President of the Royal College of Physicians of Ireland, Prof Frank Murray, welcomes the publication of the Public Health (Alcohol) Bill 2015 but expresses disappointment that it won’t contain a ban on sports sponsorship.
The Minister of Health Leo Varadkar and the Government should be wholly supported in taking further steps this week to deal with the catastrophic consequence s of our unhealthy relationship with alcohol in Ireland.
I am very pleased to see recognition of the seriousness of the problem of the way we drink in Ireland and the harm it causes to families, children and all parts of society with the publication of the Public Health (Alcohol) Bill 2015. The Bill is a huge step forward in delivering measures that will reduce the extent of illness, death and social disorder in Ireland. The legislators have listened to us and have taken action.
I believe the measures contained in the Bill will massively help to turn down the tap of cheap alcohol in Ireland and that this legislation will mark a turning point in public policy. We support the Government in taking on the vested interests of the alcohol industry and putting the best interests of the citizens first.
One of the most difficult tasks that falls to doctors is to tell distraught family members that their loved one has suffered a dreadful illness or injury, or worse, has died, as a result of alcohol use.
It is difficult for the family and for the healthcare team, and experiences such as this led to the development of the Royal College of Physicians of Ireland’s alcohol Policy Group, which has advocated for measures to reduce alcohol health harm. This group has called for the introduction of Minimum Unit Pricing, reducing the availability of alcohol and a ban on sponsorship of sports by drinks companies, because we know this is the way forward if we are serious about changing the way people consume alcohol.
In Ireland, we now consume twice as much as we did 50 years ago. As a consequence, the number of deaths from cirrhosis has doubled here in the last 20 years. This impels us to action as a nation. In addition, there is a social justice argument for action here, in that the socially disadvantaged suffer disproportionately form alcohol.
Sadly, binge drinking is the significant cause of accidents and incidents that affect the young people, who end up in our hospitals in ever growing numbers as a result of road traffic accidents, falls, fights and drinking games. We are also increasingly caring for more the almost 200,000 chronic dependant drinkers who are attending with organ damage, cancers, cirrhosis and liver failure, heart failure and problems related to the brain and nervous system.
Minimum Unit Pricing is the single most effective measure that can be taken to curb binge and hazardous drinking, particularly amongst younger drinkers. This has been introduced in Canada where it has been shown to have significant positive impacts, including saving hundreds of lives and reducing alcohol related crime. The minimum price set for a unit of alcohol must be realistic and we look forward to engaging with the legislative process around the setting of this price.
Enforcement around the sale of alcohol and the introduction of labeling as well as restrictions on advertising, marketing and sponsorship are all also potentially powerful measures that can help to change the culture in Ireland. Price and availability are crucial in altering behaviour.
Research shows that about 80 per cent of Irish adults consume alcohol and more than half of those are classified as harmful drinkers. Almost 10 per cent of those who consume alcohol are dependent- and this rises to 15 per cent among 18-24 year olds.
As a physician who specialists in liver disease it is worth saying that there is no safe level to drink. But that’s not to say that people shouldn’t drink or that I am advocating prohibition. There are low risk levels that should be observed. If, for example, a man or woman goes out and drinks their weekly allowance in one night, that is high risk drinking with an increased risk of adverse incidents and accidents. Likewise, a person unused to alcohol is disproportionately exposed to its effects. The location, previous experience of drinking, the levels of support and public tolerance are all also factors. It is important for individuals to drink in a safe way.
It is disappointing that the Public Health (Alcohol) Bill won’t contain a ban on sports sponsorship. This is something we will continue to advocate. There is very strong evidence to link promotion of alcohol through sports sponsorship with early and more problematic alcohol consumption in young people. Drinks companies are investing in advertising and sponsoring these events because they achieve their purpose – they boost alcohol sales. The alcohol industry is a powerful lobby that protect their bottom line and their wider interests.
Equally, it is in all of our interests to reduce the awful misery alcohol abuse can bring and the social disorder many towns experience every weekend. Think of what could be done in the health services if the 30 per cent of the money put into Accident and Emergency Department’s to deal with alcohol-related illnesses and events was available to improve patient care and social and justice services?
We need strong Government and public policy measures now because as a nation we are not as good at making choices for optimal health as we’d like to think we are. We respond less to education campaigns on the ill-effects of tobacco use and excessive alcohol consumption than we do to increases in the prices and reduced availability of those products. This is well illustrated in a recent survey of first year students in University College Cork that found that only 9 per cent would reduce consumption based on awareness of medical consequences, while 21 per cent would reduce their intake if the price of alcohol were to increase.
The widescale availability of alcohol in almost every convenience store is nothing to be proud of either. Patients of mine with alcohol problems often speak of their difficulty in making a simple trip to the shop for basic groceries where drink at pocket money prices is hard to avoid.
We know that initiatives around price and availability change behaviour, indeed Ireland led the way with the smoking ban using this formula. Campaigns advising us to ‘drink responsibly’ won’t change the drink culture; rather, actions on price and availability will have much greater effect, particularly on younger drinkers and harmful or hazardous drinkers.
This opinion piece by Professor Frank Murray appeared in the Irish Times on 6 February 2015.