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Do we need same approach to booze as smoking?

Posted on 19 December 2009 | 9:12am

There can’t be many teenagers out there unaware that if a boy and a girl have unprotected sex, there is a chance of a girl getting pregnant, and/or both getting a sexually transmitted disease. 

Just as there can’t be too many people unaware that if you drink a lot, there is a chance of getting drunk, and if you get drunk a lot, there is a danger you become a problem to yourself and to others.

Those two rather obvious thought came into my mind when I heard someone commenting on Chief Medical Officer Liam Donaldson’s recent comments on Britain’s booze culture. ‘We need a major public education campaign,’ the commenter said.

But to do what?

Can we really say the public are uneducated about drink? Were any one of the people I saw around EC1 last night, on my way home mid-evening from a Christmas party – one guy throwing up, one group of young women staggering towards a club, a group of young men fighting – be in any doubt this morning that drink may have been a significant causal factor? I doubt it.

I have been trying to think back to the days of my own heavy drinking, which eventually helped contribute to a fullscale breakdown, and whether we were as aware then as we are now. So far as I can recall, the answer is we were generally aware, but perhaps less specifically aware. So there has been a fair bit of public education. It may have had some effect, on some individuals. But I think we’d be hard pressed to disagree with the notion that Britain still has a booze culture.

I can remember at the time of the liberalising of the licensing laws making the point on behalf of government that this was partly about trying to make Britain’s attitudes to alcohol more like those of the French.

But whilst there may be more coffee bars, bistros and the like, few now make the claim that this change has worked.

Back in my boozing days, there was a lot of public education going on about smoking. It didn’t stop me chainsmoking. Well, at least not until the negative effects of smoking became all too apparent, not least on my health, and I made a determined effort to stop, eventually doing so with the help of a hypnotist.

I knew when I was still smoking that it was bad for me. Ultimately the judgement to stop came from within. But who knows the extent to which the ‘public education campaigns’ had an effect too. So maybe the person who commented on Donaldson was right.

But ultimately the progess made on smoking has been the result of government action, much of it controversial and unpopular at the time, about labelling, pricing and finally banning.

I’m not saying for sure that we should be going down the same route for alcohol. But we’re at least going to have to think about some pretty significant change, in the face of considerable public and industry opposition, if we are serious about the kind of cultural shift this issue seems to need.

  • Julia

    I’m quite hard-line on alcohol because coming from a different country (and not one where drinking is exactly frowned upon), I happen to think that the UK’s problems with alcohol are actually about four times worse than everybody says…

    Up here in Scotland, Labour have just come out against minimum pricing for alcohol for various reasons but I have to admit, I wouldn’t be at all opposed to us coming up with another way of making alcohol more expensive.

  • Quietzapple

    I too gave up smoking when it was apparent it would kill me otherwise with enormous difficulties. My 20st pink haired Dr had acupuncture training in China, my ear remains, but at the time I felt as though she was removing it.

    The silly carping by the tobacco lobby about the destructiveness of smoking tobacco was never up to much, surely? It has been apparent since the 1960s than any smoking is inimical to health.

    Alcohol is not a good parallel. The extent to which it damages whose health at various levels of consumption is disputed, and not solely by the brewers and distillers.

    It may be that strategies like taking a month off from drinking should be promoted more, but this may not be the best time for such a promotion.

    In view of the appalling furore about Prof Nutt’s apparent promotion of “soft” drugs the climate doesn’t look propitious, does it?

  • Steven Calder

    It’s great that you’ve came out in support of the SNP on policy again Alistair, well done for not treating this issue as a partisan one.

    Good luck at the inquiry, I’m sure you’ll do well.

  • Shibley

    It was very helpful to me for you to share your experiences of suffering from an alcohol problem. I share your concern that the quick fix of educating the public sounds good, but may not actually be the solution. I suppose that people treat this as an urgent problem. Sir Liam Donaldson may wish to see results before he goes early next year.

