Bottling it: Why fixing the price of alcohol won’t solve our drink problem
Will fixing the price of alcohol per unit really help combat binge drinking?
IS BRITAIN really in the grip of an alcoholic orgy of irresponsibility? Our politicians seem to think so and the crackdown on ‘alcohol abuse’ is reaching intoxicating levels. Yesterday, Home Secretary Alan Johnson announced plans to ban all-you-can-drink and speed-drinking promotions in pubs in England and Wales. The Tories also want more powers for councils to tackle ‘problem’ bars and clubs.
To many people these might seem like sensible measures. Estimates of annual alcohol-related deaths in England and Wales vary from 5,000 to 40,000. This includes deaths from long-term drinking related health problems, along with deliberate and accidental overdoses, traffic deaths, fatal accidents while drunk and so on.
However, given that serious health problems only arise from long-term heavy drinking, it is not clear how targeting promotions in pubs will help address the issue. All-you-can-drink and speed-drinking promotions are not generally taken up by hardened alcoholics. They are enjoyed instead by young adults, particularly students, who do not have to get up for work the next day. Very few of these people will become alcoholics (the only rational target for intervention), and even if they do, it is not the result of a happy hour promotion in the pub.
Alan Johnson’s measures can only be seen as killjoy and illiberal. They are part of an attempt to denormalize binge drinking when really it should be seen as a natural part of growing up.
Despite all the political posturing, some campaigners are still not satisfied. Alcohol Concern, for instance, claimed the Government were just “tinkering” with the price of alcohol, and that the measures wouldn’t stop people “pre-loading” with supermarket bought booze before going out.They are also insistent that what is required to solve the problem of long-term heavy drinking is a fixed minimum price per unit on alcohol.
International plans to introduce a minimum price for alcoholic beverages have been gaining significant ground over recent months. As far away as Russia, a minimum price for vodka has been introduced. And closer to home, the Scottish Executive is trying to convince MSPs that it is actually a good idea when many of them think it’s a vote loser.
The Commons’ Health Select Committee has recommended minimum pricing. And while Gordon Brown and David Cameron say they are against the idea, it is not known, of course, whether they will change their minds after the General Election.
In Wales, various ministers who lack their own legislative clout have been lobbying Westminster to introduce such a charge. This is an issue, it seems, that will not go away until it is resolved. Former Social Justice Minister Brian Gibbons has been enthusiastic about the Welsh campaign, which is backed by Alcohol Concern Cymru. The three Welsh Labour leadership contenders also called for strong action against the ‘culture of binge drinking‘, while Dr Tony Jewell, Chief Medical Officer for Wales, has said: “The strategy for alcohol misuse makes the case for stricter rules on the promotion of alcohol, increasing taxation and the introduction of minimum unit pricing, and restrictions on advertising.”
But how convincing is their case?
It is said that over a quarter of adults regularly binge drink – that is, a man might consume more than two pints of beer on a night out, or a woman a large glass of wine. Alternatively, over the course of a week a man might exceed 21 units (10 pints of 4% beer) or a woman 14 units. However, many of us exceed this recommended weekly ration as the limit is set far too low, and with no scientific justification.
In the UK, a unit of alcohol equates to 8 grams of ethanol, while in Ireland, Austria, Poland and Spain, it is 10g. In Denmark, France, Italy or South Africa it is 12g, in Portugal and the US it is 14g. A Japanese unit contains 19.75g. So while many countries advise the same upper limit of 21 units per week for men and 14 for women, this can mean dramatically different amounts of drink.
The figures from the authoritative Royal College of Physicians in 1987 have formed the basis for official guidance ever since. And, it can be argued, they were “plucked out of the air”, as Richard Smith, former editor of the British Medical Journal and member of the college’s working party on alcohol, put it: “The epidemiologist on the committee’s line was that ‘We don’t really have any decent data whatsoever. It’s impossible to say what’s safe and what isn’t’. The feeling was that we ought to come up with something. So those limits were really plucked out of the air. They weren’t really based on any firm evidence at all. It was a sort of intelligent guess by a committee.”
Furthermore, in the years since the 1987 guess, a host of new epidemiology has seen evidence to the contrary. In 2000, the World Health Organisation’s International Guide for Monitoring Alcohol Consumption and Related Harm set out drinking ranges that qualified people as being at low, medium or high-risk of alcohol-related harm. For men, less than 35 weekly units was low-risk, 36-52.5 was medium risk and above 53 was high risk. Recommendations for women were roughly half of those for men.
