In this month’s alert
Daily Express launches ‘protect our children’ campaign to halt alcopop production
Smash the alcopops says the Express Campaign in order to protect our children. Alcopops salesmen admit teen targeting says The Sunday Times. Feelings are certainly running high as awareness of the abuses surrounding alcopops become daily chatter in all walks of life. Police officers are shocked at the extent of the problem of underage drinking. At weekends, some children are getting so drunk that they have to be literally picked up off the streets and rushed to hospital. A 14 year old girl who had collapsed was found urinating in the street when police arrived.
The BMA warns…
Children as young as 11 years old who are so drunk that they have to be kept in hospital overnight are now a common sight on paediatric wards.
Delegates to the British Medical Association annual meeting condemned alcopops and demanded that it be made illegal to market alcopops at children. They also called for the alcohol content to be reduced.
Dr Robin Davies, a paediatrician in Gwyneth, said that the “average”general hospital at which he worked now saw “one or two children a week absolutely comatose”, to the point where they needed to be put on a drip overnight to rehydrate them. “This is only the tip of the iceberg. This is a very, very widespread problem in every paediatric unit in the country,” he said. “In a 30-bed unit you will get a child in every weekend who is absolutely blotto.”
“When you get the blood alcohol level results back it’s enough to make your hair stand on end,” Dr Davies told the meeting in Edinburgh. “What I am objecting to is the deliberate targeting of children by the drinks companies. There is no doubt that they are trying to target children”.
“Alcopops are sweet; they are flavoured with lemonade, cherry and milk, all childish tastes. No one would seriously target adults with tastes like these,” he said. He added that doctors were worried about the long-term effects of alcohol on children and about how alcoholic binges affected young bodies, because there had been little research.
There were also concerns that children apparently did not suffer hangovers. Hangovers, Dr Davies said, were a very effective way of deterring adults from drinking too much too often.
Dr Tim Webb, a GP from Clwyd, attacked the cynical attitude of the drinks industry. “The tobacco and alcohol barons have worked out that if you get them young and get them addicted you’ve got them for years to come.”
Dr Sandy Macara, chairman of the BMA, told the meeting that the association was involved with the government investigation of alcopops and the way they were sold. “The breathtaking hypocrisy of the industry in pretending that they are not targeting our young people is absolutely incredible.”
Alcohol Alert is grateful to the Daily Express and Channel Four Television for the use of the pictures illustrating the alcopop problem.
Government climbs down – the problem with alcopops is stirred but not shaken
Threats to the alcohol industry that if it did not clean up its act in regard to alcopops the Government would do it for them were exposed largely as bluff when the much heralded Government crack-down gave the industry yet another last chance to ‘prove that self-regulation works’.
Critics, including the Institute of Alcohol Studies, welcomed some of the moves but said they did not go far enough and relied too heavily on self-regulation by the alcohol industry. This had already been shown to be ineffective.
The Government has placed the onus on retailers to control alcopops, whilst refraining from any direct sanctions on producers. Bass continues freely to advertise Hooch on Television.
Professor Brian Pritchard, Chairman of the Institute of Alcohol Studies, commented: ‘It is inappropriate for alcopops to be advertised on TV particularly when the viewers will include a substantial number of children and young people. The Government should have declared its intentions to ban such advertising.’
The package of measures announced by the Ministerial Group on Alcopops is designed to reinforce the stronger code on alcohol marketing drawn up by the alcohol industry’s Portman Group. The main measures are bringing into force the Act, introduced under the previous Government, to allow the police to confiscate alcohol from under-18’s drinking in public; clarifying the law to allow under-18’s to attempt to buy alcohol in order to help the police detect retailers who are selling illegally and making it an offence for adults `to buy alcohol from a shop or off-licence at the request of an unsupervised youngster’. This last measure will bring English and Welsh law into line with Scottish law.
Ministers welcomed the cash support pledged by the alcohol industry to extend the existing proof of age card scheme. They hope that the extended scheme will effectively make the proof of age card essential for 18-20 year olds who want to buy alcohol.
Home Office Minister George Howarth, chairman of the Ministerial Group on Alcopops, said: ‘The Government is determined to do all it can to tackle alcohol abuse by young people. The Portman Group’s new tougher Code of Practice takes on board our demands for additional controls on the marketing and promotion of alcohol. The whole industry must now prove that self- regulation works.
This action, and steps taken by individual companies, goes a long way towards meeting our concerns about alcopops and the wider problem of irresponsible underage drinking. Our proposals will reinforce their action.
‘It is vital that retailers play their part by not selling alcohol to under 18s. And we are taking steps to bring law-breakers to justice with the help of teenage ‘alcocops’ working under close supervision of the enforcement authorities. Widening the ‘Prove-It’ scheme will help ensure that the law is upheld. However, if these measures fail to curb the problem then the Government will take further steps.’
The Ministerial Group will meet in the autumn to monitor progress and will review the effectiveness of self-regulation after 12 months.
Magistrates respond to Government
At the request of the Government, the Magistrates’ Association and the Justices’ Clerks’ Society issued a joint statement urging all Licensing Committees to adopt a code of practice or policy statement dealing specifically with the question of under -age drinking.
The Joint Statement also suggested that applicants for licences should be asked about their willingness to uphold the legal requirements and that, in particular they should be encouraged to adopt a proof of age scheme; to attend a British Institute of Innkeeping course or one of like standard and to adopt the Portman Group Code of practice. The Statement added that where appropriate, Committees should consider whether conditions can be attached to the grant of a licence to ensure that these objectives are achieved.
However, the Statement by the Magistrates’ Association prompted a sceptical reaction from critics of the Government’s policy. They argued that the Statement was little more than wishful thinking. It was being said that retailers stocking products ruled out of order under the Portman Group Code could be required to ‘explain themselves’ to the licensing justices. But as the Code was that of a trade association and entirely voluntary, it had no status in law. Thus, if a retailer refused to take products off his or her shelves, there was still nothing the licensing justices could do about it.
I.A.S. Director Derek Rutherford commenting on the announcement criticised the Ministerial Group for `passing the buck’. He said: `Whilst we welcome measures which help to enforce the law to curb under age drinking and protect minors, we believe that the proof of age scheme together with the code of practice should have been made mandatory if it is to have the desired impact.
The buck has been passed to the retailers to act responsibly. The retailer is to be hauled before the courts to answer the question why his shelves contain alcopops which have been declared irresponsible by the Portman Group. Yet it is the Portman Group’s paymaster who has committed the primary offence in producing the socially unacceptable drink. The Minister has ignored the demands of a substantial number of his own backbenchers who have called for ‘stringent statutory controls’.
No tax hike on alcopops in the budget
The new Chancellor of the Exchequer, Gordon Brown, disappointed public health advocates and many others besides by ignoring the demands for a major tax increase on alcopops in his first Budget.
In the event, despite the intense public clamour, and the fact that the alcopop manufacturers were clearly braced for a large tax increase, the Chancellor made no specific reference to the drinks and the tax on alcopops was increased only in line with inflation, along with all other alcoholic drinks. The increase does not take effect until 1st January 1998.