    I used to suffer from a massive drink problem, and it ruined my life in every conceivable way. Since my two month coma in 2007 (unrelated as it happens; it was due to meningitis), I have not touched a drop. I don’t even like the sight or smell of the stuff. However, I don’t harbour any hostility to it; I wish people who can enjoy alcohol my very best wishes. It just that I couldn’t.

    I can’t stop if I have a drink. That’s why I don’t touch a drop. This is clearly abnormal – pathological – call it what you will. But I am genuinely concerned for people who have the same problem as me, but they don’t realise it. With an increasing amount of people drinking overall, only a handful more people who could have their lives ruined.

    Whilst I have always been in a drinking culture, particularly at Cambridge, nobody forced me to drink. My parents do not drink because they are Muslim. Where I think that Sir Liam Donalson might have a valid point is better eeducation on when somebody normal becomes a problem drinker, and then becomes an alcohol. I don’t think I understood this, nor did my parents, until it was too late.

    So I find the issue of alcohol and the public a very emotive one. However, I admire you Alastair for speaking out on the dangers of it. However, I don’t deny that there are many who enjoy a drink perfectly innocent. In some ways, I wish still I were one of them, but I have moved on my times ‘just for today’. I genuinely have deleted it from my life.

    I do share people’s concerns, that once an alcohol, always an alcoholic, but that makes me doubly viligant. For me, if I have another drop, I fear I will die. I don’t want to turn my comment into a public health broadcast, like the one that has been banned from You Tube. It’s just that I want to share my support for you Alastair and also talking elsewhere on the link between alcoholism and mental illness. I remember that Christmas parties were always a difficult time for me. However, remembering the images of people throwing up around Clerkenwell Road easily negate that now.

  • Judith Haire

    I am tee total but realise that people will drink if they want to, whatever the government says or does. Supermarkets should be banned from selling cases of drink at very low prices and the price of alcohol in pubs should be increased.All advertising of alcohol should be banned. Alcohol is poison, it’s a depressant and it artifically alters the mood; any new campaigns should highlight the harsh reality and the unpleasant facts about alcohol and try to dissuade people from drinking to get drunk. And most importantly, look at the reasons why people drink to get drunk.

  • Colin Morley

    Just as a coma finally made Shibley stop drinking, so Legionnaire’s Disease stopped me from smoking. But we can’t arrange a trauma for every addict to find his ‘road to Damascus’. You can only educate so far and after that unless you legislate you get nowhere, which will always be a huge dilemma for those of liberal mind. Maybe we need to re-read John Stuart Mill and unilitarianism to agree that even for those of us who enjoy a drink, excessive drinking is damaging the whole country and we should act according to the country’s best interests and not always our own. Living in France I can attest to the difference in social attitudes to alcohol – but alcoholism in France is a very serious problem – it just isn’t made public all the time. Drunkenness and alcoholism stay indoors but are just as damaging to the health service, the economy and the general wellbeing of this lovely country

  • Em

    I knew you’d write this blog one day.

    You don’t exactly argue for legislation in your last paragraph and yet… of course, you don’t pursue your initial analogy and say how “we’re at least going to have to think about some pretty significant change” when it comes to sex… thank God for that.

    I love alcohol. Love it — and somehow I never manage to drink more than one or two units per day. I’m not talking about an average that means seven units on Fridays and Saturdays, I mean one to two units most days. Maybe it’s because I’m French and my parents allowed me a drink on special occasions and even when I was very little, they made me mocktails. I know this line of thinking is controversial but one thing for sure, alcohol was never taboo for me and I’d never use it consciously or unconsciously as a means of rebellion. And if I’d had a visceral, chemical reaction to alcohol, my parents would have noticed it.

    But back to smoking: my drinking one unit of alcohol per day does not affect the health of those around me whereas moderate smoking would have a cumulative effect on those around me. That is why the state had to intervene.

    UK governments are enthusiastic enough about “looking after” their citizens is so many ways, I sincerely think you’ve got the ground covered. Let us preserve the few civil liberties we have left.

