We’ve all heard the refrain, “Britain has a drinking problem.” This is a problem that long predates the Covid-19 pandemic, but the evidence for this claim seems more evident than ever. Millions drank to harmful levels while at home during lockdown, and alcohol-related deaths – mostly from liver disease – jumped to a 20-year high in 2020. The closure of vital support services also contributed to higher relapse rates and fewer referrals from doctors and hospitals, while large numbers of long-term Covid patients consumed problematic amounts of alcohol, a small study suggests.
The reasons for such 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 the general human predilection for alcohol’s relaxing properties. These demand-side factors are essential to understanding alcohol use here – or anywhere else. Beer, wine and spirits are not foisted unilaterally on the British public, but consumed with enthusiastic participation by the drinkers.
But what we don’t talk about enough is the influence of supply-side actors on our national consumption: namely, the incredibly powerful multinational companies that produce and sell alcohol for huge profits, including brewers (such as AB InBev and Heineken), distillers (such as Diageo and Pernod Ricard), as well as 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.
The industry and its army of trade associations and front groups are constantly fighting to increase consumption, market share and profits by manipulating and influencing pricing and taxation, licensing and retail density, advertising and sponsorship, international trade agreements, obfuscating scientific discoveries and slow down public health efforts. Rather than being subject to intensive 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’.
But alcohol-related harm is not limited to those who experience addiction (only around 600,000 people in England). 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 almost 750,000 new cases of cancer in 2020 were attributable to alcohol use worldwide, including about 100,000 from “moderate drinking.” Previously announced claims that alcohol, especially red wine, provides a “protective” function for problems such as heart disease and diabetes are also being questioned and are now considered to be “offset by monotonous [closely correlated] associations with cancer’.
The crisis in alcohol-related harm is largely due to the profit-driven alcohol industry structurally incentivizing higher-risk drinking. Industry revenues would fall by 38%, or £13 billion a year, if all drinkers consumed alcohol below the recommended guidelines, according to a study. Companies have a clear interest in preventing such reductions, but exactly this kind of structural change – rather than the voluntary and ineffective measures favored by the industry – is needed to seriously limit alcohol harm.
Public health organizations such as the World Health Organization have long called for measures to reduce the power of the alcohol lobby by banning advertising, limiting retail density and hours, and increasing taxes and minimum unit prices. Other policies along these lines include mandatory nutrition information and warning labels, banning industry participation in policymaking, and coordinating global restrictions to curb predatory capital flight. The profit motive driving ever-expanding consumption must also be curbed by increasing public ownership of manufacturing and retailing. But restrictions alone will not be enough.
We also desperately need to start a conversation about real alternatives to its use. To begin with, there should be a massive expansion of free and public alcohol-specific health care for higher-risk drinkers who do not require sobriety as a condition of use, including supervised alcohol programs, therapy, medication-assisted treatment, and psychiatric cares. This should also include the public development of desirable alternatives such as ‘synthetic alcohol’, the legalization and regulation of lower-risk psychoactive drugs, and the promotion of public spaces that are not exclusively alcohol-oriented.
Ultimately, it’s about expanding opportunities for relaxation, communication, and pleasure in ways that don’t end up killing, hurting, or hurting. This is undoubtedly a huge undertaking given Big Alcohol’s dominance of global politics, discourse and imagination. Radical and systemic political action is urgently needed if we are to have any chance of tackling Britain’s major alcohol problem – or we will continue to lament it.
Add Comment