Alcohol evidence and policy

Editor—Some years ago the Australian health ministers decided on a policy to reduce total alcohol related harm in their communities. One goal was to reduce the average per capita consumption of alcohol, the ministers having accepted that this was an evidence based approach. In 1990 Hawks wrote a most disturbing article on how this process had been hijacked by the alcohol industry and the rest is history.¹ Last year's alcohol summit in New South Wales was a reminder that if governments leave these problems alone they do not go away.

Now, Plant tells us, the same lobby group seems to be at work in the United Kingdom, ensuring that those most dangerous of the mad scientists, those who insist on an evidence base for policy, are put in their place.² As Marmot explains, although the evidence supporting a reduction of consumption as a means to reduce harm is solid, education (intergenerational buck passing given a new spin) and better treatment is the government's preferred option.³ One has to conclude, since the prime minister's committee has seen the same evidence, that this approach has been chosen precisely because it is unlikely to work too well. For the public to accept this approach implies that the dogma of consumer sovereignty and individual responsibility still dazzles and confuses the senses.

The evidence of mounting harm from increasing alcohol use, and of the failure of current interventions, is in the United Kingdom, as in Australia, as obvious (sometimes literally) as a punch in the mouth. This is another triumph of spin over substance.