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The Print
2 days ago
- Health
- The Print
AIIMS researchers call for warning labels on alcohol like tobacco
The opinion piece by oncologists Dr Abhishek Shankar, Dr Vaibhav Sahni and Dr Deepak Saini from the Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, AIIMS, Delhi stated that adolescence forms a crucial period for the initiation and intensification of substance use behaviour, including alcohol. In an opinion piece titled 'Expanding behavioural interventions through cancer warning labels in India: from cigarette packs to alcohol bottles' published in Frontiers in Public Health on July 24, the doctors have highlighted that alcohol, like tobacco, is a proven carcinogen, yet awareness remains low. New Delhi, Jul 27 (PTI) Researchers at AIIMS have called for strong, evidence-based warning labels on alcohol products to prevent avoidable cancers, building on India's success with tobacco warnings. Behavioural interventions instituted by means of alcohol warning labels may prove to be effective in affecting positive changes in the consumption habits of individuals belonging to this age group, particularly in Low- and Middle-Income Countries (LMICs), where it is all the more important for certain sections of society to be educated and sensitised towards the consequences of substance use, the researchers said. They stated that cancer cases in India have seen a steep rise, with data from the 2012 to 2022 period suggesting a 36 per cent increase in incidence (1.01 million-1.38 million). GLOBOCAN 2022 data saw about 1.41 million new cancer cases in India with a five-year prevalence at around 3.25 million and a total cancer mortality at 916,827. Alcohol attributable a fraction for cancer and age-standardised rate per 100,000 in India are 4.7 per cent and 4.8 per cent, respectively, according to the GLOBOCAN 2020 data. Data from 2016 suggested that 6.6 per cent of Disease Adjusted Life Years in India were attributable to alcohol consumption which followed that of tobacco at 10.9 per cent, the researchers said. The researchers also mentioned about the advisory brought out by the US surgeon general in January 2025 regarding the consumption of alcohol and the risk of cancer, which stated that alcohol consumption demonstrably elevates the risk for developing at a minimum, seven types of cancer (colon/rectum, liver, breast, esophagus, larynx, pharynx and oral cavity). The advisory also mentioned the mechanistic links between alcohol consumption and the risk of developing cancer along with the fact that this effect is observable regardless of gender. Even before the release of this advisory, alcohol-attributable cancers have been recognised to contribute significantly to the global burden of disease, the researchers said. Cancer warning labels on alcohol containers have been observed to be of benefit in reducing alcohol consumption and lowering the perception of consumption, they said. The Global Adult Tobacco Survey (GATS) in 2016-17 noted an increase by 16 per cent for health warnings on cigarette packs, with pictorial health warnings demonstrating a 50 per cent elevated impact on the intention to quit smoking cigarettes. Warnings can be differentiated based on the type of messaging involved into loss-framed and gain-framed which have an emphasis on associated risks/harms and the benefits of quitting, respectively, the researchers explained. There is evidence in literature to suggest that gain-framed messaging possesses an advantage over loss-framed warnings but the research on such aspects has mainly focused on loss-framed warnings in the case of cigarette smoking. It is also suggested that a combination of messaging can help inform behaviour change in a more effective manner which is based off the concept of the role individual beliefs play in determining outcomes, they said. India being an LMIC, this trend indicates the effect of cancer warning labels in modifying the behaviour of a significant number of people consuming such products, the researchers highlighted. 'The LMICs may look into expanding the positive experience gained from tobacco warning labels to those pertaining to alcohol containers, which clearly state a cancer risk from consumption. It may also be useful for these cancer labels to state that there is no lower threshold for alcohol-related cancer risk along with the types of cancers demonstrably attributable to alcohol consumption so far,' the doctors said. They pointed out that a crucial but often ignored aspect while considering warning labels is the multiplicative interaction of smoking and alcohol consumption in determining cancer risk. A National Cancer Institute (NCI) Workshop in December 2020 emphasised the importance of addressing the combined usage of tobacco and alcohol. Co-use of tobacco and alcohol has been found to be associated with a multiplicative effect in cancer risk, particularly for pharyngeal and oral sites. The importance of reciprocative warning labels on tobacco and alcohol product packaging is further underscored by the fact that alcohol usage has been observed to go up with an increase in cigarette smoking, with the former being associated with lower rates of quitting and higher relapse rates in smokers. It may also be worth considering to have helpful or constructive labelling on containers which guide the user to seek medical advice or undergo screening for cancer instead of being terminalistic in its messaging by suggesting graphic or fatal outcomes upon consumption, the researchers said. 'Since cancer as a disease may present as a result of the combined effect of alcohol and tobacco consumption, it makes sense to place such cancer warning labels and not address these risk factors in isolation,' they said. PTI PLB MNK MNK This report is auto-generated from PTI news service. ThePrint holds no responsibility for its content.
