Alcohol policy – Page 3 – Matters of Substance

After nearly 80 days, the BC liquor policy review wraps up today. For the last 8 weeks we have followed the comments and tweets and have heard thoughts and opinions from the public on how to change liquor policy in BC. In reviewing the comments on John Yap’s blog, several main themes continued to emerge. First, it is clear that many British Columbian’s feel the current liquor laws are outdated (i.e., “our liquor laws can only be described as archaic – insulting, too”). We agree – in the last decade we have learned much about effective alcohol policy internationally, as well as the costs and benefits of alcohol, which are not reflected in the current laws.

Second, the overwhelming majority of comments centered on a desire for increased convenience and access, both for sale and purchase of alcohol and offered suggestions such as selling alcohol in grocery stores, allowing minors to eat in pubs, and having fewer licensing regulations. Many felt that these changes would help boost local economy and tourism revenue (i.e., “Canada is one of the only countries in the world that restricts the sale of beer and wine to liquor stores. This is a huge inconvenience for consumers, hurts tourism, limits competition, and does not help our economy in any way”), while others cautioned against the harms potentially caused from alcohol, with a particular concern about increasing access to minors (i.e., “Long-term, it will encourage young people to consume more alcohol”). Further, many comments emphasized personal responsibility and suggested that liquor regulations should not punish the majority of responsible drinkers for the irresponsible few (i.e., “Why not stop punishing people for wanting to have a beer at the beach with some friends, and instead punish those who are drinking irresponsibly”). In our alcohol policy blog series we have tried to respond to these comments and offer evidence to facilitate an informed discussion around some of these issues such as balancing harms and costs, privatization, and increased accessibility.

John Yap’s announcement Tuesday indicates that BC may well go forward with some initiatives to increase consumer convenience in BC, such as selling alcohol in grocery stores. We understand the value placed on convenience in our busy lives and appreciate also the desire from people in the business sector to improve the viability of their enterprises in a challenging economic environment. We hope to see more announcements that respond to the desire for convenience while addressing British Columbian’s desire to minimize the number of deaths, hospitalization, and injuries caused by alcohol in BC every year. We know from a recent random survey of people in BC that 84% are in support of using liquor laws to reduce these types of problems that are associated with alcohol use. Research in British Columbia suggests that influencing the price of the cheapest products is of far greater significance when it comes to improving health and safety outcomes than are the number of liquor outlets. Furthermore, maintaining minimum alcohol prices protects the profits of many sectors of the alcohol industry, enhances government revenue and impacts mostly on the heaviest alcohol consumers – with substantial health benefits resulting for that group. A modern approach to liquor regulation in the 21st-century involves allowing consumers more responsibility, providing them with better information to make choices and further encouraging those choices through a price structure which favors lower alcohol content beverages. These changes may help reduce any increases in alcohol-related problems that could arise from loosening restrictions in order to increase convenience. With the right balance, maybe it is possible to increase convenience while using evidence-based strategies to simultaneously reduce the substantial harms from alcohol.

***Tune in next week for the first post in our next Blog series “The cannabis question: where do we go from here?

Authors: Kara Thompson, PhD and Tim Stockwell, Director, Centre for Addictions Research of 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?

Author: Tim Stockwell, Director, CARBC

Author: Gina Martin

Author: Andy Murie, CEO MADD Canada

Tag: Alcohol policy

What happens now? Reflecting on the BC Liquor Act Review 2013

Public opinion and alcohol policy in BC