Working to reduce alcohol harm

The Public Health (Alcohol) Bill will save lives, reduce harms, alleviate public services and release scarce public funds for greater socio-economic benefit.

The Public Health (Alcohol) Bill is a progressive piece of legislation designed to significantly and positively alter Ireland’s harmful relationship with alcohol. It will ensure that alcohol misuse is treated as a serious public health problem.

The legislation is part of a wider range of reasonable and pragmatic measures under the strategic framework of Healthy Ireland, which aims to improve the nation’s health and wellbeing. It will seek to reduce our per capita consumption from 11.46 litres in 2016 to 9.1 litres for every person over 15 and over, by 2020.

By reducing our alcohol consumption, we will reduce alcohol harm across our communities; by targeting the protection of children and young people, we can ensure a healthier outcome for future generations.

Recently, a report from DKM Economic Consultants, commissioned by the Alcohol Beverage Federation of Ireland – a representative organisation for alcohol drinks manufactures and suppliers – queried the impact of the proposed legislation, and highlighted the concerns of the alcohol industry.

The following observations outline our strong belief that these measures, taken together, will provide a practical, pragmatic means to achieving a reduction in alcohol consumption so reducing alcohol harms and the related socio-economic impact.

 

An overview of the Economic and social impact of alcohol consumption and related harms in Ireland:

  • The annual cost of alcohol related illness and harm costs the Irish exchequer €1.5bn, that is over 3% of all public current expenditure;
  • €2.35bn assessing a wider set of cost implications to other aspects of impact to current public expenditure in Justice, Children, Social Protection.
  • The cost of excessive alcohol consumption is a major drain on current public expenditure: Health, Justice, Social Protection; it is estimated that for €100m of public monies spent, €4.6m will be deployed to mitigate the harmful outcomes of alcohol consumption.
  • Over 12% of the health current expenditure budget is spend on alcohol related illnesses.
  • Every day, 1,500 beds in our hospitals are occupied by patients with alcohol related problems.
  • 283,866 work days were lost to alcohol related absenteeism in 2016 at an immediate cost to the domestic economy of €45.2m
  • Every day 3 people will die from alcohol related illnesses.
  • Each year 60,000 children will unnecessarily begin their, all too early, lifelong drinking careers.
  • The life of one in every eleven children are being negatively impacted by parental drinking.
  • Alcohol is a factor in half of all suicides in Ireland.

 

Alcohol consumption in Ireland

  • Alcohol consumption in Ireland increased during 2016.
  • The figures show that per capita alcohol consumption was 11.46 litres of pure alcohol per person aged 15+ in 2016, an increase of 4.8% from 2015, when it was 10.93 litres (Revenue Commissioners 2017).
  • Since 1960 Ireland’s alcohol consumption has increased threefold.

The Healthy Ireland survey (Ipsos MRBI: 2015) found that “drinking to excess on a regular basis is commonplace throughout the population”. It states that, “Four out of ten drinkers in Ireland drink to harmful levels, on a monthly basis, with over a fifth doing so on a weekly basis. This behaviour is evident throughout the population and is not specifically limited to particular groups. Given that 1 in 6 of those drinking at harmful levels felt in the past 12 months that their drinking harmed their health, it is likely that many of those drinking in that way are unaware of the risks associated with it”.

 

Minimum Unit Pricing

Minimum Unit Price (MUP) is a targeted measure designed to stop strong drink with the highest alcohol content being sold at the lowest price. The easy and widespread availability of such cheap alcohol has contributed to a dramatic shift in our alcohol purchasing and consumption habits from pubs to the off-trade sector.

  • MUP will not affect the price of alcohol products in pubs, clubs and restaurants with no mitigating circumstances to domestic industries or exporters.
  • As an instrument of public policy, a joint approach between both Governments on the island of Ireland has been agreed on its commencement, so avoiding any unintended consequences, particularly in relation to cross border shopping.
  • MUP will largely have no impact on the price of the seven alcohol products currently within the Central Statistics Office’s CPI rebase, Basket of Goods and Services (100)

This measure will introduce a minimum price per gram of alcohol – each product contains a gram quantity of alcohol, for example a typical can of beer has 16 grams; a can of cider 23 grams; a bottle of wine 74 grams, etc., A cheap bottle of whiskey (70cl/221grams) currently priced €15.99 under the proposed MUP (0.10c per gram) would cost €22.09.

