Women and children first: tackling harmful drinking

AlcoholIt’s the start of civilisation as we know it. The Neolithic Revolution I mean. That period around 10,000 years ago when we moved from hunter-gatherer to agricultural societies. But why did we bother? After all, hunting and gathering was quite a nice life, especially for the hunters, who probably worked less than 15 hours a week (otherwise they’d have killed everything that wasn’t likely to kill them first), leaving most of the responsibility for the groceries to the women and children doing the gathering. The answer, my friends, is demon drink.

Alcohol was discovered by Stone Age layabouts who saw birds and small animals getting hammered after eating too much fermented fruit and decided they’d like to stagger around banging into trees and telling women they’d never met before they loved them. But as Patrick McGovern explains, that meant getting a steady supply of fermentables, so little by little they learned to grow cereals, and were using them for brewing beer long before developing the far more complicated process of baking bread.

By the time writing was invented, sources from across the planet suggest that drinking was a part of daily life. And so was excessive drinking and efforts to do something about it. The Chinese made over 40 attempts to ban alcohol in the period from 1400 to 1100 BCE. They gave up, as did the US government three thousand years later. But where empires have failed, the OECD will succeed. Well, maybe not in banning it, that’s not our goal, but in tackling harmful drinking (or “use” as the experts say, leaving non-experts wondering if there’s something to those stories about alternative ways to get alcohol into your body).

Tackling Harmful Alcohol Use: Economics and Public Health Policy published today looks at trends in how much alcohol is being drunk, who’s drinking it, where, and in what beverages. Average consumption is now just over 9 litres of pure alcohol a year. When one of my journalist colleagues translated that into a more understandable beers a year, around 180, he revealed a generational split in the office: the youngsters were appalled, the adults unimpressed. That’s at odds with one finding in the report I’ll come back to below.

The bad news for the drinks industry is that for the OECD countries as a whole, per capita alcohol consumption has declined slightly over the past 20 years (down 2.5%). The good news is that now that women and children don’t spend so much time gathering, they’re drinking more. For instance, during the 2000s, the proportion of children aged under 15 who‘d never had a drink in their life fell from 44% of boys to 30%, and, in a remarkable victory for gender mainstreaming, from 50% to 31% for girls.

In more news, you can now buy Hello Kitty beer. That’s not to say the industry is targetting kids. You’d have to be particularly cynical to imagine that the goal of promoting fruit-flavoured alcopops and other mixes in cute packaging is to overcome young people’s dislike for the taste of alcohol rather than to get them to eat fruit.

What about women? When you hear about booze-fuelled lifestyles, parent-teacher associations are certainly not what comes to mind. But as this report on women drink-drivers points out, alcohol is everywhere for middle-class women, especially wine – at those school events, on nights out, and, increasingly, on nights in alone. That’s far from the stereotypical image of a woman with a drinking problem as a working-class girl slumped on the pavement on a Friday night clutching a bottle of vodka.

Tackling Harmful Alcohol Use highlights this unexpected frequency of risky drinking according to class and sex. While people with more education and a higher socio-economic status are more likely to drink than the average, risky drinking is more common in middle-class women and working-class men.

I was surprised to see how many of those risks and harms there are. Alcohol is responsible for 1 in 17 deaths. You probably know about its contribution to liver disease, but it can also be involved in cancers, cardiovascular diseases and various other conditions. Indirectly, it causes death and injury from traffic accidents and violence. And not only the drinker is affected. A study by the Australian Foundation for Alcohol Research and Education found that nearly two-thirds of respondents had experienced harm from others’ drinking, and that: “Over a million children (22 per cent of all Australian children) are estimated to be affected in some way by the drinking of others”.

There’s an economic price to pay, too. The US Centers for Disease Control and Prevention estimate that excessive drinking cost the country $223.5 billion last year, “or about $1.90 per drink”, with almost three-quarters of that due to binge drinking.

So how do you tackle binging and other forms of dangerous drinking? Most drinkers would see health benefits from reducing their consumption, but that has to be set against other benefits from not changing, in their social life for example, so you may have a hard time convincing them. The more so given how much the industry spends on persuading people to drink. In the US, drinks manufacturers told the Federal Trade Commission they spent $3.45 billion on marketing in 2011.

You could target the heaviest drinkers first. They are the ones who cause the most harm and are also the most receptive to alcohol adverts. There are few strategies in place to do this though, but doctors could be made more aware of the issues. Raising the price is an effective way to cut consumption, and strictly enforcing the laws on drink-driving reduces accidents. Stricter advertising regulations and restricting the number of places you can buy alcohol could help as well. In other words, reduce alcohol’s availability, affordability and attractiveness.

Failing that, you could try the Aztec diet. They strangled drunken plebs in public, and nobles in private.

Useful links

OECD work on tackling harmful alcohol use

OECD work on the economics of prevention

Declaration of interest: I helped to write Tackling harmful alcohol use, but the views expressed here are entirely my own and do not necessarily represent those of the OECD, its member governments (or the drinks industry).

Patrick Love

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