Time of India
2 days ago
- Health
- Time of India
AIIMS researchers call for warning labels on alcohol like tobacco
New Delhi, Researchers at AIIMS have called for strong, evidence-based warning labels on alcohol products to prevent avoidable cancers, building on India's success with tobacco warnings. In an opinion piece titled "Expanding behavioural interventions through cancer warning labels in India: from cigarette packs to alcohol bottles" published in Frontiers in Public Health on July 24, the doctors have highlighted that alcohol, like tobacco, is a proven carcinogen, yet awareness remains low. The opinion piece by oncologists Dr Abhishek Shankar, Dr Vaibhav Sahni and Dr Deepak Saini from the Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, AIIMS, Delhi stated that adolescence forms a crucial period for the initiation and intensification of substance use behaviour, including alcohol. Behavioural interventions instituted by means of alcohol warning labels may prove to be effective in affecting positive changes in the consumption habits of individuals belonging to this age group, particularly in Low- and Middle-Income Countries (LMICs), where it is all the more important for certain sections of society to be educated and sensitised towards the consequences of substance use, the researchers said. They stated that cancer cases in India have seen a steep rise, with data from the 2012 to 2022 period suggesting a 36 per cent increase in incidence (1.01 million- 1.38 million). GLOBOCAN 2022 data saw about 1.41 million new cancer cases in India with a five-year prevalence at around 3.25 million and a total cancer mortality at 916,827. Alcohol attributable a fraction for cancer and age-standardised rate per 100,000 in India are 4.7 per cent and 4.8 per cent, respectively, according to the GLOBOCAN 2020 data. Data from 2016 suggested that 6.6 per cent of Disease Adjusted Life Years in India were attributable to alcohol consumption which followed that of tobacco at 10.9 per cent, the researchers said. The researchers also mentioned about the advisory brought out by the US surgeon general in January 2025 regarding the consumption of alcohol and the risk of cancer, which stated that alcohol consumption demonstrably elevates the risk for developing at a minimum, seven types of cancer (colon/rectum, liver, breast, esophagus, larynx, pharynx and oral cavity). The advisory also mentioned the mechanistic links between alcohol consumption and the risk of developing cancer along with the fact that this effect is observable regardless of gender. Even before the release of this advisory, alcohol-attributable cancers have been recognised to contribute significantly to the global burden of disease, the researchers said. Cancer warning labels on alcohol containers have been observed to be of benefit in reducing alcohol consumption and lowering the perception of consumption, they said. The Global Adult Tobacco Survey (GATS) in 2016- 17 noted an increase by 16 per cent for health warnings on cigarette packs, with pictorial health warnings demonstrating a 50 per cent elevated impact on the intention to quit smoking cigarettes. Warnings can be differentiated based on the type of messaging involved into loss-framed and gain-framed which have an emphasis on associated risks/harms and the benefits of quitting, respectively, the researchers explained. There is evidence in literature to suggest that gain-framed messaging possesses an advantage over loss-framed warnings but the research on such aspects has mainly focused on loss-framed warnings in the case of cigarette smoking. It is also suggested that a combination of messaging can help inform behaviour change in a more effective manner which is based off the concept of the role individual beliefs play in determining outcomes, they said. India being an LMIC, this trend indicates the effect of cancer warning labels in modifying the behaviour of a significant number of people consuming such products, the researchers highlighted. "The LMICs may look into expanding the positive experience gained from tobacco warning labels to those pertaining to alcohol containers, which clearly state a cancer risk from consumption. It may also be useful for these cancer labels to state that there is no lower threshold for alcohol-related cancer risk along with the types of cancers demonstrably attributable to alcohol consumption so far," the doctors said. They pointed out that a crucial but often ignored aspect while considering warning labels is the multiplicative interaction of smoking and alcohol consumption in determining cancer risk. A National Cancer Institute (NCI) Workshop in December 2020 emphasised the importance of addressing the combined usage of tobacco and alcohol. Co-use of tobacco and alcohol has been found to be associated with a multiplicative effect in cancer risk, particularly for pharyngeal and oral sites. The importance of reciprocative warning labels on tobacco and alcohol product packaging is further underscored by the fact that alcohol usage has been observed to go up with an increase in cigarette smoking, with the former being associated with lower rates of quitting and higher relapse rates in smokers. It may also be worth considering to have helpful or constructive labelling on containers which guide the user to seek medical advice or undergo screening for cancer instead of being terminalistic in its messaging by suggesting graphic or fatal outcomes upon consumption, the researchers said. "Since cancer as a disease may present as a result of the combined effect of alcohol and tobacco consumption, it makes sense to place such cancer warning labels and not address these risk factors in isolation," they said. PTI
