I received an interesting email yesterday. Every so often the BMA will send around a mass email in an attempt to get their members to support a cause they are pursuing by asking them to sign a petition in order to further support a cause. This particular email was on the governments pledge to pursue minimum alcohol pricing, and how they are currently threatening to backtrack on their promise, requesting those within the medical community who support such a measure to make their support explicit by signing a petition which they had helped to create.
In the UK alcohol has proven to be a major problem, causing a huge number of preventable deaths and damaging the health of many people. Since we operate a socialist healthcare system, this means that the nations drinking habits have ended up costing the tax-payer (via the NHS) more money than I could even begin to estimate which is particularly critical in a time of austerity. Such a measure as minimum pricing seems rather extreme and will naturally prove to be unpopular as it was when it was introduced in Scotland. However, preliminary evidence has also suggested that it has proven that it has reduced the death toll in our northern brethren, so perhaps it is worth the minor inconvenience.
The main issue I have with this measure is that it seems to be misguided. Any measure centred around fiscal measures will always target those who are less well off more heavily than those who have more expendable income, but alcoholism is not an issue which is currently class-dependent. In fact, alcohol addiction currently shows little-to-no relationship to class, whilst excessive drinking is actually far more common in the higher socio-economic groups than those with less income. As such, I feel that – at present – this is little more than an underhanded additional tax on the poor, and that the issue should be addressed through a different means. When the problem is one which is far more prevalent in the ‘rich’ it hardly makes sense to address it in a financially centred way.
So, is there a way in which we might achieve the same ends (reducing the cost, both in terms of money and human life) without resorting to such means. Part of the issue is naturally awareness, and so one might argue that it would be far better to target such issues through a public health campaign. One of the problems with drinking is the combination of its social acceptability and the culture which has developed around binge drinking. In my experience, there is a large number of people (and especially younger people) who drinking not socially, and not because they enjoy drinking, but simply in order to get drunk. This, in itself, is a dangerous prospect and not one which a financial restriction is likely to prevent (naturally, when they’re ‘on the lash’ money soon becomes no object).
In a strange way, there is a parallel between drinking this century and smoking in the last. Smoking progressively changed from something which had been historically and culturally acceptable – and even associated with better health – to something which was identified as being hugely problematic and in need of intervention. This was achieved through a combination of better public education in addition to sanctioning of the companies profiting in the wake of addiction, and better regulation of the ways in which they were allowed to advertise. We slowly learnt – as a nation – that just because something has become integrated into our culture it does not mean that its addition has to be permanent, or that it does not need to be restricted in order so we might save ourselves from ourselves. Granted, the drinking of fermented fruit has a much richer history – at least within the UK – than that of smoking dried leaves, but this does not mean that its use should not be discouraged (or, at least, encouraged to be done responsibly).
So, if a financial restriction is not going to prove effective then what other options might be available to us? Well, what about a physical restriction? Instead of supermarkets being able to line their shelves with bottles of booze, why not take it out of the hands of supermarkets entirely by imposing a restriction on the size of a store which is able to stock alcohol? Or, why not require all alcoholic beverages of greater than a certain proof (i.e. spirits) to be sold from behind a counter (such as is the case with cigarettes)? Unpopular though this method may be, by making it more difficult to purchase alcohol – or at least more time-consuming – a reduction in the drinking of the nation might be achieved without resorting to yet another tax on the poor.