The publication of draft legislation yesterday aimed at tackling alcohol misuse is a welcome development that puts teeth on last year's National Substance Misuse Strategy report.The legislative changes are largely based on solid evidence: Scandinavia and a number of provinces in Canada have achieved similar reductions in what may appear at first sight to be an ambitious target of reducing per capita alcohol consumption from 11.9 to 9.2 litres per year for adults aged 15 and over.
An OECD average consumption of 9.1 litres of alcohol annually for adults also suggests a reasonable target has been set.
45 bottles of vodka
Our current consumption equates to 45 bottles of vodka, 125 bottles of wine or 482 pints of beer per adult annually, representing a steep increase from drinking levels seen here in the 1960s. Considering one in five of the adult population does not drink, then the actual consumption among those that do is even higher. Alcohol is causally linked to more than 60 diseases; some of this harm can even occur at relatively low levels of drinking. But it is important to acknowledge too the protective effect of a low alcohol intake for people who are middle-aged and older. The onset of coronary heart disease, stroke and diabetes can be modified by drinking alcohol, and wine in particular, within recommended limits.
Alongside the proposed legislation the Government has decided that public health messages about alcohol will switch from units to grams. It was felt that with different glass and shot sizes in different countries a move to weekly low-risk drinking guidelines of 168 grams for men and 112 grams for women would better standardise the preventive health message.
This is roughly equivalent to a maximum of 17 standard drinks per week for men and 11 for women. Another recommendation is that people take a weekly “holiday” from alcohol; for example by drinking five days out of seven rather than daily.
The World Health Organisation (WHO) says the effects of exposure to alcohol marketing seems to be cumulative and can contribute to the normalising of drinking and eventually to increased levels of harmful use. International and Irish research has shown the importance of alcohol advertising in shaping youth attitudes, perceptions and expectations about alcohol use, which then influence youth decisions to drink. Research suggests that young people have an especially high awareness of sports sponsorship which makes the row back on previous plans to ban alcohol manufacturers from sponsoring major sporting events disappointing.
A study from New Zealand has shown that sports players who received sponsorship at individual, team or club level were more likely to be hazardous drinkers.
Reduced intake
Across the EU, there is a direct link between the affordability of alcohol and the amount people consume so the minimum unit pricing initiative should result in a reduced intake and help move towards the goal of an annualised per capita consumption of 9.2 litres.
The proposed legislation is a reminder that it’s not just young people who engage in problem drinking patterns such as bingeing. A 2009 Eurobarometer survey of 29 European countries found that Ireland topped the country scale for heavy drinking by a considerable margin, with 26 per cent usually consuming at least five drinks per drinking occasion.
The most recent Survey of Lifestyle, Attitudes and Nutrition indicated that 28 per cent engaged in weekly binge drinking, defined as consuming at least 60g of alcohol on a single occasion, and over half of drinkers (56 per cent) had a positive AUDIT-C score, which equates to harmful drinking patterns. Based on 2006 census figures, this suggests that more than 1.4 million people in the Republic aged 18 or over drink harmfully. If this legislation helps to reduce the level of harmful drinking it will be a major step forward for public health in Ireland.
