A Comparison of Labelling Requirements for Alcohol, Tobacco, and Cannabis Across WHO Regions and Implications for Alcohol Labelling Policy in Canada.

BACKGROUND:Alcohol is a leading cause of global death and disability yet labelling requirements for alcohol products remain inconsistent across WHO Member States and comparatively weak in Canada, where Bill S-202 to mandate warnings is currently under review. In contrast, tobacco and cannabis are subject to more rigorous government mandated labelling requirements. This study compares federally-mandated labelling requirements for alcohol, tobacco, and cannabis across WHO regions to contextualize Canada's position within the global landscape and assess whether Canadian alcohol labelling requirements align with the documented health burden. METHODS:A systematic secondary data synthesis and document review of labelling regulations across all 194 WHO Member States was conducted in February 2023. Sources included WHO reports and regulatory databases on alcohol, tobacco, and cannabis labelling. Comparative analyses were undertaken across WHO regions. Labelling requirements were categorized by the presence and content of health warnings, including labelling design elements, and ingredient information, including allergens, calories, and additives, and content displays. RESULTS:While 32.5% of WHO Member States mandate alcohol health warnings, 84.5% WHO Member States mandate tobacco health warnings. Further, all jurisdictions with legal recreational cannabis require multiple labelling measures, including health warnings and ingredient information. In Canada, alcohol remains the only controlled substance without federally mandated warning labels. INTERPRETATION:Strengthening alcohol labelling requirements represents a policy strategy with high population reach to support informed decision-making and reduce substance-related harms. Establishing evidence-based minimum international standards for alcohol labelling could strengthen global regulatory coherence, while leadership from countries such as Canada may help catalyse progress internationally.