DSICA
Column – Our Hotel – November 2007
Patterns Approach to Drinking
By Gordon Broderick
According to World Drink Trends, Australia ranks 23rd
in the world in terms of per capita alcohol consumption. Our per capita spirits
consumption ranking is even lower at 36th. Overall Australia’s per capita
alcohol consumption ranks in the middle range of the table, and is hardly the
alcohol drenched nation that some would portray. Interesting, Australia’s
moderate per capita alcohol consumption level is often used by health bureaucratic
as a proxy for harms. In their simply arithmetic, less per capita consumption
= less harm. DSICA considers this approach requires a rethink.
Quite simply,
it is people’s pattern of drinking that best predicts whether they will
experience positive or negative consequences of their alcohol consumption. What
is important is how a person drinks; how much they drink is only one part of
that. This is a significant departure from the basis of alcohol policies in many
countries and therefore requires a new approach to the development of national
alcohol policies.
Alcohol policies in many countries have long been based on
the assumption that a wide range of health and social problems associated with
the abuse of alcohol can be directly correlated with average daily per capita
alcohol consumption. In light of increasing empirical evidence, this central
hypothesis has been increasingly challenged.
There is already declining political
support for controls over the availability of alcohol in many countries. There
is also growing dissatisfaction among scientists with simple measures of volume
of alcohol consumption as a basis for understanding drinking behaviour. It is
therefore important to distinguish between negative and positive drinking patterns.
Negative drinking patterns should be modified by reducing heavy drinking occasions
and by reducing specific adverse consequences. Positive drinking patterns should
be promoted by focusing on safe drinking limits, by educating people for responsible
drinking and by encouraging individual choice.
Many different people have an
interest in seeing alcohol policies that actually work. Politicians and public
servants in the health, social affairs, trade, agriculture and finance sectors;
medical and other health practitioners and social workers; public health practitioners
and advocates; scientists and scholars from a wide range of disciplines; those
working in the production and distribution of beverage alcohol and in the hospitality
industry; and concerned individuals around the world who devote their time and
energies to promoting responsible use of alcohol, fighting alcohol misuse and
seeking to improve the quality of life of all.
The role of alcohol differs widely
between different cultures and sub-cultures, underscoring the need to move away
from a policy paradigm which attempts to impose a uniform solution on a widely
diverse world. Measurement of average drinking levels has proven inadequate in
addressing the outcomes for a large segment of the drinking population, in particular
for those individuals with light or moderate alcohol consumption. As recent medical
evidence has demonstrated, even total abstention form alcohol may be associated
with health risks. Therefore, in predicting outcome, it is more important to
address the patterns in which individuals drink than simply how much they drink.
In a policy context it is therefore important to assess the effectiveness of
various control measures on reducing adverse outcomes of alcohol consumption,
both from a historical perspective and with a focus on measures currently implemented
in a number of countries around the world. Current measures of social cost may
result in incorrect policy prescriptions and may thereby detract from areas truly
meriting public intervention. A more flexible approach to alcohol policy development
is a proposal which emphasizes patterns of drinking and educational measures
within their appropriate cultural context. This more integrative approach could
provide a viable alternative to the more rigid command and control policies of
the past.
Measurement of the parameters of alcohol consumption reveal more detail
about specific drinking behaviours and their relationship with particular outcomes
in diverse cultures. New approaches to prevention, education, and screening must
cover the full spectrum of use from abstainers and very light drinkers to excessive
and dependent drinkers. DSICA consider that the way ahead lies in greater attention
to measures which focus on preventing problems associated with particular harmful
patterns of drinking and less attention to general population measures which
restrict all access.