In contrast, in his last budget, Mr. Brown’s predecessor as Chancellor, Kenneth Clarke, increased the tax on alcopops by around 8 pence in response to worries about their popularity with under age drinkers.
Commenting for the Institute of Alcohol Studies, Derek Rutherford said that the Chancellor had declined an opportunity to tackle a serious and growing problem. “The public were clearly expecting and hoping for the tax on alcopops to be increased. The fact that this has not happened makes even more necessary the introduction of a statutory code on the marketing of alcopops. The IAS also calls on the Government to take further action through the Office of Fair Trading to remove the worst offending products from the shelves.”
Mr. Brown’s only comment on alcohol excise duties was that they, and tobacco duties, demand careful consideration because of the problems of fraud, smuggling and cross-border shopping. “I have therefore decided to review all tobacco and alcohol duties and while this review is under way, inflation only rises for alcohol will take effect from January.”
However, despite the review, with effect from 1 December this year, tobacco duties were increased by an extra 2 per cent above the annual 3 per cent real rate of increase established by the previous Government. As a result of duty increases, the price of a packet of 20 cigarettes will rise by 19 pence on 1 November.
On the assumption that the rate of inflation is 3 per cent, the new rates of duty plus VAT will have the effects shown in the table.
The alcohol industry broadly welcomed although the Scotch Whisky Association condemned the duty increase on spirits as a retrograde step. However, the Association did welcome the review of excise duties and called for Mr. Brown to introduce a system of unit taxation – all drinks being taxed according to their alcohol content.
Commenting on the review, Financial Secretary to the Treasury, Dawn Primarolo, said: “The Government is concerned about the level of fraud and smuggling in relation to alcohol and tobacco. This is having a serious impact on Government revenues. It cheats the taxpayer and damages legitimate businesses. We want to forge a partnership with the industry with a view to finding new ways of tackling these problems.
Fraud is a Europe-wide problem, which we are addressing in the UK and the Community. There will be no let up in Customs’ fight against this criminal activity. I have asked Customs to consult interested parties with a view to reporting to me by the end of the year.”
Ms. Primarolo explained that trade associations and other interested parties will be consulted at an early stage and their views sought on the extent of the problem and practical ways in which it can be tackled. While the review will take health considerations into account, it will concentrate on fraud, smuggling and cross-border shopping.
Despite the slender acknowledgement of the health dimension of alcohol taxes, the basic terms of reference of the review imply that it is more likely to result in alcohol excise duties being restructured in a downward rather than an upward direction.
70cl bottle of spirits +19 pence
Pint of beer +1 pence
75cl bottle of table wine +4 pence
Pint of cider +1 pence
33cl bottle of high strength alcopop +1 pence
The Co-op and Iceland ban the sale of alcopops
Prior to George Howarth’s statement the Co-op and Iceland had banned the sale of alcopops and called on other retailers to follow their example.
Announcing the move, the Co-op’s head of buying and marketing team, Bill Shannon, said: ‘As responsible retailers, we feel the time has come to act, given the concern expressed by our own customers, pressure groups and the Government. We believe these drinks are designed specifically to appeal to young people and are, in fact, largely consumed by under-18s who cannot legally buy them.’
Mr. Shannon went on to criticise the self-regulation of the manufacturers carried out by the industry’s Portman Group, saying it was `inadequate and ultimately powerless to stop such drinks coming onto the market.’
Malcolm Walker, chairman of Iceland, said his company’s decision not to sell alcopops had been prompted by customer concern.
‘While commercially this decision will hurt, as a family company we must act responsibly and reflect the views of customers. There is definite evidence that these drinks are encouraging under-age drinking – this cannot be tolerated. We very much hope that our action will motivate other retailers to do likewise and would ask manufacturers of these products to consider their community obligations.
Bass, which produces two-thirds of all alcopops and sponsors the Portman Group, said: `We are disappointed with the Co-op’s actions and totally disagree with their comments regarding alcopops. Under-age drinking will not be eradicated by arbitrarily targeting or demonising popular drinks which are enjoyed responsibly by the vast majority of consumers.’
Tesco, Sainsbury, Asda and Safeway all rejected the call to ban alcopops. However, Tesco announced that it was banning `alcoholic milkshake’ and all the retailers said they were tightening up on sales of alcopops to the underaged. Tesco is demanding that alcopops carry stronger warning labels and has banned all in-store alcopop promotions. Asda said it was meeting suppliers to insist on stricter control of marketing and labelling of the products. Sainsbury said it was putting stickers over the bar codes of alcopops to remind staff to check the age of the customers. However, a spokesman for Sainsbury added:
‘We don’t make moral decisions on behalf of our customers. Where there is a demand for a product, we believe customers should have a choice.’
Since the Government statement a number of retailers, including JD Wetherspoon the independent pub chain, have followed the earlier lead of the Co-op. Bass continues to protest that such action is extreme.
Stirling University together with its students union has banned designer drinks such as Hooch, TNT and MD 20/20 from all the campus bars. The ban has been praised by the Scottish Health Education Board who wish more institutions would follow Stirling’s ‘responsible approach’.
MPs sign motion to control alcopops
Before the Government announced its policy 85MP’s supported Donald Anderson’s Early Day Motion to ban alcopops and introduce statutory controls.
The motion stated:
That this House congratulates Her Majesty’s Government on its prompt response to the revelations about alcopops and other designer drinks; recognises that belated attempts at self-regulation by the alcohol industry have failed; and calls upon the Government to protect children and young people by a ban or the most stringent statutory controls on these products.
..one third of MEPs call for action
Two hundred and one members of the European Parliament signed Eryl McNally’s declaration on alcopops. The declaration called for European-wide guidelines on their promotion, marketing and retailing. If producers failed to enforce control, then member states should enact statutory measures. Alcopops should be taxed at the spirits rate. MEPs from all fifteen Member States supported the declaration. Of the 87 British MEPs, 66 signed up – 58 Labour; 3 Conservative; 2SNP; 1 Lib Dem; 1 UUP; and 1DUP
Underage drinkers are still buying from supermarkets
Another ‘sting’ operation by The Sunday Times found that youngsters can buy ‘alcopops’ without challenge despite the stores’ claims that new vetting procedures have eliminated underage buying.
The operation was carried out after the big four supermarkets – Sainsbury, Tesco, Safeway and Asda – refused to follow the example of the Co-op and Iceland to stop selling the drinks. The stores said that banning the drinks was unnecessary because rigorous security measures would prevent them from being sold to those under 18.
However, a Sunday Times team of five underage teenagers had little problem buying alcopops in London, Manchester and Edinburgh. In total, 37 transactions were attempted at branches of 10 stores. In only four cases were the teenagers – aged 15 to 17 – challenged about their age. They were prevented from buying alcopops in only two stores.
Natalie Price, 15, from Kingston upon Thames, bought five bottles of alcopops, including Hooper’s Hooch and Woody’s Pink Grapefruit, from London branches of Sainsbury, Waitrose, Tesco, Asda and Somerfield in less than three hours. She was not challenged.
