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Health Select Committee calls for tougher controls on alcohol advertising

The House of Commons Health Select Committee has issued a report generally supportive of the Coalition Government’s new Alcohol Strategy for England, but calling for tougher controls on alcohol advertising. The report followed an inquiry which gathered evidence from both public health and industry sources.

The Committee proposes the introduction of a UK version of the French Loi Evin, which effectively bans alcohol advertising on TV along with alcohol sponsorship of sports and cultural events. The Committee also calls for the Alcohol Strategy to have a wider focus and for the introduction of specific quantifiable targets and performance indicators in regard to alcohol-related mortality, hospital admissions and crime and disorder.

Launching the report, Committee Chairman, Stephen Dorrell, said:

“The main focus of the Strategy is binge drinking and its consequences for antisocial behaviour and public disorder. Those are important issues, but the health impact of chronic alcohol misuse is, in our view, also significant and greater emphasis needs to be placed on addressing that impact.

“The Strategy contains a series of outcomes the Government wishes to bring about but does not define success. We believe that, in order to be effective, the Strategy needs some clearer objectives to provide a framework for both policy judgements and accountability.

“We recommend that Public Health England should have a central role in developing these objectives, and linking them to local strategies in every area across the country.”

In relation to control measures, the Committee supports the minimum unit pricing of alcohol, which the Home Office now envisages being implemented by October 2014. However, the Committee decides against a ban on multibuys, arguing that minimum pricing would provide a floor price for the sale of all alcohol, including discounted sales, so rendering a ban unnecessary. The Committee also calls for a ‘sunset clause’ on the implementation of a minimum price, so that it only remains in place if it is shown to be effective in reducing harmful drinking.

Alcohol Industry on the Defensive

The Select Committee report emphasises the limitations of the Responsibility Deal on alcohol, and warns that the industry risks being seen as only paying lip service to the need to reduce health harm related to alcohol. This prompted much of the media coverage of the report to be in terms of the alcohol industry being placed in the “last chance saloon” and facing heavier regulation if it did not take more action to discourage dangerous drinking.

In regard to the Responsibility Deal the Committee came to two main conclusions: first, that participation in the Deal by the alcohol industry should not be regarded as optional, and, secondly, that the Responsibility Deal is not, and should not be, a substitute for Government policy. The Committee states that “It is for the Government, on behalf of society as a whole, to determine public policy and ensure that a proper independent evaluation of the performance of the industry against the requirements of the Responsibility Deal is undertaken.” The Committee calls for Public Health England to commission such an evaluation, adding:

“We will be particularly interested to see the assessment of the effect of reducing the alcohol level in certain drinks. We do not believe that reducing the alcohol in some lagers from 5% to 4.8% will have any significant impact. If the industry does not bring forward more substantial proposals than this it risks being seen as paying only lip service to the need to reduce the health harms caused by alcohol.”

However, while this comment is self-evidently a warning shot at the alcohol industry, it is less clear that the Committee has any serious disagreement with the Government over the Responsibility Deal. In stating that the RD is not a substitute for Government policy, the Committee is simply reiterating what Public Health Minister Anne Milton told them: “It (the RD) is an opportunity to add something. It is not a substitute for, and it is not a forum for developing, (alcohol) policy.” The Minister also raised the possibility of an independent evaluation of the RD.

Loi Evin

There is a clearer disagreement between the Committee and the Government in relation to alcohol advertising, for, unlike the Select Committee, the Government has shown no signs of wanting to adopt in the UK the principles of the French Loi Evin. In relation to advertising, the Committee commented that it was concerned that those speaking on behalf of the alcohol industry “often appear to argue that advertising messages have no effect on public attitudes to alcohol or on consumption. We believe this argument is implausible. If the industry wishes to be regarded as a serious and committed partner in the Responsibility Deal it must acknowledge the power of advertising messages and accept responsibility for their consequences.”

The Committee also comments on the alcohol industry’s Drinkaware organisation, and on the health service response to alcohol health issues. On Drinkaware, the Committee welcomes the education and awareness campaigns it runs, but complains of a perceived lack of independence from the industry, which limits the value of its contribution.

On the health service, the Committee praises the work the Department of Health is undertaking to provide an evidence-base of the most effective models of treatment provision. The Committee concludes, on the basis of the evidence presented to it, that the establishment of Alcohol Specialist Nurse services throughout the country would be a major step forward.

Reactions

The public health and alcohol control organisations welcomed the Committee’s report. Sir Ian Gilmore, special adviser on alcohol for the Royal College of Physicians, Chair of the Alcohol Health Alliance and President of the British Society of Gastroenterology, said that he particularly welcomed “the Committee’s recognition of the insidious and pervasive health damage from chronic use – they have clearly listened to the voice of medical bodies to conclude that it’s not just about young people binge drinking but the chronic health harms that affect many people in the UK.”

Sir Ian continued:

“I am pleased to see the Committee’s support for setting a minimum unit price for alcohol and agree that the price should be set at a level that is shown to be effective, and that a clear process is needed for monitoring and adjusting the price over time. We will continue to seek a minimum unit price of at least 50p per unit of alcohol.

“We also welcome the Committee’s emphasis on the cost-effectiveness of interventions, the important role of alcohol specialist nurses, and the call for tougher measures on advertising. We support looking at whether some form of the measures used in France, such as a ban on sports events advertising, could be applicable in England. But we are disappointed they didn’t call for a review of the overall regulatory structures and I’d also like to see more done to tackle the growing problem of marketing through digital, online and social media – to reduce children and young people’s exposure.

“As the Committee says, it’s time that the alcohol industry acknowledges the power of its advertising messages and accepts responsibility for their consequences. We need a clear Government commitment to an independent evaluation of the Responsibility Deal and a timetable for reviewing progress and detail of the action that will be taken if outcomes are not achieved.”

For the IAS, Katherine Brown said:

“We welcome the Committee’s calls for measures to strengthen the Government’s Alcohol Strategy. The Government has set out some commendable ambitions in the Strategy; however, we agree that a framework of quantifiable targets and indicators is essential in order to measure what success looks like.

“It is encouraging to see that the Committee supports the introduction of minimum pricing, a policy which has the potential to make a real impact on levels of health and social harm caused by alcohol. Given the question over how the market will respond to this policy, it is both sensible and helpful to recommend a sunset clause, which will stimulate a robust monitoring and evaluation process. Many other countries are waiting with bated breath to see how minimum pricing works, so evaluation is crucial to building an evidence base for an innovative policy that could be applied internationally.

“Britain has the opportunity to be a vanguard in public health policy, so support for minimum pricing is crucial.”

A copy of the full report can be downloaded here: http://www.publications.parliament.uk/pa/cm201213/cmselect/ cmhealth/132/132.pdf