News18
2 days ago
- Health
- News18
AIIMS researchers call for warning labels on alcohol like tobacco
Last Updated: New Delhi, Jul 27 (PTI) Researchers at AIIMS have called for strong, evidence-based warning labels on alcohol products to prevent avoidable cancers, building on India's success with tobacco warnings. In an opinion piece titled 'Expanding behavioural interventions through cancer warning labels in India: from cigarette packs to alcohol bottles" published in Frontiers in Public Health on July 24, the doctors have highlighted that alcohol, like tobacco, is a proven carcinogen, yet awareness remains low. The opinion piece by oncologists Dr Abhishek Shankar, Dr Vaibhav Sahni and Dr Deepak Saini from the Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, AIIMS, Delhi stated that adolescence forms a crucial period for the initiation and intensification of substance use behaviour, including alcohol. Behavioural interventions instituted by means of alcohol warning labels may prove to be effective in affecting positive changes in the consumption habits of individuals belonging to this age group, particularly in Low- and Middle-Income Countries (LMICs), where it is all the more important for certain sections of society to be educated and sensitised towards the consequences of substance use, the researchers said. They stated that cancer cases in India have seen a steep rise, with data from the 2012 to 2022 period suggesting a 36 per cent increase in incidence (1.01 million-�1.38 million). GLOBOCAN 2022 data saw about 1.41 million new cancer cases in India with a five-year prevalence at around 3.25 million and a total cancer mortality at 916,827. Alcohol attributable a fraction for cancer and age-standardised rate per 100,000 in India are 4.7 per cent and 4.8 per cent, respectively, according to the GLOBOCAN 2020 data. Data from 2016 suggested that 6.6 per cent of Disease Adjusted Life Years in India were attributable to alcohol consumption which followed that of tobacco at 10.9 per cent, the researchers said. The researchers also mentioned about the advisory brought out by the US surgeon general in January 2025 regarding the consumption of alcohol and the risk of cancer, which stated that alcohol consumption demonstrably elevates the risk for developing at a minimum, seven types of cancer (colon/rectum, liver, breast, esophagus, larynx, pharynx and oral cavity). The advisory also mentioned the mechanistic links between alcohol consumption and the risk of developing cancer along with the fact that this effect is observable regardless of gender. Even before the release of this advisory, alcohol-attributable cancers have been recognised to contribute significantly to the global burden of disease, the researchers said. Cancer warning labels on alcohol containers have been observed to be of benefit in reducing alcohol consumption and lowering the perception of consumption, they said. The Global Adult Tobacco Survey (GATS) in 2016-�17 noted an increase by 16 per cent for health warnings on cigarette packs, with pictorial health warnings demonstrating a 50 per cent elevated impact on the intention to quit smoking cigarettes. Warnings can be differentiated based on the type of messaging involved into loss-framed and gain-framed which have an emphasis on associated risks/harms and the benefits of quitting, respectively, the researchers explained. There is evidence in literature to suggest that gain-framed messaging possesses an advantage over loss-framed warnings but the research on such aspects has mainly focused on loss-framed warnings in the case of cigarette smoking. It is also suggested that a combination of messaging can help inform behaviour change in a more effective manner which is based off the concept of the role individual beliefs play in determining outcomes, they said. India being an LMIC, this trend indicates the effect of cancer warning labels in modifying the behaviour of a significant number of people consuming such products, the researchers highlighted. 