The People vs. Population

Last week in New South Wales we saw a return to policies that focus on the actions of individuals. In this instance it was adults purchasing alcohol for children and the announcement of potential prosecutions of people who supply alcohol to minors.

For those of us working in the alcohol policy field, a sole focus on individual responsibility as a solution is not particularly helpful.  Policies that only aim to change the behaviour of individuals can never adequately address all of the reasons why people do the things they do. Behaviour and choice is informed by personal history as well as psychological, social and environmental factors.

That’s not to say, that changing behaviours not important. If individuals increase their levels of exercise, reduce their alcohol consumption, wear seatbelts, and use sunscreen, we will go a long way to improving the overall health and wellbeing of the Australian population.

In order for individuals to make these choices and changes in behaviour, they need to be supported by population-wide measures that create an environment and a culture where certain decisions and behaviours can occur.

Just think about the social change in the acceptability of drink driving over the last few decades. Individual change was supported by legislative measures together with sustained public education campaigns. In combination, these actions have resulted in a dramatic decrease in drink driving rates.

Another area where change is now needed is the issue of consuming alcohol during pregnancy.

In Australia it is often portrayed that we are already aware of the harms caused by alcohol, but the statistics tell a different story. 95% of Australians don’t know what the recommended guidelines for alcohol consumption actually are.[1] Few Australians (24%) are aware that alcohol is associated with mouth and throat cancer and even fewer (11%) are aware of the link between alcohol and breast cancer.[2]

Similarly we know that the majority of Australians (79%) believe that consuming alcohol while pregnant is harmful to the fetus.[3] But only 47% are aware of Fetal Alcohol Syndrome and related disorders, which occur as a direct result of alcohol consumption during pregnancy.³

Fetal Alcohol Spectrum Disorders (FASD) describes a range of conditions that result from alcohol exposure before birth, including physical abnormalities, organ damage, and brain damage. Fundamental to preventing new cases of FASD is reducing the harmful consumption of alcohol in the general population, and changing our alcohol culture in Australia. To enable women to have alcohol-free pregnancies, the Australian public needs to be aware of the risks associated with consuming alcohol while pregnant.

Alcohol health warning labels are one such population-wide policy option available to us. Australia would not be alone in introducing warning labels as at least 18 countries or territories already have them, including France, South Africa, Brazil, America and Mexico[4]. They are cost effective and economic analysis undertaken in 2009 showed that they are likely to prevent 25 to 77 new cases of Fetal Alcohol Spectrum Disorders each year.[5] This analysis also found that the social benefits of warning labels and preventing FASD far outweighed any costs in implementing them.⁵

But warning labels are only one part of a comprehensive approach, they need to go hand in hand with strategies that aim to target individual behaviour, as well as with population measures that seek to change entrenched culture and create supportive environments. Only then will we see meaningful policy change and a reduction in alcohol-related harms in Australia.