Seanad Statement
Alcohol Awareness and related issues
Minister for Health – Leo Varadkar, T.D.
12th May 2015
Introduction
I would like to thank the House for raising this issue and giving me the opportunity to discuss it.
Alcohol Misuse
Ireland has a serious problem – we drink too much overall and binge drink a lot. In spite of what we might like to think, alcohol is not abused by a small minority of individuals – the majority of people who drink do so in a harmful way. Our alcohol consumption is in the top 5 among EU 28 Member States. Although alcohol consumption per capita declined between 2007 and 2013, it remains high and the damaging dominance of a harmful drinking pattern remains very high by European standards and is a major public health concern.
From the provisional figures available, we know that consumption per capita increased from 10.6 litres in 2013 to 11 litres in 2014. This is probably related to the upturn in the economy.
If so, it is a matter of real concern as it indicates that without policy change, as people have more money in their pockets, they are likely to drink more of it.
Patterns of drinking, especially drinking to intoxication, play an important role in causing alcohol-related harm. In Ireland, unfortunately, when we drink we tend to binge drink. Ireland was second in the WHO European Region in relation to binge drinking with 39% of the population misusing alcohol in this manner at least monthly.
The Health Research’s Board Alcohol Diary Survey found that:
54% of drinkers (aged 18-75) were classified as harmful drinkers
75% of all alcohol consumed was done so as part of a binge drinking session
Irish drinkers underestimate their alcohol intake by 61%.
The study found that over half of adult drinkers in the population are classified as harmful drinkers – this equates with between 1.3 and 1.4 million harmful drinkers in Ireland.
These findings lead to the conclusion that harmful drinking is the norm in Ireland, in particular for our young people – men and women under 35 years.
Harms of Alcohol
This pattern of drinking is causing significant harm to individuals, their families and society. It is estimated that alcohol :-
was responsible for at least 83 deaths every month in 2011
was associated with 8,836 attendances in 2012 to specialised addiction treatment centres;
is involved in one of every three poisoning deaths in Ireland in 2012 and remains the substance implicated in most poisonings (i.e. toxic effect of drugs in the body);
was a contributory factor in half of all suicides and in deliberate self-harm;
is associated with a risk of developing health problems such as alcohol dependence, liver cirrhosis, cancer and injuries;
is a factor in many assaults, including sexual assaults, and in rape, domestic violence and manslaughter;
contributes to high levels of non-attendance at work and lower productivity
is associated with college drop-out
is a factor in 30% of all road collisions and in 36.5% of fatal road collisions.
The European Alcohol Policy Alliance has warned that, taking all diseases and injuries at a global level into account the negative health impact of alcohol consumption is 31.6 times higher than the benefit from low levels of alcohol consumption.
Alcohol Harm to Others
The HSE report ’Alcohol Harm to Others’ examines the damage that alcohol causes in the general population, the workplace and children in families.
The report says that over one in four people in Ireland reported experiencing negative consequences as a result of someone else’s drinking; one in ten Irish workers experienced negative consequences due to co-workers who were heavy drinkers and one in ten Irish parents reported that children experienced harm in the past 12 months as a result of someone else’s drinking.
The results confirm that alcohol is causing significant damage across the population, in workplaces, to children and carries a substantial burden to all in Irish society. Action is required to protect the health and well-being of the wider public and especially children, from alcohol use.
Public Health Alcohol Bill
This Government is committed to tackling alcohol misuse in Ireland and the widespread harm and pain it causes. A comprehensive and detailed package of measures has been approved to do so.
As you are aware, the General Scheme of the Public Health (Alcohol) Bill was published last February and my Department is currently drafting the Bill. I intend to have the Bill before the summer recess and introduced in the Houses of the Oireachtas in autumn. This legislation is the most far-reaching proposed by any Irish Government, with alcohol being addressed for the first time as a public health measure.
This bill is part of a comprehensive suite of measures to reduce excessive patterns of alcohol consumption as set out in the Steering Group Report on a National Substance Misuse Strategy. It is also one of the measures being taken under the Healthy Ireland framework.
