the least likely to seek help after seeing warning signs, how can signs prevent FAS?
A: Warning signs do have a substantial indirect impact on heavy drinkers. Family members who have learned from warning signs that drinking can harm the fetus can help motivate the problem drinker to seek treatment. In addition, alcohol-related birth defects can occur in the offspring of moderate drinkers, who may also be affected by warning signs.
Q: Aren't the warnings too late to prevent damage to the fetus, since FAS occurs early in the first trimester, before a woman knows she is pregnant?
A: The warnings may be too late for some women, but others who are considering pregnancy or who believe they may be pregnant will have time to change their behavior and avoid harm to the fetus. Researchers have not established any safe time to drink during pregnancy. One study shows that heavy drinkers who stopped drinking during the middle of the second trimester significantly improved their pregnancy outcomes.
Q: Won't warnings frighten pregnant women who drink, resulting in hysteria or anxiety, and possibly leading them to seek abortions?
A: This allegation presumes that ignorance is better than truth and is unsupported by anything more than anecdotal information. It is a favorite scare tactic of the alcoholic-beverage industry and its spokespersons. Critical medical information must not be withheld from women based on the paternalistic argument that they may find the truth upsetting.
Q: What national organizations support the warning signs? Who opposes them?
A: Organizations that favor point-of-sale health and safety signs include the American Medical Association, the American Public Health Association, the National Association of State Alcohol and Drug Abuse Directors, the U.S. Department of Health and Human Services, the Arc, and the March of Dimes. The signs have been opposed by the alcohol industry, which fears that the warnings will hurt sales. Isolated feminist organizations and the American Civil Liberties Union have protested that warnings regarding drinking during pregnancy discriminate against women by focusing on pregnancy and ignoring a broad range of other problems caused by alcohol. This charge can be answered by including warnings about other alcohol-related problems on the signs.