Meanwhile, back in 1993, a study of 12,000 middle-aged male doctors led by Sir Richard Doll found that the lowest mortality rates – lower even than teetotallers – were among those drinking between 20 and 30 units of alcohol each week. The level of drinking that produced the same risk of death as that faced by a teetotaller was 63 units a week, or a bottle of wine each day. In 1995, another study of 13,000 men and women found that drinking 50 units a week cut the risk of premature death by half. Meanwhile, a recent study found that teetotallers are more likely to have a heart attack than heavy drinkers.
A quarter of the British population do not drink dangerous amounts of alcohol, exceeding 60 units a week, for many years. They are somewhere in between. In Wales, only one in 25 male deaths lists alcohol as a factor. This means 25% of the population are not drinking dangerously, only 4% are. Of this 4%, of course, many will have powerfully complex reasons for doing so. The short version is that they have difficulty facing life and find consolation in a bottle. But that these are powerful reasons for them to drink should indicate that they are unlikely to be deterred by a small price increase. Charging a minimum price of 50p per unit of alcohol will not have the desired effect of cutting the numbers of deaths. This is because those who really are at-risk will not care. However, it seems unlikely that such common sense will deter the health zealots.
As the Bible has waned as a practical guide to day-to-day living in the 21st Century, health advice has filled its shoes. We are bombarded with lectures on what to eat, to avoid fatty food and salt, get your five-a-day fruit and veg and Omega 3 supplements. The advice that we shouldn’t smoke is so constant it has faded into white noise, while there is similar droning on about how much exercise you should take.
Alcohol moralising fits into this broader picture. Health zealots are the new vicars and chief medical officers are the new high priests. Drinking alcohol is viewed as a sin, and so charging a minimum price per unit of alcohol is really a punishment for sinning. It should be called a ‘sin-fine’.
Furthermore, the sin-fine unfairly targets those on low incomes. Those who drink fine wines that already cost more than £5 per bottle, or consumers of quality whisky, will not notice the price increase. The real target is cheap booze such as Frosty Jacks white cider, which contains 22.5 units per three-litre bottle and currently costs around £3.50. This will have to cost over £11 and will, as a consequence, be priced out of existence. Meanwhile deals on lager like six Stella Artois for £5 will no longer be found since it would become illegal to sell six Stella Artois for less than £6.60. It is clear then, that those on low incomes are the real target for this crusade. It is an onslaught on the working class and those with a care-free attitude.
Faced with this evidence, the health zealots would agree they are targeting the poor. They would claim that of the 1,000 Welsh male alcohol-related deaths each year, a substantial portion come from low income households. But it is far from clear how the sin-fine will address this issue.
Comprehensive research has found that only 21% of adults would buy less alcohol if a minimum price was set, while 52% said they would either spend more on the same amount of drink or look for cheaper alternatives.
Of the 4% previously-mentioned problem drinkers, it is clear they fall into the 52% category of those who would simply spend more or look for cheaper alternatives. The 21% that would lower their intake are already those people for whom alcohol does not have a grip on them, and who are, therefore, an irrational target for this intervention.
This evidence leads us to the inescapable conclusion that charging a minimum price for alcohol is senseless. What this campaign is really about is bolstering the new health-morality in an age where the Church’s power has waned. But we should have no truck with a morality that is inherently against poor people and freedom.
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This health zealotry is the main reason why I don’t watch UK news in the morning. BBC Breakfast for instance literally has some new health statistic to wave in our faces every single morning, often contradicting previous statistics that were waved in our faces with equal insistence.
I mostly agree, some bits I would take issue with, but on the whole I would say you’re very right and I’m glad someone wrote this.
The main issue as I have seen it is the targetting of lower income people. It seems OK for the middle classes to drink their bottle of wine a day after a stressful day in the office – they won’t be hit by the 50p minimum charge as they can either afford it, or are paying more than that already.
People such as lower paid office workers on minimum wage, or factory workers etc will be hit – people who deserve a drink at the end of the week, but won’t be able to enjoy a six pack at home on a Friday without having to pay excess for it. Someone on minimum wage will have to work around 2 hours for that Stella!
What about freedom of choice and the free market?
And another thing that worries me. If the price of alcohol goes up then there’s a temptation for those who go out to get wasted to pop a ecstasy or whatever for £15. It happens now, but if a bottle of cider will cost £11+, then it will happen a lot more. And you know where that will lead.
A solid and provocative article which pulled no punches. Class is a critical issue here and one which will underpin the whole debate.
Am definitely going to try Frosty Jacks before it moves out of my price range. Can’t believe our paths haven’t crossed before now.
