Public opinion and alcohol policy in BC

As the BC government’s public consultation on liquor control and licensing laws draws to a close at the end of this month we wish to highlight findings from a province-wide opinion survey conducted last month for MADD Canada and CARBC. While telephone surveys have their limitations we believe the results are indicative of broad support across BC for some fundamental principles: that a major purpose of liquor laws should be to reduce alcohol-related harm (84% support); that consumers need to be better informed about risks, e.g. through labeling (71%); and that some kinds of pricing can be used to reduce harm (62% to 65%).

In this blog, we will mainly address the issue of public support for alcohol pricing policies because the strong evidence behind this approach is not widely known. The scientific evidence shows that alcohol consumption decreases when alcohol prices increase – and, more importantly, there are associated reductions in premature deaths, admissions to hospital and accidents on our roads. However, opinion research has found that most people do not believe heavy drinkers will reduce their drinking if prices are increased.

Furthermore, in the many hundred comments on the public consultation website and the blog series from the parliamentary secretary for the review, John Yap, a common sentiment is expressed: why punish the responsible majority for the behaviour of a small minority who misuse alcohol? While this viewpoint overlooks the existence of risks from moderate drinking (e.g. cancers), widespread occasional heavy consumption and harm from others drinking, this is a critical objection to address in discussions of policies like pricing.

Setting a minimum or floor price on alcoholic beverages is a policy that the BC government has implemented for the last 25 years, though BC minimum prices tend to be lower than most other provinces and are considerably lower than some (e.g. Saskatchewan). This type of policy is well targeted towards heavier drinkers as several studies have shown that those who drink low cost alcohol tend to consume higher amounts.

So do BC minimum prices provide any public health or safety benefit? Using BC hospital data, a recent study published in the American Journal Public Health found that for every 10% increase in minimum prices there was an immediate 9% reduction in hospital admissions for injuries and poisonings ‒ and a similar reduction in serious illnesses caused by alcohol (e.g., liver cirrhosis, cancers) 2 to 3 years later. Similarly, we have found immediate and delayed effects from minimum price increases on alcohol-related deaths.

Thus, there is strong evidence that minimum alcohol pricing avoids punishing the majority of responsible drinkers while having the greatest impact on the behaviour and the health of those most at-risk. We would love to know how public opinion would change if these facts were more widely known. We believe British Columbians would tolerate price increases on the very cheapest, often high strength alcohol products if they actually believed this would prevent fellow citizens becoming seriously ill, injured or dying from the effects of alcohol.

Because minimum prices here are relatively low and, unlike in Saskatchewan, they are not adjusted to reflect alcoholic strength, there are some products that cost less than 75 cents per “standard drink” (i.e., 17.05 mL ethanol or the amount of alcohol in a 12oz can of 5%beer). This makes it possible to exceed Canada’s Low-Risk Drinking Guidelines while spending less than three dollars per day – usually less than a loaf of bread.

Would you accept increasing the price of the cheapest alcohol to $1.50 per standard drink if you knew that it would save a few lives each year and reduce health care costs?

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Author: Tim Stockwell, Director, CARBC

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Author: Gina Martin

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Author: Andy Murie, CEO MADD Canada

Should the minimum legal drinking age of 19 years old in British Columbia be reduced?

Alcohol use is the largest contributor to injury, disability, and death among adolescents and young adults aged 10-24 years old. As a result, Canada and other countries worldwide have implemented minimum legal drinking age (MLDA) legislation for many decades now, and drinking-age laws are considered a cornerstone of alcohol-control policies designed to reduce harms among young people. In Canada, the minimum legal drinking age is 18 years of age in Alberta, Manitoba, Québec, and 19 years of age in the rest of the country.

No other alcohol policy has generated more research or debate than minimum legal drinking age legislation. Usually the debates about the most appropriate drinking age involve competing views about how society should assign importance to the harms versus the benefits of such legislation. Some people put more emphasis on the importance of individual choice in alcohol consumption, while other people place more value on restricting alcohol consumption in some age groups so as to safeguard young adults and improve overall public health. And so, there is a healthy tension between individual rights and the greater public good underlying debates about the minimum legal drinking age, and where individuals sit on this continuum will often affect how they interpret the scientific findings.

The large majority of the scientific evidence on this topic, however, is consistent and clear: raising the MLDA is associated with reductions in alcohol-related harms (such as motor vehicle collisions, injuries, assaults, and deaths), and lowering the MLDA is associated with increases in alcohol-related harms.

Advocates for lowering the MLDA might argue that most MLDA studies rely on United States’ data from the 1970s and 1980s, and usually have fatal/nonfatal motor vehicle collisions as their most harmful outcomes. And, critics of MLDA legislation might continue, the large MLDA impacts on motor vehicle collisions observed in the 1970s and 1980s might be substantially diminished in the contemporary British Columbia context due, in large part, to advances in both traffic safety and other alcohol policies (e.g., improvements in road safety/motor vehicle safety; introduction of provincial graduated driver licensing legislation; increases in the severity of penalties for drinking and driving).

Could it be that the MLDA has lost much of its effectiveness in reducing alcohol-related harms among young people in British Columbia?

In four recent studies, my colleagues and I have demonstrated that drinking-age legislation continues to have a powerful impact on alcohol-related harms among young people in Canada. Relative to youth slightly younger than the minimum legal drinking age, young adults just older than the MLDA incur immediate and significant increases in a range of serious alcohol-related harms, including: motor vehicle collisions; inpatient/Emergency Department admissions for alcohol-use disorders, attempted suicides, injuries, assaults; and death. An example of our work was published recently in the American Journal of Public Health.

Along with the prior MLDA literature, our Canadian studies provide up-to-date and persuasive evidence that lowering the MLDA will likely result in significant increases in serious alcohol-related harms among young people in British Columbia. Proponents of a lower MLDA in BC will need to make an even more convincing argument that such substantial damages to youth in British Columbia will be outweighed by the benefits of lowering the drinking age in our province.

Authors:

Dr. Russ Callaghan, PhD (Russ.Callaghan@UNBC.ca); Jodi Gatley, BSc (jgatley@gmail.com)

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Jodi Gatley