Alcohol: harm reduction policy's ‘best buys’

The burden of alcohol harm in Ireland remains unacceptably high. There is still a high level of consumption across the population, at 9.45 litres per capita over the age of 15 years.[i] This is still nearly 5% above the modest reduction target of 9.1 litres per capita which was set by government in 2013, to be achieved by 2020.[ii] Very concerningly it is 35% above the level if the adult population who consume alcohol stayed within the current HSE lower risk drinking guidelines. These guidelines are acknowledged as being very high compared to other jurisdictions and are currently being examined for revision.

The outworking of such high levels of consumption are the associated harms which alcohol causes across several areas, not least health care, criminal justice, roads and transport, and economic productivity, to name but a few. For instance, alcohol harm costs high-income countries like Ireland 2.5% of GDP annually – that’s €14bn for 2024 – according to the World Health Organisation.[iii]

In terms of the impact on health and the health service:

• an estimated 11% of the health budget is spent on dealing with alcohol each year;
• 1,500 hospital beds in daily use due to alcohol harm;
• almost one million people have grown up with a problem drinker in the home;
• 600,000 people are classified as having alcohol use disorder;
• 37% of driver fatalities with a toxicology result available had a positive toxicology for alcohol;[iv]
• regional research has shown that alcohol is associated with one-third of self-harm hospital presentations[v] and is a factor in close to half of all suicide cases;[vi]
• alcohol is a commercial driver of violence and crime, especially the crimes of domestic, sexual, and gender-based violence (DSGBV), with past research indicating that alcohol was a factor in up to 70% of cases of domestic violence against women;[vii]
• 15 babies are born every day in Ireland with Foetal Alcohol Spectrum Disorders (FASD), a group of disorders caused by prenatal alcohol exposure and are associated with a range of lifelong physical, mental, learning/educational, social, and behavioural difficulties;[viii]
• four people die every day in Ireland due to alcohol.[ix]

According to the WHO, ‘the global epidemic of Non-Communicable Diseases (NCDs)’ can be averted through interventions and policies that reduce major risk factors. Noncommunicable diseases (NCDs), commonly known as chronic or lifestyle-related diseases, are diseases that are not infectious to others. NCDs tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.[x] Alcohol use is a risk factors contributing to NCDs, however, as previously stated, this can be averted through interventions and policies that reduce major risk factors such as alcohol.

The WHO identifies the following priority actions for alcohol policy in its so called- Best Buys –

• Pricing to help regulate demand for alcoholic beverages 
• Restrictions or bans on alcohol advertising 
• Restrictions on the availability of alcoholic beverages 

Essentially, the WHO contends that interventions on affordability, advertising, and availability are the most effective public policy measures that governments can take to offset at least some of the harm caused by alcohol. 

In Ireland, the Public Health Alcohol Act (PHAA) began the state’s journey in implementing some of the WHO’s best buys. See below for an overview of how Ireland is faring under each of the main measures.