Minimum pricing. Higher alcohol tax. Late-night levies. Could these help cure binge drinking? The Government's latest plans were put under the microscope at a lively conference. John Harrington reports
How do we beat binge drinking? It's hardly a new issue, and the new Government is just the latest to present radical plans for tackling the issue, with an overhaul of licensing, bans on below-cost sales and late-night levies on the horizon.
But what do health professionals and the industry think is the best way forward? There was no shortage of opinions about the merits (or otherwise) of the new proposals at a major conference in central London last week.
All were in agreement about one thing: there's a problem that needs to be addressed. Any consensus, however, appeared distant as health professionals and industry figures locked horns in a lively debate in the Westminster Food & Nutrition Forum seminar on alcohol.
Former public health minister Caroline Flint, who oversaw the introduction of the smoking ban amid much opposition from the pub trade and others, kicked off proceedings with some perhaps ominous advice for her successor.
"Sometimes Government has to lead opinion, not follow it," she said. "Legislation can lead attitudes and control behaviour."
The new public health minister Anne Milton gave little away about the details of the Government's programme. But she set some positive "mood music", saying she recognises the "tensions" that exist between a government's responsibility to protect people and individual freedom. As she put it: "You can't frog-march people out of off-licences."
Milton stressed the important role of education in tackling problems, saying: "Legislation has its place in some instances, but we must also focus on giving people means to make the right decisions on health." Getting the message in at an early age is key, she said.
Alcohol labelling is important, she added. Milton's department is "looking closely" at responses to the recent consultation on labelling.
But it's the environment in which people grow up, she said, that "must encourage responsibility". She gave her backing for the "social norms" approach — the idea that
positive actions should be encouraged by stressing that they represent normal behaviour.
Milton also made a clear distinction between action taken against smoking and against excessive drinking.
"They are different. We want people to stop smoking — end of. We want people to reduce their alcohol consumption. It's slightly trickier and the lever won't be the same."
The subtext was: we don't consider alcohol to be the new tobacco.
Decisive action
Professor Vivienne Nathanson of the British Medical Association
urged decisive action across a range of areas.
"We need to act on price," she stressed. "We need to act on availability. We need to act on attitudes, and knowledge."
Nathanson poured water on the argument that drinking in moderation can be good for people. "How do you know that moderate drinking wouldn't become problem drinking? The risks are so high, most people would say it's better to avoid it."
And as with other health professionals, the main target was supermarkets. "Why is alcohol available at pennies, 24 hours a day?" she asked.
She also called for a more robust alcohol labelling scheme —for example, one that spells out the dangers of operating machinery.
Tobias Paul from the Scottish Youth Commission on Alcohol, which has advised the Scottish Government on its policies, also had the industry in his sights when he called for "considerably stricter enforcement of the licensing laws."
This includes "much greater use of test purchases" and "the scrap-ping of giving notice about when police are coming around to do test purchasing".
There should also be "serious consideration of the method of age verification". It's "essential", Paul said, that Challenge 25 "should be rolled out as an obligatory minimum" and there should be an investigation into the possibility of "compulsory universal identification for alcohol purchases".
Education matters
The need for education was also stressed by Drinkaware chief executive Chris Sorek.
He pointed out that the average age of people having their first drink was 13 — but the average age parents think they should first talk to their children about alcohol is 14. "This gap needs to be closed," he said.
Sorek disputed claims that youth drinking is on the rise; fewer youngsters are drinking, he said, but those who are, drink more. For 18 to 24- year-olds, "getting drunk is much more part of their social routine" — and one in four think the health risks of alcohol are exaggerated,
Offering youngsters alternatives to alcohol at an early age, such as sports and other activities, could be one solution, he added.
He highlighted Drinkaware's involvement in Newquay, where the charity is running an alcohol-free beach café where children can get advice on alcohol, as a positive partnership alongside tough policing of underage drinking in the resort.
Sorek concluded: "It will take a co-ordinated and unified approach to address alcohol misuse in the UK."
Government is attacked
British Beer & Pub Association chief Brigid Simmonds hit out at some of the current administration's plans.
She questioned the logic behind introducing £20,000 fines for underage sales: "Wouldn't we be better by insisting on more training? That's going to be more effective than endless fines on pubs."
As for the late-night levy, she said larger town-centre venues already pay higher licence fees.
Simmonds also made the case for lower tax on beer, saying a reduced tax rate for brews up to 3.5% ABV would encourage more production of lower-strength beer. "I believe beer is the low-alcohol drink of choice and should be taxed that way," she explained.
Diageo corporate social responsibility manager Mark Baird argued against minimum pricing — questioning why it's assumed to be such a good idea when the measure has never been tried properly.
He also questioned the link between advertising and excessive drinking. If advertising encouraged heavy drinking, he asked, how come beer sales declined 12% between 1988 and 2010, while the amount spent on alcohol advertising increased 170% in that time?
Baird also pointed to France's ban on alcohol advertising, which he said had not been shown to reduce alcohol use.
Advertising debate
This issue of advertising was taken up by Ian Twinn, director of public affairs at ISBA, which represents advertisers.
Twinn said advertising encourages customers to choose certain brands over others of a particular drink type, adding: "What it doesn't do is increase the overall consumption of that category."
Twinn said the industry, rather than Government, is more effective at encouraging sensible drinking through its adverts.
Several speakers highlighted apparent lack of control over online promotions, even if these don't originate from the brand owners themselves.
Tobias Paul said he knew of 1,900 groups on social networking site Bebo, particularly popular among school children, that are dedicated to one alcohol product. One group had more than 30,000 members.
"That's the sort of irresponsible, but unregulated, promotion that's a really big influence on young people," Paul said.
The issue of viral emails also cropped up. Twinn explained that any virals issued by the producers would be covered by the Advertising Standards Authority code. However, there's no redress for anything produced by a third party.
Twinn stressed: "What we can't have is advertisers being held responsible for what a bunch of students did at three in the morning."
No nanny state
The most laissez-faire attitude came from Josie Appleton, director of civil liberty campaign group the Manifesto Club, who argued strongly against interference by the nanny state.
"I really think that the Government is not a shareholder of our bodies. We have the right to carry out behaviour that