AT WAR WITH THE MODERN WORLD

A report titled ‘Anytime, Anyplace, Anywhere’ was published in May this year by two neo-temperance research and lobby groups - the UK’s Institute of Alcohol Studies (IAS) and Australia’s Foundation for Alcohol Research and Education (FARE). If anyone was in any doubt that so-called ‘public health’ is a far-left socialist project opposed to consumer capitalism in all its forms, then take a look at this report and at the organisations that stand behind it.

The report is a comprehensive articulation of one of the three strands of neo-temperance, anti-alcohol strategy, namely, reducing the physical availability of beverage alcohol products – hence the title. The other two strands are affordability and advertising. IAS and FARE want to reduce all three as part of a whole population approach to alcohol harm reduction. I will give a detailed analysis of this report in Propel Quarterly, but here’s a taster:

The report comes up with 10 recommendations, all aimed at reducing alcohol consumption:

1.     Restrict trading hours for off-licence liquor.

2.     Restrict trading hours of on-licence venues to limit the availability of alcohol after midnight.

3.     Improve regulation of off-licence liquor sales by confining alcohol to specific areas within supermarkets to discourage impulse purchases and reduce alcohol sales.

4.     Enhance community involvement - provide residents with access to legal resources and advice to ensure that the community is able to engage with licensing systems.

5.     Clearly define licensing policy to minimise the cumulative harm associated with higher densities of liquor outlets.

6.     Place the onus on applicants to prove that their venue is in the public interest.

7.     Include and prioritise public health and/or harm minimisation objectives in liquor legislation.

8.     Enhance data sharing to facilitate more targeted policy interventions.

9.     Restrict the sale of high risk products in areas of concern.

10.  Deprioritise alcohol industry voluntary schemes.

Neo-temperance campaign groups like IAS and FARE believe that it’s the availability of alcohol that makes people drink it; that supply begets demand. The fact that such a proposition turns established economic theory on its head bothers them not one jot. You might think that the wish-list of a bunch or temperance cranks isn’t worth the effort of rebutting, but these are the same temperance cranks that hugely influenced the Chief Medical Officers’ of Health revised ‘low risk’ drinking guidelines. The IAS is very experienced at insinuating itself and its advocates into positions of influence.

They always play down their temperance aspirations and their broader ideology, but IAS is owned by a charity called Alliance House on whose board sits a variety of temperance organisations. Essentially the IAS is the research arm of the International Order of Good Templars (IOGT) and their offices are located at the same address in London. So, it’s worth looking at what IOGT believe if we are to understand the underlying motives of IAS.

IOGT believe that Big Alcohol is part of something they call the “corporate consumption complex”, which they define as: “an intricate web of organizations including the multination corporations manufacturing the goods of consumer capitalism, retail giants selling those products, trade associations doing the political lobbying as well as advertising and law firms supporting PR and political campaigns of these industries.”

And then this:

“Together with Big Tobacco, the food, pharmaceutical, firearms and automobile industries, the alcohol industry forms the so-called corporate consumption complex – a network of corporations, financial institutions, banks, trade associations, advertising, lobbying and legal firms that together promote “hyper consumption”.

“The corporate consumption complex has become the most powerful force to impact human health and the communities in which humans live. It is the primary modifiable cause of the biggest cause of premature mortality in the 21st century, Non-communicable diseases.”

So, there you have it - IAS and IOGT aren’t simply opposed to excessive consumption of alcohol and the health harms associated with that, they are opposed to the modern world! It’s all a conspiracy! They regard the pharmaceutical industry as part of this corporate consumption complex – as part of what causes non-communicable diseases. Have they heard of anti-biotics? And the automobile industry – get rid of cars! When you read through IOGT’s detailed analysis of what is wrong with modern society they are not just enemies of alcohol but are at odds with consumer capitalism – run by a bunch of bad-guys intent on putting profit before public health; apparently we all believe it is in our economic self-interest for our customers to die prematurely!

What is implied by their analysis is that the only way for us to live is to embrace a kind of woolly, agrarian communitarianism – back to the horse and cart, lots of brown rice and above all a life free of alcohol or any other intoxicant by means of which human beings might change their consciousness.

