The perils of liberalising the law on the sale of alcohol

Press, 1 June 1989, Page 16

The perils of liberalising the law on the sale of alcohol

Dr Robert Crawford, medical superintendent of Queen Mary Hospital, urges caution on liquor

PEOPLE TEND to be bored stiff with any mention of the subject of liquor laws. They mutter something about “it’s a personal responsibility” or “interference with personal liberty” — and reach for another drink.

Along with politics, religion and sex, everyone has an entrenched emotional position on the subject, which for the most part obscures rational debate. This is unfortunate because our liquor laws do play a part in controlling harm from alcohol. But because they inconvenience us, they tend not to be popular. Parliamentarians are wary of inconveniencing the electorate because' they get voted out of office when they do so. Nobody would envy the, task of Mr Philip Woollaston’s select committee considering revision of the Sale of Liquor Act. - J .' ■ ;

The two most crucial areas are the liberalising: proposals to sell liquor in supermarkets and grocery stores (but not dairies — the distinction’ may be difficult); and to lower the drinking age from 20 years to 18. years. I write as a doctor interested In public health and behavioural; change. What does this viewpoint say about liberalisation? i

The problem with i selling alcohol in grocery stored is that it treats alcohol as a food, and ignores the fact that it is a drug. People do not die from; driving cars after a binge ort bread. Domestic violence and the undermining of children's selfesteem are not associated with butter intoxication. ■ I am fond of pointing out that

if alcohol were discovered today it would be a restricted tranquilliser, like Valium or sleeping pills, available only on prescription. Indeed a cartoonist once drew a man and wife opening the mail. She was studying an invitation and says: “I’ve been invited to a Valium morning!” It is an accident of history that alcohol is so freely available, and we must look beyond consideration of personal convenience to understand the issues. A commonsense approach would be: How bad is our alcohol problem; how does it compare with other countries; and what should we do about it?

The graph shows how the per capita intake has increased over the last 100 years, expressed in litres of pure alcohol (ethanol) per inhabitant. The increase is striking. In 1 1984 New Zealanders over 15 years of age drank 11 litres of pure alcohol. This is an average of 30ml or three standard drinks per day for everyone. Although recent consumption figures show a slight fall from 1984, it is yet to be shown whether this alters the situation meaningfully. Drinking guidelines indicate damage to the body (liver damage/brain damage) begin at 20ml per day for women and 30ml per day for men. Mental effect occurs at less than this. Therefore drinking has already reached serious hazardous levels.

It is accepted by the select committee that 9 per cent of drinkers consume 60 per cent of all alcohol drunk. (International research supports this finding, which is an uncomfortable one if you are in the liquor trade, because profitability depends on the heavy drinker, who is clearly a health risk. Estimates vary but alcohol-related damage is probably at least double the annual excise tax take.)

The committee goes on to say that since only this 9 per cent are heavily at risk, the other drinkers shouldn’t be discommoded by considerations of this 9 per cent, or that the liquor laws are only a small part of the thrust necessary to do something constructive about these 9 per cent, so the liberalisation which is proposed will somehow not make any real difference. This ignores the fact that the family members of these 9 per cent of drinkers are severely affected by them. If we say that this amounts to about 9 per cent of the rest of the population, we have a figure of 18 per cent of all New Zealanders affected by alcohol, or nearly one in five. With a problem of this magnitude we must be quite certain that any measures introduced are not likely to add to it. It is certainly up to those who want to liberalise to prove it will not be harmful.

Recent research carried out in Christchurch shows that a lifetime chance of suffering serious alcohol abuse or dependence for males was 30 per cent — or one of three. For women it was nine per cent in the age group 18-24 and less in older age groups.

This reflects the “unsaturated” market that exists in women. How convenient to sell liquor in supermarkets then, where even in this liberated age, more women shop than men. This move cannot be said to enhance the health of women. It is much more likely to harm it. Christchurch has a significantly higher rate of alcohol abuse than five American centres (New Haven, St Louis, Piedmont, Los Angeles and Puerto Rico). France, Germany, and Spain are all countries with few liquor laws, and all have higher consumption and higher problem rates than here. "Civilised” drinking in France is a myth. A special Government Department (much more significant and powerful than our Alcoholic Liquor Advisory Council) has struggled there for 30 years to reduce per capita consumption. A recent international review suggested France would like to introduce liquor laws like ours as one measure in a number of policies to further reduce consumption. Scotland liberalised its liquor

laws in 1976. At first this made no obvious change. But recent research shows that in spite of a depressed economy (somewhat like New Zealand at the moment) young people and women have increased their drinking.

In the United States, several states have found lowering the drinking age is associated with increased traffic fatalities in young drivers, and they have put the age back up again. To be fair to the select committee, in recommending a reduction to 18 years they are reducing the number of exceptions, saying that the resulting law will be more restrictive than the present one.

From a public-health perspective it is still a brave step to recommend a move downwards from 20 to 18. Who wants more young victims that we have now?

From all this it is easy to see New Zealand has already got a big problem with alcohol. How is liberalisation going to make this any better? It is far more likely to increase consumption by making it easier for young people to drink (pub drinking at 18 legally), and women to buy liquor while shopping for groceries.

The only sensible course of action is to leave these laws unchanged until those wanting liberalisation prove it will not be harmful to our young men and women. Men already face a one-in-three chance of an alcohol problem. Changing the law amounts to an experiment with the nation’s health.