As a GP for 30 years, I have witnessed first-hand how the misuse of alcohol destroys lives. I have seen people who were drunk, people who had cirrhosis of the liver or another alcohol-related illness, such as heart disease, as well as those who were injured or assaulted while drunk. My colleagues working in accident and emergency departments tell me that every weekend they see children who have been found unconscious through drink on the street and brought to hospital by the police or the ambulance service. Nationally, one child under 12 is admitted to A&E because of alcohol every 48 hours – with 181 such admissions last year. Further, alcohol-fuelled crime has left many people too scared to walk the streets at night in many of our towns and cities.
The majority of the British population may not have made this lifestyle choice, but for the advertising of alcohol and heavily discounted offers. Alcohol, in anything but very modest quantities, is potentially a very destructive and toxic substance. Your first pint of the day may be beneficial, but your second eliminates the benefit of the first and from then on it is harmful. According to the World Health Organisation, alcohol is the leading risk factor for premature death and disability in developed countries after smoking and high blood pressure. It is related to more than 60 medical conditions – and to violent crime and domestic abuse, destroying families. More than 400 people are admitted every day to hospitals in the north-west of England due to alcohol-related causes. That’s enough to fill Manchester’s MEN Arena more than seven times a year. The north-west also has the highest rates of alcohol-related hospital admissions for people under the age of 14. Twenty thousand people die annually in Britain through drink-related causes. This is nothing less than a tragedy.
The generation born in the 1980s and ’90s, now in their 20s and 30s, have higher death rates than were experienced at the same age by those born in the 1950s, ’60s and ’70s. If this continues as they age, in a decade or two, life expectancy will start to fall and the present figures will represent a peak. Ours would not be the first country to experience this as a result of heavy drinking – it has happened already in Russia. Over the centuries, alcohol has become established as the country’s favourite drug. We are encouraged to consume on numerous occasions – whether in celebration or mourning. The introduction of round-the-clock licensing in 2005 has led to serious concerns that this has helped to cause an increase in violence and alcohol abuse rather than the sophisticated “café culture” that Labour claimed. The 24-hour drinking legislation has severely undermined clinician and police efforts to get to grips with this problem. Almost half of all violent crime victims report that their attacker was under the influence of alcohol.
Our society needs to stop marketing the myth of alcohol and start telling the truth: too much alcohol causes huge damage; too much alcohol kills. Yet advertisements offering cut-price drinks are everywhere. Alcohol is marketed through increasingly sophisticated advertising and promotional techniques,?including sponsoring sporting events and concerts and through social media sites. Voluntary codes aren’t working. There has to be legislation and Britain should become the first country to introduce a comprehensive ban on alcohol advertising, sponsorship and promotions to curb the binge drinking culture. There will be protests about individual freedom, but we need to think the issue through properly. There should be freedom of debate about alcohol issues. But there is no reason to concede any freedom to persuade people to harm themselves, especially if the persuasion is motivated by commercial gain. If we are to have the freedom to control our own lives and make our own decisions, we should also have the freedom not to be guided down a foolish path by those who want to gain from our lack of knowledge.
The ban should include all sports and music sponsorship, and adverts in all media. It should mean an end to happy hour and two-for-one promotions. The alcoholic drinks industry is the second largest sponsor of sporting and cultural events, after the financial services sector. Around £800 million is spent on promoting alcohol – twice as much as on the marketing of food. Other factors, such as soap operas set in pubs, drinking references on greetings cards and radio DJs bragging about their hangovers, all serve to give alcohol legitimacy and status. In order to entice adolescents, products such as alcopops (sweeter in taste and more palatable than traditional alcoholic drinks) are developed. From an early age, young people are groomed in behaviour that is extremely injurious to their health – a legacy that many find hard to shake off when they become adults. Young people take the blame when they succumb to pressures put on them by the likes of heavy advertising – to the extent that some of them fall foul of the law and are subjected to anti-social behaviour orders. But the irresponsible marketers of alcohol are the ones on whom ASBOs should be slapped.
Labour under Gordon Brown rejected any minimum pricing on alcohol and ruled out a ban on alcohol advertising. Now Conservative Health Secretary Andrew Lansley proposes not to change this situation. Politicians may have been tapping into populist sentiments of a booze-loving nation, but they are also playing with lives. Once again, the Government in England is bowing down to big business. Ministers now are doing what ministers in the past have done with these public health measures – kicking them into the long grass.
The short-term revenue gains from alcohol advertising do not tell the full story of how much social, financial and medical misery alcohol abuse causes. An ethical ban would send a powerful message across the world and have far-reaching consequences for many nations swimming against the tide of the alcohol barons.
The Association of Chief Police Officers and the Police Federation have pressed for a hardline stance on binge drinking. Much of the medical establishment, including the British Medical Association, the Royal College of Physicians, and now even the National Institute for Clinical Excellence – the government-appointed body – is urging the introduction of a minimum price per unit of alcohol. According to The Lancet, setting a minimum price of 50 pence per unit would increase the spending on alcohol of moderate drinkers by only 23 per cent per week. It would decrease consumption by underage and heavy drinkers by 7.3 per cent and 10.3 per cent respectively. The estimated benefits would be a reduction of 100,000 hospital admissions per year in England alone. Over a decade, there would be health savings of £1.37 billion.
No one should be in any doubt that the heavy marketing and promotion of alcohol, combined with low prices, encourages young people to drink at levels with which the National Health Service and our society are struggling to cope. Alcohol misuse costs the NHS and the justice system around £25 billion every year. That figure covers the cost of healthcare, crime, social disorder and lack of productivity at work attributable to alcohol, including the £2.7 billion the NHS spends treating the chronic and acute effects of drinking.
Establishing a minimum price and restricting promotions would be the most effective way to reduce the harm alcohol causes. However, that is unlikely to be enough to change the drinking culture in Britain. The historical cultural acceptability of alcohol needs be questioned, starting at primary school level. We also need to get to the root causes of what motivates significant numbers of people who think it is acceptable to go out on Friday and Saturday nights, drink to excess and indulge in anti-social behaviour.
Successive governments have been far too complacent about the problem of alcohol abuse – particularly among young people. We need to involve schools, parents,?police, local authorities and health professionals in new approaches to tackling the drinking problem, such as providing better information and education about how alcohol can damage health.
Kailash Chand is chairman of Tameside and Glossop primary care trust
