Crikey



Alcohol control no nanny state conspiracy: preventive health lobby

Bernard Keane’s skewed rant claims there is a public health conspiracy afoot. It is no conspiracy — the facts are clear.

Worldwide there are 60 million deaths annually attributable to non-communicable diseases. The four top risk factors are alcohol, tobacco, unhealthy diet and physical inactivity. Alcohol ranks third among these risk factors and is responsible for 2.5 million of these deaths.

Around Australia there are many people outside the preventive health sector, in our cities, rural communities and in remote Australia, who are working hard to combat the appalling impact of too much booze. Your correspondent’s opinion is reminiscent of The Times thundering in 1851 “We are willing to take our chances of cholera and the rest than be bullied into health by Mr Snow”, as efforts mounted to clean up London’s water. For a point-by-point response …

Basic rights: There is no public health campaign against human rights. Just a simple evidence-based case that illustrates alcohol causes harm to drinkers and to others. This is in the fine tradition of public health interventions that over the past 150 years have been the key driver of increased life expectancy in Australia. That’s a human right.

Alcohol in schools: Increasingly schools are removing alcohol from school-based events because they acknowledge that the normalisation of alcohol influences the drinking behaviours of young people.

Legal drinking limit: The AMA has not said this, the media has; what the AMA has said is that we should be conscious of the evidence that alcohol harmfully affects the developing brain. It is also worth noting that more than half of adult Australians support raising the legal drinking age.

Online wine: Keane explicitly accuses Professor Jones of “declaring (without evidence)” — this is incorrect, which he would have discovered if he had checked with her. The evidence shows that young people are the highest social network users; in 2011 40.2% of US Groupon users were aged 18-34 (there is no data on under 18s); and studies consistently show that lower socioeconomic groups and people with limited disposable income (young people, indigenous groups and heavy drinkers) are more responsive to price.

Alcohol floor price: ANPHA has made an economically convincing case that reforming the wine equalisation tax (WET) must come before introducing minimum price regimes. A view supported by brewers, distillers and two of Australia’s largest wine corporations.

Alcohol taxation benefit cost analysis: The research is clear that alcohol taxation reform is justified. 85% of Australians will be better off as a consequence. Access Economics’ analysis has been repudiated and the $20 billion a year cost estimate of alcohol’s “harm to others” confirmed.

Calculated hedonism: There are too many examples of workplace booze cultures being responsible for tragic events that have ended lives and careers. Alcohol’s drag on productivity is only just beginning to be understood and if employers are not concerned about the social harms then they should be concerned about the impact on their bottom line.

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Categories: Australia, People & Ideas

21 Responses

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  1. Sorry, I hear what your saying but I’m with Bernard here.

    by michael.burgun on Nov 21, 2012 at 1:19 pm

  2. Go, Michael and Sandra!! You’ve got my support. (And btw as a fatty-boom-bah who really would like to lose weight but finds it incredibly difficult, it would also be nice to see some money going into obesity surgery in public hospitals, rather than paying for the inevitable cost of diabetes later.)

    by dani fried on Nov 21, 2012 at 1:36 pm

  3. Well said. Have to say I didn’t think much of Beakie’s article and I’m far from a teetotaller so should have been on his side.

    by Mark from Melbourne on Nov 21, 2012 at 2:09 pm

  4. Bingeing by young people is a modern phenomenon”? So modern that kids were doing it when I was at school in the 70s.

    Rapidly changing patterns of drinking, including the middle class’s new obsession with wine…” The horror.

    by Cyndi on Nov 21, 2012 at 2:39 pm

  5. Lots of good points - and I agree with the role of public health in determining good policy - but if you’re going to speak in terms of ‘rights’, it’s good to know what right you’re seeking to promote and how that right interacts with others.

    Article 12 of the International Covenant on Economic, Social and Cultural Rights states[1]:

    The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

    So sure, that supports public health initiatives . But, as this treaty (and its sister Agreement, the ICCPR[2]) states:

    Nothing in the present Covenant may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights or freedoms recognized herein, or at their limitation to a greater extent than is provided for in the present Covenant.” (Art. 5)

    and “the State may subject such rights only to such limitations as are determined by law only in so far as this may be compatible with the nature of these rights and solely for the purpose of promoting the general welfare in a democratic society.” (Art. 4)

    So you have to be careful that, in promoting the right to health you don’t destroy other rights: e.g. self-determination; autonomy; privacy and non-discrimination (when it comes to, for example, raising the drinking age).

