Working to reduce alcohol harm

Measures

Public Health (Alcohol) Bill – Main Measures

Labelling

Consumers should have the right to make informed decisions about the products they purchase, especially those, such as alcohol, which are potentially harmful to their health.

Health warnings are now a familiar and prominent feature on tobacco products in Ireland, while detailed nutritional labelling is ubiquitous on food products and soft drinks. However, consumer information on alcohol products at the moment generally extends no further than its volume strength (ABV).

That the health labelling of alcohol products is included in the Public Health (Alcohol) Bill is important for a number of reasons. Firstly, to track our alcohol intake it is essential that we have accurate information on the alcohol content of specific drinks.

It is important to know how much we are drinking if we are trying to stay within the low-risk weekly guidelines for alcohol consumption and it becomes even more important to track our alcohol intake when you consider that the most comprehensive survey of alcohol consumption ever carried out in Ireland revealed that we underestimate what we drink by about 60%.

Labelling will also help drinkers understand the health risks associated with alcohol, such as those associated with drinking during pregnancy. The level of public awareness or understanding of many of the health problems associated with alcohol consumption, such as the cancer risk, are quite low, as is awareness of the amount of calories contained in alcohol products.

The Public Health (Alcohol) Bill states that labels on alcohol products will have to detail:

    • A health warning to inform the public of the danger of alcohol consumption.
    • A health warning to inform the public of the danger of alcohol consumption during pregnancy.
    • The quantity of grams of alcohol contained in the product.
    • The number of calories contained in the alcohol product.
    • A link to a public health website, to be set up by the HSE in 2016, giving information on alcohol and related harms.

As well as the labels on alcohol products themselves, those selling alcohol, whether in pubs or the off-trade, will be required to display a notice containing the health warnings mentioned above, the link to the public health website, and indicating to the customer that the alcohol and calorie content of alcohol products is on the products themselves or, for all ’poured drinks’, can be found in a document, which must be made available upon request.

Following a consultation conducted by the Department of Health, it has been decided that there will be a three-year transition period before manufacturers and retailers of alcohol products will have to comply fully with the labelling requirements.

Availability

The Public Health (Alcohol) Bill contains a provision for structural separation of alcohol products in mixed retail outlets, such as supermarkets and convenience stores, which will mean that they will no longer be displayed like ’every day’ or ’ordinary’ products, such as bread or milk.

Retailers will have to choose to store alcohol either in a separate area of the store, or in a closed storage unit or cabinet which contains only alcohol products. Alcohol products behind check-out points will need to be concealed. Point of sale advertising of alcohol products will now be confined to the designated display area or the inside of the storage cabinet.

If a premises which sells alcohol products chooses to separate the alcohol from other products by confining the sale of alcohol to a single area in the premises, it must ensure that:

  • It is separated from the rest of the premises by a physical barrier, through which alcohol products and advertisements for alcohol products are not readily visible to members of the public
  • Members of the public do not have to pass through that area in order to gain access to or purchase any products other than alcohol product

If a premises which sells alcohol products chooses to use a closed storage unit containing only alcohol products, it must ensure that:

  • The storage unit is not accessible to the public
  • It doesn’t contain any advertisements for alcohol products
  • Alcohol products are not visible to members of the public and the storage unit remains closed when not in use

Restricting the physical availability of alcohol is a critical component of any evidence-based approach to reducing consumption and consequently alcohol harm. Greater ease in obtaining alcohol is associated with greater amounts being consumed and the majority of alcohol sold in Ireland is now sold through the off-trade, rather than in pubs.

Alcohol is not an ordinary consumer product and this is recognised by the State through the fact it needs a license to be sold and is subject to specific excise duty. However, despite being a licensed product and recognised as a drug, when it comes to selling alcohol in Ireland currently, it is largely treated like a regular grocery.

Alcohol is sold to consumers by utilising what is termed the ’marketing mix’: product, price, place and promotion. The number of places where people can buy alcohol has increased dramatically in the past 20 years and it is now available from almost every supermarket, convenience store and petrol station in Ireland.

