The UK government's alcohol strategy

Congratulations to Cameron and his government for putting forward an alcohol strategy that addresses alcohol, recognizing the redundancy of the word, harmful, as in harmful use of alcohol; demonstrates joined up action to a common problem (HM Government, 2012); is aligned with evidence (Anderson, Chisholm, & Fuhr, 2009; Anderson, Møller, & Galea, 2012; Babor et al., 2010; WHO, 2009) and, is consistent with public health strategies (WHO, 2010). In the lead up to the September 2011 United Nations High level meeting on NCDs, a joint publication of WHO and the World Economic Forum identified three ‘best buys’ to reduce the harm done by alcohol: price increases, reduced availability and bans on advertising (WHO and World Economic Forum, 2011). Cameron’s strategy addresses the first of these two and recognizes the third, although does not go the whole way to tackle commercial communications. The jewel in the crown is the proposal for the introduction of a minimum price per gram of alcohol. This would mean that the whole of the UK, including Scotland and Northern Ireland, together with the Republic of Ireland are aligned in their policies in the same direction. A number of Canadian provinces have had a minimum price per unit of alcohol for some time, with obvious benefit (Stockwell, Auld, Zhao, & Maryin, 2012). Modelling estimates for England suggest that a minimum price per gram of alcohol will bring major immediate and sustained benefit in reducing deaths, hospital admissions and crime (Purshouse, Meier, Brennan, Taylor, & Rafia, 2010). There will be beneficial effects on employment, and, indeed, extra income for the alcohol industry. Added to that the continued modest tax increases proposed by the strategy, there is a win–win situation for all, public health, different government sectors and the private sector. All the modelling estimates suggest that a minimum price per gram of alcohol impact preferentially on heavier as opposed to lighter drinkers (Purshouse et al., 2010) and are minimally regressive (Ludbrook, Petrie, McKenzie, & Farrar, 2012). It is in this sense that a minimum price per gram of alcohol is proportionate. In the area of availability, the new strategy turns round the ineffectual approaches of previous alcohol strategies (Room, 2004), with, amongst other initiatives: ‘giving local agencies powers to reduce alcohol harm through the changes to public health, new Police and Crime Commissioners, and by rebalancing the Licensing Act; giving local communities the tools to restrict alcohol sales late at night, if they are causing problems; and, strengthening local powers to control the density of premises licensed to sell alcohol, including a new health-related objective for alcohol licensing for this purpose’. The evidence shows that these approaches will be effective in reducing the harm done by alcohol (Anderson, Møller, et al., 2012). It is in the area of advertising that the strategy could and should have been stronger. It clearly recognizes the importance of advertising as a health determinant, but continues along the path of self-regulation, the experience and evidence for which does not and cannot work (Hastings, Brooks, Stead, Angus, & Anker, 2010). The bulk of commercial communications are now channelled through social media, which are accessible to all. With such media, self-regulation becomes irrelevant – advertisements pulled because of breach of codes, simply live on through social media (Anderson, Suhrcke, & Brookes, 2012). As Hastings et al. (2010) concluded: ‘The current problems with UK alcohol promotion are reminiscent of those seen before tobacco advertising was banned, when attempts to control content and adjust targeting simply resulted in more cryptic and imaginative campaigns. Indeed David Abbott, a leading advertiser of the time, argued that the codes were in fact acting as a stimulus, not a constraint, on creative imagination and that the only solution was an outright ban. History suggests that alcohol advertisers are, appropriately enough, drinking in the last chance saloon’. It is perhaps in its messages to the alcohol industry that the strategy offers the most refreshing approach, leading us away from social corporate responsibility approaches, which are just window dressing, and away from trivial commitments for action towards something that might make a difference. As paragraph 4.4 of the strategy notes, ‘the alcohol industry has a direct and powerful connection and influence on consumer behaviours. We know that: people consume more when prices are lower; marketing and advertising affect drinking behaviour; and store layout and product location affect the type and volume of sales’. The real commitment, as the strategy proposes is to ‘take one billion units (8 billion grams of alcohol) out of the market by 2015. This will bring significant benefits for