Alcohol Labeling Regulations and Industry Compliance in Nigeria: Evidence to Guide Policy Implementation.

OBJECTIVE: Alcohol labeling raises consumers' awareness of a product's composition and the risks associated with alcohol consumption. We identified mandatory elements and health warnings in alcohol regulations in Nigeria and evaluated selected product labels on alcoholic beverages produced in Nigeria to determine their compliance with the requirements. METHOD: A descriptive case study was used. Labeling requirements were extracted from two alcohol regulations and one related document retrieved from the website of the National Agency for Food and Drug Administration and Control (NAFDAC). The information on the product labels of 59 selected beers and spirit drinks produced in Nigeria was assessed based on six mandatory elements: list of ingredients, allergens, nutritional information, percentage of alcohol by volume (ABV), "drink responsibly" statement, and age restrictions. Five health warnings were also assessed: standard drinks per container, drinking guidelines, link to an alcohol education website, a "drinking during pregnancy" logo/text, and drink driving logo/text. RESULTS: Different regulations exist for beer and spirit drinks in Nigeria. Health warnings are not mandatory on labels of alcoholic beverages. No single product label included all six mandatory elements. Four mandatory elements--list of ingredients, ABV, drink responsibly statement, and age restrictions--were present on 61% of the product labels examined. CONCLUSIONS: The alcohol labeling regulations in Nigeria fall short of the World Health Organization labeling recommendations. The alcohol industry does not fully comply with labeling requirements in Nigeria. Enhanced labeling inclusive of health warnings should be mandatory as a strategy to create awareness of alcohol-related risks while monitoring industry-labeling practices to ensure compliance.

Evaluation of Alcohol Taxes as a Public Health Opportunity to Reduce Liver Transplant Listings for Alcohol-Related Liver Disease.

BACKGROUND: Alcohol-related liver disease (ALD) is a leading indication for liver transplantation. METHODS: State consumption of spirits, wine, and beer was determined from published sources. Excise and ad valorem alcohol taxes of spirits, wine, and beer were calculated following standard practices and correlated using multiple logistic regression models to 2002 to 2015 ALD transplant listing data from the United Network for Organ Sharing database. RESULTS: 21.22% (29,161/137,440) of transplant listings were for ALD. Increased consumption of spirits was associated with increased ALD transplant listings (odds ratio [OR]: 1.67; 95% CI: 1.12 to 2.49, p = 0.01), but wine and beer consumption did not have a statistically significant association with ALD transplant listings. Spirits excise taxes on- and off-premise were inversely associated with ALD transplant listing (OR: 0.79 and 0.82, respectively, both p < 0.02). Beer and wine taxes were not significantly associated with ALD transplant listings. CONCLUSIONS: Transplant listings for ALD are directly associated with spirit consumption and inversely associated with spirits excise taxes. These findings suggest a possible public health benefit of increasing excise taxes for spirits.

Is There an Increased Risk of Criminal Behavior Among Children Who Were In Utero When Their Mothers Were Exposed to Increased Alcohol Availability? A Register-Based Study Using a Natural Experiment Setting.

OBJECTIVE: Increased alcohol availability influences drinking behavior; however, little is known about the effect of availability changes on subsequent generations. This study examined whether exposure to increased alcohol availability while pregnant is associated with criminal behavior in subsequent generations. METHOD: A register-linked study was conducted using data from a natural experiment setting, including 363,207 children born between 1965 and 1971. During 1967/68, strong beer became temporarily available in grocery stores instead of state-owned monopoly stores only, for individuals less than 21 years of age, in two regions of Sweden. Children born in regions exposed to the policy change were compared with children born elsewhere in Sweden (excluding a border area), children born before 1967, and children conceived after 1968. Information on criminal outcomes was obtained from the National Register of Criminal Convictions. Follow-up was from age 15 to 42 years. Hazard ratios with 95% confidence intervals were estimated using Cox regression analysis. RESULTS: Compared with the unexposed cohorts, children conceived by young mothers before the policy change but exposed to the change in utero did not appear to be at an increased risk of being convicted of a violent crime, theft, or drunk driving later in life. Similar patterns of results were found among children conceived by older mothers. CONCLUSIONS: Using data from a natural experiment setting, no consistent evidence was found that being exposed to increased alcohol availability while pregnant increased the risk of having a child who would be convicted of a crime later in life.