Alcohol policy comment: determinants, influences and the media

James Nicholls, an alcohol policy and history researcher from Bath Spa University, has contributed the following guest post. It explores recent news and developments in the alcohol field within the context of policy making and journalism.

The Department of Health recently launched its Responsibility Deal on alcohol – but only after many leading medical bodies involved very publicly withdrew their support. In a joint statement, they accused the Government of allowing the drinks industry to set the policy agenda and called for evidence-based policies that could be evaluated using rigorous metrics. It marked the latest phase in a long-running conflict between health campaigners who seek ‘population’ based alcohol policies (in which the state actively reduces overall consumption through pricing and licensing controls), and an industry which argues alcohol harm is an issue of problematic minorities that should be tackled through voluntary action. 

If the goal is to significantly reduce alcohol attributable disease, then there is little hard evidence that the provisions set out in the Responsibility Deal will have much impact. The Health Secretary, however, has argued that the Deal represents only one part of a wider Public Health Strategy. There is evidence that other projects supported by the Government, such as Community Alcohol Partnerships, have worked in small towns such as St Neots – though a CAP scheme in Kent produced more mixed results in larger towns like Canterbury. On the other side, alcohol health campaigners have, over many years, accumulated evidence to support their claim that reducing consumption at a population level is the most effective way of tackling harm (see Section 3 of the latest WHO Global Status Report on Alcohol and Health, for a recent presentation of this).

Alcohol policy in context

But politics is never just about evidence: it is about persuasion, power and consensus. Both politicians and the public make decisions based on values, prejudices, personal interest, fear and countless other intangible factors. Furthermore, most lay observers would probably see elements of truth in the perspectives of both health campaigners and the industry, so consensus is there to be won on where the balance should lie. Perhaps this is why, in the polarised world of alcohol policy debates, evidence sometimes becomes the servant of other forms of persuasion.

Complex data means little in terms of public opinion if it cannot be rendered into bite-sized chunks that can make a headline, and news journalism plays a key role in setting the political agenda. ‘Media advocacy’ is recognised by health campaigners as key to shifting policy perspectives, and alcohol presents powerful opportunities for pursuing this. Journalists need headlines and facts, and alcohol data, cut the right way, can provide both.

Consumption debates

There are, however, downsides.  Complexity can be lost as journalists are pumped to present available data in ways that reflect entrenched policy positions.  ONS data released in February, for instance, appeared to confirm a downward trend in overall consumption since the mid-2000s as well as a more recent decline in mortality. Shortly afterwards, the BBC Magazine ran a story in which trade representatives pointed to the overall decline as evidence that the claims of health campaigners were exaggerated – but here important variations by pattern, region and income were glossed over (my own comments on that were, frustratingly, absent from quotes selected for the published version).  Alcohol Concern, whose most recent report emphasises upward trends in overall consumption (see table on p. 9), issued a press release saying reduced mortality was due to the recent recession – but without explaining the very short lag between declining consumption and reductions in alcohol deaths this implies. 

In February, following a widely reported study of projected alcohol-related deaths (which itself has been criticised by some statisticians) the BBC news website reported that while overall consumption was falling, ‘fewer people were drinking more’.  But what might that mean? The 2007 ESPAD report suggested  ‘fewer drinking more’ was a trend for under-15s, although the most recent ONS data on drinking among young people states that since 2007 ‘average consumption by pupils has varied … but with no clear trend’ (p. 127).  One recent JRF report suggested that excessive and binge-drinking was falling for 16-24 year-olds, but had increased among some older drinkers up to 2006.  Another JRF study highlighted the way ethnic diversity creates underlying variations that can be masked in headline consumption figures. However, important details such as these (which run counter to the blanket images of young drinkers which regularly accompany news reports on alcohol harms) rarely figure in the coverage.

See here for a recent Findings entry on consumption trends.

Alcohol policy and the media

Non-specialist journalists aren’t to blame for overlooking nuances – that is, to some degree, inevitable. Nor can health campaigners, seeking to counter powerful trade influence, be blamed for accentuating negative projections in order to keep their perspective in the headlines. However, it is unfortunate that news reporting often edges out not only complexities within the available data, but also crucial issues which are less easily quantifiable: the role of cultural beliefs in shaping expectancies, geographical variations, the impact of income on patterns of both consumption and harm.  It also edges out good news stories (such as declining use among young people) which could be harnessed to encourage a shift in the perceptions of peer drinking which may shape individual behaviour. 

Alcohol policy is a fraught issue, and it can be hard to comment on policy debates without appearing to take sides.  Both health campaigners and the drinks industry have a lot invested in the way issues are debated in public, while journalists often gravitate towards black-and-white versions of events.  Given the way news works, this is not surprising: news is much more interesting where there is conflict and drama. Making grey areas newsworthy is never an easy task, but it is time reporting moved on from ‘Binge Britain’ to something more nuanced. This might benefit all involved in the effort to understand and tackle the very real alcohol-related harms which exist in our society.

James Nicholls is a Senior Lecturer in the School of Humanities and Cultural Industries at Bath Spa University. He is author of The Politics of Alcohol and History of the Drink Question in England (Manchester University Press, 2009) and has recently written on Wine, Supermarkets and British Alcohol Policy.

A detailed exploration of alcohol policy can be found in the 2009 paper 'The Orientation and Integration of Local and National Alcohol Policy in England and Wales'.

Comments

[Drinks in a Click]

Alcohol in moderation is enjoyable and government should stop supermarkets from selling it under cost price, because this is in my opinion the reason why people drink more than they should

[Ben]

As a Bristol alcohol delivery company we view all aspects of the drinking culture and everything has health risks, social drinking or binge drinking in moderation is fine but where is the line that is overstepped. Thanks for the review, very interesting indeed.

[Alcohol News Articles]

Alcohol in moderation is healthy. Just don’t step over the line, or else you’ll cause more health risks. A drink or two a day can give you that health boost you need. Even if it’s a glass of red wine or an ice-cold beer, you can be sure you’re getting the benefits you deserve.

[rsa training]

alcohol policy and influences from the media is overrated. Alcohol prevention should start from one individual to another. However, the government should also take part in this by regulating laws such as bar attendants/waiters bar owner and those who are related to alcohol should have a RSA certificate.

[Brett]

I think you are being too forgiving of those advocates/researchers who overstate the negative and ignore the positive. They also have a financial and career interest in maintaining the public's fear and misunderstanding, and hence research grants, just as the industry has an interest in downplaying how bad the abuse is. Self-interest is self-interest, no matter what they tell themselves.

Yes, they are trying to fight a very serious social issue, but they are also deliberately misleading the public.

The negative news certainly gets the media's attention, but the public balances that against their own recent experience and knowledge, and that may not gel with the advocates' picture.