Rory Cahill and Katie Mackintosh look at what the Scottish Government can do to reverse a culture of alcohol abuse
All of us will attend at least one Christmas party in the coming fortnight and nearly all of us will drink alcohol while we are there. And more than a few of us will drink more than we should. We might not end up vomiting in the street, or in the police cells after getting into a drunken fight. But most of us will end up with a throbbing hangover that leaves us barely able to function at work the next day.
But that’s OK, because you’re allowed to get a bit drunk at the Christmas party. Everyone knows it. Then there’s Christmas itself. You always meet up with your old pals on Christmas Eve and have more than a few. Then Christmas itself always involves a nice old drink. Hogmanay speaks for itself. Then it’s a few short weeks to Burns Night. Your football team has a good run so you have a few too many while celebrating. Your pal announces her engagement and it’s champers all round. The days get longer and the beer gardens and terraces of summer beckon. Before you know it, an email is going around the office canvassing for ideas on where the Christmas party should be held.
Scotland doesn’t have a love affair with alcohol; it has a bitter, dysfunctional and abusive relationship. We kid ourselves that we like it but we know deep down it is hurting us. Alcohol kills six of us every day. Alcohol-related problems cost us over £1bn a year. We are twice as likely to die of an alcohol-related injury as other citizens of the UK. Our hospitals deal with 70 alcohol-related assaults every day, with hundreds more going unreported. The average murderer in Scotland is a drunken 18-year-old male who kills another drunken 18-year-old male, usually one he knows.
And the problem is getting worse. With half of women and two-thirds of men exceeding the recommended daily limits of alcohol consumption, the number of us being diagnosed with alcoholic liver disease has increased by 52 per cent. The situation is clearly unsustainable. But what can be done to arrest this bleary decline of our society into a 21st century version of Hogarth’s Gin lane?
Everyone, from police to health professionals to professors agrees that we need to change Scotland’s drinking culture. That is all well and good, but how precisely do we go about doing that? What practical steps can we take to go about doing this? How long will it take and is it even possible?
Justice Secretary Kenny MacAskill has been quietly winning plaudits for his willingness to challenge some of the comfortable assumptions and received wisdom afoot in Scotland on issues like the role of prison and our attitude to drink. He has highlighted tackling Scotland’s ‘bevvy culture’ as one of the key priorities of the SNP Government. In one of his first statements as Cabinet Secretary, he said:
“Alcohol misuse is causing too much harm to Scottish people and communities. It’s destroying health, fuelling anti-social behaviour and causing crime – and that’s why we need to take action to make our communities safer today and make our nation healthier for the future.
“Those who are given the right to sell alcohol must bear the responsibility for the social and economic costs. The effects of alcohol on our city and town centres is not cost free and those who profit from it must contribute to addressing it. It’s not right that taxpayers pick up the whole of the bill, licensees should pay their way too.”
MacAskill has been quick to try and translate these words into action, announcing his intention to use the new licensing Act in order to change the way alcohol is sold and marketed. In September, he told Alcohol Focus Scotland’s annual conference that:
“This is immediate action to kick start a long-term drive to change Scotland’s culture – to help make sure drinking to get drunk is simply no longer seen as acceptable. To end the days of ‘buy two, get one free’ type promotions reducing the cost of beer to as little as 43 pence a pint. These measures will also support long-term change in all our drinking habits.
“We will stop shops displaying beer all around the store or cross-merchandising wine in the pizza counter to entice impulse buyers to buy and drink more alcohol. I hope this will help us to remind people that alcohol is not just another commodity and it shouldn’t be treated in the same way as buying a tin of beans or loaf of bread.”
This is a phrase used time and time again by those studying how to reshape Scotland’s culture away from one so infused with alcohol. Evelyn Gillan, director of Scottish Health Action on Alcohol Problems (SHAAP), a joint effort by the royal medical colleges to investigate ways of dealing with Scotland’s alcohol problems, says:
“Alcohol is sold like bread or milk or anything else but it’s not a product just like anything else, it’s an addictive, psychoactive substance. All the international evidence shows us that dangerous intake is clearly linked to price and availability, so in that respect, Kenny MacAskill’s approach is clearly evidence based.”
Professor Gerard Hastings, Professor of Social Marketing at Stirling University is another who repeatedly uses the ‘bread and milk’ example. For Hastings, we will not be able to reduce our alcohol intake, until we ‘de-normalise’ the notion that drinking to excess is culturally acceptable, or even encouraged.
“It’s about de-normalising alcohol so it is not so central to everything we do
It’s about de-normalising alcohol so it is not so central to everything we do 
. There are so many situations where you are expected to drink,” he says.
Encouragingly though, Hastings does think that it is possible fundamentally to change the way in which our culture views alcohol, and points to France as an example of a country that has managed to reduce its consumption of alcohol drastically.