Lisa Connor, 16, from southwest London, was stopped at the checkout of Waitrose when she tried to buy two bottles of Hooch. “The cashier asked me if I had proof I was 18 and I said no. Then she called her supervisor who asked how old I was. I said I was 21 and she waved me through,” she said.
The only stores to refuse the teenagers alcopops were branches of Sainsbury in London and Manchester.
All the stores approached by The Sunday Times teenagers said they would investigate why their detection systems had failed.
It wasn’t me, your honour… it was the drink
A traditional plea of mitigation in relation to offences conducted under the influence of alcohol. But what is the legal position? Are people under the influence regarded as not being fully responsible for offences committed while in that state? Or is being under the influence, or at least drunk, regarded as an additional offence rather than as an excuse for the first.
These questions may have a particular importance In the alcopop era given, for example, that in these drinks the taste of alcohol is typically disguised, possibly making it difficult for people to know whether or to what degree they are under the influence.
Here, Dr Slapper, Principal Lecturer in Law, Staffordshire University, explains how the new kind of drinks could lead users into a difficult legal area.
Alcopops over popcorn?
Every year desk sergeants record the details of tens of thousands of alcohol-related offences. In such a setting, the recent profusion in the drinks market of alcopops and ready-mixed sweet cocktails can be seen as fuelling an already significant problem.
Last month a publican and his wife from Ormskirk in Lancashire were fined £7,820 and lost their licence after Graham Bailey, a boy they had served alcopop drinks, was hit by a train after leaving their pub very drunk. At the time of the decision by Ormskirk magistrates, yet another new alcoholic product apparently aimed at children – a vodka and raspberry ice pop – was coming under investigation.
The proliferation of alcopops is likely to increase alcohol-related offending, both by people who know what they are drinking and by others who become involuntarily intoxicated. It may be seen as alarming in this context that both voluntary and involuntary intoxication are valid defences to many criminal charges.
Alcopops, which generated profits of more than £280 million last year, have an alcoholic content higher than that of most beers and lagers but with strong flavours like vanilla or lemonade it is quite possible to drink such a product without realising its true content.
In many types of crime, the prosecution has to prove that the defendant had a particular frame of mind, such as intention or recklessness. Where a defendant has the stipulated attitude, it is irrelevant whether or not he or she was drunk. He cannot be heard to say that he would never have behaved as he did were he sober.
In one case, a man gave way to his paedophiliac inclinations only, he said, because someone had laced his drink with sedatives. The drink had been surreptitiously spiked by a business enemy specifically to help to procure sexual acts with a 15-year-old boy that were to be recorded and used in a blackmail scheme. The defendant was convicted at Lewes Crown Court of indecent assault but his conviction was at first quashed by the Court of Appeal, which took the view that a man could not be convicted where his otherwise-controlled desires were released through the secret administration of a disinhibiting substance “because the operative fault is not his”.
The House of Lords restored the conviction and stated that when the defendant committed the indecent assault, though he would not have acted as he did were he sober, he did know what he was doing when he behaved sexually with the boy. The Lords adopted a dictum from another case that “a drunken intent is still an intent”.
Where, however, through involuntary intoxication, a person does not have the required mental element for a crime, the prevailing view is that there should be an acquittal.
Yet the courts have been very cautious about the notion of involuntary intoxication. In one case a man charged with indecent assault argued that he had not known what he was doing. He admitted to having been drinking in a pub but claimed that wine he had drunk afterwards had contained more alcohol than he had realised. The Court of Appeal rejected this argument, ruling that where a person has been voluntarily drinking even a little alcohol, he was not permitted to argue that intoxication was involuntary simply because he had underestimated the amount or strength of alcohol he was imbibing.
Where a defendant commits a crime while drunk, his intoxication will not afford him a defence if he has been charged with an offence for which the prosecution need prove only recklessness. Indeed, in such a case anyone arguing that through his own efforts he had become so drunk as not to appreciate what he was doing will be condemning himself of recklessness. By contrast, where a defendant is facing a serious charge such as murder, requiring proof of a specific intention, then his intoxication at the time of the crime can be a defence if it prevented him having the relevant information.
The concession to people charged with “specific intent” – broadly, the most grave crimes – arose in the early 19th century as a way of allowing defendants to avoid being hanged or transported if they were too drunk when committing an offence to have been seen as coldly wicked.
In some circumstances, of course, being affected by alcohol is an integral part of an offence. The Road Traffic Act of 1988 for example, includes several offences such as driving or being in charge of a vehicle while under the influence of drink or drugs.
Here, victims of laced drinks cannot escape conviction, although the courts can be sympathetic. In one case a man in a pub who had drunk beer moderately, then ordered a tonic water, had had his last drink laced with vodka by a woman planning to reveal the trick before he left. She wanted him not to drive back to his home but to sleep with her and she expected that when told of the vodka he would not risk the drive. He left before she had a chance to tell him, but though he was convicted of a drink-driving offence, he was given an absolute discharge.
There have been various reports recommending legal reforms in this area. The Law Commission has rejected the idea of replacing the existing law with a new offence of “criminal intoxication” and recommended instead a series of revisions to today’s rules.
After recent disturbing news, such as the findings of Swansea’s Centre for Substance Abuse Research that 55 per cent of 11 to 16-year-olds are regular drinkers of alcohol (rising to 71 per cent of 16-year-olds), George Howarth, the Home Office Minister, has begun an inquiry on this issue. Whichever way the law is finely tuned, deeper social questions need to be asked about why a generation of children has come to favour alcopops over popcorn.
Reproduced by permission of Dr Garry Slapper and The Times Newspapers Limited.
Alcoholic iced lollies
Three varieties of alcoholic iced lollies are due to be launched this summer. Spiked Ice (produced by Thornlodge), which looks like an ice pop, is made from vodka and raspberry with a strength of 5.5 per cent. Distributors claim that the iced lollies would not attract youngsters as they would only be sold in clubs to adults.
Frappe (produced by Split Drinks Company) is a flavoured frozen liquor sold in a carton with a 4.5 per cent alcohol content. It will cost £1.50 and will be available in pubs, clubs and restaurants from July.
Tony’s Freezer Cocktail is a sachet to be bought in off licences and frozen at home and eaten like a lolly.
Donald Anderson, Labour MP for Swansea East said: “This is clearly the latest insidious example of the drinks industry trying to hook the young market. Lollipops are even more of a childhood thing than soft drinks. The industry clearly cannot be trusted to regulate itself”.
Drink and drug driving – New Government to lower drink drive limit?
The Baroness Hayman, the Minister for Roads, has left the new Government’s options open in regard to lowering the legal drink drive limit. The Minister said that lowering the limit was one of the options the Government was considering and that it would listen carefully to the experts. However, aspirations had to be tempered with realism especially in regard to public attitudes and perceptions.
Speaking at a Portman Group conference to launch the publication of a new report on drink driving, ‘Which Way Forward?’, the Baroness said that while reducing the limit to 50mg% could have benefits, there were also some potential drawbacks.
