Based on Clare Slattery’s presentation “Using Law to Reduce the Cancer Burden of Alcohol” at Turning Point’s Talking Point series, 30th July 2025

Law represents one of the most effective policy tools to address alcohol-related harm, including cancer. The World Health Organization has identified specific legal measures that countries can implement to reduce the burden of cancer and other non-communicable diseases caused by alcohol use.

The Global Context of Alcohol Regulation

Alcohol presents a unique challenge in global health regulation. According to the World Health Organization, approximately 2.5 billion people consume alcohol worldwide, yet alcohol remains the only psychoactive substance with dependence-producing qualities and significant public health harm that is not governed by an internationally legally binding treaty.

Unlike tobacco, which has the WHO Framework Convention on Tobacco Control adopted in 2003, alcohol regulation relies on soft law instruments that provide guidance but lack binding legal force. However, these instruments remain crucial in dictating how countries implement domestic alcohol policy.

Alcohol and Cancer: The Scientific Evidence

The International Agency for Research on Cancer classified alcohol as a Group 1 carcinogen in 1988, placing it in the highest risk category. Alcohol is linked to at least seven different types of cancer, including the most common types affecting Australia.

Crucially, there is no safe level of alcohol consumption for cancer prevention. A landmark 2018 study concluded that alcohol represents “a colossal global health issue” and that small reductions in health-related harms at low levels of alcohol intake are outweighed by the increased risk of cancer and other health-related harms.

According to the WHO, currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol switch on and start to manifest in the human body.

WHO Best Buy Interventions for Legal Alcohol Control

The World Health Organization has identified three “best buy” interventions for alcohol control that represent the most cost-effective, evidence-based measures countries can implement:

1. Increasing Excise Taxes on Alcoholic Beverages

Taxation policies directly affect alcohol affordability and consumption patterns. WHO recommends appropriate taxation and pricing policies to address the affordability of alcoholic beverages.

2. Comprehensive Advertising Restrictions

WHO recommends enacting and enforcing bans or comprehensive restrictions on exposure to alcohol advertising across multiple types of media, including digital platforms. Self-regulation by the alcohol industry has consistently proven ineffective compared to government-mandated legislation.

3. Physical Availability Restrictions

This involves enacting and enforcing restrictions on the physical availability of retail alcohol through measures such as reduced hours of sale and licensing controls.

Australia’s Implementation of WHO Recommendations

According to Australian government reporting to WHO in 2023, Australia’s implementation of best buy interventions shows mixed results:

Physical Availability: Australia has partial restrictions through liquor licensing systems. For example, alcohol is not sold in supermarkets as it is in some other countries.

Advertising Restrictions: Australia relies on self-regulatory measures for alcohol advertising rather than comprehensive government restrictions, falling short of WHO best buy recommendations.

Taxation: The Australian government considers it has fully achieved increasing excise taxes, though the treatment of wine through the wine equalisation tax differs from other alcohol products.

Using Law to Reduce Alcohol Cancer Risk Through Warning Labels

Beyond the three best buy interventions, WHO recommends providing consumers with information including labels and health warnings about alcoholic beverage content and associated harms. In 2019, fewer than 40% of countries reported having at least one alcohol health warning on beverages.

Low Public Awareness of Cancer Risk

According to Alcohol Change Australia, only 14% of Australians are aware that alcohol can lead to breast cancer, one of the most common cancers in Australia. Just one-third know that alcohol causes cancers of the mouth and throat. Knowledge is particularly low among men, younger Australians, people in regional areas, and those in lower-income households.

Ireland’s Comprehensive Legal Framework

Ireland has introduced comprehensive alcohol control laws through the Public Health (Alcohol) Act 2018, which includes minimum pricing, advertising provisions, and availability restrictions. The alcohol labelling regulations, implemented through Ministry of Health regulations in 2023, were designed to require warning labels stating “There is a direct link between alcohol and fatal cancers” on all prepackaged alcohol.