The aim is to reduce alcohol consumption in Ireland to 9.1 litres per person per annum (the OECD average) by 2020, and to reduce the harms associated with alcohol.
At the recent National Alcohol Forum Conference, Dr Thomas Babor spoke about the need to tackle the problems of alcohol misuse by focusing on affordability, availability and attractiveness
The Public Health (Alcohol) Bill provides for:
minimum unit pricing to eliminate very cheap alcohol from stores.
health calories labelling on alcohol products to improve information
structured separation in stores to reduce availability and visibility
restrictions on the advertising and marketing
regulation of sports sponsorship
enforcement powers for Environmental Health Officers
Minimum Unit Pricing
Addressing the price of alcohol is an important component of any long-term approach to tackling alcohol misuse. The price of alcohol is directly linked to consumption levels and levels of alcohol related harms. The World Health Organisation has said that there is “indisputable evidence that the price of alcohol matters. If the price of alcohol goes up, alcohol-related harm goes down”. Despite Ireland having relatively high excise duty rates, the price of alcohol remains very affordable, particularly in supermarkets.
A woman can reach her low risk weekly drinking limit for just €6.30, while a man can reach this weekly limit for less than €10.
The Bill will make it illegal to sell or advertise for sale alcohol at a price below a set minimum price. Minimum Unit Pricing sets a minimum price per gram of alcohol and will be based on the number of grams of alcohol in the product.
I know that many of you listened to the excellent presentation given by Dr John Holmes and Dr Colin Angus from the University of Sheffield on MUP and the study they carried out in Ireland, so I will not dwell on those results. Suffice to say that the study provided robust evidence that:
Minimum Unit Pricing policies would be effective in reducing alcohol consumption, alcohol harms (including alcohol-related deaths, hospitalisations, crimes and workplace absences) and the costs associated with those harms; and
MUP would only have a small impact on alcohol consumption for low risk drinkers. Somewhat larger impacts would be experienced by increasing risk drinkers, with the most substantial effects being experienced by high risk drinkers.
This is because MUP is aimed at those who drink in a harmful and hazardous manner. Alcohol products which are strong and cheap are those favoured by the heaviest drinkers, who are most at risk of alcohol-related illness and death and young people who have the least disposable income.
MUP is not expected to affect the price of alcohol in the on-trade. But it will prevent large multiple retailers from absorbing increases in excise rates and from using alcohol as a loss leader. Officials in my Department are also looking at possible mechanisms to ensure that some of the financial benefits of MUP, if any, may flow back to the Exchequer.
Some have been calling for a ban on below-cost selling instead of MUP. I would like to take the opportunity to clarify why MUP is more effective than a ban on below cost selling. First of all, there is no agreed definition of below cost selling in Ireland or how it could be calculated. If it is interpreted as alcohol being sold below VAT and excise duty then very little alcohol is sold at this price in Ireland. The University of Sheffield study found that a ban on below-cost selling would have a negligible impact on alcohol consumption or related harms.
Working out a cost price that incorporates other costs such as manufacturing, transportation and retailing is a complex and expensive exercise. It might not even be accurate. Banning below cost would be difficult to implement, monitor and enforce. MUP is easier to understand measure and enforce.
Others have been calling for a general increase in excise rates. But further increases in excise rates would render premium and higher-priced alcohol more expensive, which is unnecessary for the purpose of targeting hazardous and harmful drinkers – who purchase larger quantities of cheap alcohol.
A tax increase would not necessarily have the same effect as a compulsory minimum price, because of the risk that taxes would not be passed on in full. However, MUP prevents large multiple retailers from absorbing increases in excise rates and from using alcohol as a loss leader.
We are currently considering what the appropriate MUP might be and in this process we are taking into account estimates from the report of the University of Sheffield. We are also consulting with the relevant Departments. Ultimately, the price needs to be set at a level that will reduce the burden of harm from alcohol use or it will be ineffective, but not so high that it increases the cost of a pint in the pub or a glass of wine in a pizzeria.
