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23/10/2014

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Making alcohol policy: increasing consumption or reducing harm?

Claire Harkins and David Poley disagree

Dear David,

Alcohol is damaging the health of the British population. Respected medical organisations are now calling for evidence-based alcohol control policy to tackle this public health crisis.

Over recent decades alcohol has become increasingly affordable. Drinking excessively is more prevalent and socially acceptable, particularly for young women, than it was in the past.

The domination of large alcohol companies has created a market reliant on high volume sales. Heavy supermarket discounting, marketing and promotions have also contributed to the escalating rates of alcohol related harm. Meanwhile, alcohol policy has, in the words of the 2009 Health Select Committee report, ranged from ‘the non-existent to the ineffectual’.

We require a strategy which will promote public health instead of cosseting the alcohol industry.  The most robust evidence points to the need for restrictive measures on pricing, availability, advertising and marketing. All of these measures pose a serious threat to alcohol industry profits.  The industry depends on harmful drinking: if people drank responsibly, alcohol sales would plummet by 40 per cent.  It is the industry’s job to increase sales of alcohol.  It is the government’s job to regulate and protect public health over trade — just as with other addictive drugs. Government should ignore special pleading by the alcohol industry and prioritise public health.

Yours, Claire 

Dear Claire,

There is a problem of alcohol misuse in the UK; the question is how it should be addressed. 

The health lobby favours restrictive measures on pricing, availability, advertising and marketing in the belief that this will reduce overall levels of consumption.  Leaving aside some of the flaws in that assumption, is this really the fairest and most effective way of tackling the problem? 

Most of us who drink, do so moderately and responsibly; we don’t need to drink less.  The people who need to cut back are the 7 per cent of drinkers whom, it is estimated, account for 33 per cent of all alcohol consumption in the UK.  These are also the people who are least likely to change their drinking behaviour if their favourite tipple is made a little bit more expensive, or if they had to travel a little bit further to the nearest retail outlet.

Rather than impose these blunt, ineffective measures that impact on the moderate majority, the industry believes that one should instead educate consumers into drinking responsibly.  It is only through education, coupled with targeted interventions against misusers, that we shall ultimately change the drinking culture and make a lasting difference to alcohol health harms.

Yours, David

Dear David,

As a lobbyist, you argue that ‘we do not need to drink less’ and that alcohol-related harm is essentially a problem for only 7 per cent of drinkers, presumably those who are addicted. The evidence, as opposed to alcohol industry propaganda, shows that the greatest costs associated with alcohol are linked to drunkenness rather than addiction, with the involvement of emergency, social and law-enforcement services.

Education has been found to be an ineffective means of controlling alcohol consumption (price and availability are the most effective tools, as virtually all disinterested parties agree). A worrying precedent can be found in the anti-smoking campaigns funded with tobacco money which actually raised smoking rates.  Research on ‘responsible’ drinking campaigns found that such messages often encourage alcohol consumption by reinforcing social norms of drunkenness as part of a night out, rather than acting as a serious health warning.

The public need to be aware that most alcohol 'education' originates from the alcohol industry itself. It is a drive towards greater corporate social responsibility for economic ends rather than an altruistic source of objective public health information. 

Yours, Claire

Dear Claire,

I appreciate that drunkenness is as big a problem as chronic misuse.  The 7 per cent of drinkers who consume a third of all alcohol (Department of Health estimate, not drinks industry propaganda) will include many of those who get drunk and cause trouble in town centres.

Education doesn't work?  Take a look at drink-driving.  Deaths are 70 per cent lower than they were a generation ago.  Educational campaigns have transformed attitudes and behaviour.  We should now do the same to make public drunkenness socially unacceptable.

And yes, the industry is responsible for much of the alcohol education that takes place.  Surely, this is to be applauded?  In fact, the industry's educational effort is now channelled through Drinkaware, an independent charity funded but not controlled by the industry.  You are right that the alcohol industry, like any industry, acts more out of self-interest than pure altruism.  That doesn't mean its actions can't be worthwhile and of benefit to society.

No doubt, if the industry didn't have a social responsibility programme, the health lobby would be even more apoplectic.  It seems a case of ‘damned if you don't and damned if you do’.  The industry should, and does, play its part in tackling alcohol misuse.

Yours, David

Dear David,

The 7 per cent you refer to accounts for harmful drinkers whose consumption has already damaged their health or are addicted.  Hazardous drinkers are those whose consumption risks their health but who have not yet developed health problems.  This applies to 33 per cent of men and 16 per cent of women.  Your use of the statistics to frame the debate in your favour is propaganda which replaces objective information. 

Education alone did not change behaviour and attitudes towards drink driving; supporting sanctions such as fines, or even prison did that.  The effects of educational campaigns are counterbalanced by widespread advertising of alcohol that does not portray the serious consequences of the drug.

The Portman Group is an effective lobby for specific private interests which profit from the harm that drink does.  Industry-funded educational campaigns underplay the dangers and provide a sanitised view of alcohol-related harm – further offset by the illusions fostered by marketing, advertising and PR.  The problem for those interested in the health of ordinary people is the power and influence that alcohol lobbyists have over public health policy. An industry that sells an addictive drug should not be responsible for education relating to its safe use.  This is a clear conflict of interest and should be the responsibility of independent health organisations — not the alcohol lobby or its proxies.

Yours, Claire

Dear Claire,

I'm sorry if I did not make this clear enough last time: Drinkaware is independent.  Its board includes highly respected academics and health experts.  Are you saying that the industry is wrong to fund it?

The industry voluntarily promotes Drinkaware's educational website on over 3 billion drinks containers each year and in all advertising.  This helps the website to attract over 130,000 visitors each month.

Alcohol marketing must be responsible and is regulated through strict Codes of Practice operated by the Advertising Standards Authority and Portman Group.  The Codes are independently enforced; the rare examples of irresponsible marketing are immediately withdrawn.

Finally, let's return to your belief that the only way to reduce alcohol problems is to curb overall demand through restrictions on price and availability.  Since 2005, (which, incidentally, was when licensing laws were relaxed), alcohol consumption has fallen by 11 per cent.  Alcohol-related hospital admissions over the same period have risen by 52 per cent.  The link between per capita consumption and alcohol-related harm unfortunately is not as simple as you portray.  We need to persuade excessive drinkers to cut back through targeted, innovative actions.  The industry should be seen not as part of the problem but as part of the solution.

Yours, David

David Poley
David Poley is Chief Executive of the Portman Group, the social responsibility organisation for UK drinks producers
Claire Harkins
Claire Harkins is at the School of Applied and Social Sciences, University of Strathclyde
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