NICE recommends minimum price for alcohol to curb high risk drinking
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2927 (Published 02 June 2010) Cite this as: BMJ 2010;340:c2927
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Dear Editor,
May I use this medium to applaud Zosia for recommending a strategy to
curb high risk drinking? In addition to that suggestion I would like to
add some other interventions that should contribute to the prevention and
management of this disease. I am a registered nurse of many years and
among my varied experiences, I have worked with alcoholics in a
Detoxification Unit and a Community Mental Health Programme. Many
alcoholics have had readmissions and interventions for the use of the same
substance, but as soon as they were discharged, they resumed the habit
regardless of financial status.
It is my opinion that there can be no single approach that will succeed as
a deterrent to persons from using alcohol, because the contributing
factors are multiple and complex.
Many experts agree that a combination of emotional, mental physical
and possibly genetic factors are determinants of the crave for alcohol
(King, T. et.al. 1996) Alcoholism is considered an illness that develops
slowly for varying reasons. This notion that increasing the price of
alcohol will reduce or prevent its consumption is an attempt to prescribe
a single reactive modality to a multifaceted syndrome.
This devastating phenomenon that affects families globally and
threatens nations’ building and survival must be tackled with a multi-
sectoral and multi-dimensional approach. The change strategy must be
undergirded by the fact that alcoholism is a disease and so early
diagnosis and treatment will determine outcomes.
Prevention and reduction of alcohol consumption strategies are
critical success factors, and can be achieved through community education,
inclusion in schools’ curricula as well as by government legislation. A
combined and sustained effort of ministries of health and education and
other stakeholders is required to defeat the effects of this monster.
Policy makers need to embrace health promotion and disease prevention
strategy which is inclusive of legislation against the promotion of
alcohol use in any forum e.g. advertisement in the media, teenagers under
the statutory age of adulthood entering bars or any place where alcohol
is sold or used, raising the legal drinking age to twenty five years, and
making fines for alcohol - related accidents penal. As a government
policy, all radio and television stations must carry prime time
information outlining the deadly effects of alcohol consumption. In
addition, the price of alcohol should be prohibitive as a facet of the
comprehensive attack on its use.
My conclusion is that there must be a comprehensive and sustained
approach to this chronic disease and the concomitant consequences that
transcend geographical and cultural boundaries.
Reference
1. Arno, R.G., Arno, P.T., King, T.D., King, D. L.,(1996) Christian
Psychology and Counseling
Competing interests:
None declared
Competing interests: No competing interests
NICE are naive in their interpretation of the evidence
Skepticism is often deadened when the evidence backs your
pre-existing prejudices. NICE have fallen into the same trap
as Liam Donaldson and the BMA in how they interpret evidence
about what affects the level of alcohol consumption. All
risk implementing simple direct solutions that will
pander to their desire to do something but will not help in
the long run.
All have failed to read the evidence carefully. We have
convincing evidence that short term increases in price cause
a drop in consumption (and vice versa). It does not follow
logically or evidentially that price increases have an
affect on the long term behaviour of the population
(otherwise Norwegians would be virtuous teetotallers and the
French would be drunken louts). Deep seated social habits
are not cured by simplistic government actions like minimal
prices.
NICE also recommends restrictions on availability. There is
even less evidence here. It seems obvious (at least to
tabloid headline editors, NICE and the BMA) that tightly
restricting opening hours will curb the amount we drink. The
current lax licensing hours presumably explain why the
English drink so much more than they did before the
relaxation of the rules. Except that they don't: consumption
in England has fallen every year since the rules were
relaxed.
Alcohol consumption has been an English problem for a long
time. Simplistic efforts to combat the problem look good,
but don't work and distract from the slow search for long
term solutions that tackle the underlying culture.
Competing interests:
None declared
Competing interests: No competing interests