There was the question of the extra police resources that might be required to enforce a lower limit; the danger of prosecuting relatively minor cases at the expense of dealing with the `hard core’ of drink drivers who ignore the existing limit, and also the question of how the public would react to drivers facing severe penalties for offences at lower alcohol levels. It might be necessary to introduce less severe penalties for offences between 50 and 80mg%.
The Baroness also noted that the great reduction in alcohol-related casualties over the last 10 to 15 years had occurred without any reduction in the legal limit. However, she confirmed that in recent years the improvement had stalled. Drink-related casualties had risen in 1995, and while the 1996 figures (not yet published) showed a small improvement, the casualties were still higher than in 1993 and 1994.
Also speaking at the conference, Assistant Commissioner Paul Manning, Secretary of the Traffic Committee of the Association of Chief Police Officers (ACPO), confirmed that the police wish to see a lower (50mg%) legal limit and increased police breath testing powers. By refusing to introduce these measures, Mr. Manning said, the previous (Conservative) Government had simply got it wrong.
The Report `Which Way Forward?’, a review of drink driving countermeasures in selected countries, was written for the Portman Group by Dr. Andrew Clayton, Executive Director of the British Institute of Traffic Education Research. The report, and the Portman Group’s response to it, suggests that at least some sections of the alcohol industry have softened their opposition to further legal measures against drinking and driving.
At the conference, Portman Group officials stated that the Group is no longer opposed to a 50mg% limit for driving. Rather its position now appears to reflect the conclusion of the Clayton report that reducing the limit to 50mg% would have only limited beneficial effect unless accompanied by other measures. These are specified as more police powers to identify and apprehend suspected drink drivers; tougher sentences such as immediate licence suspension and confiscation of cars belonging to convicted drink drivers; expansion of rehabilitation programmes for offenders and the use of breath alcohol ignition interlock devices.
However, it is understood that one of the Portman Group’s member companies criticised the Group for not positively supporting demands for a lower legal limit on the grounds that as a lower limit is probably going to be introduced anyway, it would be better for the industry to be seen to be in willing rather than reluctant support or opposition.
…drivers to face drug tests…
Drivers may be asked to take roadside drug tests, possibly at the same time as alcohol breath tests under proposals being drawn up by the police and the transport department. The plan comes in response to government research which confirms a dramatic rise in the number of fatal road accident victims who test positive for illicit drugs. The illicit drug found most frequently is cannabis.
Preliminary results of the research into drug taking by road accident victims, including drivers, passengers, riders and pedestrians, indicate that compared with 10 years ago illicit drug
taking has increased four-fold and that an increasing number of victims are taking more than one kind of illicit drug. The presence of medicinal drugs in fatal accident victims is more or less the same, and the presence of alcohol has fallen substantially in the last 10 years. Nonetheless, alcohol remains the bigger problem.
Overall, the preliminary results show that a quarter of car drivers killed in road traffic accidents are found to have traces of illicit or medicinal drugs in their bodies. However, the figures do not show how many of the fatalities were caused by drug-taking. Cannabis remains in the bloodstream for up to 4 weeks after it has been taken by regular users, whereas its effect on driving is probably limited to at most 24 hours after it is taken. So far, no case has been found involving the use of cocaine or LSD, and there is little evidence of use of amphetamines including ecstasy. In contrast, opiates and methadone, which were hardly in evidence 10 years ago, do now appear to be a problem.
Commenting on the results, Roads Minister Baroness Hayman said that while the figures were only preliminary they were worrying. She continued: “The Government has announced its intention to appoint a `drugs czar’ to lead the fight against drugs. These emerging findings are among the issues the appointee will address. We are co-operating with the police in developing a roadside screening device for drugs (and we) have discussed with police how best to enhance their ability to detect drug use by drivers.”
The RAC welcomed the prospect of drug screening: “Drug-taking among young motorists, especially those going to raves, has reached epidemic proportions. It is a much bigger problem than people realise. The message is as important as the enforcement. A high-profile pilot campaign will help send the message.”
The RAC’s own research indicates that 85% of young motorists consider drug-driving to be common among their age group, and 96% of motorists want it to be made illegal.
The British Medical Association has also called for drug testing of, for example, drivers involved in accidents, although the BMA noted the problem that it is currently impossible to correlate blood or urine levels of some drugs with impairment of driving ability, as can be done with alcohol. The BMA also noted the problem of prescribed as well as illicit drugs.
Reportedly, one possibility is that Transport Department officials will recommend that Britain follows Germany in testing a skin wipe that can detect four classes of drugs: opiates, cocaine, amphetamines and cannabis. The present plan is that the wipe, which is cigar-sized and costs about £10, would be administered at the roadside if a driver appeared to be impaired but tested negative for alcohol. The device, manufactured by Securetec of Munich, is already on trial in Britain with customs officers. As with the breath test, a positive result would be followed up by the taking of a blood or urine sample at a police station.
…Great Britain road deaths and serious injuries fall to new low…
There were 3,598 deaths in personal injury road accidents in Great Britain during 1996, the lowest annual figure since records began in 1926. This compares with 3,621 deaths recorded in 1995. There were 44,473 serious injuries and 272,231 slight injuries, down 2 per cent and up 4 per cent respectively on 1995 levels. Road traffic rose by 3 per cent and the overall casualty rate by distance travelled rose 1 per cent.
Fatalities are now 36 per cent below the 1981-85 baseline average. Serious injuries are 40 per cent below, whilst slight injuries are 13 per cent above. All casualties, 320,302, are now 1 per cent below the baseline average and total traffic has increased by 50 per cent during this period.
…Zero limit for young drivers a success…
Some jurisdictions have introduced a differential lower, or zero, drink drive limit for newly qualified drivers. The idea has been opposed by some, on the basis that a lower limit, and especially, a zero limit may be interpreted by youngsters as giving the message that it is acceptable to drink (more) and drive later on in their driving career. However, the evidence suggests that this objection may be misplaced.
An evaluation of the `graduated’ licensing system introduced in Ontario, Canada in 1994, suggests that it has cut the proportion of young male drink drivers by over 20%. The new system imposes a zero alcohol limit on new drivers for the first two years after qualification; avoiding major motorways, drive only during the day and be accompanied by a fully qualified and experienced driver.
Before the system was introduced, 23.2% of young male drivers reported driving after drinking: two years after the new system came into operation, the figure was down to 17.9%. There was no significant drop in relation to young women drivers.
Addiction Research Foundation researcher Bob Mann believes the figures show the graduated licensing system is having a general deterrent effect, and that many young men are changing their behaviour to conform to the new requirements. It appears it is not just drinking behaviour which has changed. Following the introduction of the new system there seems to be fewer new drivers. The implication being that some youngsters have delayed obtaining a driving licence
In New Zealand, the first country to introduce graduated licensing, deaths among 15-17 year old drivers and their passengers fell by around 25% during the first two years of the programme. The Canadians are hoping for a similar impact.
