We've drunk the Kool-aid when it comes to casual acceptance of booze's harms.
The battle to recruit young drinkers continues. Alcohol photo via Shutterstock.
The list of things we accept as "normal" in our society that actually cause enormous harm is a long one. For example, any objective assessment of how we collectively deal with the excessive consumption of alcohol would lead to the conclusion that we simply don't give a damn about the lives of young people (especially men) for whom alcohol-related disease and accidents are among the leading causes of death. According to the World Health Organization, in the age group 20 to 39 years "approximately 25 per cent of the total deaths are alcohol-attributable." We have all, it seems, drunk the (spiked) Kool-Aid when it comes our casual acceptance of preventable death and illness.
The issue came around again (as it seems to every few years) for me reading a Financial Times article, "Rhythm and booze: the battle to recruit young drinkers," about the lengths to which the purveyors of this poison (it is poison, after all) will go to expand the number of regular drinkers. "Alco-money flows to musicians, promoters, venues and record labels from endorsement deals and commercial partnerships. Last year the world's largest brewer, Budweiser's owner Anheuser-Busch InBev, took Coca-Cola's place as the most active sponsor in the US$1.4 billion music sponsorship market. Five other alcohol giants followed it in the top 10 list: Jack Daniel's maker Brown-Forman, brewers MillerCoors and Heineken, U.K. multinational Diageo and U.S. vodka distiller Fifth Generation."
The companies have now "branded" themselves into the pop world, with this week's Grammy's being the latest brazen effort: Ciroc vodka was the show's "official" vodka. Rapper Sean Diddy Combs became the company's pop promoter in 2007, helping increase sales by nearly 1,200 per cent by 2015.
Interestingly, young people in Britain on which the Times article focused are actually drinking less. But that is not the case in Canada. The Centre for Addiction and Mental Health revealed in a 2013 study that Canadians drink 50 per cent more the global average. Nearly 25 per cent of drinkers older than 15 indulge in binge drinking. And those ages 15 to 24 are trending to more excessive drinking. In a separate 2013 report, the centre identified alcohol as one of Canada's greatest public-health threats. Yet according to the WHO, we have no plan to address it.
It's not as if we don't know the impact of alcohol consumption -- it's so well established that it isn't news any more. There are 200 different diseases and conditions caused by or exacerbated by alcohol consumption. According to the National Institute of Health, regular drinking "increases the risk of developing cancers of the mouth, throat, larynx, esophagus, liver, breast, colon and rectum." The Centre for Addiction and Mental Health calculates that the cost of alcohol use in Canada ($14.6 billion) to Medicare, policing and lost productivity outstrips the tax revenue collected by the provinces. The Canadian Cancer Society simply says that "there is no 'safe limit' of alcohol consumption when it comes to cancer prevention."
Under the influence
Big Alcohol's influence is only growing. Following in the footsteps of Big Tobacco, the transnational booze corporations are heavily targeting developing countries and especially emerging economies like India, with rapidly growing middle classes. In India, the target groups are women and youth. Upwards of 35 per cent of adult men drink there, but only four per cent of women -- making them a huge potential market. A study by the Public Health Foundation of India revealed the big companies' marketing strategies. In concert with the producers, local pubs have weekly "ladies nights" where booze is free, often featuring a single brand. "Bacardi's 'breezer,' a pre-mixed flavoured rum, is being promoted as a brand meant primarily for women."
The success of Big Alcohol's Indian youth campaign -- identifying booze with physical attractiveness, reinforced by popular icon endorsements -- is unmistakable: for those 21 years of age or under, drinking has increased sevenfold in 15 years. The poor are also specifically targeted, according to the president of the public health foundation: "Alcohol shops are strategically located near workplaces of the poor. They get their daily wage and stop at the alcohol shop that falls right on their way."
One effect of the alcohol industry's relentless promotion can be seen in a 2014 report by the WHO. Deaths due to excessive alcohol consumption reached 3.3 million in 2012 -- 5.9 per cent of total deaths recorded worldwide. "In terms of disability-adjusted life years (DALYs)," said the report, "5.1 per cent of the global burden of disease and injury can be attributed to alcohol."
The WHO, not surprisingly, has repeatedly called for much stronger "population-based" measures by government to reduce the harm done by excessive alcohol use. Another WHO report on the most effective way of reducing harm reinforces the conclusions of many national studies, and recommends "a combination of increases in alcohol prices, a reduction in the availability of alcohol, and measures against drunk driving and underage drinking." The report highlights the fact that public education aimed at reducing consumption has very little impact, which may be why this is the industry's favourite recommendation when confronted with its product's negative impacts.
While 66 countries implemented stronger alcohol policies in 2012, they are up against the imperative of another international organization that supports ever more deregulation -- the World Trade Organization. The World Spirits Alliance, the global alcohol lobby group, relentlessly pursues countries that try to restrict importation of their products. In 2008 the European Union was about to launch WTO proceedings against India where two states had "discriminatory" alcohol measures, when India caved one week before. In 2005, the WTO forced Algeria, a Muslim country where alcohol is rarely served except in restaurants and bars in cities, to end its ban on alcohol imports before it would allow the country join the organization. Taiwan had to lift a ban on alcohol advertising and all prices to be "determined by the market" in order to gain entry to the WTO. Japan, Chile, the Philippines and Korea have all had their alcohol laws or regulations challenged through the WTO.
Here in BC, we're 'modernizing'
But these are jurisdictions that actually wanted to maintain or increase the regulation of alcohol. Here in B.C., the Liberal government of Christy Clark in 2014 voluntarily deregulated -- or in her favourite euphemism, "modernized" B.C. liquor laws, allowing happy hours, the sale of alcohol in grocery stores and farmers' markets, and making liquor licenses easier to obtain (private stores already competed with public ones). The results weren't long in coming.
According to a University of Victoria study, alcohol consumption in B.C. went up an unprecedented three per cent in the single year after the changes. Dr. Tim Stockwell, one of the study's authors, stated: "We can't be certain, but it won't have helped that the liquor laws have been relaxing availability and improving affordability with happy hours and the like." Regardless, the research team estimated that the consumption increase would translate into an additional 655 hospital admissions and 31 deaths in B.C.
This all boils down to a simple question: what kind of society do we want? The stock response to critics of the alcohol industry and Canadian drinking patterns is to bring out the "nanny-state" cannons and blow it all away. The tobacco companies tried the same strategy. But that argument is spurious. Binge drinkers aren't free agents, completely unimpeded in making the best decisions about their health. They are subject to sophisticated marketing and billions of dollars in advertising. Surely a mature democracy can and should make it as easy as possible for citizens to make the right decisions. That means establishing a social counterweight to the power of Big Alcohol.