A coalition of representatives from leading national health bodies are briefing parliamentarians today, calling for alcohol pricing to be placed on the agenda of the upcoming Federal Tax Forum in October.
Alcohol is widely used in Australia but its misuse causes substantial health and social harms. Increasing taxes is an effective strategy to reduce these harms.
Preventing harm from alcohol misuse hasn’t received as much attention as tobacco but lessons learnt from regulating tobacco use can arguably be applied to alcohol.
That’s because alcohol and tobacco are similar – both are addictive, toxic substances that are legal but highly regulated. Both cause a considerable health burden.
The harms caused by smoking are well documented. And despite resistance from the tobacco industry, much has been done to decrease tobacco consumption through restrictions on the availability and marketing of tobacco products.
Most recently, the Australian government, with much opposition from the tobacco industry, has introduced a Tobacco Plain Packaging Bill, which will mandate plain packaging for tobacco products.
In Australia, the annual social burden of alcohol-related harm is estimated at $15.3 million, which is second only to tobacco for all drug-related costs.
On a global level, the burden from alcohol consumption is greater than the effects of other health problems that receive considerable attention. These include high cholesterol, greater body mass index, low fruit and vegetable consumption, physical inactivity and illicit drug use.
Yet, to date the growing evidence of alcohol-related social burden hasn’t been sufficient to generate interventions of equivalent effect as those for tobacco.
The reasons for this include:
the high prevalence of alcohol consumption (approximately 83% of the Australian population over 14 years of age drink at least occasionally);
the resulting normalisation of drinking as part of the culture,
the perceived health benefits of alcohol and;
the marketing of alcoholic products.
Significantly, the limited discussion of the extent of harms from alcohol to people other than the consumer is also a factor.
Alcohol’s harm to others
The effects of second-hand tobacco smoke or passive smoking, has received much attention and led to restrictions on consumption in public areas, restaurants and cars.
In contrast, the “collateral damage” from alcohol, the damage or social harm from alcohol on people other than the drinker – either another drinker or a non-drinker, including unborn children – are only now receiving attention.
A recent Australian study has highlighted the harm of alcohol on people other than the drinker.
It includes many costs not incorporated in previous estimates and finds heavy drinkers cost those around them in excess of $13 billion in out-of-pocket expenses and in forgone wages or productivity.
Hospital and child protection costs add a further $765 million and other large intangible costs are estimated at a minimum of $6 billion dollars.
Another study – a survey of residents in regional New South Wales as part of the Alcohol Action in Rural Communities (AARC) – found about two-thirds of the respondents thought someone they knew drank too much.
Almost half reported that alcohol had caused a significant problem for themselves or someone close to them.
In addition to survey data, the AARC study used routinely collected data at the local level to measure the extent to which alcohol impacts on communities.
It found that alcohol-related crime, hospital data and traffic accidents differ between towns, which suggests using local level data to inform and evaluate policies is essential.
Despite the extent of alcohol’s harm acting as a call for effective policy, there’s still a gap between practice and what is being done to reduce negative effects emanating from alcohol use.
Evidence-based strategies known to be effective in reducing the burden from alcohol include regulating the marketing environment, particularly price and availability.
Research has shown this to be a cost effective way of reducing alcohol-related harm.
Although not popular, there is strong evidence showing increasing the cost of alcohol reduces overall consumption.
Price increases in a range of countries have shown a reduction in alcohol consumption and related harms in the general population and at-risk populations, such as young people and heavy drinkers.
Conversely, price decreases have resulted in an increase in consumption and harm.
Banning alcohol advertising, random breath testing and intervention for individuals identified as risky drinkers are also cost effective.
Moves in the right direction?
There is now more discussion of the negative impacts of alcohol and regulatory efforts to reduce harm within the Australian government: Health Minister Nicola Roxon has agreed on a plan develop a minimum price for alcohol.
The minimum price would operate separately from alcohol tax and make it illegal for any retailer to sell alcohol below a certain price for each standard drink.
Such attempts at increasing regulation have been touted by opponents as creating “nanny state”.
But we still need a discussion about whether the community is willing to countenance modest price increases or restrictions to improve the common good.
Data from the AARC project show the average household in rural New South Wales would be willing to pay an estimated $44 to reduce alcohol-related harm by a tenth.
There is also an argument that we need a greater focus on personal responsibility instead of regulation. But implementing this kind of behaviour change is difficult.
Alcohol causes substantial harm to people other than the drinker and the evidence to date suggests regulation, including appropriate taxation, is the most effective way to reduce this harm.
Let’s hope today’s briefings will set the government on the path to implementing real change to how alcohol is consumed in Australia.