Anomalous warning labels on alcoholic energy drink cans

To the Editor: Despite longstanding calls for mandatory evidence-based warning labels on alcoholic beverages or at point of sale,1 they remain elusive and are actively resisted by industry groups.2

There is widespread ignorance of the current Australian guidelines to reduce health risks from drinking alcohol3 as well as the recommended daily limits for consuming highly caffeinated energy drinks. In high enough quantities, caffeine is toxic; consequently, some advisory labelling is already mandated for these controversial “soft” drinks.4 These labels are often difficult to find, and if the caffeine is from guarana only, a statement that the drink contains caffeine is the only warning required. This has resulted in anomalous and confusing labelling on cans of the even more contentious alcoholic energy drinks5 — such that consumers could be forgiven for thinking the alcohol component is not as potentially injurious to their health as the caffeine.

Based on caffeine content, labelling on cans that also contain between 1.3 and 1.9 standard drinks of alcohol advises a limit of two cans per day, which equates to a daily intake of between 2.6 and 3.8 standard drinks of alcohol. This exceeds the limit recommended in the Australian guidelines — two standard drinks per day — for reducing the risk of long-term damage to the body from alcohol.3 The advice on brands at the higher end of this range barely complies with the recommended limit of four standard drinks per day for preventing acute harm.

With such confusing advice, the general public cannot be expected to understand or follow recommended limits for either alcohol or caffeine consumption. Packaging should display unambiguous and prominent warnings, including whichever is the lower of the two daily use limits calculated according to guidelines on alcohol and caffeine intake. A second maximum might be given for usage in a single session. Public health messaging needs to be clear and consistent, and an overhaul of both alcohol and caffeine advisory labelling is long overdue.