The biggest, most destructive drinking game of all

There is a ubiquitous, wildly popular pink elephant in the room. The “bad news” about alcohol keeps rolling in, but boy oh boy, it’s a whole lot easier to ignore it. In November 2010, The Guardian reported the results of a study produced by the Independent Scientific Committee on Drugs and published in the Lancet. The study suggested that alcohol was “the most dangerous drug in the UK” by a fair margin, more holistically destructive than even heroin, cocaine and tobacco. Late last week, research conducted by the European Prospective Investigation into Cancer and Nutrition Project (EPIC) was released, finding that some 13,000 cancers each year in the United Kingdom are likely traceable back to people’s drinking habits. As Sarah Boseley reports, even small or moderate levels of consumption (e.g. 2 daily drinks for men and 1 for women) appears to significantly increase the risk of cancer, particularly in the mouth, oesophagus, voicebox and pharynx.

Clearly, the prisms through which governments, societies and indeed individuals across the world view drugs are incredibly distorted. It’s not over-egging it to suggest that triple or quadruple standards are in play. In the red corner, we have dangerous, illegal drugs like heroin and cocaine which are almost universally considered globally to be “bad” drugs, with stiff legal penalties imposed for both possession and trafficking. About the length of a good jab away, we have cannabis: still an illegal substance in most jurisdictions, but broadly becoming acceptable for medicinal purposes, and widely viewed as a much less dangerous drug than so-called “Class A” drugs, as they are known in the UK.

Taking a few more drowsy steps across the ring, we have tobacco; once upon a time, a wildly popular, publicly accepted drug, but now suffering from pariah status. It’s widely accepted that prohibition is not a reasonable or workable solution, so instead governments across the world have sought to educate people about the dangers of smoking and to incrementally legislate tobacco towards the margins of society, through advertising bans, usage restrictions, and even, more recently, packaging controls. There is a general sense in the public that governments are doing the right thing in engaging in these sorts of “soft touch” draconian measures. Of course, when it comes down to it, smokers are effectively being instructed that they are only allowed to poison themselves and others in a strictly regulated environment according to certain conditions – which in a more straightforward world, wouldn’t pass the laugh test as a final solution to a public policy problem relating to a specific product. Let’s not even get started on government’s implied preference for smoking over euthansia.

In the blue corner, finally, we have alcohol: the widely available, gloriously advertised, practically unrestricted opiate of the masses. The short-term health implications of alcohol usage are negligible, but the long-term health implications and indeed the sociological implications are very slowly coming to be understood as disastrous. We have to assume, given its ubiquity, that alcohol touches many more people’s lives negatively than either heroin or cocaine. It’s the questions that we don’t really know the answers to, or don’t really care to know the answers to, that provide the kicker. What proportion of assaults, domestic violence cases, thefts, killings, rapes and car accidents have alcohol abuse at their root? What is the annual cost to the health sector of treating patients who have suffered one of the wrongs mentioned, developed liver disease, or indeed a form of alcohol-related cancer? How can we ever hope to measure or quantify the distress and pain caused by people (particularly in struggling socio-economic areas) who abuse alcohol and make decisions that emotionally or physically damage their friends, families, and communities?

I am sure that in the heyday of tobacco, during the middle of the twentieth century, the idea that one of the world’s favourite substances would eventually be unmasked as a “bad drug” would have been laughed off by many. It’s hard not to wonder what the next fifty or sixty years will bring for the alcohol industry, given the pressures being applied to governments across the world to be “tough on crime” whilst also reducing public spending, impacting areas of public policy like health and policing. These pressures directly collide with the enormous popularity of alcohol and its acceptance as an everyday recreational substance.

If the somewhat rapid stigmatisation of tobacco is any guide, today’s blockbuster alco-dollar ads and “drink, drink, drink … spew” popular culture could eventually recede into the annals of human history; just another of those crazy, stupid things that people did back in those days before they knew any better or society chided them into behaving differently.

No, (sadly) I’m not holding my breath either… er, drink?