    And last night… a person heaving is, I understand, very unpleasant but “girl staggering towards a club”? This is 2009. Women are able to take care of themselves and don’t need the state to tell them how ladies should behave.

    By the way… it’s Christmas. People party.

  • RTS

    I’m still trying to work out at what point the government decided my health was their concern – beyond keeping me informed.
    If people want to drink then surely the quantity is entirely THEIR business and only becomes the state’s business when it starts to effect other people i.e fights in town centres and domestic violence.
    Providing taxation is set to cover costs to the NHS and costs of make the public aware then the government’s job is done.
    Anything beyond this is force, be it minimum pricing or other legislation, and forced aimed at protecting people from themselves. Really? Is that what MPs think they were elected to do?
    Last thought for you Alastair. How would feel about me stepping in to protect you from yourself because I’ve decided I know better?

  • olli issakainen

    I am glad to hear that you have stopped smoking. I have never smoked, and I am also a teetotaller.
    But why do people smoke and drink too much in the first place as it is nowadays clear that these habits are harmful to you? Why do they prefer short-term pleasure to long-term gains? It is not a wise thing to do, but even many intelligent people do it.

  • C Burke

    Living in London will give you the lungs of a smoker anyway due to the terrible air quality. We don’t see the gov pushing to ban 4x4s and trucks.

  • Helen

    I’m a little confused.

    In your penultimate paragraph you state “the progress made on smoking”. What progress do you mean? The latest government intervention on smoking has stopped in its tracks the steady downward decline of smoking prevalence and smoking take-up.

    Smoking prevalence had reduced year on year for decades before anti-smoking legislation was introduced. We are now seeing a reverse of this decline.

    If you want to reduce drinking and smoking, you have to remove draconian techniques which people will always rebel against. Both substances are legal and are highly taxed. If you want to receive the tax off these products then you should ensure that you cater correctly and poline correctly, those who indulge.

    Bullying will not work with alchohol, as the majority of people enjoy the odd tipple.

    Bullying is ongoing against our legal smokers (instead of solutions introduced to cater for all our legal citizens) and the labour party is so obviously receiving the silent treatment from its core voters.

    You may wish for a country full of puritans, but I say that variety is the spice of life.

  • Chris

    No.

    And while we’re there, legalise weed and promote reformed taxation on substance use and abuse. Let’s start taking some responsibility for our own lives and our own choices, and start raising funding for doing so.

    We all pay high premiums into a system where risk is more adequately covered than in the private sector, where we pay lower premiums but end up with a trade-off in access to care.

    So bearing in mind those high premiums, cover the risk by building NHS infrastructure on new taxation models that include behaviours that people participate in anyway.

    Inform, educate, choose.

  • Nick

    No. This fag- end of a Labour Government needs to stop dictating to people how they lead their lives.

  • Elliott Burton

    No, because they are fundamentally different. With smoking, you can take it down to the level where you can say smoking even 1, single cigarette is bad for you. You simply cant say that with alcohol, in fact, alcohol in moderation is actually good for you, especially with drinks like red wine. Teetotallers die younger, a proven fact.

  • Sean O\’Hare

    What right have governments (of either party) got to dictate to people what they shall and shall not drink or where and when they can smoke? In case you have forgotten Alastair, governments work for the people not the other way around. Just tell Brown and the rest of them to get off our backs or one day you will find you have pushed just a little too far and the people turn. That wouldn’t be pretty would it?

  • Chris

    I’d save revolution for the important stuff, Sean. Or if getting pissed is the important stuff to you, perhaps adjust your priorities.

  • Robert Jackson

    The Late Barbara Castle was crucified by the tippling motorist for introducing the breath test and it’s taken 40 years to get where we are now.

    This the stuff of politics and it’s tough.

    Good article, Alastair. This is what separates the parties. Inheritance Tax breaks for the wealthy and wittering on about a “Broken Society” or doing something about the root causes of poverty, broken homes, ill health and early avoidable death.

    Vision to drive the right agenda.

    It’s tough and it’s right.