Key message: Public Health Association of Australia: Policy-at-a-glance Alcohol Policy 1. Alcohol is responsible for a substantial burden of death, disease and injury in Australia. Alcohol-related harm to health affects not only drinkers themselves but also families and the broader community. 2. The PHAA supports a comprehensive approach to prevention, treatment, support services and research to minimise alcohol harms. 3. Alcohol taxation can increase the price of alcohol with the aim of decreasing the level of alcohol consumption and related problems. This taxation should be maintained as it has proven to be an effective policy intervention. There should be a high priority on implementing volumetric tax approaches. 4. Alcohol marketing should be regulated by governments, with a special focus on minimising exposure to children and young people. Areas to concentrate on include sporting and music events, television time slots, online promotions and lobbying. 5. Alcohol availability in the form of late trading hours and outlet density can lead to alcohol-related violence and other harms. Governments should place public health and safety ahead of the needs of alcohol retailers in framing licensing legislation and when making determinations on current and future outlet developments. There should be continuing focus on ensuring that children and young people are not able to purchase or be inappropriately provided with alcohol, and that there are constraints on sales of products such as energy drinks in association with alcohol. 6. Adequately funded, sustained alcohol education and awareness programs, independent of the alcohol industry, should be supported as part of a long-term comprehensive approach to reducing harm to the individual and the community. There should also be specific programs for disadvantaged groups. 7. Evidence and research-based warning labels on alcoholic beverages should be required by governments. There should be a special focus on the risks of consuming alcohol while pregnant, particularly Fetal Alcohol Spectrum Disorder (FASD). 8. The PHAA supports the view of WHO, as expressed by WHO Director General Dr Margaret Chan that the alcohol industry has 1
no role in the formulation of alcohol policies, which must be protected from distortion by commercial or vested interests. Summary: Audience: Responsibility: The National Alliance for Action on Alcohol (NAAA) is a national coalition of health and community organisations from across Australia which integrate their collective expertise to address Australia s drinking problem 1. This policy aims to outline a number of evidence-based approaches with the goal of reducing alcohol-related harm in line with the NAAA framework. Australian, State and Territory Governments, policy makers, public health and other relevant groups and the community. PHAA s Alcohol Special Interest Group (SIG). Date policy adopted: September 2013 Contacts: Mike Daube, Alcohol Convenor, Alcohol SIG M.Daube@curtin.edu.au 2
Alcohol Policy The Public Health Association of Australia notes that: 1. The consumption of alcohol is widespread in Australian culture. Much alcohol is consumed in Australia at levels of low immediate risk 2. However, many people drink at levels that increase their risk of health problems and social harm or injury 3. In 2010, 20% of people aged 14 or older reported drinking alcohol at levels that exceeded the guideline levels for lifetime harm according to the 2001 National Health and Medical Research Council guidelines 4. 2. In 2011-12, 82.4% of Australians aged 18 years and over had consumed alcohol in the past year. Of all males, 87.6% had consumed alcohol in the past year while for females the proportion was lower (77.3%) 5. 3. Results from the National Drug Strategy Household Survey show that, in 2010, 30% of those aged 16 17 and 5% of those aged 12 15 had consumed alcohol at levels that put them at risk of harm from a single occasion of drinking at least once a month 6. Among young adults, alcohol is responsible for the majority of drug-related deaths and hospital episodes, causing more deaths and hospitalisations in this age group than all illicit drugs, and many more than tobacco 7. In 2009 10, there were more than 20,000 hospitalisations with an alcohol-related principal diagnosis for people aged 10 39, more than any other drug 8. 4. Alcohol is responsible for a substantial burden of death, disease and injury in Australia. Alcoholrelated harm to health not only affects the drinkers themselves, but also their families and the broader community. Long term alcohol consumption has been associated with a variety of diseases such as cardiovascular disease, cancer, diabetes, liver disease and mental health conditions 9. Alcohol is second only to tobacco as a preventable cause of drug-related death and hospitalisation in Australia 10. In 2012 the Australian Bureau of Statistics reported that harmful alcohol consumption was responsible for 3.2% of the total burden of disease and injury in 2003 11. This is in addition to the consequences of road crashes, violence (including domestic violence) and other social harms caused by alcohol. 5. There is strong evidence to support the introduction of a volumetric tax system, with a high priority on ending the Wine Equalisation Tax 12. 6. Alcohol use among young people is the cause of substantial social and health problems. Almost 90% of young Australians report trying alcohol by the age of 14 13. 80% of the alcohol consumed by young people aged between 14 24 is consumed at levels that put them or others at immediate risk. There is also growing evidence on the harms of alcohol use to the developing 3
