Australians currently enjoy near the best health in the world. Furthermore, our life expectancy continues to increase. Averaged over the last 100 years, our life expectancy is increasing at three months per year. This rate of increase is showing no signs of slowing and has come about in more recent times in large part because of the reduction in smoking rates for Australians, who are now near the lowest in the world. However, other risk factors for chronic diseases in Australia are not improving relative to the rest of the world and these will slow any further gains in life expectancy and improved health.

Chief among these are overweight/obesity and alcohol consumption for which Australia ranks in the lowest and middle third of OECD countries, respectively.

The lessons from the successful anti-smoking campaign can be applied to both of these lifestyle risk factors, but it is alcohol abuse that most closely resembles smoking and for which the lessons are most easily translated. Both are addictive drugs derived from cultivated crops. Both have well accepted health-risk profiles.

While deaths and morbidity attributed to alcohol are not as high as those attributed to cigarette smoking, data nevertheless show that acute and chronic alcohol abuse account for 45,000 hospitalisations in Australia per year. It can also contribute to fetal growth retardation and can cause fetal alcohol syndrome. It is estimated that alcohol abuse costs the Australian community in excess of $15B per annum.

How can we diminish risky alcohol consumption (defined by proposed new NHMRC guidelines as being greater than two standard drinks per day)?

The factors that were most successful in reducing cigarette smoking included public education, “de-normalisation” of smoking, taxes on cigarette, graphic labelling and bans on smoking in public places. However, the policy that was most closely associated with the drop in smoking rates was the ban on smoking advertising.

This history of risk factors associated with the decline in cigarette smoking is instructive and may provide the way to improve Australian’s position in alcohol consumption from the middle third of OECD countries and consequently deliver Australians further gains in life expectancy, further improvements in quality of life and significantly reduced health expenditure.

If we do not learn from the past we will squander a precious opportunity for the future.

Those who may disagree with the idea of a ban of advertising should ask themselves if they would support a re-introduction of smoking advertising. No single positive thing comes from advertising either cigarettes or alcohol.

*These are not necessarily the view of the NHMRC nor the QIMR.

Peter Fray

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