The Balding report confirms that alcopop drinkers do drink more
Teenagers who drink alcopops do drink more than non-alcopop drinkers and they are also more likely to consume the drinks outside in a public place rather than at home.
These are among the range of findings of a new report `Young People and Alcohol: Its Use and Abuse’, largely funded by the Institute of Alcohol Studies, and produced by John Balding and the Schools Health Education Unit at the University of Exeter.
The report is based on a survey of over 8,000 boys and girls aged 12-13 and 14-15 living in ten regions of England. As well as obtaining information on alcohol consumption, the survey also enquired into children’s attitudes and beliefs about alcohol and also asked about their family circumstances and their experience of aggression at home in relation to alcohol use. The main findings here are that around a quarter of teenagers report experiencing physical aggression in the home during the last three months. Most instances of aggression appear to occur in the absence of alcohol, but a minority (4 -5 per cent) of teenagers report that physical aggression occurs only after someone in the home has been drinking.
Alcopops and Alcohol Consumption
The survey found that more than 1 in 5 12-13 year old boys and girls (Year 8) report having consumed alcopops in the previous week, this proportion increasing to nearly 1 in 3 in Year 10. The report also shows that by Year 10 the majority of boys and girls are regular consumers of alcohol and that those who consume alcopops drink considerably more alcohol than those who do not. In other words, alcopops clearly appeal to heavier drinking children and, presumably, themselves encourage heavier consumption. By year 10, over 13 per cent of boys and nearly 10 per cent of girls drink four days a week or more and 7.4 per cent of boys and just under 10 per cent of girls report exceeding the old `sensible limits’ proposed for adults of 21 and 14 drinks per week for men and women respectively.
The home – their own or a friend’s or a relation’s – is the main place where alcohol is consumed, although substantial minorities report that their parents do not always know about their drinking at home. Between 5 and 7 per cent report that their parents never know.
Substantial minorities also report drinking in pubs, clubs and discos. By Year 10, up to a third of teenagers report drinking outside in a public place, with alcopop drinkers being more likely to do this than non-alcopop drinkers.
Aggression at Home
Over half (55 per cent) report some experience of verbal aggression in the home, with up to 30 per cent reporting experience of physical aggression. Verbal aggression after their own consumption of alcohol is reported by 40 per cent of teenagers and by 30 per cent after consumption by someone else in the household. The mother is the other member of the household most likely to be mentioned in this context.
There appears to be a link between unsupervised drinking at home and experience of verbal or physical aggression. Around 45 per cent of teenagers who do not drink at home report some experience of aggression during the last three months. In teenagers who do drink at home, but whose parents always know, the proportion rises to 53 per cent. If parents usually know, there is a rise to 65 per cent and where parental awareness is even lower, the figure rises to 71 per cent. A possible interpretation of these findings is that whatever social or personal difficulty is prompting the aggression also results in a lack of openness about home drinking.
There is also a link between family composition and experience of aggression, both alcohol -related and non-alcohol-related. In this survey, experience of aggression was most likely to be reported by the older girls, and for family types other than the mother and father type. In relation to non-alcohol related physical aggression, just under 1 in 5 Year 10 girls living with mother and father reported recent experience, the figure rising to just under one in three living with a parent and another adult partner.
Alcohol-related aggression was also least likely to be reported for the mother and father type of family.
Some Other Findings from the Survey
- Young people say they drink alcohol to feel good and because friends do and, as they get older, to get drunk.
- Young people think adults drink alcohol mainly to cope with emotions, to relax, and to be with friends.
- Young people think that while saying `no’ to an alcoholic drink is acceptable in principle, they find it difficult to do themselves.
- Around 12 per cent of Year 8’s say that they intend never to drink alcohol at all. However, by Year 10 this proportion has dropped to 7-8 per cent.
- Over 70 per cent of young people (83 per cent of the girls) say that they intend never to drink and drive.
- Similar proportions say that they intend to avoid being a passenger in a car with a driver who has been drinking.
- Ten percent of young people believe that alcohol could lead to improvement in health. However, three quarters believe the opposite.
New Labour’s Health Policy taking shape
A tough line against illegal drugs and smoking are two main components of the new Government’s approach to public health policy, commitment to which is indicated by the appointment of Tessa Jowell as Public Health Minister. However, there are mixed signals in relation to the Government’s policy on alcohol. The Government has made efforts to tackle alcopops, but it appears to be considering reducing alcohol taxes and possibly also further relaxing the licensing laws.
Smoking and illegal drugs
The Government made clear immediately its determination to tackle smoking and to ban tobacco advertising and sponsorship.
Ann Taylor, the President of the Council and Leader of the House, has been given the job of overseeing the Government’s plan to tackle drug misuse and to chair the Ministerial anti-drugs committee.
Announcing her appointment, the Prime Minister, the Rt. Hon. Tony Blair MP, said: “I have asked Ann Taylor to chair a high-powered Cabinet committee to tackle the menace of drugs. I want to breathe new life into the battle against drugs. I want to draw together all parts of the community – police, teachers, our health professionals, parents and youngsters – to work together against this modern evil. We will hit hard on drugs and on the drugs trade. And this will run alongside a strategy to deal with lack of educational opportunity, poverty of ambition, homelessness and social decay. That is what our young people deserve.” Mrs Taylor said that tackling drug misuse was a priority for the Government and one of its biggest challenges. She said: “Drugs wreck lives and damage communities and can corrupt the energy and vitality of our young people.”
The Government’s opposition to legalisation or decriminalisation of drugs was reiterated by Home Office Minister George Howarth, addressing the Chief Police Officers’ drug conference in June.
Mr. Howarth said that any debate about legalisation or decriminalisation detracts from the message that drugs destroy lives.
He continued: ‘Drugs devastate those who take them, their families and their communities. Every city, town and village is affected in some way. I refuse to accept that drugs have become part of growing up. Just one in four young people have taken drugs in the last year and even fewer – just one in seven – has done so in the last month. But these figures are too high. The Government is determined to repair those communities damaged by drug use – by getting young people into employment and drug users into treatment.’
Mr Howarth stressed the Government’s co-ordinated approach to tackling drugs and detailed measures it will be taking. These include the Testing and Treatment Order, part of the Crime and Disorder Bill, which aims to break the link between drugs and crime.
Overall Public Health Strategy
Ms Jowell announced that the Government is to launch a new approach to public health strategy designed to tackle ‘the root causes of ill health’ and, especially, health inequalities.
The implications of the proposed new approach for alcohol policy are unclear. Under the previous Government, the principal targets in relation to alcohol policy were contained in its health strategy, ‘Health of the Nation’. The targets were reduced proportions of adults exceeding the `sensible limits’, which were then increased.
Announcing the new Government’s approach, Ms Jowell, without referring specifically to alcohol, criticised ‘Health of the Nation’ for, amongst other things, an “excessive emphasis on lifestyle issues that cast the responsibility back on to the individual”.
Ms Jowell announced an autumn Green Paper for health strategy in England; an independent review of health inequalities by Sir Donald Acheson, the former Chief Medical Officer for England; `Our Healthier Nation’ – a new approach to health targets and new plans to promote healthy schools and workplaces.
