Consuming alcohol is an accepted and common social practice.
We imbibe to celebrate, forget, relax, drink with our meals and sometimes, to get us up on the dance floor. However, there are significant implications for health, both for the individual and for the community. We must be aware of the limits and dangers of inappropriate consumption, including from a public health perspective.
We are not saying consuming alcohol is inherently bad nor are we suggesting unreasonable controls. However, there are policies and practices that allow people to enjoy a drink while maintaining some control over potential problems.
To that end, a report funded by the Canadian Institutes of Health Research published in 2013 looked at the various practices surrounding alcohol across Canada. The report, called "Strategies to Reduce Alcohol-Related Harms and Costs in Canada," focuses on the health and safety issues associated with the sale, distribution and consumption of alcoholic beverages.
More than 80 per cent of Canadian adults partake in alcohol and in most instances, do so responsibly. But alcohol is also associated with a wide range of harms, from acute injuries to trauma and violence. It is also connected to the development of many chronic diseases and is one of the leading causes of disease and disability. The research on these links is deep and thorough.
Canadian data indicates that alcohol consumption increased by 13 per cent between 1996 and 2010. Likely reasons for this include moves to increased privatization, more access to alcohol and extensive marketing using sophisticated promotion and sponsorship methods. In fact, international literature connects the privatization of retail alcohol with substantial increases in sales. It also offers an established proxy for excessive alcohol consumption.
The "Strategies" report highlights the harms that come from inappropriate use of alcohol and recommends changes in provincial policy to reduce harm from alcohol. All provinces offer some examples of what is effective, and what is not. From these come a number of recommendations that can work to reduce the costs of alcohol for society, and for individuals.
First, alcohol pricing is one of the most potent policy levers to reduce alcohol-related harm. This means setting minimum pricing, a proven method of reducing over-consumption. Pricing should reflect alcoholic content so as to be equitable.
Provincial controls over the sale and service of alcohol offers a strong point of control and provinces should be encouraged to place a moratorium on private outlets including agency stores and grocery store kiosks. That is, government monopolies should be maintained.
Having a comprehensive graduated driver licensing program, as BC does, is an effective way to reduce drinking-driving problems. The program provides for zero blood alcohol levels for all drivers under 21 with less than five years driving experience.
Mandatory server training and 'challenge and refusal' programs have been shown to reduce over-service and service to minors. These should be implemented fully across Canada.
Using policy interventions to deal with alcohol-related harms are especially effective because they can work with little administrative cost and bureaucratic machinery, and will benefit all segments of our communities.
Editor's note: Dr. Paul Martiquet is the medical health officer for rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.
