Alcohol Report 2
Transcript of Alcohol Report 2
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MFAC1521Health and Maintenance B, UNSW Medicine
A3: Global impact of alcohol licensing laws
(Australia, Spain and Nigeria)
Student No.: 3341589
Date: 15/08/2011
Word Count: 2000
Not including:Headings, content page, references and appendix
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Content Page
1. Orientation and Direction of Report2. Investigating the epidemiology of alcohol use, different levels of alcohol use and
alcohol-related harm across the three countries
2.1. Australia 5
2.2. Spain 5
2.3. Nigeria
2.4. Comparison across the 3 countries 6
3. Examining alcohol licensing laws across the three countries3.1. Australia
3.2. Spain
3.3. Nigeria
3.4. Comparison of alcohol advertising restriction across the three countries
4. Social and cultural issues which influence the patterns of alcohol use and accountfor the implementation of licensing laws across the three countries
3.1. Australia
3.2. Spain
3.3. Nigeria
5. Comparison of effectiveness of alcohol advertising restriction in preventingalcohol-related harm in comparison to two other public health initiatives
5.1. Effectiveness of alcohol advertising restriction
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5.2. Effectiveness of law enforcement
5.3. Effectiveness of taxation
6.Conclusion 8
7. Reflections 9
8. References 10
9. Appendix 13
1. Orientation and Aim of Report
1.1.Overview
This report is aimed at examining the factors behind the global incidence of alcohol use,
health burden and liquor laws focusing on Australia, Spain and Nigeria. Lastly, the
effectiveness of alcohol advertising restrictions will be contrasted with two other public
health initiatives.
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1.2. Defining Alcohol
What is alcohol?
National Drug and Alcohol Research Centre (NDARC) defines alcohol as an intoxicating
substance made from fermented starches and a central nervous system depressant
which can adversely affect an individuals body if he is unable to tolerate large amounts.
Quantifying alcohol consumption
In Australia, a standard drink contains 10g of alcohol. It is on this basis that the amount of
alcohol consumed can best be quantified depending on the different types of alcohol-
containing beverages and varying drinking serving sizes. National Health and Medical
Research Council (NHMRC) recommends that both men and women should drink no more
than two standard drinks daily.
Figure 1: NHMRCs Australian Guidelines to Reduce Health Risks from Drinking Alcohol, 2009.
2.Epidemiology of alcohol use and health burden
2.1. Australia
In Australia, beer is the most consumed beverage (46%), followed by wine (32%) and
spirits (22%). Per capita alcohol consumption increased from the 1960s and peaked in
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mid-1970s along with beer consumption, and finally returned to a stable figure of 10 litres
of pure alcohol in the last two decades.
Figure 2: WHO, 2011.
Despite the significant drop of the number of Australians drinking daily from 8.9% to 8.1%
between 2004 and 2007, 22% of teenagers drink weekly. 9 in 10 of them had consumed
alcohol at certain points and 82.9% had drunk in the previous year.
Figure 3: National Drug Strategy Household Survey (AIHW, 2007).
Alcohol-related health burden
The National Drug Strategy 2010-2015 estimates the cost of alcohol to Australian society to
be at $15.3 billion. Alcohol consumption is responsible for 3.2% of the total burden of
disease and injury with 3430 deaths and at least 85 disability-adjusted life years (DALYs)
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per annum (Begg et al., 2007). A larger number of youth died from acute conditions
(deaths and hospitalisations caused by road accidents and violent attacks), whereas
chronic diseases (liver cirrhosis, cognitive issues, pancreatic injury as well as heart and
blood diseases) occurred amongst those above 30 years old (Chikritzhs et al., 2003).
Alcohol-attributable injury and disease are especially high among the Indigenous, with the
rate of alcohol-related deaths being twice that of the non-Indigenous Australians
(Chikritzhs et al., 2007).
2.2. Spain
Similarly in well-developed Spain, the most consumed alcoholic beverage is also beer
(45%), followed by wine (36%), spirits (13%) and other types (6%).
Figure 4: WHO, 2011.
Spaniards consumed much more alcohol, especially wine, per capita compared to the
Australians and Nigerians in the past. Beer consumption is steadily rising to a level
comparable with Australias. Another similarity is that almost 90% of the Spanish
population has drunk alcoholic beverages in their lifetime.
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Figure 5 shows that half of the Spanish population drinks weekly and around 20% admit to
have suffered a drunkenness episode the previous year.
Figure 5: Spain: National Household Surveys on Drugs (Gual, 2006).
Figure 6: WHO, 2011.
The alcohol-related death rates seem to be decreasing from 2000 to 2005 for both liver
cirrhosis and road traffic accident cases. However, it is inadequate to confirm that the
burden is also decreasing with the high current per capita consumption of 10 litres.