    Also, it’s disingenuous to say that “more than half of adult Australians support raising the legal drinking age” as a rational argument in favour of raising the drinking age - I’m sure “more than half” of 16-18 year-olds support keeping the drinking age at 18.

    I could of course also use examples of majorities supporting all kinds of discriminatory laws in the past (women voting, slavery, age of voting etc…).
    But I think it’s better to quote from the AIHW report you link to, namely:

    Between 1993 and 2007, the daily drinking patterns of people in Australia aged 14 years or older remained largely unchanged, at around 8% (Table 4.1). However, in 2010, there was a statistically significant decrease (since 2007) in the proportion of people drinking daily (from 8.1% to 7.2%).” (p 46)

    The age group most likely to drink daily were those aged 70 years or older, for both males (18.4%) and females (12.0%) (Table 4.3). For people aged 12 years or older:
    • the peak for weekly drinkers was among those aged 50–59 years for males (50.6%) and those aged 40–49 years for females (40.9%)”
    (p 47)

    Finally, the business of selling alcohol is licenced. Not it’s possession. Just like I’d need a health and safety certificate to run a Café but not one to buy a coffee there.

    [1] http://www.austlii.edu.au/au/other/dfat/treaties/1976/5.html
    [2] http://www.austlii.edu.au/au/other/dfat/treaties/1980/23.html

    by Tim on Nov 21, 2012 at 3:01 pm

  6. Crapola on a shovel. We have been in “health” for the past 35 years. This mob have sucked hospital funding dry in an attempt to justify their existence at every level.
    Where are the fabulous results? People still die for lots of reasons, regardless of your health promotion.
    Their quality of life is directly the result of their economic situation & has little to do with much else.
    Who can prove that the money spent on preventative health and health promotion would not have been better spent on improving the bottom line of lower income earners? Better education, better decisions, better quality products and more appropriate decisions.

    by drmick on Nov 21, 2012 at 3:02 pm

  7. thank you for this helpful and fact based analysis. Bernard Keane’s article was so full of straw men, inaccuracies and misquotes that i was inspired to write but defeated by the sheer volume of issues. Thank you for enumerating them so clearly and without rancour. Here’s to policies based on the evidence.

    by Sean Baker on Nov 21, 2012 at 3:22 pm

  8. I’m with you drmick.

    These self-perpetuating, self-agrandising, self-righteous, grandstanding, rent-seeking, single-issue foundations have become a pestilence over the last couple of decades.

    We need a foundation dedicated to their elimination.

    by ianjohnno1 on Nov 21, 2012 at 3:59 pm

  9. Why is it so hard ? Surely it’s a no-brainer.
    Too much alcohol is bad news.
    Alcohol should be taxed more !
    More importantly, ALCOHOL SHOULD BE TAXED BY VOLUME !
    Who can argue ?
    Stop pandering to the nay-sayers.
    Just f@#king bring it on.
    A uniform national volumetric alcohol tax.
    Just pick a number (10c/ml,say) adjust it up or down from time to time just to keep us guessing.
    Dead simple.
    Signed,
    A daily drinker, happy to pay alcohol tax.

    by GrumpyOK on Nov 21, 2012 at 4:00 pm

  10. +1 Bernard.

    by Coaltopia on Nov 21, 2012 at 4:07 pm

  11. Dear me, if you are going to cite Hogarth in support you really should take the time to check whether there might be a companion etching to “Gin Lane” called “Beer Street” which shows consumers of beer to be pictures of rude good health and prosperity. Hogarth, too, was a polemicist - as are the authors, they are just not nearly as good at it.

    Case in point, citing Groupon’s customer base as the “evidence” needed to back up the frankly very silly claims that sites like Vinomofo are paaradise for under-age drinkers. Underage drinkers are buying wine in 6 bottle or case lots a week or so before they want to drink it? Really? You sure?

    by legal-affairs on Nov 21, 2012 at 4:59 pm

  12. Indeed there is a companion etching to Gin Lane. Because back then beer was thought to be less harmful than spirits. And it probably is!

    by Caterina Giorgi on Nov 21, 2012 at 9:45 pm

  13. The figures for European consumption indicate that Australian per capita consumption is significantly less than major western European countries like Germany, UK, France, Netherlands and Switzerland. Our drinking age is reasonable, considering that one can die for one’s country at that age, as well as being able to vote. Some European countries (including Germany and Italy) have a legal drinking age of 16. These heath fanatics are 21st century prohibitionists!

    by michael dwyer on Nov 21, 2012 at 10:47 pm

  14. […] the normalisation of alcohol influences the drinking behaviours of young people[…]

    Drinking alcohol _is_ *completely normal*. It is absurd to even suggest otherwise. Alcohol as been a part of human society for all of known history, and almost certainly a lot longer.

