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November 21, 2017

Changing the conversation about alcohol  

For decades, public health advocates have fought hard to build a firewall around the tobacco industry, pushing for policies that keep the industry from interfering with governments to advance their own profits at the cost of millions of lives.

Though there is still a long way to go, these efforts have seen significant progress. Big Tobacco has largely been quarantined from crucial policy discussions at the United Nations and the World Health Organization, and nations are reconsidering their partnerships and commitments to the industry. The benefit of these efforts is millions of lives saved.

But there is another product, and industry, whose health effects are devastating communities and deserves the scrutiny of those who are working to prevent premature disease and death: alcohol.

Alcohol is a major determinate of ill health and a leading cause of disability worldwide. The human and economic burden of drinking and driving, or by the alcohol-related conditions like liver cancer, are staggering. More than 3.3 million are killed people globally each year from alcohol-related causes. This immense toll of death and disability makes alcohol use one of the main causes of many non-communicable diseases. And yet, compared to tobacco, the global effort to address the harms of alcohol is markedly subdued.

Vital Strategies’ Rebecca Perl is among those qualified to compare these efforts. Since 1993, she has worked in tobacco control, both as a reporter uncovering the industry’s deceitful tactics and as a public health advocate improving policies that blunt tobacco’s social impact.

In October, Rebecca attended the Global Alcohol Policy Conference in Melbourne, Australia to share her experience in tobacco control, and how it might be useful to advocates committed to changing how the world relates to alcohol.

While the alcohol control movement is smaller than the tobacco control movement, it makes up for it with perseverance, a deep understanding of the issues, and a comprehensive knowledge of what is required to drive progress.

What’s needed can be broken down into similar components that were essential to shifting the tide against tobacco: fighting back against industry tactics, and advocating for policies that reduce harmful alcohol use.

Unlike tobacco, most people are unaware of the serious risks associated with harmful drinking. For instance, most people don’t know that alcohol is linked to over 200 disease and injury conditions, including breast, oral and colon cancer.

Alcohol use is also strongly tied to violence against women, child abuse, car crashes, suicide and homicide. And while people may be somewhat more aware of the link between these acute issues and alcohol, they are still likely to consider them matters of personal responsibility.

One of the main reasons for this lack of awareness is the alcohol industry. For decades, they have pulled tactics from the tobacco playbook, using front groups and poor scientific studies to muddy public perceptions around alcohol’s harms. Meanwhile, the industry utilizes sophisticated billion-dollar youth marketing campaigns, often targeting woman and teens, to convert people that would not normally have used alcohol around the world.

These tactics have succeeded in many cultures accepting alcohol as an essential part of our social interactions. “The industry,” as Rebecca Perl puts it, “has convinced many people that drinking is an integral part of many social occasions, from dinner parties to sporting events.” And what’s worse is that they have successfully stalled many efforts for change by insisting the dangers of alcohol come down to self-regulation.

It is a phrase we know all too well: Drink Responsibly.

We know what will work to reduce the societal harms of alcohol. As we’ve seen with tobacco, there are proven policies and interventions that can reduce the deadly prevalence of harmful alcohol use. Taxation on alcohol products, reducing availability, and restricting advertising and marketing are the most important. These interventions have proved effective in the fight against tobacco, and can be just as effective when applied to alcohol. And some places are already moving in that direction. Just last month, the New York State Metropolitan Transportation Authority announced that they would no longer allow advertisements for alcohol in the New York subway system come January 1, 2018.

While such efforts are encouraging, there is still a long way to go. Unfortunately, what’s lacking in many governments is the will to do it. But even when there is political will for change, it’s still an uphill battle.  Alcohol is in a similar place to where we were with tobacco some decades ago. People are convinced that it is too ingrained in our culture to change.”

Alcohol needs a champion. Advocates need to step up, and governments need to step up. Given that it’s a population-level problem which effects development, governments have a responsibility to protect their citizens from the harmful effects of alcohol, and people need to be educated to the dangers.

Advocates know what needs to be done. All that’s left is making it happen.

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