I think both our sector and government needs to be more aware of the ideology underpinning neo-temperance, and what it means for business and our society if these crackpots are successful in propagating their influence. Keep watching this space.

Paul Chase

Beyond Parody

As the dust settles on the general election result we can see that a period of great political uncertainty lies ahead. But in an uncertain world, the one thing you can rely on is that the public health racket will carry on regardless with their efforts to achieve world domination!

It has become a cliché to say that “alcohol has become the new tobacco” – that the methods used to damn tobacco smoking, and to control the advertising and availability of tobacco products – has provided a template for the same project in respect of beverage alcohol. But the ambitions of ‘public health’ don’t stop there. Whilst remorselessly campaigning for minimum unit pricing as a panacea for all alcohol-related problems, people variously described in the media as ‘doctors’ or ‘experts’ have called for a minimum price on sweets to cut obesity in children. It’s a magic formula you see. As Professor Sir Ian Gilmore of the Alcohol Health Alliance once put it “price changes culture”.

According to the Daily Mail:

•         Doctors have called for a minimum price on sweets to tackle the nation's obesity crisis 

•          The move would raise the price of the most sugar-laden snacks in a bid to deter children

•         Experts believe raising prices of sweets and chocolate is one of the best ways to tackle the problem

All this harks back to what ‘public health’ regards as a watering down of the obesity strategy of the Conservative Government, and represents a further attempt to build on the ‘sugar tax’ on fizzy drinks. It also fits into a wider ‘public health’ agenda to leverage government control on all the “industries of addiction”, which in their view drive ill-health globally, and to force the food industry into a mass reformulation of products. The fight to eliminate sugar and salt from our diet – essentially to render food tasteless – is well and truly on!

The notion of a minimum price for sweets seems to me beyond parody – not least because it is based on a false premise that the numbers of children who are overweight or obese is dramatically increasing, when essentially it has flat-lined. The headlines about rising childhood obesity have one fatal flaw: they aren’t true.

The official figures show that about one in five year 6 children are obese. This figure hasn’t changed significantly in five years: 2010/11: 19%; 2011/12: 19.2%; 2012/13: 18.9%; 2013/14: 19.1% and 2014/15: 19.1% (all official HSCIC figures). Now, it isn’t good that one in five kids are obese at year 6, but to frame it as a “growing crisis” is simply not true. Data from the Health Survey for England going back to 1995 show that rates of obesity among kids aged two to 10 peaked in 2005 and have fallen by a third in the last decade. Among 11 – 15 year-olds, the peak arrived in 2004 and rates have since fallen by a fifth (Diet & Fitness, C. Snowdon).

The number of adults overweight or obese has likewise flatlined at around 60% of the population. Nearly always ‘overweight’ and ‘obese’ get combined in order to make the number more scary, but paradoxically overweight people have greater longevity than people of a healthy weight or obese people; suggesting some problems with the definitions!

It shouldn’t surprise anyone that the proposal for a minimum price for sweets comes from Scottish doctors – Scotland is the home of minimum pricing and the SNP government is completely in thrall to temperance thinking and more generally to the world view of those who see the food and drink industries as conspiracies that have addicting the population to alcohol/sugar/salt at the heart of their commercial strategies. We’re back to one-dimensional capitalist bad guys.

The proposition for minimum pricing for sweets comes from the Lothian division of the BMA and is proposed as a motion to be heard at the BMA’s Representative Meeting to held later this month. It states:

“This meeting believes in line with rising obesity and increasing burden of type 2 diabetes on the NHS that the government tax sugar and bring in minimum pricing for all confectionary products and sweets.'

The BMA's Agenda Committee has also tabled a similar motion. Doctors will vote on the motions at the meeting, which takes place in Bournemouth, and if approved could become BMA policy.

Beyond parody? You couldn’t make it up.

