Targeted approach to harm reduction urged
Rather than simply trying to limit alcohol consumption through increased taxation, the Amsterdam Group's conference, 'Young People and Alcohol in Europe', was told that targeted harm reduction strategies need to be pursued. Olly Wehring reports.
In his opening speech at the 'Young People and Alcohol in Europe', Patrick Ricard, CEO of Pernod Ricard and vice-president of the industry-wide Amsterdam Group, highlighted the industry's awareness of the situation it finds itself in. "We are in agreement with political, public and private groups that the abuse of alcohol, especially by the young, must be combated," he told delegates. "This is the biggest issue facing the drinks industry."
Following presentations highlighting the nature and scope of alcohol problems among young people in Europe, the conference moved to look at alternative approaches to these alcohol problems. Eric Single, professor of public health sciences at the University of Toronto and scientific advisor emeritus at the Canadian Centre on Substance Abuse, led the presentation and focused on the pros and cons of both the control of consumption and a harm minimisation approach.
Professor Single said the control of consumption method is easy to implement. By raising taxes or increasing prices of a product, the amount of alcohol consumed does indeed tend to drop. The best example of this approach comes from several Western European governments in the field of flavoured alcoholic beverages (FABs), or alcopops. The UK's experience of soaring consumption levels off the back of FABs has served as a warning sign. Not only is it easy to implement, Professor Single continued, but controlling the amount consumed tends to produce other positive side effects. Most obviously is the increase in government revenues from higher taxes.
But Professor Single warned there is a considerable downside to this approach to the problem of young people's alcohol consumption. "Controlling consumption lacks complete effectiveness and is poorly targeted," Single said. When trying to control how much their citizens drink, governments are providing a far too scattershot solution to the problem, with availability controls applying to everyone, he added.
One other disadvantage is the reduction of health benefits from alcohol use by non-problem drinkers. By attempting to control how much alcohol is being drunk, citizens are, in effect, being punished for consuming something that, albeit when drunk in moderation, can be good for them. Consequently, generally speaking, there has been declining political support for strict alcohol control, Professor Sample says, with governments loath to adopt a policy of a nanny state. Indeed, in his opening speech at the conference, Robert Madelin, director general of EU Commission's DG Sanco, said that this was not the way forward. "I do not believe that we have the mandate within the EU to pursue a nanny state," he said.
The distinction between controlling consumption and minimising harm is not always clear. Whereas controls over availability can reduce harm in specific drinking situations, harm reduction measures can impact on the levels of consumption.
"Drinking is always going to take place - that is a fact," says Single. The principal aim of harm minimisation, therefore, is to reduce the risk and severity of problems from drinking without necessarily decreasing the levels of consumption. The key prevention message that this approach carries is 'avoid problems when you drink,' rather than 'drinking less is better.'
Professor Eric Single
One example of this approach described by Professor Single was the early opening of an off-premise retail outlet in Edmonton, Canada. With homeless men in the area drinking ethanol and methanol, the opening of the off-licence encouraged the consumption of a far less dangerous kind of alcohol. Similarly, the introduction of special glassware in Scottish pubs, whilst doing nothing to lower the amount of alcohol being drunk, reduced the amount and severity of injuries relating to violence brought on by consumption. The promotion of low alcohol content beverages is another way in which harm minimisation can be implemented. "Governments should be reducing taxes on lower alcohol beverages as opposed to increasing taxes across the board," says Professor Single.
The harm minimisation approach, Professor Single is at pains to point out, is not an alternative to the control of consumption, but should be considered as a complement to it.
"The three most significant findings from alcohol epidemiology in the past two decades all support a greater focus on harm minimisation," Professor Single concluded. While drinking patterns play a major role in determining the levels of alcohol problems, harm reduction measures focus on high-risk drinking patterns rather than the level of alcohol consumption. The most efficient approach to the prevention of alcohol problems among young persons would be to maintain reasonable controls over alcohol availability, says Single, while increasing harm reduction measures to reduce the adverse consequences of excessive drinking in particular situations.
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