Most people who drink alcohol beverages do so moderately and responsibly. Only a minority of drinkers abuse alcohol and cause problems for themselves or others.
Limitations of Population-Based Alcohol Policies
For nearly as long as people have enjoyed alcohol beverages, governments have sought to regulate them and alcohol beverage producers fully acknowledge that our products should be regulated.
Alcohol beverages are intended for adult enjoyment, and should only be consumed by people above the legal drinking age who are not at risk. People should refrain from engaging in certain activities when they have been drinking.
No one should ever drive while intoxicated, serve alcohol to intoxicated persons, or violate any other law or regulation concerning alcohol beverage products. We fully support vigorous enforcement of these laws and regulations.
History has however shown that population-based approaches to promote temperance generally – such as increased taxes, bans on sales and advertising, and prohibition –will not stop that minority of people who engage in problem drinking or alcohol abuse.
In addition, such measures often have unintended consequences that may decrease, rather than increase, public health and safety, such as shifting consumption to low quality non-commercial alcohol and increasing illegal trafficking in smuggled or counterfeit goods.
There is little scientific evidence to suggest that population-based approaches will change problematic drinking patterns that are culturally based. Moreover, population-based approaches cannot differentiate between those who exhibit problematic drinking patterns and the vast majority of drinkers who consume alcohol moderately and responsibly.
The Value of Targeted Interventions
Instead of blunt, population-based policy approaches to alcohol beverage regulation, what have proven effective in actually combating the problems associated with alcohol abuse are targeted interventions.
Targeted interventions are pragmatic, flexible, efficient, and culturally-sensitive approaches to the complex issue of why some people drink to excess. Targeted interventions identify the particular individuals, populations, and settings in society where harmful drinking patterns exist and focus exclusively on them, rather than on society at large.
By targeting those with problematic drinking patterns, and understanding the factors leading to their inappropriate alcohol consumption, alcohol abuse and its consequences can be significantly reduced.
There are many kinds of targeted intervention programmes that have well-documented success in changing drinking patterns and behaviour. Early identification and brief intervention strategies are extremely important.
These approaches, which can take place in doctors’offices, medical clinics, and a host of other settings, can be used to reach problem drinkers who otherwise may lack access to adequate health care. Early identification promotes health by focusing the interventions at a time when behaviour is most amenable to change.
Other kinds of targeted intervention programs can be tailored to address particular issues, including drinking and pregnancy, “binge drinking,” and responsible hospitality.
For example, drink-drive programs, which may include responsibility advertisements, educational campaigns, server training, and “designated driver” programs, have proven to be successful complements to the enforcement of laws targeting drunk driving, and have contributed to the reduction in alcohol-related traffic fatalities in countries across the globe.
Targeted interventions are an important way in which governments, public health organizations, and the alcohol beverage industry can partner together in fighting alcohol abuse and misuse.
Education is the Key to Responsibility
Education about alcohol gives individuals over the legal drinking age the facts to make informed, responsible choices about drinking or not drinking. The industry supports and participates in a wide variety of education programs, including industry-initiated programs and those conducted in collaboration with a variety of partners.
Broad programs, such as responsibility advertising campaigns, have been effective in altering drink-drive behaviours. In addition, many U.S. colleges have implemented “social norms” programs which teach students that irresponsible behaviours such as “binge drinking” are not the norm on their campus. These too have been effective.
There are many school-based programs that teach at-risk youth the effects of intoxication and long-term effects of alcohol abuse. And many alcohol beverage producers have developed expert-designed guides that give parents strategies for talking with their children about drinking.
The industry strongly supports alcohol education, and is eager to continue working with governments, public health organizations, and communities in promoting educational programmes and campaigns.
Underage and Youth Drinking
Countries differ widely in setting their minimum drinking age. Although the most common legal drinking age is 18, some countries, including the United States, Indonesia, and Egypt, have a legal drinking age of 21. Surveys from around the world show great diversity in how many young people drink in different countries, how much they drink, and what they drink.
In some countries, including France and other Mediterranean countries, young people are taught to drink beverage alcohol moderately and responsibly at family events, dinners and celebrations. In other cultures, particularly Muslim countries, drinking is strictly forbidden.
In the United States and Canada, recent data show important declines in the incidence and frequency of youth drinking. ESPAD data from Europe show favourable trends in some regions in the amount of “binge” drinking by young people.
In many developed and developing areas, however, more research is needed. In many countries harmful drinking patterns peak at the legal drinking age and then decline significantly thereafter. Data from around the world make clear that the majority of young people are not regular, heavy drinkers.
Researchers have long studied why young people experiment with alcohol. Drinking is one marker of adulthood in most countries, and adolescents throughout world history have always wanted to participate in adult activities before they were legally allowed to do so.
Societies exhibit different attitudes toward underage drinking and, not surprisingly, youth drinking is a larger problem in some countries than in others. The scientific literature has clearly established that parents and peers are the strongest influences on a young person’s decisions about drinking.
Many complex factors contribute to youth drinking, and young people who drink often exhibit other risky behaviours that adversely affect their health. Targeted intervention programs can identify at-risk youth and reduce alcohol abuse and harmful consequences.
Real efforts to combat underage drinking must involve the long-recognized primary influences on young people’s decisions about drinking: parents and peers. Alcohol producers have developed and funded a variety of targeted intervention programs that seek to involve parents and peers in reducing underage drinking.
Long before the first alcohol beverage commercial aired on television or appeared in a magazine, some people have consumed to excess alcohol and people under the legal drinking age have experimented with drinking.
