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INTERVIEW ALCOHOL CONCERN: Call to action

From anti-social behaviour to alcohol-related illnesses, booze is making the news for all the wrong reasons. Alcohol Concern’s Srabani Sen says it’s time the drinks industy faced some home truths. By Patrick Schmitt

Alarm bells are ringing but one fears the drinks industry is covering its ears. What began as a hum of concern about the harmful effects of excessive drinking has now grown into a din calling for drastic action to curb increasingly costly, drink-related problems.

The trade must lower its hands, listen and react because whatever the causes of heavy drinking in Britain, anyone handling alcohol is under the spotlight. It is no longer an idle threat to suggest that unless the industry unites and identifies solutions to prevent Britain drinking itself into an unhealthy state, heavy-handed measures, enshrined in legislation, and damaging to trade and profitability, will quickly emerge. Experience of other sectors such as tobacco or food have shown the government’s readiness to regulate those who don’t play a part in controlling the abuse of their products.

Perfectly equipped to pass a particularly powerful cup of coffee under the noses of the drinks trade is Srabani Sen, chief executive of Alcohol Concern, an agency with the attention of the government, and myriad alcohol-related facts at its fingertips. Interestingly and tellingly, Sen has never been invited to talk to the drinks trade. She is, however, keen to express her views and “enter into a dialogue” – something she says a lot of lobbying groups aren’t.

She is also quick to stress that Alcohol Concern is “not anti-alcohol. If we are anti anything we are anti-alcohol damage and we are clear about the fact you can drink alcohol safely.” She is also clear on the dangers of excessive consumption and the scale of alcohol-related damage. “Far too many of us are drinking too much and it would serve the drinks industry well if it was prepared to accept that the volume of people drinking too much is unacceptably high.”

And the data on this, Sen believes, is a “significant underestimate”. This is because information from the Office of National Statistics (ONS) “is based on self-reporting and alarmingly high levels of people don’t know what a safe amount of alcohol is.

“If you are asking them ‘how many units are you drinking’ and they don’t know what a unit is, in terms of a glass of wine or pint of beer, how do you know that figures they are giving you are accurate?”

Accurate or not, in relative terms, “the numbers of us who are drinking too much are going up while in other parts of western Europe the opposite is occurring,” she says.

The impact of this development is frightening but Sen manages to present it, initially at least, impassively. Excessive drinking is the cause of “heart disease, liver cirrhosis, strokes, cancers, as well as depression, anxiety, and higher-level mental health problems,” she says. “It also acts as a trigger for issues such as domestic violence and relationship breakdown.” (See inset for full extent of the effects.)

Then she begins to display her frustration. “So when the drinks industry continues to promote the line that it is only a small number of people who drink problematically, firstly, I’m not sure we know that – we don’t have robust enough data to back that up – and secondly, even if it is a minority we are still talking about substantial numbers of people. According to a government estimation – which we would question because it uses an odd definition of dependency – the number of people physically or psychologically dependent on alcohol is around the 1.1 million mark. In addition to that there are about 8-9m people drinking in this country to what is known in the jargon as harmful and hazardous levels.”

Harzardous she describes as “drinking alcohol in manner which puts yourself at risk or people around you” and harmful as “actually hurting yourself and those around you – so that you can’t parent kids properly, or you’re messing up your liver.

Sen goes on: “So that’s a total conservatively of around 10m people in a population of 60m. It’s not an insignificant number.”

Where can we go from here? “We need to start with a sensible debate,” says Sen, “and not have two extreme sides throwing things at each other.”

Cause and effect
A major issue for Sen is the messages surrounding alcohol, which she describes as “very confusing”, preventing sensible drinking guidelines getting through to the consumer. “People don’t understand how low an

amount of alcohol you can drink before it starts hurting you.” This is exacerbated by “the overblown promotion of the health benefits of drinking alcohol.

“The classic is ‘red wine is good for me’ but knocking back a couple of glasses [not units] a day is actually putting you at risk of heart disease and hypertension, as well as strokes.