I know that many of you are concerned about the impact that MUP might have on cross-border trade. The Minister for Health in Northern Ireland has also announced plans to introduce Minimum Unit Pricing for alcohol.
My officials are in contact with their counterparts in the Department of Health, Social Services and Public Safety on the matter and we are cognisant of the requirement to work with the North on implementation.
Finally, on MUP, I want to give you an update on the current European court case. Last February, the Scottish Inner Court of Sessions, Scotland’s highest court, referred a number of questions on MUP to the European Court of Justice. The Court held a hearing on this case on 6th May and we expect a judgment by the end of the year. We intervened in this case by making a submission in writing and delivering an oral statement in Luxembourg last week. We are confident that MUP will be found to be compatible with EU treaties and rules and it is therefore important that all the necessary steps have been put in place to commence the legislation, if enacted.
Section 16 of the Intoxicating Liquor Act Regulations
MUP will be complemented by the making of regulations under Section 16 of the Intoxicating Liquor Act 2008.
This section provides for the making of regulations which may prohibit or restrict advertising, promoting, selling or supplying of alcohol at reduced prices or free of charge in order to reduce the risk of a threat to public order and health risks from the misuse of alcohol. So for example, we will be able to prohibit volume-based offers, such as 3 for the price of 2.
Regulation of Advertising and Marketing of Alcohol
Protecting children from exposure to alcohol marketing is an important public health goal.
There is a body of research which shows that exposure to alcohol marketing, whether it is on TV, in movies, in public places or alcohol branded sponsorship, predicts future youth drinking.
Numerous longitudinal studies have found that young people who are exposed to alcohol marketing are more likely to start drinking, or if already drinking, to drink more. Research also shows that self-regulation is not able to protect young people from exposure to large volumes of alcohol marketing and appealing alcohol advertising. The Bill will make it illegal to market or advertise alcohol in a manner that is appealing to children.
It provides for the making of regulations regarding the marketing and advertising of alcohol and includes provisions for restrictions on broadcast marketing and advertising, cinema advertising, outdoor advertising, print media and the regulation of sponsorship by alcohol companies.
This will encompass major sporting events for the first time by putting the existing Code of Practice for Sponsorships by Drinks Companies on a legal footing with enforcement powers and penalties.
The legislation will contain a commitment that the provisions on marketing and advertising will be reviewed after 3 years.
Labelling
On labelling, research shows that accurate information on the alcohol content of specific beverages is essential to promote awareness of alcohol intake. However, ’standard drink’ or units are widely misunderstood by the general public.
In order to address this, the Bill will provide that labels on alcohol products will contain:
Health warnings including for pregnancy;
The amount of pure alcohol as measured in grams; and
The calorie count
Under the Bill, pubs and restaurants will also be obliged to provide this information to customers for alcohol products sold on draught or in measures e.g. pints, glasses of wine and measures of spirits. Health warnings will also be included on all promotional material.
Structural Separation of Alcohol Products
From a merchandising perspective, at the moment, my colleague, the Minister for Justice and Equality and I, are examining the best way to implement the separation of alcohol products from other products in mixed trading premises. Our aim is to ensure that alcohol products cannot be displayed as ordinary grocery products
Enforcement Measures
As you are aware, it is vital that any measures introduced to tackle the misuse of alcohol are enforceable. The Bill will be enforced by Environmental Health Officers.
Provisions to be enforced include:
minimum unit pricing
health labelling
the control of marketing and advertising
structural separation of alcohol from other products; and
regulations relating to the sale, supply and consumption of alcohol products under section 16 of the Intoxicating Liquor Act 2008.
These pertain to restrictions on advertising, promoting, selling or supplying alcohol at reduced prices or free of charge.
Conclusion
Senators
We need to inform the public about the damage caused by alcohol abuse, the aims of our policies and to change our attitude to alcohol in general. I hope that by working together, we can achieve and surpass our goal of reducing our consumption of alcohol to the OECD average by 2020 and reducing the significant harms caused by the misuse of alcohol.
As I said earlier, I will be seeking Government approval to publish the Bill before the summer recess and I look forward to your continued support during its passage through the Houses of the Oireachtas.
