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In the last couple of months, alcohol minimum pricing has been widely, and often fiercely, debated. To add to the discussion, the Faculty of Public Health decided to conduct a survey of its 3,000 public health specialist members to see what they thought.

Out of the 274 Faculty respondents the vast majority (87%) supported the policy of a mandatory minimum price for alcohol.

59% were in favour of raising the alcohol price to 60p per unit.  A level of 50p per unit was voted for by 35%, and only 5% thought 40p per unit was sufficient.

Professor Alan Maryon-Davis commented: “There’s a lot of evidence showing that cheap drink is fuelling Britain’s booze culture and ruining so many lives.  We need to set a minimum unit price that’s high enough to deter heavy binge drinkers without hitting too hard the much greater number of people who drink sensibly and moderately.”

The noughties saw the ban on smoking in public places.   Perhaps the next decade will witness the introduction of minimum pricing for alcohol.

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It could have been a big day for public health in Scotland. It could have been the day when notice was served on Scotland’s ugliest health blight – its rising tide of binge drinking, drunkenness and alcohol-related illness and injury.

On Thursday this week, Health Secretary Nicola Sturgeon introduced the Alcohol etc (Scotland) Bill – a raft of proposals including further restrictions on drink promotions, powers to raise the legal purchasing age to 21 and, most controversially, mandatory minimum pricing to banish all those special offers of ultra-cheap drink at ‘pocket-money prices’ lining supermarket shelves

Everyone knows Scotland has the worst alcohol problem in the UK, indeed in most of Europe. We’ve seen its alcohol-related death rates doubling in the last 15 years, and alcohol-related liver disease rising faster than almost anywhere in the world.

Drink now kills about one person in 20 in Scotland and costs the country at least £2.25 billion in extra services and lost productivity. This toll is nothing less than shocking and amounts to a huge public health crisis that demands to be tackled with steady determination.

The SNP-led Scottish Government’s Alcohol Bill looked set to do just that until it came up against the combined machinations of party politics and the drinks trade.

Just hours before the Bill was launched, the Scottish Labour Party finally decided to join the Tories and Lib-Dems in declaring themselves opposed to the minimum pricing proposal. Unless deals can be done and sensible compromises reached, this element of the Bill will fail, knocking a great hole in the new legislation.

Needless to say this is all a massive disappointment to the supporters of minimum pricing, including all four UK Chief Medical Officers, the Royal Colleges of Nursing, Physicians, Surgeons and GPs, the UK Faculty of Public Health, the BMA, the Association of Chief Police Officers in Scotland and even the Scottish Licensed Trade Association.

We at the FPH have done all we can to bring the arguments to bear, and at our recent Scottish conference have pointed out the potential gains in health, wellbeing and lives saved if the minimum price were set at various levels. Alcohol consumption is closely associated with price – and the higher the minimum is set, the more it would deter heavy drinking. But too high a price would be punitive for the great majority who drink moderately and sensibly – and could encourage crime and smuggling – so a compromise would have to be reached through rational, informed debate.

I hope that the Scottish Parliamentary process will allow such debate to take place. I hope that Labour’s newly declared position is tactical and that they will at least offer enough support to the minority SNP government to permit proper discussion. Their current argument that minority pricing is ‘probably illegal’ under EU law seems very weak when stacked up against the hugely pressing social and humanitarian issue that heavy drinking in Scotland has undoubtedly become.

This week could have seen a major step being taken on the way to better health for the people of Scotland. Despite the latest setback, perhaps it still can be.

Let us have the debate – and let us see if, once again, Scotland can set an example to the rest of the UK by taking a strong, brave and decisive step for public health.

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One in 20 deaths in Scotland is linked to alcohol, said Dr Lesley Graham at the Scottish FPH conference.

Scotland has the fastest growing rate of liver disease in the world, said Graham, public health lead for alcohol and on the policy team for alcohol in the Scottish government.

The estimated cost to Scottish society was £2.25m per year, she added.

Price and consumption were linked, she argued. “Tackling price is so important,” she said.

Education is not powerful enough on its own, she said, putting the argument for minimum alcohol pricing.

Graham’s speech at the annual FPH Scottish conference, being held in Peebles, caused a call for a vote from the floor in support of minimum pricing.

The ad hoc vote was massively in favour of the proposal.

 

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Before you put that glass to your lips, just remember that this is Alcohol Awareness Week. Just stop and think about the huge impact alcohol is having on the health and wellbeing of the nation – and perhaps on you too. Some good, some bad, some ugly.

Most of us enjoy a drink from time to time. It helps us unwind. It breaks down barriers. It helps things go with a swing. Trouble is, all too often, what unwinds is someone’s life. What breaks down is their relationships. What swings is a right hook to the jaw.

The personal, social and economic cost of alcohol-related injuries, illness and general mayhem is mounting by the minute. As our consumption rises, so does the casualty rate. About 9,000 deaths a year, tens of thousands of hospital admissions, countless A&E and GP attendances. According to Government estimates, the NHS bill was £2.7 billion at 2006-07 prices, and in 2008 the total cost of harm from alcohol across the whole UK economy was between £17.7 and £25.1 billion per year. That’s mega.

Everyone knows there’s a booze culture in Britain – not just among our young people. In fact the UK, led by Scotland, is rapidly becoming the booze capital of Europe.

But it’s only relatively recently that the real cost of booze has begun to impinge on the public consciousness. We’ve all seen the CCTV footage of staggering, threatening, puking young revellers trashing our city centres. We all know about the horrific toll of drink-drive accidents and alcohol-related domestic violence. But perhaps we’re less aware of the rising tide of alcohol-related liver disease, such as cirrhosis, affecting younger and younger drinkers. Or the links between alcohol and unwanted pregnancy. Or  the increase in alcohol-linked depression and dementia.

Much of Britain’s booze culture has been driven by an unholy alliance of the drinks industry, with its sophisticated marketing techniques, and the ‘off-trade’ (mainly supermarkets), with its deeply discounted ultra-cheap loss-leader drinks. Up till now, the ‘alcohol lobby’, which wields considerable power with HM Treasury and influential politicians of all parties, has managed to fend off attempts to use legislation to clip its wings. They argue that self-imposed voluntary codes to restrict the way drinks are advertised and marketed are working well. They say young people are not being specifically targeted, and that the industry is no longer using cool, sexy, potent or otherwise glamorous images to promote drink. And they say the issue of cheap offers should be taken up with the retailers, not with them. The retailers in turn say they are just responding to public demand.

But attitudes are beginning to shift, and I believe we are reaching the same sort of tipping point that we did a few years ago with the issue of smoke-free legislation. Of course, unlike smoking, alcohol isn’t all bad. But the public and the politicians are hardening their views and talking more about tougher action – like mandatory restrictions on advertising and marketing and banning the easy availability of ultra-cheap drink.

And as with the smoking ban Scotland is leading the way. A government-sponsored bill is currently going through the Scottish Parliament that would bring in a minimum price per unit of alcohol, together with a range of other restrictions. I don’t think England will be far behind once the election is out of the way.

Like fire, alcohol is a good servant but bad master. It is available far too cheaply. For too long we have let its promotion and marketing run virtually unfettered.  Drinking excessively is now an almost essential part of being young. The burden of ill-health this leads to is horrific. As a society, it’s time to call time on our booze culture and the drinks trade. We must bring in clear standardised labelling of alcohol content, mandatory restrictions on promotion and marketing, and a minimum price per unit to do away with ultra-cheap deals once and for all.

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