11.0 Alcohol Control Policies

11.1 A main aim of drinks industry publications is to convince policy makers that control policies such as higher taxes and prices or liquor licensing laws do not affect alcohol 'abusers' or the level of alcohol abuse but only serve to 'penalise' the moderate drinking majority. Thus, for example, the Amsterdam Group report asserts "Do higher prices influence abuse or misuse? They do not." It also states: "Broad-based restrictions and tax increases offer no useful assistance and little deterrent to those with alcohol problems."⁸

11.2 The drinks industry's constant refrain is that the public health approach to prevention of alcohol problems is misguided because it advocates or requires "restrictions", which it appears to regard as arbitrary infringements of personal liberty for no good purpose.

11.3 In regard to the libertarian argument, despite the drinks industry's pretence, there is no actual dispute that people have the right to consume alcohol if they choose. The point, however, is that people also have the right to be protected from, for example, alcohol-impaired driving and other alcohol-related crime. Liquor licensing controls and drink drive laws which, presumably, are examples of the "broad-based restrictions" to which the drinks industry object, exist to protect public order and public safety. It is because alcohol "abusers" affect others as well as themselves, with high levels of alcohol "abuse" affecting society as a whole that public policy on alcohol is both legitimate and necessary.

11.4 In regard to the effectiveness of controls, were the Amsterdam Group's arguments correct, then, presumably, all European countries could abolish all their "restrictions" and all tax on alcohol in the sure knowledge that doing so would have no adverse effects whatever.

11.5 Objective commentators and, it is to be hoped, policy-makers will recognise that this argument is no more than a self-serving piece of fiction. There is no real controversy that alcohol control policies can and do reduce the level of alcohol-related harm. There is, for example, ample evidence from around the world that levels of tax and price can reduce alcohol-related harm not only by providing an incentive for heavy drinkers to drink less than they would otherwise do but also by providing an incentive for moderate consumers to remain moderate.¹⁷

11.6 A consequence of the drinks industry's arguments being at variance with the scientific evidence is that they are not only in opposition to those of public health bodies and organisations the industry would class as "anti-alcohol", they are also diametrically opposed to the conclusions of, for example, the World Bank.

11.7 Commenting that "decisions about the use of tobacco, alcohol and other drugs are among the most important health related choices that individuals can make" and that because individual options are limited by the strongly addictive character of these substances, decisions about their control "are among the most important health-related choices that societies can make collectively", the world Bank notes that past successes in controlling use and associated problems through measures such as restrictions on promotion and access, high taxation, rehabilitation of addicts and public education "should spur efforts towards full implementation".²⁶

11.8 In regard to alcohol taxation, the European Commission, as well as individual member states, has already accepted the principle that this has a public health dimension. ³⁶

11.9 Other control policies for which there is scientific evidence of effectiveness include: ¹⁷

• Controls on the retail sales of alcohol - the number of licensed outlets and their hours of opening; age limits; controls on selling to the already intoxicated.
• Countermeasures against specific problems such as drinking and driving.
• Treatment and early intervention into alcohol problems, especially in primary health care settings.

11.10 Other measures which may usefully be considered but for which there is less clear-cut evidence of effectiveness include:

• Controls on advertising and promotion of alcoholic drink.
• Public education campaigns.

11.11 A crucial consideration is that control measures are unlikely to be effective or sustainable in the longer term if they lack public understanding and support and that they cannot, therefore, be imposed from above on an unwilling population. It is precisely for this reason that that the WHO Action Plan advocates a comprehensive approach which includes popular participation and involvement.

11.12 The Amsterdam Group, having condemned "broad-based restrictions", which, presumably, encompass drink drive laws, liquor licensing controls and age limits for public drinking and controls on alcohol advertising - then proceed to imply that such restrictions are stepping stones to prohibition and that the real aim of the WHO and other alcohol control organisations is to achieve zero alcohol consumption by coercive means.

11.13 This is, of course, a fundamental misrepresentation of the standpoint of WHO and other organisations, and the spectre of "prohibitionism" is bogus. There is no prospect or wish for prohibition in any European country. Moreover, in several countries the actual trend is the opposite of anything resembling prohibition - it is the dismantling of controls that previously existed. In some of the former Eastern Bloc countries, for example, previous controls on the sale and marketing of alcohol have been largely removed and in consequence, and in complete contradiction to the arguments of the Amsterdam Group, levels of both consumption and harm are rising steeply.³⁷ For example the Russian Federation appears to have displaced France as the heaviest alcohol consuming nation, and increased alcohol consumption is a major cause of declining average life expectancy in the Federation. ³⁸

11.14 What is the case is that in some European countries which historically have had high levels of alcohol related harm, measures are now being implemented or considered to reduce the level of harm. Thus, for example, in Spain the harm-reduction measures proposed by the Government include:

• Tighter controls and a possible ban on alcohol advertising.
• The introduction of warning labels on alcoholic beverage containers.
• Stricter enforcement of and possibly raising the legal drinking age.
• Reduced numbers of outlets for alcoholic drink.
• Increased alcohol taxes.

11.15 Such policies may be anathema to the European drinks industry but there is no reason to doubt that were they to be implemented they would succeed in reducing the level of alcohol-related harm in Spain and other countries.

11.16 It should be noted that in relation to alcohol advertising, the European Court has already stated:

"It must be recognised that the connection made by the French Government between the control of advertising in respect to alcoholic drinks and the campaign against alcoholism does exist. It is, in fact, undeniable, that advertising acts as an encouragement to consumption and that the disputed rules are not therefore a matter of indifference from the point of view of requirements of public health recognised by Article 36". ³⁹