Ms Jowell said that the Government sought to attack the underlying causes of ill-health and to break the cycle of social and economic deprivation and social exclusion. This signalled a major change in the nation’s policy,
“to maximise good health, as well as treating sickness. You might call it being tough on the causes of ill health. Poverty, unemployment, bad housing, social isolation, pollution, ethnic minority status and gender have for too long been regarded as peripheral to health policy. Public health has been marginalised and its laws and structures have been neglected.”
Ms Jowell said that the Health of the Nation strategy “gives us something to work from but leaves much to be desired. It ignored health inequalities and paid little more than lip service to the essential ingredient of collaboration across government. It failed to consider population groups. By focusing on diseases and services it cast the burden back on to the NHS and its excessive emphasis on lifestyle issues cast the responsibility back on to the individual.
“Our Healthier Nation, the new approach to be set out in the Green Paper, will address these issues effectively. It will set out current work, recognise inequalities, emphasise the need for local as well as national targets, and take account of population groups – children, the working age population, elderly people – so that everyone is included.
“We shall build on what has been done, not sweep it all away. It was sensible to concentrate on the biggest killers and causes of avoidable ill-health, but we must maintain a relatively small number of health targets and for these to be defined with quantified, dated changes.”
Ms Jowell also set out the proposed collaboration on schools and workplaces: “Inequalities are set in childhood and this is the area of greatest potential. Healthy schools will be one of the first priorities for our new health strategy. This is about more than health education, though that plays a part. It is more about developing a whole-school ethos which promotes health and well-being.
“Healthy schools can help to break the cycle of inequality. Teenage pregnancy for instance is all too likely to be a cause as well as a symptom of poor education, unemployment and social exclusion. If a healthy school can keep a child from following her mother by getting pregnant at 17, she has a better chance of getting qualifications, getting a job, breaking out of the loop.
“There have already been pilot healthy schools in this country as part of the European Network. There is a great deal of work going on in schools and education authorities all over the country. David Blunkett and I are already looking to encourage this and to spread good practice. The potential is enormous.”
“Healthy workplaces are another area where we shall concentrate attention. A healthy workforce has benefits for individuals, for their families, for businesses and for the country as a whole. And when I say `workforce’ I mean all of the population of working age, whether they are in conventional employment or not.
“Different groups will need different approaches. The workplace is one especially promising setting. Yet the CBI’s figures for sickness absence show that in 1996 there were 187 million days lost to sickness – 12 million more than in 1994.
New Labour… Beer the drink of choice
Since the election, Labour MPs have drunk so much beer that the best known bar in the House of Commons – the Strangers bar – ran out. Commons catering managers have also had to open the Terrace bar, normally closed during the summer, to cope with the demand. Even before the election, around 1 million pounds worth of alcohol was consumed in Parliament each year. However, a member of the catering staff says that since the election ‘They (the MPs) are breaking all records. We’ve never seen anything like it.’
Alan Meale, Labour MP for Mansfield and chairman of the Parliamentary Beer Club said he was proud that most of the new Labour MPs drank the traditional brew of the working class. He suggested that one reason for the heavy consumption was that House of Commons committees had not yet been established with the result that a lot of new MPs were sitting around without a great deal to do. They were also still celebrating the election victory.
Global alcohol is big, profitable and powerful
This was the message of David Jernigan speaking at an Institute of Alcohol Studies conference to launch the UK release of his report Thirsting for Markets: The Global Impact of Corporate Alcohol.
Jernigan, associate director of The Marin Institute for the Prevention of Alcohol and Other Drug Problems called for an end to unrestricted alcohol trade and for controls on alcohol marketing.
“Alcohol causes health and safety problems, and heavy use of alcohol causes major health and safety problems,” he said. “What we have here is a small club of companies that have divided up the world to minimize competition and maximize profit. The combined sales of the top 10 global brewers and top 10 distilled spirits companies total nearly $200 billion. Companies with these resources can afford to be part of the solution, not just the problem.”
Jernigan referred to a recent study by WHO, the World Bank and the Harvard School of Public Health that holds alcohol responsible for between three and four percent of all global disease and disability. This puts alcohol problems on a level with measles, tuberculosis and malaria, more damaging than tobacco and more than five times as severe as illegal drugs in terms of impact on global health.
In his report, Jernigan tracks what he calls “big alcohol” around the world with in-depth looks at alcohol marketing in newly industrializing Malaysia in Asia; developing Zimbabwe in Africa; and post-communist Estonia in North-Eastern Europe.
The world’s largest alcohol companies are aggressively promoting their products to the poorest and heaviest drinkers in countries where Western-style beer is a badge of honour even when purchased at the expense of food.
Their predatory marketing tactics in developing and post-communist countries are often fuelled by governments thirsty for business and by the World Bank, which pressures them to cut spending and deregulate markets including alcohol sales – if they want World Bank dollars. Unlike the more health-conscious western world, where alcohol consumption is flat, these nations have inadequate prevention or treatment programmes.
In the majority Islamic country of Malaysia, where a small percentage of the population drinks heavily, Jose Cuervo tequila offers a national promotion with the theme “Lick, shoot and suck”: lick salt from a woman’s breasts, take a shot of tequila, then suck from the lime she holds in her mouth. Jose Cuervo is affiliated with the largest spirits transnational, Grand Metropolitan, which owns Burger King, Pillsbury, and Haagen-Dazs.
With the blessing of the Malaysian Government, Benedictine D.O.M. (nearly 40 per cent alcohol content), touts its “health-enhancing” powers for new mothers with a poster of a woman holding her infant next to the liqueur bottle. Facing a government threat of adding print and cinema advertising to its ban on broadcast alcohol ads, Denmark’s Carlsberg creates its own vehicle to advertise beer – a chain of stores that sell only comic books, sports trading cards and CDs, while decorating every aisle with Carlsberg’s beer posters.
In Zimbabwe, where about 80 per cent of people earn less than $21 a month, households spend about seven percent of their annual income on alcohol – seven times the proportion spent by families in the U.S. The Minister of Health and Child Welfare blames alcohol for half the country’s divorces and a majority of traffic crashes. The leading cancers for men and women are strongly related to alcohol use, according to a 14-year study of nearly 11,000 cases.
The Zimbabwe affiliate of Grand Metropolitan advertises “Robert E. Lee” whisky with the flag of the U.S. Confederacy to an overwhelming black African market.
In Estonia more than 70 percent of adults apprehended in 1995 for homicides, serious assaults and rapes were drunk. Alcohol was involved in 72 percent of drowning deaths. Today, the capital has four times the number of alcohol outlets mandated for most California cities. Giant street kiosks depicting a man holding a woman’s hand over a glass of beer adorn nearly every corner of the capital, where few women drank beer prior to free market reforms.
In Zimbabwe and Estonia, modern alcohol marketing techniques operate in societies already saturated with alcohol, where illegally produced alcohol competes with corporate alcohol and increases the problems. In Malaysia and Zimbabwe, where most people drink in places open to the public rather than at home, vestiges remain of colonial rule that used alcohol to keep native workers tied to plantation work and indebted.