    Indeed, given that binge drinking is much less of a problem in countries with far easier, cheaper and more common access to alcohol than Australia, but where drinking it is considered as normal as, say, fruit juice or milk, it’s fairly arguable that “normalisation” of alcohol is exactly what we *need*.

    This is just another thinly-veiled attempt at prohibition. Made all the worse by people who don’t even have the integrity to be honest about what they want.

    I’m quite capable of regulating how much I drink without causing any harm to others. It is outrageous that I have to pay 50-100% more as I do in other countries.

    by drsmithy on Nov 21, 2012 at 11:17 pm

  15. @drmick: Retrospective “proof” doesn’t really cut it in science.
    @ianjohnno1: Missed out on a grant for want of a catchy name?
    And it’s “-aggrandising”.

    by Salamander on Nov 22, 2012 at 12:00 am

  16. Now that the authors of this article have shown us all their intellectual superiority, and disdain for the plebs, I suppose we are all supposed to fall about in amazement!
    Well, I am not surprised by any of that tosh, and agree with remarks from others that they are just prohibitionists in (not very good) disguise.
    I’m still with Bernard - most people are quite capable of deciding for themselves how much they drink, smoke and consume. But of course, the bottom line here comes in the last paragraph - a huge whinge about how much the reprobates COST!!! It is all about money (as if we didn’t know that?)
    Why don’t you both use your admitted lobbying skills to make sure the various governments listen to the people, and pass legislation allowing voluntary euthanasia? With 77% of the public in agreement, I don’t know why you are concerned about keeping those of us alive forever who don’t want to be. So, do something useful, or pi+s off!!

    by CML on Nov 22, 2012 at 2:20 am

  17. Well the “science” of health promotion is yet to show its usefulness and in the court of taxpayer frustration and natural indifference, is an expense we can ill afford. There are too many parasites like health promoters to support as it is.

    by drmick on Nov 22, 2012 at 5:37 am

  18. The only reason brewers and distillers support reforming the wine equalisation tax is because the former in particular get royally screwed by comparison under the current taxation regime that applies to them.

    by Rohan on Nov 22, 2012 at 11:27 am

  19. Yes I hear what you are saying - Alcohol does major harm. I am an Alcoholic who has been abstinent for 10 years and I grew up in a nice middle class professional Alcoholic Abusive home. What I would like to see from you guys is some action apart from an advertising campaign and taxation that will inevitably see people switch to Metho. I’d like for instance to be able to take someone who is detoxing and suicidal to an emergency ward and get some help without having to dump them there and leave.
    Yes I know the old adage that ‘prevention is better than cure’ but unfortunately we have failed to come up with any real ways of preventing addiction as a whole from occurring in society. Those of us who are prone just tend to swap one for another

    by Shaniq'ua Shardonn'ay on Nov 22, 2012 at 1:40 pm

  20. Those who scorn policies of prevention and heatlh promotion presumably believe that today’s Marlborough Man should still be flogging fags on TV. Prominent actors involved in those tobacco promotions of the 50s and 60s died of lung cancer and reckoned they had been suckered. You pseudo libertarians take no account of the reality of corporate hegemony. I think you must be geriatric adolescents living in la-la land.

    by Salamander on Nov 22, 2012 at 5:27 pm

  21. ”..Who can prove that the money spent on preventative health and health promotion would not have been better spent on improving the bottom line of lower income earners?..”

    That’s it, right there.

    Improving people’s quality of life ( not with a hammer and sickle preventative approach ) but with a guarantee of useful and stimulating employment ( a future ) and a basic right to affordable housing, would go a long way in reducing drug and achohol abuse, particularly in young people.

    Take away their hope and you open the door to all sorts of abuses. But I guess it’s more important to feed the monolithic monuments of Health Dept budgets, careers and lets not forget, egos. They are all straining out a gnat to swallow a camel.

    Thank Dios for Keane.

    by Chrissy Nockles on Nov 22, 2012 at 6:42 pm

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