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Tuesday, February 26, 2008

Editorials - Tackling alcohol misuse in the UK
BMJ, doi:10.1136/bmj.39496.556435.80 (published 22 February 2008)

Higher alcohol taxes and restricting availability are more likely to succeed than partnerships with industry

Nations, like people, can develop a pathological pattern of alcohol misuse. Ever since the Blair government consolidated its alcohol control policy around a "partnership" with the alcohol drinks industry,1 the United Kingdom has been anything but united about how to deal with the nation’s alcohol problems.2 3 While some people have seen collaboration with industry as a way of "disabling the public interest,"2 the ostensible rationale was to involve alcohol producers and retailers in new initiatives—such as voluntary limits on advertising, safer packaging, and codes of good conduct—to make town centres safer at night. In response to mounting evidence that this approach is not working,3 this week the BMA voices its opinion on how the problem should be tackled through the release of a report on alcohol misuse.4

According to the report the long wave of increasing alcohol consumption—which has moved the UK into eighth position in the hard drinking nations of Europe—did not occur by chance. It was facilitated by the progressive dismantling of previously effective alcohol control policies through deregulation and trade liberalisation, exemplified by 24 hour a day opening.

Although the connection between deregulation, consumption, and alcohol related problems is admittedly complex, the BMA report makes a good case for a combination of new regulatory measures, controls on consumption, and approaches to minimise harm. The evidence base for effective alcohol policy reviewed in the report is impressive. Universal strategies like increased alcohol taxes can drive down per capita consumption, especially in younger drinkers, and targeted approaches such as early intervention and specialised treatment are effective ways to deal with hazardous and harmful drinkers.5 The BMA’s recommendations are organised into six areas: controlling access to alcohol, promoting responsible industry practices, introducing measures to reduce drink driving, promoting health education and healthy living, encouraging early intervention and treatment, and supporting international cooperation on alcohol control .
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