The formula for marketing alcohol changes little from country to country: Target the poor, the young, the addicted, and encourage them to drink even more; capitalise on local customs as marketing opportunities; build on brand prestige. Jernigan discovered that alcohol promoters in the developing world are proud of the success of their campaigns to keep heavy drinkers drinking.
“If you want to talk about success, a lot of the promotional campaigns we can directly relate to consumption,” says Lee Kee Hock, marketing director of Guinness Anchor Berhad in Malaysia. “If you look at people who actually drink, we probably have the highest consumption in the world. Have you seen the Chinese drink? Each one can finish one bottle of cognac. Out of the 18 million total population, our research tells us that less than one million people actually drink. Of that, 20 per cent account for 80 per cent of the consumption.”
A similar observation comes from Maureen Paul, assistant director of marketing for African Distillers in Zimbabwe. “The cheapies make up 95 to 97 percent of our volume ” she says, describing their best-selling, inexpensive line of sherry packaged in small containers. “People can put them in their pocket and carry them around and strengthen their drinks (beer) with them.”
And from Richard Wylie, who creates advertising for three of the six brands of clear, European-style lager produced by National Breweries in Zimbabwe, which spends about $1.2 million annually on advertising:
” There is a marked tendency among that (lower-income) population to drink for effect. They drink to get drunk… and you’ll find that the wage earner will have a big family, he’ll have five to eight children. They’ll struggle to make ends meet. He’ll go and spend on alcohol for himself… the worry in those situations is that they don’t get decent food to eat… it’s way down on the list. At the very bottom end of the market is image. Western culture sets the pace in terms of what people aspire to.”
It was Wylie’s company that forged the Carling Black Label campaign for “the denim jeans brigade” with the tag line, “It All Happens Quicker With Carling Black Label.” The tag line was “a subtle way of telling them it’s stronger,” Wylie explains.
Urve Vali, production manager of Liviko, the state-run largest vodka producer in Estonia, also boasts of marketing to a heavy drinking population: “We advertise how to drink, how to make cocktail mixes, we have to educate the people.”
Although these three countries are very different, they experience similar marketing strategies – philanthropy and sponsorship (sports in particular), sweepstakes that appeal to low-income people, use of sexual imagery and messages that alcohol strength matters and that alcohol enhances health. As Koh Poh Tiong, CEO of the Asia Pacific Breweries, says, “We are not selling beer, we are selling image.”
In Malaysia, Carlsberg has won the loyalty of Chinese consumers through funding a local rock and roll band competition that culminates in a tour by the winning bands to the largely privately financed Chinese language schools. Carlsberg pays all costs for concerts, enabling the schools to keep all of the proceeds. When Carlsberg built its Malaysian brewery in the early 1970s, the brand had only a five percent share of the beer market. Since that time, its sales there have exploded to more than 60 percent of the market. Carlsberg’s advertising executive, Raymond Choong, credits “the long cool Dane” campaign targeted primarily to rural drinkers and starring a Caucasian blonde dressed in a white bathing suit.
Over time, the blonde has become more a part of the beer she advertises — her hair blending into the golden bubbles of the brew — and she plays opposite the “Carlsberg man,” whom Choong describes as “pan-Asian” and, if unable to obtain the Caucasian woman, capable of having the beer. Choong says this makes the brand “a person rather than a product so it’s like to him the brand is a friend he can rely on.”
Lee Kee Hock says that his company meets its goal of making personal contact with each of the estimated 200,000 heavy consumers of Guinness, Heineken, Tiger and Anchor beers in Malaysia. Both Guinness and Carlsberg hire young women to work in pubs and restaurants representing the brewer. Whether they are “women in green,” “women in red,” or seasonal variations such as the Anchor Santarinas, they are there to greet customers and offer the company’s beer. In addition to the bar and restaurant women, the brewers sponsor tours of beauty queens and models through bars.
The spirits trade in Malaysia has its own version of personalised marketing that happens in hostess clubs catering mostly to local businessmen. Virtually everyone working in the club has an interest in seeing the clientele drink heavily each night, according to information provided by Paul Chin, marketing director for Riche Monde, which handles the leading cognac. Management receives a bonus over and above profits from sales to push a particular brand. Spirits companies offer customers a variety of gifts perfume, watches, leather goods – based on how much of a brand the businessman drinks. It is understood that drinkers pass the gifts on to the hostesses, who are hired by the club.
“Ladies sit with you, they are your companion for the evening,” says Chin. “The percentage (of evenings that end in sex) is as low as 20 per cent. It is not necessary that you have to. It is only meant for sitting there, and if she likes you, fine, you (the drinker) are influenced by her because if the company selling a particular brand is giving a gift that she wants, she will then say, ‘Could you please open this brand x tonight?’ And you may feel obliged.”
Although alcohol advertising is not permitted in Estonia, there is no law defining what alcohol is, so the Saku brewery advertises on television and even boasts in its annual report that it sponsors a TV program from its pub in Tallinn, bringing “a beer drinking atmosphere to 200,000 viewers in their homes.”
Since this small country declared its independence from the Soviet Union in 1991, Estonia has moved beyond vodka on its way to being the quintessential modern alcohol market. After independence, Scandinavian alcohol transnationals began to transform centuries-old drinking habits. Liviko, the state-run vodka maker, is producing lower-alcohol, sweet liqueurs (about 21 percent alcohol) that appeal to women, lower-volume drinkers than men.
Thanks to marketing, beer – once the drink of choice for male island dwellers – is now a major focus for more urban drinkers, particularly women and youth. At the start of 1990, Saku and Tartu breweries had almost even shares of the bottled beer market. Between 1991-95, Saku’s sales shot up to 57 percent of the market’s volume because a holding company owned by the largest Norwegian, Swedish and Finnish brewers took majority control and redesigned the bottles, labels, and advertising campaigns. For younger drinkers, they created a stronger beer, Saku Rock .
Tartu, purchased by Estonians, is evening the marketing score. With a Finnish partner, it produces many of the sweet, higher alcohol content drinks with names like rum-cola and vodkaexotic that are sold next to soft drinks and cigarettes at nearly every kiosk. Tartu sponsors rock bands in bars and sports such as basketball and cross-country skiing. Located in a university town, the brewer arranges for every student to receive a stamp on a card for beer purchase. Completed cards may be entered in a lottery in which the prize is 40 cases of beer. “Enough to get drunk for a long time for the whole dormitory,” according to Arho Antilla, Tartu’s marketing director.
Western packaging is also a sales success story for Chibuku Brewery, which makes about 90 per cent of the traditional (opaque) beer in Zimbabwe. Dubbed “Scud” because of its resemblance to the missiles used in the Persian Gulf war, the two-litre plastic container solved the brewer’s problem with packaging shortages. The Scuds are recyclable and can be sold “in four walls or a shack,” according to Ben Tafa, Chibuku’s marketing director.
