Working to reduce alcohol harm

Making the healthy choice an easier one will not turn Ireland into a Nanny State

People looking at the recently published Nanny State Index would do well to ask who really has their best interests at heart before accepting that Ireland is one of ‘the worst places in the European Union to eat, drink, smoke and vape’.

This index has been compiled by free-market lobby groups, the Institute of Economic Affairs and the European Policy Information Centre. If it is to be taken seriously, one first has to accept that all regulations governing food, alcohol and smoking are inherently bad regulations. The index does not address why these regulations were introduced or what benefit they bring to individuals, families and wider society.

Ireland is penalised by the index for the introduction of life-saving measures, such as the smoking ban and our drink driving legislation. It tells us we should be ashamed of regulations such as protecting children from exposure to tobacco and junk food advertising.

Of course, if all these pesky regulations were removed in the morning and we dropped down the Nanny State Index, what would happen? We’d be fine, apparently, as personal responsibility would take over.

While it is undoubtedly important that we take responsibility for our own behaviour, this approach completely ignores both the influence of the environment we live in and the harm that our behaviour causes to others and society as a whole. Ireland has a chronic disease crisis that is being driven by our smoking, drinking and eating habits, as well as a lack of physical activity. Chronic diseases, such as cancer, heart disease, liver disease and diabetes, now account for the majority of ill-health and death, as well as putting an enormous burden on our health service that has crippled its ability to function effectively, leaving hundreds of people on trolleys and waiting for months on end for procedures.

This increasing burden of disease is not due to an epidemic loss of willpower or an abdication of personal responsibility. People have not changed dramatically in recent decades, but the environment in which they grow up and live has, making it far more likely that they will be unhealthy due to their significantly altered lifestyles and consumption habits. This was made starkly obvious by shocking new obesity figures published in recent days.

As weight loss expert Dr Yoni Freedhoff has pointed out, “the longer we retain the trope of personal responsibility as the foil to the forces that torrentially push us into the arms of illness, the longer we as a society will remain ill. When there’s a flood knowing how to swim is all well and good, but even the strongest swimmers will tire if the current doesn’t abate. While there will always be a role for personal responsibility, we need to do something about this current.”

We need to make the healthy choice an easier one.

Regulation is important to protect and promote public health as we cannot build an environment that supports people and their families to lead healthier lifestyles while ignoring the influence of the tobacco, alcohol and food industries (supported by the advertising and retail sectors) on our daily lives.

In the drive for increased consumption of unhealthy products these industries often step well beyond their remit and use their considerable power to influence the policy and legislative process in favour of their business interests. Attempts to protect and promote public health are fought relentlessly, from lobbying to legal action, and the State is denounced as a ‘Nanny’ for putting the interests of its citizens first.

One of the main reasons the State must act is that while decisions to smoke, drink alcohol and what to eat are individual ones, we simply can’t pretend that these decisions don’t have significant social and economic impacts that affect every single taxpayer and user of our health service – and that’s before you count the huge personal costs.

An Irish family who lost a loved one due to the actions of a drink driver would take little comfort from being told our stringent legislation is being relaxed in favour of personal responsibility. The thousands of Irish children whose lives are negatively impacted every day by the harmful drinking of a parent would hardly cope better if it were explained to them that this decision to drink is their parents and theirs alone. The many innocent victims of alcohol-fuelled crime are unlikely to feel any better if it is explained to them that they are in fact free market casualties.

The Nanny State critics are also very inconsistent in how they apply their concept of State interference, with interventions on behalf of industry seemingly never deemed to be ‘Nanny State’. For example, why does this index not penalise Ireland for the billions of euro worth of bank debt transferred to generations of taxpayers, but does penalise us for the fact that our pubs have designated closing times?

It is because the ‘Nanny State’ label seeks to exploit a fear of government regulation and restriction of personal freedoms to ensure that profit continues to be prioritised over public health, no matter what the cost. There are few things more limiting to personal freedom than ill-health and the poorer you are, the greater your chance of ill-health and the worse your health outcomes.

Nanny State critics invariably champion exactly the type of economic policies that deepen these inequalities and then call on the State not to get involved to help those communities worst affected. However, it is the job of a government to strike a balance between preserving our personal freedoms and the need for regulation, a balance that is good for both the economy and our society.

This piece by Conor Cullen, Head of Communications and Advocacy at Alcohol Action Ireland, was published in the Irish Independent.