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Priority: Restrict alcohol advertising, promotion and sponsorship

Introduce higher standards for marketing of alcohol products to reduce community, particularly children’s exposure to alcohol marketing.  

Alcohol is more heavily advertised than the average advertised product, resulting in widespread marketing that is impossible to avoid.37,38 It is marketed and promoted in many settings, including across traditional channels such as broadcast, print and out-of-home media, at point of sale through price promotions and in-store placements, and at sporting and cultural events through sponsorship.

In Australia, controls on alcohol marketing are largely limited to a set of voluntary, industry-developed and managed codes, and are ineffective at preventing children and young people’s exposure to alcohol marketing.39,40 These industry-managed codes do not effectively control alcohol advertising in the public interest or protect public health. The inherent weaknesses and critical limitations of existing codes have been documented, and there is an urgent need to address and regulate alcohol marketing in Australia to ensure that alcohol companies do not target people who are most at risk.41

The market for products with no and very low alcohol content has grown substantially in recent years, both in terms of the product range and availability and consumer demand. Zero alcohol products that share branding with alcoholic products are available from a wide range of outlets, including specialist online retailers, liquor stores, supermarkets, bars, and restaurants. Based on the current well-established alcohol advertising literature, there are concerns about marketing associated with alcohol-branded zero alcohol products.42,43,44,45 The current limited restrictions on advertising, and no legislated requirements on where zero alcohol products can be sold even if they share a brand with alcoholic products, means that alcohol companies can promote the use of zero alcohol products during times in which alcohol would not normally be drunk.42,45,46 This further exposes young people to alcohol advertising.

Alcohol brands often promote alcohol products in a manner that repeatedly exposes young people to the slogans and imagery of products containing alcohol through the circumvention of existing controls on alcohol marketing as observed with public transport infrastructure.47,48 The inconsistent adherence to the voluntary, industry governed advertising code and the unreliable application of access policies according to age has been considered as key drivers for increased exposure to alcohol product promotion among young people.49 This increased exposure to promotions has been found to subsequently accelerate alcohol initiation among young people.44,50

Cancer Council recommends the introduction of a comprehensive and robust national regulatory framework with a legislative basis that effectively minimises community exposure to alcohol marketing, that includes:

  • Federal legislation addressing alcohol advertising, promotion and sponsorship, that applies to traditional media platforms and new and emerging forms of media, including social media; incorporates regulation of low and zero alcohol products and includes monitoring and enforcement by independent regulators, with appropriate penalties and mechanisms to address non-compliance.

Strengthen data protection and privacy laws to prohibit the collection and use of data for alcohol marketing purposes.

It is vital that children’s privacy and data is protected from alcohol companies. Research shows that by the time a child is 13, an estimated 72 million data points have been collected to build a personalised profile for targeted marketing.41

Cancer Council recommends the federal government:

  • Prohibits the collection, use and disclosure of children’s data for commercial purposes (including the profiling, monitoring, tracking and targeting)
  • Prohibits the collection, use and disclosure of personal information for commercial marketing purposes unless a person has provided active, informed, voluntary and non-incentivised, opt-in consent.
  • Even when consent is provided for the collection and use of a person’s information for marketing purposes:

i. Prohibit the collection, use or disclosure of sensitive information; and

ii. Require a fair and reasonable test to be met whereby it is ensured that the risk of adverse impact and harm are minimised.

Prohibit the use of nutrition content claims on alcohol products, including claims about carbohydrate and sugar content and any claims promoting health benefits from alcohol.

Alcohol is a harmful product, and health and nutrition content claims on alcohol products are marketing tools designed to drive sales and undermine efforts to communicate the risks of drinking alcohol.51 One study examining virtue marketing on new alcohol products in the Australian market found that over one-third of alcohol products released between 2013 and 2023 contained health-oriented claims including ‘no additives/preservatives’, vegan and nutrient content claims related to sugar.62 Systematic reviews on the influence of nutrition content claims have shown that they influence purchasing decisions, with consumers often evaluating products with claims as more healthy than they actually are.53,54 Further, nutrition content claims may also make an ‘appropriate’ portion size appear larger and lead to consumers underestimating energy contents of food and drinks.50 This is especially problematic for alcoholic beverages, as drinking larger serves can be detrimental in the short-term (such as driving) and for long-term health (such as increased cancer risk).

Cancer Council recommends the development of specific provisions on standard labelling for alcoholic beverages, including requirements that:

  • Alcohol products display alcohol content by volume
  • Alcohol products display energy value (kilojoule content).
  • Prohibit nutrition and health claims, including prohibiting the use of claims about carbohydrate and sugar content and any claims promoting health benefits from drinking alcohol.
  • Require mandatory inclusion of health-related information and labels including the link between alcohol and cancer.

Priority: Reform alcohol pricing policies

Alcohol taxation and pricing policies are among the most effective and cost-effective alcohol control measures to reduce harms.55 Evidence from the WHO shows that increasing the price of alcohol products through taxation is one of the ‘best buys’ to reduce harms from alcohol.55 Minimum unit pricing is also recommended by the WHO as an effective measure.55 One in two Australians support taxing all alcoholic drinks, including wine products, based on the amount of alcohol they contain.56 The National Alcohol Strategy recommends taxation reforms such as volumetric taxation and the introduction of a minimum floor price for alcohol to reduce harms from alcohol,57 however this recommendation has not been progressed.

