Three cheers for the possibility of sensible alcohol policy

Alcohol control is not an area for win-win policies and lately, the community has been losing heavily. Carsten Nielsen

Many Australians believe that there isn’t much we can do about our dangerous levels of alcohol consumption. But the real difficulty is that we don’t know how to get effective prevention policies through the political maze.

Many people believe that nothing prevents alcohol problems and that there’s no treatment for it. This is not the case – we do know how to reduce these problems and treatment is about as effective as medical treatments for other common, chronic health problems.

The problem with alcohol, in fact, lies elsewhere. The all-powerful drinks industry, representing about 2% of GDP, ensures that any politician publicly supporting effective policies to reduce alcohol problems will soon spend much more time with her family.

Alcohol is consumed very unequally in our community – a minority drink a lot while most drink much less. The heaviest drinking 10% of the community account for half the alcohol consumed. Interfering with that 50% of alcohol consumption would have a huge impact on the alcohol industry’s bottom line.

This is not an area for win-win policies. And, lately, the community has been losing heavily.

Among people interested in alcohol prevention around the world, there’s a strong consensus about what works and what doesn’t. Increasing the price of alcohol even slightly has a noticeable benefit. So if we were serious about trying to reduce alcohol-related problems, we would tax alcoholic drinks differently (according to their alcohol content rather than their beverage class).

Alcohol taxation in Australia makes no economic sense and even less sense as a public policy. The federal treasury decides alcohol taxes and only considers economics factors. And the states and territories don’t influence tax policy even though they pay most of the costs in terms of hospitals, police, courts and prisons.

Economists call this inefficient arrangement – where one level of government raises revenue while another pays the costs – “vertical fiscal imbalance”. The public likes to see some of the revenue allocated to alcohol prevention and treatment, though treasury always opposes hypothecated taxes. When the Northern Territory government introduced a taxing policy like this in the 1990s, alcohol problems fell dramatically.

The number of outlets selling alcohol has proliferated in recent decades, largely because of competition policy. We now have far too many outlets with far too liberal conditions. And we know that slightly shorter opening hours in Newcastle reduced alcohol-related violence by 37%. Sadly, in the battle between community interests and the drinks industry over outlet numbers and conditions, the industry wins every time.

There’s growing evidence (not yet quite as good as for taxation and availability reform) that curbing alcohol advertising, marketing and promotion reduces alcohol problems. Young children now recognise alcohol brands many years before they have their first drink. We saw with tobacco just how important advertising, marketing and promotion were in getting young Australians to start smoking.

The five major motor sports events in Australia are sponsored by the drinks industry. In a number of other countries, the drinks industry bans advertising at motor sports events. It writes the rules and provides the judge and jury for alcohol advertising regulation, even though self-regulation is to regulation what self-importance is to importance.

Herb Stein, an economics adviser to former US president Richard Nixon, used to say that “things that can’t go on forever don’t”. Forty years ago, the tobacco industry seemed invincible. But after decades of relentless pressure, the public-health David has now largely tamed the tobacco-industry Goliath.

It’s time that the community told our political masters enough is enough. If all the major political parties crossed the line together, Australians would be healthier and safer and still be able to enjoy alcohol.

In 2003, the then-NSW government convened an alcohol summit. There were some benefits from this meeting but, in many ways, we are further behind now than we were when that summit was held. Today, there is a meeting in the NSW parliament to discuss how well we are balancing the benefits and harms of our favourite drug. Maybe this time we will work out how to thread effective policies through the political maze.