Increased Availability Leads to Greater Harm

Article excerpt

BYLINE: Jonny Myers and Tracey Naledi

Alcohol is no ordinary commodity and consequently the alcohol industry is no ordinary industry. Alcohol is a drug that causes significant and substantial harm to health, society and the economy generally.

Specific interests of the alcohol industry must be counterbalanced with the need to reduce these harms for society in general. While the liquor industry and the tavern owners profit, alcohol harm incurs substantial economic costs, with a net loss to the provincial government and the population at large.

The Western Cape Department of Health leads a transversal workstream called Reducing the Burden of Disease in the Western Cape. Burden of disease research has found that alcohol is the second-largest contributor to the provincial burden of death and disease through its impact on major infectious disease (HIV/TB and unsafe sex), interpersonal violence and traffic-related injury, mental health disorders, chronic diseases and children's diseases.

The latest draft of the Western Cape Liquor Bill (March 2008) envisages a particular implementation of national and provincial liquor policy which points to the need to bring small retailers, formerly operating outside the formal regulated sector as shebeens in the townships, into the mainstream as taverns, with the dual aim of economic empowerment as well as licensing and regulating their operations.

Unfortunately, the balance in the bill is seriously skewed against the reduction of alcohol harm. Expanding the operations of the alcohol industry in the manner envisaged in the bill is likely to result in considerable damage to the Western Cape population, with negative developmental implications for the majority of the inhabitants of the province, while benefiting a small number of people involved in a highly concentrated liquor industry. It is the considered opinion of the authors of these comments that once taverns are allowed to proliferate as permitted by this bill, it will be impossible to reverse the situation in order to regain reasonable control of liquor outlets in the future.

Their diffusion and multiplication throughout residential areas in the entire province will increase alcohol availability and will incur considerable economic, social and health costs for the inhabitants of the province. Indeed, evidence from across the globe indicates that there is a direct relationship between alcohol availability and alcohol harm.

Substantial evidence has accumulated globally about the effectiveness, efficiency and feasibility of interventions to reduce alcohol harm in individuals and populations. The most successful interventions, those which effectively reduce alcohol consumption and harm at the individual and population levels, are those that reduce alcohol availability and accessibility.

They do this by regulating the number and density of liquor outlets, hours of trade, alcohol content and price of alcoholic beverages, age of legal consumers, and drivers' blood alcohol concentrations.

The common denominator of such interventions is to make alcohol less accessible by means that have repeatedly been shown to be inexpensive to implement and effective in reducing the volume of alcohol consumed. In doing so, it is possible to obtain dramatic decreases in unsafe sex, interpersonal and traffic-related injury, mental illness, and foetal alcohol syndrome.

Other more downstream interventions target the behaviour of people who have already accessed alcohol and aim to reduce alcohol harm, particularly intoxication after the event. Tavern staff, consumers, school children and the general public are the targets of educational interventions with these goals in mind. However, educational interventions have been found to be ineffective in reducing alcohol harm worldwide, and those few interventions that show some promise are heavily dependent on the effectiveness of external enforcement and are consequently expensive to implement. …