Our entrenched culture of heavy drinking

The National Alliance for Action on Alcohol held a forum at Parliament House on 25 June 2014  focused on the impact of alcohol marketing on children,. The event also featured the 2013-14 Alcohol Advertising Review Board Annual Report, which was launched by Dr Steve Parnis, Vice President of the Australian Medical Association.

Today on Drink Tank we continue our coverage of the forum with an edited trranscipt of Dr Parnis’s address, as well as extensive video coverage from the event.

Australia has an entrenched culture of heavy drinking. The data is apparent to all. It’s demoralizing to all and it is quite conspicuous in that the evidence detects and makes clear that things are getting worse.

Data from the recent National Drug Strategy Survey and other sources show that:

• One-fifth of Australians (20.1%) consumed alcohol at levels that put their health at risk on a regular basis, with this risky drinking being significantly higher among young adults.
  

• Young people are starting to drink at an earlier age and in ways that put their health at risk. Over 70% of 14 to 19 year olds have consumed alcohol in the previous year, despite the minimum legal drinking age being 18.
  

• More than a quarter of these teenagers are at risk of alcohol-related harms in the short term at least once a month.
  
• Rates of alcohol-related harm among young people have increased significantly in recent years, particularly those 16 to 24 years. Over the last 10 years, about 15% of all deaths among 15 to 24 year olds were directly related to risky or high risk drinking.

A study, put out last December by my college of emergency medicine, which encompassed almost every emergency department in the country, showed, that on one Saturday night in December on average 1 in 7 emergency beds in this country were occupied by people who would not be there if it weren’t for alcohol. In some emergency departments, that figure was as high as 1 in 3.

Over the ten years between 1995 and 2005, over three-quarters of a million Australians were hospitalized for causes related to alcohol consumption.

The results from the 2013 Foundation for Alcohol Research and Education (FARE) Alcohol Poll show that:

• One in six drinkers consume more than 6 standards drinks on a typical drinking occasion, which fits the bill for binge drinking.
• One-quarter of Australian drinkers felt they were unable to stop drinking once they started.
• More than a third of Australians have been affected by alcohol-related violence and nearly three-quarters of the adult population have been negatively affected by someone else’s drinking in some way, including through property damage and physical abuse;

Australians also have an astonishingly low awareness of the health impacts of alcohol use (including cancers and stroke), as well as the Australian alcohol consumption guidelines.

It can often be an academic exercise to recite these facts and figures about alcohol-related harms. But when you have to deal with the real life impacts of alcohol abuse in your daily professional life, like I and my colleague doctors have to, the alcohol problem takes on a whole new significance.

I spoke at this event last year and in the last 12 months, I’ve been subjected to an assault by a drunk patient in my emergency department. I was shaken up, thankfully I wasn’t physically injured. This person was very big and they were able to bend an intravenous pole, which is quite thick in terms of measurements. This is in the context of another reoccurring theme, which is domestic violence precipitated by alcohol. It is a story that so many of my medical colleges could rely on a daily basis.

What supports and drives this culture of excess alcohol use? What feeds it and keeps it alive? This is no great mystery, it’s about the affordability, availability and ubiquitous advertising of alcohol. There is a cultural tolerance, of not only alcohol consumption but actual alcohol abuse.

• Alcohol can be purchased very cheaply. That puts alcohol well within everyone’s reach, especially young people.
• Alcohol is just about everywhere. There are licensed premises and sellers within easy travelling distance to us all.
• Positive and glamorous images and messages about alcohol are everywhere as well, thanks to the ubiquitous advertising and marketing of alcohol.

When marketing and advertising consistently glamorizes and reinforces alcohol consumption in the eyes of young people, this is how Australia’s culture of drinking becomes entrenched. The AMA is arguing that the abuse of alcohol is far too prevalent and the harms are profound. Alcohol remains, in terms of Rugby League, the Premiers, as its harm in terms of mortality and morbidity, far outweigh any other drug that faces our society.

The AMA believes that the promotion and advertising of alcohol is a particularly strong and pervasive influence on the culture of drinking, especially in a way that recruits young people and sustains this culture. Therefore, it has to be a target for action. The FARE Poll last year showed that this view is shared by many Australians:

• Nearly three-quarters (71%) of Australians believe that alcohol advertising influences the behaviour of people under 18 years.
• 22% of Australians have noticed alcohol advertising or promotion on social media – an increase from 14% in 2013. We all know what age demographic most uses social media.

A significant amount of alcohol marketing takes place through sporting, cultural and music events. And these, of course, are all very accessible to and populated by young Australians. Nearly half of all alcohol advertisements that are broadcast on television are aired during sporting telecasts. It is known that children readily absorb sports sponsorship messages, with 76% of Australian children aged between 5 and 12 years being able to correctly identify at least one sport with its sponsor. We know that the giant loophole in our regulations in Australia relate to advertising during sport before the time of 8.30pm.

Research consistently shows a strong association between exposure to alcohol advertising and young people’s early initiation into alcohol use, and/or their increased alcohol consumption.

The AMA has, for some time, been very aware of the need to address the problematic influence of alcohol marketing, knowing that prevention is better than a cure. A couple of years ago, the AMA published a major policy report called Alcohol Marketing and Young People – Time for a new policy agenda.   It can be found on the AMA website. The central message of that report, is that advertising and promotion of alcohol to young people should be prohibited through appropriate government regulation, and not left to ‘voluntary’ industry self-regulation. Industry self-regulation has failed. Self-regulation is a toothless tiger that puts up a front of respectability for the alcohol industry. It is unacceptable, it is impotent and it is time to change.

The AMA is completely in step with community views on alcohol advertising

• 67% of Australians support a ban on alcohol advertising on weekdays and weekends before 8.30pm.
• 55% of Australians believe that alcohol sponsorship should not be allowed at sporting events, which is an increase from 47% in 2013

There is a consensus among expert health groups, including the National Preventative Health Taskforce, the National Alliance for Action on Alcohol and the World Health Organisation regarding the need for appropriate controls on alcohol advertising. The failure of the self-regulatory system that is now in place for alcohol advertising is why the establishment of the Alcohol Advertising Review Board has been so important, to provide an independent set of eyes on what is happening with alcohol advertising.

The evidence from the complaints and the determinations detailed in the 2013-14 Alcohol Advertising Review Board Annual Report further reinforces that the current self-regulatory system has to change if we are to reduce the instances of harm, as it fails to prevent children and young people’s exposure to alcohol promotion.

The continuation of this failure is not acceptable.

The AMA, along with many other peak health, law enforcement and community organisations believes that the establishment of strong, independent and mandatory legislative controls on all forms of alcohol advertising and promotion is long overdue.

It is my pleasure, as Vice President of the Australian Medical Association, to officially launch the 2013-14 Alcohol Advertising Review Board Annual Report, and I commend it to all parliamentarians and decision-makers who care about the future health of Australia’s children.

To view the speech in full click here.