2.3. NigeriaNigeria is a developing country where traditional home-made liquor constitutes 94% of
alcoholic drinks consumed.
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Figure 7: Taken from WHO, 2011.
Per capita consumption of alcohol increased steadily throughout the 1970s and peaked at 8
litres in 1981, declined until about 1995 and increased slowly to an estimated 10 litres in
2001 similar to both Spain and Australia. Alcohol was the most commonly used drug, both
in terms of lifetime history and recent use in five geo-political regions of Nigeria (Gureje et
al., 2007). Heavy episodic drinking, rather than regular moderate drinking, is common
among users of alcohol in Nigeria (Gureje, 2007).
Amongst Nigerian men, 81% of liver cirrhosis cases and 22% of cancers were attributed to
alcohol (WHO, 2004).
2.4. A simple comparison of epidemiology
Country
Recorded
Consumptio
n
Unrecorded
Consumptio
n
Total
Consumptio
n
Beer
Wine
Spirits
Other
Total
M
ale
drinkers
Total
Fem
ale
drinkers
Totaldrinke
rs
Australia 9.89 0.13 10.02 4.56 3.12 1.16 1.02 16.30 7.20 11.90
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Spain 10.22 1.40 11.62 4.52 3.59 1.31 0.61 24.80 15.60 21.10
Nigeria 9.78 2.50 12.28 0.54 0.01 0.02 9.17 36.90 23.00 32.10
In relative terms, Nigeria has the most number of drinkers, followed by Spain and lastly
Australia. However, the latter two largely consume beer and wine while Nigeria mainly
consumes other forms of alcohol including traditional brew.
Comparing WHO (2011)s scores regarding patterns of drinking, Spain was the least risky
followed by Australia and Nigeria being the most risky, suggesting that the latter has the
highest alcohol-attributable disease burden amongst the three countries.
3.Examining alcohol licensing laws
3.1. Australia
In Australia, alcohol licensing laws are exercised independently within each individual
state and territory jurisdiction. The object of these Acts was previously centralised around
developing the liquor industry in order to encourage economic and social growth. In
recent times, the focus now is shifted to harm minimisation considering how the
repercussions of loose legislation are hindering growth, not excluding NSW.
In NSW, liquor legislation is now guided by the Liquor Act 2007 (repealing the previous
Liquor Act in 1982), including Liquor Regulations 2008 (NSW, 2007). The Casino Liquor
Gaming and Control Authority, in charge of handling applications and considerations made
under the Act, has replaced the previous Liquor Administrative Board. An example of major
changes is the reduction of license categories from twenty-one to just six in hope of
diminishing the incentive for vendors to obtain a license and thus restrict liquor supply.
(Tsia&Mouakkassa, 2008)
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Regulating alcohol advertising
For young people, studies have proved that exposure to alcohol commercials and drinking
role models can be directly linked to acute alcohol consumption.
There are currently no alcohol advertising bans in Australia unlike that of tobacco. The
Liquor Act does not clearly emphasise on advertising controls; the Alcohol Beverages
Advertising Code (ABAC) is more relevant in this case. As a separate law along with other
codes, it works on the basis of various legislative and self-regulatory mechanisms
pertaining to events, internet and retail advertisements. However, other than a system
whereby the public can lodge a complaint, there are no other direct controls over drinkpromotions to limit excessive consumption. (ABAC, 2009)
3.2. Spain
In 1976 a code for television advertising was adopted by the Commission for Control of
Television Advertising. In 1988 and 1990, the General Advertising Law of 1988 and the
Television Advertising Resolution were introduced to forbid advertising of alcoholic
beverages containing over 20% alcohol by volume on broadcast media. Advertising alcohol
is also not permitted before 9.30 p.m. (sterberg, andKarlsson, 2002).
Similar to Australias situation, the Spanish Brewers Association instated a self-regulation
code in 1995 which expects all members to include a responsible consumption message in
all advertisements (Hurst, Gregory &Gussman, 1997).
3.3. Nigeria
Nigeria Brewing and Guinness Nigeria both sell popular alcohol products in the market.
Because of their large economies of scale, they now monopolise Nigerias beer industry andhave since forced the shutdown of many smaller breweries since the 1980s.
Their marketing activities are catered towards the youth (Obot&Ibanga, 2002). Michael
Power is one famous example who serves as the beer icon for Guinness in Africa. They
include sponsorship of sports events, fashion shows and beauty contests on campus and
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Sponsorship of sporting events by the liquor industry is common and it is arguable
whether associating alcohol with sport disregards the advertising code due to its adverse
effects on minors. One ethical issue is autonomy and freedom, what environments exist for
the youth to enjoy participating in sport that is free of these pressures and links to alcohol
(Jones, Phillipson&Lynch, 2006).
