A new Health Scotland report, Monitoring and Evaluating Scotland’s Alcohol Strategy: Monitoring Report 2017, shows that in 2016, 10.5 litres of pure alcohol were sold per adult in Scotland, equivalent to 20.2 units per adult per week. This means that enough alcohol was sold last year in Scotland for every adult to exceed the weekly guideline limit (of 14 units per week on a regular basis) every week. “Alcohol has become more affordable in recent years as disposable income has increased,” said Lucy Giles, the report’s lead author. BMA Scotland council chair Peter Bennie said wide-ranging action was needed. ‘In particular, minimum-unit pricing – a policy that big alcohol producers have spent the last five years delaying, and trying to prevent – would have a significant impact on reducing alcohol harms and must be implemented as swiftly as possible.
Previous studies have described various associations between tax policy and health. This article proposes a unifying conceptual framework of ‘Five R’s’ to stimulate awareness about the importance of tax to health improvement. First, tax can improve representation and democratic accountability, and help make governments more responsive to the needs of its citizens. Second, tax can create a revenue stream for a universal pool of public finance for health care and other public services. Third, progressive taxation when combined with appropriate public spending can help redistribute wealth and income and mitigate social and health inequalities. Fourth, the re-pricing of harmful products (e.g. tobacco, alcohol and unhealthy food) can help reduce their consumption. Fifth, taxation provides a route by which certain harmful industries can be regulated. The paper also discusses the barriers that hinder the full potential for taxation to be used to improve health, including: weak tax administrations, large ‘shadow economies’, international trade liberalisation, tax avoidance, transfer pricing by transnational corporations and banking secrecy. The authors suggest that a greater awareness of the manifold associations between tax and health will encourage health practitioners to actively promote fairer and better taxation, thereby helping to improve health and reduce health inequalities.
Citation: Mccoy D, Chigudu S, Tillmann T. Framing the tax and health nexus: a neglected aspect of public health concern. Health Econ Policy Law 2017 Apr;12(2):179-194.
The alcohol industry have attempted to position themselves as collaborators in alcohol policy making as a way of influencing policies away from a focus on the drivers of the harmful use of alcohol (marketing, over availability and affordability). Their framings of alcohol consumption and harms allow them to argue for ineffective measures, largely targeting heavier consumers, and against population wide measures as the latter will affect moderate drinkers. The goal of their public relations organizations is to ‘promote responsible drinking’. However, analysis of data collected in the International Alcohol Control study and used to estimate how much heavier drinking occasions contribute to the alcohol market in five different countries shows the alcohol industry’s reliance on the harmful use of alcohol. In higher income countries heavier drinking occasions make up approximately 50% of sales and in middle income countries it is closer to two-thirds.
Full citation: Casswell S, Callinan S, Chaiyasong S, Cuong PV, Kazantseva E, Bayandorj T,Huckle T, Parker K, Railton R, Wall M. How the alcohol industry relies on harmful use of alcohol and works to protect its profits. Drug Alcohol Rev. 2016;35(6):661-664.
A new report from the Commission to the European Parliament and Council regarding the mandatory labeling of the list of ingredients and the nutrition declaration of alcoholic beverages recommends the industry develop a voluntary labeling proposal. Mariann Skar, Secretary General of the European Alcohol Policy Alliance noted: “We welcome the report as it clearly recognizes the need for better alcohol labeling and widespread support for it. Disappointingly, the conclusions do not seem to be in line as it asks for self-regulatory proposal from the industry. Self-regulation is not a suitable regulatory mechanism. Member States in the European Council should follow up and empower the European Commission to take regulatory actions.”
A new special issue of the journal Addiction examines the state of knowledge on regulating alcohol marketing. In an overview, Maristela Monteiro, Thomas Babor, David Jernigan and Chris Brookes summarize three key themes in these papers: alcohol marketing causes harm to vulnerable populations; industry self-regulation is ineffective in protecting vulnerable populations; and alternatives are available to address the problem. They conclude that renewed action by governments to control alcohol marketing is needed.
A recent study used advertising industry standard sources to evaluate youth exposure to alcohol advertising, and relative advertising exposure of youths versus adults, in 168 national magazines published in the United States . The study found that from 2001 to 2011, magazine alcohol advertising seen by youths declined by 62.9%, from 5.4 billion impressions (single person seeing a single advertisement) to 2.0 billion impressions. Most alcohol advertising (65.1% of ads) was for spirits (e.g., vodka, whiskey). Since 2008, alcohol companies achieved 100% compliance with their limited guidelines. However, youths were overexposed to magazine advertising relative to adults on average 73% of the time. The authors concluded that despite improving compliance with placement guidelines in these magazines, most youth exposure to magazine alcohol advertising exceeded adult exposure, per capita. If alcohol companies adopted stricter guidelines based on public health risk assessments, youths would not be overexposed to alcohol advertising in magazines.
Full citation: Ross CS, Henehan ER, Jernigan DH. Youth Exposure to Alcohol Advertising in National Magazines in the United States, 2001-2011. Am J Public Health. 2017;107(1):136-142.
Another recent review article summarized the literature on the use of digital media to market alcohol.
Full citation: 1: Lobstein T, Landon J, Thornton N, Jernigan D. The commercial use of digital media to market alcohol products: a narrative review. Addiction. 2016. doi:10.1111/add.13493
The distribution of drinkers in England. Credit
This review was commissioned by the Department of Health of England, which asked Public Health England (PHE) to provide an overview of alcohol-related harm in England and possible policy solutions. The report offers a broad and rigorous summary of the types and prevalence of alcohol-related harm, and evidence for the effectiveness and cost-effectiveness of alcohol control policies. Effectiveness is defined as the degree to which an intervention reduces the public health burden (health, social, and economic) of alcohol. The findings are interpreted within the English context and will be relevant to academics and researchers, public health professionals and policymakers in the health and non-health sectors. The review provides national and local policy makers with the latest evidence to identify those policies which will best prevent and reduce alcohol-related harm. It covers the following areas: taxation and price regulation, regulating marketing, regulating availability, providing information and education, managing the drinking environment, reducing drink-driving, and brief interventions and treatment.