Retailers also create opportunities for impulse purchases through placement of alcohol opposite or near checkouts rather than create conditions whereby the purchase of alcohol is a more conscious and planned decision.

As well as driving sales, this product placement reinforces the perception that alcohol is an ordinary consumer good. Alcohol is sold alongside food and other everyday goods, which has the effect of categorising alcohol as just another commodity, another item in the family shopping basket. This has a particular impact on children.

However, alcohol is not an ordinary product and the Public Health (Alcohol) Bill will ensure that this reflected in appropriately restricted availability, display and sale arrangements for mixed retails outlets, such as supermarkets and convenience stores.

The legislation will replace a current voluntary code in operation by the Responsible Retailers of Alcohol in Ireland (RRAI), which has proven unfit for purpose, as reflected by the clear, existing lack of separation of alcohol products in mixed trading premises throughout Ireland. Not only has this code not worked, but it is designed in a way that it simply cannot work.

The RRAI code is not and cannot be effective in achieving the separation of alcohol, structural or otherwise, from other beverages, food and other items in mixed trading premises. The key reason for its incapacity to effect separation is due, in the main, to the use of the term “as far as possible” in the code.

The RRAI code states that:

Alcohol products will, as far as possible, be displayed only in a part of the premises through which customers do not have to pass in order to obtain access to other beverages and food products (except where, for security reasons, such products are displayed behind the counter but not in the window). Alcohol products will be confined to that one part of the premises and will, as far as possible, be separated from other beverages and food products.

This term “as far as possible” means mixed retailers simply do not have to display alcohol in a separate part of the premises from other beverages and food products. It also provides an easy opt out which many chose to take, with very weak sanctions for non-compliance.

It should also be noted that many mixed retail outlets in Ireland are not RRAI members and only legislation will can achieve the aim of structural separation of alcohol products in mixed retail outlets in Ireland, such as supermarkets and convenience stores. The legislation will be monitored and enforced by Environmental Health Officers.

Price-based promotions

Price-based promotions are used extensively in Ireland to attract customers, with young people particularly price-sensitive and often targeted by these promotions.

These can range from promotions such as reduced drinks prices on certain nights for students or those targeted at other groups, as well as price-based promotions which extend for certain periods of time.

Offers that promote reduced prices depending on the number of drinks purchased, i.e. quantity discounts, are also commonplace in the on and off-trades.

Price-based drinks promotions like these are often aimed at young people and encourage the type of harmful binge drinking that is such a threat to their health and wellbeing. The primary purpose of regulating price-based promotions is to reduce the health harms from alcohol, but it can also have a positive impact on alcohol-fuelled crime, such as public order offences.

The Public Health (Alcohol) Bill allows the Minister to make regulations for prohibiting or restricting the:

  • Selling or supplying alcohol products free of charge or at a reduced price to a particular category of people.
  • Selling or supplying alcohol products during a limited period (three days or less) at a price less than was being charged for those same products the day before the offer began.
  • Selling or supplying alcohol products free of charge or at a reduced price to someone because they have bought a certain quantity of alcohol products or any other product or service.
  • Promoting a business or event in a way that it intended or likely to cause people to drink in a harmful manner.

The Bill states that the provisions regarding price-based promotions also include the award, directly or indirectly, of bonus points, loyalty card points or similar benefit for purchasing alcohol products, which can be used to obtain alcohol products or other products or services free of charge or at a reduced price.

Similarly, these schemes where ’points’ etc are awarded for the purchase of other products or services cannot then be used to obtain alcohol products free of charge or at reduced prices. The legislation will be monitored and enforced by Environmental Health Officers.

Marketing

Alcohol marketing, including advertising, sponsorship and other forms of promotion, increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol. Young people’s drinking patterns have a direct effect on their health, development and welfare. Therefore reducing children’s exposure to alcohol marketing is a child protection issue.

