The booze battle
We know that Ireland has a drink problem, but how to tackle it has become a fight between politicians, lobby groups and the alcohol industry. How will we wean ourselves off the drink, asks PATRICK FREYNE
FIRST THE GOOD NEWS. The awareness campaigns have worked. We are now very aware of our drinking. We are also aware of a whole range of drinks products readily and cheaply available on the supermarket shelves – and, as a nation, we continue to drink them, fully aware of it.
Eighty-five per cent of us believe we drink too much, according to an Ipsos MRBI poll this month for the Health Research Board. Seventy-eight per cent believe the Government has a responsibility to address the issue, and 58 per cent believe it isn’t doing enough.
This follows decades of mixed-up thinking, in which successive governments bemoaned our drinking culture on the one hand while taking the tax revenue and liberalising the industry on the other. In this environment, soft rhetoric about education and awareness was the easy option. But policymakers have concluded more recently that the Irish will moderate their drinking only once price, availability and marketing are curbed.
Minister for State for Primary Care Róisín Shortall is pushing proposals based on February’s report from the National Substance Misuse Strategy Steering Group. These firmly target issues of price and marketing and will, if passed by the Cabinet, form the basis of a new public-health Bill and the fulcrum of a raft of new alcohol policies.
The statistics have always been stark. The Irish recently came top of the Eurobarometer for heavy drinking. Twenty-eight per cent of Irish drinkers binge-drank and 56 per cent overall drank harmfully, according to a Slán survey of 2007. And Ireland’s per capita alcohol consumption was 11.3 litres per adult, compared with an OECD average of 9.1 litres, according to OECD Health Data 2011. This behaviour is not without consequences. The health, crime and child-welfare ramifications of this national pastime cost an estimated €3.7 billion a year.
“While drink has always been part of Irish culture, the data suggests that the amount of drink we’re taking increased rapidly up to a peak of about 10 years ago,” says Dr Joe Barry, professor of population-health medicine at Trinity College Dublin and a member of the National Substance Misuse Strategy Steering Group. “We passed out countries like France that formerly consumed more than us. As we became wealthy we could afford drink, and when we could afford it we drank more.”
James Doorley, assistant director of the National Youth Council of Ireland, explains how the context has changed for young people. “In the past 10 years or so we’ve seen prices come down, we’ve seen much more advertising targeting young people and much more availability. Twenty years ago if a young person wanted to get access to alcohol it was at a local off-licence or pub. It wasn’t everywhere. Now there’s a lot more alcohol available and it’s much cheaper.
“The youth workers that we are engaged with are saying that things have changed. Twenty years ago people were drinking under the age of 18 but they were drinking wine and beer. Now it’s spirits, and they’re drinking more and younger. They’re also turning up with serious liver problems at a younger age.”
It has been convenient for politicians to assume that liberalisation of the market could be balanced out by education and awareness programmes. But public-health experts say education, on its own, is one of the least effective ways of addressing the issue.
“The uncomfortable truth is that advertising is also a form of education, and some of the best brains of that industry are working on drinks ads,” says Barry. “They’re educating people to drink. Expecting state education schemes to compete with that is unrealistic. The effect is completely asymmetrical.”
The reality, says Barry, is that when you increase availability and reduce price, Irish people drink more. So those concerned with formulating policy around alcohol favour the World Health Board framework, which, among other things, targets pricing, availability and marketing. The World Health Organisation guidelines are echoed in the steering-group recommendations advocated by Róisín Shortall. These follow in the policy footsteps of another hard-drinking nation.
“Scotland is leading the way in many respects,” she says. “They’re currently facing a challenge on the basis of EU competition law over minimum pricing and have gathered a very substantial body of evidence, some very significant research done by Sheffield University, making a case on the European level that the negative health impact outweighs competition concerns. I’d be keen that we wouldn’t just leave it up to Scotland to fight this battle alone and should row in to support them.”
The headline issues in Shortall’s proposals include a minimum price for alcohol, a 9pm watershed for drinks advertising and the phasing out of alcohol sponsorship of sporting and cultural events. The latter point is contentious for some of her colleagues, most notably Minister for Sport Leo Varadkar and Minister for Agriculture and Food Simon Coveney. This has led to some procrastination.
“My understanding was that it would go to the Cabinet last week, but I understand that the decision has been taken to refer the memo and the plan to the Cabinet Committee on Social Policy,” says Shortall.
On sport sponsorship in particular, she says: “The recommendation of the steering group was to ban sponsorship by 2016. I think that’s a bit too ambitious given the levels of debt in some of the sporting organisations, and it’s certainly not my intention to damage sport in any way. But I think the vast majority of people accept at this stage that we need to break the link between sport and alcohol. And the issue is not whether we do it or not, it’s about when and how we do it.”