Reducing harm caused by alcohol


Scotland has so much to gain from reducing how much we drink

I recall writing in my Chief Medical Officer’s annual report of 2005 that Scotland was seeing early signs of shedding its ‘Sick Man of Europe’ tag. The most significant measure in a generation to improve the nation’s health - the ban on smoking in public places – had just been passed and I sensed the start of a wider cultural change that good health was something to be enjoyed. However, I also cautioned that there were serious and growing health challenges facing us and in particular, alcohol and health inequalities.

In 2005, more than 1,500 Scottish men and women lost their lives because of alcohol – that’s 29 people on average every week that year. Now the figure is 22 alcohol-related deaths per week - think of all the players in a football match dying of alcoholic liver disease and other conditions every single week. While we have made some progress, every one of these is a tragic, premature and most importantly, preventable death. What’s more, people living in the poorest communities of Scotland are six times more likely to die because of alcohol than those in more affluent areas.

Whether we’re talking about alcohol, gambling, obesity or physical activity, we need to consider how all of our high streets and neighbourhoods can support good health rather than contributing to ill-health. For example, we know that deprived areas have 40% more places to buy alcohol than more affluent areas. The more widely available and easily accessible alcohol is, the more we drink and the more harm will be caused.

Global Alcohol Policy Conference

As Chair of Alcohol Focus Scotland, one of my proudest moments was welcoming alcohol campaigners, researchers and health professionals from all over the world to Edinburgh last October. Scotland was chosen to host the Global Alcohol Policy Conference (GAPC) because of the progressive approach that we have been taking to addressing alcohol harm, particularly in pursuing minimum unit pricing.

It was evident at GAPC that while drinking levels and patterns vary considerably around the world – in fact almost half of adults in the world have never consumed alcohol – rising consumption is a growing threat in most regions. This is being driven by a powerful global alcohol industry which is recruiting drinkers in new markets with products backed by big budget marketing campaigns. The global industry acts quickly to block or at least delay effective alcohol control policies because they are so concerned about losing any of their substantial profits. They copy the tactics of Big Tobacco, and do not hesitate to put their profits and the interests of their shareholders above the good of public health.

Minimum unit pricing

Here in Scotland, global corporations fronted by the Scotch Whisky Association, have taken the Scottish Government to court over minimum unit pricing, delaying the implementation of the bold legislation passed by the Scottish Parliament on this issue by more than three years now. Setting a floor price below which alcohol cannot be sold will prevent an estimated 1,600 hospital admissions, 3,500 crimes and save 60 lives in the first year alone. I am so disappointed that this policy has still not been put in place; the Scotch Whisky Association’s challenge is absolutely inexcusable.

Beyond minimum pricing, there are other things we can do to reduce the impact of alcohol in Scotland and especially to protect the next generation. For example, it is deplorable that our children are exposed to so much alcohol marketing as they go about their daily lives.

There is strong evidence that the more advertising messages they see, the more likely they will be to start drinking and to drink more if they are already drinking. Despite the efforts of the alcohol industry to portray it as just part of the weekly shop, alcohol is an addictive, toxic, age-restricted product.  Why, then, do we allow alcohol brands to reach under 18s through sophisticated advertising campaigns, sports and festivals sponsorship and celebrity endorsements? Scotland could and should take steps to protect our children from exposure to alcohol marketing.

Scotland has made great strides in reducing tobacco use. The health benefits to all of making public places smoke-free are priceless and Scotland’s action on tobacco control shows we can be bold when it comes to protecting and improving public health. But we must remember that alcohol too is an addictive, carcinogenic product which causes thousands of premature deaths and which impacts on innocent bystanders. 

If we want to reduce cancer, liver disease, cardiovascular disease, injuries, and mental health problems, we need to step up our alcohol control efforts. Scotland has so much to gain from reducing how much we drink.

As I step down as Chair of Alcohol Focus Scotland, I know that I am leaving a well-led organisation with a wonderful staff supported by a committed Board. They will continue to work with the whole public health community in Scotland to change Scotland’s relationship with alcohol and improve the nation’s health.

Dr Mac Armstrong CB
Chair, Alcohol Focus Scotland