From Science to Action? 100 Years Later — Alcohol Policies Revisited PDF
Preview From Science to Action? 100 Years Later — Alcohol Policies Revisited
FROM SCIENCE TO ACTION? 100 YEARS LATER – ALCOHOL POLICIES REVISITED F S A ? ROM CIENCE TO CTION 100 Y L – EARS ATER A P R LCOHOL OLICIES EVISITED Edited by Richard Müller Swiss Institute for the Prevention of Alcohol and Other Drug Problems, Lausanne, Switzerland and Harald Klingemann University of Applied Sciences, School of Social Work, Bern, Switzerland KLUWER ACADEMIC PUBLISHERS NEW YORK,BOSTON, DORDRECHT, LONDON, MOSCOW eBookISBN: 1-4020-2605-6 Print ISBN: 1-4020-1801-0 ©2004 Springer Science + Business Media, Inc. Print ©2004 Kluwer Academic Publishers Dordrecht All rights reserved No part of this eBook maybe reproducedor transmitted inanyform or byanymeans,electronic, mechanical, recording, or otherwise, without written consent from the Publisher Created in the United States of America Visit Springer's eBookstore at: http://www.ebooks.kluweronline.com and the Springer Global Website Online at: http://www.springeronline.com Generous support and sponsorship has been assured by a number of national as well as international agencies, societies and public authorities: − The Regional Office for Europe of the World Health Organization − The Kettil Bruun Society for Social and Epidemiological Research on Alcohol − IVO (Instituut voor Onderzoek naar Leefwijzen & Verslaving) − Addiction Research Institute, Rotterdam − The Swiss Federal Office of Public Health − The Swiss Alcohol Board − The Swiss National Science Foundation − The Swiss Academy of Medical Sciences − The Swiss Foundation for Alcohol Research TABLE OF CONTENTS 1. Introduction...............................................................................................1 Richard Müller, Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme, Lausanne, Switzerland INTERNATIONAL PERSPECTIVE 2. Alcohol policy on the agendas of the European Union.............................5 Salme Ahlström, Thomas Karlsson & Esa Österberg, STAKES, NationalResearch and Development Centre for Welfare and Health, Alcohol and Drug Research, Helsinki, Finland 3. From Alcohol, Society and the State to Broken Spirits to… .................15 Pekka Sulkunen, Department of Sociology, University of Helsinki, Helsinki,Finland 4. Alcohol policy and the public good: As simple as one, two, three?........29 Thomas F. Babor, University of Connecticut School of Medicine, Dept of Community Medicine and Health Care, Farmington, Connecticut, USA 5. Harm reduction: the drugification of alcohol policies and the alcoholisation of drug policies ...............................................................49 Tim Stockwell, National Drug Research Institute, Curtin University, Perth, Australia HISTORY 6. From temperance movement to state action: A historical view of the alcohol question in industrialised countries............................................59 Irmgard Eisenbach-Stangl, Ludwig Boltzmann-Institut für Suchtforschung, Wien, Austria viii TABLE OF CONTENTS 7. Reducing discursive complexity – The case of alcohol policies in Europe (1850-2000)................................................................................71 Barbara Lucas, IEPI, Université de Lausanne ; Département de science politique, Université de Genève, Lausanne and Geneva, Switzerland ACTION 8. Community action from an international perspective...........................101 Harold D. Holder, Prevention Research Center, Berkeley, California, USA 9. Does price matter? The effect of decreased price on spirits consumption in Switzerland .................................................................113 Jean-Luc Heeb, Gerhard Gmel, Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme, Lausanne, Switzerland; Meichun Kuo, Jürgen Rehm, Institut für Suchtforschung, Zürich & University of Toronto, CanadaCentre for Addiction and Mental Health, Toronto, Canada 10.Policies and politics in France ..............................................................125 Michel Craplet, Association Nationale de Prévention de l'Alcoolisme (ANPA),Paris, France 11.Drunkenness and preference for spirits in different countries...............131 Holger Schmid, Schweizerische Fachstelle für Alkohol- und andere Drogenproblem, Lausanne, Switzerland 12.Towards evidence-based policy............................................................141 Henk F.L. Garretsen and Ien van de Goor, University of Tilburg, Faculty of Social and Behavioural Sciences, Tilburg, The Netherlands TABLE OF CONTENTS ix ETHICS AND POLITICS OF POLICIES 13.“What if we found the magic bullet?”...................................................153 Robin Room, Stockholm University, Centre for Social Research on Alcohol and Drugs, Stockholm, Sweden 14.Science, public policy and the alcohol industry....................................163 Norman A. Giesbrecht, Centre for Addiction and Mental Health, Social, Prevention & Health Policy Department, Toronto, Ontario, Canada 100 YEARS SWISS ALCOHOL POLICY 15.Swiss alcohol policy – ‘Model or Sonderfall’?.....................................185 Richard Müller, Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme, Lausanne, Switzerland R. MÜLLER INTRODUCTION 100 Years Later – Alcohol Policies Revisited Alcohol has been central to social, religious and personal use throughout history. Alcohol drinking goes back almost as far as the human race does. A hundred years, therefore, may be seen as only a flash. The past century, however, has witnessed a fundamental change in dealing with alcohol problems. Hence, to give an overview of a hundred years of alcohol policies is a rather ambitious task and the contributions to this book shed only some light on the ways in which alcohol policy issues have changed in this period. Alcohol control peaked in the politics of prohibition in many countries in the first half of the 20th century, and has decreased in the last 50 years in Europe and North America. Alcohol control measures directed at alcohol availability and supply have lost ground, mainly, it is thought, because of the orientation towards a free market and the growth of consumerism. Many control measures concerned with production, import, export and wholesale monopolies ended in new, liberal regulations on licensing of retail sale outlets and were finally abolished. Every applicant fulfilling some basic requirements could obtain a licence. Consumers are no longer willing to