In 1970, the French consumed 20.4 litres of alcoholic drinks per person, which had fallen to 13 litres by 2004. Conversely, in the UK, we were drinking 7.1 litres in 1970 and 11.5 in 2004.
“France is quite interesting because over the last four generations its alcohol use has fallen. In the 1950s, it was everywhere but less so now, largely because its importance has been actively demoted, rather than promoted. Instead of opening a bottle of wine with every meal, they may only have a glass, and they have serious controls on their alcohol advertising,” says Hastings.
The French are also quick to intervene in the alcohol market to try and gain a social result, placing a tax on alcopops in 1996 that dramatically reduced consumption. The Germans too have been unafraid to use taxation to try and reduce the sales of alcopops to underage drinkers in a way that would be highly unlikely in Britain. After the release of a government report in 2003 showing that every second alcopop sold in Germany was purchased by 14 to 19-year-olds, the German government placed an extra €0.80 tax on each bottle, raising the price from €2.00 to €2.80, and cutting consumption by young people unable to afford the higher prices.
Similarly, in some Australian states, governments have raised taxes on premixed spirits and alcopops popular with youngsters, yet reduced duties on low strength beers in an attempt to encourage people to drink in moderation and price alcopops out of the youth market.
We can also look to Australia for lessons in dealing with the most important yet challenging factor in our drinking culture. Put simply, what we believe to be the truth is often not what is actually happening, yet because we believe it is, we, consciously or unconsciously, live up to what we think everyone else is doing. Sydney’s recent experience in attempting to reform its licensing laws (see box) showed that the prevailing wisdom about how much people drink, and how they like to do it, was fundamentally wrong.
Professor John McMahon, an alcohol and drugs lecturer at the Paisley campus of the University of the West of Scotland, describes these as ‘normative behaviours’, and studies show they directly effect people’s actions.
McMahon recently conducted a study of students asking them how much alcohol they drank, how many cigarettes they smoked, how much sex they had and other lifestyle factors, like the amount of exercise they did. The study also asked the students how much drinking, smoking and casual sex they thought their peers were engaging in. McMahon found that the vast majority of respondents thought that those around them were not only having more sex and drinking more than they were, this figure was also far higher than what their peers were actually engaging in.
McMahon says that while the gap between the reality and the perception was large, the fact that the perception exists is in many ways encouraging people to drink more.
“What we do is kind of think we are down here while everyone else is having more drink, more fags and more sex than we are. There are two theories about what happens there. One is people think, ‘I’m an under-achiever, I’d better up my game and get more alcohol and more fags and more sex’, everything that I think everyone else is doing.
“The other theory is that people think, ‘Oh, I’m drinking ten units a night and everyone else is drinking 15’, so it’s permission to drink more rather than a target. Personally, I think it’s the second one.”
McMahon says the challenge is to change our culture so we arrive at a situation where people think their peers – the norm – are drinking five units rather than 15. This way, they will moderate their drinking rather than increase it.
“There’s no permission then, it doesn’t grant you the permission to drink 15 units instead of ten. Instead, it makes you think, ‘My behaviour is out of control and needs to come back down to the norm and what everyone else is doing’,” he says.
McMahon says the university plans to take his research on board in launching a new alcohol awareness campaign in the New Year. Instead of the graphic warnings – “Alcohol will kill you and your legs will fall off” – that appear on desk tops, information will be placed there that accurately reflects the true amount of alcohol being consumed by students in the university in the hope of getting others to realise what a normal level of alcohol consumption is.
While MacAskill’s practical reforms are likely to have some effect on the short-term drinking habits of Scotland, it is obvious that if he is to achieve his longterm goal of reducing the harm caused by alcohol in Scotland, it is initiatives like those pioneered by McMahon that must be deployed and supported over the long term.
But there is concern, especially among the on-license trade, that some measures undertaken by MacAskill – such as allowing licensing boards to set their own fees for licenses and renewals - may have the counterproductive result of harming places like local pubs where drinking is, by and large, responsible.
Pat Browne of the Scottish Beer and Pub Association says that there needs to be more “balance” in the way the off and on-licence trades are governed. “It’s fair to say that pubs and the onlicence trade as a whole have been the focus of much policy, but politicians now seem to be waking up to the fact that supermarket sales are also a major factor,” he says.
While MacAskill has declared his intention to take on the supermarkets, battle is yet to be joined. The likes of the Big Four supermarkets are among the wealthiest and best connected of all the industry groups not only in Britain, but the world, when one considers that Asda is owned by American giant Walmart. The supermarkets use alcohol as a loss leader to attract shoppers through the door and record profits for the likes of Tesco suggest that the strategy is working. They are unlikely to let it go without a fight.
Yet as the experience of the French and the city of Sydney shows, significantly reducing the amount of alcohol we as a society consume is possible, as is dramatically altering the way in which we consume it. The challenge is there, but is the genuine political will or ability to meet it?
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