Yet every day, in numerous ways and through numerous media, children and young people in Ireland are continuously exposed to positive, risk-free images of alcohol and its use. Due to a lack of effective regulations, young people are poorly protected from these sophisticated and powerful influences on their drinking behaviour and expectations.

They are bombarded with positive images of alcohol through marketing of brands and products – in effect, the alcohol industry has become a child’s primary educator on alcohol. Marketing can shape youth culture by creating and sustaining expectations and norms about how to achieve social, sporting or sexual success, how to celebrate, how to relax and how to belong. The failure to protect children from exposure to alcohol marketing is associated with earlier and increased alcohol consumption.

The Public Health (Alcohol) Bill contains a number of important regulations that will reduce children’s exposure to alcohol marketing and move us away from many of the existing systems of industry self-regulation and voluntary codes, which have proved completely ineffective and are without meaningful sanction.

Breaches of the regulations governing alcohol marketing contained in the Public Health (Alcohol) will be subject to prosecutions under the criminal justice system. Some of the main regulations regarding advertising products in the Bill are:

  • Advertisements must only give specific information about the nature of the product, such as where it is from, its price, a description of the taste etc
  • Advertisements must contain health warnings regarding alcohol consumption, including during pregnancy, and a link to a public health website, to be set up by the HSE in 2016, giving information on alcohol and related harms.
  • Advertisements in cinemas will be limited to films classified as over 18s
  • There will be a 9 p.m. broadcast watershed for advertisements on television and radio
  • The marketing and advertising of alcohol in print media (both domestic and foreign publications) will be restricted in relation to volume and type of publication (e.g. no more than 20% of advertising space for alcohol products)

Restricting advertisements for alcohol products to content about the nature of products will mean that advertisements will be less likely to glamourise alcohol or making it appealing to children, as they will no longer see alcohol products aligned with physical performance, personal success, social success and a variety of other positive outcomes.

Similar restrictions on alcohol advertising content have been successfully in place in France since 1991, though the French laws go much further than what is proposed in Ireland and provide for no alcohol advertising on television or in cinemas, and no sponsorship of cultural or sporting events.

To further protect children from exposure to alcohol marketing, the Public Health (Alcohol) Bill will prohibit advertising in certain places, including:

  • in or near a school
  • in or near an early years service (e.g. crèche)
  • a park, open space or playground owned or maintained by a local authority
  • on public transport
  • in a train or bus station, and at a bus or Luas stop.

In relation to the schools, early years services and playgrounds, alcohol advertisements must not be within 200 metres of the perimeter of the premises or grounds. A restriction on merchandising of children’s clothing which promotes alcohol consumption or bears the name of an alcohol brand or product is also included in the Bill.

While it does not ban alcohol sponsorship of sport, the Bill prohibits advertising in sports grounds for events where the majority of competitors or participants are children or directly on a sports area for all events (e.g. on the actual pitch, the race track, tennis court etc.)

Minimum unit pricing

Minimum unit pricing (MUP) is a ’floor price’ beneath which alcohol cannot legally be sold and is based on the amount of pure alcohol in a product, measured in grammes. One standard drink in Ireland contains 10 grammes of alcohol and the Public Health (Alcohol) Bill provides for an MUP of €1 per standard drink.

MUP is a targeted measure, designed to stop strong alcohol being sold at very low prices in the off-trade, particularly supermarkets, where alcohol is frequently used as a ’loss leader’ and sold below cost. The easy and widespread availability of such cheap alcohol has contributed to a dramatic shift in our alcohol purchasing and consumption habits from pubs towards the off-trade sector, which now accounts for the majority of alcohol sold in Ireland.