The World Bank and the International Monetary Fund hold development credits hostage in third world countries unless they cut government spending and free up markets. The former tends to undercut health education and health care; the latter forces countries to treat alcohol as if it were a normal commodity – like soap – without attendant serious health problems. Encouraged to privatise alcohol production and sales, drop tariffs on imported alcohol, and allow liberal alcohol marketing, these governments are going in the opposite direction from prevention.
This editorial, which could have appeared during colonial times in Zimbabwe, was published in that country’s Daily Gazette in 1994:
“By providing easily accessible beerhalls as the only recreation centres, the colonial rulers made sure that when the African worker was not toiling in their factories, he was in a beerhall getting drunk to the extent where he could not be bothered about his wretched status. Consequently, the ordinary African worker was cultured to work and drink with little else to occupy his time.”
Zimbabwean beerhalls are owned by municipalities. Although South African Brewers built Zimbabwe’s legal beer industry, the government owns the controlling interest in that industry. Located today mostly amidst dense clusters of housing on the edge of urban centres, these beerhalls are the size of mini-malls and hold hundreds of drinking men. Even cheaper are the “shebeens” run by women who brew traditional alcoholic beverages and commonly use the money they get to pay for their childrens’ schooling.
David Jernigan ended by proposing a series of recommendations for national governments, international organisations and the alcohol industry.
The report is available price $35 from the Marin Institute, 24 Belvedere Street, San Raphael, California 94901 USA.
Are there identifiable causal factors to problem drinking?
One of the anxieties about alcopops is that by encouraging children to drink they may increase the risk of problem drinking later in life.
Yet there are clearly other factors involved besides the age of starting to drink. Ian Sutherland of the Centre for Substance Abuse examines the issue.
Within the context of our society, drinking alcohol is a perfectly normal activity, indeed the adult who does not enjoy the occasional glass is often viewed, at the very least, with a degree of suspicion. Indeed, even though the legal public drinking age is eighteen, it seems fair to say that a very large
number of young people from about the age of twelve upwards also drink on a fairly regular basis. As we all know, for most people drinking a moderate amount of alcohol can be a pleasurable, not to say, fairly beneficial experience that can facilitate sociability and provide an antidote to a stress filled life. However, for a minority of people drinking alcohol is an activity that is fraught with danger and, for a very few, is akin to taking a poison that will almost inevitably ruin their lives and those of their family and friends.
What makes these two groups so different? At one end of the spectrum we have people who enjoy using the drug in a responsible manner and at the other those who alcohol seems to inevitably kill, having reeked years of havoc along the way. Surely there must be some way to differentiate these people from each other and , in so doing, be able to identify those at risk from the downside of alcohol use before the inevitable occurs?
In the not too distant past, researchers from various different disciplines sought to pin down a single cause for alcoholism and problem drinking. There was the concept of the addictive personality whereby it was suggested that anyone with this particular personality type was almost inevitably doomed to alcoholism as soon as the first pint passed their lips.
In a similar way, the presence of a close family member with a drink related problem was also considered to be a danger of almost epic proportions with various people suggesting that their lifestyle would undoubtedly rub off on anyone unfortunate enough to live near them. There was also the genetic lobby who proposed that the presence of an alcoholic gene predestined a person from birth. None of these individual theories have really provided an answer and yet, from the three areas a concept known as the BioPsychoSocial theory has arisen that has, in the past decade or so begun to make more and more sense.
As the name implies the BioPsycho-Social model is an amalgamation of the theories mentioned above and does, on the surface at least, appear to make intuitive sense.
One of the reasons that the other, single entity models, have fallen down is that clearly there can be no single cause of addictive behaviours. We live extraordinarily complex lives and we are acted upon by a myriad of variables affecting all aspects of our activities so it really does appear nonsensical to suggest that a single factor can cause problem drinking. On the other hand, the BioPsychoSocial model seeks to take into account all of these variables.
The Bio part of the theory suggests that whilst there may not be an alcoholic gene, certain individuals may have a genetic predisposition to alcoholism. Extensive work has been done on the DRD2 gene which indicates that aspects of the gene may have a role to play in the development of severe alcoholism. However, at this juncture anyway, it is not possible to carry out a test and proclaim an individual to be at risk because of a biological factor.
The Psycho part of the model stems from the concept of the addictive personality mentioned earlier and although it is not suggested that such a personality exists, there may be aspects of a persons psychological makeup that puts them at risk. For instance, people low in personal self-esteem are at greater risk from alcohol problems than those with high levels. In the same way, people with a tendency towards being generally over anxious seem to be at greater risk than those who take everything in their stride and people who tend towards a depressive outlook on life also seem at increased risk.
Possibly of most interest at the moment is the Social component of the model. There has been a lot of work in this area, particularly in relation to adolescent alcohol/substance use and it appears there are various aspects of young people’s lives that can be considered to be pointers to later problems. One of the most important is the age at which they began to use alcohol, essentially the earlier they begin drinking the more likely it is they will encounter problems further down the track.
Reasons for early initiation are extremely complex, but may include peer group pressure and abnormal levels of alcohol use within the household. Another area which may be a factor is religiosity, a person who does not believe in some form of deity appears to be at greater risk than a person with religious convictions. Academic achievement and academic expectations can also be pointers, a person with low expectations may often be drinking more heavily than a person who intends to go onto higher education. Finally, amongst the more obvious examples, is a person’s history of trouble either at school or with the law. A far higher proportion of young drinkers have been suspended from school and have had encounters with the police than non-drinkers.
The key to understanding the BioPsychoSocial theory is that one particular risk factor on its own does not mean that a person is liable to have a drink problem. For instance, if a person does have a genetic predisposition they may also need to be in an appropriate (or rather, inappropriate) social setting before they start to notice a problem. Alternately, they could be genetically predisposed, live in a pub and still not develop any sort of problem until a particular turn of events makes them particularly depressed and therefore vulnerable.
I believe that we will never be able to say with one hundred percent certainty that a particular person will become a problem drinker in the same way that we can never say definitely that a two pack a day smoker will develop lung cancer (after all, we all know of people who say they have a granny of 103 who smoked since she was twelve and still runs five miles a day). However, I believe that what may be possible is to assess the risk factors within a person, particularly an adolescent – and, at the very least, make them aware that they are potentially more at risk than their friends.
For instance, we may be able to say that a person is at risk because they have a history of alcoholism within the family, they appear to be genetically prone, they spend time with a heavy drinking peer group, they started drinking at a very young age and appear to have a tendency towards depression. While there may be little they can do about their family and genetic predisposition, they could, if they wished, do something about some of the other risk factors.
Whilst it would not be desirable to attempt to prevent people from drinking alcohol, we can at least make them aware of the dangers in their particular cases and allow them to make an informed choice based on knowledge of their circumstances.
Perhaps if people were aware they were at special risk, they might take more care in their drinking activities.
Alcohol Alert Digest
Our monthly podcast features interviews with experts from across the sector.
Dr Aalaa Jawad –
Public Health Registrar
Susan Taylor – Head of Alcohol Policy, Balance