Monday, 11 April 2011

Message on a bottle: can Minister Reilly's health warning survive Ireland's alcohol industry lobby?

As Bertie Ahern memorably said of Lehman's Bank, 'they had testicles everywhere'.  So it is with the alcohol industry.  A cautious welcome then for Minister for Health James Reilly's announcement last week in the Dail that: “My Department is developing legislative proposals to provide for the inclusion of health advice/warnings on alcohol drink containers (bottles, cans) and on promotional materials”. A GP himself, the Minister must be aware of the consequences of alcohol consumption in the world's third biggest consumer per capita - both in human terms and in the emormous cost to a creaking and underfunded health service.

Research confirms that warnings on bottles and cans do influence people's buying and drinking habits as long as they are specific and serious.  Warnings that 'smoking may harm your health' were seen to be weak, for example, and were replaced by the far more effective 'Smoking Kills' campaign which made a real impact on tobacco sales and, in turn, smoking related deaths.  Now the Minister intends “to warn pregnant women on the dangers of consuming alcohol during pregnancy”.  But will the wording be clear about the risks of foetal alcohol syndrome?  And on other risks James Reilly intends, he says, to “inform the consumer about the dangers associated with the alcohol product being consumed”.

So who will advise the Minister in drafting the legislation and the wording of the warnings?  It will, the Minister announced, be the National Substance Misuse Strategy (NSMS) Steering Group due to report later this year. When that group published its National Drug Strategy (NDS) for 2009-16 it did, for the first time, recommend that alcohol be included as a harmful substance alongside heroin, opiates et al.  A welcome step given that alcohol is responsible for more crime, hardship and deaths than all those drugs put together.  But the inclusion of alcohol in the strategy, while very welcome, is carefully managed so that it is treated with more deference and respect than its bad-boy illegal cousins.

Alcohol is not clearly recognised as a problem drug in its own right in the NDS. Rather it is contextualised mainly as a problem "in association with illicit drug use"...or as "a gateway to illicit drug use” and “poly - drug use which very often includes alcohol - is now the norm among illicit drug users”.   After a very thorough but separate examinaton of the risks and costs of alcohol use, there is a disappointingly hurried and undeveloped commitment “to address broader issues around the supply and availability of alcohol, pricing, marketing, promotion and sponsorship etc”. Alcohol is then left to one side while the strategy gets down to the real busness “as outlined in the the primary focus of this Report, illicit drug use”.  A gaping hole in the data is the lack of comparative information that could only show that it is alcohol in its own right that should have been the primary focus of the strategy. 

So it remains to be seen how strong any advice on alcohol from this Steering Group will be. What we already know is that, unlike tobacco, the intended warnings will not be on every bottle, because pubs, hotels and restaurants are to be exempted from the legislation for the time being. And while the number of licenced premises has grown by 150% since 2000 (pubs declining by 14%), off-licences still acccount for less than 40% of sales (government figures), meaning that over half of all drinks sold will be without the new health warnings.

Some already see that as a warning sign that this government initiative will attempt the impossible: to limit alcohol related harm while not actually upsetting the powerful industry itself, particularly the publicans who have succesfully lobbied for a soft-pedalling on legislation in the past . As John Lee writes in the Irish Mail on Sunday “Sources indicated publicans would welcome the warnings as they may help reverse the trend towards cheap alcohol from off-licences and supermarkets”. Or as you might say, it's those damned industry testicles again.

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