Why are we complacent about alcohol?

doi:10.1136/bmj.328.7441.0-g

BMJ 2004;328 (20 March), doi:10.1136/bmj.328.7441.0-g

Editor's choice

Why are we complacent about alcohol?

Twenty years ago I was a firebrand on firewater. I wrote rabidarticles in the BMJ describing the dramatic range and extentof damage from alcohol and considering the options for responding.If the media wanted an anti-alcohol campaigner I was one oftheir first choices. I ranted and raved, and one unintendedconsequence was that I became friends with many wine writersand got to taste some exquisite vintage claret and 100 yearold calvados. Now an old colleague in the battle against drinkwrites to ask me what went wrong. Why when things have got worsenot better am I silent on the issue? The more important question,I think, is why are we as a society so complacent about alcohol.The two questions have similar answers.

The answers are topical because the British government has justproduced its strategy for reducing harm from alcohol (p 659).It's the dampest of squibs. Any government that was seriousabout reducing alcohol problems would increase the price ofalcohol. It's the one measure that will reliably reduce harm.And yet, as the Academy of Medical Sciences showed in its recentreport (6 March, p 542), the price in Britain has fallen andconsumption and damage have increased. Education, controls onadvertising, and partnerships with the drinks industry are somuch flim flam.

Why then are we all so complacent? One reason is that it's ourfavourite drug. Most people in England drink, and many of us—includingprime ministers, journalists, judges, doctors, policy pundits,and medical journal editors—like to stack it away. Righteousindignation about ecstasy is easy because we don't use it anddon't want to.

For politicians there is the important problem of a millionjobs, tax revenues, and exports. There are few votes in beingserious about alcohol problems—and those there are haveto do with drunks vomiting on people's lawns. And the politicalpower of the drinks lobby is huge, far beyond that of a rowof doctors wringing their hands. Hence, Tony Blair starts hisforeword to a strategy to reduce harm by writing: "Millionsof us enjoy drinking alcohol with few, if any, ill effects.Indeed, moderate drinking can bring some health benefits." So,what's the problem, Tony? His first answer is "antisocial behaviourin towns and city centres."

Another cause of complacency is that a little alcohol—andmaybe even quite a lot—does seem to help you live longer.This fact leads to confusion over the message. Is it drink less,drink sensibly, drink like me? And what is sensible drinking?Is there something not sensible about my daily wine with dinner—andmaybe Lagavulin later? I can't believe that: I'm not being sickover anybody.

Finally, it's too easy to be defeatist. Dozens of reports haveproduced no improvement. In contrast, we've made progress withsmoking—because even those who smoke want to stop.

Richard Smith, editor

rsmith{at}bmj.com

To receive Editor's choice by email each week subscribe viaour website: bmj.com/cgi/customalert

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Relevant Articles

UK government announces plan to tackle alcohol: Lynn Eaton
BMJ 2004 328: 659. [Extract] [Full Text] [PDF]

Pfizer will not apply for a licence for sildenafil for women: Susan Mayor
BMJ 2004 328: 542. [Extract] [Full Text]

Rapid Responses:

Read all Rapid Responses

Social problems and health problems: Peter J Allmark
bmj.com, 19 Mar 2004 [Full text]
Epidemiological studies underestimate alcohol risks: Ellen C G Grant
bmj.com, 19 Mar 2004 [Full text]
Complacency about alcohol equals lack of action.: Peter R O'Loughlin, et al.
bmj.com, 19 Mar 2004 [Full text]
A Societal Problem: Graeme M. Cunningham,M.D.,FRCP(Glas,FRCPC
bmj.com, 19 Mar 2004 [Full text]
A look from the third world: Silvio Najt
bmj.com, 21 Mar 2004 [Full text]
Alcohol misuse&Substance misuse are the major problems of the developed World.: AK Al-Sheikhli
bmj.com, 21 Mar 2004 [Full text]
very sad indeed: Dr mohan devegowda
bmj.com, 22 Mar 2004 [Full text]
"Courage mon Brave": Alex Thain
bmj.com, 23 Mar 2004 [Full text]
Alcohol price raise and alcohol impaired driving prevention: Ediriweera B.R., Desapriya
bmj.com, 24 Mar 2004 [Full text]
Wrong question: Wouter Havinga
bmj.com, 5 Apr 2004 [Full text]
On complacency about alcohol: Linda Hawes Clever
bmj.com, 26 Apr 2004 [Full text]