Cancer Council recommends:

  • Replacing existing tax structures for alcoholic products with a volumetric tax on alcoholic products with incremental increases for products with higher alcohol content by volume.
  • Introducing a minimum (floor) price for alcohol that sets a price per standard drink below which alcohol cannot be sold, at a level informed by evidence and regularly indexed for inflation.

Priority: Build community understanding of the risks of alcohol use through evidence-informed health warning labels and public education campaigns

Introduce comprehensive health warning labels on all alcoholic products that are mandated, standardised and present rotating health messages, prioritising cancer risk messaging.

From August 2023, visible and effective health warnings have been mandatory on alcohol products sold in Australia and New Zealand to warn the community about the risks of alcohol use during pregnancy. The warnings were introduced following decades of significant pressure from health and community organisations and significant opposition from and failed attempts at self-regulation by the alcohol industry.58 The first formal application for a pregnancy warning label to be placed on alcoholic products was made to the Australian and New Zealand regulator in 1996, and the labels were mandated over two decades later in 2020.

Australian research showed that cancer warnings on alcohol products constitute a potential means of increasing awareness about the link between alcohol use and cancer.59 However, aside from pregnancy warning labels, no other warnings are mandated to be placed on alcohol products sold in Australia.

Governments have a responsibility to inform and protect communities, and there is now an opportunity for the Australian and New Zealand Governments to build on the existing pregnancy warning labels and warn communities about the other harms from alcohol, including cancer.

Invest in well-developed and evidence-based public education campaigns to increase awareness of the risks associated with alcohol use and awareness of the NHMRC Alcohol Guidelines to reduce health risks from drinking alcohol.

Empowering people with the knowledge that alcohol causes cancer is an important part of a comprehensive approach to reducing harm from alcohol. There is a need for all levels of government to commit to raising awareness of the harms from alcohol, help de-normalise alcohol use, and encourage behaviour change. Community awareness of the harms associated with alcohol use is low across the Australian population. At a national level, less than half (46%) of Australians are aware that alcohol causes cancer.56 Previous research has shown that among those who are aware, 57% report that knowing the link between alcohol and cancer has motivated them to drink less.60

Community awareness of the NHMRC alcohol guidelines is also low. Only around two thirds (65%) of all Australians are aware of the guidelines, and relatively few (26%) are confident that they know the guideline recommendations. In addition, awareness of the guidelines is also low among some health professionals.61

Well-designed, evidence-informed, well-funded and sustained public education campaigns can play an important role in informing the community of the risks associated with alcohol use. Mass media campaigns have been successful in changing many health behaviours, including reducing alcohol use, and are recommended by the WHO to reduce alcohol use and associated harms.61

There is currently no national, long-term, public education program in Australia to inform the community of health risks such as cancer associated with alcohol use and other harms from alcohol.

Priority: Restrict the physical availability of alcohol through strengthened liquor laws

Legislation must keep up with market disruption to ensure that adequate checks and balances are in place to appropriately manage risks associated with evolving methods of alcohol sale and supply. Alcohol is increasingly available and therefore actions that limit availability, including reduced density of liquor outlets and restrictions on alcohol delivery methods are important. Avenues should also be provided for communities to provide input into what outlets are opened in local neighbourhoods.

Cancer Council recommends:

  • Continuing to strengthen controls on the availability of alcohol through licensing regulations.
  • Ensuring liquor licensing laws and regulations are informed by the best available evidence and community representation.
  • Restricting the availability of alcohol through limits on outlet density and trading hours.
  • Introducing comprehensive community protections for the online sale and delivery of alcohol.


References

37. Saffer H. Evaluating econometric studies of alcohol advertising. Journal of Studies on Alcohol and Drugs. Supplement 2020:s19, 106-112. https://www.jsad.com/doi/10.15288/jsads.2020.s19.106

38. Alcohol Focus Scotland. Realising our rights: How to protect people from alcohol marketing. A report by the Alcohol Marketing Expert Network. June 2020. Available from: https://www.alcohol-focus-scotland.org.uk/media/440172/alcoholmarketingreport2806.pdf

39. Reeve B. Regulation of alcohol advertising in Australia: Does the ABAC Scheme adequately protect young people from marketing of alcoholic beverages? QUT Law Review. 2018; 18(1):96-123.

40. Pierce H, Stafford J, Pettigrew S, Kameron C, Keric D, Pratt IS. Regulation of alcohol marketing in Australia: A critical review of the Alcohol Beverages Advertising Code Scheme’s new Placement Rules. Drug and Alcohol Review. 2018; 38(1):16-24.