brain 14. Young people are exposed to alcohol marketing through multiple sources. Alongside more traditional modes of advertising through television and radio, the introduction of digital technologies has opened up new platforms for marketing and promotion via online video channels, mobile phones, interactive games, and social networks such as Facebook and Twitter 15. Other areas of promotion include sponsorship at sporting and music events, where there is wide exposure to young people. 7. Alcohol is widely available. Supermarkets, internet sites, and licensed clubs, bars and restaurants are just a number of venues in Australia where alcohol can be obtained. They are often within close proximity to the vast majority of residential areas in Australia, and alcohol is available from at least one of these types of outlet at most hours of the day 16. Studies have linked higher geographical availability of alcohol with higher levels of excess drinking among teenagers 17. There is also clear evidence that reducing late night access reduces the harms for drinkers and the community 18,19. 8. Adequately funded, sustained and comprehensive public education campaigns run independently of the alcohol industry are recommended as part of a comprehensive approach to reducing alcohol harms 20.Health promotion campaigns should both encourage appropriate behaviour and prepare the ground for structural change including regulation. 9. The NHMRC Guidelines recommend that no alcohol during pregnancy is the safest choice 9. Alcohol consumption during pregnancy can lead to Fetal Alcohol Syndrome, which is characterized by growth retardation and central nervous system anomalies or dysfunction 21. Sufficient awareness for women is important to educate them on the risks associated with drinking alcohol while pregnant. The Public Health Association of Australia affirms the following principles: 1. Reducing the amount of alcohol consumed will reduce health and social harms in the Australian community. It is important to endeavour to limit the harmful use of alcohol and the amount people consume by implementing appropriate policies and legislation. 2. Restricting the marketing, promotion and availability of alcohol products, particularly to children and young people, will reduce the amount of alcohol consumed. Alcohol industry self-regulation of alcohol marketing should be replaced by regulation with sanctions for non-compliance. 3. Fetal Alcohol Syndrome is a serious and avoidable condition which needs to be highlighted to women who are pregnant or plan to be pregnant. The Public Health Association of Australia believes that the following steps should be undertaken: 1. Maintain and regulate pricing legislation to ensure that taxation on alcoholic products is consistent, according to their alcohol content level or their propensity to cause harm. 2. Regulation by government is required to ensure effective, independent controls on alcohol promotion, with a special focus on protecting young people from exposure. 4
3. There is a need for national guidelines on alcohol outlet density and opening hours in addition to a cohesive policy among liquor licensing agencies, planning departments and local governments on this issue, with legislation and action by government authorities placing a primary focus on public health and safety. 4. Programs that have proven to be effective in reducing alcohol related harm to both the individual and the community should continue to be supported. Awareness campaigns are a valuable tool in educating the community to encourage personal responsibility and prepare the ground for regulation. 5. Government regulated warning labels on alcoholic beverages should be implemented to alert the community to the risks of alcohol consumption. 6. There should be specific programs (including warning labels) about Fetal Alcohol Spectrum. The Public Health Association of Australia resolves to undertake the following actions: 1. The PHAA will develop its capacity in order to have a major role in initiating and participating in debate in Australia which leads to the development of policies which contribute to prevention and harm reduction and which protect public health. 2. The PHAA will continue to work as part of the National Alliance for Action on Alcohol in pursuing a comprehensive approach to reducing harms from alcohol, while also supporting treatment, support services and research activities. ADOPTED AND ENDORSED IN 2013 First adopted at the 2013 Annual General Meeting of the Public Health Association of Australia. 1 National Alliance for Action on Alcohol, 2012. Reducing harm from alcohol: Creating a healthier Australia. Accessed from: http://www.actiononalcohol.org.au/ 2 Australian Bureau of Statistics 2012. Australian Health Survey, 2011-2012. ABS Cat. No. 4364.0.55.001. ABS: Canberra. 3 AIHW 2012. Australia's health 2012. Australia's health no. 13. Cat. no. AUS 156. Canberra: AIHW. pp228. 4 Ibid. pp229. 5 Australian Bureau of Statistics 2012. Australian Health Survey, 2011-2012. ABS Cat. No. 4364.0.55.001. ABS: Canberra 6 AIHW 2012. Australia's health 2012. Australia's health no. 13. Cat. no. AUS 156. Canberra: AIHW. pp232. 7 Ibid. pp232. 8 Ibid. pp232. 9 National Health and Medical Research Council, 2009. Australian guidelines to reduce health risks from drinking alcohol. Canberra: National Health and Medical Research Council. 10 AIHW 2012. Australia's health 2012. Australia's health no. 13. Cat. no. AUS 156. Canberra: AIHW. pp228. 11 Australian Bureau of Statistics 2012. Australian Health Survey, 2011-2012. ABS Cat. No. 4364.0.55.001. ABS: Canberra. 12 National Alliance for Action on Alcohol. 2012. Position statement - Alcohol pricing and taxation. Accessed from: http://www.actiononalcohol.org.au 13 Dobson, Corinne, 2012. Alcohol marketing and young people : time for a new policy agenda. Australian Medical Association. ACT: Australia. pp2. 5
14 National Alliance for Action on Alcohol. 2013. Healthier Families, Safer Communities 2013 Federal Election Policy Statement. Accessed from http://www.actiononalcohol.org.au 15 Ibid. ppiv. 16 AMA, 2009. Alcohol Use and Harms in Australia. Australian Medical Association. ACT: Australia. pp4. 17 Ibid. pp4. 18 Kypri K, Jones C, McElduff P, & Barker D. 2011. Effects of restricting pub closing times on night-time assaults in an Australian city. Addiction Volume 106, Issue 2, pages 303-310. 19 Connor JL, Kypri K, Bell ML, Cousins K. 2011. Alcohol outlet density, levels of drinking and alcohol-related harm in New Zealand: A national study. Journal of Epidemiology and Community Health Volume 65, pages 841-846. 20 National Preventative Health Taskforce. 2009. Australia: The Healthiest Country by 2020 National Preventative Health Strategy the roadmap for action. Canberra: Commonwealth of Australia. 21 O Leary, CM. 2004. Fetal alcohol syndrome: Diagnosis, epidemiology, and developmental outcomes. Journal of Paediatrics and Child Health Volume 40, Issue 1-2, pages 2 7. 6