New Zealand has a “once in a gener-ation” opportunity to change patterns of alcohol consumption, according to Professor Doug Sellman.
Doug is the director of the National Addiction Centre in Christchurch and is part of the recently formed group Alcohol Action New Zealand. This group is spearheading a public campaign to tighten our liquor laws, which are being reviewed by the Law Commission.
The Commission published a discussion paper in late July called “Alcohol in our Lives” that proposes redrafting the Sale of Liquor Act. Its suggestions are wide ranging and include: making it easier to refuse a liquor licence, closing off-licences overnight, restricting bars’ sale of alcohol in the early hours of the morning, raising the age to buy at off licences to 20, making it an offence for an adult to supply liquor to a young person without their guardian’s consent, increasing the excise tax on alcohol, making drunkenness in a public place an infringement offence, and reducing the blood alcohol limit for driving.
Doug describes New Zealand as being “in the grips of an under-recognised national alcohol crisis”.
People accept the alcohol-related harm in our society, he says. “But if it was anything else that was a simple factor causing this amount of damage, then we’d all be up in arms.”
“Most cities in New Zealand now, people feel scared to go into the middle of town after dark; and all of that is because of alcohol.”
According to Police statistics, one-third of all people apprehended will have consumed alcohol before arrest. On a typical day in New Zealand, 326 offences occur where police note that alcohol was involved, including 98 offences for drink driving.
An estimated 18 percent of the Police budget is used to deal with offenders and victims who have consumed alcohol. Alcohol is involved in one-fifth of traffic crashes and one-third of violence offences.
But alcohol has even wider-ranging health implications.
According to a paper published in international medical journal The Lancet in late June, 4.6 percent of all ill health and premature death worldwide is due
to alcohol.
In addition to diseases directly caused by drinking, such as liver disorders, a wide range of other conditions including mouth and throat cancer, colorectal cancer, breast cancer, depression and stroke are linked to drinking, The Lancet says. The Law Commission’s paper cites the World Health Organisation’s International Agency for Research on Cancer’s recent classification of alcoholic beverages as “carcinogenic to humans” and in the same category as asbestos, formaldehyde and tobacco.
Doug says New Zealand sees more than 1000 alcohol-related deaths each year.
Law Commission president Sir Geoffrey Palmer told an Alcohol Advisory Council conference in May, “we are not just talking about binge drinkers”.
“Quite simply, the risk that you or I will develop chronic diseases (including a range of cancers, heart disease and liver disease) at some point in our lifetime increases with the amount of alcohol we consume over our lifetime,” Sir Geoffrey said.
Research in Australia has defined a low-risk drinker as having less than 1 in 100 chance of dying an alcohol-related death. Under this Australian definition, low-risk drinking is up to 14 standard drinks a week for both men and women.
In New Zealand, the Alcohol Advisory Council (also known as ALAC) recommends men drink no more than 21 standard drinks a week, with not more than six on any one occasion. For women, ALAC recommends drink no more than 14 standard drinks a week, with not more than four on any
one occasion.
“That’s low-risk drinking – and anything more than that is risky,” Doug says.
The Law Commission report cites research showing New Zealand’s per capita consumption of pure alcohol has increased 9 per cent in the past 10 years.
“I’m not happy using words like responsible, moderate and safe,” Doug says. “They are the words that the [liquor] industry likes to use.”
“The public needs to know what low-risk drinking is. The government should be telling us all, using the best science possible.”
Doug says he enjoys a drink every now and then, “though like most people, I drink less as I get older”.
He says it’s changing the behaviour of the 25 percent of New Zealanders who are heavy drinkers that would have the most impact on crime and health statistics; but this can only be done by making changes to the drinking environment. “People don’t change by education alone or spontaneously becoming more responsible.”
Doug and Alcohol Action want a multi-pronged approach to reducing alcohol harm, tagged as the “five+ solution”:
+ increase treatment opportunities for heavy drinkers.
“This is the best public health advice in the word, it’s that simple,” Doug says.
The Lancet paper cites a metanalysis of 112 studies that proves increasing the price of alcohol reduces consumption. The researchers also conclude that price increases and a set minimum price for alcohol have a much great effect on heavier than on lighter drinkers.
Doug says a small increase in the price of alcohol or decrease in its accessibility are “a very small price to pay for a safer and healthier society”.
The key question is not “do you want to pay more for alcohol?” he says, but “would you support an increase in its price if you knew that that would lead to a safer society?”
“The first think to look at is a minimum price for alcohol. But for that to come in, there has to be a recognition that alcohol is not an ordinary commodity. We’ve really got to treat it differently from fruit and veges.”
Other countries are trying this approach: at the moment Scotland (where one in 20 people are dying from alcohol-related diseases) is investigating a minimum price policy, with the Government proposing that the cost of alcohol be no less than 40p a unit. This means a bottle of vodka containing 26 standard drinks will cost a minimum of £10.40 – instead of being on sale for less than £7.
In New Zealand, alcohol can be bought for as little as $1 per standard drink, and the Law Commission says it’s watching the Scottish experiment with interest.
But increasing the price alone is not enough, Doug says. Making alcohol less available and reducing alcohol advertising also have strong evidential backing.
“The five+ solution being promoted by our campaign is based on the best international evidence related to effective public alcohol policy.”
According to The Lancet, systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed are effective in reducing alcohol-related harm.
Doug says he expects strong opposition from the liquor industry to the campaign, which has been developed by professionals in the addiction treatment and public health fields but is being endorsed by health and medical services, social services, police, councils, churches, iwi, schools and other groups.
The Presbyterian Church of Aotearoa New Zealand is supporting the campaign. Moderator the Right Rev Dr Graham Redding says the five+ solution being advocated by Alcohol Action constitutes a positive response to a very real problem
“The Presbyterian Church supports moves to expose and combat destructive behavioural habits, including current patterns of alcohol consumption, which are exerting a terrible toll on New Zealand society,” Graham says.
Doug says increasing numbers of individuals are also expressing their support. “Judging by the response so far, without any publicity at all, there is a huge groundswell of ordinary New Zealanders who want change and will give strong support to the campaign.”
“The majority of the campaign’s supporters enjoy drinking alcohol but all are alarmed by the scale of unhealthy and dangerous drinking in contemporary New Zealand.”
“I have a lot of faith that this kind of sense will prevail.”
Doug is taking three months’ sabbatical to hold 37 public meetings around New Zealand to promote Alcohol Action’s campaign, delivering a lecture titled “10 things the alcohol industry won’t tell you about alcohol”.
The Law Commission’s report says, “the New Zealand public needs to decide where the balance should lie between the benefits we derive from alcohol and the harm being experienced by individuals and society at large”.
By Amanda Wells