I. INTRODUCTION

On May 7, 1979, during consideration of S. 440, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act Amendments of 1979, the Senate passed by voice vote (after refusing to table by a vote of 21 yeas, 68 nays) an amendment offered by Senator Strom Thurmond to require beverages containing more than 24 percent alcohol to bear the following warning on their labels:

Caution: Consumption of alcoholic beverages may be hazardous to your health.

The House companion to S. 440, H.R. 3916, does not contain a warning label provision.

During floor debate on this amendment, Senator Donald W. Riegle, Jr., Chairman of the Subcommittee on Alcoholism and Drug Abuse and author of S. 440, proposed a hearing on the question of consumer health warnings for alcoholic beverages to supplement a January 31, 1978, hearing on "Alcoholic Labeling and Fetal Alcohol Syndrome. That hearing has been scheduled for September 14, 1979.

During hearings on S. 440, former Senator Harold E. Hughes, author of the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, testified in support of Senator Riegle's bill. Senator Hughes spoke movingly of his own history as an alcoholic and of the many tragedies he had witnessed in his years of trying to help others who suffer from alcoholism and recounted several of his experiences as first Chairman of the Subcommittee on Alcoholism and Drug Abuse. He then challenged the Subcommittee with several piercing questions, among them:

Why are we unwilling to put warning labels on alcohol to warn pregnant women of the danger to their unborn children [of consumption of alcohol during pregnancy]?

In drafting S. 440, the main purpose of which is to renew the authorizations of the National Institute on Alcohol Abuse and Alcoholism, the question of warning labels was not considered. Warning labels had, however, been the subject of considerable debate during the preceding two years. On November 15, 1977, Dr. Donald Kennedy, then Commissioner of the Food and Drug Administration (FDA), called upon the Bureau of Alcohol, Tobacco, and Firearms (BATF) in the Treasury Department to require warning labels concerning the fetal alcohol syndrome (FAS) on all alcoholic beverage containers. BATF responded by publishing in the Federal Register on January 16, 1978, an advance notice of proposed rulemaking concerning warning labels on alcoholic beverages. This advance notice requested information on whether existing labeling regulations should be amended to require a warning label on containers of alcoholic beverages warning

(1)

women of the possible birth defects resulting from consumption of alcoholic beverages during pregnancy. BATF eventually decided to postpone decision on whether to require warning labels pending further study and analysis of ongoing efforts to raise public awareness of the fatal alcohol syndrome.

On January 31, 1978, the Subcommittee on Alcoholism and Drug Abuse held a hearing on "Alcohol Labeling and Fetal Alcohol Syndrome". That hearing concentrated primarily on documenting the fetal alcohol syndrome and reviewing the efforts of the National Institute on Alcohol Abuse and Alcoholism, FDA, and BATF to warn pregnant women of this syndrome.

Following Senate passage on May 7, 1979, of S. 440, incorporating the Thurmond warning label amendment, Senator Riegle propounded six questions concerning consumer health warnings and related questions. These questions were printed in the Congressional Record on June 12, 1979, with a request for public response. In addition, Senator Riegle mailed approximately 200 letters to individuals and organizations concerned with alcohol-related problems requesting responses to these questions. This staff report summarizes the responses to these questions and discusses the legislative, bureaucratic, and political background of this issue. It was compiled by Craig Polhemus, Subcommittee Counsel and Staff Director, and Nancy Olson, professional staff member, with the assistance of Ruth Kane.

II. ANALYSIS OF RESPONSES

In order to supplement the public record of the BATF proceedings and the Subcommittee's 1978 hearing, Senator Riegle requested comments on consumer health warning for alcoholic beverages and related issues through a statement in the Congressional Record on June 12, 1979, and through letters to leaders in the alcoholism field and representatives of the alcoholic beverage industry. The six questions posed by Senator Riegle were:

1. Would warning labels be effective in raising public awareness of the health hazards involved in the use of alcohol?

2. Should such warning labels, if any, be of a general nature, or should they address specific dangers such as the fetal alcohol syndrome, driving impairment, etc.?

3. Should Congress consider requiring a rotating system of labeling? For example, Congress could require that 10 percent of the labels contain a warning about the fetal alcohol syndrome, 10 percent on driving impairment, etc.