“Secondly, my understanding is to get the protective benefits of red wine you need to drink a small amount and if you drink above those amounts you put yourself at risk of eroding what you are trying to protect yourself from. It also only works if you are already at risk of heart disease. So if you are a pre-menopausal woman and therefore have low risk of heart disease or a youngish bloke without a history of heart disease in the family, and you are reasonably healthy, it is not going to do you a smattering of good.”

But why are the British drinking more? Surely we need to understand the reasons before we can put in place measures to curb the situation?

“There are a whole range of causes,” begins Sen. “People are blissfully ignorant of how alcohol can hurt you. Social norms around drinking have changed, for example the increased acceptability of drunkenness and drinking alcohol being an everyday activity; alcohol is now much more affordable – 54% more so in 2003 than in 1980 – and it is heavily promoted. It varies between £800m and £1 billion that is spent every year on alcohol advertising, sponsorship and so on.”

Continuing, she says: “We have greater disposable incomes now than we used to and there is a marked increase among women – they are drinking more partly because they tend to be employed, they tend to live a single lifestyle for longer, and there is increased social acceptability of women drinking.

“Also the government hasn’t put a huge amount of effort into tackling the problem. We have a strategy that has no teeth – there are no sanctions for non-delivery on the strategy. So I think there’s loads of factors which, when put together, result in people drinking more.”

However, as these mostly cultural factors for excessive drinking attest, Sen is not pointing the finger solely at the drinks industry and insists she’s not “in the blame game”, as she puts it, because “it doesn’t achieve anything”.  However, she adds that “there are things that the drinks industry does that contribute to the problem and things that the drinks industry doesn’t do, which if it did would make the situation a hell of a lot better – not only in terms of reducing harm but also in terms of the industry being able to fight its own corner. It doesn’t really box very clever.”

Sen then settles on the issue of price, “a producer and retailer issue”, but also something both parties are almost powerless to control – not without resorting to price-fixing. Nevertheless, Sen says “it makes no sense to me when retailers know how much damage alcohol causes that some will actively choose to sell alcohol at a loss in order to get bodies into their shop. There is a lot of evidence that links price to damage; a report from the Academy of Medical Sciences shows that if you increased the price of alcohol by 10% you could cut the number of people who died as a result of alcohol by up to 37%. The effect of price in terms of consumer behaviour has more impact on vulnerable people like kids – who shouldn’t be buying alcohol in first place – and problem drinkers.”

The advertising of drinks and sponsorship by alcohol brands is also something Sen would like to see the industry regulate. “They are spending massive amounts of money promoting their products – around £800m is a lot of money. I would want to look at how that money is being spent, where and who it is being targeted at. I am deeply uncomfortable about the fact that alcohol brands do things like sports sponsorship when they know that massive proportions of sports audiences are children, underage drinkers or those who are 18-24-year-old binge drinkers.

“Another area is product development. When I walk down supermarket aisles and I see butterscotch or double choc chip-flavoured alcopops being sold – products clearly attractive to children in little things that look like ice cream pots – I find it hugely distasteful and certainly irresponsible.”

The blame game
Importantly these are issues which, as Sen stresses, the drinks industry needs to embrace as a whole. “When I talk to spirits producers they blame beer producers and when I talk to beer producers they say ‘it’s not me, it’s the supermarkets’ and supermarkets say ‘it’s the pubs and bars’ and everybody blames everybody else. If you were to believe what all the segments of the drinks industry tell you then nobody in the drinks industry is to blame for anything.

“That lack of willingness to take responsibility for the damage products are undoubtedly causing, whether you are the producer or retailer, is profoundly unhelpful. The drinks industry must step up to the plate and say ‘some people are drinking our products in a way that is hurting them’.” Then, says Sen, “we can talk about how to fix it.”

Bugbears for Sen don’t stop there. “From an Alcohol Concern perspective, another thing I find annoying is that every time we suggest something we get the response ‘oh we can’t do that because…’ We never get the response ‘we can’t do that because of this but to achieve the same thing we could try this…’ I would rather the industry then came back with an alternative.”