These behaviours exist today even in parts of the world with limited access to advertising and mass media or where advertising is banned entirely. Indeed, in many parts of the world people drink non-commercial alcohol that is not advertised and in a number of countries drinking has declined over decades or remained flat despite increases in alcohol advertising. Similarly, in some parts of the world, most notably the United States, underage drinking has also declined notwithstanding increases in advertising.
Decades of research have not shown that alcohol advertising causes an individual, including a person under the legal drinking age, to drink or abuse alcohol. Even proponents of advertising restrictions admit that the evidence supporting a causal link is, at best, weak and inconclusive.
Those persons in the alcohol beverage industry are parents, too, and do not want underage people to drink. We market our products solely to adults above the legal drinking age, and have adopted voluntary advertising and marketing codes to make our intentions abundantly clear.
Alcohol advertising influences brand choice, it does not make “drinkers” out of non-drinkers, and it has not been shown to increase overall alcohol consumption. Advertising is an important method of communicating information to those who have made the choice to consume alcohol beverages.
It also is a primary tool to promote free and fair trade, and is essential to foster innovation and new products. Without advertising, market entry is impeded and brand competition is undermined.
It should be no surprise that people who abuse alcohol also engage in other high-risk behaviours that endanger their health and the health of others. That does not mean, however, that those high-risk behaviours are caused by drinking.
Indeed, an equally plausible explanation is that certain individuals for various reasons are more likely to engage in dangerous or self-destructive behaviours generally, and that when they do so, they are likely to engage in clusters of such risky behaviours.
Thus, although the scientific literature may report associations between alcohol abuse and certain other risky behaviours, that literature does not establish a causal relationship between the two.
Violence and Alcohol Abuse
Violent behaviour occurs in all societies, including those that largely abstain from drinking. Cultural factors clearly play a role in the observed association between some forms of violence and alcohol abuse.
For example, in Mediterranean countries where drinking is part of everyday life and dining, the rates of alcohol-related violence are much lower than in Nordic and Northern European countries where episodic drinking is more prevalent. Importantly, where violence is condoned on a societal level, there are stronger associations between violence and drinking.
Targeted interventions, such as public education, social norms programs, and responsible hospitality measures, can address community attitudes about violence and alcohol abuse. Law enforcement is another important component in effecting change and individual factors also clearly play a role.
Violence and alcohol abuse share numerous risk factors, including poor parental modelling, prior physical abuse, and mental illness. Targeted interventions can effectively screen for people who are predisposed to engage in violence and alcohol abuse and seek to prevent such destructive behaviours through education and treatment.
Sexually-Transmitted Diseases and Alcohol Abuse
Although a general association between sexually-transmitted diseases (“STDs”) and alcohol abuse is reported in the literature, none of the studies purports to establish a causal connection between the two. Moreover, these studies do not control for the many other factors associated with individuals who engage in high-risk sexual behaviours, and most do not differentiate between amounts of alcohol consumed.
Furthermore, they do not control for the level of education individuals may have about the risks that various sexual activities may pose for contracting STDs. In this area too, targeted interventions can be used to (i) educate the public (and specific populations) in culturally-sensitive ways about risk avoidance, (ii) screen for individuals who may engage in such high-risk behaviours and implement brief interventions to change behaviours, and (iii) modify the drinking environment to implement safeguards that may reduce the potential for harm.
Moderate Alcohol Consumption
Although it is clearly known that the abuse of alcohol leads to a variety of negative health outcomes, a scientific consensus has emerged around the world that moderate consumption of alcohol has potential health benefits for some people or is at least compatible with a healthy lifestyle.
Over the last decade, many studies have confirmed that people who drink in moderation, regardless of the form of alcohol beverage they drink, experience a lower risk of premature death than do people who abstain from drinking.
Research also shows that moderate drinking is associated with a reduced risk of cardiovascular disease, Type 2 Diabetes, gastrointestinal disease, cognitive decline and some forms of dementia, osteoporosis, and obesity. Again, targeted interventions can effectively focus on those who drink to excess without negatively impacting those who may derive benefits from drinking moderately.
Illicit and Non-Commercial Alcohol
Non-commercial alcohol beverages have a rich history in most cultures and may represent as much as half of the total worldwide consumption of alcohol beverages.
These products are not advertised and exist largely outside of the regulatory framework governing commercial alcohol products, and they are among the most understudied areas of alcohol policy research. Non-commercial and illicit alcohol beverages of poor quality present serious health risks.
Population-based government policies aimed at restricting the sale and consumption of commercial alcohol can have the unintended consequence of increasing the production and consumption of non-commercial and illicit alcohol, which exist outside regulatory controls designed to protect public health.
Much more study on non-commercial and illicit alcohol needs to be undertaken, and policymakers must keep this large market in mind when setting policies regarding commercial alcohol.
- Governments, public health organizations, and the alcohol beverage industry agree that there is much more to do in the fight against the irresponsible consumption of alcohol beverages.
- We believe there is much common ground among these various stakeholders that can form the basis of an effective, long-term partnership. Targeted interventions hold great promise in educating consumers and changing behaviours that harm individuals and society at large, while at the same time preserving the social, economic, and public health benefits associated with responsible consumption of commercial alcohol beverages.
- The industry is committed to continuing to develop, implement and support a broad array of targeted intervention programs to achieve substantial reductions in irresponsible consumption and a substantial improvement in public health, and we look forward to working with other stakeholders in this process.
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