'The LMICs may look into expanding the positive experience gained from tobacco warning labels to those pertaining to alcohol containers, which clearly state a cancer risk from consumption. It may also be useful for these cancer labels to state that there is no lower threshold for alcohol-related cancer risk along with the types of cancers demonstrably attributable to alcohol consumption so far," the doctors said. They pointed out that a crucial but often ignored aspect while considering warning labels is the multiplicative interaction of smoking and alcohol consumption in determining cancer risk. A National Cancer Institute (NCI) Workshop in December 2020 emphasised the importance of addressing the combined usage of tobacco and alcohol. Co-use of tobacco and alcohol has been found to be associated with a multiplicative effect in cancer risk, particularly for pharyngeal and oral sites. The importance of reciprocative warning labels on tobacco and alcohol product packaging is further underscored by the fact that alcohol usage has been observed to go up with an increase in cigarette smoking, with the former being associated with lower rates of quitting and higher relapse rates in smokers. It may also be worth considering to have helpful or constructive labelling on containers which guide the user to seek medical advice or undergo screening for cancer instead of being terminalistic in its messaging by suggesting graphic or fatal outcomes upon consumption, the researchers said. 'Since cancer as a disease may present as a result of the combined effect of alcohol and tobacco consumption, it makes sense to place such cancer warning labels and not address these risk factors in isolation," they said. PTI PLB MNK MNK (This story has not been edited by News18 staff and is published from a syndicated news agency feed - PTI) view comments First Published: July 27, 2025, 17:15 IST News agency-feeds AIIMS researchers call for warning labels on alcohol like tobacco Disclaimer: Comments reflect users' views, not News18's. Please keep discussions respectful and constructive. Abusive, defamatory, or illegal comments will be removed. News18 may disable any comment at its discretion. 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Indian Express
24-06-2025
- Health
- Indian Express
‘Nicotine addiction hasn't disappeared, it has simply shape-shifted'
Smokeless tobacco is the number one problem in India and there is an urgent need to strengthen laws and regulations to address it effectively,' Dr Shalini Singh, director of the Indian Council of Medical Research-National Institute of Cancer Prevention (ICMR-NICPR) and the World Health Organisation-Framework Convention on Tobacco Control (WHO-FCTC) Global Knowledge Hub on Smokeless Tobacco told The Indian Express. On the sidelines of the World Conference of Tobacco Control under way at Dublin, Dr Singh observed that globally, cigarette smoking is on the decline — especially in high-income countries, where public health regulations have tightened and consumer behavior is shifting. 'But nicotine addiction hasn't disappeared; it has simply shape-shifted. The rise of electronic nicotine delivery systems (ENDS), synthetic nicotine pouches, and 'flavoured wellness' lozenges represents a quiet but aggressive reinvention of the nicotine business. These products are marketed as cleaner, safer, and even medicinal — often using the language of 'harm reduction'. While India has banned e-cigarettes, these new delivery systems pose a serious public health risk in countries with poor implementation of regulations,' Dr Singh said. India is already home to one of the largest populations of smokeless tobacco (SLT) and bidi users globally. According to the Global Adult Tobacco Survey (GATS) 2016–17, over 199 million Indians use SLT, 72 million smoke bidis, whereas only 37 million smoke cigarettes. Less than 4 per cent of tobacco users use any cessation pharmacotherapy, and over 70 per cent quit without formal help. 'This makes India an especially vulnerable target for the tobacco industry's new nicotine expansion strategy,' Dr Singh said. Harm reduction, when implemented as part of a comprehensive cessation strategy, has clinical value. But the tobacco industry has co-opted the term 'harm reduction' to further its own interests of reduced regulation and to expand its user base. While India banned e-cigarettes in 2019 under the Prohibition of Electronic Cigarettes Act, experts said the same industry has repackaged nicotine in non-combustible, e-cigarettes adjacent forms — such as synthetic nicotine pouches and gums — often marketed as herbal, Ayurvedic, or wellness products on Indian e-commerce platforms. 