MUP is able to target cheaper alcohol relative to its strength because the price is determined by and directly proportionate to the amount of pure alcohol in the drink. The MUP of €1 will not affect the price of any alcohol products in pubs, clubs and restaurants, but which will raise the price of the products that are cheap relative to their strength in the off-trade: So, for example:

  • a pint of Heineken (5% ABV) would have an MUP of €2.25.
  • a pint of Budweiser (4% ABV) would have an MUP of €1.80.
  • a measure of Paddy Irish whiskey (40% ABV) would have an MUP of €1.12.
  • a measure of Huzzar vodka (37.5% ABV) would have an MUP of €1.05.
  • a 500ml can of Guinness (4.2% ABV) would have an MUP of €1.66.
  • a 500ml can of Devil’s Bit Cider (6% ABV) would have an MUP of €2.37.
  • a 500ml can of Dutch Gold (4% ABV) would have an MUP of €1.58.
  • a 440ml can of Tesco lager (3.8% ABV) would have an MUP of €1.32.
  • a 700ml bottle of Jameson whiskey (40% ABV) would have an MUP of €22.09.
  • a 750ml bottle of Jacob’s Creek Classic Chardonnay (12.7% ABV) would have an MUP of €7.52.
  • a 1,000ml bottle of Smirnoff vodka (37.5% ABV) would have an MUP of €29.59.

The targeted approach of MUP is important as the strongest, cheapest drinks are the alcohol products generally favoured by the heaviest drinkers among us, who generally seek to get as much alcohol as they can for as little money as they can and are most at risk of alcohol-related illnesses and death.

They are also favoured by our children and young people, who generally have the least disposable income and have the highest prevalence of binge drinking, putting their health and wellbeing at great risk.

An analysis of the expected impact of MUP in Ireland, commissioned by the Department of Health, found that it would only have a small impact on the alcohol consumption of those who drink in a low risk manner, increasing in line with how much a person drinks, with those who drink in a high-risk manner experiencing a significant reduction in their alcohol consumption.

As a result, MUP would be effective in reducing alcohol consumption, alcohol harms, including deaths, hospital admissions, crime and workplace absences, and the costs associated with those harms.

The analysis estimated that with a €1 MUP, alcohol-attributable deaths would be reduced by approximately 197 per year in Ireland after 20 years, by which time the full effects of the policy will be seen, due to the time-lag involved with many serious alcohol-related illnesses, such as liver cirrhosis and alcohol-related cancers.

We would also see almost 6,000 fewer hospital admissions per year, a reduction in alcohol-fuelled crime and workplace absences, while the total societal value of these reductions in health, crime and work place harms is estimated at €1.7 billion.

Research findings on the minimum pricing systems operating in two Canadian provinces show the effectiveness of a MUP in reducing alcohol consumption and related harms. In Saskatchewan province in Canada a 10% increase in the MUP was associated with an 8.4% decrease in total alcohol consumption. In British Columbia a 10% increase in the minimum price was associated with a 32% fall in wholly alcohol related deaths and decreases of 19% in alcohol-related traffic offences and 9% in crimes against the person.

The benefits of MUP

  • It will save lives.
  • There will be a reduction in alcohol harm for both the person drinking in a high-risk manner and those around them.
  • It will reduce alcohol-related hospital admissions.
  • It will reduce alcohol-related crime.
  • There will be a decrease in workplace absences due to alcohol.
  • There will be a reduction in the costs of alcohol harm to the State and taxpayer.
  • Those who drink within low-risk limits are least likely to be affected in terms of alcohol consumption and spending, regardless of income levels.
  • Large multiple retailers will not be able to simply absorb price increases, as can happen with other pricing policies (e.g. excise duty).
  • It will not affect the price of alcohol products in pubs, clubs and restaurants.
  • It will not affect alcohol exports or lead to job losses.
  • It will not influence rates of cross-border shopping, as Northern Ireland also plans to introduce MUP, in conjunction with the Republic of Ireland. Discussions are ongoing between both jurisdictions on the matter.

You can read the Public Health (Alcohol) Bill in full here.

The Regulatory Impact Analysis (RIA) of the Public Health (Alcohol) Bill can be read here.