be guided by governments. Restrictions of the days and hours of retail sale of alcoholic beverages were increasingly criticized, therefore, and have been abolished. The legal-age limits for buying alcoholic beverages have, however, been retained and even been made stricter in recent years. At the same time, alcohol policy has shifted gradually from control of supply to reduction of demand. Numerous alcohol-education programmes were developed and implemented in many parts of the world. It has to be admitted, however, that prevention and education programmes have proven less than effective. One lesson of alcohol policy over the last 50 years appears clear, therefore: the more restrictive countries still show lower alcohol consumption and lower rates of alcohol problems than the less restrictive. Through the lens of economic theory, the effectiveness of any control system depends upon the extent to which the control system is empowered to interrupt the mutual stimulation of supply and demand. With the liberalization of the markets during the last 30 years this power has decreased remarkably. An exception to the liberal trend is the harsher alcohol-control measures directed nowadays at drunken driving. Many countries have adopted lower limits of blood alcohol concentration (BAC), reflecting growing concern about traffic accidents but also the development of technical devices that can measure BAC quickly and reliably. 1 R.MüllerandH.Klingemann(eds.), FromSciencetoAction?100YearsLater-AlcoholPoliciesRevisited,1–3. ©2004KluwerAcademicPublishers.PrintedintheNetherlands. 2 R.MÜLLER As the years have passed, with the alcohol industry steadily whittling away the powers initially legislated for the licensing agencies, the public has gradually come to the view that alcohol control measures are mere revenue-collecting devices, devoid of any public health objective. The practice of directing alcohol-tax revenues to a general fund has the disadvantage of creating a conflict of interest between revenue generation and the public-health purpose of alcohol control. The alcohol industry exploits this conflict of interest by mobilizing friendly constituencies to weaken the legislative shackles in order to allow more sales and increase government revenue, and ultimately to maximize its own profits. The most striking points of concern about alcohol policy today are that the production of alcoholic beverages and the trade are increasingly in the hands of multinational corporations that operate worldwide, and that beer, wine and spirits are considered as common goods, irrespective of their intoxicating and addictive properties. Marketing strategies on a global level will help to embed the industrial beverage products in the daily life of the global population. An alcohol industry thus creates new markets in developing countries. At the same time “beverage designers” create new products, such as Alcopops, for special target groups (youth, women). For every lifestyle the appropriate drink is produced and promoted on the market. The prevention of alcohol-related problems has to be on the top of these global developments. The change and the meaning of drinking patterns have to be understood in order to prevent negative consequences of alcohol consumption, Obviously, innovative approaches are most needed in that direction. A new harm-reduction approach – inspired by the prevention of illicit-drug use – has recently been adapted to alcohol problems. The basic idea is to minimize alcohol-related problems without reducing the individual or collective amount of drinking. Thus the “world of problematic drinking and drunkenness“ would be safer. Night-bus systems or pick-up services for drunk drivers, and unbreakable glasses and conflict management for bar brawls, are examples of this harm-reduction approach to alcohol problems. In a globalized world of alcohol marketing with minimal state intervention, this form of alcohol prevention without reduction in general consumption is an additional option. Increasingly, the beverage-alcohol industry aims to create an image of a socially concerned and responsible business and engages in efforts to reduce alcohol-related problems. For the producers and distributors, education is the key to tackling alcohol abuse; the message is the demand for “responsible drinking”, especially at young ages. The industry, therefore, implements and funds programmes, including educational programmes at school, to support young people in their understanding of responsible lifestyles. In the search for legitimacy the industry seeks partnership with governmental and non-governmental organizations. The ethical base of such cooperation is controversial and conflicts of interest are inevitable. The partners do not start from a common base. The industry claims that alcohol does not have the characteristics of a drug and that the benefits of drinking outweigh its negative effects. Since it is known that the prevalence of alcohol- related problems is related not only to average per capita consumption, but also to problematic drinking patterns, policy-makers are persuaded to shift their focus to the elimination of negative patterns of drinking and to the promotion of beneficial INTRODUCTION 3 patterns. A partnership between the drinks industry and governmental and non- governmental organizations can compromise the independence of public health; this risks damaging the public good and impairing the trust of civil society in its public institutions. Non-governmental organizations may find it appealing to cooperate with the beverage-alcohol industry, but the industry has invested enormously in the promotion of new alcoholic drinks for youth; hence all cooperation remains questionable and should be carefully assessed. In our fun-oriented consumer society the trend toward the consumption of all kinds of drugs will prevail and alcohol will continue to be the drug of choice of a large part of the population worldwide. Janus, the god of two faces, will point his noses in two directions. Humans can derive enjoyment and benefits from the responsible use of alcohol but many suffer the negative consequences of drinking. Prevention in the form of individual or collective intervention is needed to minimize alcohol-related harm. A hundred years from now our activities will be judged as to whether we have advanced one step further in living with alcohol without producing harm.
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