I thought the first half of the article was fine – pointing out the facts about so called binge drinking and calling for decisions to be made upon evidence.
Unfortunately the second half of the article seemed to turn into a sensationalist Daily Mailesque rant about the end of Biblical morality and ‘Health Zealots’ (any relation to the dreaded PC Brigade?) and trying to twist a perfectly sensible argument about alcohol into one about smoking and encouraging healthy living in general – The NHS does not do this to be some sort of killjoy, it improves the quality of peoples lives and reduces the cost of healthcare in the long term.
I also believe that the claim that the policy is some sort of attack by some sort of atheist elite on ‘poor people’ is unsupported.
If the policy is intended to prevent binge drinking then it is quite right that it should disproportionately impact drinks like Frosty Jacks and Stella as these are the sort of drinks which are associated with binge drinking, and with long term alcohol related health problems.
Fine wines and quality whiskys are generally drunk in moderation, and are already reletively expensive. Incidentally as someone from a working class background I find your implication that I can only appreciate cheap and nasty drinks quite insulting.
Maybe its my imagination but I can see a rather unpleasant right wing agenda behind this article involving a return to religious authority, encouraging more people to smoke (otherwise why include these totally unrelated issues?).
@WelshConnection. Yes it is your imagination.
The argument made in the piece is that health zealotry has replaced, in some ways, the dominance of the bible as an enforcer of a spurious moral code. Barry is certainly not making the point that a return to the values of the bible is required.
He’s simply making the point that one group with a moral agenda has replaced another. He is clearly arguing from a libertarian perspective. He’s saying that we as individuals should not be taken in by the often mixed and unsupported recommendations of the government with regards to our health.
This is neither right wing, nor left wing, although I must admit Barry’s argument as a whole strikes me as neo-Marxist libertarian. I – for one – happen to agree with him.
I’d just like to add that right wingers are welcome on this site, too (right wingers, not racists). WalesHome is an ideas forum. It does not ascribe to any political view, regardless of the editors’ political convictions.
There is no hidden agenda, Welsh Connection, my only goal, good journo that I am, is the pursuit of truth. In this regard Rob is right to recognise a Marxist influence – may I point the interested in the direction of this article http://www.marxists.org/archive/marx/works/1855/06/25.htm by Karl on the Beer Bill of his day which inhibited Sunday drinking (the only day the workers got off), and led to mass protests in Hyde Park. I’d be delighted if we could see similar protests against the current crackdown on alcohol abuse and, if there was, it wouldn’t be caused by troublemaking journalists such as myself, but by the irrationality of Government policy.
I’m no fan of the Daily Mail either – whilst they are against some forms of moralism (ostensibly), they promote other forms, e.g. demonising single mothers, asylum seekers, those on benefits etc. They’re no friend of a consistent liberal. And I don’t think standing up for liberty is right-wing – it can only appear so if you believe left-wing equates to either Labourism or Stalinism which I don’t believe it has to. The American Civil Liberties Union has a lot of left-wing members, but over here, the left is wrongly suspicious of freedom having let people like Margaret Thatcher assume a monopoly over the concept.
I didn’t say people from a working class background can only appreciate cheap drinks – of course they’d like the dearer stuff – the point is that for those on low incomes, this is all they can afford. This is reflected in consumption habits where lager and cheap cider are primarily consumed by the less well-off whilst fine wine and quality spirits are middle class. I’m not being patronising, it’s just the way it is.
The crackdown policies as they stand will only lead to increased moderation for those for whom alcohol is not a health problem – it won’t reduce consumption for alcoholics and long-term very heavy drinkers who are the ones making up the death statistics. Things like banning happy hours are truly bizarre since they disproportionately effect the young who have no health problems. One can only conclude health zealotry is all about social control.
Thought provoking article! The problem, as I see it, is that every group who are against drink use each others arguments. So people who believe drink to be immoral cite “health risks” as their “justification”, the media are not quite sure about the difference between alcoholism and drink induced violence, and the government are desperate to appear to be doing something about an ill-defined problem. Not a very encouraging situation for common sense!
Excuse me if I rant a bit, but a related issue was seen with the recent recommendation from the English Chief Medical Officer that no-one under 15 should ever drink any alcohol. The arguments put forward in the document were things like “children who drink are more likely to truant”, (hardly cause and effect), and some quite spiteful comments made about the “middle class obsession with watering down wine” – a common practice in many other countries, but apparently harmful in Britain.
Or alternatively, the recent advice change to pregnant women that they should now drink nothing at all during pregnancy. The CMO office actually admitted that there was no new evidence, but that some people didn’t know what “moderate” meant. What?