4. Should such warning labels be required on beer and wine as well as distilled spirits?

5. Should beer and wine containers be required to indicate the percentage of alcohol per volume?

6. Should warning labels also be required on advertisements of alcoholic beverages?

Of the more than 250 responses received by the Subcommittee, those favoring warning labels outnumber those in opposition by better than two to one. Many letters and postcards were clearly inspired by articles in alcoholism publications, while others appeared to reflect industry efforts against the proposal.

Organizational support for warning labels was expressed by the Department of Health, Education, and Welfare; the American Medical Association; the National Association of State Alcohol and Drug Abuse Directors; the Salvation Army; the National Association of Alcoholism Treatment Programs; the National Association of Alcoholism Counselors; the American Business Men's Foundation; Women for Sobriety, Inc.; the Association of Halfway House Alcoholism Programs of North America; the Christopher B. Smithers Foundation; the Psychiatric Institute; and the Alcohol and Drug Problems Association of North America.

Organizations writing in opposition to warning labels were the Distilled Spirits Council of the United States, Inc.; the U.S. Brewers' Association; the Wine Institute; the Health Education Foundation; the National Licensed Beverage Association; the American Council on Alcoholism; Volunteers of America; and the North Conway Institute. Before reviewing the organizational and individual responses to these questions, a review of the alcoholic beverage industry's efforts to combat alcohol abuse seems in order.

The Distilled Spirits Council of the United States, Inc., in April of 1979 distributed a brochure describing its support of programs designed to combat alcohol abuse problems. This support includes such items as:

1. A public education effort focusing on the related concepts of responsible drinking and responsible decisionmaking. The outreach includes the use of major magazines, network television and radio, mass transit car cards, newspapers, motion pictures, posters, mass distribution wallet cards, and pamphlets.

2. DISCUS is working with the National Football League and the Education Commission of the States in a special program focused on young people and based on the findings of ECS's three-year Task Force on Responsible Decisions About Drinking. In 1978, this report included: 30-second and 60-second television spots starring Rocky Bleier and Drew Pearson; print ads in Pro magazines distributed at every stadium; radio messages used by the CBS Network; messages on stadium scoreboards; a new booklet, Winning Decisions, written by the Commissioner of Education from Rhode Island; and special NFL schedules featuring guidelines for responsible use or non-use of beverage alcohol.

3. Public service print advertising: Using ads developed in cooperation with Playboy magazine, DISCUS has requested magazines to donate public service space. In 1978, the following magazines carried one or more of the six DISCUS messages: Playboy, New Times, National Lampoon, Penthouse, Business Week, Psychology Today, and Atlanta Gazette.

Ladies' Home Journal, Omni, Esquire, Industry Week, and the CBS Special Interest Publications, including Road & Track, pledged to run one or more ads in 1979.

Major exposure of these messages was achieved through saturation mass transit coverage arranged by the TDI/Winston Network agency on vehicles in New York, Washington, Philadelphia, Oakland, Pittsburgh, Minneapolis/St. Paul, Atlanta, and Miami. A special pamphlet containing four of the new messages was distributed on fifty college campuses in the spring of 1978.

4. In twenty-five states and the District of Columbia, DISCUS has joined with state and local governments for public education efforts based on the theme, "Know Your Limits."

5. DISCUS has established an Education Advisory Council to advise it on the need for sound alcohol education in the schools. It has sponsored several major projects, including the development of a major new sourcebook for educators, Learning About Alcohol.

6. DISCUS funds basic research into the causes, results, treatment, and prevention of alcohol abuse. Under the Auspices of DISCUS's Scientific Advisory Council, seeding grants have been provided for over 350 individual research projects. Current members of the Council include: Fred Ellis, Ph. D., professor of pharmacology, University of North Carolina; Leon Greenberg, Ph. D., professor emeritus of physiology, Rutgers University: Robert Malmo, Ph. D., director, Neuropsychology Laboratory, McGill University; Arthur Patek, M.D., professor of medicine emeritus, Tufts Medical College; David Pittman, Ph. D., chairman, Department of Sociology, Washington University (at St. Louis); Alfred Smith, M.D., professor of psychiatry, New York Medical College; and Jackson Smith, M.D., chairman, Department of Psychiatry, Loyola University of Chicago. Most prominent researchers in the alcohol studies field have been assisted through this program. DISCUS has sponsored 11 independent research projects to date, as well as pledged its support of a nationwide public education program on drinking and pregnancy.

