Cautious optimism

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Screen shot 2014-12-01 at 14.34.10Just because minimum pricing is on the back burner doesn’t mean it’s time to get despondent, hear delegates at Alcohol Concern’s annual conference

‘I think we’re actually in a better place to reduce the harm from alcohol than we have been for some time,’ Alcohol Concern’s president, Professor Sir Ian Gilmore, told delegates at the charity’s annual conference, Facing our alcohol problem: taking back our health and high street.

‘As professionals, our messages are much more joined-up and complimentary than they were a few years ago,’ he said, plus there was much better sharing of evidence internationally and the media and public were more onside. ‘Just because MUP [minimum unit pricing] has rolled into the long grass in Westminster and become becalmed in Brussels regarding Scotland, I don’t think we need to be depressed.’ It was a matter of ‘being ready on all fronts’, he stressed.

Two key fronts, however, were the general public and treatment services. In terms of the former, ‘If you put it in the context of city centres and children being safer then they do get it’, and a crucial area to focus on was harm to others. ‘The harm to third parties is hugely greater than with passive smoking, which was what helped to swing public opinion there.’ Regarding treatment services, it was vital to keep emphasising that they were ‘incredibly good value’ in terms of the cost savings to the system, and also to ‘do a really good PR job on our colleagues’, he told delegates. ‘There’s still a huge stigma around alcohol dependence.’

There was ‘no doubt’ that patients were suffering because of a ‘judgemental and nihilistic’ approach on the part of some professionals, agreed Dr Michael Glynn, NHS England’s national clinical director for GI and liver disease. ‘There’s this sense of “well, you can’t do anything for them”. There’s still a long way to go in terms of changing attitudes.’ It was also essential that every health professional should be vigilant, he stressed. ‘Everyone has to understand that they can make a difference – the concept of “every contact counts”. Anybody involved in health – and other professionals – can give an intervention, even with very little training.’

‘Too often the debate on alcohol is a debate on anti-social behaviour, rather than public health and prevention,’ said shadow public health minister Luciana Berger. ‘It’s not like we’re short on evidence on the damage that alcohol does.’

The government’s responsibility deal showed that it was too close to vested interests to take the necessary action, she told the conference. ‘There’s a difference between listening to the concerns of industry and being dictated to by them,’ with the scale of the challenge too great to rely on a ‘non-binding and piecemeal’ deal. Labour’s approach would be to put the ‘needs of the population, not industry’ first, she said, with targeted action on pricing, labelling, licensing and education.

Although a Labour government would ‘strengthen efforts’ on higher-strength, low-cost products, when questioned on minimum pricing she said that her party was considering ‘a range’ of options. ‘We don’t think MUP as currently modelled is the way to go on this, but we’re looking very carefully at this issue.’ Labour was, however, committed to reviewing the licensing system and making public health a mandatory factor in licensing decisions.

Presenting the government’s view, new crime prevention minister Lynne Featherstone told the conference that MUP was ‘not permanently off the table, but we didn’t feel it was sensible to proceed while it’s being challenged in the courts’ regarding Scotland.

The government had ‘challenged the industry to do more, and it has responded’, she stated, with six new responsibility deal pledges over the summer (DDN, August, page 4). ‘We also want to cause a cultural shift in the nation’s attitude to alcohol,’ while moving public health to local authorities presented ‘tremendous opportunities’, including the framework for ‘commissioning the right sort of responses’ to alcohol problems. ‘There’s a massive appetite for partnership working and local solutions.’

In terms of tackling promotion it was vital that adverts were not targeting young people directly and ‘encouraging them to be part of an unhealthy drinking culture’ said Chante Joseph of the Youth Alcohol Advertising Council (YAAC), with social media in particular ‘pushing the boundaries’.

‘A lot of companies will target university students during Freshers’ Week, for example,’ she said. ‘A lot of it is incredibly inappropriate, and there are no real deterrents.’ Advertising regulations also were ‘weak and vague’, such as ‘not using actors under 25 – it’s these vague codes that allow them to tackle young people’. 

‘We’ve learned with tobacco that the only way to deal with the problem is to take away the marketing,’ said Professor Gerard Hastings of the University of Stirling. ‘It’s like trying to deal with malaria without trying to deal with the mosquito. If we’re really serious about this then the only solution is an outright ban.’

The problem was ‘power’, he told the conference. ‘Massive companies that are so large they no longer just control us as consumers, they control our leaders as well. Corporations have the power to ignore, make up and break the rules, and with social media they now have the power to be my mate. More and more, they have the power to create our realities.’

Marketing became toxic when wedded to the massive power of corporate alcohol, he said. ‘We desperately need red lines. We have to get serious and say, “marketing is driving this problem. The only solution is to remove marketing.” The lesson from tobacco is that half measures just don’t work, so we need to absorb some of that ruthlessness of the corporate sector and be really single-minded and determined about what we want and where we’re going.’