Harm to others: Is alcohol just a private matter?

While we know that there are individual risks associated with consuming alcohol, such as acute injuries or chronic diseases such as liver cirrhosis, how often do we think about the impact that our own alcohol use has on those around us? Alcohol use has many potential negative secondhand effects including stress to relationships, impacts on other’s health and safety (e.g. on the roads, in the streets late at night, in the workplace), violence and property crime, developmental problems in children and substantial economic costs.  For example, in 2012 alone there were 17,888 alcohol-related violent crimes committed in BC.

Looking at the overall impact of all these second-hand effects of alcohol has been an important focus of research in recent years. When smoking was linked with cancer and people became aware of the effects of second hand smoke, we began to see major developments in tobacco policy designed to protect those affected by other people’s smoking. The same is true of changes to drinking and driving policies and to some degree initiatives to prevent Fetal Alcohol Spectrum Disorder (FASD)—when innocent people are harmed it gets people’s attention and this can pave the way for change.

While there is limited data on this specific to Canada, three Canadian studies conducted between 2004 and 2008 found that nearly one in three adults reported experiencing one or more types of harm resulting from someone else’s drinking in the past 12 months. In contrast, according to the Canadian Alcohol and Drug Use Monitoring Survey results for 2010, of those who drank alcohol in the past year fewer than one in ten reported experiencing any harm to self, showing that individuals are much more likely to be affected my others drinking than their own drinking.

Do we need to use a wider-lens when we think about the impact of alcohol use? Would social norms around alcohol use change significantly if we started taking harms to others more seriously? Many individuals are ‘responsible’ drinkers, but others are often not. Moreover, our level of responsibility declines as our level of consumption increases. Liquor laws help protect everyone, drinkers and non-drinkers and we need to carefully consider how access to cheap alcohol affects drinkers and non-drinkers alike.

Now probably the most important question is what can we do about harm to others? There are many specific measures to reduce these harms that can be applied in different contexts e.g. policing late-night drinking venuesdeterring impaired driving and also more general measures which target hazardous drinking in the whole population. CARBC research shows that while BC leads in some areas of alcohol policy it also lags well behind in others and, overall is only achieving half its potential for alcohol harm reduction – both for drinkers and those around them.

How important is it that we implement evidence-based policies that can reduce harm for everyone?

Image

Authors: Kate Vallance (pictured), Kara Thompson, Ashley Wettlaufer

What is the purpose of BC’s liquor laws in 2013?

Almost 100 years ago Canadian provinces other than Québec voted for the total prohibition of alcohol. In BC this occurred in 1917 following a referendum but was soon repealed in 1921, overwhelmed by a tide of organized crime, official corruption and political scandal. Prohibition was imposed on the aboriginal people of Canada for over a century ending only in 1962.

Key elements of our present system of liquor control in BC emerged out of those prohibition years. In 1921, social concerns were addressed through a government owned sales and distribution system. There were few liquor outlets, operating for limited hours and drinkers had to purchase a license.

This month the BC government announced a review of its liquor policies, the first comprehensive review since 1999. The conditions that led to prohibition are largely no longer with us: a world war, disenfranchised women and sky high alcohol consumption, mostly by men.  But the “social concerns” about alcohol have not disappeared. What can we learn from that the prohibition era? What have we learned about alcohol problems and how best to address them at this time in our history?

Alcohol is enjoyed by most people in British Columbia, most often with little or no harm.  The government collects over $1 billion in revenue from alcohol sales. However, the BC Vital Statistics Agency also reports there were 18,752 alcohol-related deaths between 2002 and 2011. BC Ministry of Health data shows around 190,000 alcohol-related hospital admissions over those 10 years with a distinct upward trend. Police tell us that most of their work is alcohol-related—the Vancouver hockey riots of 2011 a particularly notorious instance.

This is the first of a series of blogs on alcohol and alcohol policy in British Columbia prepared by graduate students and staff at CARBC. We wish to stimulate informed debate by asking questions, giving opinions and highlighting relevant research.

The current legislation refers to “the public interest” and highlights “public safety” but is silent on “health”. The review is to make recommendations that will ensure “government revenue is maintained or increased” while the “health and social harms caused by liquor” are minimized. Clearly alcohol is no ordinary commodity and governments cannot simply allow the alcohol market to govern itself. It is alcohol’s potential for harm that warrants this special treatment. But is this sufficiently clear in BC’s legislation? Our first question, therefore, in this series opener is:

Should a modern liquor control act have clear objectives that include encouraging low-risk use and minimizing alcohol-related harms to individuals and communities?

ImageImageImage

Authors & Series Editors, from left to right: Tim Stockwell, Dan Reist, Kara Thompson