Cross-posted at Larvatus Prodeo

Peanut farmers, rocks, and hard places

It’s becoming clear that the Rudd Government never expected the strong level of opposition to its health funding reforms that John Brumby and the Victorian Government have served up over the course of the last couple of weeks. As Michelle Grattan and David Rood reported in yesterday’s Age, the relationship is quickly becoming toxic. Premier Brumby stepped up and addressed the National Press Club on the topic yesterday, and on Tuesday, even drew parallels with the behaviour of the Prime Minister and the behaviour of Queensland Premier Joh Bjelke-Petersen in the 1970’s. This was an extraordinary contribution to the debate, considering that Brumby and Rudd are supposedly from the same political party and that Brumby could hardly have cast a greater slur on his northern colleague. The germination of the Prime Minister’s political career in Queensland was arguably in no small part driven by the vulgar excess of the Bjelke-Petersen years.

The Prime Minister seems determined to win the day on health reform, and is prepared to continue upping the ante with more funding and incentives until he gets it, whilst refusing to fundamentally alter the underlying structure of the deal. Whether the Federal Government’s approach in a policy sense is correct seems, sadly, to have degenerated into a second order issue, at least when compared to the political shit fight for ownership over health reform.

This puts Premier Brumby in an invidious position, given the staunchness and nature of his opposition thus far. Brumby has already proposed an alternative plan (e.g. a 50/50 funding split without the 30% loss of GST implied by the Rudd/Roxon plan) that he holds to be a considerably better agreement for all parties. But as the offer on the table from Canberra gets bigger and more attractive, the pressure on the Victorian Premier to bite the bullet increases. The overwhelming majority of the shot in this war is in the Federal Government’s locker. The fraternal politics of the situation for the Labor Party are diabolical. No Labor Premier would want to be remembered as the person responsible for critically undermining a Federal Labor Government about to wage its first election campaign after over a decade of conservative hegemony. Sooner or later, the Victorian Premier will be coerced into caving in by the sheer force of the taxpayer dime on offer, and the broader ramifications of not signing up.

In the next couple of weeks, Brumby is going to have to find a way to be a good little Labor Premier and acquiesce, whilst at least appearing to have won some concessions from those bovver boys and bovver girls from the nation’s capital.

LOSTNEARFOSSILCREEK

It seems as though the entire Opposition has managed to get itself lost near Fossil Creek. At the end of last week, they were riding high on the home insulation scandal, delighting in the prospect of blaming the Environment Minister and the Prime Minister for deaths caused by dodgy insulation start-ups. The “oppose everything” routine was going great guns. The poll numbers for Tony Abbott were looking bad for Labor, and the Prime Minister felt the need to indulge in some extraordinary self-flagellation on Insiders last Sunday.

What a difference a week makes. This week, the Rudd Government has come out playing ball in election mode, announcing major initiatives in education and health. It is looking like Labor’s health reform plan will form the cornerstone of its re-election campaign. Despite some general public reservations about whether this plan was a process that should have already been well underway, people know that big changes need to be made to the way in which health services are provided in this country. When push comes to shove, health as an issue trumps most other issues out there, and the government’s plan is going to prove difficult to counter; unless, of course, the states and territories don’t play nice.

The timing of Tony Abbott’s barmy disappearance into Central Australia could not really have been worse. I’m not sure if his trip was planned significantly in advance or not, but it should have been gently postponed given the political developments of last week. In his absence, the government has had a free-hit, launching policies and looking positive, while Abbott scratches about in the outback, looking unkempt and managing to make an arse of himself by getting lost. His “oppose everything” schtick is starting to wear a bit thin, especially when it is phoned in from no-man’s land and he is offering no serious policy alternative.

I don’t doubt that the Opposition Leader could learn a lot from engaging more closely with Aboriginal communities, but it was very, very questionable politics to do so while he had the government looking like it might collapse on the canvas after a tough week. Federal Labor has now regained control of the news cycle, and I would not be surprised if the polls in the next couple of weeks reflect that.

