Hardly a day passes without the media reminding us how alcohol is causing harm. Now the government has a golden opportunity to create a change in our binge drinking culture, so will it step up to the mark?
Another week in Godzone and we have seen yet more evidence of the harm alcohol can cause in the lives of our citizens. A study in the New Zealand Medical Journal showed how emergency department staff suffer physical and verbal abuse on a regular basis from drunk patients fronting up for treatment.[1] It also showed how these patients negatively affect other patients in the ED – by increasing waiting times, reducing the quality of care of other patients, as well as making the ED experience often intimidating and unpleasant.
Another study in the same issue of the Medical Journal reported on a nationwide survey that found one quarter of Kiwis had at least one heavy drinker in their life and the majority had experienced harm from this person’s drinking.[2] Both of these studies show, again, that alcohol does not just hurt the person drinking, but those around them.
How should we respond to this issue? When evidence was found of the harm from second-hand smoke to the health of non-smokers, such as children and hospitality workers, the government took bold steps to protect non-smokers by introducing the smokefree laws. In doing so, the culture around smoking changed.
We are now faced with another series of questions about protecting innocent people. Is protecting frontline emergency staff important to our society? Is improving the quality of care to all patients on weekends in the ED? Is reducing the roadtoll from drunk driving? Is protecting our young people from premature death due to alcohol intoxication? If so, then we have an opportunity now to do something about it, to introduce bold measures to change the drinking culture, with the Alcohol Reform Bill.
This means the government needs to pay attention to their own Chief Science Advisor Professor Sir Peter Gluckman. Along with this they need to take notice the thousands of submissions that were made to the Select Committee on the Alcohol Reform Bill and the extremely thorough and comprehensive recommendations made by the Law Commission on revising the Bill. Gluckman’s report is particularly relevant, given that it specifically focussed on how to reduce harm to mental health and social functioning during adolescence – including from alcohol. The Gluckman Report included recommendations to increase the purchase price of alcohol and restrict the marketing and availability of alcohol, as these measures have the weight of evidence behind them to reduce binge drinking and harm from alcohol use.
Why has the government been so reluctant to include policies that are known to work into the Alcohol Reform Bill? The most common barrier is a perception that they are not popular with voters.
However, lowering the blood alcohol level was widely supported by many New Zealanders and still the government resisted making this change, demanding New Zealand-specific evidence. As if Kiwi drunk drivers and road fatalities are somehow completely different from those in Australia or anywhere else in the world. Increased alcohol prices may not be popular with some voters, but they should also be concerned about their tax dollars going to patch up the health and social harms from our binge drinking culture. Also it is unlikely that people will march in the streets to protest if Lion Nathan is not allowed to sponsor the All Blacks or if we never see another Tui advert.
Another barrier is poor communication of the evidence, so that it appears ambiguous, distorted or unclear to the public or politicians. However, many reputable, independent organisations and researchers (including the Prime Minister’s personally appointed Chief Science Advisor) have reached a strong consensus about the evidence around pricing, marketing and advertising and other alcohol policies, so this does not appear to be a barrier.
Another possibility is that policies such as tax increases, advertising restrictions and lowering the blood alcohol level are strategies that cause grave concern to the alcohol industry, because these policies may cut into profits – which was the conclusion of a group of Australian researchers who accessed industry documents. [3]
By not accepting advice from the Law Commission and Gluckman’s report, but by cherry picking some of the options, the Alcohol Reform Bill is unlikely to substantially reduce alcohol-related harm in this country. It will not fundamentally address the problems faced by ED staff, patients in the ED, reduce the road toll, the number of young people dying from alcohol related causes or any of the many other harms caused by alcohol.
This is the time for the government to prove that they truly endorse and support evidence-based policy. This is an opportunity to pass a Bill that, like the Smokefree Environments Act 1990, leaves an enduring legacy of protecting innocent people from harm and is admired both nationally and internationally as a landmark piece of legislation. This is an opportunity that we cannot afford to waste.
This was co-authored with Caroline Shaw.
1. Imlach Gunasekara, F., et al., How do intoxicated patients impact staff in the emergency department? An exploratory study. NZ Med J, 2011. 124(1336).
2. Casswell, S., et al., Alcohol’s harm to others: self-reports from a representative sample of New Zealanders N Z Med J, 2011. 124(1336).
3. Bond, L., M. Daube, and T. Chikritzhs, Access to Confidential Alcohol Industry Documents: From ‘Big Tobacco’ to ‘Big Booze’. AMJ, 2009. 1(3).