However, Ireland recently delayed implementation by two years, citing trade concerns and industry pressure following Donald Trump’s tariffs. This delay demonstrates the significant commercial resistance to public health measures.

Industry Opposition to Legal Alcohol Control Measures

The alcohol industry represents a powerful force against effective regulation. The world’s ten largest alcohol producers control most global alcohol production, with the largest company generating approximately $56 billion in annual sales in 2018.

The industry employs consistent tactics across countries to delay and deter effective public health legislation. These include:

• Claims about implementation costs
• Trade-related arguments
• Threats of legal challenges
• Self-regulatory alternatives to government legislation

Australia’s Experience with Mandatory Health Warnings

Australia successfully implemented mandatory pregnancy warning labels on all alcohol sold in Australia and New Zealand from August 2023. However, this achievement required decades of advocacy, with the alcohol industry using self-regulatory labeling measures to delay government-mandated requirements.

Clare Slattery noted that there are suggestions the mandatory labelling measure is not yet being fully implemented, demonstrating ongoing challenges even after successful policy adoption.

Legal Frameworks: Lessons from Tobacco Control

Australia’s experience with tobacco plain packaging provides important lessons for alcohol regulation. As the first country to introduce this world-leading measure, Australia faced legal challenges both domestically and under international trade and investment law.

Other countries waited until Australia successfully defended these legal challenges before implementing their own plain packaging laws. This pattern suggests that Ireland’s experience with cancer warning labels will significantly influence other countries’ decisions about introducing similar measures.

The Role of Law in Comprehensive Alcohol Control

Effective alcohol regulation requires recognition that there is no silver bullet. Comprehensive approaches combine multiple legal measures addressing pricing, availability, advertising, and consumer information.

Law plays a crucial role in:

• Implementing evidence-based policy measures
• Defending public health policies from commercial challenges
• Ensuring policy coherence between health, human rights, and trade law
• Leveling the playing field between public health and commercial interests

Emerging Challenges for Legal Alcohol Control

Home Delivery Services

The rapid expansion of alcohol home delivery, particularly during COVID-19, has created new regulatory challenges. Many legal systems have not yet comprehensively covered these developments, with the alcohol industry moving faster than the legal landscape.

Low and No-Alcohol Products

These products present new regulatory challenges, particularly regarding marketing to children and youth exposure. Products are now sold alongside soft drinks in supermarkets and appear at sporting events where alcohol was previously restricted.

Future Directions for Using Law to Reduce Alcohol Cancer Risk

WHO’s global alcohol action plan for 2022-2030 emphasises implementing high-impact strategies and interventions supported by legislative measures. This recognises that law is essential for addressing alcohol’s cancer burden.

Key priorities include:

• Comprehensive advertising restrictions rather than industry self-regulation
• Taxation policies that address affordability
• Evidence-based health warning requirements
• Protection of public health policies from commercial interference

Clare Slattery emphasised that while alcohol consumption is declining in some demographics, the alcohol industry continues to invest heavily in marketing and will seek new markets and products to maintain profitability. This underscores the ongoing need for strong legal frameworks.

Conclusion

Using law to reduce alcohol cancer risk requires comprehensive approaches that address multiple aspects of alcohol control. The WHO best buy interventions provide evidence-based frameworks that countries can implement, but success depends on political will to resist industry opposition.

Australia’s mixed implementation of WHO recommendations highlights opportunities for strengthening legal responses to alcohol’s cancer burden. The country’s successful experience with tobacco plain packaging demonstrates the potential for world-leading public health legislation when supported by strong legal frameworks.

As Clare Slattery concluded, pregnancy warning labels represent “a really great start” for Australia, with potential for extension beyond pregnancy warnings to include cancer risk information. The development of comprehensive legal approaches to alcohol control remains essential for reducing the significant cancer burden associated with alcohol consumption.

Source: Mailchi