Injecting some nutrition into the GST

Like many of us, I suspect, I have a strong disposition towards eating significant quantities of chocolate on a regular basis, so I do have some vested interest in the so-called “fatty food tax” that is being bandied about as an option in the war on obesity. The Obesity Policy Coalition, which consists of Cancer Council Victoria, the Victorian branch of Diabetes Australia, VicHealth, and the World Health Organization Collaborating Centre for Obesity Prevention at Deakin University, proposes that an annual nutritional survey be introduced, and that the data gathered from this survey be used to drive the particular foods that the tax would target.

While conservatives are sure to baulk in quick time at the prospect of another tax being introduced and the government sticking its grubby nose into our shopping trolleys, I really do think that a tax-neutral scheme could work, work well, and better yet for the poll junkies in the Rudd Government, be sold effectively to a sceptical public. Tax-neutral, you ask? As Jane Martin suggests in the article linked above, what I believe would work best is for healthy foods (e.g. particularly fruit and vegetables, wholegrain-based foods, lean meats, etc.) to be subsidised by the government through a reduction in the rate of GST for those items, with tax reductions funded through corresponding increases in the rate of taxation on unhealthy foods (e.g. alcohol, sweets, high-fat snacks, soft drinks, energy drinks, etc.). Such a scheme would inject two powerful incentives into the market for people to think more carefully about the choices they make at the supermarket, and the sorts of food that they should be eating a lot of.

Making the scheme tax neutral cuts through a lot of the “tax rubbishing” that is sure to be done by the sorts of one-eyed ideologues who would be happy to drive their expensive cars through the undergrowth before they will contribute to a public roads system, or are happy to see the less well-off attend substandard schools and be treated as substandard hospitals because they don’t believe in public education or health systems. In short, such people are selfish mugs, and normally shouldn’t be given the time of day. However, they also shouldn’t be allowed to let their prejudices taint the perspective of everyday folk who just want the best for their families. Presumably there will also be costs to the economy involved in instantiating such a scheme, but I’m fairly certain that modelling of the scheme would produce long-term health benefits for the nation that dwarf the initial costs of its introduction.

This issue could be a quick win for public health; all that is needed is some analysis as suggested, what is likely to be some fairly gentle tuning of an existing tax measure, and the job is practically done. Mr. Rudd? Ms. Roxon?

Deflating a culture of alcoholism?

It is of concern to hear that new figures released by NSW Health suggest that there has been a 59% increase in alcohol-related emergency department cases in NSW from 2000 to 2007. Let’s be blunt; in today’s modern era of global financial upheaval, governments across the country can scarcely afford to continue to fund people’s alcohol-related stupidity. We are perhaps at the point now where some new measures need to be introduced to try and turn this concerning trend around. NSW Health Minister John Della Bosca has expressed a willingness in recent days to do just that, although the proposals he has floated as possibilities so far seem only to be targeting the advertising arm of the alcoholic beverage industry (e.g. the introduction of warning labels and a full or partial ban on alcohol advertising).

To be honest, I am not sure either of these measures in isolation will achieve anything near the desired result. If the campaign that has been waged on tobacco over the last decade by both the public sector and NGOs has taught us anything, it is that a co-ordinated campaign has the best chance of making long-term inroads. It is of course a difficult task for a government in any country to “crack down” on a national pastime that has gotten somewhat out of control. The liquor industry and powerful industry organisations like Clubs NSW and the Australian Hotels Association would no doubt fight any measure from the government that threatened to eat into alcohol sales. Unless a bipartisan approach to the issue was forged by Labor with the Coalition, there is also little doubt that the Liberal Party would seek to fight any measures that could conceivably damage the alcoholic beverage industry, citing their doctrine of individual choice and responsibility. A frighteningly stereotypical rag-tag mob of yobs, publicans and anti-regulation zealots would then almost certainly jump on the Liberal Party’s bandwagon, and the NSW Government would suddenly have a difficult fight on its hands given it’s extremely vulnerable political position at the present time.