4.2. Spain
Spain has had a long-lasting tradition of alcohol consumption, where such beverages are
also seen as a crucial part of the social, nutritional, and dietary needs of the Spaniards. New
drinking patterns across Europe bring with it a permissive wet drinking culture(theBotelln phenomenon), making alcohol relatively cheap and easily accessible to all
young people. Rapid urbanisation in this developed country has increased the popularity of
beer especially amongst young people who consider it as part of their modern and casual
lifestyle (sterberg and Karlsson, 2002).
The influence of peers in Spains drinking context is not far off from Australias and
Nigerias; it is considered to occur through peer pressure, peer leaders or going out with
alcohol-using friends. The perception of alcohol as a health hazard also seems to be
diminishing.
4.3. Nigeria
Alcohol has always been a part of Nigerian heritage, where the Kofyar people in Jos
consumed for social harmony (Odejide, 2006). Traditional wines, including palm-wine and
alcohol produced from cereals, have been consumed for centuries. The drink is is present
in cultural ceremonies revolving around birth, death and to resolve disputes. However, due
to the lack of government support, complacency and education, Nigeria continues to be in
the high-consumption countries along with Australia and Spain (WHO, 2004).
In recent times alcohol is perceived to be a religious divide between Muslims and
Christians where liquor availability led to conflict and communal violence in Northern
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Nigeria. Sale and consumption are banned in sharia states such as Zamfara and Kano
(Babor&Winstanley, 2008).
Severe licit drug use including alcohol spread from urban and historically advantaged
regions to rural and disadvantaged communities, where the youth have a tendency to link
alcohol abuse with fun, enjoyment and survival. Some studies conducted in Nigeria suggest
that the use of local alcoholic beverages is also gradually decreasing with rising
commercialization and social affluence, further compounded by the two major beer
companies uncontrolled media advertising (Odejide, 2006).
5.Comparing alcohol advertising restrictions with other initiatives
5.1. Alcohol advertising
ABAC is a self-regulating system which is dependent on the publics knowledge of the code
and an independent authoritative body to act on complaints. Recent studies have shown
that 72% of those surveyed lacked knowledge on restrictions regarding alcohol advertising,
and that it is estimated that a mere 3% of Australian adults are aware of the ABAC Schemeand its role. Among the 30% of people who reported being concerned about any alcohol
advertising, only 2% had formally lodged a complaint (King, Taylor & Carroll, 2005).
In 2003 the Ministerial Council on Drug Strategy (MCDS) identified that at present ABAC
fails to bring up public health concerns on alcohol promotions and consumption, and that
the lack of community confidence is contributed by the large amount of time spent to settle
complaints.Despite the ABAC Schemes rule to discourage advertising that has strong or
evident appeal to children or adolescents, research shows that a significant amount of
alcohol advertising is communicated to the youth (National Preventative Health Taskforce,
2011).
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5.2.Effective law enforcement
Despite bans on serving minors and the intoxicated, efficacy depends on the degree to
which these laws are enforced. The NSW police have adopted the Alcohol Linking Program
which obtains feedback to police regarding any alcohol-related crimes that have followed
drinking at a specific licensed premise, which has seen results. Responsible Service Alcohol
(RSA) programs have the potential to raise awareness of relevant issues. Publicizing severe
financial penalty has also been particularly effective at encouraging licensees to regulate
their premises, reducing harm. However it is uncertain whether these penalties are
impactful in the long run without regular and obvious examples of enforcement (Wiggers
et al., 2004).
5.3. Taxation
Despite the principles that price controls would certainly reduce alcohol consumption
especially for the price-sensitive group of young drinkers, the current tax system, based on
differential tax rates on different alcoholic beverages, produces undesirable distortions.
The Northern Territory Living with Alcohol Program suggested the levy itself had a major
impact on reducing alcohol-related deaths rather than the programmes the levy was used
to fund, proving that tax can still play an important role. Introducing a tiered volumetric-
based excise system based on alcohol content is currently under review (Findlay, Sheehan,
Davey, Brodie&Rynne, 2002).
6. ConclusionTight law enforcement by the police seems to be the most direct impact on reducing
alcohol-related harm amongst the three initiatives above. More reforms are needed for the
advertising code to be more useful in educate and reduce the exposure of alcohol to youth.
A better tax system will also take a long time to be implemented. In order to tackle the high
consumption levels amongst these three countries, a myriad of policies must be in place.
This would be a greater challenge for developing countries like Nigeria.
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7. Reflections
8. References
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