41. VicHealth (2020), Under the radar: Harmful industries’ digital marketing to Australian children. A report prepared by the Victorian Health Promotion Foundation, Melbourne. https://doi.org/10.37309/2020.CI910

42. A. Hew, S. Arunogiri. Zero alcohol, but not zero risk? Australian and New Zealand Journal of Psychiatry (2023), Article 00048674231200399, 10.1177/00048674231200399

43. R. Kaewpramkusol, K. Senior, S. Nanthamongkolchai, R. Chenhall. Brand advertising and brand sharing of alcoholic and non-alcoholic products, and the effects on young Thai people's attitudes towards alcohol use: A qualitative focus group study Drug and Alcohol Review, 38 (3) (2019), pp. 284-293, 10.1111/dar.12910

44. M. Miller, S. Pettigrew, C.J.C. Wright. Zero-alcohol beverages: Harm-minimisation tool or gateway drink? Drug and Alcohol Review, 41 (3) (2022), pp. 546-549, 10.1111/dar.13359

45. World Health Organization. A public health perspective on zero and low-alcohol beverages. Brief, 10 (2023) (Snapshot series on alcohol control policies and practice) https://www.who.int/publications/i/item/9789240072152

46. K. Bury, D. Keric, D. Riesenberg, L. Wellard-Cole, S. Pettigrew. Falling through the cracks: How do policies for alcohol marketing apply to zero alcohol products in Australia? Drug and Alcohol Review (2023), 10.1111/dar.13757

47. Critchlow, N., Moodie, C. & Houghton, F. Brand sharing between alcoholic drinks and non-alcoholic offerings: a challenge to Ireland’s restrictions on alcohol advertising. Ir J Med Sci 192, 1975–1977 (2023). https://doi.org/10.1007/s11845-022-03161-0

48. Weaver ER, Wright CJ, Dietze PM, Lim MS. ‘A Drink That Makes You Feel Happier, Relaxed and Loving’: Young People’s Perceptions of Alcohol Advertising on Facebook. ALCOHOL AND ALCOHOLISM. 2016;51(4).

49. Pierce, H., Vidler, A. C., Stafford, J., & Keric, D. (2022). Alcohol brands' use of age-restriction controls on Facebook and Instagram in Australia. Public health research & practice, 32(2), 31232109. https://doi.org/10.17061/phrp31232109

50. Keric, D., Myers, G., & Stafford, J. (2022). Health halo or genuine product development: Are better-for-you alcohol products actually healthier?. Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals, 33(3), 782–787. https://doi.org/10.1002/hpja.531

51. Pitt, H., McCarthy, S., Keric, D., Arnot, G., Marko, S., Martino, F., Stafford, J., & Thomas, S. (2023). The symbolic consumption processes associated with 'low-calorie' and 'low-sugar' alcohol products and Australian women. Health promotion international, 38(6), daad184. https://doi.org/10.1093/heapro/daad184

52. Haynes, A., Dixon, H., & Wakefield, M. (2024). Virtue marketing: Trends in health-, eco-, and cause-oriented claims on the packaging of new alcohol products in Australia between 2013 and 2023. Journal of Studies on Alcohol and Drugs, jsad-23. https://doi.org/10.15288/jsad.23-0037

53. Oostenbach LH, Slits E, Robinson E, Sacks G. Systematic review of the impact of nutrition claimsrelated to fat, sugar and energy content on food choices and energy intake. BMC Public Health. 2019;19(1):1296.

54. Kaur A, Scarborough P, Rayner M. A systematic review, and meta-analyses, of the impact of health-related claims on dietary choices. Int J Behav Nutr Phys Act. 2017;14(1):93.

55. World Health Organization. “Best buys” for the prevention and control of NCDs. Available from: https://www.paho.org/sites/default/files/2019-10/NCDs-Bestbuy2-eng-ad.png

56. Alcohol Change Australia. 2023. Public Opinion on Alcohol in Australia: Knowledge, Attitudes and Support for Change. Alcohol Change Australia; Available from: https://alcoholchangeaus.org.au/wp-content/uploads/2023/11/AlcoholChangeAustralia_Report_FINAL.pdf

57. Department of Health. National Alcohol Strategy 2019-2028. Commonwealth of Australia; 2019. Available from: https://www.health.gov.au/resources/publications/national-alcohol-strategy-2019-2028?language=en

58. Hennan M, Shanthosh J, Cullerton K, Jan S. Influencing and implementing mandatory alcohol pregnancy warning labels in Australia and New Zealand. Health Promotion International. 2022; 38(3):daac022. Available from: https://academic.oup.com/heapro/article/38/3/daac022/6573372

59. Miller, E. R., Ramsey, I. J., Baratiny, G. Y., & Olver, I. N. (2016). Message on a bottle: are alcohol warning labels about cancer appropriate?. BMC public health, 16, 139. https://doi.org/10.1186/s12889-016-2812-8

60. FARE.Annual Alcohol Poll - Attitudes and Behaviours 2020 FARE. Available from: https://fare.org.au/wp-content/uploads/ALCPOLL-2020.pdf

61. World Health Organization. “Best buys” for the prevention and control of NCDs. Available from: https://www.paho.org/sites/default/files/2019-10/NCDs-Bestbuy2-eng-ad.png