What I would encourage the NSW Government to pursue is a long-term, multi-tiered strategy for reducing alcohol abuse in the state. Policy measures introduced to begin with should be relatively moderate, with pre-legislated increases in the rigor of measures if annual targets are not met on an ongoing basis. While limitations or outright bans on advertising in some sectors should be considered as part of this strategy, I think the government also needs to attack alcohol abuse from other avenues. Carefully conceived information campaigns (such as the Quit for Life campaign) and the more recent punitive negative advertising introduced by the Howard Government in relation to tobacco also clearly have a role to play. People across the country (and in particular young people) need to be reminded and understand that they will turn into blithering morons after a certain number of drinks, and that it’s not “cool” to be in that state, it’s actually pretty sad.

Despite the prevailing economic orthodoxy, it remains true that targeted increases to taxation can also be a powerful part of a co-ordinated government strategy. I think there are grounds, given these recent figures, to increase the amount of excise on alcoholic beverages in NSW, particularly if the excess funds gained are pumped straight into programs that seek to minimise alcohol abuse. Given the increasing scale of costs, private and public damage, injuries and death that alcohol abuse causes every year in this state, surely it is only fair to expect that alcohol consumers cover more of the public costs that their hobby generates when it is taken to excess?

Bring us your fat and your poor and we’ll kick them

I am really not sure what to make of this article in Uncle Rupert’s Times today. When I first saw the headline plastered over the free morning shitsheets on the tube this morning, I thought that just maybe, Tory Leader David Cameron had taken a step too far in his belligerent, wealthy-folks-oriented conservatism and would get a well-deserved whack for it. The title of the article is “David Cameron tells the fat and the poor: take responsibility”, and remarkably enough, the title is in fact a fairly accurate synopsis of what Cameron is reported as saying:

In a conscious shift of strategy, the Tory leader said he would not shirk from discussing public morality and claimed that social problems were often the consequence of individuals’ choices. “We talk about people being ‘at risk of obesity’ instead of talking about people who eat too much and take too little exercise,” he said. “We talk about people being at risk of poverty, or social exclusion: it’s as if these things — obesity, alcohol abuse, drug addiction — are purely external events like a plague or bad weather.

Of course, this being the Times, these comments are described matter-of-factly in the article, with nary a hint that just perhaps Cameron’s comments are controversial, or for some, offensive. Certainly what we have an example of here is the rhetoric of individualism taken to yet another fanciful extreme, the prejudices of an arrogant upper-class twat fashioned crudely into a faux-bold pronouncement. I don’t believe it to be true that modern society makes individuals feel blameless for their various predicaments, as Cameron seems to be suggesting. If anything, both Britain and Australia have over the last couple of decades moved away from being societies where one’s rights towered over one’s responsibilities, to societies where the balance between one’s rights and responsibilities are more evenly (and perhaps, more effectively) poised.

It is interesting that Cameron is all for heaping responsibilities onto individuals who may or may not have the capacity to solve their problems on their own, but does not seem to be very interested in the responsibilities of society. Moreover, is it not true that society has a responsibility to lend individuals a helping hand when they fall foul (whether partly or wholly through their own hand) of afflictions like poverty, alcoholism, drug abuse, or obesity? Isn’t it not just the individual that has failed when this scenario unfolds, but society itself? What is clear from these sorts of questions is that conservatives like Cameron seem to lack the very basic human ability of taking a walk around the block in someone else’s shoes. Not everyone grows up in a wealthy family, with excellent parents and a good understanding of how to play the 21st century economic game to perfection. Not everyone emerges, blinking, into the light of the global economy at 18, ready to plug in with a metaphorical USB cable dangling from the back of their skull. I don’t see why we should be surprised that people who come from difficult backgrounds might struggle to make the right decisions in their lives, perhaps leading to some of these afflictions taking hold.

The people of Great Britain would do well to remember at the next election that a vote for David Cameron is a vote against the sorts of people right across the kingdom who need a helping hand. If you are thin, white, rich, and don’t give a shit about other people, the Tories are making it damned well clear with comments like this that they are your party.