EditorialAs we enter the New Year, Drink Tank spoke to a number of stakeholders working in the alcohol and other drugs sector in Australia. We asked these public health experts to reflect on the past year in alcohol policy and to offer their insights and predictions for what lies ahead in 2015.
- Dr John Crozier, Chair of the National Trauma Committee,
Royal Australasian College of Surgeons - Professor Sandra Jones, Centre for Health and Social Research (CHaSR),
Mary MacKillop Institute for Health Research, Australian Catholic University - Professor Kypros Kypri,
School of Medicine and Public Health, University of Newcastle - Vicki Russell, Chief Executive Officer,
National Organisation for Fetal Alcohol Spectrum Disorders - Michael Thorn, Chief Executive,
Foundation for Alcohol Research and Education - Brian Vandenberg, Executive Officer,
National Alliance for Action on Alcohol - Dr Dennis Young, Executive Director,
Healthy Options Australia
When reflecting on the past year of Australian alcohol policy, Drink Tank received a mixed bag of responses highlighting the various improvements and shortcomings we’ve concurrently seen throughout 2014.
However when asked what the future holds, the public health experts we spoke to were enthusiastic and hopeful about the many opportunities for improving on Australian policies if governments decide that they are serious about reducing the harms caused by alcohol.
Brian Vandenberg is highly optimistic about the future given the emergence of organised alcohol policy advocacy networks across the country.
“There is a growing chorus of activists around Australia calling for action on alcohol,” he says. “In the absence of strong government leadership in this area, I hope that our growing band of coalitions can turn up the volume for stronger alcohol policy. From what we have seen in 2014, the challenge is both protecting the alcohol policies and programs already in place, as well as building on these.”
Protecting existing policies from being watered down, and ensuring that the right questions are being asked, appears to be one of the most pressing concerns for the future of public health.
“In the immediate future I hope the NSW Government will continue the Sydney CBD arrangements and extend them to the rest of NSW,” says Professor Kypros Kypri. “I would also like to see communities given a greater say on the sale of alcohol locally.”
In 2015 Vicki Russell would like to see policymakers and inquiries “begin asking questions about resilience – who is not drinking and how is it that people are able to resist the persuasive tactics of the alcohol industry and the social/cultural context of alcohol? It is also vital that those who are living with Fetal Alcohol Spectrum Disorders (FASD) are not overlooked in policy.”
More broadly, the longer term visions of advocates all share the same common thread; the desire to see future alcohol policies which incorporate tried-and-tested harm prevention measures that have a huge base of evidence attesting to their effectiveness.
Professor Kypros Kypri maintains “high hopes for the adoption of rational national alcohol policy, such as a volumetric tax, greater restrictions on physical availability, and the elimination of the promotion of alcohol.”
Similarly, researcher Professor Sandra Jones says that her hope “is that we will reach a point where Australia’s alcohol policies become evidence-based with the primary aim of reducing alcohol-related harms, rather than to assist the alcohol industry in increasing them.”
As a trauma surgeon who sees the impact of alcohol related harm daily, “I’d like to see evidence based public health measures implemented in Australia,” says Dr John Crozier. “This includes the introduction of price controls on alcohol sales (particularly volumetric taxation based on alcohol content); national reductions in hours of alcohol trade; better controls around density of liquor outlets; and the de-linkage of alcohol advertising from sport.”
Dr Dennis Young also supports these “well-researched strategies that reduce the serious health issues associated with alcohol consumption; including standardising taxation, limiting advertising and reducing the hours of operation for licensing venues.”
He adds that such measures should be summarised in “a new National Alcohol Strategy that addresses Australia’s harmful drinking culture and brings a single national approach to this most serious issue.”
Michael Thorn agrees with the call for political action: “Our political leaders need to find it within themselves to do more than simply acknowledge that Australia has a problem with alcohol. A failure to act will mean the social, health and economic burden of alcohol will continue to rise. We need to instead be adopting policies that the research evidence shows will stop harms caused by alcohol,” says Mr Thorn.
