WWe’ve all heard the refrain: “Britain has a drinking problem.” It’s a problem that long predates the Covid-19 pandemic, but the evidence for this claim seems starker than ever. Millions of people drank at harmful levels while staying at home during the lockdown, and alcohol-related deaths – mostly from liver disease – soared to a 20-year high in 2020. The closure of vital support services has contributed to this, with higher relapse rates and fewer referrals from doctors and hospitals, while large numbers of Covid patients are consuming problematic amounts of alcohol, one small study has suggested.
The causes of these patterns seem equally clear: the extreme stress, boredom, trauma and isolation of a protracted and dangerously mismanaged pandemic, combined with Britain’s deep-rooted drinking culture and a general human predilection for the relaxing properties of alcohol. These demand-side factors are critical to understanding alcohol consumption here—or anywhere else. Beer, wine and spirits are not unilaterally forced upon the British public, but consumed with the enthusiastic participation of drinkers.
But what we’re not even remotely talking about is the influence of supply-side contributors to our national consumption: namely, the incredibly powerful multinationals that make and sell alcohol for huge profits, including breweries (such as AB InBev and Heineken), distilleries (such as Diageo and Pernod Ricard) and both “off-trade” and “on-trade” retailers (such as Tesco and Stonegate, respectively). Alcohol has an extremely long and complex history, but its ever-increasing ubiquity is largely a product of its commodification and deregulation by Big Alcohol.
Industry and its army of trade associations and front groups constantly strive to increase consumption, market share and profits, manipulate and influence prices and taxation, licensing and retail density, advertising and sponsorship, international trade agreements, obfuscate scientific knowledge and delay the public. health efforts. Rather than being subject to intense tobacco-style restrictions, the alcohol industry has so far successfully fought to maintain “self-regulation” and shift responsibility for alcohol-related harm to individual “problem” users, particularly through the discourse of “responsible drinking”. “.
However, alcohol-related harm is not limited to those who suffer from addiction (around 600,000 people in England alone). Even relatively low doses of alcohol consumed regularly increase the risk of health problems, including digestive and cardiovascular diseases, traumatic injuries, and cancers of the esophagus, liver, and breast; a recent study estimated that nearly 750,000 new cancer cases in 2020 were due to alcohol use worldwide, including about 100,000 from “moderate drinking”. Previously reported claims of alcohol, especially red wine, providing a “protective” function against problems such as heart disease and diabetes are also being questioned and are now seen as “compensated by monotonous [closely correlated] association with cancer”.
The alcohol-related harm crisis is primarily due to the profit-driven alcohol industry structurally incentivizing higher-risk drinking. According to one study, industry sales would fall by 38%, or £13 billion a year, if all drinkers consumed alcohol below the recommended guidelines. Companies have a clear interest in preventing such declines, but it is precisely this kind of structural change – rather than the voluntary and ineffective measures favored by the industry – that requires serious reductions in alcohol harm.
Public health organizations such as the World Health Organization have long called for measures to reduce the power of the alcohol lobby through advertising bans, restrictions on retail density and hours, and increases in taxes and minimum unit prices. Other principles along these lines include mandatory nutrition information and warning labels, prohibiting industry involvement in policymaking, and coordinating global restrictions to curb predatory capital flight. The profit motive that drives the ever-expanding consumption should also be curbed by increased public ownership of production and retail. However, restrictions alone will not be enough.
We also desperately need to start a conversation about real alternatives to its use. To begin with, massive expansion of free and public alcohol-focused health care for high-risk drinkers that does not require sobriety as a condition of use is needed, including managed alcohol programs, therapy, assisted treatment, and psychiatric care. This should also include the public development of desirable alternatives such as ‘synthetic alcohol’, the legalization and regulation of less risky psychoactive drugs and the promotion of public spaces that do not exclusively focus on alcohol use.
Ultimately, it’s about expanding opportunities for relaxation, socialization, and pleasure in a way that ultimately doesn’t kill, hurt, or harm. Given Big Alcohol’s dominance of global politics, discourse and imagination, this is undoubtedly a huge undertaking. Radical and systemic policy action is urgently needed if we are to have any chance of solving Britain’s big drinking problem – or continue to mourn it.
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