Time for change
In general, Sen senses what she calls a “nervousness” in the drinks industry about working in partnership with organisations like Alcohol Concern. “I think it’s because they think we are anti-alcohol lobbyists,” she says, “and the barriers immediately go up.

“It doesn’t have to be that way and the development of the Drinkaware Trust is a classic example of how get over that. It was, however, dependent on people taking big risks – from an industry and personal perspective – and that took a bit of courage.

“My message to the drinks industry is: be prepared to take a risk because if you don’t, if you circle the wagons, you will end up in deep problems because you will be resisting solutions which may actually work to the industry’s benefit, let alone to the benefit of people who are actually damaged.”

But what does Sen mean by risk? She is quick to give an example: “One of our policy suggestions is for the drinks industry to voluntarily not advertise alcohol before the watershed. What it takes is one or two companies to do this, take this leap in the dark, advertise after 9pm – and attached to films with an adult rating – and that sends out a message about the willingness of the drinks industry to tackle alcohol-related harm and in that instance underage drinking. Also, the PR benefits are huge.”

And what if the industry doesn’t regulate itself? How likely is it tougher measures will be brought in by the government?

Sen doesn’t have a definite answer but believes that “in the last six to nine months the increased media interest in the health consequences of drinking too much means now is the first time the government has got a public consciousness which they can then be seen to react to.

“The position now is ripe for change in terms of the government being more proactive and I think there are real opportunities for Alcohol Concern to push the alcohol agenda because the door is opening wider.”

This is a thinly disguised warning to the drinks industry, and Sen has more to add, but this time emotively. “The issue is ‘do we really care?’ At what price is our ability to drink alcohol in any way we want? How many people are we prepared to allow to get sick? To die? How many kids will we allow to live in a household where parents are drinking too much? How many relationships are allowed to break down before we say enough is enough, we’ve got to tackle it?

“The government is beginning to think this is hurting us too much and we need to do something about it. And if the drinks industry is to ride that concern effectively it needs to be prepared to enter into the debate in an open way.”

At this point Sen pauses, conceding, “ultimately, if we are going to reduce consumption, that is going to hit turnover, and for that reason I can understand why the drinks industry would be nervous in engaging in the debate.” However, as she sums up starkly, “but what’s the alternative? Ignore it and it happens anyway.”

© db April 2007

What is Alcohol Concern?

Alcohol Concern has a number of roles – both in terms of prevention and cure – and Srabani Sen describes the organisation as “the equivalent of a policy think tank for the world of alcohol”.

Its official definition is “the national agency on alcohol misuse”, and aside from attempting to reduce the amount (and cost) of alcohol-related problems and deal with the consequences, Alcohol Concern also works to influence national alcohol policy.

“Our job is to look at the various ways alcohol causes harm either to individuals or society and then look for solutions to those problems,” explains Sen.

“Any policy solutions we suggest have to be evidence-based and if there isn’t evidence we call for research – we do not lobby on the basis on some moral position.”

As for funding, Alcohol Concern receives an income from its training consultancy wing, gets a core grant from the Department of Health and gets project funding from various sources, for instance Comic Relief.

Alcohol – the facts

  • Estimates of the number of British who are physically or psychologically dependent on alcohol varies between 1.1 and 3 million
  • 7.3-8.3m Britons are drinking to harmful or hazardous levels
  • 49% of 18-24 year-old men and 39% of 18-24 year-old women admit to regularly binge drinking
  • 60% of all binge drinkers between 18-24 have reported being involved in at least one criminal, violent or disorderly incident
  • the number of deaths directly related to alcohol has doubled since 199
  • Twenty children are hospitalised daily as a result of alcohol
  • 1.3 million children are brought up by parents where one or both drink too much alcohol
  • The average age of people developing cirrhosis of the liver has dropped dramatically and doctors report regularly seeing people in thier 30s and 40s, sometimes even teenagers
  • The government spent £3.77m on the “Know your limits” campaign at the end of 2006

Source: Alcohol Concern
Information relates to the UK only

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