For many advocates, one of the biggest challenges to achieving these ambitious goals is a lack of awareness of alcohol harms and solutions.
Vicki Russell finds that: “FASD has unfortunately not yet reached the public agenda and there are not many formal inter-sectoral collaborations.
“It is often incorrectly mobilised as being an Indigenous issue or something that is only a problem amongst the most marginalised in our community, but such tactics placates the alcohol industry and limits policy scope,” says Ms Russell. “We need to focus on both preventing future exposed pregnancies across Australia and helping those already living with FASD.”
Dr Dennis Young notes that “The majority of us recognise that the harms associated with alcohol need to be addressed, and there is already growing support for some alcohol policy reforms.”
However Dr Young proposes that in order to gain support for the full range of policy reforms proposed, we need more people to be aware of the value of addressing alcohol harms in such a way. “For instance, a greater understanding of the rationale behind alcohol taxes that would then assist to offset the expenditure in health, education, and the treatment of alcohol-related problems,” he says.
Other barriers cited include frustrations with Australia’s legislation and outdated policy system.
“One obstacle for alcohol policy is the complex systems of state and federal legislation – with each hard-won battle needing to be re-fought in each state,” says Professor Sandra Jones. “For example, we still don’t have adequate and consistent secondary supply laws in every state. We also have ludicrous anomalies such as a loophole where Western Australia is the only state where supervising drivers are not required to be sober.”
Similarly, Michael Thorn believes Australia’s dysfunctional and near chaotic public policy process is preventing efforts to focus on anything other than ‘really’ big issues.
“There is for all intents and purposes no viable public health policy development process in Australia at the moment. The policy system is broken and until politicians stop ambushing the Australian public and adopt an open and engaging policy development process not much is going to change,” said Mr Thorn.
Furthermore when it comes to policy development, there is a resounding agreement that Australia needs to stop giving alcohol industry representatives a seat at the table to eliminate the influence of vested interests.
As Dr John Crozier stresses: “Our greatest barrier is the coercion of policy development by the alcohol industry.”
Overcoming this hurdle is vital for Professor Kypros Kypri: “We cannot achieve change with conflict of interest and ambivalence. Political parties should not be permitted to accept alcohol industry donations and we have to get over our ambivalence about alcohol which stems from the fact that many of us are consumers.”
Professor Sandra Jones warns that “the alcohol industry has immense power to influence government policy, compared to the very limited influence of both health advocates and the general public.” This was particularly evident in the development of the new ‘tougher’ liquor promotion guidelines in NSW.
“As fast as we see the introduction of some small restriction on the ubiquitous availability of alcohol, we see other jurisdictions ‘reducing the red tape’ and making alcohol more available,” says Professor Jones.
Brian Vandenberg echoes this concern, saying that “one of the continuing barriers is the undermining and relentless attacks from the alcohol industry in relation to any alcohol policy initiatives which they perceive to be a potential threat their profits. Despite the slick PR campaigns of DrinkWise, the industry have not shown that they are willing to be part of evidence-based solutions to our harmful drinking culture, and it’s therefore very concerning when governments allow these groups to advise on alcohol policy development.
“Their commercial imperatives mean that they have a clear conflict of interest in the shaping of alcohol policy, and it’s about time we stopped apologising for being wary about the alcohol industry and take some meaningful steps to safeguard public policy from deliberate sabotage,” says Mr Vandenberg.
Michael Thorn warned that politicians need to overcome their fear of adverse reactions from all kinds of vested interests, including the alcohol industry, and should instead prioritise the health and safety of their constituents.
“Governments appear frozen and political courage is rarely seen. Powerful vested interests are overwhelming Australia’s political system, stopping sensible policy discussion to the detriment of the public good. In response, coordinated, persistent and quality public health advocacy must be the order of the day!” says Mr Thorn.
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