Research findings on MUP systems operating in Canadian provinces demonstrate the effectiveness of the measure in reducing alcohol consumption and related harms. Specific studies on the measures impact indicate that alcohol prices in the off-trade would increase 29%. This in turn would lead to an overall decrease in consumption of 8.8%.

 

Alcohol marketing and promotion

  • Evidence based research, both internationally and nationally, has demonstrated that alcohol marketing including advertising, sponsorship and other forms of promotion, increases the likelihood that children will start to use alcohol, and to drink more, if they are already taking alcohol.
  • This consumption will have a direct effect on their health, development and welfare. So, reducing children’s exposure to alcohol marketing is a significant priority of child protection.

Everyday children and young people are continuously exposed to positive, risk free promotion of alcohol and its use.

  • In 2016, alcohol companies in Ireland spend nearly €1m per week on direct advertising campaigns, a 18.6% increase from its 2012 spend (2016: €47.03m; Nielsen Media Research).
  • The Irish Sponsorship market is expected to show a 6% growth to €173 million in 2017 with more than half of Sponsors planning to increase spend on sponsorship in Ireland during the year. (Onside)

This tsunami of imagery and brand positioning has largely become a child’s primary educator on alcohol awareness.

The Public Health (Alcohol) Bill contains a modest set of regulations that will establish a robust statutory regime, so making redundant the current ineffective self-regulation, and voluntary code, of industry.

Future product advertisements must only give specific information about the nature of the product such as its origins, price or taste description. This will ensure that advertising is no longer emotive or glamorising, and that product engagement is not aligned to physical performance, personal and social success, or other perceived positive outcomes.

All alcohol advertising will have to contain health information and harm warnings. There will be a 9pm broadcast watershed for alcohol advertising on television and radio.

To further protect children from exposure to alcohol marketing the legislation also prohibits advertising in certain places such as proximity to schools and early learning services; park and playgrounds, public transport and route designated access points.

Additionally, a range of regulations to prohibit and restrict price based promotions for alcohol products will be introduced.

 

Labelling

  • Citizens must have the right to make informed purchasing decisions about the products they consume, which are harmful to their health.
  • Label content has been effective in increasing health knowledge and perception of risk, especially amongst young people.
  • The cost impact to alcohol producers is nominal as all product housed within a container, must carry some label. The changes envisaged within the legislative measures, which have a three-year transition period of compliance, would merely require an addition to, or redesign of existing content, and not any further material resource.

The underlying evidence is that introducing health labelling, where none currently exists, will provide a significant symbolic message about known harms. It will increase consumer awareness of the harmful effects and so modify drinking behaviours, resulting in prevention, and a reduction of adverse outcomes, associated with alcohol misuse. Public health warnings on labels have proven to be effective on tobacco products in terms of increasing awareness of harmful effects and modifying cultural behaviour.

 

Product Separation

  • The reasonable measures proposed will not prevent current retail outlets from continuing to sell existing, or new, alcohol products from their premises.

The mass availability of alcohol products in our shops, is facilitating our high consumption of alcohol. The ubiquitous presence of alcohol, even on the most routine shopping trip, has enabled an adult population to casually, and impulsively, purchase alcohol products in the same manner as every day grocery items. However, alcohol is not an everyday grocery. Its impact on the individual and the wider community is known, and as such, the retailer requires a state licence to sell.

To break this ubiquity, and to re-establish an environment for considered purchasing, the changes envisaged within the legislation will ensure that alcohol products sold in mixed retailed outlets will be appropriately restricted by physical barrier. The changes, which have a one-year transition period for compliance, also state that alcohol products and promotion are not readily visible to the shopping public, and that the public do not have to pass through the area to gain access to, or purchase, any other products.

 

Drinking alcohol is an individual choice however collectively, as a society, there are significant social and economic impacts to our current excessive behaviour. Undoubtedly, in free, open market economy, business must have the freedom to develop and prosper. And, while citizens must take responsibility for own actions, society and our government, cannot rely on this approach alone as it grapples with the consequences, costs and impact of high alcohol consumption and the related harmful outcomes.  Over two generations Ireland’s consumption has increased threefold, and is continuing to rise.

In Ireland today, we face a growing chronic disease crisis as cancer, heart disease, liver disease and diabetes now accounts for the most of our ill-health and premature deaths. This crisis places a very heavy burden on our scarce health services and limited public resources.

The market will not resolve our problem. The state must have the right to protect its citizens, especially its children. International agencies and evidence based research dictates that public action must be taken to curb our excessive levels of alcohol consumption and that the rights of private economic interests must be rebalanced to allow for a structured public intervention.