THE ALCOHOL HARM PARADOX

A new study of drinking in Scotland published in the medical journal The Lancet Public Health takes a fresh look at an old subject. The so-called ‘alcohol harm paradox’ basically states that people living in socially deprived areas are more likely to suffer alcohol-related harms than those living in more affluent circumstances – even though the more affluent actually drink more alcohol. Why anyone with the smallest understanding of the complexities of health inequalities or drinking cultures should find this paradoxical I really don’t know, but apparently, some do.

So, what added value does yet another trot round this well-worn path give us? Well, temperance organisations the Institute for Alcohol Studies (IAS) and the UK Alcohol Health alliance (AHA) both like this piece of research because it concludes that targeting policies and intervention at heavy drinkers in low socio-economic groups with a view to reducing their consumption is unlikely to be as effective as whole population measures. Yes, you guessed it, minimum unit pricing, reductions in alcohol availability and advertising and marketing.

Study co-author Dr Elise Whitley said: “Heavier drinking is associated with greater alcohol-related harm in all individuals. However, our study suggests that the harm is greater in those living in poorer areas or who have a lower income, fewer qualifications or a manual occupation.”

Responding to the study, Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance, said: “The findings in this study are worrying if not altogether surprising. It is clear that the way alcohol is being sold and promoted in Scotland and elsewhere in the UK is harming some of the most vulnerable people in society.”

Now conceding, as the study does, that the poor are likely to suffer more ill-health as a result of other factors associated with poverty – lifestyle, diet, and so forth, it is something of a stretch to reach the conclusion that the alcohol harm paradox is all the fault of how Big alcohol markets its products! In the introduction to this study, the authors make this, rather telling, observation:

“Efforts to target alcohol consumption by socio-economic status are unlikely to be successful in reducing health inequalities, unless drinking cultures in the most disadvantaged populations differ systematically from societal norms. Interventions seeking to reduce consumption across the whole population are more likely to result in greater reductions in absolute health inequalities than previously thought.”

The key assumption here is that targeting alcohol consumption by socio-economic group is unlikely to be successful “unless drinking cultures in the most disadvantaged populations differ systematically from societal norms.” Societal norms? The main societal norm is moderate drinking. But we don’t have one single drinking culture in the UK, or even in Scotland, and I for one believe that differing drinking cultures are the real drivers of alcohol-related harms.

I believe that once we understand the central importance of culture to drinking behaviour then we can begin to untangle the reasons why people drink at different levels, sometimes harmfully, in different ways and for different reasons. Let’s start off with a rough-and-ready definition of culture: “Culture is what me and you get up to round here.” Put more formally, sociologists refer to “cultures of intoxication” which is an understanding that places alcohol use into a modern context - one that recognises the plurality of drinking cultures and sub-cultures; that acknowledges that in addition to alcohol a whole generation of people now find it socially acceptable to take a range of other, illegal, intoxicants as part of a night-out. And that specific cultures of intoxication drive not only the quantity people drink, but the speed at which they drink it; whether they drink with food or on an empty stomach; what else they take; and whether they drink in safe places and social surroundings or dodgy bars and late-night party-pads.

When we look at the way in which alcohol health-harms are socially distributed we can clearly see the impact of the plurality of cultures of intoxication and the simplistic nature of the whole population approach. In 2010 the North West Public Health Observatory published a series of reports that break down drinking patterns and alcohol problems into different population segments.

By using the UK Government’s Index of Multiple Deprivation, the reports showed that people living in the poorest fifth of the population are five-and-a-half times more likely to find themselves in hospital with ‘alcohol-specific mental and behavioural disorders’ than those living in the richest fifth. People living in the poorest tenth are seven-and-a-half times more likely to end up in hospital because of alcohol than those in the richest tenth. People living in social housing are eight-and-a-half times more likely to have an alcohol-related disorder than a ‘career professional’; and those classified as ‘vulnerable disadvantaged’ register 13 times more alcohol-related hospital admissions than ‘affluent families’.

Social class, prosperity or the lack of it, and a range of other social circumstances determine what your drinking culture is likely to be, and the extent to which your life revolves around a culture of intoxication. But rather than calling for policies that tackle endemic poverty, ideologically motivated academics prefer to interpret data in a way that supports their preconceived whole population measures. All roads lead to minimum pricing!