7. DISCUS supports activities of other national organizations, among them the Alcohol and Drug Problems Association (ADPA), the American Council on Alcoholism, North Conway Institute, Rutgers University Center for Alcohol Studies, National Council on Alcoholism (NCA), the National Coalition for Adequate Alcoholism Programs, the Association of Labor/Management Consultants on Alcoholism (ALMACA), the Alliance for Traffic Safety, American Association of Motor Vehicle Administrators, and National Association of Women Highway Safety Leaders.

8. DISCUS gives ongoing support for Dr. Jack Mendelson at Harvard Medical School on the development of a model course for medical schools on alcoholism diagnosis and treatment. It is kept up to date via research findings presented at the annual Harvard medical symposium, which DISCUS co-sponsors. DISCUS funds aided Dr. Mendelson in the preparation of a book summarizing the content of this course.

9. Major assistance has been provided by DISCUS to the Education Commission of the States to help disseminate the findings of its Task Force on Responsible Decisions About Drinking. A DISCUS member company funds research on the "practical application of responsible decision-making concepts" being conducted at the University of Connecticut.

10. DISCUS co-sponsored, with NCA and Rutgers, symposia on such subjects as occupational alcoholism programs, teenage drinking, the genetic factor in alcoholism, etc.

11. DISCUS works with the North Conway Institute to help stimulate activities of major religious organizations in this field.

12. Through a variety of programs, DISCUS has sought to encourage moderation for all adults through education efforts directed at

women, and, also supported the elimination of obstacles to treatment for women with drink-related problems. Other women's activities supported by DISCUS include the work of the General Federation of Women's Clubs, the National Association of Women Highway Safety Leaders, and the National Extension Homemakers Council.

13. The DISCUS Code of Good Practice builds on an already substantial base of Federal and state regulations to establish guidelines for marketing efforts that are sensitive to public feelings. Most of the Code provisions, such as the commitment to avoid use of radio, television, movie theaters, and comic books for the advertising of liquor, are aimed at reducing the exposure of children to such messages. The National Association of Broadcasters members have also, in their code, banned TV and radio advertising of liquor, but the DISCUS code predates the NAB on both counts.

The United States Brewers' Association, Inc., also supports programs designed to reduce the problems caused by use of its products. The March 1979 "Position Statement of the United States Brewers' Association, Inc., on the Problems of Alcoholism and Alcohol Misuse in American Society" summarizes these activities.

1. Brewers have instituted company programs for the detection and treatment of personnel who misuse alcohol, thereby dealing with the immediate problems of their personnel and setting an example for other companies. The United States Brewers' Association is working closely with government and the business community to expand these programs.

2. The industry has for many years funded a Medical Advisory Group, chaired by the Dean Emeritus of The Johns Hopkins University School of Medicine. The Medical Advisory Group grants research funds in response to submitted protocols and funds research projects on alcoholism and alcohol misuse.

3. The Association has published its recommended "Guidelines for Beer Advertising," which are periodically reviewed and refined. The Guidelines urge that, in addition to meeting the special legal requirements for beer advertising, brewers respect principles of candor and good taste applicable to all commercial advertising. Among basic suggestions are cautions that malt beverage advertising should not:

suggest nor encourage overindulgence;

portray amorous activity nor include risqué material;
disparage nor denigrate competing beers; and

portray nor encourage drinking by young people.

4. The United States Brewers' Association supports the work of the Rutgers Center for Alcohol Studies.

5. The Association supports the programs of organizations such as the National Council on Alcoholism, the North Conway Institute, the National Coalition for Adequate Alcoholism Programs, and the American Council on Alcoholism.

6. The Association's field staff works with retail outlets, beer wholesalers, state liquor control agencies, and local law enforcement and licensing authorities to encourage strict observance and enforcement of all laws regulating malt beverages.

7. The Association's field staff conducts youth education programs to encourage observance of laws governing alcohol use. These "Youth