'This represents not only a strategic circumvention of the e-cigarette ban but also a continuation of the industry's practice of promoting products that protect profits while presenting a facade of supporting smoking cessation,' Dr Singh added. India permits over-the-counter (OTC) sale of 2 mg nicotine gums and lozenges, based on the assumption that easier accessibility would enhance tobacco cessation efforts. The 2 mg NRT formulation, particularly when used with behavioural counselling, can play a crucial role in reducing dependence on smoking tobacco. Global evidence is clear: NRTs are most effective when used with structured counselling and support, not when taken in isolation. Many low- and middle-income countries (LMICs), including India, have NRTs in OTC markets and require integration with comprehensive cessation services. In India, the effectiveness of OTC NRT is further undermined by systemic challenges: the very low cost of smokeless tobacco (SLT) products like gutkha, khaini, and bidis; the online sales of nicotine products frequently bypass age restrictions;and the economic burden of NRT — where one week's supply often costs more than a month's worth of SLT or bidi. Without counselling support and affordability measures, OTC NRT risks becoming another market commodity rather than a true cessation aid,' Dr Singh pointed out. Long-term use of nicotine — whether through vaping, pouches, or even unsupervised NRT — poses real risks. Yet, these products are increasingly available through online platforms in India, marketed with no warning labels, no age-gating, and no evidence-based cessation claims, Dr Singh cautioned. Urgent policy priorities include banning of flavoured and industry-manufactured non-combustible nicotine products, including gums and pouches not intended for supervised cessation. There is a need to tightly regulate OTC NRT, especially in flavours and formulations attractive to youth; regulate all online sales of nicotine products with mandatory age verification, licensing, and product labelling.
New Straits Times
12-06-2025
- New Straits Times
Vape ban: Concerns are real but proposed solutions flawed
ACROSS Malaysia, we're witnessing a growing wave of state-led attempts to ban vape products with Perlis, Terengganu and Kedah announcing prohibitions, with Penang, Selangor and Negri Sembilan reportedly considering the same. Publicly, leaders and MPs are now echoing calls for a nationwide ban, citing concerns over vape products laced with drugs and growing concern over youth vaping. Let us be clear: these concerns are real, but the proposed solutions are dangerously flawed. The reason we are seeing issues like underage use and contaminated products is not because of the legal vape industry. It is because irresponsible, illegal retailers and criminal syndicates continue to operate without fear of consequences. These bad actors have no regard for regulations, age restrictions or product safety. They are the ones supplying unregistered products, selling to minors and introducing dangerous substances into the supply chain. Banning vape will not stop these criminals. It will only penalise legitimate, regulated businesses, while empowering the black market. The leaders now calling for a ban are reacting to the harm caused by illegal and unregulated players. But instead of focusing efforts on enforcement to eliminate these elements, they propose a blanket ban that would wipe out responsible retailers, many of whom are registered and comply with all current regulations. If we take the easy way out and ban vape outright, we risk creating an entirely unregulated underground market. Everything will be black market. No age checks, no quality control, no accountability. This is the worst possible outcome for public health. We must remember that the Control of Smoking Products for Public Health Act 2024 (Act 852), has now been introduced. This is the very tool meant to bring vape into a regulated space, to ensure product safety, protect youth, and allow only legal players to operate. Why are we not concentrating our energy on implementing this law effectively, with robust enforcement to weed out the bad actors? According to Global Adult Tobacco Survey (GATS) Malaysia 2023 survey by the Institute for Public Health under the Ministry of Health, the majority of vape users are aged 15 to 24 years. These numbers did not emerge under a regulated environment. They grew due the absence of a clear regulatory framework. This proves that prohibition does not work. What works is regulations, oversight and the political will to enforce the law. Malaysia Retail Electronic Cigarette Association fully supports regulations. We support clear rules that keep products out of the hands of minors and ensure safety for adult consumers. But we cannot support a system where the actions of criminal syndicates are used to justify blanket bans that harm legitimate businesses. With Act 852 already in place, the focus must be on moving forward: implementing it with urgency, investing in enforcement and strengthening the regulatory framework so that only responsible, compliant players remain in the market. Banning regulated products is not a solution, it is an abdication of responsibility that hands the market over to criminals. If we want to protect public health and consumer safety, we must stay the course, enforce the law decisively, and commit to building a legal, transparent vape industry that operates within clear and accountable boundaries.
