The World’s Drinking Problem

A succession of Chinese dynasties attempted to ban alcohol consumption at least 40 times in the 2500 years between 1100 BC and 1400 AD before finally giving up, an indication of how difficult it is to stop drinkers from drinking, according to an exhaustive 240-page report by the Organization of Economic Cooperation and Development.

China is hardly alone, according to the report, titled ‘Tackling Harmful Alcohol Abuse,” released on May 13 by the 34-country organization, although it was found that some people of Asian origin tend to drink less “since genetic predispositions may increase unpleasant effects like facial flushing and other symptoms.”

That doesn’t appear to include China. Driven by quickly increasing wealth, China is learning to drink. The April issue of The Lancet Global Health indicated that social and health issues related to alcohol use and misuse, such as liver and cardiovascular diseases, mental disorders, cancers, violence, and transport and unintentional injuries, are growing and have been largely neglected by the Chinese government.

While more than half of the Chinese population aged 15 years and older do not drink at all, 42 percent of men and 71 percent of women in 2010 who do drink averaged 15.1 liters of pure alcohol annually against a far lower 9.1 liter average for the rest of the OECD.

Archeological evidence shows alcohol was being brewed 10,000 years ago, during the Neolithic period, probably mixtures of fruit wine and fermented honey. That was 4,000 years before Adam and Eve got to Paradise, according to the Christians. There is no record that they got drunk, although apparently the first thing Noah did when he and his ark heaved up on dry land was to plant a vineyard, according to the Old Testament of the Christian Bible.

Despite the fact that it has been around for 10,000 years, there isn’t a lot of evidence that it has done anybody much good, according to the report, other than providing a lucrative method of funding for governments that run distilleries and breweries and charge outlandish taxes. In just the 20 years from 1990 to 2010, harmful consumption of alcohol rose from the eight leading cause of death and disability to fifth.

While alcohol use has both beneficial and detrimental effects on the health of individual drinkers., “the latter outweigh the former in all countries, the researchers found. “Approximately four in five drinkers would reduce their risk of death from any cause if they cut their alcohol intake by one unit (10 grams) per week.”

Nonetheless, the researchers found, while sensational stories and images abound about binge drinking, “in reality, while harmful drinking has increased in many countries in certain groups, especially young people and women, average alcohol consumption has not changed over the past two decades.” In fact, consumption has declined an average of 2.5 percent over the period.

Nonetheless, the report says, alcohol abuse has an impact on as many as 200 different diseases and types of injuries. “In a minority of drinkers, mainly older men who drink lightly,” there are health benefits. But that is a tiny minority. “The harms caused to people other than drinkers themselves, including the victims of traffic accidents and violence, but also children born with fetal alcohol spectrum disorders, are the most visible face of those social consequences.”

Governments almost since there has been alcohol have been trying to control its use, to little avail. Taxes are enormous. A study in California found that the actual cost of the alcohol is less than the cost of the bottle it comes in. California exacts an excise tax on 50 percent on dispelled spirits. Rates in other states are as little as 7 percent (Connecticut) or 8 percent in Kansas.

However, it appears taxation can be driven much higher and drinkers, as they have for10,000 years, will still drink. But can governments have an impact?

The key findings, written by Michele Cecchini and Annalisa Belloni for the report, point out that “governments have taxed alcoholic beverages for millennia. But slowing drinking – since consumption has remained steady at 9.1 liters annually across the OECD – is questionable.

Accordingly, the key messages for policy makers should be through health outcomes, since drinking less is beneficial and that most people would be healthier if they drank less. It is probably more sensible to target harmful drinkers than non-harmful ones although the “the health effects are nor=t proportional to consumption, so even a smaller reduction in consumption is likely to lead to larger health effects.

“Policy makers and researchers agree that there is no silver bullet to limit harmful drinking,” the researchers say. “Rather countries tend to adopt and combine a range of policies in different areas identified by the World Health Organization with the aim of discouraging harmful drinking

The main approaches in the policy toolkit, the authors say, start with alcohol price policies. Taxation has been around since 1776 as a means to raise revenues for the public sector, but today they are increasingly viewed as a public health measure. Bans and restrictions on promotional events such as happy hours, ladies’ nights, “2 for 1”, all you can drink specials and unlimited beverages for a fixed price for a fixed period of time

Setting minimum prices on liquor, the report contends, may produce larger effects on heavy drinkers as they tend to purchase cheaper liquor. The main impact is typically on supermarket and off-license sales. Although limiting advertising is an option, in fact, given the proliferation of social media, it appears increasingly difficult to control.

“The increasing use of media that reach across international borders and social networks for marketing alcohol suggests that governments pushing market regulation may need to consider parallel cross-border measures.”