Alcohol back in the spotlight
Recent weeks have seen the re-emergence of two long running stories about our societal relationship with alcohol. The return of minimum pricing to the policy agenda will be welcomed by all charged with tackling Scotland’s alcohol related problems. Further, new research from the Joseph Rowntree Foundation (JRF) disentangling the influence of parents and family on young people’s drinking will be welcomed by those wishing to get a handle on how we learn to drink as we do. Whereas both stories are welcome contributions to how we respond to the problem of alcohol related harm, the depth and longevity of alcohol problems in Scottish culture should warn us that there will be no easy solutions. However, this should not dent our optimism.
Available evidence suggests that the SNP’s minimum pricing proposals of 45p per unit of alcohol will save around 70 lives in the first year in Scotland. Perhaps not a great amount, but deaths from alcohol related harm, currently around 1300 a year in Scotland, will always underplay the wider societal harms caused by alcohol. Where minimum pricing will have greater and longer lasting effect is as a signal policy indicating the point at which Scotland feels it was time to address alcohol related harm and recognises the detrimental influence of cheap alcohol on how it understands it as a commodity.
Libertarian critics of minimum pricing will predictably invoke the “nanny state” and propose education of consumers to help them make better informed choices. This we have heard before but we also know that health inequalities tend to increase through the promotion of choice agendas. Positive health information memes, such as “five a day”, have a tendency to become middle class mantras. However, one criticism of minimum pricing that merits attention is that it will target a narrow range of drinkers; those who are price sensitive and therefore more likely to be on limited incomes. The charge is that minimum pricing is regressive and that alcohol use is an important component of social inclusion. It would be wrong, critics claim, to prevent people through price from enjoying either moderate or immoderate amounts of alcohol - the choice is surely theirs.
This issue takes us to the heart of the messy complexity that is our cultural relationship with alcohol and shows how singular policies, discussed or implemented in isolation, are likely to fail. The recent JRF report explores the influence of parents rather than price to show us how parental alcohol consumption – and particularly drunkenness - was, when witnessed, influential in shaping the drinking behaviour of children. This is significant, not because it is identifying another example of ‘bad parenting’ to add to the growing list, but rather it shows that our ideas around alcohol’s appropriateness and how we consume it are in no small part passed on to us. Parents who drink too much at family celebrations or at weekends are not a new phenomenon, a tendency to use alcohol to attain a degree of intoxication being culturally very normal. It is when issues of price and availability intersect with these existing cultural norms that problems can emerge.
The JRF report accords with GCPH’s on-going research around how young adults relate to alcohol. Our first report from this series of work highlighted how using alcohol to achieve the effects associated with it - drunkenness - were taken for granted by young people. Two factors in particular were found to be behind this. First, that the experience of drunkenness had become a cultural shorthand for a range of experiences that were increasingly less available in non-drinking arenas; fun, relaxation, sociability, meeting new people and deepening existing friendships and all the conviviality and positivity that is bound-up within the idea of “a good night out”.
A second issue was that the current marketing of alcohol made drinking to achieve these aims incredibly easy; alcohol was cheap, available everywhere and consequently widely understood and an acceptable, appropriate, even prestigious means to an end. Minimum alcohol pricing and other measures to target the way in which alcohol is presented to the consumer will help tackle this second issue but the first is thornier.
Tackling the cultural underpinnings of alcohol use requires understanding not just how much we drink or are willing to pay for it, but why as a society we are driven to it, problematically or not, as providing a unique psychological and social niche. These are not easy questions as the solutions may lie outside the realm of Government legislation or policy. They may require deep reflection on other areas of our collective life; our work, family and community lives and how drinking occasions fill the gaps. This may be a cause for optimism as we should not wait for Government to provide the answers alone but begin this discussion ourselves.