In short, the discussion seems to be more about agenda than any particularly well thought out policy. Having said that, I don’t think its an intentional class issue. Its more like the 10% tax rate abolition – incompetence.
By the way, what have I missed? I thought the limits had been put up to 28 and 21 units. Have they been reduced again?
“In short, the discussion seems to be more about agenda than any particularly well thought out policy. ” writes Iestyn.
Quite. It’s all a bit like pontificating that “Something should be done” but without much clue of how to go about it. Taxation alone won’t do what the government seems to want it to in terms of discouraging consumer behaviour. Yes it’s a factor but, as tobacco taxation has shown, it doesn’t provide necessarily speedy returns.
The thrust of recent government policy seems to be aimed at younger drinkers with challenges to happy hours and alcopops, as if they are the biggest social menace. Perhaps that priority has something to do with the visibility of very drunk young people in most urban centres, and not just every weekend. But if their behaviour when drunk is bad the criminal justice system is there to deal with that, and not the licensing laws.
“Or alternatively, the recent advice change to pregnant women that they should now drink nothing at all during pregnancy. The CMO office actually admitted that there was no new evidence, but that some people didn’t know what “moderate” meant. What?”
What a perfect illustration of the patronising, illogical and unsubstantiated attitude taken by those who think they know better but consistently fail to persuade. Until they start engaging in rational and supported argument, I will keep their weekly recommended alcohol unit intake as a daily target.
“Until they start engaging in rational and supported argument, I will keep their weekly recommended alcohol unit intake as a daily target.”
Isn’t that something to do with journalism?…
Hey, hold on, why can’t I post anymore…
I write this contribution as someone with a 90 bottle wine unit!
The bottom line is that there’s no easy answer to getting people to make healthy choices. Personally I am not convinced that minimum pricing will have an impact, if people want to drink then they will still do it. I see no evidence pointing to massive reductions in consumption based on rising prices. I do think there’s a couple of things we could do.
Firstly people need to understand the consequences of long term alcohol use, the potential for Liver cancer etc. Education and information is key. Secondly it shouldn’t be so easy for clubs and bars to offer big promotions which are everything to do with their profits and less to do with people having a good time. Thirdly licensing should be devolved so we can better plan our town and city centres, the current Act is weighed heavily in favour of obtaining/extending a license. In fact St Mary’s Street in Cardiff is one of the most heavily populated streets in terms of drinking establishments. 24 hour licensing is a joke and all the evidence is that people drink more and for longer.
I agree mainly with what Jonathan Morgan has to say. Hopefully I don’t have to agree with what you say for me not to be edited. Complete farce of public discussion otherwise.
Some of these finding seem very odd indeed. That a teetotaller is more likely to die younger than a drinker?
Just remember the tobacco lobby would fund studies to show smoking is not detrimental to health.
The oil companies would fund studies showing that global warming is not happening.
The thing is not to believe statistics as irrefutable. But to have a healthy open mind about mind about stats and who is compiling them, and the power that money has to achieve a statistic report that is somehow in keeping with what the funder requires.
@Senn – I refer you to our comment policy in which we specify the circumstances under which we will edit comments. I have edited your comment in accordance with the section that refers to punctuation.
Jonathan Morgan says he wants to get people to make healthy choices. Surely the whole concept of “choice” means you can choose one option or the other. “Getting people to make healthy choices” on the other hand implies coercion and makes a mockery of choice.
If someone wants to drink themselves to oblivion, no amount of education is likely to deter them because their reasons will be powerful for them. If anyone can intervene it should be their friends or family, state intervention won’t work.
And I think part of the problem with ‘education’ is that it is too moralistic at the moment and not based on the sound evidence I have discussed in the article. They imply if you have more than 2 drinks, you are on the road to ruin. Most 18 year olds will not believe this and subsequently become a generation that is distrustful of their education, no matter how well intentioned it was.
““Getting people to make healthy choices” on the other hand implies coercion and makes a mockery of choice.”
Thaler and Sunstein’s Nudge has something to say about this, defining what it calls “liberal paternalism” or the idea that the life can be organised so that people can exercise choices, but that governments and other agencies can subtly steer the presentation of those choices in favour of people doing the “right” (in this case, healthy) thing.
It could be argued, I suppose that this is even more objectionable than coercing people to do the right thing. Or you could simply acknowledge that people are rationally self-interested far less than most economic models allow, and that gentle nudges here and there help to deliver good outcomes without bullying people.
Urrgh. Nothing gets my goat more than social engineering. They presume to know more than us. They don’t. We’re just making choices.
This is price fixing, and that’s illegal.