Health damage from alcohol misuse has been underplayed in government strategy, say MPs

BMJ 2012; 345 doi: (Published 18 July 2012) Cite this as: BMJ 2012;345:e4899
  1. Adrian O’Dowd
  1. 1London

The government’s focus on antisocial behaviour and public order when dealing with alcohol misuse risks overshadowing the importance of the damage to health from excessive drinking, claim MPs in a new report.

In its response to the government’s alcohol strategy, the parliamentary select committee on health calls for clearer and more precise objectives in tackling alcohol misuse than are currently given by the government.1

The committee’s report analyses the government’s alcohol strategy, published in March by the Home Office, which set out plans to introduce a minimum unit price for alcohol and to work with the drinks industry to provide clearer information on alcohol units and calorie content.2

Although the Health Committee welcomed much of the strategy, serious flaws remain, according to the committee. “We believe that the health impact of the misuse of alcohol is more insidious and pervasive” than the strategy allows and that the government’s approach is focused on public order at the expense of health, the MPs said.

The report mentions setting a minimum price of 50 p (€0.60; $0.80) on a unit of alcohol, a proposal examined in a study by the University of Sheffield in 2008,3 which said that it could prevent 3400 deaths a year.

The new report says: “Given the government’s decision to introduce a minimum unit price, the debate has been about the level at which it should be set—whether it should be 40, 45, or 50 pence—but the setting of a minimum unit price will not be a one-off event.

“Once a minimum price is introduced, if it is judged to be successful, the level will need to be monitored and adjusted over time.”

The drinks industry has to be challenged further to act responsibly, said the committee. It recommends that participation by drinks manufacturers in the government’s responsibility deal network, a working group of representatives of the drinks industry, public health groups, and local authorities, should be mandatory.

Referring to the network, the MPs said: “We welcome the willingness of the industry to address the harms that alcohol can cause but we believe that it should be clear that the Responsibility Deal is not a substitute for government policy.”

The alcohol industry should acknowledge that its advertising messages have an effect on attitudes to alcohol and on consumption, they argued, and rules on the advertising of alcohol should be re-examined to reduce the likelihood of advertisements being seen by or directed at people under 18. Public Health England, the new body that will lead on public health, should evaluate the effectiveness of the responsibility deal, they added.

The effects on health of drinking need to have a “clearer, evidence based definition,” said the MPs.

The chief medical officer should lead on this work, and then Public Health England should use the outcome of the review as the basis for its promotion of public understanding of the issues by issuing guidelines on sensible drinking.

Launching the report, the Health Committee’s chairman, Stephen Dorrell, the Conservative MP for Charnwood, said, “The main focus of the strategy is binge drinking and its consequences for antisocial behaviour and public disorder.

“Those are important issues, but the health impact of chronic alcohol misuse is in our view also significant, and greater emphasis needs to be placed on addressing that impact.

“Striking the right balance on alcohol consumption is not straightforward. Individuals who drink alcohol and the companies which sell it have an obligation to do so in a way which respects the rights and interests of their fellow citizens.”

Ian Gilmore, special adviser on alcohol to the Royal College of Physicians and chairman of the Alcohol Health Alliance, welcomed the report, saying, “I particularly welcome the committee’s recognition of the insidious and pervasive health damage from chronic use. They have clearly listened to the voice of medical bodies to conclude that it’s not just about young people binge drinking but the chronic health harms that affect a large number of people in society.”


Cite this as: BMJ 2012;345:e4899